Cold sweats: 10 causes and treatment options

From the desk of
Robb Wolf
ScienceCold sweats: 10 causes and treatment options

Search your mind and you’ll probably find several memories of cold sweats. You might remember feeling clammy with the flu, sweaty after trying a new medication, or drenched as you prepare for a big speech.

Usually, you sweat to stay cool. But with cold sweats, a stimulus besides heat causes you to perspire.

Cold sweats aren’t generally pleasant, which is why they stick in your memory. The mind tends to remember emotionally charged events more than everyday ones. You remember feeling sweaty and nauseous a year ago, but not what you had for lunch last Tuesday.

What causes cold sweats? There are many possibilities, but generally the body is responding to a stressor. Something is off-kilter—illness, injury, anxiety, stimulants, low blood sugar, etc.—and the resulting stress triggers sweating.

Cold sweats aren’t pleasant, but they can be a valuable indicator of an underlying medical issue. For instance, cold sweating can be an early sign of a silent heart attack. That’s why it’s smart to do your research on unidentified sweats and potentially seek medical attention.

Today I’ll be helping you identify what causes cold sweats. Stick around for five minutes and you’ll be better able to address and treat the problem, including how to rehydrate properly. First, though, let’s contrast cold and regular sweating.

Cold Sweats vs. Regular Sweating

A cold sweat is a sweat that’s not triggered by external heat. That’s the basic definition.

Regular sweating is triggered by heat. Sweating helps your body maintain a stable core temperature in warm or humid climates. Maintaining this core temperature is essential for the proper functioning of your internal organs, circulatory system, and any other bodily process. Deviations in core body temperature—such as severe overheating, or heat stroke—can be fatal.

Sweat prevents this from happening. And as you might expect, when folks have trouble sweating (e.g. newborns and seniors), they’re at higher risk for heat-related illnesses.

Think of cold sweating as your thermoregulatory system gone awry. Instead of your body responding to heat, it’s responding to stress from illness, injury, or mental suffering. So while cold sweating doesn’t necessarily cool you down, it still provides useful feedback on your state of health.

I should also mention that cold sweats aren’t synonymous with night sweats. Night sweats simply mean sweating while asleep. Night sweats can overlap with cold sweats, but not always. You might just be overheating and soaking the sheets to cool down.

Okay, let’s talk about cold sweat causes now.

10 Causes of Cold Sweats

If you find yourself sweating in a cool environment, that’s a cold sweat. Here are ten possible causes.

#1: Illness and nausea

When you’re sick, your body may heat up to combat the infection. During this fevered state, your core temperature fluctuates, often triggering cold sweating.

But fever isn’t the only illness-related cause of sweating. Simply feeling nauseous (or worse: vomiting) can also trigger the pathways that lead to cold sweats. This is why stomach flu (which often combines fever and nausea) often causes significant perspiration. Many other things can cause nausea, so it’s worth considering the root cause.

Here are some potential causes of nausea-induced cold sweating:

  • Overeating
  • Eating spoiled food
  • Food intolerances or sensitivities
  • Drugs or medications
  • Drinking too much alcohol (see this article on hangover causes and remedies)
  • Vertigo
  • Shock

#2: Shock

After an extreme injury or environmental stress, the body can go into shock. Reduced blood flow to organs can cause nausea, pale skin, fatigue, and cold sweating.

#3: Stress

Think back to a high-pressure moment you experienced. I’ll list some examples to jog your memory:

  • Giving a toast at your best friend’s wedding
  • Interviewing for a job you really need
  • Approaching an attractive stranger while your friends watch in amusement
  • Worrying about a loved one caught in a lightning storm
  • Singing Mozart’s Marriage of Figaro while jogging through a public square in a Speedo

Now think about how you felt moments before the stressful situation. Sweaty, right? Wiping your clammy palms off on your pants before meeting the hiring manager, right?

It’s that fight-or-flight response. And cold sweats are part of it.

#4: Low blood sugar

Since the early 20th century, researchers have linked sweating to hypoglycemia (low blood sugar). Cold sweats are an early symptom of this dangerous condition.

What causes low blood sugar? Often, it’s too much insulin or other blood sugar-lowering medications, making this a pressing concern for folks with diabetes.

#5: Low blood pressure

Low blood pressure (hypotension) is another possible cause of cold sweats. As blood pressure plummets, the body reacts with excessive sweating and (sometimes) fainting.

Hydration status is crucial for maintaining blood volume, and therefore blood pressure. Staying hydrated means getting enough fluids, sodium, and potassium to maintain fluid balance. More on that later.

#6: Low oxygen

Low blood pressure (hypotension) and low oxygen in your tissues (hypoxia) can trigger sweating. This is why cold sweats commonly occur before fainting. The brain isn’t receiving sufficient oxygen, the stress response gets activated, and cold sweats ensue.

#7: Perimenopause

Around age 50, women undergo a series of hormonal changes known as perimenopause. (Menopause is when a woman’s periods stop, whereas perimenopause is the transition period that precedes menopause.) Perimenopause frequently brings on hot flashes, excessive sweating, and many other symptoms. There’s no easy fix for these frustrating symptoms, but it’s critical to stay hydrated with fluids and electrolytes to prevent further discomfort.

#8: Drugs and alcohol

Numerous medications list sweating as a side effect. These include:

  • Diabetes medications (like insulin) that lower blood sugar
  • Pain medications
  • Antibiotics
  • Gastroesophageal reflux disease (GERD) drugs
  • Antidepressants
  • And many others
  • Stimulants, including caffeine

Alcohol is another drug that can cause cold sweats. Consider that:

  • Drinking too much alcohol can cause nausea and sweating
  • Alcohol can cause dehydration and reduce blood pressure (another cold sweat cause)
  • Alcohol withdrawal is well-documented to cause excessive sweating

Depending on which substance is causing your cold sweats, you may or may not be able to cut it out.

#9: Migraines

Migraines are severe headaches that throb on one side of the head. Other migraine symptoms include nausea, light sensitivity, and sweating.

#10: Heart issues

Cold sweats are a potential sign of an impending heart attack. Sweating doesn’t usually indicate heart trouble, but—especially in the presence of other risk factors (family history, prior heart attacks, high blood pressure, old age, no other apparent cause of sweating, etc.)—you shouldn’t take it lightly.

Sweat and Hydration

Before talking about treatments for cold sweats, we need to cover hydration basics. Rehydrating after sweat loss can make a massive difference in your energy levels, comfort, and overall well being. Let’s explore why.

When you sweat, you lose water and sodium through your skin. You lose other minerals and compounds too, but water and sodium are the most significant. Logically, you need to replace both water and sodium to rehydrate, keep your brain firing, move blood through your veins, and grease countless other functions dependent on proper fluid balance.

Unfortunately, most people rehydrate with water alone. Or they rehydrate with a sports drink that’s loaded with sugar and light on sodium. These are terrible solutions to our collective hydration needs.

Consider the elite endurance population. Many of these folks guzzle sodium-free fluids during a race, then end up with clinically low sodium levels (hyponatremia) at the finish line. Some of them have even passed away.

The strategic mistake? Overhydrating with plain water and neglecting to replace sodium lost through sweat. Fortunately, hyponatremia is preventable by drinking to thirst and consuming electrolytes.

Most of us aren’t elite athletes, but we can still learn a lesson from them. Hydration isn’t just about drinking water. You also need electrolytes (especially sodium) to replace what’s lost through sweat, urine, and feces. Without electrolytes, you can’t perform, heal, or recover. This is definitely relevant to cold sweats.

How To Treat Cold Sweats

If you have cold sweats, the first step is determining what’s causing them. Maybe the cause is obvious (you’re super stressed about a presentation), or maybe it’s not. If you’re not sure—or if you believe the cause is serious—consider seeing a doctor.

Beyond seeking medical attention, reducing stress in your life, revisiting your medications with your doctor, and remediating other causes, focus your attention on rehydration. If you don’t rehydrate properly, you’ll worsen the effects of the underlying problem.

To replace fluids and electrolytes depleted through sweat, drink electrolyte water to thirst. You can concoct an electrolyte drink with salt and a dash of lemon, or simplify your life with LMNT for a no-sugar, no-mess hydration solution. It’s the only electrolyte drink mix with enough sodium (1000 mg per stick) to make a meaningful impact, and it tastes so good you’ll look forward to it daily.

Cold sweats are no fun, but hydrating helps you recover faster, feel better, and get on with your life. Thanks for reading, and Stay Salty.

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