Changes in Body-Temperature Regulation (Feeling Cold / Chills / Heat Intolerance)
Users on Reddit report a variety of experiences with changes in body-temperature regulation while on GLP-1 medications, with many experiencing feeling cold or having chills, while some also report heat intolerance or fluctuations between feeling hot and cold.
Experiences with Changes in Body-Temperature Regulation:
Some users experience this early on: "I got cold the first week, before losing any significant weight, so it definitely wasn’t the insulating fat for me! "[2]
The cold feeling can be intense: "Not cold all the time but I have had sudden 'drops' where I cannot get warm and get the shakes... I've literally had to go out to the car, get hot soup and crank the heater up because even crawling under the sheets can't make my teeth stop chattering during those incidents - twice in the last year. "[4]
Users with pre-existing conditions like fibromyalgia report amplified symptoms: "The chills…. Mixed with fibro temp intolerance, is just insane. Feels like I’m getting dunked in an ice bath while flickered by a flame torch. "[12] Another user with fibromyalgia said, "I did feel really cold on the compound when I was taking it more frequently/higher dose but that went away after a few months. "[14]
One user noted, "I took Mounjaro for over a year. I lost 30 pounds but was miserable with insomnia, feeling cold and it definitely made my joints hurt worse. "[11]
Another user mentioned, "I didn't even realize the cold could be a side effect, but it is real! I was always the guy who people shook hands with on a cold day and were like 'OMG, your hands are so warm! ' Now I get into bed and make my wife jump by putting my icy feet on her legs, LOL. "[6]
A user on Zepbound stated, "All I really know is, I’m cold 🤷🏻♀️"[7]
One user on Zepbound mentioned, "I get overwhelmed in the heat/sun and get freezing at night. "[2]
Another described, "I could be sitting on the couch freezing and then five minutes later I’m burning up and then five minutes later I’m freezing again. "[2]
A user with MS developed heat intolerance after starting GLP-1s: "As far as symptoms go, I developed heat intolerance after starting them, so.... "[9] However, another MS patient reported their heat intolerance resolved: "My heat intolerance resolved after about 3 weeks on tirzepatide. "[10] and "My neurologist told me their center was working on doing a tirzepatide clinical trial ! I just had an appointment this week and we discussed how my heat intolerance had resolved since starting tirzepatide. "[10]
One user explained a potential mechanism: "GLP-1 and GIP can stimulate BAT (brown fat) thermogenesis... leading to increased heat production and potentially influencing body temperature regulation... GLP-1 also seems to have a protective effect on the vascular system by enhancing nitric oxide production, which leads to vasodilation (relaxation of blood vessels). When your blood vessels dilate they come closer to the surface of your skin, which is the same process your body uses to cool off. "[1]
A user described their experience with increased dosage: "But with the increase in dosage, came constant discomfort - either I'm too hot or too cold. I am never just naturally at a comfortable temperature anymore. I wake up at least 5 times a night. I go to bed all bundled up cuz I'm cold and abruptly wake up a couple hours later sweating and so hot that I ligit throw the covers off me b/c I'm burning up. Not even two minutes later, I'm literally freezing and can't warm up fast enough. "[2]
Another user gets "cold and hot. Back and forth between the two. "[21]
Possible Explanations Mentioned by Users:
Loss of Insulating Fat: Some attribute feeling cold to weight loss. "As someone who was literally ALWAYS warm, I have definitely been experiencing this - though I chalked it up to weight loss (I'm a few months in and down 35ish pounds). "[16] However, others experience it before significant weight loss. [2, 18]
Metabolic Changes: "Reduced body fat could influence thermogenesis, as adipose tissue plays a role in insulating the body and may influence heat production during cold exposure. With less fat, the body may need to work harder to maintain heat. "[2]
Calorie Deficit: "I tell myself it's due to the calorie deficit, which helps me tolerate it a bit more. "[19] Another user suggested, "You too are eating too little. "[22]
Remedies and Preventions Recommended:
"I’m typing this under a heated blanket"[3]
"NOW I sleep with long pants on, a thick t-shirt or hoodie, and socks and have to prepare for sleep by preheating my bed with a heated blanket + taking a hot shower to increase my basal body temp. "[17]
"Even on the hottest nights, I'm piling more duvets on my bed. The other day it was about 77F/25C - I was out in heavy fleece while my neighbors were out in jeans and tee shirts. I always have a space heater blasting in my office at work. "[18]
Warm Baths/Showers:
"I get super chilly and either have to go bake in the sun or boil myself warm in a bath. "[19]
Taking a hot shower to increase basal body temperature before bed. [17]
Eating Before Bed: "I've noticed that if I eat a small nutrient dense snack an hour before bed, it helps my overall warmth and ability to STAY asleep too (a protein shake and about an oz macadamia nuts)"[17]
Iron Supplementation: One user suggested, "take some iron supplement. it's bc of low blood sugar"[23] (though feeling cold is not directly a symptom of low blood sugar, iron deficiency can cause it).
Adjusting Dosage: For one user with fibromyalgia, feeling cold on a higher dose went away after a few months, and they also mentioned taking the medication less frequently or at a lower dose to manage side effects. [14] Another user with fibromyalgia who experienced intense chills recommended going down on the GLP-1 dose. [12]
Tylenol: For chills, one user mentioned, "For the chills, I used a heated blanket and sometimes took a Tylenol. "[12]
Staying Hydrated: While not a direct remedy for cold, it's often mentioned for overall side effect management. [12]
It's important to note that some users do not experience these temperature regulation issues, or find that they resolve over time.
Experiences with Changes in Body-Temperature Regulation:
- Feeling Cold/Chills: This is a commonly reported side effect.
- Heat Intolerance/Fluctuations: Some users experience the opposite or a mix of sensations.
Possible Explanations Mentioned by Users:
- Hypothalamus Regulation: Several users mentioned the hypothalamus's role.
Remedies and Preventions Recommended:
- Dressing Warmly/Using Blankets: Many users resort to extra layers or heated blankets.
It's important to note that some users do not experience these temperature regulation issues, or find that they resolve over time.