11 Causes of Cold Sweats and How to Treat Them

The weather isn’t hot or humid, you haven’t been working out, and even though there seems to be no external reason for it, you’re sweating. Most people have experienced a cold sweat before, whether you’ve broken out in sweat during a fever, or your palms have gotten clammy when you’re nervous, or maybe you’ve woken up from a nightmare completely drenched. But what causes cold sweats?

Sweating is the body’s natural response to heat or stress. The heat commonly may be generated from internal sources, such as muscle activity or infection, or it can also exist externally from environmental factors or excessive clothing, says David Cutler, M.D., family medicine physician at Providence Saint John’s Health Center in Santa Monica, CA. “Stressing the body to elicit a sweating response might occur from emotional, physical, or chemical stressors. Although there are many different causes, the result is sweating or in medical terminology, diaphoresis.”

When the cause of sweating is excessive internal or external heat, the body is sweating to cool off. This cooling will occur quite naturally because the evaporation of sweat removes heat from the body, explains Dr. Cutler. “In exceptionally dry climates, you might not even feel the sweat because it evaporates so quickly…and in humid climates, the sweat may not evaporate at all, leaving you feeling very sweaty.”

So what are cold sweats, and what does having a cold sweat mean? We spoke to experts in family medicine and primary care to get to the bottom of it.

What are cold sweats?

Sweating is typically a natural, beneficial bodily function: When we’re too hot, we sweat to keep our body temperature in check, explains Nate Wood, M.D., Instructor of Medicine, Section of General Internal Medicine at Yale School of Medicine. “But sometimes, we sweat even when we’re not hot. This is generally what people mean when they talk about ‘cold sweats’.”

Cold sweats differ from night sweats in that cold sweats usually don’t happen across your entire body and aren’t limited to when you’re in bed or sleeping at night. “Many people often say cold sweats, but what is often found in practice is many individuals are experiencing night sweats associated with chills,” says Tamika Henry, M.D., founder of Unlimited Health Institute. She explains that cold sweats can be defined as “a large amount of sweating that can be in response to decrease the body’s temperature, often followed with feeling chills.”

What causes cold sweats?

It is not uncommon to feel a “cold sweat” when sweating results from a cause other than excessive heat, says Dr. Cutler. Cold sweats can be caused by many things, some of which are not concerning and some of which are very concerning. For this reason, cold sweats can be confusing and distressing for many patients, says Dr. Wood.

Having a “cold sweat” does not necessarily indicate any particular medical condition, says Dr. Cutler. Rather, it simply indicates simultaneous sweating and feeling cold. “Understanding the cause of a ‘cold sweat’ depends on properly understanding the cause of the sweating and simultaneously understanding why there is a feeling of being cold,” he adds.

So, if you start to experience cold sweats and you don’t know yourself to be a quick-to-sweat person, it could mean that something else is going on under the surface. Below are some more potential causes for your sudden bout of cold sweats.

Hyperhidrosis

“Some people just sweat a lot, and seemingly all the time, whether they’re hot or not. This is called ‘primary focal hyperhidrosis,’”says Dr. Wood. He explains that hyperhidrosis is rarely a medical issue, although it can be annoying for those who suffer from it. The areas of the body most commonly affected are the underarms, palms, and soles of the feet, although the face, scalp, and groin may also be affected.

Dr. Wood notes that patients can be reassured if this type of sweating starts before age 25, stops during sleep, and is not associated with any other symptoms.

Fever

This is perhaps the most common culprit of cold sweats. Most of us can remember having the flu, or a particularly bad cold, that resulted in a high fever and chills or miserable cold sweats.

A cold sweat can occur when the body sweats to give off excess heat, but then the ambient temperature drops and cold is felt while the body is still wet with sweat, explains Dr. Cutler. “This could occur if you were sick with a fever causing sweating and also took medication like acetaminophen to lower body temperature.”

Research has shown that fevers are usually responsible for cold sweats due to the associated swings in body temperature.

Menopause

Hot flashes associated with menopause are another potential cause of excessive sweating that many of my friends, family members, and patients have experienced, says Dr. Wood. He adds that although sweating associated with hot flashes wouldn’t generally be considered cold sweats, many people who are going through menopause could have similar symptoms.

It’s important to note that cold sweats aren’t restricted to menopausal women. “Women between the ages of mid 30’s to early 60s can experience changes in their menstrual cycle and menopausal symptoms that can be associated with night sweats and chills,” says Dr. Henry.

Some research has suggested that following a hot flash, body temperature in menopausal women can drastically decline, which could trigger a cold flash and with it, cold sweats.

Medications

“Cold sweats can be a side effect of many medications, including various over-the-counter supplements,” says Dr. Wood.

Research has shown that cold sweats, or excessive sweating in general, can be brought on by taking medications such as cholinesterase inhibitors (medications used for dementia), selective serotonin reuptake inhibitors (commonly prescribed antidepressants such as Lexapro, Celexa, Zoloft, Paxil and Prozac), opioids (such as OxyContin, Vicodin, and Demerol), and tricyclic antidepressants (such as Elavil and Pamelor).

According to Dr. Henry, cold sweats have been associated with the following medications:

• Antidepressants for example Selective serotonin reuptake inhibitors (SSRIs) and Tricyclics
• Angiotensin II receptor blockers
• Corticosteroids
• Estrogen/Androgen modulating agents like gonadotropin-releasing hormones agonists , aromatase inhibitors—”These medications impact estrogen/androgen levels or hormone receptor binding that can lead to hot flashes associated with sweating at any time of the day,” says Dr. Henry.
• Hypoglycemic agents—these are medications used to treat diabetes that can lead to low blood sugars and result in excessive sweating

Stress & anxiety

Stress or anxiety caused by overwhelming responsibilities at home, at work, or at school can trigger cold sweats. Dr. Wood notes that cold sweats can be caused by “psychological stress, including panic attacks and social anxiety.”

Dr. Henry notes that any mood disorders, such as anxiety, depression, panic attacks, and post traumatic stress disorder, can trigger cold sweats.

One study tested how people reacted in a virtual stress environment by measuring the amount of sweat they had secreted, demonstrating how stress itself can bring about cold sweats.

Low blood sugar

Low blood sugar, or hypoglycemia, occurs when your blood sugar drops below normal levels. Your body reacts to a lack of blood sugar similarly to a lack of oxygen. Dr. Cutler says that your body can also react by breaking out in a cold sweat.

Research has shown that diabetes, both Type 1 and 2, is associated with reduced ability to regulate body temperature under both heat and cold stress, meaning those with diabetes can have difficulty regulating their body temperature.

If you have diabetes and you are experiencing cold sweats, the first step is to check your blood sugar if something feels off. If you are dipping below a threshold you set with your doctor, you should seek emergency medical help right away to restore your blood’s glucose levels. Eating or drinking sugary foods and beverages, such as a meal replacement bar or fruit juice, can also help restore blood sugar in a short amount of time.

Sleep disorders

While many people can experience night sweats without the presence of a sleep disorder, Dr. Henry notes that “sweating has had an indirect association with sleep apnea.”

According to ApneaMed, if you are experiencing chronic night sweats, that could be an indicator of Obstructive Sleep Apnea (OSA). However, you also need to be aware of other side effects that you may be experiencing in conjunction with your regular night sweats.

Infections

Many infections, both auto-immune and bacterial, can trigger a bout of cold sweats. According to Dr. Henry, the following infections could be the reason behind your cold sweats:

• Acute and chronic infections can cause generalized sweating along with night sweats
• Tuberculosis
• HIV
• COVID
• Pneumonia
• Bacterial infections like endocarditis, osteomyelitis, mononucleosis

Hyperthyroidism

If you have issues with your thyroid, this could also be a reason for experiencing cold sweats. Hyperthyroidism, specifically, can “lead to total body sweating,” says Dr. Henry.

Research has shown that specific thyroid hormones released in the skin may be the mechanism behind the connection between hyperthyroidism and cold sweats.

Cancer

A more rare reason behind your perspiration, cold sweats can also be a symptom of several types of cancer. Sweating is most commonly associated with Lymphoma (Hodgkin and non-Hodgkin), says Dr. Henry. She adds that leukemia has also been associated with sweating.

According to Cancer Research UK, carcinoid tumors, mesothelioma, bone cancer, and liver cancer are also known to cause you to sweat more than usual.

Heart Attack

Cold sweats can also be a sign of a heart attack. Seek emergency medical help right away if you suddenly have a cold sweat along with any of the following symptoms:

• discomfort or pain in your chest that feels like pulling, squeezing, or bloating
• difficulty breathing
• discomfort or pain in your neck, jaw, stomach, or back
• dizziness or lightheadedness
• a feeling that you’re going to pass out

How are cold sweats treated?

The treatment for cold sweats depends on the cause, says Dr. Wood. “The goal is to determine the underlying cause and treat accordingly,” says Dr. Henry.

“For patients with primary focal hyperhidrosis, their doctor may offer prescription-strength antiperspirants, Botox injections, or a variety of procedures aimed at treating the affected sweat glands and nerves,” explains Dr. Wood.

As far as some of the other known causes of cold sweats, the treatment is more tailored to the condition that causes the cold sweats, rather than treating the cold sweats themselves.

For example, Dr. Wood explains that “for an overactive thyroid, there are medications to calm it down. For those found to have a bacterial infection, antibiotics will be required. Cancer may be treated with chemotherapy, radiation, and/or surgery. CPAP machines can treat sleep apnea. A variety of medications are available to temper menopausal hot flashes.”

And of course, Dr. Wood notes, heart attacks must be addressed in the emergency room.

When to see your doctor about cold sweats

Cold sweats are something patients should always talk to their doctor about, says Dr. Wood.

Dr. Henry agrees that at any point a person is experiencing night sweats and they are persistent, it’s important to bring it to the attention of their primary care doctor. “The primary care doctor will assess the patient's degree of night sweats followed by if there is any associated fatigue, sleep disturbances, fever, more than one sensory deficit, muscle cramps or restless legs, uncontrolled pain and mood disorders…The history and physical exam are essential,” she says.

“I would especially encourage patients to make an appointment with their doctor if their cold sweats are new or seem to come out of nowhere,” says Dr. Wood. He adds that you should also be sure to see your doctor if you are experiencing a fast heart rate (greater than 90 beats per minute while at rest), weight loss, or anxiety along with cold sweats, as these can be signs of a thyroid issue.

If you are having cold sweats with fevers, chills, headaches, body pain, or fatigue, you should reach out to your doctor, as Dr. Wood warns that these can be signs of infection. Also, “patients who have cold sweats at night—especially if they also have weight loss, loss of appetite, or swollen glands—should contact their doctors immediately,” says Dr. Wood, as these are common signs of cancer or tuberculosis. Last, but not least, “patients who have sudden-onset cold sweats with chest pain, dizziness, low blood pressure, shortness of breath, or confusion should call an ambulance to be immediately evaluated in the nearest emergency room,” says Dr. Wood, as these can be signs of a heart attack or other serious issue.

The bottom line is that if you are having cold sweats and you’re not sure why, see your primary care physician right away to rule out any serious health concerns.

Madeleine Haase

Madeleine, Prevention’s assistant editor, has a history with health writing from her experience as an editorial assistant at WebMD, and from her personal research at university. She graduated from the University of Michigan with a degree in biopsychology, cognition, and neuroscience—and she helps strategize for success across Prevention’s social media platforms.