Staying warm is important for people with cold autoimmune hemolytic anemia (AIHA). This condition causes the immune system to make autoantibodies (proteins that attack healthy red cells). People with this autoimmune disease experience hemolysis (red blood cells are destroyed) when temperatures are too cold.

There are two main types of cold AIHA, cold agglutinin disease (CAD) and paroxysmal cold hemoglobinuria (PCH). CAD most often causes hemolysis at temperatures of 37 to 39 degrees Fahrenheit, while people with PCH experience immune reactions when temperatures drop below 37 F. This is in contrast to warm AIHA when red blood cell death happens at normal body temperature.

Staying warm and keeping safe during the winter may help you avoid or lessen symptoms of cold AIHA. Keep reading for practical tips on protecting your health when it’s cold.

1. Limit Your Time Outside

Try to stay indoors as much as possible, where it’s warmer. You may need to avoid participating in outdoor activities until the temperature starts to rise. When you have to venture outside, check the temperature, including the wind chill, and try to plan your outings when it’s warmest.

If you have to shovel sidewalks or clear your driveway of snow, ask for help from a family member or a friend, or hire someone if you can.

If you drive, buy a remote starter for your car. This allows you to start your car and turn on the heat while you are still inside and then enter your vehicle after it’s already warmed up and ready to go. While you’re at it, check your antifreeze levels and put an emergency kit in your car with blankets and extra clothes in case you break down or wind up stranded in the snow.

2. Invest in Proper Cold Weather Gear

Wearing the right clothes can make a big difference in staying warm.

Dress in loose layers rather than wearing one heavy clothing item. Warm air can be more easily trapped between each layer of clothing. If you’re going outside, make your outer layer something that will protect you from rain, snow, and wind.

Your clothing’s fabric also plays a role in your ability to stay warm over time. Synthetic fabrics help you stay warm even when they get wet. Cotton, on the other hand, becomes cold when it’s damp. Try wearing synthetic leggings or long thermal underwear under your clothes.

3. Keep Your Head and Face Warm

You lose about 10 percent of your body heat through your head, so cover up. This can help you protect against AIHA problems.

When you go outside, wear a warm hat or hood to prevent body heat from escaping through your head. It may even help to wear a knit hat in your home, office, or school if you tend to get cold.

Keep your face from getting too cold by wearing a knit mask or balaclava. A warm scarf or even a face mask can also help you stay warm.

4. Protect Your Hands and Feet

It may be particularly important for people with cold AIHA to avoid cold temperatures on their heads and faces. This condition often makes the hands and feet feel extra cold. Your fingers and toes may even turn red or blue or become painful. This is called acrocyanosis or Raynaud’s phenomenon.

To protect your hands, wear gloves that contain an insulated inner lining and an outer waterproof layer. Additionally, you should always try to wear water-resistant shoes or boots. You can buy waterproofing spray to help your shoes stay dry.

5. Consume Warm Foods and Drinks

Heating up food and drinks can help prevent hemolysis if you have cold AIHA.

Avoid ice-cold drinks and sip on hot tea, coffee, or hot chocolate. Drinking warm water may also keep your body temperature elevated.

Choose warm meals when possible during the colder months. A hot soup, stew, or casserole may help you avoid triggering an immune system reaction.

6. Take It Easy During Cold Months

If you need to spend a lot of time in the cold, anemia (loss of red blood cells) can lead to tiredness and weakness. Don’t plan to do too much during the winter if you’re prone to these symptoms. You may need to take a break from certain activities so you have extra time to rest and recharge.

7. Prep Your Home

Keeping your home insulated and your furnace working properly is a good idea for anyone, but it can be a health necessity for people with cold AIHA.

You can help winterize your living space by putting weather stripping around gaps in windows or doors. Additionally, you can limit drafty air by installing window insulation using a simple kit from your local hardware store. Hanging up blankets in front of windows may also help.

Get your heater, ducts, and vents inspected and cleaned once per year. This maintenance can help your heating system more efficiently warm your home or apartment. If you rent, ask your landlord if your heater has been checked recently.

8. Use AIHA Treatments

If you’re having a hard time staying warm enough to manage your symptoms, talk to your health care team about your treatment plan. Not everyone with cold AIHA needs treatments, but they may help if you have ongoing or severe anemia.

CAD can be treated with a blood transfusion if you don’t have enough red cells. Immunosuppressive medications like rituximab (Rituxan) that help calm the immune system may also help. A newer drug option, sutimlimab-jome (Enjaymo), is a type of monoclonal antibody (laboratory-made immune system inhibitor). It can block the destruction of red cells from the body’s immune system.

PCH often gets better on its own, but if the condition is ongoing, it can be treated with corticosteroids or with immunosuppressive medications.

If your CAD or PCH was caused by another health condition such as lymphoma, chronic lymphocytic leukemia, or an infection, treating the underlying disease is also essential for getting your cold AIHA under control.

Connecting With Others

AIHA is a rare disease, but you’re not alone. On myAIHAteam, people with AIHA and their loved ones come together to ask questions, give advice, and share their stories with others who understand life with this condition.

How do you keep yourself warm while living with cold AIHA? Share your experience in the comments below, or start a conversation by posting on myAIHAteam.