It could be one of several different things including:  weak or sub-optimal
thyroid, weak adrenals, electrolyte imbalance, low blood volume, or
overstimulation of the nervous system due to stress or the use of caffeine
and other stimulants.  There is a certain segment of the population who
tends to have cold hands and feet along with a rail thin build and also is
prone to a minor heart valve defect called mitral valve prolapse.  In this
condition the cold hands and feet are typically caused by low blood volume.
My guess is that since you say these symptoms have gotten worse since
beginning paleo eating that you are simply eating too few calories and have
slowed your thyroid/adrenal functions.  Try to eat more calories and carbs
for a period of 5 days and see if this doesn't rememdy the situation.  One
way to tell if this is caused by nervous overstimulation is to try a simple
deep breathing technique.  Breathe in deep on a 4 second count, hold for 7
seconds and blow slowly out for 8 seconds.  repeat 4-8 times.  If your hands
and feet warm up significantly than it's a good bet you were either
overstressed and/or overstimulated (Note:  some people can become neurally
overstimulated quite easily without caffeine, etc).
Hope this helps

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