I hate to be cold.  This is unfortunate because I’m cold most of the time. I’m that person who can’t go out, even in the summer, without a sweater or sweatshirt in tow. Being cold is on my mind a lot, especially this time in year living in Michigan.

Don’t get me wrong—I love winter. I’m a big fan of celebrating the first snowfall, strapping on my snowshoes and tramping through the woods, and enjoying the beauty of a winter landscape. It’s just that it’s so … cold. In the southern climes, you don’t have words in your vocabulary like windchill, subzero, and polar vortex so you can’t quite relate.

In Chinese medicine, cold is considered to be a pathogen—a way we describe an illness or a pattern of disharmony. You can be cold, damp, hot, or windy—any of which are a bit like bad weather in your body. However, cold is a pathogen that we don’t frequently talk about.

There are a number of different ways cold can manifest in your body. You can have external cold, which is the stuff of colds and flu. It begins with a light fever (or none at all) and lots of chills, aches and pains, and usually upper respiratory symptoms. It’s considered to be an external problem because in most cases your body shrugs it off fairly quickly. Treating external cold in Chinese medicine involves acupuncture and herbs that relieve your symptoms, strengthen your immunity, and help you fight off the virus or bacteria at hand.

Internal cold is a different story. Your body has the equivalent of an internal pilot light, which we practitioners call yang. It keeps your body warm, fuels digestive fire, and keeps your metabolism running smoothly. When you have an imbalance described as yang depletion, you feel cold to your core that no amount of warm clothing can change. You may retain water, have problems with your digestion, struggle with an underactive thyroid, and feel sluggish or tired most of the time.

Treating a pattern of internal cold is a significant undertaking and takes more time than dealing with an external pattern of the flu or an upper respiratory infection. If your yang is depleted, treatment would likely involve a combination of acupuncture, warming herbs, food therapy, and even warming your body from the outside. It takes longer to treat because in most cases your pattern of internal cold was a long time in the making

The third kind of cold pathogen in Chinese medicine is called a cold strike. This is when cold affects your body directly in the form of muscle pain, muscle cramps, joint pain, or even a hernia. I experienced a cold strike several years ago when I was on a kayaking trip. Sitting in a wet kayak for hours on end caused a muscle in my butt to seize up to the point that I couldn’t walk. It took several weeks of acupuncture and physical therapy to recover.

A cold strike usually comes from being out in the cold, and often manifests as a spastic muscle or a very cold and achy joint. Think about it:  Cold causes everything to contract—including your muscles and joints. Treatment for a cold strike is pretty straight-forward and involves a combination of acupuncture and heat.

In Chinese medicine, we’re big fans of keeping warm. If you run cold, there are a number of things you can do at home to help stoke your internal pilot light. Among them:

-Warm your core. Use a heating pad, hot water bottle, or heated rice bag to warm the small of your back or your abdomen right below your navel.

-Add some warming herbs to your meals. Ginger, garlic, mustard, cayenne, pepper, and cinnamon are a good place to start.

-If you have muscle or joint pain that is worse with the cold weather, applying heat can help relieve the pain and loosen it up.

-Dress appropriately when you’re spending time outdoors in the cold (and the wind). Cover your head and ears, and wear a jacket that is long enough to cover your lower back and butt.

-And finally, if you are constantly cold to your core, struggle with pain that’s worse in the cold, or seem to catch every cold or flu that’s going around, enlist the help of a practitioner of Chinese medicine. They have a number of tools that can help warm you up and strengthen your immunity.