For many people, having cold feet is more than a figure of speech. While it is possible to simply have cold sensations without any serious underlying cause, chronically cold toes could be a sign of poor blood circulation. Smoking and smoking-related conditions like COPD can reduce the lungs’ ability to fully absorb oxygen, leading to lower oxygen levels in the blood. Additionally, peripheral arterial disease (PAD) and several other forms of heart disease can cause your arteries to narrow, which can impede the flow of blood throughout the body. Extremities like hands and feet are particularly susceptible to poor circulation, which may manifest itself through cold sensations. If you notice that your feet are almost always cold or numb, consult your doctor to figure out whether there are any underlying medical problems.