Why never to dismiss waking up with swollen hands and feet as ‘just another side effect’ of alcohol and hot weather. It can be the first sign of a life-threatening condition …

Do you feel the heat? I don’t just mean being hot and sweaty; You may also have noticed that your feet and even your toes are swollen and swollen.

Whenever the heat hits the UK or people start returning from summer holidays, I start to see a familiar pattern in my patients.

They arrive confused and a little panicked, describing swollen ankles, rings that won’t come off their fingers, or feet that look enlarged by the end of the day. They often believe that something is seriously wrong. Fortunately, most of the time it is not like that.

But knowing the difference and knowing when to seek help is really important.

This can affect you anywhere where temperatures increase significantly; You do not need to be abroad. The heatwave in the UK is more than enough to trigger this, especially since almost no one here has air conditioning.

When the temperature rises, your body has a clever way to cool you down. Your blood vessels dilate; They expand and push more blood towards the skin surface, releasing heat from the body.

The problem is that this expansion makes the blood vessel walls more permeable and fluid can leak into the surrounding tissues. This fluid then tends to accumulate where gravity pulls it; For most of us, that means our feet, ankles, and lower legs when we walk upright. We call this heat edema.

Your hands may also be affected, especially if you are going for a long walk or run in the heat and your hands are hanging below the level of the heart for a long time, because the blood returning to the heart from the hands and feet must move upwards against gravity.

The veins in the limbs rely on tiny valves and muscle movement to push it up. Anything kept below the level of the heart allows fluid to accumulate in the tissues more easily, especially in hot weather when the vessels are already dilated and sluggish.

If you’ve ever returned from a summer run and noticed that your fingers look distinctly sausage-like, that’s exactly what’s happening.

The face may swell from the heat, especially around the eyes, fingers, and lips. (The ear lobes may be the same way, but this is because the small blood vessels in the outer ear dilate, sending more blood to the skin, causing the ear lobes to appear red, warm, and puffy.)

And this can happen at any age. But older adults tend to struggle more with heat edema because circulation becomes less efficient as we age. Over time, the tiny valves in the leg veins that work against gravity to push blood back towards the heart don’t always work as well as they used to, meaning fluid is more likely to build up.

And women are more prone to this type of fluid retention than men. The hormone progesterone promotes water retention, which is why many women notice swelling in their ankles two weeks before their period. During a heatwave, this hormone combined with blood vessels dilating due to heat causes swelling to worsen. Women in menopause may also be more vulnerable because falling estrogen levels disrupt the body’s fluid regulation.

Being less active puts you at risk. Movement is actually one of the primary ways your body pumps blood back from the lower extremities; Therefore, swelling is more likely if you sit for a long time, on an airplane, at a desk, in a wheelchair, without moving.

This is something I always mention to patients. The combination of a long-haul flight and a heatwave destination is a special double whammy, and it’s exactly why your feet look so big when you arrive at a warm destination.

But you don’t need to get on a plane to experience this. The exact same thing could happen during a heatwave like the one we’re seeing now in the UK, and in some ways it could catch people off guard because they’re at home and they’re not expecting it. With no air conditioning to shelter in, there’s nowhere to escape the heat, and swell can sneak up on you like it did on a beach in Lanzarote.

It may develop within a few hours, especially if you are standing or sitting still. Once you cool down, elevate your legs, or lie flat (as gravity no longer pulls the fluid into your lower extremities) it begins to relieve fairly quickly and usually improves within a few hours. Most cases resolve completely overnight in a cooler environment.

Pregnant women are prone to swelling, especially in the heat. Pregnancy already places extra demands on the circulatory system; Blood volume increases by up to 50% to nourish the placenta and growing baby.

The heart is working much harder, and the expanding uterus puts direct pressure on the large veins that carry blood from the lower body to the heart. This increases the likelihood of fluid accumulation in the legs even without heat; Add a heat wave and the effect increases significantly.

The growing uterus also puts pressure on the veins that bring blood from the lower part of the body. Heat strengthens all this.

While swelling of the feet, ankles, and lower legs are the most common, swelling in the hands and face (especially a puffy face or fingers that suddenly bend) is more concerning during pregnancy and should always be evaluated as it may be a sign of preeclampsia (high blood pressure).

People who carry excess weight are more likely to experience heat swelling because excess weight means the veins in the legs have to work harder to return blood to the heart; More tissue puts more pressure on the veins.

Here’s the reassuring news: For the vast majority of people, heat edema is harmless. Disturbing, yes. It can cause your shoes to feel tight and your rings to be uncomfortable. However, it is not dangerous on its own.

If the swelling goes down overnight or when you lie flat, this is a very good sign.

However, swelling in the legs and feet can sometimes be the body’s way of signaling a more serious condition. Heart failure is one of those conditions that I want to ignore because when the heart isn’t pumping efficiently, fluid can pool and build up in the legs.

Kidney problems can also cause the body to retain excess fluid (because they can no longer effectively filter excess sodium and water from the blood, so fluid accumulates and leaks into surrounding tissues). It tends to appear on the legs, ankles, and feet (due to gravity), as well as around the eyes; A swollen face first thing in the morning may be a sign of kidneys. Unlike heat edema, kidney-related swelling does not resolve overnight and tends to be permanent.

Here are the signs I would like you to take seriously. If swelling persists or continues to worsen, seek medical attention; If you feel shortness of breath, especially when you exert yourself or lie flat; If you notice that you are producing much less urine than normal; or if the swelling is in only one leg rather than both legs.

Unilateral leg swelling (especially if it is red, warm to the touch, or painful) may indicate deep vein thrombosis or a blood clot and needs to be evaluated urgently.

Movement is actually one of the primary ways your body pumps blood back from the lower extremities, so swelling is more likely if you sit without moving for long periods of time.

With no air conditioning to shelter in, there’s nowhere to escape the heat, and swell can sneak up on you like it did on a beach in Lanzarote. Picture: Sun seekers in Weymouth this weekend

But the most effective emergency solution for heat edema is to elevate your feet. Lie down and lift your legs above your heart level and let gravity work in reverse.

But the most effective emergency solution for heat is to elevate your feet. Lie down and lift your legs above your heart level and let gravity work in reverse. Adequate fluid intake is also important; This may sound counterintuitive when you’re already feeling bloated, but dehydration actually causes the body to retain more fluid as a protective response (causing the release of a hormone called vasopressin, also known as antidiuretic hormone, which instructs the kidneys to stop excreting water and reabsorb it instead). The body essentially goes into survival mode and hoards whatever fluid it has.

If you constantly struggle with heat-related swelling, compression socks or tights can help significantly by helping the veins push blood upward. I know it’s totally wrong to wear tight clothes when it’s hot, but for those prone to edema it really makes a difference.

If you’re caring for elderly relatives during a heatwave, make sure they’re drinking enough, not overdressing out of habit, and getting around as much as they can.

For young people, those who exercise or play sports outdoors in the heat are most at risk. The advice is the same: keep moving rather than standing still, drink plenty of fluids, and if you’re running, try to periodically raise your hands above heart level; Some runners wave their hands for this very reason.

These simple steps can make a real difference.

• Dr Stephanie de Giorgio is a GP in East Kent.

AS TOLD TO STODDART