Exertional fatigue and cold exposure: mechanisms of hiker's hypothermia

Participants in prolonged, physically demanding activities in cold weather are at risk of a condition known as "hiker's hypothermia". During exposure to cold weather, the increased gradient favoring body heat loss to the environment must be balanced by physiological responses, clothing, and behavioral strategies that conserve body heat stores, or else body temperature will decline. The primary human physiological responses elicited by cold exposure are shivering and peripheral vasoconstriction. Shivering increases thermogenesis and replaces body heat losses, while peripheral vasoconstriction improves thermal insulation of the body and retards the rate of heat loss. A body of scientific literature supports the concept that prolonged and (or) repeated cold exposure, fatigue induced by sustained physical exertion, or both together can impair shivering and vasoconstrictor response to cold. The mechanisms accounting for this thermoregulatory impairment are not clear, but the possibility that changes in blood glucose availability or sympathetic responsiveness to cold due to exertion and fatigue merit further research.