II. Causes: Environmental exposure
- Cold water immersion or Submersion
- Cold Exposure
III. Causes: Altered Thermoregulation
- Endocrinopathy- Hypothyroidism including Myxedema Coma
- Adrenal Insufficiency
- Pituitary or Hypothalamus dysfunction
- Diabetic Ketoacidosis (or Alcoholic Ketoacidosis)
- Lactic Acidosis
 
- Central neurologic disorders
- Peripheral neurologic disorders
- Miscellaneous causes- Anorexia Nervosa
- Shivering impaired (e.g. medications)
- Hypoglycemia or Malnutrition
- Extremes of age (very young or very old)
 
IV. Causes: Increased Heat Loss
- Septic Shock and other shock states
- Dermatitis- Severe Burn Injury
- Severe skin exfoliation
- Severe Psoriasis
 
- Iatrogenic- Therapeutic Hypothermia
- Over-correction of Heat Illness
- Cold fluid infusion
 
V. Causes: Substances
- Impact both increased heat loss and altered Thermoregulation
- Alcohol Intoxication
- Phenothiazines
- Benzodiazepines or Barbiturates
