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I will upload a new B42 version and leave this one unchanged for B41/MP folks.
Cryogenic winter modifies the minimum and maximum temperatures to make every day insanely cold - it doesn't change how the base game treats hypothermia (which will cause your hp to slowly decrease to 1, but will never kill you). This mod simply adds damage to your character based on how low their body temperature is.
KYR Real Weather is another alternative to Cryogenic Winter - you can tweak minimum and maximum temperatures to your liking in order to get a challenge that still feels fairly realistic.
The idea is to rename this mod and have it include a total of 3 submods: Hypothermia Kills DE (current version), “Heat Stroke Kills: Definitive Edition” and “Advanced Thermoregulation and Thirst”
Heat Stroke Kills will add a very similar system as Hypothermia Kills, except for hyerthermia/heat stroke.
Advanced Thermoregulation and Thirst will improve the realism of how weather, sunshine, character weight, alcohol consumption, and various other factors influence body temperature and thirst gain (I don’t understand why your character can get completely TRASHED on bourbon and it doesn’t dehydrate you)
Everything will be customizable in the sandbox settings and modular (so you don’t even have to load the other submods if you don’t want them).
It will also, of course, be save-game safe.