Raynaud's Phenomenon

Raynaud's Phenomenon: Overview

Raynaud's disease, syndrome or phenomenon, whether primary or secondary, is characterized by extreme coldness in the hands or feet, the fingers or toes becoming white and numb.  The color may change to blue and finally red, as the blood returns to the tissues.  This can take from several minutes to many hours, and can be extremely painful.  It may also affect the ears and nose.

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When exposed to cold, do your fingers feel numb, tingling, and painful, and look pale and blue? You may have an annoying type of circulation problem called Raynaud's phenomenon, also known as Raynaud's disease or syndrome.  It usually affects the same two or three fingers on each hand.

Incidence; Causes and Development

It is much more common in women than in men and in smokers than in nonsmokers.

Why Raynaud's phenomenon occurs is not well understood.  Usually, the body conserves heat by reducing blood circulation to the extremities, particularly the hands and feet.  This response uses a complex system of nerves and muscles to control blood flow through the smallest blood vessels in the skin.  In people with Raynaud's phenomenon, this control system becomes too sensitive to cold and greatly reduces blood flow in the fingers.  Damage to either the muscles or nerves that control blood flow may be the cause of Raynaud's phenomenon.

Raynaud's is caused by tiny arteries that go into spasm, clamping down on the blood supply to the fingertips (and, less often, the toes).  Stress can make it worse.  The phenomenon may occur along with certain disorders, such as rheumatoid arthritis or lupus erythematosus, but in most cases the underlying cause for the blood-vessel spasm is unknown.

Treatment and Prevention

Treatment may vary according to the severity of the symptoms.  In mild cases it may be sufficient to maintain a constant body temperature, and, if possible, avoid extreme cold and sudden changes in temperature.  Attacks can also be caused by stress and smoking.  It is important to try and prevent attacks occurring in the first place.

There are a number of options for treating more severe Raynaud's, such as calcium channel blockers, vasodilators, or infusions of Iloprost.  Your doctor will decide on the most suitable treatment.

Natural treatments can provide benefit.  Consider the use of Vitamins C and E, cayenne, ginger, garlic, gingko biloba, and/or Inositol Hexaniacinate (IH, the non-flushing form of niacin).  IH does dilate blood vessels.  There is one study supporting its use in Raynaud's: it may work by keeping vessels chronically dilated.  In trials, 500mg once a day was the initial dose, then twice a day up to a total of 4gm per day.  Check with your doctor.  Though liver involvement is less with IH than niacin, larger doses may require monitoring for liver enzyme elevations.  Objective and subjective improvement in patients with coldness, pain, numbness and burning was statistically significant.  It may need to be taken regularly over a significant period of time (6 months or longer) for full effect.

Various medications have been tried for Raynaud's, but the simplest management is to wear thick or thermally insulated gloves and socks and avoid direct contact with cold surfaces, air, or water.  And, of course, give up smoking.

Signs, symptoms & indicators of Raynaud's Phenomenon:

Symptoms - Nails

Conditions that suggest Raynaud's Phenomenon:

Immunity

Chronic Fatigue / Fibromyalgia Syndrome

Raynaud's phenomenon is found in between 30% to 50% of CFS/FMS sufferers.

Skin-Hair-Nails

Symptoms - Cardiovascular

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Risk factors for Raynaud's Phenomenon:

Allergy

Autoimmune

Lupus, SLE (Systemic Lupus Erythematosus)

Raynaud's phenomenon has been observed in 17-30% of patients with SLE, depending on the study.

Environment / Toxicity

Raynaud's Phenomenon suggests the following may be present:

Circulation

Recommendations for Raynaud's Phenomenon:

Botanical

Vitamins

Inositol Hexaniacinate

Inositol hexaniacinate, a variation on the B-vitamin niacin, has been used with some success for relieving symptoms of Raynaud's disease.  30 people in one study with Raynaud's disease took 4gm of inositol hexaniacinate each day for 3 months and showed less arterial spasm.  [J Int Med Res 1979;7: pp.473-83]

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