Raynaud’s Phenomenon

Also known as Raynaud’s phenomenon, Raynaud’s syndrome and Raynaud’s disease, Raynaud’s is much more than simply having sluggish circulation. Raynaud’s blocks the blood supply to extreme parts of your body (usually your fingers and toes but sometimes your earlobes, lips, nose, tongue or nipples) by constricting the small blood vessels, causing them to turn white. As the tissues in your fingers or toes quickly use up the oxygen in the narrowed blood vessels it can turn them blue or purple, sometimes even black.

Then as the blood vessels relax and open up again, fresh blood flows through, turning your fingers or toes bright red. At the same time, you may experience pain, tingling, throbbing or numbness, and the symptoms can last from minutes to several hours. Eventually, your skin returns to its normal colour.

In most cases, only the fingers are affected, with some people also experiencing symptoms in their toes. The classic colour changes also don’t apply to everyone some may only develop pale, cold extremities while others may find their fingers or toes start by going blue, then red.

Primary and secondary

There are two types of Raynaud’s: primary and secondary. Primary ¬¬– where the condition develops on its own (that is, there is no explanation for it) – is the most common type (more than nine in 10 cases are primary Raynaud’s (i) ). Secondary Raynaud’s is when the condition is caused by another health problem, usually an autoimmune condition (these are conditions where the immune system attacks healthy tissue in the body).

Raynaud’s is a fairly common condition in the UK, with up to 10 million thought to be affected – which is around one in six people (20 per cent of the world’s population are also thought to have Raynaud’s) (ii) . It’s thought to affect slightly more women than men, and it’s more widespread in countries with colder climates (iii).

Raynaud’s is very common in teenagers, says Scleroderma & Raynaud’s UK (iv), though the symptoms seem to improve in many as they get older.

How is it diagnosed?

There’s no specific test to diagnose Raynaud’s, so most cases are confirmed by the symptoms described above. For instance, if you go to your GP, they may place your hands in cold water to see if it triggers your symptoms. If you have suspected secondary Raynaud’s, you may also need blood tests to find out what other health conditions are causing your Raynaud’s symptoms.

What causes Raynaud’s?

Experts don’t really know why some people develop Raynaud’s, but it happens when blood vessels in your extremities become over-sensitive to the cold. Your symptoms can be triggered by even mildly cool weather, or you may find you have an attack after handling cold objects such as food from your fridge or freezer or just by placing your hands or feet in cold water. Experts also claim stress, anxiety and other strong emotions can trigger a Raynaud’s attack.

Primary Raynaud’s is thought to be caused by the way the nervous system controls the blood vessels. Normally, the nerves reduce the blood supply to your blood vessels in your extremities when you’re exposed to very cold temperatures to stop too much heat being lost from your body. But if you have Raynaud’s, it’s thought that your nerves have an exaggerated response to milder cold temperatures, which means the blood flow to your extremities is blocked much faster than in a normal person.

And while it isn’t associated with any other health condition, primary Raynaud’s is also thought to run in families, which means you may have a greater risk of being affected if someone in your family has it (iii).

However, in secondary Raynaud’s, the blood vessels may become over-sensitive as the result of an underlying medical condition, such as one of the following:

Autoimmune conditions

These are health conditions that are the result of the immune system attacking healthy tissues in the body, such as rheumatoid arthritis and scleroderma.

Cancer

The types of cancers associated with secondary Raynaud’s include those that affect the blood, bone marrow or immune system. These include cancer of the white blood cells called acute lymphoblasic leukaemia (this mostly affects children), multiple myeloma and lymphoma.

Hepatitis

The viral infections hepatitis B and hepatitis C may sometimes cause Raynaud’s in some people.

Other things that may trigger secondary Raynaud’s include taking certain medicines, including decongestants, the contraceptive pill, hormone replacement therapy (HRT), some times of migraine remedies, and medicines used to treat high blood pressure and heart disease called beta blockers. Taking illegal recreational drugs such as amphetamines and cocaine can also cause secondary Raynaud’s.

If you’ve had frostbite that has damaged your skin, or if you use your fingers and hands a lot if you’re a musician, for example, or you do a lot of typing it can cause Raynaud’s. Smoking also increases your risk of developing it.

Raynaud’s complications

If you have secondary Raynaud’s, you may also have other conditions or an increased risk of developing complications (according to the NHS, on in 10 people with primary Raynaud’s also go on to develop a condition associated with secondary Raynaud’s(ii)). These other conditions include the following:

Scleroderma

One in 50 men and one in 16 women who have Raynaud’s - typically those aged between 25 and 55 go on to develop scleroderma (ii) . This condition affects the immune system, blood vessels and connective tissue, and makes the skin on the hands and feet tight, stiff, puffy and shiny, a result of the body producing too much collagen. It can also affect internal organs such as the lungs, bowel, heart and kidneys.

Other symptoms include joint discomfort, swallowing problems, diarrhoea, bloating, constipation and little calcium deposits under the skin, which can cause ulceration of the fingertips. According to the NHS, Raynaud’s is often the first symptom of a type of scleroderma called limited systemic sclerosis (vi).

Rheumatoid arthritis

This autoimmune condition causes inflammation of the joints, casing redness, swelling and pain. According to Scleroderma & Raynaud’s UK, it is an autoimmune condition known to be associated with secondary Raynaud’s (vii). Learn more about rheumatoid arthritis treatments in our guide.

Sjogren’s syndrome

This autoimmune condition affects the sweat, saliva and tear glands, making them inflamed. Two of the main symptoms are dry eyes and dry mouth. It mostly affects women aged between 40 and 60 (viii). It’s thought that up to half a million people in the UK are affected (ix), with some also having Raynaud’s.

Vibration white finger

If you use vibrating tools on a regular basis, you may develop this condition. People affected include road diggers, mine workers and shipyard workers. Experts believe the long-term exposure to vibrations may affect the nerves or the small blood vessels in the fingers. VWF is an industrial disease, and if you have it you may be eligible for compensation.

Systemic lupus erythematosis

This is one of two forms of lupus, which is an autoimmune disease. It affects your skin and joints, plus often also your internal organs such as your heart or kidneys (according to Versus Arthritis, one in three people with SLE have significant inflammation of the kidneys (x)). It causes chronic inflammation of the blood vessels and connective tissues of the body, and can cause a rash on your cheeks and bridge of your nose. As well as Raynaud’s symptoms, you may also experience tiredness, joint pain, mouth ulcers and hair loss if you have SLE.

Chilblains

Many people who have Raynaud’s also suffer from chilblains. These cause itchy, red and tender swellings on the skin on your fingers, toes, heels, nose and ears, and usually develop a few hours after you’ve been exposed to the cold. Chilblains usually heal within a few weeks without any medical intervention.

Ulcers, gangrene

People with severe secondary Raynaud’s also have a higher risk of developing ulcers and gangrene in the affected parts of their body. Thankfully, this is fairly rare. Discover more on the signs and symptoms of mouth ulcers in our guide.

Living with Raynaud’s

If you have Raynaud’s, there are several things you can do to reduce the severity of attacks, including the following:

Stay warm

Whenever possible, avoid getting cold or moving quickly between warm and cool temperatures (such as during warm weather when you visit a building with air conditioning). Keep your whole body warm by wearing several layers of clothing during the winter, not forgetting socks, hats and gloves (you may also want to wear socks and gloves in bed at colder times of the year). Think about buying hand warmers to put in your pockets, and if you do get too cold, run warm water over your fingers or toes as soon as possible. Also avoid the rain and the damp stay indoors if you can. And if you’re handling cold or frozen food, put a pair of gloves on beforehand.

Meanwhile there’s no evidence that any specific diet has a protective effect against Raynaud’s attacks, but you could try eating and drinking hot foods and drinks to keep you warm, whatever the time of year.

Give up smoking

According to Scleroderma & Raynaud’s UK, smoking constricts blood vessels and is a potential cause of Raynaud’s (xi). Quitting, on the other hand, will help to improve your circulation and improve your symptoms. That’s because tobacco makes your blood vessels constrict, which reduces the blood flow to your extremities. If you need help with giving up, there are stop smoking aids such as patches, lozenges and gum that could help you stay smoke free.

Get advice on medicines

If you suspect a medicine you’re taking ? whether a prescription medicine or over-the-counter remedy has caused or is aggravating your Raynaud’s, speak to your GP or pharmacist. These medicines include decongestants (also found in cold and flu remedies), the contraceptive pill, hormone replacement therapy (HRT), migraine medicines such as sumatriptan and ergotamine, and beta blockers, medicines used to treat high blood pressure and heart disease.

Keep stress in check

Since stress is associated with Raynaud’s, it’s a good idea to reduce your stress levels whenever possible. Try to learn some relaxation techniques that could help you feel calm, such as meditation, deep breathing or yoga. Learning to recognise and avoid stressful situations may also help to keep your symptoms at bay.

Stay active

Regular exercise is recommended to those with Raynaud’s as it can help to boost your circulation as well as reduce feelings of stress. Aim for at least 150 minutes of moderate activity each week, but speak to your GP before starting a new exercise regime if you’re new to exercise or you haven’t been very active lately.

Natural remedies for Raynaud’s

A medical treatment for Raynaud’s called nifedipine is usually offered to those whose symptoms don’t improve after making lifestyle changes. This is the only medicine licensed in the UK to treat Raynaud’s, and while it isn’t a cure it may relieve the symptoms. There are, however, several common side effects, including headache, palpitations, dizziness and oedema (swelling).

If you like the idea of trying natural supplements, there are several that may help, including the following:

Ginkgo biloba

Thought to be the oldest surviving species of tree, ginkgo is widely used in traditional Chinese medicine and for a range of health problems in the West too. It’s thought to be an important antioxidant for peripheral circulation in helping to relax the small blood vessels. Studies also suggest it may help to reduce the number of attacks in people who have Raynaud’s (xii).

Fish oil

The omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), found in oily fish, are believed to help improve blood flow in the arteries. Indeed, there’s some evidence that taking fish oil supplements may reduce symptoms in those with primary Raynaud’s (xii).

If you’re a vegetarian or vegan you can still benefit from an omega-3 supplement, thanks to the availability of products that contain the natural triglyceride (TG) form of omega-3, which is sourced from plant organisms called microalgae rather than fish oils.

Vitamin E

Like fish oils, vitamin E may help to improve blood flow too. Experts believe it may also reduce symptoms in cases of Raynaud’s that are caused by vibrating machinery (xiv).

Magnesium

This mineral is also thought to help open up tightened blood vessels, which may explain why some nutritional practitioners recommend it to people who have Raynaud’s. Plus there’s evidence that being under a lot of stress could result in lower magnesium levels (xv). A study has also found that levels of magnesium in the blood are lower in women exposed to the cold who have primary Raynaud’s compared with those who do not have the condition (xvi).

Cinnamon

Anecdotal reports suggest this warming spice may help relieve Raynaud’s symptoms, while books on medicinal herbs claim cinnamon may help to stimulate the circulation (xvii).

Raynaud’s syndrome can be difficult to manage on a daily basis, but these simple steps should help to make it a little easier. Want to learn more? You can discover even more helpful articles just like this in our health library.

 

References:

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13. Di. Giacomo. RA, Kremer. JM, Shah . DM, et al. Fish-oil dietary supplementation in patients with Raynaud’s phenomenon: a double-blind, controlled, prospective study. Am J Med. 1989;86:158-164. Available online: https://pubmed.ncbi.nlm.nih.gov/2536517-fish-oil-dietary-supplementation-in-patients-with-raynauds-phenomenon-a-double-blind-controlled-prospective-study/

14. Matoba. T, Kusumoto. H, et al. Comparative double-blind trial of dl-alpha-tocopheryl nicotinate on vibration disease. Tohoku J Exp Med. 1977 Sep;123 (1):67-75. Available online: https://pubmed.ncbi.nlm.nih.gov/335571-comparative-double-blind-trial-of-dl-alpha-tocopheryl-nicotinate-on-vibration-disease/

15. Grases G. et al., Anxiety and stress among science students. Study of calcium and magnesium alterations. Magnes Res. 2006 Jun;19(2):1-2-6. Available online: https://pubmed.ncbi.nlm.nih.gov/16955721-anxiety-and-stress-among-science-students-study-of-calcium-and-magnesium-alterations/

16. Leppert. J, Alberg. H, et al. Lower serum magnesium level after explosure to cold in women with primary Raynaud’s phenomenon. J Intern Med. 1990 Sep;228(3):235-9. Available online: https://pubmed.ncbi.nlm.nih.gov/2401874-lower-serum-magnesium-level-after-exposure-to-cold-in-women-with-primary-raynauds-phenomenon/

17. Bhatacharjee. Hand Book of Indian Medicinal Plants. Jaipur: Pointer Publishers. 1998.
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Disclaimer: The information presented by Nature's Best is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications.
 

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