Raynaud's Phenomenon

Raynaud's phenomenon is a condition where blood vessels in the fingers and toes (and sometimes in the earlobes nose and lips) constrict. It is usually triggered by cold or by emotional stress. Episodes are intermittent and may last minutes or hours. Approximately 5 to 10 percent of the U.S. population is affected and women are affected five times more often than men. It usually occurs between the ages of 20 and 40 in women and later in life in men.

Signs and Symptoms

• Changes in skin color in the fingers or toes and sometimes in the nose legs or earlobes (may occur in three phases: white blue then red)
• Throbbing tingling numbness and pain
• Deterioration of the pads on fingertips or toes
• Gangrenous ulcers near fingertips

What Causes It?

Risk factors for Raynaud's phenomenon include the following.

• Cigarette smoking
• Age in women (onset primarily between the ages of 20 and 40)
• Occupation (for example using vibrating tools such as chain saws and jackhammers)
• Drug use including some cancer drugs narcotics and over-the-counter cold medications
• Electric shock injury
• Previous frostbite
• Repetitive physical stress (for example typing or playing the piano)
• Primary pulmonary hypertension
• Exposure to cold
• Psychological stress
• General medical conditions such as rheumatoid arthritis scleroderma systemic lupus erythematosus and carpal tunnel syndrome

What to Expect at Your Provider's Office

Your health care provider may conduct several laboratory tests such as the antinuclear antibody test to look for antibodies associated with connective tissue disease or other autoimmune disorders. If you have Raynaud's phenomenon your provider will most likely begin with a conservative approach involving non-drug and self-help measures (for example dressing warmly avoiding the cold controlling stress).

Treatment Options

Treatment Plan

If you smoke it is very important to stop because nicotine shrinks arteries and decreases blood flow. Protecting yourself well from the cold reduces episodes. Exercising can be good to increase circulation. Raising your arms above your head and vigorously whirling them can be a helpful exercise. Be careful not to cut or injure affected areas to avoid tissue damage. Several types of drugs and even surgery are used in more severe situations.

Drug Therapies

Prescription

• Calcium channel blockers—are vasodilators (drugs that open up blood vessels) that reduce frequency and severity of episodes; various side effects including dizziness headache flushing and heart palpitations
• Adrenergic blocking agents—increase blood flow to fingers and toes; various side effects
• Nitroglycerine—relaxes smooth muscle and dilates veins

Over the Counter

N/A

Surgical Procedures

If attacks become extremely frequent and severe and interfere with your well-being and ability to work or function a surgical procedure called sympathectomy may be used. This surgery becomes less effective as the disease advances.

Complementary and Alternative Therapies

Nutrition

• Vitamin E (400 to 800 IU per day) improves circulation and helps certain blood cells function well.
• Vitamin C (1 000 mg two to three times per day) supports connective tissue and reduces swelling.
• B-complex (50 to 100 mg per day) reduces stress.
• Coenzyme Q10 (100 mg two times per day) promotes healthy tissues.
• Calcium (1 500 mg per day) and Magnesium (200 mg 3 times per day) relieves spasm.
• Omega-3 oils (1 500 mg two to three times per day) reduce swelling and help certain blood cells function well.
• Zinc (30 to 50 mg per day) boosts your immune system.

Herbs

Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy it is important to work with your provider on getting your problem diagnosed before you start any treatment. Herbs may be used as dried extracts (capsules powders teas) glycerites (glycerine extracts) or tinctures (alcohol extracts). Unless otherwise indicated teas should be made with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers and 10 to 20 minutes for roots. Drink 2 to 4 cups per day. Tinctures may be used singly or in combination as noted. The following herbs are circulatory stimulants with other properties as well. Use one or more tinctures in combination. Take 20 to 30 drops two times per day.

• Hawthorn berries (Crataegus oxyanthoids) strengthens and mildly dilates blood vessels
• Ginkgo (Ginkgo biloba) (120 to 160 mg per day for dried extracts) keeps blood cells from sticking together
• Rosemary (Rosemariana officianalis) is a gentle relaxant
• Ginger root (Zingiber officianale) is a mild soothing agent
• Prickly ash bark (Xanthoxylum clava-herculis) enhances lymph activity and integrity of blood vessels

Homeopathy

Homeopathy may be useful as a supportive therapy.

Acupuncture

Acupuncture may be useful as an adjunct therapy.

Following Up

Most milder cases can be brought under control through self-help measures.

Special Considerations

Many drugs used to treat Raynaud's phenomenon can affect a growing fetus and should not be used by pregnant women.

Supporting Research

Balch JF Balch PA. Prescription for Nutritional Healing. 2nd ed. Garden City Park NY: Avery Publishing Group; 1997.

Batchelder HJ. Allopathic specific condition review: Raynaud's disease. The Protocol Journal of Botanical Medicine. 1996;2:134–137.

Fauci AS Braunwald E Isselbacher KJ et al eds. Harrison's Principles of Internal Medicine. 14th ed. New York NY: McGraw-Hill; 1998.

Mitchell W Batchelder HJ. Naturopathic specific condition review: Raynaud's disease. The Protocol Journal of Botanical Medicine. 1996;2:138–140.

Thierney LM Jr McPhee SJ Papadakis MA eds. Current Medical Diagnosis & Treatment 1999. 38th ed. Stamford Conn: Appleton & Lange; 1999.

Copyright © 2000 Integrative Medicine Communications

The publisher does not accept any responsibility for the accuracy of the information or the consequences arising from the application use or misuse of any of the information contained herein including any injury and/or damage to any person or property as a matter of product liability negligence or otherwise. No warranty expressed or implied is made in regard to the contents of this material. No claims or endorsements are made for any drugs or compounds currently marketed or in investigative use. This material is not intended as a guide to self-medication. The reader is advised to discuss the information provided here with a doctor pharmacist nurse or other authorized healthcare practitioner and to check product information (including package inserts) regarding dosage precautions warnings interactions and contraindications before administering any drug herb or supplement discussed herein.