The symptoms of Raynaud’s can include a biting pain through the hands, fingers and toes, perhaps even the nose, nipples, knees and ears when exposed to the cold! Sometimes just one digit can be affected first, with more areas becoming affected over time. Alongside the pain can come discolouration of the extremities with blue, deep red or white, or a combination, frequently seen. The pain and change in colour are caused by blood vessel spasms which prevent normal blood flow, nutrients, heat and oxygen to reach the areas most affected.
The white colour commonly comes first as the spasm happens, with the blue phase happening due to lack of oxygen and the red phase coming as blood starts to flow freely again. The pain and colour can take time to normalise and it can be difficult to walk or use the hands/fingers when they are compromised by the cold. Emotional stress and medication or drug-use can also trigger Raynaud’s phenomenon. Having a thyroid condition can also increase the risk.
It is thought 5-20% of women and 4-14% of men may be affected by Raynaud’s at some point in their life, however, rates do decline with ageing, so for many spontaneous remission can occur, perhaps in as many as half of people who have a diagnosis.
There are two types of Raynaud’s; primary and secondary:
Primary- Typically begins between the ages of 15 and 30. A benign condition that is typically seen throughout families and is more common in women. There are usually negative auto-immune markers found on blood testing such as a negative ANA test and no inflammatory markers positive either. There are also no long-term effects from the changes e.g. pitting of nails or tissue changes such as ulceration.
Secondary- Onset typically is seen over the age of 40 and more in males. There is more risk of ulceration of the finger and toe tissue with nail and skin around the nail changes. This is due to increased capillary changes (capillaries are the small blood vessels at the extremities). Capillary damage is also more likely to be found in other auto-immune conditions such as scleroses, myositis and other connective tissue diseases. In one study around 25% of those with secondary Raynaud’s and a capillary abnormality developed systemic sclerosis, 35% of those with sclerosis also had antibody presence and those with both an antibody and nailfold capillary specific change comprised 80% of those with systemic sclerosis.
Raynaud’s is therefore frequently seen as the main presenting symptom pattern for several connective tissue conditions e.g scleroderma and lupus. Around 13-20% of people who have it will go on to develop a connective tissue disease that is auto-immune in nature, so accessing a medical diagnosis can be important for many with Raynaud’s. We make a point of offering to write to all our client’s GPs when we consider that a client may have symptoms of Raynaud’s so that a possible diagnosis is not missed. The three questions you should expect your GP to ask are:
Your GP may also refer you on for further tests such as testing to look at the tiny blood vessels in your nails. If you are over 35 then further auto-immune testing will likely be considered.
We have known about Raynaud’s since 1862 when it was identified by Maurice Raynaud, but more than 150 years later we still don’t know all we need to know about it! There is also a very personalised element to Raynaud’s with smoking, genetic factors and hormones playing their own part in severity and duration.
What can be done asides from speaking with a GP for further investigations? Well, avoiding the cold and very abrupt temperature changes is recommended. Smoking and caffeine are also recommended to be avoided, especially in the winter as they can affect severity of symptoms. Considering additional auto-immunity risk can also be achieved by undertaking intestinal permeability testing, and looking at key antibodies. This can be done in combination with tests via your GP and our clinic.
Vasodilation support is key for Raynaud’s and in primary Raynaud’s there may be an improved effect on symptoms. Gingko biloba (240mg max a day through three doses) is a natural supplement that is a known vasodilator and also supports nitric oxide levels. Vitamin D (2,000iu daily) can also be considered as it is supportive of the immune system and levels have been found to be low in those with systemic sclerosis.
In addition these the Scleroderma and Raynaud’s website lists several other natural therapies including:
Vitamin C- 500-1000mg daily
Vitamin E- 200-400mg daily
GLA- 320mg daily (e.g. from starflower/borage or evening primrose oil, or from fish oils)- do not take for more than 3 months if you are getting no benefit
Ginger- 200-4000mg daily
The supplements noted above should be avoided if you are taking blood-thinning medication e.g. warfarin/heparin. Support from our clinic can also be gained to fine-tune a supplement protocol to run alongside any medical oversight from your Doctor relating to poor perfusion/blood flow through the capillaries, which can also be trigged by other conditions and situations.
Author: Louise Carder
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