Ashley Burkman, ND
Raynaud’s (pronounced rey-nohz), named after the French doctor who first described this certain set of symptoms, is characterized by short periods of blood-vessel spasm, most commonly occurring in distal extremities and areas of the body with decreased blood flow, including the fingers, toes, nose, and ears. When these blood-vessel spasms occur without known cause, it is considered Raynaud’s disease or primary Raynaud’s. Certain diseases or conditions, including connective tissue disorders like scleroderma, Systemic Lupus Erythematosus and Sjogren’s Syndrome also can cause blood vessel spasms. When there is an explanation for vessel spasms this is considered secondary Raynaud’s phenomenon or secondary Raynaud’s disease. Previous trauma, carpal tunnel syndrome, Rheumatoid Arthritis, medication interactions or peripheral vascular disease can predispose a person to secondary Raynaud’s. Primary Raynaud’s is most common and tends to be less severe than secondary Raynaud’s.
Symptoms
During a blood vessel spasm, normal blood flow to the area is interrupted. This leads to temperature changes that can be felt in the affected part as well as color changes that can be seen. For example, fingers can become white, blue and purple during a vasospasm. Once the spasm has resolved, blood rushes into the affected part, which can be seen as redness and felt as tingling or pain. Spasms can last from several minutes to hours and can occur several times in a day.
For some, these blood vessel spasms only occur when there is a significant external temperature change. Winter weather can precipitate a vasospasm event; something as benign as taking a cold package from the freezer with bare hands can lead to occlusion of blood flow and set off a vasospasm. Occasionally, individuals will note Raynaud’s events coinciding with stressful events. The danger in decreasing blood flow to a part of the body is that it increases the potential for frostbite and, in severe situations, gangrene.
Prognosis
The prognosis for an individual with primary Reynaud’s is often very good, as it can be managed through lifestyle modifications which help prevent vasospasm events. Secondary Raynaud’s carries differing prognoses which truly depend on the management of the comorbidity. In any event, with either primary or secondary Raynaud’s, taking the following precautionary steps can help reduce the number and severity of vasospasm events.
Lifestyle Modifications to Prevent Vasospasm
- Cover affected parts when going outdoors in cold weather. Gloves with a low temperature rating and wool socks can do the trick. Also, ensure you have proper footwear for snowy conditions.
- Consider carrying a few instant-heat hand/foot warmers with you in the winter. You never know when you may get stranded and need to keep warm.
- Keep a pair of thick rubber gloves in the kitchen specifically for handling cold freezer items. These gloves also can be used when hand-washing delicate items in cold water.
- Quit smoking; smoking leads to vasoconstriction and can precipitate a vasospasm.
- Have a space heater available for cold bathrooms, office spaces and various other indoor places. Maintaining a level temperature in your surroundings will help reduce vasospasm events.
- Decrease caffeine consumption. Caffeine can increase vasospasm and constrict blood vessels and thus increase the likelihood of a Raynaud’s event.
Nutritional Considerations for Raynaud’s
Homocysteine
Homocysteine is an amino acid that is formed during protein metabolism. High amounts of homocysteine are linked to an increased risk of cardiovascular disease. Cardiovascular disease can lead to an increase in Raynaud’s vasospasm events due to narrowing and hardening of arteries. Specific B vitamins are essential in clearing homocysteine from circulation, therefore, diets heavy in animal proteins and low in B vitamins can lead to elevated blood levels of homocysteine and thus increased vasospasm.
Magnesium
Magnesium is an essential mineral needed for a multitude of enzymatic reactions in the body. Its health benefits range from detoxification to maintenance of strong bones and teeth. The smooth muscles that surround the arteries tend to relax with magnesium supplementation, thereby increasing blood profusion. When it comes to Raynaud’s, magnesium could help to increase blood flow to hands and feet and reduce incidence of vasospasms.
Fish oil
Fish oil supplementation may help Raynaud’s patients tolerate cold temperatures. Although it is still important to cover exposed parts when out in the cold, fish oil supplementation can help make scraping the car more tolerable on those frosty mornings! Supplementation doses vary depending on patient size and weight.
Nitric Oxide
Nitric oxide is a molecule that is well known for its benefits for the cardiovascular system. It directly promotes the relaxation of the smooth muscle found within blood vessels. Several medications take advantage of the vasodialating effects of nitric oxide for treating patients with atherosclerosis to promote normal blood flow. Nitric oxide can promote blood flow to the hands and feet in the same way, thus preventing further vasospasm events.
It is always recommended that you speak with your doctor about your concerns and considerations when it comes to Raynaud’s, as it’s important to rule out any underlying cardiovascular disease as a cause for vascular compromise. Although there is no cure, there are several options to reduce the symptoms and discomfort of Raynaud’s.
Dr. Ashley Burkman is a board certified licensed Naturopathic Physician at Connecticut Natural Health Specialists, LLC. Like all the physicians at Connecticut Natural Health Specialists, LLC, Dr. Burkman is dedicated to treating the cause of disease and is an in-network provider for most insurance companies. Visit http://www.ctnaturalhealth.com. For an appointment, please call (860) 533-0179.