Raynaud’s, pronounced rey-nohz, named after French doctor who first described this certain set of symptoms, is characterized by short periods of blood vessel spasm most common in distal extremities and areas of the body with decreased blood flow including 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 can precipitate a blood vessel spasm including connective tissue disorders like scleroderma, Systemic Lupus Erythematosus and Sjogren’s Syndrome. When there is an explained reason for these 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 to secondary Raynaud’s. Primary Raynaud’s is most common and tends to be less severe than Secondary Raynaud’s.
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 often precipitate a vasospasm event, however, something as benign as taking a cold package from the freezer with a bare hands can lead to occlusion of blood flow and therefore 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 comes in the form of an increased potential for frostbite and in severe situations gangrene.
The prognosis for an individual with Primary Ranyanud’s is often very good as it can be managed through lifestyle modifications to help prevent a vasospasm event. Secondary Raynaud’s, being that it comes secondary to another disease, carries a differing prognosis and truly depends on the management of the comorbitidy. In any event, with either primary or secondary Rayndaud’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 can also be used when hand washing delicate items in cold water.
• Quit smoking as this leads to vasoconstriction and can precipitate a vasospasm.
• Have a space heater available for cold bathrooms, office spaces and various other indoor places. Trying to maintain 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, an amino acid that is formed during protein metabolism, that when found in high amounts in circulation 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 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 supplementation had been studied to help improve the ability to tolerate cold temperatures in patients with Raynaud’s. Although it is still recommended to cover exposed parts when out in the cold, fish oil supplementation can help those frosty mornings while scraping the car more tolerable! Supplementation doses vary depending on patient size and weight.
Nitric oxide is a molecule that is well known for its benefits for the cardiovascular system as 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. In this same way, nitric oxide can promote blood flow to the hands and feet, 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 is 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 symptoms and discomfort of Raynaud’s.