The condition presents an intricate vascular disorder in which blood vessels overreact to exposure to cold temperature or emotional stress. The reaction causes blood vessels to narrow which reduces the blood flow and oxygen to the affected extremity. As a result the area can become numb, but as the blood vessels dilate again after the attack it is often combined with a tingling and or painful sensation, before returning to normal conditions.
Frequently Asked Questions
Raynaud's phenomenon is most often present in the extremities of the hands and feet, affecting the fingers and toes (and in more rare cases the tongue, nose, lips, ears or nipples can also be affected). The condition presents an intricate vascular disorder in which blood vessels overreact to exposure to cold temperature or emotional stress. The reaction causes blood vessels to narrow which reduces the blood flow and oxygen to the affected extremity. As a result the area can become numb, but as the blood vessels dilate again after the attack it is often combined with a tingling and or painful sensation, before returning to normal conditions. The attacks are experienced different by all patients; they can be for a brief few minutes, or last up to hours, and the intensity of the discomfort may also vary from mild and tolerable to severe.
- Raynaud's phenomenon attacks are most often triggered by cold temperatures and emotional stress. It is important to note that the blood vessel constriction can be triggered during any time of the year, not only during the cold seasons.
- Alcohol consumption & smoking can also be a contributing factor to this condition.
- Certain Medications can cause Raynaud's phenomenon as a side effect of using them (these can include beta-blockers, ergotamines (used for migraines), interferon alpha, cyclosporine (a drug that suppresses the immune system), and certain chemotherapy drugs).
- Other causes of Raynaud's phenomenon include hypothyroidism (when a patient is diagnosed with having low levels of the thyroid hormone); carpal tunnel syndrome; certain cancers; thoracic outlet syndrome (which occurs when nerves and blood vessels of the upper extremities are compressed between the collar bone and the first rib); atherosclerosis; frostbite; and hand-arm vibrations from operating certain machines or tools (occupational related).
There are two types of Raynaud's phenomenon: primary and secondary.
- Primary Raynaud's phenomenon (Raynaud disease) is the more common type, which most individual with this condition have. In the primary type of Raynaud's there is no underlying cause that can be identified, the numbing sensation is the result of a spasm or constriction of the blood vessels. As this is not a permanent condition such attacks generally do not lead to permanent tissue injury. Apart from natural occurring biological changes this condition can be caused by some medication or occupational exposures. Lifestyle changes can improve this condition.
- Secondary Raynaud's phenomenon is much more serious and can leave the affected area severely compromised after a prolonged attack. There is usually an underlying cause to this phenomenon such as an autoimmune disease like Lupus or scleroderma. If the condition goes without treatment (usually in the form of prescription medication) it could result in ulceration, gangrene, and/or loss of the affected digit(s).
In many cases, individuals who experience Raynaud's phenomenon do not discuss their symptoms with their doctor, considering them just a periodic nuisance. This is unfortunate. Some people, initially thought to have primary Raynaud's phenomenon, go on to develop a systemic autoimmune disease, where early recognition could help improve management and outcomes. Those patients who experience episodes of Raynaud's phenomenon are encouraged to mention their symptoms to their doctor, simple blood tests and clinical examinations can help rule out a potentially serious underlying disease.
The most prominent visual symptom is the affected extremities going through a "tricolour phenomenon" colour change: starting by turning white (due to a lack of oxygen), to blue (indicating cyanosis, which is the result of having no oxygen), to red (indicating the attack has passed when blood flow returns to the area). This "tricolour phenomenon" is a key diagnostic tool, and will results in clinical management of the condition.
There are three diagnostic lab tests which can be done, including:
- FBC blood count,
- Erythrocyte sedimentation rate (ESR) and
- Anti-nuclear antibody screening (ANA).
Your doctor may also assess thyroid hormone levels and perform an X-ray to confirm there is no cervical rib, a condition in which an extra rib sometimes develops in conjunction with a vertebra in the neck. This can affect blood flow, especially to the arms.
Hormonal factors, particularly estrogen, may also play a role in the cause of Raynaud's phenomenon among women. Female patients are advised to have the sex hormone levels tested, and if an imbalance is detected, then women can work with a Heath Renewal Doctor experienced in bioidentical hormone replacement therapy (BIHRT) to naturally restore hormonal balance. More information is available in the Female Hormone Balancing protocol.
By using a combination of prescription medications, nutraceuticals and in office Carboxytherapy treatments, the condition may be improved.
A medical consultation with one of the Health Renewal Medical Doctors is mandatory to ensure a complete medical evaluation before any treatment is started. In addition, certain blood tests may be ordered to exclude medical conditions. If indicated, the patient may be referred to a specialist for further evaluation.
At Health Renewal, we offer Carboxytherapy treatments for Raynaud's disease. Carboxytherapy uses five to six (5 to 6) micro injections of medical grade carbon dioxide into the affected area to stimulate the tissues to grow new capillaries. This replenishes the blood supply, improves circulation to the area and thereby restores the function of the tissues and increases the amount of tissue in the treatment area. The effects of each treatment are accumulative, and therefore a course of treatments will be recommended.
Your Health Renewal Doctor will recommend the specific dosage and combination of:
- Magnesium, to maintain smooth muscle relaxation in blood vessels.
- N-Acetylcysteine (NAC), which is a powerful anti-oxidant.
- Vitamin D, this vitamin supplement may act as a vasodilator, blood levels need to be between 50-80 ng/mL.
- Essential Fatty Acids, such as Fish Oils & Gamma-linolenic acid (GLA) have blood thinning effects and may relieve the symptoms of Raynaud's phenomenon.
- Vitamin C, important for the synthesis of collagen and the improvement of vasodilation.
- L-Arginine, a potent vasodilator.
- Vitamin E, an anti-oxidant that protects fatty acids from oxidative damage.
- Niacin (Vitamin B3), helps prevent formation of blood clots, and improves peripheral vasodilation. Selenium, a mineral which helps with anti-oxidant defense mechanisms in the body.
The primary form of Raynaud's phenomenon is often controllable with lifestyle changes, such as avoiding cold temperatures and wearing gloves, but the secondary form generally requires medical treatment to address the underlying cause. Complications will only set in in advanced cases of untreated Raynaud's disease. These can ulceration, gangrene, and/or loss of the affected digit(s).