IS THERE HOPE FOR MY COLD HANDS (RAYNAUD’S)? New research pinpoints two genes that facilitate inappropriate blood vessel constriction. Today, we look at thawing the ice: A Raynaud’s survivor’s guide to toasty hands.
My father had it (and got frostbite in Korea). My son has it. Other relatives have it, too.
Have your fingers or toes ever felt numb and cold in response to cold temperatures or stress? You, too, may have Raynaud’s (ray-NOSE) disease.
Today, I want to tell you a bit about Raynaud’s disease. We will then pivot to new insights about the condition. The results of the largest genetic study of the condition could lead to more effective management. I will end with “A Raynaud’s Survivor’s Guide.”
First, a bit from Alice’s Adventures in Wonderland / Through the Looking-Glass:
“I wonder if the snow loves the trees and fields, that it kisses them so gently? And then it covers them up snug, you know, with a white quilt; and perhaps it says, “Go to sleep, darlings, till the summer comes again.”
― Lewis Carroll,
What is Raynaud’s?
Raynaud’s disease causes some body areas — for example, the fingers and toes — to feel numb and cold in response to cold temperatures or stress.
Our smaller arteries that supply blood to the skin narrow for those of us with the condition. The resultant drop in blood flow to affected areas is vasospasm.
Other names for the condition are:
- Raynaud’s phenomenon. Raynaud’s phenomenon, or secondary Raynaud’s, occurs secondary to various other conditions.
- Raynaud syndrome. Raynaud’s disease (primary Raynaud’s) is diagnosed if the symptoms are idiopathic — if they occur by themselves and not in association with other diseases. Some refer to primary Raynaud’s disease as “being allergic to coldness.”
Learn more about some causes of Raynaud’s here:
Raynaud’s disease: Treatment, causes, and symptoms
www.medicalnewstoday.com
Raynaud’s and Me
I am among the three to five percent of the population that suffers from Raynaud’s.
Here is what happens to me: Cold temperatures trigger spasms in the small blood vessels near my skin’s surface. As a result, the vessels constrict and reduce blood flow.
In those of us with Raynaud’s phenomenon, cold temperatures or stress trigger spasms in the small blood vessels near the skin’s surface, causing the vessels to constrict and limit blood flow.
Raynaud’s is Painful For Me
According to the Mayo Clinic, the fingers and toes are most commonly affected. That certainly is the case for me.
My skin will turn white and then blue. Pain ensues. Finally, as the attack wanes, my fingers and toes become red.
Did I mention that the attacks bring pain? Once I warm up, blood flow returns to my fingers and toes in 10 to 15 minutes.
A New Study Provides Insights into Raynaud’s
Raynaud’s can run in the family; sometimes, the condition is inherited. I count myself among the half of those with primary Raynaud’s phenomenon who have a first-degree relative (my dad) with the condition.
A new study explains why.
Researchers in Berlin and London examined data from over 440,000 people in the UK Biobank, a massive medical and genetic database.
The team identified 5,147 cases of Raynaud’s, 68 percent of which were primary Raynaud’s. Another 439,294 records served as controls.
The scientists identified two distinct genes that point to two mechanisms:
- One gene variant affects how blood vessels narrow. Those with this variant have a high number of a receptor for hormones that are released when the body is cold or stressed. The hormones tell the tiny vessels in the skin to narrow, causing blood to flow away from the extremities to our vital organs.
- Another gene variant affects how blood vessels dilate (relax).
The study did not examine people across a broad range of ethnicities. Moreover, the researchers relied on diagnostic codes in people’s electronic health records; these records are not always reliable. The team may have missed some Raynaud’s cases.
A Raynaud’s Survivor’s Guide
Let’s look at some steps I take to decrease the frequency and severity of Raynaud’s.
First, I avoid smoke. No smoking, vaping, or second-hand smoke for me. All can tighten my blood vessels, leading to a drop in my skin temperature.
Second, I exercise. Physical activity can increase my blood flow.
Third, I manage my stress. Stress can be a trigger for Raynaud’s.
Finally, I try to dodge rapidly changing temperatures. Going quickly from heat to air conditioning can set off my Raynaud’s.
Traditional Approaches to Managing Raynaud’s
Depending on the symptom cause, medications may be helpful to you. Here are two classes of medicines that your clinician may offer:
- Calcium channel blockers. These medicines relax and open small blood vessels in the hands and feet. Nifedipine (Procardia), amlodipine (Norvasc), felodipine, and isradipine are examples.
- Vasodilators. These drugs relax blood vessels. Examples include the erectile dysfunction medicine sildenafil (Viagra), the high blood pressure drug losartan (Cozaar), the antidepressant fluoxetine (Prozac), and a medicine class known as prostaglandins.
Uncommonly, surgery or shots (such as Botox) might be offered to manage severe Raynaud’s.
What To Do During an Attack
The Mayo Clinic offers guidance for what to do if you suffer from a Raynaud attack. Warm your hands, feet, or other affected areas.
Here are some ways to gently warm your fingers and toes: Do the following to warm your fingers and toes gently:
- Get indoors or to a warmer area.
- Wiggle your fingers and toes.
- Place your hands under your armpits.
- Make wide circles with your arms. This is a favorite of mine; I rapidly spin my arms in a wide arc to force blood into my fingers.
- Run warm — not hot — water over your fingers and toes. I repeat: Not hot.
- Massage your hands and feet. This is not a go-to maneuver for me.
- If stress triggers an attack, get away and try to relax.
My Final Thoughts on Raynaud’s
I left New England, at least in part, because I suffered frequently from Raynaud’s. Cold, painful fingers and toes. The Seattle area is much more mild.
I hope that identifying genes associated with Raynaud’s will facilitate the creation of new treatments. I can imagine that drugs could target this hormone receptor.
Notably, a currently available antidepressant drug — mirtazapine — acts on the receptor. Could we repurpose this pharmaceutical?
For now, I will continue not to smoke (as doing so increases the intensity and frequency of attacks).
I don’t take drugs that may exacerbate Raynaud’s (for example, estrogen or so-called non-selective beta-blockers). I also limit my caffeine consumption.
You will know why if you see my hands looking like the pictures above.
Thank you for reading “A Raynaud’s Survivor’s Guide.”
