What Is POTS??

What Is POTS??

Friday, April 14, 2017

What is Raynaud's (ray-NOHDZ) disease?

What is Raynaud's (ray-NOHDZ) disease?

It is a condition that causes some of the areas of your body, usually but not always the extremities, such as your fingers and toes — to feel numb and cold when they become cold. Stress can also cause symptoms.   When you have Raynaud's disease the smaller arteries which supply blood to your skin narrow, decreasing the blood flow to affected areas. This is called vasospasm.

More women than men have Raynaud's disease. It is also called Raynaud's phenomenon or syndrome. People who have it usually just say, “Raynaud's” without the other descriptive words. People who live in colder climates are more likely to have it.

If you have Raynaud's, your treatment is largely dependent upon how severe it is and also any other conditions you may have. It isn't usually life threatening, but it does affect how you live on a day to day basis.

Simple things can bring on an attack, like digging around in your freezer for that roast you know is in there somewhere. It doesn't take long for your hands to turn colors and hurt. And it gets worse when you take your hands out of the freezer and the circulation comes back into them. Other things like going out into the cold or putting your hands into cold water can cause the same symptoms.

Some of the symptoms include:

Cold fingers or toes
Color changes in your skin in response to cold or stress
Numb, prickly feeling or stinging pain upon warming or stress relief

Your fingers or toes get cold and then they turn white. Then they progress to blue and start to feel numb and cold. And then when you seek to warm them up, and the circulation starts to come back into them, they become painful, with throbbing and tingling and they turn red. Some people like me don't have all three color changes. I usually don't turn blue. But that may be because I avoid getting my hands and feet cold. They may never get cold enough to cause the change from white to blue. But I have had them do that years ago. It can take as much as 15 minutes for the blood flow in an affected area to return to normal.

There are other areas of the body besides the fingers and toes that can be affected by Raynaud's. Your ears, lips, and nose can be affected.  Raynaud's can even affect the internal organs. And even more embarrassing areas like your nipples and your rear end. Yes, now you can tell your husband that “turkey butt” is a medical condition and you can't help it.

I purposefully chose photographs that don't look too severe. Not everyone looks like they are ready for amputation when they have an attack of Raynaud's and if you look at the severe cases you might not recognize it in yourself. If you have bad discoloration you can google it and come up with photos.

The exact cause of Raynaud's hasn't been determined yet. Something causes the blood vessels in the hands and feet to overreact to cold temperatures or stress. This overreaction is called vasospam. During vasospasm the arteries that supply blood to your fingers and toes spasm due to cold exposure or stress and narrow which causes a decrease in the blood supply. This eventually causes the arteries to thicken which further limits the blood flow.

Raynaud's phenomena in real time.

There are two classifications of Raynaud's.

It is also called Raynaud's disease and it's usually isn't caused by some other medical condition. It usually begins earlier in life than Secondary Raynaud's between 15-30 years of age. There seems to be a genetic predisposition to Primary Raynaud's. Approximately 1/3 of patients with Primary Raynaud's have a parent, sibling or child who also has it the disorder.

It is also called Raynaud's phenomenon and is less common than Primary Raynaud's. and it usually is caused by something else. It is usually more serious. Onset is usually around the age of 40.
There are two main types of the condition.

Things that cause Secondary Raynaud's are Connective tissue diseases like Scleroderma, Rheumatoid Arthritis, Sjogren's syndrome, and Lupus. Scleroderma can cause a hardening or thickening of the blood vessels. Sjogren's, Lupus and RA cause inflammation of the nerves that cause the blood vessels to constrict. Up to 1/3 of Lupus patients have Raynaud's. And 15-30% of Sjogren's patients have Raynaud's. I have both Lupus and Sjogren's so it was probably inevitable that I would have Raynaud's.

Hardening of the arteries also called atherosclerosis and high blood pressure in the lungs called primary pulmonary hypertension also cause Raynaud's. These things can be exacerbated by smoking because it causes the blood vessels to constrict.

If you have Carpel tunnel syndrome causes numbness and pain in your hands due to pressure on the nerves. This can cause your hands to be susceptible to temperature changes and lead to Raynaud's. Operating tools which vibrate can cause you to develop Secondary Raynaud's.

Raynaud's disease is also associated with dysautonomia. With regard to Postural Orthostatic Tachycardia, Neurocardiogenic Syncope and Orthostatic Hypotension, an interview on Dysautonomia International had this to say:  “We do not know how many POTS, NCS or OH patients have APS, but Dysautonomia International recently funded a research project designed by Dr. Svetlana Blitshteyn to try to shed some light on the topic of autoimmune markers and autoimmune conditions in patients with POTS.  Dysautonomia International will make an announcement when Dr. Blitshetyn’s study results are released.” And in the article, it says that Raynaud's disease is a symptom of Antiphospholipid Syndrome. So you can say that Raynaud's is associated with dysautonomia.What Dysautonomia Patients Should Know About Antiphospholipid Syndrome Postural Orthostatic Tachycardia SyndromeA Dermatologic Perspective and Successful Treatment with Losartan

That's not too surprising. People with dysautonomia and POTS have problems regulating temperature in general and blood flow problems because of inadequate pressure in the blood vessels. And POTS, like Raynaud's disease, is associated with autoimmune diseases.


Beta blockers, migraine medications, ADD/HD medication, and cold medications can all cause Raynaud's or make it worse because they cause constriction of the blood vessels.

There are also some chemicals that can cause Secondary Raynaud's.

It can become severe enough that you need to seek medical help. You definitely need to see a doctor if you get a sore on one of the areas affected so that you don't end up with an infection and lose an appendage.

Some people have a permanent reduction or blood flow which causes their fingers and toes to become deformed. If a complete blockage of an artery occurs, you can get skin ulcerations and ultimately gangrene, which is why it is important to see a doctor if you get a sore on an affected area to avoid having an amputation.


There are things you can do for Raynaud's. Wearing warm clothes, socks and gloves in cold weather are essential. Ear muffs and masks and scarves to keep your nose warm are also good ideas. Some people wear the socks and gloves when they are sleeping. And the gloves come in handy when you have to get into the freezer, but I personally never remember to do it. Avoid getting cold in the first place. Smoking is a no-no. Avoid stress because it can bring on an attack. And exercise increases circulation.

If you get cold, go inside and warm up. Two things that you should do are almost instinctive for people to do. Wiggling your fingers and toes and rubbing them to get them warm. You can also put your hands in your armpits and swing your arms to increase blood flow. You can run warm water over them too. Just don't get the water too hot.


And there are medications that help.

Calcium Channel Blockers relax the small blood vessels which help avoid the vasospasms. Common drugs in this class are Procardia, Norvasc, and Verapamil and Nifedipine.

Alpha blockers like prazosin and Cardura work by counteracting noradrenaline also called norepinephrine. This hormone causes blood vessels to constrict.

Vasodilators Nitroglycerin works as a vasodilator and comes in a cream and will facilitate the healing of ulcers. Losartan, which is a high blood pressure medication, and Viagra, as well as antidepressants like fluoxetine, can help treat Raynaud's.

Fish oil has fatty acids in that are supposed to make you less susceptible to cold.  Studies have shown that it didn't help people who have Secondary Raynaud's. You have to be careful when taking high doses of fish oil because it acts as a blood thing and increases your risk of bleeding, particularly if you take blood thinners, like as warfarin (Coumadin), clopidogrel (Plavix), or aspirin. Discuss it with your doctor.

Gingko is also supposed to be helpful by opening up the blood vessels. One study showed that Raynaud's patients had less pain if they took 160 mg of ginkgo per day. DO NOT take ginkgo if you have a history of seizures. Ginkgo can also increase risk of bleeding, especially if you take blood thinners. Talk to your doctor.

Evening primrose oil also contains a  type of fatty acid which keeps your body from making chemicals that narrow blood vessels.  Studies have shown that taking Evening primrose oil will lessen the severity of attacks as well as the frequency. EPO can make seizures worse in people who already have them and they shouldn't take it. And just like fish oil, there is a risk of bleeding with it.

There is a form of vitamin B3(niacin) called Inositol hexaniacinate. It may reduce the number of Raynaud's attacks. But it requires high doses and needs to be monitored by a doctor.

Taking Magnesium supplements opens the blood vessels, but there haven't been any studies to show if it works. Some people get diarrhea from taking it, so take it with a meal to help avoid this problem. It can also interfere with some medications like high blood pressure medication and antibiotics, so your doctor needs to be aware if you are taking it.

Biofeedback to lessen the effects of stress on your body may help lessen the frequency of attacks. Accupuncture is another treatment option that helps by improving blood flow to the affected areas. There is also a specific kind of biofeedback called Thermal Biofeedback that studies have shown works.

Surgery and injections

When lifestyle changes and medication don't help enough, sometimes things like surgery and injections of chemicals are the next line of treatment.

There are nerves in your feet and hands that control vasoconstriction and dilation. There is a surgery called a sympathectomy, in which these nerves around your blood vessels in your hands or feet are cut to stop the over-constriction. For some people it is helpful.

Botox injections can also block the sympathetic nerves and block the over-constricion.

For more information visit this link for a guide to Raynaud's
Raynaud’s Guide: The Cold Facts on Raynaud’s

These are links to my sources:



Raynaud's Awareness

Pathophysiology Raynaud's Disease  

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