T Nation

Raynauds Syndrome

I was hoping Bill R. or Cy could answer this one. Or anyone that has any opinions. The last few months I have been sufferring from what my Doc says is raynauds syndrome, My fingers and toes get extremely cold at weird times but not always, he says there is no cure. I notice it gets worse whenever I have a meal with no carbs. Is there something more to this? I have been having a hell of a time leaning out. I had blood work done and my thyroid is not low, nor is it high. I don’t know what else it could be?

I used to have the same problem in the front
half of my feet. If you ask a MD what causes
Raynauds Syndrome, or how to treat it, they
will tell you they don’t know and can’t. I
am not an MD, but my opinion is that this is
due to early stage diabetes (either type 1
or 2) or inadequate insulin production by your
pancreas. One of the complications of diabetes
is vascular disorder, and it is not uncommon
for diabetics to have to have peripheral limbs
(most often feet) amputated. Now Raynauds
Syndrome is definitely a circulatory problem
so you would think that taking supplements or
drugs that improve circulation would cure the
problem. But in my case, it only helped a
little. I was able to fix this problem in
myself by taking a lot of things used to treat
diabetes. One thing that many people forget
about insulin is that it is a potent
vasodialator. When you eat carbs, you get more
insulin output from your pancreas, and hence
better blood flow. But when you eat only a P+F
meal, you don’t have much insulin in your
blood, hence circulation is less good. Fish
oil can help in two ways here: it acts as a
natural “blood thinner” and it can help with
the pre-diabetic (type 2) problem. So in my
case, taking a combination of supplements and
drugs used to treat diabates made the Raynauds
go away. Of course, doctors think I’m crazy
when I tell them that I think that Raynauds
Syndrome is an early symptom of diabetes.
Their egos prevent them from listening to
anyone who doesn’t have a piece of paper
hanging on their wall, or anything that
wasn’t spoon fed to them in med school. Oh
well. If I were you, I would get tested for
both type I and type 2 diabetes.

Thanks for your input that really seems to be the case. When I eat carbs the symptoms get better. I don’t know how all of a sudden I could become a type I diabetic? Type II seems to develop only with inactivity obesity and poor eating choices, could a restricted carb diet make you a diabetic, hence causing raynauds syndrome (is it fixable? without forgowing fatloss?. I defenitely take fish oil, and flax and have for quite sometime. My problem is I have been trying to leanout so I keep carbs relatively low (70-100g), I always found I didn’t tolerate starches and high carb diets Limiting my choices to low glycemic carbs except for postworkout . My problem is when I up my carbs 200+ my symptoms get better, but I can’t get leaner many times I get fatter. Even JMB recommendations don’t work for me to lean out and when I get to the P+F meals I get the cold fingers and toes. I don’t know what to do? I’m stuck between a rock and a hard place.

It sounds to me like you are suffering from
insulin resistance of muscle tissue, but not
fat tissue. This happens in type 2 diabetes.
This could explain why you have trouble
getting lean; insulin resistance makes getting
lean much more difficult. Type 2 diabetes can
occur even in people who eat well and exercise
(ie are not obese). Type 2 diabetes has a
genetic component just as type 1 does. And
it can be brought on by things other than
obesity. (Such as caffeine, stress/cortisol,
sleep deprivation, and nutritional
deficiencies, among others.) In addition to
the fish oil, try taking large amounts of
chromium, ALA, and if you can get it,
metformin. This is the combination that I was
using that I believe helped to treat the
Raynauds. It may also be that you are not
diabetic, and it’s just that you have poor
circulation when your insulin levels are low.
In this case you could try taking supplements
that help with vascular function: gingko, GLA,
niacin, magnesium, arginine, aspirin etc. Hope that helps. Consider talking with your doctor
about this concept.

lifted from another website:

Biofeedback. Using biofeedback, people can "teach" their blood vessels to relax. One form of biofeedback is simply "thinking" your hands warm. Another is more specific. Starting in a warm room, place your hands in a warm bowl of water for 5 minutes, then move to a cold room or outdoors and again place your hands in warm water, this time for 10 minutes. Repeat the procedure several times a day for as many days as necessary to produce a conditioned reflex that is the opposite of the normal one: when exposed to cold, the blood vessels in the fingers will open up rather than close down, without the aid of warm water. The efficacy of biofeedback has been documented by many scientific studies. A recent study determined that biofeedback subjects showed significant elevations in finger blood flow, finger temperature, and skin conductance level, suggesting an active vasodilating mechanism that goes beyond generalized relaxation. Other studies have found that symptomatic improvement was maintained 9 weeks, 1 year, and even 3 years after the start of training. Biofeedback is generally not as effective for Raynaud's phenomenon as for primary Raynaud's and may not work as well for foot warming.

Heatsocks are tubes of fabric filled with grain that can be warmed in the microwave and applied to affected areas. “Heat wheat” mitts are commercially available. You can make your own by filling a sock with heavy rice and heating it in the microwave for about 3 minutes. The heat will last around 3 hours.

Paraffin treatments. Regular paraffin (hot wax) treatments can be helpful, but caution must be exercised. Use only physician-prescribed hot wax units, since using wax that is too hot will damage already delicate blood vessels. Never heat wax on the stove or in crock pots. A physical or occupational hand therapist can train you in the proper procedure.

Pharmacological and Nutrient Therapies

Pharmacological treatments for Raynaud's syndrome have limited efficacy and unpleasant side effects.

Calcium channel blockers. Drugs that block the calcium channels found in blood vessels have traditionally been the first choice of prescription medications used to treat Raynaud's syndrome. Nifedipine is considered the standard. These drugs block the calcium channels in the smooth muscle of vessel walls, thereby preventing contraction. Side effects are frequent and include dizziness, headaches, nausea, feelings of warmth or flushing, ankle-swelling, constipation, and an increase in symptoms of heartburn, which may subside once the body becomes used to the drug. Long-acting preparations may minimize these side effects. Other blockers, such as diltiazem, have fewer side effects but are less effective.

Vasodilators and pentoxifylline. Drugs that work to dilate blood vessels (reserpine, guanethidine) would seem to be helpful in treating Raynaud's, but according to a recent review in a major American medical journal, they usually do not produce complete relief. In addition, the review reports that full benefit is often prevented by unpleasant and sometimes severe side effects. These drugs are considered second-tier choices. Both can enhance circulation: alpha-adrenergic blockers by dilating blood vessels, and pentoxifylline through an unclear mechanism that improves disorders in the circulation of the very small blood vessels such as capillaries where vasodilators have limited effect.

Antiplatelet agents. Platelets clump together to form clots, inhibiting circulation; antiplatelet agents prevent this. Dipyridamole is a prescription drug. Low-dose aspirin is also a highly effective antiplatelet agent. Take one Healthprin tablet (81 mg) a day.

New drugs. Recently, several new pharmacological therapies are being studied for effectiveness on Raynaud's syndrome, including Iloprost (stable prostacyclin), piracetam, Ketanserin (S2-serotonergic antagonist), and dazoxiben (thromboxane synthetase inhibitor). Although prostaglandin E1 and prostacyclin have been successfully used to treat Raynaud's, they are unstable and require intravenous administration (reserved for emergencies). Oral Iloprost was proven ineffective for Raynaud's phenomenon in scleroderma patients in a recent scientific study, although it has been reported as beneficial by patients, including those unresponsive to other treatments. Another route to increasing the levels of these beneficial molecules is to stimulate the body's own production using evening primrose oil (see below). Piracetam is a drug used in Europe whose therapeutic efficacy has been experimentally established. It has a unique dual mode of action: inhibition of platelet function by inhibition of thromboxane synthetase or antagonism of thromboxane and increasing cell membrane deformability and decreasing plasma concentrations of clotting factors. Piracetam appears to be devoid of adverse effects.

Nitroglycerine cream. Nitroglycerine dilates blood vessels, but must be used sparingly.

Nutrient Supplements Nutrient supplements exert comparable preventive effects without side effects and at the same time improve overall health. Supplements important for Raynaud's sufferers include the following:

Vitamin E. Vitamin E (along with vitamin C) is the key antioxidant in the body, protecting polyunsaturated fatty acids from oxidation. Red blood cell membranes are especially rich in these fatty acids; therefore, vitamin E stabilizes red blood cells and maximizes their efficacy in carrying oxygen to the tissues. A recently published article argued that autoimmune diseases result from hydrolytic enzymes that escape from lysosomes (cellular organelles that digest waste) whose membranes have been damaged by oxidation. These enzymes denature (destroy) proteins to the point that they are viewed as foreign objects by the body's defenses. Vitamin E deficiency was proposed as the root cause of the damage to the lysosomal membranes. Vitamin E has also been found to have direct therapeutic effects. For example, a recent clinical trial stated that vitamin E was a "curative agent" for patients with occupational Raynaud's. Take 800 international units (IUs) of vitamin E a day as two divided doses.

Vitamin C. Vitamin C plays a key role in the synthesis of collagen, which is the key component in the walls of blood vessels. Vitamin C is therefore essential to ensure that the small arteries that supply the fingers do not become damaged during Raynaud's attacks. In addition, vitamin C is important in the synthesis of prostaglandin E1--a hormone-like unsaturated fatty acid that acts on the smooth muscle of small arteries and decreases platelet aggregation--which has been accepted as one of the most effective treatments for emergency cases of Raynaud's. Vitamin C deficiency was found to predispose toward irreversible injury in a recent study of Raynaud's patients. Research suggests that 500 mg of vitamin C a day is effective.

Other vitamins. The vitamins supplied by the Life Extension Mix, including vitamins B6, D, and E and riboflavin and pantothenic acid, aid in the adrenal gland's ability to handle stress. This will positively impact Raynaud's, which is triggered by stress. Take three tablets of Life Extension Mix 3 times a day.

Inositol nicotinate or nicotinic acid. These are forms of niacin (vitamin B3), which directly relaxes the smooth muscle in blood vessels. A recent experimental evaluation of the usefulness of inositol nicotinate in treating Raynaud's concluded that it produced beneficial therapeutic effects on the microcirculation not only through vasodilation, but also through mechanisms such as enhanced fibrinolysis (clot breakup) and lowering of lipids (fats) in the blood. Moreover, the researchers noted a lack of side effects and contrasted it with standard drug treatments. Another study agreed that long-term treatment with nicotinate acid derivatives may improve peripheral circulation through a different effect from the one detected by short-term studies. A variety of other research groups have documented statistically significant improvement in symptoms and reduction in frequency of Raynaud's attacks with inositol nicotinate. Depending on your sensitivity, nicotinic acid may cause flushing, the result of a harmless, temporary release of histamine, at doses as low as 50 to 75 mg. Some people like the sensation; others find it uncomfortable. It lasts 20 to 30 minutes. Doctors recommend staying at the lowest dose that relieves your symptoms and going no higher than 200 to 300 mg a day without medical supervision. Inositol nicotinate, at doses of 1500 to 4000 mg, which does not cause flushing, should be taken daily as three or four divided doses. Be aware that niacin is destroyed by excessive sugar, alcohol, sulfa drugs, and the antibiotic chloramphenicol.

CAUTION: Niacin has been known to cause liver damage in high doses. If you have liver disease, do not take high doses of niacin without medical supervision.

Magnesium and calcium. Adequate calcium and magnesium are essential to maintain relaxation of the smooth muscle of the small arteries affected by Raynaud's. In addition, the requirement for magnesium increases with psychological or physical stress, which in turn is associated with Raynaud's episodes. Take 500 mg of each a day. The Life Extension Foundation offers calcium citrate capsules (220 mg), Bone Assure (1000 mg calcium, 320 mg magnesium plus a host of other nutrients in 6 capsules), and Ultramag, which contains the different forms of magnesium (400 mg in 2 tablets).

Gamma-linolenic acid (GLA). GLA is an essential fatty acid found in primrose, borage, or black currant oils important for relaxing smooth muscles because it is the precursor for prostaglandin E1. A recent scientific study found that 12 capsules a day of primrose oil dramatically decreased the number of Raynaud's attacks, and blood tests showed some antiplatelet (blood thinning) activity. A typical daily dose of GLA is about 1500 mg. The Life Extension Foundation suggests that the optimal dose of GLA be obtained by taking five MEGA GLA (borage oil) capsules a day.

Omega-3 and omega-6 oils. Flax and fish oils contain essential polyunsaturated fatty acids, known as omega-3 and omega-6 fatty acids, that have been shown to lower serum triglycerides (fats) and decrease platelet aggregation (thin the blood). Research has demonstrated that fish oils inhibit arachidonic acid metabolism, which makes them useful in the treatment of autoimmune diseases like those associated with Raynaud's. One recent study found that a higher percentage of patients given fish oils reported clinical improvement in a variety of symptoms, including Raynaud's, in comparison to a control group. A significant decrease in laboratory values that reflect autoimmune disturbances (cryocrit and rheumatoid factor) was also observed. Another recent clinical study found that ingesting fish oil increased the median time (especially in those patients with primary Raynaud's) before the onset of Raynaud's after exposure to cold. Moreover, fish oil improved tolerance to cold exposure, as evidenced by significantly increased blood pressures in the fingers, and almost half of the patients in the fish oil group did not exhibit Raynaud's in response to cold water baths. The Foundation recommends that fish, flax, or perilla oil be taken in doses ranging from 4,000 to 8,000 mg a day.

Ginkgo biloba. This well-tolerated plant extract has been proven to stimulate circulation in the small blood vessels in addition to its other benefits. Take ginkgo biloba 120 mg once a day.

Summary Raynaud's syndrome is a fairly common condition caused by spasms in the blood vessels supplying the fingers and toes. These spasms are brought on by cold or stress. Although maddening, it is usually mild but can have serious consequences, such as tissue death or gangrene, if not tended to. The best treatment for Raynaud's is prevention through behavioral strategies, including keeping yourself warm at all times, protecting your hands from any cold, and avoiding precipitating factors such as certain activities, substances, and stress.

Given the association of Raynaud's syndrome with serious diseases, consult a physician upon developing the symptoms. Prevent attacks by adopting the behavioral strategies outlined above to keep yourself warm and protect your hands from the cold. Reduce stress and avoid precipitating substances and activities. Respond immediately to every attack with motion and moist heat. Use biofeedback to train your blood vessels to relax. Take 800 IU of vitamin E a day as two divided doses. Take 500 mg of vitamin C a day. Take the lowest dose of nicotinic acid that relieves your symptoms, going no higher than 200 to 300 mg a day without medical supervision. 1500 to 4000 mg of inositol nicotinate, which does not cause flushing, should be taken daily as 3 or 4 divided doses.

CAUTION: Niacin has been known to damage liver in high doses. If you have liver disease, do not take high doses of niacin without medical supervision.

Take 500 mg of magnesium and calcium a day: calcium citrate (2 capsules a day) and Ultramag (1 to 2 tablets a day) or Bone Assure (6 capsules a day) plus extra magnesium.
Take 1500 mg of GLA a day from borage oil.
Take 4000 to 8000 mg of omega-3 fatty acids from fish, flax, or perilla oils.
Take 120 mg of ginkgo biloba extract once a day.
Take 1 Healthprin tablet (81 mg) a day with the heaviest meal.
Take 3 tablets of Life Extension Mix 3 times a day.
For unresponsive cases, consult your physician regarding pharmacological therapies.
Consult your physician regarding any progression in your condition, any alterations in your health, and any infections or injuries in affected areas to prevent serious consequences.

Coyote posted some good info on this topic
(which I believe he got from the Life
Extension web site). However I want to comment
on a few things. First, I tried pentoxifylline
to treat my Raynauds, and like the article
states, it often doesn’t provide a complete
solution. Second that protocal takes the
same approach that mainstream doctors do -
and that is that Raynauds is just a harmless
condition, not indiciative of any more
serious disorder. And I have to disagree with
that. I think that Raynauds is in most
cases indicitave of a more serious condition
and should be treated as such, not as
something benign.

Finanally, I want to mention that it is really important to avoid any kind of vasoconstricting substance, such as thermos (caffeine, ephedra), because they will only make the problem much worse.

I know little about this condition,
but I happen to recall that stanozolol
(Winstrol) can be of value in treating it:

Helfman T et al. J Am Acad Dermatol (1995) 33 254

I certainly hope you can see some improvement from one of the many suggestions you’ve received!

Raynauds is also often linked with autoimmune diseases such as rheumatoid arthritis, lupus, and auto-immune disorders of the thyroid. Usually it seems just from my observation that among these people who experience Raynauds also have very lethargic metabolisms and also experience symptoms of hypothyroidism even though blood tests may not detect it. In your case your low carb diet may be a culprit. Inadequate blood flow to the hands and feet can also be caused by low blood volume or overstimulation of the sympathetic nervous system. The latter reason would be why minimizing stimulants such as caffeine might be of some benefit. Deep breathing exercises along with all the other recommendations can also help relax the nervous system and get better blood flow to the extremities.

Reynaud’s is very often associated with an autoimmune disease called “scleroderma.” I sincerely hope this is not true in your case but there is a great deal of info out there on the web about this condition. See if any of the other symptoms match yours.

Yea I got it from LEF

Im suprised no one has mentioned L-Arginine, freind of mine has good results from it

What other bloodtests could I get that would determine if I have autoimmune disorders of the thyroid etc? I defenitely feel I have sluggish metabolism and a host of other problems. My doc doesn’t really know anything. I have to specifically request the tests.