Raynaud's is a disorder that impacts blood vessels that carry blood from your heart to different parts of your body (arteries), especially in the hands and feet. What causes Raynaud's disease is excessive constriction (vasospasm) of these small blood vessels which limits blood flow to the tips of the fingers (or toes). They then become cold and change color due to a lack of blood reaching the tissues. Episodes come and go and may last minutes or hours. A functional medicine approach to Raynaud's disease addresses the root causes of this vascular reaction, such as exaggerated responses to stress and cold, imbalanced blood sugar, or toxicity. In other cases, Raynaud's can occur along with connective tissue diseases such as scleroderma or lupus.
Raynaud's is more common in women, affecting around 5–20% of women and 4–14% of men. Diagnosis most commonly occurs before the age of 30.
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Raynaud's Signs & Symptoms
Raynaud's attacks can last a few minutes up to a few hours, and each episode can vary in duration, symptoms, and severity. Often, the tips of the fingers (or toes) turn white, then blue, then bright red, before returning to normal. The lips, nose, ears, or nipples can also be affected. This can be accompanied by pain and numbness since the small blood vessels within the hands are excessively constricting, limiting blood flow to the tissue.
A typical attack progresses in the following manner:
- The skin of the affected body part turns pale or white due to blood vessels constricting quickly and leading to a lack of blood flow.
- Then the area turns blue and feels cold and numb, as the tissue lacks oxygen since no fresh blood is flowing into it.
- Finally, as the tissues warm up and circulation returns, blood flow returns to the area, and it turns red and may swell, tingle, burn, or throb.
In severe cases, repeated uncontrolled attacks can lead to small, painful sores, especially at the tips of the fingers or toes, or gangrene (death and decay of the tissue).
What Causes Raynaud's Disease
There are often multiple factors that contribute to Raynaud's.
Primary Form Raynaud’s
In primary forms of Raynaud's (the most frequent form), the exact cause is not always identified, but several factors contribute to increased reactivity of blood vessels in the extremities.
Cold exposure
The most common trigger for Raynaud's is exposure to cold temperatures, such as taking something out of the freezer or going suddenly into a colder environment.
Emotional stress and nervous system imbalances
As part of a complex coordinated response, nerve and hormonal signals influence blood flow in the skin. Some people with Raynaud's seem to have a lower threshold for the body's normal stress response to cold and emotional stress. This is governed by the body's protective fight or flight mechanism facilitated by the sympathetic part of the autonomic nervous system. Under stress, hormones are released to cause arteries to narrow and divert blood flow away from smaller extremities like the fingers toward large muscles so you can run away or fight.
Stress also impacts your immune system and may make it more likely to attack your own body.
Imbalanced Blood Sugars
Imbalanced blood sugars can trigger the body's stress response and contribute to the constriction of blood vessels. Over time, body sugar issues like metabolic syndrome and diabetes can also damage the delicate lining of blood vessels. This can lead to circulation issues, including Raynaud's.
Genetics
Although single genes are unknown, genetic factors influence the risk of primary and secondary Raynaud's.
Secondary Form Raynaud’s (Raynaud's Phenomenon)
The secondary form of Raynaud's occurs along with other health conditions, especially autoimmune diseases like lupus, rheumatoid arthritis, Sjögren's syndrome, scleroderma, or environmental exposure. For example, certain medications used to treat high blood pressure, migraines, or attention-deficit/hyperactivity disorder may cause constriction of blood vessels and symptoms similar to Raynaud's or make underlying Raynaud's worse.
Additionally, ongoing exposure to repeated vibration (such as occupational exposure to machinery), cold, or certain chemicals can contribute to Raynaud's. Nicotine in cigarettes may also increase risk.
Does Raynaud's Affect the Circulatory System?
These factors contribute to changes in circulation. Raynaud's affects the circulatory system, which is made up of the heart and blood vessels that carry blood throughout the body.
Typically, when sensory nerves in the skin sense coldness, they send messages to the brain to constrict (or narrow) the blood vessels in the skin of the extremities to reduce heat loss. Raynaud's affects the circulatory system so that the blood vessels react to even tiny changes in temperature or stress with excessive narrowing that reduces blood flow. This causes numbness and color changes in the fingers and toes.
How Does Raynaud's Disease Affect the Heart?
Although the impairment in circulation most commonly impacts peripheral tissues like the fingers and toes, Raynaud's can sometimes affect the heart. The changes in circulation that occur in Raynaud's may impact how well blood is delivered to the heart, especially when Raynaud's occurs due to another connective tissue disorder. Therefore, proper screening and care from a heart specialist are important to prevent potential complications.
Functional Medicine Labs to Test for Raynaud's
Raynaud's is often diagnosed based on symptoms and physical exam. It may be confirmed with a cold stimulation test which is used to trigger Raynaud's symptoms.
Functional medicine testing can help uncover potential underlying causes of Raynaud's to address and possibly resolve symptoms. Blood tests can measure autoimmune antibodies, inflammation, blood sugar balance, and gut health to evaluate factors that may exacerbate Raynaud's.
Autoimmune screening
Blood tests can detect antibodies associated with various autoimmune conditions that can lead to Raynaud's.
Testing can look for anti-Nuclear antibodies (ANA) that target normal proteins within the nucleus of a cell and may be indicative of autoimmunity when present along with suggestive symptoms.
A positive ANA accompanied by symptoms can be followed up with testing for extractable nuclear antibodies (ENA) to look for different proteins and help to distinguish between autoimmune disorders.
Inflammation
Markers such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) assess inflammation throughout the body that is often associated with altered immune function in autoimmunity.
Metabolic and Blood Sugar Balance
NutraEval FMV provides insights into cellular health and assesses several of the risk factors for Raynaud's, including toxin exposure and how the body handles oxidative stress.
Several tests assess how the body handles sugars:
- fasting glucose
- hemoglobin A1c measures the average blood sugar level over the previous six weeks
- fasting insulin
- C-peptide, a marker that the body is producing insulin
These can identify blood sugar imbalances that can contribute to inflammation and damage blood vessels.
Gut health
Imbalanced bacteria in the gut (microbiome), unaddressed food sensitivities, toxicity, and a leaky gut barrier that allows food and other substances to enter the bloodstream increase inflammation that can contribute to the risk of autoimmunity associated with Raynaud's.
A Comprehensive Stool Test measures gut bacteria, inflammatory markers, leaky gut, and pathogens to assess the state of the gut and guide treatment aimed at restoring balance.
Functional Medicine Treatment for Raynaud's
A functional medicine approach to Raynaud's addresses underlying contributing factors to improve blood vessel function and reduce the number and severity of Raynaud's attacks.
Lifestyle approaches
Lifestyle approaches can help you avoid situations that may trigger a Raynaud's attack. For example, avoiding cold temperatures and keeping hands and feet warm with mittens (which are more effective than gloves), warm socks, and hand/foot warmers during cold weather. It is also helpful to address any workplace or recreational risk factors such as contact with certain chemicals, machinery, vibrational tools, or medicines. Avoiding caffeine, tobacco, and alcohol can also reduce the frequency of Raynaud's attacks.
Manage stress
Using effective mindfulness and other coping mechanisms to manage emotional stress can reduce the frequency of Raynaud's attacks. Ways to cope with stress should be individualized and include practices like physical activity, listening to music, yoga, tai chi, or meditation.
Supplements
- Omega-3 fatty acids, found in fish oil, salmon, and walnuts, may reduce symptoms in people with primary Raynaud's when exposed to cold.
- Evening primrose oil (EPO) contains a different type of fatty acid that may also help reduce Raynaud's symptoms.
Stabilizing Blood Sugar
Maintaining a balanced blood sugar level throughout the day helps prevent damage to the blood vessels over time and reduces the risk of blood vessel narrowing, causing Raynaud's. Choosing carbohydrates in whole foods like vegetables that provide fiber helps keep blood sugar levels more stable than processed flours and starches that give a rapid sugar influx that damages the blood vessel lining over time.
Incorporating healthy fats like olive oil, avocados, grass-fed butter, walnuts, salmon, flaxseeds, fish oil, and complex carbohydrates can slow the absorption of sugar to keep blood sugar and appetite balanced.
Improve circulation
Research suggests that the herb Ginkgo Biloba can help open up blood vessels and improve blood flow to the fingers to reduce Raynaud's attacks.
Summary
Raynaud's occurs when blood vessels in the fingers and toes (and sometimes in the earlobes, nose, and lips) narrow and cause the skin to turn white (as blood is cut off), then blue (as oxygen declines), and then red (as blood returns). The affected area can feel numb and cold. This exaggerated narrowing of the small blood vessels in the fingers and toes is most commonly triggered by cold or stress.
Functional medicine testing can assess autoimmune antibodies, blood sugar balance, inflammation, and gut health to evaluate these factors that may exacerbate Raynaud's. Treatment strategies aim to reduce the inappropriate constriction of blood vessels in response to triggers like cold, stress, or blood sugar imbalances. Lifestyle and nutritional approaches help improve circulation and reduce attacks.
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