Raynauds Syndrome
Raynaud's Syndrome
18 Toasty Tips
You know Raynaud's syndrome all too well. You open a refrigerator door and your hands chill out in nothing flat. Or you notice changes in your fingers when you're punching away at your keyboard.
Suddenly the blood vessels to your fingers constrict. (Sometimes your toes are affected, too.) What you get at first is a spasm. Blood flow slows to the affected area, and that lack of oxygenated blood causes it to pale, maybe even take on a bluish tinge. Sometimes you experience a sensation of numbness from the lack of blood. Your fingers turn red again when the blood returns. In advanced stages of Raynaud's, poor blood supply can weaken the fingers and damage your sense of touch.
Cold isn't the only culprit. This odd but common affliction can result from injury to the blood vessels from the vibrations of powerful equipment like chain saws and pneumatic drills and from hypersensitivity to drugs that affect the blood vessels, or disorders of the connective tissue. Other causes include nerve disorders.
How can you protect yourself from Raynaud's syndrome? Here's what our experts advise.
Condition yourself to overcome chills. Train your hands to heat up in the cold by adapting this technique that U.S. Army researchers in Alaska devised.
Choose a room that's a comfortable temperature and place your hands in a container of warm water for 3 to 5 minutes. Then go into a freezing room and again dip your hands in warm water for 10 minutes. The cold environment would normally make your peripheral blood vessels constrict, but instead, the sensation of the warm water makes them open. Repeatedly training the blood vessels to open despite the cold eventually enables you to counter the constriction reflex even without the warm water.
In the army experiments, this procedure was repeated every other day for three to six times on 150 test people. After 54 treatments, the results were impressive. Their hands were 7 degrees warmer in the cold than before.
"People are training on the rooftops in New York City, in freezer lockers, in grocery stores, and in hospitals and hotels," says Murray Hamlet, director of the army's cold research program.
Twirl your arms to generate heat. You can actually force your hands to warm up through a simple exercise that Donald McIntyre, M.D., a dermatologist in Rutland, Vermont, devised. Pretend you're a softball pitcher. Swing your arm downward behind your body and then upward in front of you at about 80 twirls per minute. (This isn't as fast as it sounds; give it a try.)
The windmill effect, which Dr. McIntyre modeled after a skier's warm-up exercise, forces blood to the fingers through both gravitational and centrifugal force. This warm-up works well for chilled hands no matter what the cause is.
Eat iron-rich foods. Lack of iron may alter your thyroid metabolism, which regulates body heat. That's what researchers at the USDA Human Nutrition Research Center in Grand Forks, North Dakota, suspect. They measured the effects of dietary iron on six healthy women when they entered a cold chamber. When the women took only 1/3 of the recommended amount of iron for 80 days, they lost 29 percent more body heat than when they were on an iron-replete diet for 114 days.
Iron-rich foods include poultry, fish, lean red meat, lentils, and leafy green vegetables. Orange juice is okay, too, since it increases the body's ability to absorb iron.
Dress smart to maintain your core body temperature. To keep warm, you have to dress warmly. Common sense, yes, but many people will slap on gloves and footwear without taking equal precautions to maintain their core temperatures, which is really more important.
Choose fabrics that wick away perspiration. Perspiration is an even bigger cause of cold hands and feet than temperature. Sweat is the body's air conditioner, and your body's air conditioner can operate in cold weather if you're not careful. The hands and feet are especially susceptible because the palms and heels (along with the armpits) have the largest number of sweat glands in the body. That's why the heavy woolen socks and fleece-lined boots you bought to keep your feet warm may instead make them sweaty and chilly.
Wear cotton-blend socks rather than pure cotton socks. You want to wear socks that wick moisture away from your feet and insulate them. All-cotton socks can soak up your perspiration and chill your feet. Those made of Orlon and cotton are a better choice.
Make sure garments are loose. You want to wear socks that wick moisture away from your feet and insulate them. All-cotton socks can soak up your perspiration and chill your feet. Those made of Orlon and cotton are a better choice.
Dress in layers. None of your garments should pinch. Tight-fitting clothes, whether they are nylons, garter belts, jeans, or shoes, can cut off circulation and eliminate insulating air pockets.
Dress in layers. If you're stepping out into the cold, the best warming measure you can take is to dress in layers. This helps trap heat and allows you to peel off clothes as the temperature changes. Your inner layer should consist of one of the new synthetic fabrics, like polypropylene, which wicks perspiration away from your skin. Silk or wool blends also are acceptable. The next layer should insulate you by trapping your body heat. A wool shirt is one of your best options.
Waterproof your body. Choose a breathable, waterproof jacket or windbreaker. Gore-Tex shoes and boots are the best choice for keeping your feet warm and dry.
Wear a hat. Another good piece of clothing you can wear to warm your hands and feet is a hat. Your head is the greatest site of body heat loss. The blood vessels in your head are controlled by cardiac output and won't constrict like those in your hands and feet.
If you want to keep your hands and feet warm, says John Abruzzo, M.D., director of the Division of Rheumatology and a professor of medicine at Thomas Jefferson University, it's as important to wear a hat as it is to wear gloves and socks.
Wear mittens. Mittens keep you warmer than gloves because they trap your whole hand's heat.
Try foot powder. Clothes aren't the only way to keep dry. "Absorbent foot powders are excellent for helping keep feet dry," says Marc A. Brenner, D.P.M., a private practitioner in Glendale, New York, and past president of the American Society of Podiatric Dermatology. But he cautions people with severe cold feet problems caused by diabetes and peripheral vascular disease to use a shaker can rather than an aerosol spray, since the mist from the spray can actually freeze your feet.
Don't smoke. Smokers set themselves up for cold hands and feet whenever they light up. Cigarette smoke cools you in two ways. It helps form plaque in your arteries and, more immediately, nicotine causes vasospasms that narrow the small blood vessels.
These effects can be especially hard on people with Raynaud's. "Raynaud's patients are sensitive even to other people's smoke," says Frederick A. Reichle, M.D., chief of vascular surgery at Presbyterian-University of Pennsylvania Medical Center.
Chill out to warm up. Staying cool and calm may help some people stay warm. Why? Stress creates the same reaction in the body as cold. It's the fight-or-flight phenomenon. Blood is pulled from the hands and feet to the brain and internal organs to enable you to think and react more quickly.
Calming techniques abound. Some, like progressive relaxation—in which you systematically tense, then relax the muscles from your forehead to your hands and toes—can be practiced at any time, in any place.
Eat a hot, hearty meal. The very act of eating causes a rise in core body temperature. This is called thermogenesis. So eat something before you go out to stoke your body's furnace. And eat something hot to give the stoking a boost. A bowl of hot oatmeal before your morning walk, a soup break, or hot lunch will keep your hands and feet toasty even in inclement weather.
Drink up. Dehydration can aggravate chills and frostbite by reducing your blood volume. Ward off the big chill by drinking plenty of fluids such as hot cider, herbal teas, or broth.
But pass on the coffee. Coffee and other caffeinated products constrict blood vessels. The last thing you want when you have Raynaud's syndrome is to interfere with your circulation.
Avoid alcohol. Don't be misled by the lure of a hot toddy, either. Alcohol will temporarily warm up your hands and feet but its detrimental effects outweigh its benefits as a hand and foot warmer.
Alcohol increases blood flow to the skin, giving you the immediate perception of warmth. But that heat is soon lost to the air, reducing your core body temperature. In other words, alcohol actually makes you colder. The danger comes from drinking an immodest amount and being subjected to unexpected cold for an extended period, which can lead to severe problems like frostbite.
PANEL OF ADVISERS
John Abruzzo, M.D., is director of the Division of Rheumatology and a professor of medicine at Thomas Jefferson University in Philadelphia, Pennsylvania.
Marc A. Brenner, D.P.M., has a private practice in Glendale, New York, is past president of the American Society of Podiatric Dermatology, and author of The Management of the Diebetic Foot.
Murray Hamlet is director of cold research at the U.S. Army Research Institute of Environmental Medicine in Natick, Massachusetts.
Donald McIntyre, M.D., is a dermatologist in Rutland, Vermont.
Frederick A. Reichle, M.D., is chief of vascular surgery at Presbyterian-University of Pennsylvania Medical Center in Philadelphia.