{"id":28747,"date":"2021-04-23T09:30:39","date_gmt":"2021-04-23T13:30:39","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=28747"},"modified":"2021-04-26T15:16:17","modified_gmt":"2021-04-26T19:16:17","slug":"raynauds-treatment","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/raynauds-treatment\/","title":{"rendered":"Diagnosing and treating Raynaud&#8217;s disease"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">I first noticed that my body wasn\u2019t responding well to the cold when I was living in Vermont, where the average winter temperature is 22 degrees Fahrenheit. My fingers and toes turned red and purple; they became stiff and difficult to move. It took me three years, a visit to a specialist, and a trip to the lab before receiving a diagnosis of primary Raynaud&#8217;s disease.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Raynaud&#8217;s occurs when the small blood vessels in your extremities (including fingers and toes, but also nose and ears) contract in cold weather and cut off blood supply to your skin in the localized area. Despite this common and largely manageable symptom, Raynaud\u2019s can affect people differently. There are considerations for diagnosis and treatment of Raynaud\u2019s that can improve quality of life and even lengthen lifespan.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">Raynaud&#8217;s disease vs. Raynaud&#8217;s phenomenon<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">There&#8217;s not just one type of Raynaud&#8217;s. There are two categories you should know about (which are collectively known as Raynaud&#8217;s syndrome):<\/span><\/p>\n<ul>\n<li><b>Primary Raynaud&#8217;s<\/b><span style=\"font-weight: 400;\"> (also called Raynaud&#8217;s disease) occurs when there is no known underlying condition that contributes to the symptoms of Raynaud&#8217;s. This version is more common and typically more mild.<\/span><\/li>\n<li aria-level=\"1\"><b>Secondary Raynaud&#8217;s <\/b><span style=\"font-weight: 400;\">(also called Raynaud&#8217;s phenomenon) occurs when there is an underlying condition that contributes to the symptoms of Raynaud&#8217;s. Some examples of underlying medical conditions include scleroderma, <\/span><a href=\"https:\/\/www.singlecare.com\/conditions\/lupus-treatment-and-medications\"><span style=\"font-weight: 400;\">lupus<\/span><\/a><span style=\"font-weight: 400;\">, rheumatoid arthritis, and <\/span><a href=\"https:\/\/www.singlecare.com\/conditions\/carpal-tunnel-treatment-and-medications\"><span style=\"font-weight: 400;\">carpal tunnel syndrome<\/span><\/a><span style=\"font-weight: 400;\">. While less common, secondary Raynaud&#8217;s tends to be more severe.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">In both primary and secondary Raynaud&#8217;s, the key component is vasoconstriction (or the narrowing of blood vessels). The presentation is the same, with discoloration of the extremities of white, purple, and red as the blood flow cuts off and subsequently returns. However, only secondary Raynaud&#8217;s phenomenon has a traceable root cause.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">Diagnosing primary and secondary Raynaud&#8217;s<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">When looking for Raynaud&#8217;s symptoms, a healthcare provider may simply be able to see the white, purple, and red color changes on your digits through a physical exam. Otherwise, a physician may use a cold water test, where you place your hands and feet into ice water to see how skin reacts.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Because primary Raynaud&#8217;s has no known cause, the diagnosis process involves ruling out underlying conditions. &#8220;You can only be diagnosed with primary Raynaud&#8217;s after completely evaluating for other causes,&#8221; says <\/span><a href=\"http:\/\/pharmacytechscholar.com\/\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">Aaron Emmel<\/span><\/a><span style=\"font-weight: 400;\">, Pharm.D., the program director at Pharmacy Tech Scholar. &#8220;So you really have to rule out secondary Raynaud&#8217;s phenomenon before you can have a diagnosis of primary.&#8221; If you show signs of Raynaud&#8217;s, a doctor may do this by ordering blood tests.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">When diagnosing secondary Raynaud&#8217;s, healthcare providers are often dealing with autoimmune diseases. &#8220;The skin is a window to the inside in these autoimmune conditions,&#8221; explains Noreen Galaria, MD, board-certified dermatologist and owner of <\/span><a href=\"https:\/\/www.galariamd.com\/\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">Galaria Plastic Surgery &amp; Dermatology<\/span><\/a><span style=\"font-weight: 400;\">. Those who have these types of autoimmune disorders may be more inclined to experience sunburn, rashes, hair loss and\u2014of course\u2014Raynaud&#8217;s phenomenon.\u00a0\u00a0<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">How common is Raynaud&#8217;s?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Upwards of 20% of the world\u2019s population have either the primary form or secondary Raynaud\u2019s, according to <\/span><a href=\"https:\/\/www.nhsinform.scot\/illnesses-and-conditions\/heart-and-blood-vessels\/conditions\/raynauds-phenomenon\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">National Health Scotland<\/span><\/a><span style=\"font-weight: 400;\">. However, the estimates vary widely and the number may be much greater because only a portion seek treatment. Many may never notice symptoms because they are so mild or the person may live in a warm climate. (My own symptoms subsided for a full year when I lived in a tropical country.)<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Anyone can get Raynaud&#8217;s syndrome, but women are slightly more likely than men to develop symptoms of the health condition. Primary Raynaud&#8217;s tends to be diagnosed younger (between ages 15 and 30). Secondary Raynaud&#8217;s diagnoses tend to come later in life, typically <\/span><a href=\"https:\/\/www.pennmedicine.org\/updates\/blogs\/health-and-wellness\/2017\/december\/raynauds\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">between the ages of 35 and 40<\/span><\/a><span style=\"font-weight: 400;\">.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Sometimes, people who are diagnosed with primary Raynaud&#8217;s eventually receive a diagnosis of an underlying disease later in life. &#8220;\u200bIn my experience, about 10% of those with primary Raynaud&#8217;s go on to develop a secondary cause in the future,&#8221; Dr. Galaria says.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">What triggers Raynaud&#8217;s?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">There are many different factors that can cause a new onset of Raynaud\u2019s symptoms.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Medications<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Medicines that cause symptoms consistent with Raynaud&#8217;s are widespread. Drugs that cause vasoconstriction\u2014such as birth control or beta blockers\u2014often result in Raynaud\u2019s presentation. Or, the blood thinner Warfarin \u201ccan cause this distal ischemia that almost mimics Raynaud&#8217;s,&#8221; Dr. Emmel says.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">This reaction may happen for people with underlying Raynaud\u2019s. Or, it may simply mimic the symptoms. In those cases, once a patient ceases a drug that&#8217;s causing the condition, the symptoms are reversible. &#8220;Any time somebody&#8217;s got a new symptom of anything, the first thing that comes to my mind is, &#8216;Okay, review the medication list,'&#8221; says Dr. Emmel.\u00a0<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Smoking<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Smoking makes your blood vessels stiffen and contract, which can trigger symptoms. The <\/span><a href=\"https:\/\/www.cdc.gov\/tobacco\/data_statistics\/fact_sheets\/adult_data\/cig_smoking\/index.htm\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">CDC<\/span><\/a><span style=\"font-weight: 400;\"> reports that 14% of U.S. adults currently smoke tobacco, and so this raises the possibility that many people may experience Raynaud symptoms.\u00a0<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Moisture<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">For people who have Raynaud&#8217;s, moisture from sweat can cool the skin and activate symptoms. For example, if you wear warm socks, but the material doesn&#8217;t wick moisture, your sweat can then trigger a Raynaud&#8217;s attack.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Caffeine<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">For some, too much <\/span><a href=\"https:\/\/www.uofmhealth.org\/health-library\/hw180981\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">caffeine<\/span><\/a><span style=\"font-weight: 400;\"> also triggers attacks of Raynaud\u2019s.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">How serious is Raynaud&#8217;s?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Primary Raynaud&#8217;s disease likely won&#8217;t get <\/span><a href=\"https:\/\/www.health.harvard.edu\/a_to_z\/raynauds-phenomenon-a-to-z\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">worse with age<\/span><\/a><span style=\"font-weight: 400;\">, though it can last for a lifetime. For those with a secondary condition, you could be dealing with other symptoms of a rheumatic disease or injury down the line. That underlying illness could come with additional risks or reduction in life expectancy. For example, there is no cure for scleroderma (which is associated with Raynaud), though the <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/29573101\/\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">mean life expectancy<\/span><\/a><span style=\"font-weight: 400;\"> has improved to 74.5 years old.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Even primary Raynaud&#8217;s (which isn&#8217;t associated with an underlying condition) has risks. &#8220;If Raynaud&#8217;s goes unmanaged, the lack of blood flow to digits can lead to ulcers, necrosis, and\u2014in severe cases\u2014death of the digit, requiring amputation,&#8221; says Dr. Galaria.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Despite the fact that Raynaud&#8217;s most commonly affects the extremities, it can also affect your heart. In 2017, a <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/27870974\/\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">study<\/span><\/a><span style=\"font-weight: 400;\"> showed patients with Raynaud&#8217;s have low blood penetration in heart tissue, which can result in heart conditions down the line. However, not all have heart involvement, and many people manage their condition well through preventive techniques.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">How to treat Raynaud&#8217;s<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Despite the fact that Dr. Emmel is a pharmacist, he says, &#8220;It&#8217;s always best to start with any non-pharmacological therapies.&#8221; Most people choose to utilize lifestyle changes and holistic remedies rather than depending on full-time or seasonal medication.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Lifestyle changes<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">For primary and secondary Raynaud&#8217;s, preventive care is key. The following techniques can help keep symptoms at bay:<\/span><\/p>\n<ul>\n<li><b>Avoid cold weather. <\/b><span style=\"font-weight: 400;\">This can mean living in a warm climate, or staying indoors when the temperature drops.<\/span><\/li>\n<li><b>Keep yourself warm when you are outdoors<\/b><span style=\"font-weight: 400;\">\u2014and not just your digits. &#8220;I always tell my patients it&#8217;s important for them to keep their core warm,\u201d Dr. Galaria says. \u201cIf the body feels that it is warm centrally, it will more readily send blood to the extremities instead of constricting the small arteries in the fingers and toes.&#8221;<\/span><\/li>\n<li><b>Stay toasty indoors, too.<\/b><span style=\"font-weight: 400;\"> Use a heating pad, blanket, portable heater, or fingerless gloves in the house<\/span><\/li>\n<li><b>Wear gloves, socks, and hats made from moisture-wicking material,<\/b><span style=\"font-weight: 400;\"> such as merino wool. Consider using hand warmers inside of gloves or mittens.<\/span><\/li>\n<li><b>Hold or drink a warm beverage<\/b><span style=\"font-weight: 400;\"> such as decaffeinated tea or cocoa.<\/span><\/li>\n<li><b>Limit caffeine<\/b><span style=\"font-weight: 400;\">, which can constrict your blood vessels.<\/span><\/li>\n<li><b>Work on smoking cessation<\/b><span style=\"font-weight: 400;\">. This habit can constrict blood vessels.<\/span><\/li>\n<li><b>Place fingers and toes in a warm water bath.<\/b><span style=\"font-weight: 400;\"> Unlike frostbite, warm water improves Raynaud&#8217;s symptoms.<\/span><\/li>\n<li><b>Complete a medication review with your pharmacist<\/b><span style=\"font-weight: 400;\"> to ensure you\u2019re not taking anything that could constrict blood vessels. If necessary, look for alternatives to those medications.<\/span><\/li>\n<li><b>Avoid emotional stress.<\/b><span style=\"font-weight: 400;\"> Stress can cause blood vessel constriction. Addressing environmental stressors is important from a holistic standpoint.<\/span><\/li>\n<li><b>Consult with your healthcare provider about supplements that promote blood circulation, <\/b><span style=\"font-weight: 400;\">such as ganoderma lucidum, or <\/span><a href=\"https:\/\/nulivscience.com\/blog\/many-uses-reishi-mushroom\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">reishi<\/span><\/a><span style=\"font-weight: 400;\"> mushroom<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">If these techniques don\u2019t help to alleviate symptoms, there are other Raynaud\u2019s treatment options available.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Medications<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">If Raynaud&#8217;s is still impacting your quality of life after making lifestyle changes, you may want to seek pharmacological treatment. There are four main prescription options.<\/span><\/p>\n<h4><span style=\"font-weight: 400;\">1. Calcium channel blockers<\/span><\/h4>\n<p><span style=\"font-weight: 400;\">&#8220;Calcium channel blockers are generally the first line of therapy,&#8221; Dr. Emmel says, specifically dihydropyridine calcium channel blockers like amlodipine or nifedipine. These drugs are vasodilators, which means they dilate the blood vessels. &#8220;That dilation of the blood vessel may help blood flow into the fingers and toes and help relieve the symptoms,&#8221; explains Dr. Emmel<\/span><\/p>\n<h4><span style=\"font-weight: 400;\">2. Topical nitrates<\/span><\/h4>\n<p><span style=\"font-weight: 400;\">Your healthcare provider may also prescribe a topical nitrate, such as nitroglycerin. This treatment has minimal evidence supporting its efficacy, it can be messy, and it often causes headaches as a side effect. Despite its topical nature, nitroglycerin is rather strong and can lower your blood pressure a marked amount. However, some people can&#8217;t take calcium channel blockers and may be inclined to try it.<\/span><\/p>\n<h4><span style=\"font-weight: 400;\">3. Phosphodiesterase inhibitors<\/span><\/h4>\n<p><span style=\"font-weight: 400;\">There&#8217;s also a class of potent vasodilators called phosphodiesterase inhibitors, and one of these medications is more widely known under the brand name Viagra. &#8220;There&#8217;s minimal evidence\u2014but some evidence\u2014of benefit,&#8221; Dr. Emmel says.<\/span><\/p>\n<h4><span style=\"font-weight: 400;\">4. Botox<\/span><\/h4>\n<p><span style=\"font-weight: 400;\">Dr. Galaria adds that there is <\/span> <span style=\"font-weight: 400;\">another surprising treatment out there for Raynaud\u2019s: &#8220;Botox helps with vasodilation and may also inhibit some neurotransmitters, helping with mobility and decreasing the number of attacks.\u201d<\/span><\/p>\n<table class=\" singlecare-table\">\n<thead>\n<tr>\n<th><strong><span class=\"title\"> Medications that treat Raynaud\u2019s <\/span><\/strong><\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr class=\"header-row\">\n<td><span style=\"color: #ffffff;\"><b>Drug name<\/b><\/span><\/td>\n<td><span style=\"color: #ffffff;\"><b>Drug class<\/b><\/span><\/td>\n<td><span style=\"color: #ffffff;\"><b>How it helps<\/b><\/span><\/td>\n<td><span style=\"color: #ffffff;\"><b>Get coupon<\/b><\/span><\/td>\n<td><span style=\"color: #ffffff;\"><b>Learn more<\/b><\/span><\/td>\n<\/tr>\n<tr>\n<td><span style=\"font-weight: 400;\">Norvasc (amlodipine)<\/span><\/td>\n<td><span style=\"font-weight: 400;\">Dihydropyridine calcium channel blockers\u00a0<\/span><\/td>\n<td><span style=\"font-weight: 400;\">Dilates blood vessels<\/span><\/td>\n<td><a class=\"cta-button\" href=\"https:\/\/www.singlecare.com\/prescription\/amlodipine-besylate\"><span style=\"font-weight: 400;\">Get coupon<\/span><\/a><\/td>\n<td><a class=\"cta-button\" href=\"https:\/\/www.singlecare.com\/prescription\/amlodipine-besylate\/what-is\"><span style=\"font-weight: 400;\">Learn more<\/span><\/a><\/td>\n<\/tr>\n<tr>\n<td><span style=\"font-weight: 400;\">Nifedipine<\/span><\/td>\n<td><span style=\"font-weight: 400;\">Dihydropyridine calcium channel blockers\u00a0<\/span><\/td>\n<td><span style=\"font-weight: 400;\">Dilates blood vessels<\/span><\/td>\n<td><a class=\"cta-button\" href=\"https:\/\/www.singlecare.com\/prescription\/nifedipine-er\"><span style=\"font-weight: 400;\">Get coupon<\/span><\/a><\/td>\n<td><a class=\"cta-button\" href=\"https:\/\/www.singlecare.com\/prescription\/nifedipine-er\/what-is\"><span style=\"font-weight: 400;\">Learn more<\/span><\/a><\/td>\n<\/tr>\n<tr>\n<td><span style=\"font-weight: 400;\">Nitroglycerin<\/span><\/td>\n<td><span style=\"font-weight: 400;\">Topical nitrate<\/span><\/td>\n<td><span style=\"font-weight: 400;\">Dilates blood vessels<\/span><\/td>\n<td><a class=\"cta-button\" href=\"https:\/\/www.singlecare.com\/prescription\/nitroglycerin\"><span style=\"font-weight: 400;\">Get coupon<\/span><\/a><\/td>\n<td><a class=\"cta-button\" href=\"https:\/\/www.singlecare.com\/prescription\/nitroglycerin\/what-is\"><span style=\"font-weight: 400;\">Learn more<\/span><\/a><\/td>\n<\/tr>\n<tr>\n<td><span style=\"font-weight: 400;\">Viagra (sildenafil)<\/span><\/td>\n<td><span style=\"font-weight: 400;\">Phosphodiesterase inhibitors<\/span><\/td>\n<td><span style=\"font-weight: 400;\">Dilates blood vessels<\/span><\/td>\n<td><a class=\"cta-button\" href=\"https:\/\/www.singlecare.com\/prescription\/sildenafil-citrate\"><span style=\"font-weight: 400;\">Get coupon<\/span><\/a><\/td>\n<td><a class=\"cta-button\" href=\"https:\/\/www.singlecare.com\/prescription\/sildenafil-citrate\/what-is\"><span style=\"font-weight: 400;\">Learn more<\/span><\/a><\/td>\n<\/tr>\n<tr>\n<td><span style=\"font-weight: 400;\">Botox (botulinum toxin)<\/span><\/td>\n<td><span style=\"font-weight: 400;\">Neurotoxic protein<\/span><\/td>\n<td><span style=\"font-weight: 400;\">Dilates blood vessels<\/span><\/td>\n<td><a class=\"cta-button\" href=\"https:\/\/www.singlecare.com\/prescription\/botox\"><span style=\"font-weight: 400;\">Get coupon<\/span><\/a><\/td>\n<td><a class=\"cta-button\" href=\"https:\/\/www.singlecare.com\/prescription\/botox\/what-is\"><span style=\"font-weight: 400;\">Learn more<\/span><\/a><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><span style=\"font-weight: 400;\">In general, Emmel says, &#8220;All these drugs that you could use to treat it have caveats.&#8221; Patients should discuss drug interactions and drug-disease interactions with their healthcare provider before taking a specific medication.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>I first noticed that my body wasn\u2019t responding well to the cold when I was living in Vermont, where the average winter temperature is 22 degrees Fahrenheit. My fingers and toes turned red and purple; they became stiff and difficult to move. It took me three years, a visit to a specialist, and a trip [&hellip;]<\/p>\n","protected":false},"author":94,"featured_media":28732,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[8029],"tags":[790,12752],"coauthors":[19908],"class_list":["post-28747","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health-education","tag-chronic-disease","tag-medication-side-effects","wpautop"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Raynaud&#039;s treatment: Lifestyle changes and medication<\/title>\n<meta name=\"description\" content=\"Raynaud\u2019s disease and Raynaud\u2019s phenomenon occur when blood vessels in extremities contract. 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