Raynaud’s disease…are you at risk?

If your hands turn shades of white during times of stress, or with the slightest exposure to cold, there may be something else going on.

Circulation


Owen Wiseman
@AVogel_ca


15 January 2017

Generally thought to affect 3-5% of the population, Raynaud’s disease causes digital ischemic vasospasm. Digital comes from the Latin word, digitus, meaning finger or toe; ischemic from the Greek iskhaimos – stopping blood, and vasospasm – the sudden constriction of blood vessels. A cycle through white, progressing to blue and becoming numb, before changing to red with a tingling sensation is the most common presentation. These episodes can last upwards of 15 minutes until normal blood flow resumes. Understanding why these episodes occur is still far from a definitive answer, but researchers have ideas.

Blood vessels come in a variety of shapes and sizes throughout the body. Arteries carry oxygenated blood to the various tissues around the body. When these oxygenated red blood cells reach their destination, they provide oxygen to the tissues and take waste products, such as carbon dioxide and metabolites from chemical reactions, away from the tissue through a network of veins. The anatomy of the vessels resembles the branching pattern of a tree, progressively becoming smaller the further away from the heart they get.

Additionally, these vessels undergo changes in their diameter on a near-continuous basis due to numerable factors. When blood pressure changes, the brain detects this and sends a signal through the vascular nerve branches to cause either vasodilation or vasoconstriction, widening or narrowing of the vessels, respectively. The body accomplishes this through a layer of smooth muscle cells that surround the vessels.

In those affected by Raynaud’s, the vessels located in the hand inappropriately react to stimuli such as cold or stress, and rapidly undergo vasoconstriction. To put this in perspective, when those white flurries begin to fall from the sky, the last thing on your mind is shedding layers of clothing and laying down with your arms and legs spread wide. When you get cold, just as you bundle up and huddle close, your blood vessels constrict to conserve heat.

Throughout the research, women are disproportionally affected by Raynaud’s phenomenon.

One study analyzed postmenopausal women receiving estrogen replacement therapy and found that estrogen caused an increase in the incidence of Raynaud’s. Cold-induced vasoconstriction is mediated by certain receptors found in the blood vessels muscular wall. Estrogen has been shown to increase the expression of these receptors, and therefore, make women more susceptible to cooler temperatures and subsequent constriction of the blood vessels.

Does this explain the age-old truth of why dads ask who touched the thermostat, less estrogen? That is something humanity may never understand.

In another study looking at those with primary Raynaud’s, increased levels of a protein known as tyrosine kinase were present in their body, and related to greater vasoconstriction in response to cooling. When these participants were given a drug that decreased the release of the protein, they experienced a normalized response to a drop in temperature. Higher levels of tyrosine kinase circulating in the blood also showed to be present in those with secondary Raynaud’s, particularly in individuals who suffer from scleroderma, a connective tissue disorder.

Tips to manage Raynaud’s disease symptoms

There is still lots of research to be done, but as imaging techniques improve, researchers are able to witness a greater level of anatomical detail during an episode, and understand the condition better. In the meantime, here are a few tips to manage your symptoms:

  • Put the cigarette down. The detrimental impacts of smoking continues to grow daily. Components of the cigarette induce vasoconstriction in various areas of the body, and studies have shown that the hands are not spared from this. A lifestyle change could potentially reduce the severity and frequency of Raynaud’s episodes. There are lots of resources available to help reduce the frequency of smoking, and countless health benefits that will occur as a consequence.
  • Symptomatic relief. Ginkgo biloba is traditionally known as a circulatory tonic. It has the ability to dilate blood vessels through the active components known as polyphenols. The whole premise of Raynaud’s is vasoconstriction preventing the normal flow of blood through the hands, so dilating these vessels in beneficial. Another cause of a Raynaud’s attack is stress, and polyphenols also help in managing dangerous oxidants that form as a result of stress. Adding a little Ginkgo to your life is as easy as using Ginkgoforce.
  • Larger than life L-arginine. L-arginine is an important amino acid obtained from our diet. This increases the activity of an enzyme known as nitric oxide synthase. As the name of the enzyme implies, this synthesizes nitric oxide, increasing the level circulating in the body. Nitric oxide is a known vasodilator which could increase the blood flow in the hands. Foods such as turkey, pumpkin seeds, and peanuts all carry notable levels of the amino acid.

References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1873701/
https://www.ncbi.nlm.nih.gov/pubmed/9696729
https://www.ncbi.nlm.nih.gov/pubmed/10071480
https://www.ncbi.nlm.nih.gov/pubmed/12710841
https://www.ncbi.nlm.nih.gov/pubmed/15146428
https://www.ncbi.nlm.nih.gov/pubmed/15639062
https://www.ncbi.nlm.nih.gov/pubmed/15695304
https://www.ncbi.nlm.nih.gov/pubmed/17322645
https://www.ncbi.nlm.nih.gov/pubmed/17644575
https://www.ncbi.nlm.nih.gov/pubmed/28960445

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