Raynaud’s Disease

Also indexed as: Raynaud’s Syndrome

Raynaud’s disease is a condition caused by constriction and spasms of small arteries, primarily in the hands after exposure to cold. Frequently, white or bluish discoloration of the hands (and sometimes toes, cheeks, nose, or ears) will occur after exposure to cold or emotional stress. The cause of Raynaud’s disease is unknown. A condition called Raynaud’s phenomenon causes similar symptoms, but it is the result of connective tissue disease or exposure to certain chemicals. The same natural remedies are used to treat both disorders.

Checklist for Raynaud’s disease

Rating Nutritional Supplements Herbs
2Stars Fish oil
Inositol hexaniacinate (vitamin B3)		  
1Star Evening primrose oil
L-carnitine
Magnesium		 Ginkgo biloba
See also:  Homeopathic Remedies for Raynaud’s disease
3Stars Reliable and relatively consistent scientific data showing a substantial health benefit.
2Stars Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
1Star An herb is primarily supported by traditional use, or the herb or supplement has little scientific support and/or minimal health benefit.

What are the symptoms of Raynaud’s disease? Fingers (generally not the thumb) or other affected parts of the body may feel numb or cold during an episode, and later, after warming, may become bright red with a throbbing painful sensation.

How is it treated? People with Raynaud’s disease are commonly advised to dress warmly during the winter and to avoid tobacco use and unnecessary exposure to cold, especially of the affected parts. Conventional treatment also includes medicines such as calcium channel blockers (e.g., nifedipine, diltiazem) and sympatholytic agents (i.e., drugs that interfere with the effects of certain types of nerve transmission, including reserpine, prazosin, doxazosin, terazosin, methyldopa, guanethidine, and phenoxybenzamine). In severe cases, sympathectomy (surgical interruption of sympathetic nerve pathways) may be recommended.

Lifestyle changes that may be helpful: Dressing warmly and wearing gloves or mittens often help prevent attacks of Raynaud’s disease. Individuals with Raynaud’s disease should not smoke, because nicotine decreases blood flow to the extremities. Women with Raynaud’s disease should not use birth control pills, as this method of contraception can adversely affect circulation.

Nutritional supplements that may be helpful: In a double-blind trial, supplementation with 12 large capsules of fish oil per day (providing 4 grams of eicosapentaenoic acid [EPA] per day) for 6 or 12 weeks reduced the severity of blood-vessel spasm in 5 of 11 people with Raynaud’s phenomenon.1 Fish oil was effective in people with primary Raynaud’s disease, but not in those whose symptoms were secondary to another disorder.

Inositol hexaniacinate—a variation on the B vitamin niacin—has been used with some success for relieving symptoms of Raynaud’s disease.2 In one study, 30 people with Raynaud’s disease taking 4 grams of inositol hexaniacinate each day for three months showed less spasm of their arteries.3 Another study, involving six people taking 3 grams per day of inositol hexaniacinate, again showed that this supplement improved peripheral circulation.4 People taking this supplement in these amounts should be under the care of a doctor.

Fatty acids in evening primrose oil (EPO) inhibit the formation of biochemical messengers (prostaglandins) that promote blood vessel constriction. A double-blind trial of 21 people with Raynaud’s disease found that, compared with placebo, supplementation with EPO reduced the number and severity of attacks despite the fact that blood flow did not appear to increase.5 Researchers have used 3,000–6,000 mg of EPO per day.

In one study, 12 people with Raynaud’s disease were given L-carnitine (1 gram three times a day) for 20 days.6 After receiving L-carnitine, these people showed less blood-vessel spasm in their fingers in response to cold exposure.

Abnormalities of magnesium metabolism have been reported in people with Raynaud’s disease.7 Symptoms similar to those seen with Raynaud’s disease occur in people with magnesium deficiency,8 probably because a deficiency of this mineral results in spasm of blood vessels.9 Some doctors recommend that people with Raynaud’s disease supplement with 200–600 mg of magnesium per day, although no clinical trials support this treatment.

Are there any side effects or interactions? Refer to the individual supplement for information about any side effects or interactions.

Herbs that may be helpful: Ginkgo biloba has been reported to improve the circulation in small blood vessels.10 For that reason, some doctors recommend ginkgo for people with Raynaud’s disease. One preliminary trial found that 160 mg of standardized ginkgo extract per day reduced pain in people with Raynaud’s disease.11 Larger clinical trials are needed to confirm ginkgo’s effectiveness for this condition. Ginkgo is often used as a standardized extract (containing 24% ginkgo flavone glycosides and 6% terpene lactones). Doctors who recommend use of ginkgo often suggest that people take 120–160 mg per day.

Are there any side effects or interactions? Refer to the individual herb for information about any side effects or interactions.

References:

1. Digiacomo RA, Kremer JM, Shah DM. Fish-oil dietary supplementation in patients with Raynaud’s phenomenon: a double-blind, controlled, prospective study. Am J Med 1989;86:158–64.

2. Aylward M. Hexopal in Raynaud’s disease. J Int Med Res 1979;7:484–91.

3. Holti G. An experimentally controlled evaluation of the effect of inositol nicotinate upon the digital blood flow in patients with Raynaud’s phenomenon. J Int Med Res 1979;7:473–83.

4. Ring EF, Bacon PA. Quantitative thermographic assessment of inositol nicotinate therapy in Raynaud’s phenomenon. J Int Med Res 1977;5:217–22.

5. Belch JJF, Shaw B, O’Dowd A, et al. Evening primrose oil (Efamol) in the treatment of Raynaud’s phenomenon: A double-blind study. Throm Haemost 1985;54(2):490–4.

6. Gasser P, Martina B, Dubler B. Reaction of capillary blood cell velocity in nailfold capillaries to L-carnitine in patients with vasospastic disease. Drugs Exptl Clin Res 1997;23:39–43.

7. Leppert J, Aberg H, Levin K, et al. The concentration of magnesium in erythrocytes in female patients with primary Raynaud’s phenomenon; fluctuation with the time of year. Angiology 1994;45:283–8.

8. Smith WO, Hammarsten JF, Eliel LP. The clinical expression of magnesium deficiency. JAMA 1960;174:77–8.

9. Turlapaty P, Altura BM. Magnesium deficiency produces spasms of coronary arteries; relationship to etiology of sudden death ischemic heart disease. Science 1980;208:198–200.

10. Kleijnen J, Knipschild P. Ginkgo biloba. Lancet 1992;340:1136–9 [review].

11. Clement JL, Livecchi G, Jimenez C, et al. Modifications vasomotrices des extrémités lors l’exposition à des conditions thermiques défavorables. Méthodologie et résultant de l’étude de l’extrait de Ginkgo biloba. Acutal Angiol 1982;7:3–8.