Raynaud's phenomenon is a condition where blood vessels in the fingers and toes (and sometimes in the earlobes, nose, and lips) constrict. It is usually triggered by cold or by emotional stress. Episodes are intermittent and may last minutes or hours. Approximately 5 to 10 percent of the U.S. population is affected, and women are affected five times more often than men. It usually occurs between the ages of 20 and 40 in women and later in life in men.

• Changes in skin color in the fingers or toes and sometimes in the nose, legs, or earlobes (may occur in three phases: white, blue, then red)
• Throbbing, tingling, numbness, and pain
• Deterioration of the pads on fingertips or toes
• Gangrenous ulcers near fingertips

Risk factors for Raynaud's phenomenon include the following.

• Cigarette smoking
• Age in women (onset primarily between the ages of 20 and 40)
• Occupation (for example, using vibrating tools such as chain saws and jackhammers)
• Drug use, including some cancer drugs, narcotics, and over-the-counter cold medications
• Electric shock injury
• Previous frostbite
• Repetitive physical stress (for example, typing or playing the piano)
• Primary pulmonary hypertension
• Exposure to cold
• Psychological stress
• General medical conditions such as rheumatoid arthritis, scleroderma, systemic lupus erythematosus, and carpal tunnel syndrome

Your health care provider may conduct several laboratory tests, such as the antinuclear antibody test, to look for antibodies associated with connective tissue disease or other autoimmune disorders. If you have Raynaud's phenomenon, your provider will most likely begin with a conservative approach involving nondrug and self-help measures (for example, dressing warmly, avoiding the cold, controlling stress).

One of the most important preventive measures you can take is to stop smoking because nicotine shrinks arteries and decreases blood flow. Other preventive measures include the following.

• Protecting yourself from cold, especially outdoors in the winter
• Guarding against cuts and other injuries to affected areas
• Exercising, such as raising your arms above your head and then whirling them vigorously, to increase circulation

Several types of drugs are used to treat Raynaud's phenomenon. Calcium-channel blockers can reduce the frequency and severity of attacks. Vasodilators (drugs that open up blood vessels) are also recommended.

If attacks become extremely frequent and severe and interfere with your well-being and ability to work or function, a surgical procedure called sympathectomy may be used. This surgery becomes less effective as the disease advances.

• Vitamin E (400 to 800 IU per day) improves circulation and helps certain blood cells function well.
• Vitamin C (1,000 mg two to three times per day) supports connective tissue and reduces swelling.
• B-complex (50 to 100 mg per day) reduces stress.
• Coenzyme Q10 (100 mg two times per day) promotes healthy tissues.
• Calcium (1,500 mg per day) and magnesium (200 mg three times per day) relieves spasm.
• Omega-3 oils (1,500 mg two to three times per day) reduce swelling and help certain blood cells function well.
• Zinc (30 to 50 mg per day) boosts your immune system.

Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy, it is important to work with your provider on getting your problem diagnosed before you start any treatment. Herbs may be used as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, teas should be made with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots. Drink 2 to 4 cups per day. Tinctures may be used singly or in combination as noted. The following herbs are circulatory stimulants with other properties as well. Use one or more tinctures in combination. Take 20 to 30 drops two times per day.

• Hawthorn berries (Crataegus laevigata) strengthens and mildly dilates blood vessels
• Ginkgo (Ginkgo biloba) (120 to 160 mg per day for dried extracts) keeps blood cells from sticking together
• Rosemary (Rosmarinus officinalis) is a gentle relaxant
• Ginger root (Zingiber officianale) is a mild soothing agent
• Prickly ash bark (Xanthoxylum clava-herculis) enhances lymph activity and integrity of blood vessels

Homeopathy may be useful as a supportive therapy.

Acupuncture may be useful as an adjunct therapy.

Most milder cases can be brought under control through self-help measures.

Many drugs used to treat Raynaud's phenomenon can affect a growing fetus and should not be used by pregnant women.

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