Cold hands and feet? Here’s what the alarm­ing cause might be...

Daily Mail - - Good Health - By RICHARD WEBBER

CHElsEA Wood still laughs at the mem­ory of a pupil de­scrib­ing her as a real-life smurf. she was a teach­ing as­sis­tant in a West Mid­lands school and the tem­per­a­ture in the class­room dropped.

In sec­onds, Chelsea’s fin­gers turned dark blue, prompt­ing a nineyear- old to com­pare her to the car­toon char­ac­ters. ‘Af­ter I’d stopped laugh­ing, I ex­plained I had Ray­naud’s,’ she says.

The con­di­tion af­fects ten mil­lion peo­ple in the uK. It’s as com­mon as hay fever, but even some GPs don’t ap­pre­ci­ate its sig­nif­i­cance. The con­di­tion doesn’t just make you more sen­si­tive to tem­per­a­ture; it can be a warn­ing of serious health com­plaints such as rheuma­toid arthri­tis or thy­roid prob­lems.

Ray­naud’s makes the small blood ves­sels in the ex­trem­i­ties, such as fin­gers, toes, ears, nose and nip­ples, re­act ex­ces­sively to changes in tem­per­a­ture or emo­tional stress.

Mus­cles in the blood ves­sel walls con­tract, stop­ping blood flow. The skin in th­ese ar­eas turns white, then blue (as the trapped blood loses its oxy­gen) and lastly red as the ves­sels open wide to let blood rush back.

At­tacks last up to an hour. The pain and numb­ness make tasks such as but­ton­ing jack­ets and un­zip­ping purses dif­fi­cult.

Chelsea, now 26, was di­ag­nosed aged 15. But the un­der­ly­ing cause was not found for three years.

‘I al­ways had tingly fin­gers when I got cold, but they didn’t start go­ing blue un­til I was a teenager,’ says Chelsea, who lives in Dud­ley, West Mid­lands, with her hus­band Ian, a mo­tor­cy­cle me­chanic, and their 16month-old son, Toby.

‘My GP thought I’d grow out of it — but I didn’t,’ she says.

A Con­sulTAnTin 2007 pre­scribed nifedip­ine — a drug that opens blood ves­sels. It didn’t help, prob­a­bly be­cause her Ray­naud’s was caused by an­other con­di­tion.

When it oc­curs as a stand­alone prob­lem, it is known as Ray­naud’s phe­nom­e­non. This nor­mally starts soon af­ter pu­berty. Most suf­fer­ers are women and symp­toms may im­prove with age, par­tic­u­larly around the menopause.

In 10 per cent of cases an un­der­ly­ing is­sue causes the con­di­tion, though cold and stress are still the trig­gers. This is called sec­ondary Ray­naud’s.

Early di­ag­no­sis is crit­i­cal since the symp­toms, and the un­der­ly­ing cause, may get worse.

‘I was a county net­ball player, but Ray­naud’s pre­vented me play­ing out­doors be­cause I couldn’t feel the ball,’ says Chelsea. ‘In win­ter, even walk­ing be­came prob­lem­atic.’

In the early stages, sec­ondary and pri­mary Ray­naud’s ap­pear iden­ti­cal. sec­ondary is more likely if, for ex­am­ple, the pa­tient is male or if prob­lems emerge af­ter the age of 30 or af­fect just one side of the body.

sores on the skin and puffy fin­gers and toes can in­di­cate sec­ondary Ray­naud’s as they show dam­aged blood ves­sels.

In Chelsea’s case, the un­der­ly­ing prob­lem was an un­der­ac­tive thy­roid and an in­flam­ma­tory con­di­tion called mixed con­nec­tive tis­sue dis­ease.

This is like lu­pus and other au­toim­mune dis­eases, where the im­mune sys­tem at­tacks healthy tis­sue.

such con­di­tions can damage blood ves­sels and cause Ray­naud’s symp­toms.

An un­der­ac­tive thy­roid gland can be re­spon­si­ble be­cause it af­fects me­tab­o­lism and causes the body’s tem­per­a­ture to drop — a trig­ger for Ray­naud’s.

‘We en­cour­age GPs to refer pa­tients if they might have sec­ondary Ray­naud’s,’ says Dr John Paul­ing of the Royal na­tional Hospi­tal for Rheumatic Dis­eases. ‘un­der­ly­ing con­di­tions may re­sult in damage to the in­ter­nal or­gans,’ he says.

‘ De­lays in di­ag­no­sis may re­sult in poorer re­sponse to treat­ment.’

WHEn­none of the ves­sel-open­ing drugs worked for Chelsea, and some caused headaches or dizzi­ness, she took a range of tests.

Even­tu­ally, a blood test found her un­der­ly­ing con­di­tions.

Treat­ment for an un­der­ac­tive thy­roid in­volves re­plac­ing the thy­rox­ine hor­mone nor­mally pro­duced by the gland.

‘ When I started tak­ing thy­rox­ine I be­gan feel­ing bet­ter,’ says Chelsea.

‘But noth­ing has worked for my sec­ondary Ray­naud’s. In win­ter, I struggle to get out of the house.’

Any change of tem­per­a­ture can in­duce a Ray­naud’s at­tack, even in sum­mer.

‘At the supermarket, I use gloves to pick up boxes from the freezer. once I didn’t and when I was pay­ing at the till, the as­sis­tant asked: “Has a pen ex­ploded on your hands?” ’

Chelsea’s symp­toms im­proved when she was preg­nant, but re­turned af­ter Toby was born.

‘Ray­naud’s and the mixed con­nec­tive tis­sue dis­ease im­proved. Hav­ing a child gives you your own lit­tle heater.’

Ian helps with tasks Chelsea can’t do, such as walk­ing the dog in win­ter. And her son keeps her ac­tive and pos­i­tive.

‘Be­fore hav­ing Toby, there were win­ter days when I’d stay in bed. now I have some­thing more im­por­tant to fo­cus on.’

For more in­for­ma­tion, con­tact Sclero­derma & ray­naud’s UK on 020 3893 5998 or visit

Blue fin­gers: Chelsea Wood

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