Cold hands and feet? Here’s what the alarming cause might be...
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.
AConsulTAnT in 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.’
WHEn none 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.’