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Dx Raynaud's Phenomenon Treatments:

Raynaud's Phenomenon

N.H.S. Choices
"Raynaud’s phenomenon is a common condition that affects the blood supply to certain parts of the body, usually the fingers and toes. It is often also referred to as Raynaud’s syndrome, Raynaud’s disease or just Raynaud's.

Why does it happen?
The condition occurs because your blood vessels go into a temporary spasm which blocks the flow of blood. This causes the affected area to change colour to white, then blue and then red as the blood flow returns.

Raynaud’s is usually triggered by cold temperatures or by anxiety or stress.

You may also experience pain, numbness and pins and needles in the affected body parts. Symptoms can last from a few minutes to several hours.

It is not a serious threat to your health but can be annoying to live with because it makes fine movements of the fingers difficult. People with Raynaud’s often go for long periods without any symptoms and sometimes the condition goes away altogether.

In many cases it may be possible to control the symptoms of Raynaud’s yourself by avoiding the cold, wearing gloves and using relaxation techniques when feeling stressed.

Stopping smoking can also help improve symptoms, as smoking can affect your circulation.

If you are unable to control your symptoms yourself, then a medication called nifedipine may be recommended.

Types of Raynaud's:
There are two types of Raynaud's. These are:
*primary – when the condition develops by itself (this is the most common type)
*secondary – when it develops in association with another health condition

Most cases of secondary Raynaud’s are associated with conditions that cause the immune system to attack healthy tissue (autoimmune conditions), such as:
*rheumatoid arthritis: when the immune system attacks the joints causing pain and swelling
*lupus: when the immune system attacks many different parts of the body causing a range of symptoms, such as tiredness, joint pain and skin rashes.

The causes of primary Raynaud’s are unclear. However one in 10 people with primary Raynaud’s will go on to develop a condition associated with secondary Raynaud’s, such as lupus.

Your GP can help to determine whether you have primary or secondary Raynaud's by examining your symptoms and carrying out blood tests.

Possible complications:
Secondary Raynaud’s can cause a more severe restriction of blood supply so it does carry a higher risk of causing complications such as ulcers, scarring and even tissue death (gangrene) in the most serious cases. However, severe complications are rare.

Medications Used in Treatment:
1. Calcium Channel Blockers: Norvasc®/amlodipine, Cardizem®LA/diltiazem er, Calan®SR Verelan®/verapamil er Procardia®XL/nifedical xl, nifedipine er, Plendil®/felodiipine,Tiazac®/diltzac, Adalat®CC Procardia®/ nifedipine, Sular®/ nisoldipine
2. Beta Agonists: isoxsuprine
3. Hyaluronic Acid: Perlane®

[Editor] Three case reports document that 1-2cc of Perlane®/hyaluronic acid were used to fill the dorsum (back) of each hands of women with mild Raynaud's Phenomenon. Thermagraphy in an ambient room setting identified two groups: 1) hand temperatures of 20*C (severe disease) and 2) hand temperatures of 30*C (mild disease). The Perlane® treatments were beneficial in two-thirds of the mild disease group and ineffective in the severe disease group.[Patent issued].

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*[Editor] One report suggests a therapeutic glove, another gingko biloba 120mg four times daily [although nifedipine was more effective], a third suggests 7-keto-DHEA may be helpful.

*[Editor] Helfman detailed that Stanazolol (which is a component of the mixed androgen injection) could be effective in some cases of Raynaud's phenomenon. A Yacoub documented that although women had more Systemic Lupus than men, androgens in the treatment of men with systemic lupus erythematosis the Russians have reported some decreased symptoms of their Raynaud's phenomenon.

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