If you have unusually cold fingers or toes that often change color when exposed to the cold, you are likely one of the millions affected by Raynaud's syndrome. Conventional treatments often focus on symptom management, but an integrative and functional medicine approach can offer a more comprehensive solution. By addressing the underlying factors contributing to Raynaud's, better blood flow and clinical outcomes can be achieved.

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What Is Raynaud's? 

Raynaud's syndrome, also known as Raynaud's disease or Raynaud's phenomenon, is a condition that affects the blood vessels, particularly in the fingers and toes. It is characterized by episodic attacks of vasospasm, a sudden narrowing of the blood vessels, leading to reduced blood flow to the affected areas. The exact cause of Raynaud's syndrome is not fully understood, but it is believed to involve an overreaction of the blood vessels to cold temperatures or emotional stress. (19)

What Is the Difference Between Raynaud's Disease, Raynaud's Phenomenon, and Raynaud's Syndrome?

Raynaud's syndrome is a broader term that encompasses both primary Raynaud's disease and secondary Raynaud's phenomenon. 

Raynaud's disease, or primary Raynaud's, refers to the most common form of the condition. Raynaud's disease occurs on its own without an underlying medical condition causing it. The cause of primary Raynaud's is believed to involve an exaggerated response of the blood vessels to certain triggers, such as cold exposure, emotional stress, and dysglycemia. This form of Raynaud's is usually less severe and tends to have milder symptoms. (19)

Raynaud's phenomenon, also called secondary Raynaud's, occurs when the condition is associated with an underlying medical condition or factor. It is called a "phenomenon" because it is a manifestation or symptom of another primary condition. Underlying conditions that can cause secondary Raynaud's include autoimmune diseases, connective tissue disorders, vascular diseases, certain medications, occupational factors, infections, and smoking. Secondary Raynaud's often has more severe symptoms and may require additional medical attention to manage the underlying cause. (12, 13) 

Who Does Raynaud's Affect?

Raynaud's syndrome can affect individuals of any age, gender, or ethnicity. Raynaud's syndrome affects an estimated 5-10% of the general population. Women, people under age 30, and those with a family history of Raynaud's disease have an increased risk of developing the condition. (15) 

Raynaud's phenomenon usually affects people with another disease or who perform a job that puts repetitive pressure on their hands. Patients with concurrent autoimmune conditions, especially connective tissue diseases, are at a higher risk for developing Raynaud's phenomenon. About 90% of people with scleroderma and 33% with lupus also have secondary Raynaud's. The condition is also more common in people who work with vibrating tools (e.g., jackhammers, chainsaws) or are pianists and keyboard operators. (15) 

Raynaud's Symptoms

Raynaud's symptoms are episodic, associated with specific triggers. During an episode of Raynaud's syndrome, the affected areas, usually the fingers and toes, may turn white or blue in response to the reduced blood flow. In addition, the affected body part may feel cold or numb. As the blood vessels relax and blood flow is restored, the affected areas may turn red and throb or tingle. The episodes can vary in duration, ranging from minutes to hours, and severity. (15, 19)

How Does Raynaud's Syndrome Affect the Body?

Primary Raynaud's syndrome is not dangerous, although the symptoms can be uncomfortable and disrupt daily activities (15).

In contrast, secondary Raynaud's phenomenon can not only impact the quality of life, but it can cause damage to the circulatory system. Poor blood flow may lead to Chilblains (inflamed swollen patches and blisters), skin ulcerations, gangrene (tissue decay) on the hands and feet, and heart problems. (19)

Functional Medicine Labs That Can Help Individualize Treatment Options

Advanced diagnostic testing options enable doctors to uncover the underlying causes of Raynaud's syndrome and personalize the treatment approach, resulting in enhanced quality of life and clinical outcomes.

Autoimmune Screening

An antinuclear antibody (ANA) with extractable nuclear antigen antibodies (ENA) panel can detect immune proteins associated with various autoimmune diseases. 

Inflammatory markers erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are also often elevated in active autoimmunity and can be helpful in screening for and monitoring autoimmune activity. 

Cardiometabolic Screening

Dysglycemia, imbalanced blood sugar, can trigger the body's stress response and contribute to inappropriate vasoconstriction. Over time, chronic blood sugar and cholesterol elevations contribute to vascular disease and damage to the inner lining of blood vessels, exacerbating circulatory disorders. Tests, including a comprehensive metabolic panel (CMP), lipid panel, and diabetes panel, can screen for metabolic and cardiovascular diseases that may exacerbate Raynaud's symptoms and contribute to poor vascular outcomes.

Nutritional Assessment 

A micronutrient panel can be valuable in assessing Raynaud's syndrome by providing insights into the individual's nutritional status and identifying potential deficiencies or imbalances that could contribute to the condition. By evaluating key vitamins, minerals, antioxidants, and other micronutrients, the panel can help guide targeted interventions, such as supplementation or dietary modifications, to address identified deficiencies and optimize overall vascular health.

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Conventional Treatment for Raynaud's

Treatment for Raynaud's syndrome focuses on managing symptoms and preventing complications. This may involve lifestyle modifications such as avoiding cold temperatures, wearing warm clothing, and using hand warmers. In some cases, medications that help to relax blood vessels, such as calcium channel blockers, may be prescribed. (12)

Functional Medicine Treatment Protocol for Raynaud's

In addition to simple lifestyle modifications to avoid known triggers for Raynaud's episodes, a functional medicine approach also integrates a variety of complementary modalities to improve vascular health and function, reducing the number and severity of Raynaud's attacks. In addition to dietary modifications and targeted supplementation (discussed in more detail below), complementary and integrative medicine modalities backed by evidence to be efficacious in treating Raynaud's include thermal biofeedback and acupuncture. 

Therapeutic Diet and Nutrition Considerations for Raynaud's

Dietary strategies for treating Raynaud's should encompass heart-healthy, anti-inflammatory nutritional modifications that promote cardiovascular health and reduce the risk of autoimmune disease. Maintain a balanced diet rich in fruits, vegetables, complex carbohydrates, lean proteins, and healthy fats. A predominantly plant-based diet is rich in antioxidants, known to promote vascular health and reduce oxidative stress. 

Omega-3 essential fatty acids, found in fatty fish, walnuts, flaxseeds, and chia seeds, have anti-inflammatory properties, may improve blood circulation, and delay the onset of vasospasm in patients with primary Raynaud's when exposed to cold.

Warming foods, including ginger, oranges, and cayenne pepper, may induce chemical reactions to boost circulation and reduce Raynaud's symptoms. 

Avoidance and caffeine and alcohol can reduce the frequency and severity of Raynaud's attacks (19).

Supplements Protocol for Raynaud's

The following supplements are known to support vasodilation and improve blood flow to reduce the frequency and severity of Raynaud's symptoms.

Neo40®

Neo40® is a patented formula designed to increase nitric oxide production. Nitric oxide is a gaseous signaling molecule that supports endothelial function and prevents cardiovascular disease. Due to nitric oxide's vasodilatory effects, blood flow can be improved, potentially alleviating the symptoms associated with Raynaud's.

Loading Dose: dissolve two tablets on the tongue daily for 30-45 days

Maintenance Dose: dissolve one tablet on the tongue daily for at least six months

Magnesium

One study found that decreased serum magnesium levels were more common in women with primary Raynaud's than in healthy women. Magnesium is required to maintain smooth muscle relaxation in blood vessels. Additionally, the requirement for magnesium increases with physical and emotional stress, both known to trigger Raynaud's phenomenon. Furthermore, low magnesium levels can increase endothelial contractility when magnesium requirements are not met, exacerbating Raynaud's. (18) 

Dose: 250-1,000 mg daily

Duration: 6-12 months

Ginkgo

Ginkgo biloba extract may decrease vasoconstriction. A study showed that treatment with ginkgo extract reduced the number of Raynaud's phenomenon attacks per week by 56%. 

Dose: 120 mg three times daily

Duration: 10 weeks

When to Retest Labs

The interval at which labs are retested for patients treated for Raynaud's should be based on clinical necessity. For patients with primary Raynaud's and normal baseline testing, clinically monitoring patient symptoms should be sufficient in monitoring treatment efficacy. Labs should be repeated for patients with Raynaud's phenomenon based on the monitoring guidelines for specific underlying conditions.

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Summary

By harnessing advanced diagnostic testing and a holistic understanding of the body's interconnected systems, functional medicine offers tailored treatment options that go beyond symptom management for Raynaud's syndrome. Integrating lifestyle modifications, dietary strategies, supplements, and other therapeutic complementary interventions address the underlying imbalances leading to excessive vasoconstriction and symptoms of Raynaud's.