Raynaud's phenomenon is a little understood condition in which the fingers and toes show an exaggerated sensitivity to cold. Classic cases show a characteristic white, blue, and red color sequence as the digits lose blood supply and then rewarm. Some people develop only one or two of these signs.
The cause of Raynaud's phenomenon is unknown. It can occur by itself, as primary Raynaud’s (also called Raynaud’s disease), or as a consequence of other illnesses, such as scleroderma . In the latter case, it is called secondary Raynaud’s.
Conventional treatment consists mainly of reassurance and the recommendation to avoid exposure to cold and the use of tobacco (which can worsen Raynaud's). In severe cases, a variety of drugs can be tried.
Preliminary evidence supports the use of several natural supplements in the treatment of Raynaud’s phenomenon. Most of the positive evidence regards primary Raynaud’s.
In a 17-week, double-blind, placebo-controlled trial of 35 people with Raynaud’s, fish oil (taken at a dose that provided a total of 3.96 g of EPA and 2.64 g of DHA daily) reduced reaction to cold among those with primary Raynaud’s disease, but did not seem to help those with Raynaud’s caused by other illnesses. 2
In an 84-day, double-blind, placebo-controlled study of 23 people with primary Raynaud’s, use of inositol hexaniacinate significantly reduced the frequency of attacks. 1
The herb Ginkgo biloba has been found to increase circulation in the fingertips 6 and thus has been proposed as a treatment for Raynaud’s. A 10-week, double-blind, placebo-controlled trial of 22 people with primary Raynaud’s found that use of ginkgo at the very high dose of 120 mg 3 times daily reduced the number of Raynaud’s attacks. 8
One very small double-blind study found suggestions that evening primrose oil might help primary or secondary Raynaud’s. 4,5
A double-blind, placebo-controlled crossover trial of 10 individuals failed to find arginine at 8 g daily helpful for primary Raynaud’s. 7
A small double-blind trial tested the effects of a single dose of 2 g vitamin C on Raynaud’s caused by scleroderma and found no benefit. 9
Current evidence suggests that biofeedback is at most no more than marginally effective for Raynaud’s. 10,11 The same is true of acupuncture . 12
References
1. Sunderland GT, Belch JJ, Sturrock RD, et al. A double-blind randomised placebo controlled trial of hexopal in primary Raynaud’s disease. Clin Rheumatol . 1988;7:46-49.
2. DiGiacomo RA, Kremer JM, Shah DM. Fish-oil dietary supplementation in patients with Raynaud’s phenomenon: a double-blind, controlled, prospective study. Am J Med . 1989;86:158-164.
3. Ringer TV, Hughes GS, Spillers CR, et al. Fish oil blunts the pain response to cold pressor testing in normal males [abstract]. J Am Coll Nutr . 1989;8:435.
4. Belch JJ, Shaw B, O’Dowd A, et al. Evening primrose oil (Efamol) as a treatment for cold-induced vasospasm (Raynaud’s phenomenon). Prog Lipid Res. 1986;25:335-340.
5. Belch JJ, Shaw B, O’Dowd A, et al. Evening primrose oil (Efamol) in the treatment of Raynaud’s phenomenon: a double-blind study. Thromb Haemost . 1985;54:490-494.
6. Jung F, Mrowietz C, Kiesewetter H, et al. Effect of Ginkgo biloba on fluidity of blood and peripheral microcirculation in volunteers. Arzneimittelforschung . 1990;40:589-593.
7. Khan F, Litchfield SJ, McLaren M, et al. Oral L-arginine supplementation and cutaneous vascular responses in patients with primary Raynaud's phenomenon. Arthritis Rheum . 1997;40:352-357.
8. Muir AH, Robb R, McLaren M, et al. The use of ginkgo biloba in Raynaud's disease: a double-blind placebo-controlled trial. Vasc Med . 2002;7:265-267.
9. Mavrikakis ME, Lekakis JP, Papamichael CM, et al. Ascorbic acid does not improve endothelium-dependent flow-mediated dilatation of the brachial artery in patients with Raynaud's phenomenon secondary to systemic sclerosis. Int J Vitam Nutr Res . 2003;73:3-7.
10. Raynaud's Treatment Study Investigators. Comparison of sustained-release nifedipine and temperature biofeedback for treatment of primary Raynaud’s phenomenon. Results from a randomized clinical trial with 1-year follow-up. Arch Intern Med . 2000;160:1101-1108.
11. Freedman RR, Ianni P, Wenig P. Behavioral treatment of Raynaud's phenomenon in scleroderma. J Behav Med . 1984;7:343-353.
12. Hahn M, Steins A, Mohrle M et al. Is there a vasospasmolytic effect of acupuncture in patients with secondary Raynaud phenomenon? J Dtsch Dermatol Ges . 2005;2:758-762.
Last reviewed April 2009 by EBSCO CAM Medical Review Board
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