Dale Hipps
2-18-11
Pathology research paper
Raynaud’s disease
Raynaud’s Disease
Raynaud disease is a vascular reaction in the fingers or toes to changes in temperature or emotional events. This reaction is known as vasospasm. It was medically identified in 1862 by a French physician named Maurice Reynaud. A typical Raynaud’s episode consists of the digits first turning white due to vasoconstriction causing a diminished blood supply and then blue, due to prolonged lack of blood and then red as the blood vessels re-open. This is most commonly initiated upon exposure to cold temperature. This cold temperature trigger could simply be stepping outside on a cold day, taking something out of the refrigerator, or spending a few moments in a air-conditioned room.
Raynaud’s disease is commonly divided into 2 categories. Raynaud’s apart from any other pathology is considered primary Raynaud’s, or Raynaud’s disease, and even sometimes referred to as idiopathic Raynaud’s. When Raynaud’s is associated with some other pathology it is considered Secondary Raynaud’s or Raynaud’s phenomenon. Raynaud’s occurs in 3-5% of the general population (5-10% in the U.K.). The phenomenon is more common in women than men, with the Framingham Study finding that 5% of men and 8% of women suffer from Raynaud Phenomenon. [1] Raynaud’s primarily affects the finger and toes, almost never the thumb, sometimes the ears and toes. [2] Raynaud’s has also occurred in breastfeeding mothers, causing nipples to turn white and become extremely painful during breastfeeding. [3]
There are several groups of disorders that tend to precipitate Secondary Raynaud’s. Autoimmune diseases, trauma, certain medications, and hyper-thyroidism can all precipitate secondary Raynaud’s. The autoimmune diseases include Systemic Lupus, Sclera Derma, and Rheumatoid Arthritis. Frost bite and excessive use of vibrating tools are primary traumatic precipitators. The list of individual medications is long, but in general they include estrogen, Beta blockers, and weight control medications.
Typically people with Primary Raynaud’s show no signs of any other cardiovascular disorder or circulatory disorder. “The anatomy of the digital arteries of these patients shows no variation from normal.”[4] There seems to be a strong link to the sympathetic response of the autonomic nervous system. As was noted in a 1980’s article in the British Medical Journal, “Raynaud himself considered that his phenomenon was due to excessive sympathetic activity; but in over 120 years this theory has never been substantiated and the many treatments directed towards minimizing sympathetic control of the vasomotor tone have given disappointing results.”[5] While this remains true for the most part, regarding treatment from the field of allopathic Medicine, there has been some measureable success for treatment among CAM modalities that attempt to exercise some control over the sympathetic nervous system. These treatments will be discussed later in the “treatment” section of this paper.
Both primary and secondary Raynaud’s episodes share common triggers, and avoiding these triggers remains the most effective and first line of defense in treatment. The first trigger is temperature and staying warm is the obvious remedy. However there does not seem to be a certain temperature that precipitates an episode, even on an individual basis. Patients interviewed shared in common that 60 degrees in the fall of the year would almost certainly trigger an episode while the same temperature at the end of winter most likely would not. Only a slight drop in the surrounding temperature will trigger an episode if the patient is anxious. Handling a vibrating tool or wearing tight fitting rings or arm bands can trigger an episode. Even gloves that fit to snugly, even though meant to prevent an episode by keeping the fingers warm can have the opposite effect. Both 1st and 2nd hand smoke can contribute to the severity and likelihood of a Raynaud’s reaction. The second major trigger is emotional stress. Emotional stress both increases the likelihood of a reaction to a physical trigger, i.e. cold, and also can trigger the onset of an episode by itself. Of those interviewed all reported that nervousness in a situation could cause a Raynaud’s reaction even in an otherwise temperate environment.
Diagnosing Raynaud’s
Diagnosis starts with a detailed medical history, evaluating the symptoms, and ruling out any other possible pathologies. Diagnosing Raynaud’s is relatively simple as the characteristic ischemia resulting in first pallor and then cyanosis and finally redness upon vasodilatation is unique. Diagnosing whether it is primary or secondary Raynaud’s however is not so easy. Often Raynaud’s is the first symptom of some other pathology, especially sclera derma. (See photos for the characteristic white patches on the fingers during an attack)
“ Nailfold capillaroscopy (study of capillaries under a microscope) can help the doctor distinguish between primary and secondary Raynaud’s phenomenon. During this test, the doctor puts a drop of oil on the patient’s nail folds, the skin at the base of the fingernail. The doctor then examines the nail folds under a microscope to look for abnormalities of the tiny blood vessels called capillaries. If the capillaries are enlarged or deformed, the patient may have a connective tissue disease.
The doctor may also order two particular blood tests, an antinuclear antibody test (ANA) and an erythrocyte sedimentation rate (ESR). The ANA test determines whether the body is producing special proteins (antibodies) often found in people who have connective tissue diseases or other autoimmune disorders. The ESR test is a measure of inflammation in the body and tests how fast red blood cells settle out of unclotted blood. Inflammation in the blood can cause an elevated ESR.” [6]
Treating Raynaud’s
Allopathic methods of treatment
Behavioral Therapy
Behavioral therapy such as cessation of smoking (the nicotine in cigarettes causes the skin temperature to drop, which may lead to an attack), avoidance of cold exposure, avoidance of caffeinated beverages, and the use of gloves (preferably mittens) are important initial interventions. If possible, certain medications should be avoided; these include estrogen without progesterone, beta blockers such as atenolol, metroprotol, and nadolol, and some medications used for weight control. There was an interesting study linking the use of estrogen and Raynaud’s in the Annals of Internal Medicine with the following conclusion: “…, we found an association between unopposed estrogen replacement therapy and the Raynaud phenomenon in postmenopausal women. This effect was not seen in women receiving combined hormone replacement therapy. We would not recommend that physicians change their treatment approaches on the basis of these preliminary results. Should our findings be confirmed, we would advise prescribing combined hormone therapy, not unopposed estrogen therapy, in postmenopausal women with established Raynaud phenomenon.”[7] In addition to the increased risk of estrogen treatment in postmenopausal women, the use of estrogen in birth control pills can also aggravate Raynaud’s according to a publication by the Mayo Clinic.[8]
Exercise as a preventative therapy
“Many doctors encourage patients who have Raynaud’s phenomenon, particularly the primary form, to exercise regularly. Most people find that exercise promotes overall well-being, increases energy level, helps control weight, and promotes restful sleep.”[9] In my own interviews exercise appeared to have no direct effect on the duration or frequency of Raynaud’s attacks. Strenuous exercise that involved the hands or feet however, could trigger an episode.
Medications used to help control Raynaud’s
A host of medications have been used to help control the frequency and severity of Raynaud’s episodes. These include calcium antagonists (calcium-channel blockers), alpha blockers, and meds for controlling blood pressure. People with secondary Raynaud’s phenomenon are more likely than those with those with the primary form to be treated with medications. According to an article regarding Raynaud’s by the APSFA, a foundation specializing in Antiphospholipid antibody Syndrome, “Many doctors believe that the most effective and safest drugs are calcium-channel blockers, which relax smooth muscle and dilate the small blood vessels. These drugs also can help heal skin ulcers on the fingers or toes.
Other patients have found relief with drugs called alpha blockers that counteract the actions of norepinephrine, a hormone that constricts blood vessels. Some doctors prescribe a nonspecific vasodilator (drug that relaxes blood vessels), such as nitroglycerine paste, which is applied to the fingers, to help heal skin ulcers. Patients should keep in mind that the treatment for Raynaud’s phenomenon is not always successful. Often, patients with the secondary form will not respond as well to treatment as those with the primary form of the disorder.
Patients may find that one drug works better than another. Some people may experience side effects that require stopping the medication. For other people, a drug may become less effective over time. Women of childbearing age should know that the medications used to treat Raynaud’s phenomenon may affect the growing fetus. Therefore women who are pregnant or are trying to become pregnant should avoid taking these medications if possible.”[10] Specific calcium antagonists are Amlodipine, Felodipine, and Nifedipine. Alpha blockers include prazosin (Minipress) and doxazosin (Cardura). Of those I personally interviewed, one used both of these types of medications without any noticeable improvement, and negative side effects she did not disclose.
An article from the staff at the Mayo Clinic wrote the following regarding the use of vasodilators in the treatment of Raynaud’s. “Some doctors prescribe a vasodilator, a drug that relaxes blood vessels, such as nitroglycerin cream to your fingers to help heal skin ulcers. Your doctor may also prescribe vasodilator drugs that are commonly used to treat other conditions, but may effectively relieve the symptoms of Raynaud’s. These drugs include the high blood pressure drug losartan (Cozaar), the erectile dysfunction medication sildenafil (Viagra), the antidepressant medication fluoxetine (Prozac), and a class of medication called prostaglandins.”[11] The following article appeared in Medical News as did a host of other articles in other publications in November of 2005 regarding the treatment of Raynaud’s with the drug sildenafil (Viagra):
“Raynaud’s phenomenon is characterized by spasms in the small blood vessels of the hands and feet in response to cold or stress, and results in poor circulation and pain. In extreme cases the disorder can also lead to ulceration or tissue death in the toes and fingers. Until now the condition has been difficult to treat as it does not generally respond to conventional therapy. The investigators report that in patients with ulcers on their fingers or toes, the treatment leads to healing. Originally Viagra was developed to treat male erectile dysfunction, and is a phosphodiesterase inhibitor that affects very small blood vessels, but studies have shown it improves circulation in other conditions, such as coronary artery disease.
In their research Dr. Roland Fries and colleagues, from Gotthard-Schettler-Klinik in Bad Schonborn, Germany, monitored 18 patients with severe Raynaud’s phenomenon that had failed to respond to at least two other drugs. They were randomly assigned 50 mg of Viagra twice daily for 4 weeks or a placebo for 4 weeks, followed by a “washout” period of 1 week with no treatment; then the groups switched treatments. According to their report, Viagra reduced the frequency of Raynaud’s attacks (35 versus 52), attack duration(581 versus 1046 minutes) and Raynaud’s phenomenon scores (2.2 versus 3.0). In the six patients who had chronic toe or finger ulcerations, the sores healed significantly during active treatment, disappearing completely in two patients. However the sores reappeared or progressed again after treatment with Viagra was stopped. The team says that treatment with this class of drugs promises a new approach for patients with microcirculatory disorders.”[12]
The drug Pentoxifylline improves the flow of blood through blood vessels. It works by making the red blood cells more pliable. While it is prescribed for leg cramps and other circulatory disorders it is also used for treatment of Raynaud’s. Respondents on a drug review site reported a 50% success rate when using Pentoxifylline to control the symptoms of Raynaud’s.[13]
Digital Sympatectomy
Digital Sympatectomy is a surgery that strips out the sympathetic nerves along the sides of the base of the fingers. Only the tiny nerves that surround the blood vessels are removed. This is a last resort treatment that has questionable benefits and is employed only in extreme cases. According to Dr Yee, Professor of Medicine, Weill Cornell Medical College, “Digital sympathectomies/advential strippings are salvage procedures that should be considered only when more conservative therapies for Raynaud’s phenomenon – such as behavioral modification (especially smoking discontinuation), vasodilators, anticoagulants, and other non-invasive interventions – have been tried and failed or when there is a particular digit that appears to be imminently at risk for loss of tissue. Even after surgery, these therapies should continue to be employed.”[14]
CAM methods for treatment
Biofeedback
Bio feedback boasts the highest success rate of all treatments for Raynaud’s. Bio feedback practitioners claim an 80-90% rate of success in reducing the incidence of Raynaud’s symptoms. Similar to other treatments it seeks to modify the effect of the sympathetic nervous system. Instead of using a medication like an alpha blocker to reduce the effect of the sympathetic nervous system, bio feedback helps an individual mentally exercise control over their own autonomic nervous system. It works by using an electronic device to monitor the sympathetic nervous system and then instructs the patient how to avoid a sympathetic response. An electric device such as the GSR (galvanic skin response devise) is worn on the hands. This devise monitors moisture changes on the skin by measuring change in electrical conductance. Since the sweat glands are controlled by the sympathetic nervous system and sweat increases the conductivity of the skin the GSR can be used to alert the patient of sympathetic nervous system activity. This is the same sort of technology used in a lie detector test. Once the patient is alerted of a slight increase in their stress level by the GSR, they can respond by employing a relaxation technique such as deep breathing or meditation (visualization) to avert a sympathetic response, and ultimately a Raynaud’s episode. Typically a patient will receive 20 or more hours of training from a bio feedback practitioner to control the vasodilatation in their extremities. [15]
Reconditioning (hydrotherapy)
This unique form of hydrotherapy, developed by U.S. Army Research Institute of Environmental Medicine, like bio feedback, attempts to retrain the sympathetic nervous system. “If you periodically submerge your hands in a tub of warm water while standing in a cold room, you can retrain you’re your body to warm up rather than cool down when it’s exposed to a cool environment.”[16] The following procedure was recommended by Murray Hamlet, director of research, plans and operations at the U.S. Army Research Institute of Environmental Medicine.
* Fill two buckets or Styrofoam coolers with water of about 100◦ F
Place one container in a cold area such as outdoor patio and the other in a warm room.
* Dressed lightly, in the warm room, immerse both your hands in the water for two to five minutes.
* Wrap your hands in a towel and go to the cold area. Again put both hands in the 100◦F water—this time for ten minutes.
* Return indoors and put both hands in the 100◦F water for two to five more minutes .
* Repeat procedure three to six times a day, every other day.
Many people who try the submersion technique experience remission of Raynaud’s after only a few repetitions, notes Dr. Hamlet. Some people, however, may need to repeat the procedure as often as 40 to 50 times over the course of several days.[17]
Herbal treatments
Ginkgo biloba
With many herbal treatments it is difficult to find any definitive studies evaluating their effectiveness, but this is not the case with ginkgo biloba. The results of a frequently referenced, double-blind placebo-controlled trial were published in the November 2002 edition of Vascular Medicine. The text read as follows: “Raynaud’s phenomenon (RP) is a common and painful condition characterized by episodic digital ischemia produced by emotion and cold. Treatment of RP is notoriously difficult because of the high incidence of side effects. The aim of our study was to investigate the clinical efficacy of a standardized ginkgo biloba extract (Seredrin) in the treatment of RP in patients with no apparent, associated condition such as systematic sclerosis.
A two week assessment period was done during which patients were asked to record frequency, severity and duration of attacks in diaries. Subjects were then randomized independently of the study centre to receive either active or placebo treatment for two weeks, during which time the same data were recorded in their diaries. Patients were seen after two and four weeks of treatment and at the end of the 10 week treatment phase. Blood samples pre- and post-treatment were taken for haemorrheology.
Only in the number of attacks per day was there a significant effect of treatment over placebo. The number of attacks per week prior to treatment with Seredrin was 13.2>16.5 reducing to 5.8>8.3, a reduction of 56%, whereas placebo reduced the number by only 27% (p<0.00001). There were no significant differences in haemorrheology between the two groups.
Ginkgo biloba phytosome may be effective in reducing the number of Raynaud’s attacks per week in patients suffering from Raynaud’s disease.”[18]
Ginkgo biloba is almost universally recommended by herbalists for the treatment of Raynaud’s.
Dr. Andrew Weil also recommends 120 to 240 mg per day of ginkgo to help increase circulation in the fingertips for those with Raynaud’s.[19]
Magnesium
The Blue Shield health insurance company of California has developed a rating system of supplements and other cam modalities based on their own extensive research. There are 3 levels, and only those treatments deemed viable are rated. Magnesium received their lowest rating indicating that there are no conclusive studies and only indirect or testimonial evidence indicating magnesium as a treatment for Raynaud’s they reported the following. “Abnormalities of magnesium metabolism have been reported in people with Raynaud’s disease. Symptoms similar to those seen with Raynaud’s disease occur in people with magnesium deficiency, probably because a deficiency of this mineral results in spasm of blood vessels. Some doctors recommend that people with Raynaud’s disease supplement with 200-600 mg of magnesium per day, although no clinical trials support this treatment.”[20]
“The mineral magnesium is known for relaxing smooth muscle, the kind that lines the insides of blood vessels. ‘Magnesium can counter the inappropriate activation of the sympathetic nervous system,’ says Jay Lombard, M.D., assistant medical professor of neurology at Weill Medical College of Cornell University in Ney York City and co-author of The Brain Wellness Plan. Instead if shutting down, the blood vessels may be encouraged to open up when they are under the influence of magnesium.
Take 1,000 milligrams of magnesium a day, Dr. Lombard recommends. One form that he suggests is magnesium gluconate, which won’t give you the diarrhea that may be caused by other forms. Avoid magnesium oxide or magnesium chloride, he advises.”[21]
Further, one study indicated that magnesium levels in women Diagnosed with Raynaud’s showed seasonal fluctuations in magnesium levels, with significantly lower levels in the winter months than in the summer.[22]
Evening Primrose Oil
The following 1985 study of evening Primrose showed promise of mitigating symptoms of Raynaud’s.
“Prostaglandin E1 (PGE1) and prostacyclin have been used in Raynaud’s phenomenon (RP) but are unstable and require intravenous administration. An alternative approach is to stimulate the body’s own PGE1 production via administration of the precursor essential fatty acid. We studied the effect of 12 capsules/day of evening primrose oil (EPO) on the manifestations of Raynaud’s. Twenty one patients received a two week course of placebo, thereafter 11 received EPO for 8 weeks and 10 patients received placebo. As the weather worsened the placebo group experienced significantly more attacks than the EPO group. Visual analogue scales assessing severity of attacks and coldness of hands improved in the EPO group. No changes were seen in either group in hand temperatures and cold challenge plethysmography. Blood tests showed some antiplatelet effects of the drug .In conclusion patients receiving EPO benefited symptomatically. This was not matched however by any change in objective assessment of blood flow, although changes in platelet behavior and blood prostanoids were observed.”[23]
Other studies indicate that Omega-3 and gamma-linoleic acid (an omega-6 fatty acid found in evening primrose oil and borage oil) have been shown to help relieve symptoms of Raynaud’s fish oil is also a good source of Omega-3. “Fish oil also improved tolerance to cold exposure, as evidenced by significantly increased blood pressure in the fingers. Almost half of the people who ingested fish oil did not exhibit symptoms of Raynaud’s in response to a cold water bath (DiGiacomo RA et al 1989)”[24]
Saint John’s Wart
Saint John’s Wart is recommended for treatment by many herbalists including Nicholas Schnell of Four Winds Natural Healing Center in Omaha Nebraska. The active ingredient in Saint John’s Wart is hypericin which is believed to aid in elevating the levels of serotonin and dopamine in the brain. It is also believed to slightly suppress adrenal activity. As Raynaud’s is a sympathetic nervous system reaction, decreasing adrenal activity should also reduce frequency and severity of Raynaud’s episodes. Saint John’s Wart has received a lot of attention for treatment of depression as well as Raynaud’s over the last 15 years, but clinical trials remain inconclusive, some studies indicate positive results while others show results equal to the placebo.[25]
Other Herbal Treatments
The following herbs were recommended by various herbalists as having benefits for those with Raynaud’s the benefits of these herbs could be either direct or generally supportive.
Jethro Kloss Liniment is recommended by herbalist Nicholas Schnell. The liniment is used because of it’s warming, stimulating, anti-inflammatory qualities. It is also used to increase circulation.
Ginger is recommended by herbalist Lisa Barger for use in diminishing the effects of Raynaud’s due to its ability to increase circulation by dilating blood vessels.[26]
Hawthorn berry is also recommended by Lisa Barger for its anti-inflammatory properties. She cites a 2005 study on animals that indicated Hawthorn berry as an effective means of increasing circulation.[27]
Cayenne is recommended by Clinical herbalist David Hoffmann. He recommends making an ointment and applying this ointment directly to the affected fingers or toes to improve circulation.[28]
Water!! “Dehydration can aggravate chills and frostbite by reducing your blood volume. Ward off the big chill by drinking plenty of fluids such as hot cider, herbal teas or broth.”[29]
Indian snakeroot (Rauwolfia serpentina) “This herb contains the chemical reserving, which opens (dilates) the blood vessels. It has often been used to treat Raynaud’s disease, according to medicinal herb expert Walter Lewis, Ph. D., professor at Washington University in St. Louis, and Memory Elvin-Lewis, Ph.D., authors of Medical Botany.”[30]
Garlic is recommended on many websites for treatment of Raynaud’s for its properties in improving circulation.
Warning!
It is important to note that many herbs interact with prescription medicines, and a doctor should be consulted before using.
Ayurvedic Treatment
The following was written by Ayurvedic Dr. A.A. Mundewadi who is Chief Ayurvedic Physician at Mundewadi Ayurvedic Clinic based at Thane, Maharashtra, India. “The Ayurvedic treatment of Raynaud’s disease is aimed at reducing the number and severity of attacks, preventing tissue damage and treating any underlying condition. To prevent the spasm of the arteries, medicines from the ‘Rakta-Prasaadak’ category are used in this condition. These include Saariva (Hemidesmus indicus), Manjishcha (Rubia cordifolia), Chopchini (Smilax china), Suranjaan (Colchicum luteum)), Mundi (Sphaeranthus indicus), Khadeer (Acacia catechu), Guduchi (Tinospora cordifolia), Haridra (Curcuma longa), Daruharidra (Berberis aristata), Mahamanjishthadi Qadaha, Saarivasav, Arogya-Vardhini, Panch-Tikta-Ghrut-Guggulu and Kaishor Guggulu.
To prevent over-reaction of the blood-vessels to stress, medicines like Brahmi (Bacopa monnieri), Jatamansi (Nardostachys jatamansi), Shankhpushpi (Conbolvulus pluricaulis), Vacha (Acorus calamus) and Sarpagandha (Raulwofia srepantina) are used. From this category of medicines, the herb Mandukparni (Centella asiatica) deserves special mention, since it not only reduces stress, but also improves blood circulation in the extremities,thereby reducing spasm, and preventing or healing ulcers.”[31]
Regenerative treatments
Massage
Most treatment of Raynaud’s is focused on managing episodes and many doctors indicate taking measures to halt a Raynaud’s attack as quickly as possible due t the potential tissue damage caused by the diminished blood supply. In some severe cases the damage is significant causing legions and in some cases gangrene. While the importance then for regenerative measures would appear obvious, little work has been done in this area. Increasing blood to the affected digits is necessary for this regeneration to take place. While massage during a vasospasm is not indicated due to the fragile state of the capillaries and the potential damage massage might cause, massage is indicated to help restore damaged tissue. Receiving full body Swedish massage has not rendered any measurable success in this regeneration or in episode prevention in my own experience. Giving massage, on the other hand, has proven a powerful regenerative tool. During the 8 weeks that I gave 4 or 5 daily Swedish massage treatments at least 4 days a week, I noticed significant tissue regeneration in my hands. This was in the form of improved color, tighter skin, increased finger plumpness and increased rate of nail growth. It is difficult for me to asses if the frequency of Raynaud’s episodes was affected as outside the massage room the environment was normally prime for aggravating a Raynaud’s attack. In the subsequent 2 months I gave 5 Swedish massage treatments only one day per week. This resulted in overall decline in tissue health, indicating the need for frequency in administrating massage to maintain tissue health given a constant rate of Raynaud’s attacks.
Paraffin, Antioxidants
One web site that gave extensive information on Raynaud’s suggested the use of hot paraffin treatments for regeneration of tissue. This same site recommended the use of anti-oxidants. “Although the causes of RS have remained mysterious, researchers understand the damage cascade that RS can touch off. During episodes of RS, high levels of free radicals are generated that damage the inner lining of arteries (endothelium) and surrounding tissue. The use of antioxidants in treating RS is based on research studies that showed that levels of important antioxidants (such as vitamin E, vitamin C, and selenium) are depleted in patients who have RS.”[32]
L-Arginine
“L-Arginine has been shown to reverse tissue damage caused by RS and improve symptoms in subsequent attacks (Rembold C et al 2003). Studies on L-arginine are mixed, with some showing efficacy and others showing no effectiveness.”[33] There are some adverse affects in taking L-arginine in specific situations and the following guidelines should be followed.
· Do not take L-arginine if you have the rare genetic disorder argininemia.
· Consult your doctor before taking L-arginine if you have cancer. L-arginine can stimulate growth hormone
· Consult your doctor before taking L-arginine if you have kidney failure or liver failure.
Consult your doctor before taking L-arginine if you have herpes simplex. L-arginine may increase the possibility of recurrence.[34]
The effects of diet on Raynaud’s
The following article published on the web site for Raynaud’s and Scleroderma association or U.K. by Gareth Zeal was so inclusive on this subject that I wanted it to be included in its entirety.
“We have all been encouraged to eat more fruit and vegetables but there are many foods which can positively influence Raynaud’s and a couple, which might have a slight beneficial effect on scleroderma.
For those who find their Raynaud’s is uncomfortable, not to say painful, magnesium can play a very important role. It is an essential mineral and found in abundance in green foods; one particularly rich source is pumpkin seeds. Typically our diet and lifestyle deplete magnesium at an alarming rate such as any white food, including rice, bread, pasta, sugar, biscuits, and cakes. This can be exacerbated by stress, poor sleep patterns and excessive exercise. Try to ensure that you have a least one leafy green vegetable daily. You could try keeping a bag of pumpkin seeds in the car or at your desk, where they are infinitely preferable to a sugary snack. Some individuals will need a magnesium supplement, ideally taken twice daily to ease the discomfort of Raynaud’s.
General health advice has suggested that all our hearts would be healthier if we ate a piece of oily fish one to three times a week (not everyone enjoys fish so for them a fish oil supplement 3 to 6g a day would be appropriate). For strict vegetarians or those with an allergy to fish, oil from sea buckthorn is a wonderful alternative. Oily fish helps overall circulation and the benefits can be enhanced with the addition of garlic, ginger and cayenne pepper. Not everyone enjoys seasoned food but they may enjoy ginger tea. If none of the above foods have any appeal, then the herb ginkgo biloba becomes almost essential. It is one of the few herbs where the activity can be measured a few hours after ingestion. There are numerous studies showing its benefits for circulation, including Raynaud’s. For those who climb the stairs, and upon reaching the top, can’t remember why they are there; then ginkgo is almost certainly the herb for you. Long-term use of ginkgo has been shown to ease the symptoms of age-related depression and reduce the risk of erectile dysfunction.
Talks from nutritionists tend to focus on the negative, what we can’t or shouldn’t eat. It is probably more helpful to focus on the positive e.g., the benefits of fresh pineapple as it contains an enzyme called bromelain. This enzyme is a powerful anti-inflammatory; it can also help us digest protein rich foods. Two or three slices a day can help reduce the risk of varicose veins, recovery from injury or surgery, while enhancing circulation. Pineapple is one of the few foods that may help with scleroderma. There is also a compound known as beta-glucan, which was once abundant in our diet being found in various grains and beer. Today its role in scleroderma is speculative, but there is good reason to believe it may be helpful.
We can all improve our diet and feel the benefits. Even the best diet in the world can be enhanced with appropriate supplementation.
Gareth Zeal is one of the UK’s leading experts in the field of nutrition and naturopathy and has over 20 years experience at advising patients on the benefits of good nutrition and natural medicine.”[35]
Undocumented testimonials and suggestions
“Let me suggest warm soup (for Raynaud’s.) I recommend vegetarian minestrone liberally spiced with garlic, mustard, plus oils of borage, currant and evening primrose.”[36]
“I started adding 2 drops of Grapefruit Seed Extract to my lemon juice (1 oz) and water (24 oz). I have not had a Raynaud’s episode since. Works for me.”[37]
Sources
As part of my preparations for this paper I interviewed 3 other individuals besides myself that all have Raynaud’s. I am male, 48 years old, in good health, and have Secondary Raynaud’s precipitated by frostbite. The other three are all female; they are 48, 49, and 23 years old. All consider themselves to be in good health; two of these women have primary Raynaud’s, and one secondary Raynaud’s with Scleroderma the primary disease. The following questions were asked.
1. At what age were you diagnosed with Raynaud’s
2. Do you have primary or secondary Raynaud’s
3. If secondary, what is the primary disease?
4. What parts of your body are affected by Raynaud’s
5. Are all these parts affected evenly and if not which more than others?
6. What triggers a Raynaud’s attack for you?
7. Does stress have an effect, and if so how much?
8. Does exercise have any effect?
9. What treatments have you tried?
10. What was the success of these treatments?
11. Were there side effects?
12. Have you tried any alternative medical treatments?
13. Would you be interested in learning about possible alternative treatments?
14. Would you like to receive a copy of this report?
Information gleaned from these interviews has been interspersed throughout this paper with reference to “those interviewed”. None have tried any alternative medical treatments, and all were interested in receiving this report.
[3]Holmen OL, Backe B (2009). "An underdiagnosed cause of nipple pain presented on a camera phone". BMJ 339: b2553
[4] British Med Journal 1980 October 18; 281(6247): 1027–1028.
[5] British Med Journal 1980 October 18; 281(6247): 1027–1028.
[7] Liana Fraenkel, MD, FRCPC, MPH; Yuqing Zhang, DSc; Christine E. Chaisson, MPH; Stephen R. Evans, BA; Peter W.F. Wilson, MD; and David T. Felson, MD, MPH Annals of Internal Medicine 1 August 1998 • • Volume 129 • Number 3
[18] doi: 10.1191/1358863x02vm455oa Vasc Med November 2002 vol. 7 no. 4 265-267
I had my first outbreak of Herpes virus nearly 4 years ago. Of all the horridness, the pain and itching were unbearable. I literally freaked out as my general physician said that it had no cure. The outbreaks were not that frequent initially, but every time I fall sick, it would resurface. I had so many sores this year that I was desperate to try anything to get rid of them. Three months ago a friend suggested that I try Dr sikama remedy that's helping people get cured from HSV, COUGHING, HIV&AIDS, GENITAL HERPES, SNEEZING, HEPATITIS B, CANCER e.t.c. I quickly ordered the product and started using the remedies. I'm so relieved to say that I've not had even one outbreak for a whole month now. Moreover, I'm feeling great from within. I truly endorse this herbs product Dr sikama render to me. So if you are suffering from any deadly disease you can also contact this great man on his email: Drsikama@gmail.com call/WhatsApp:+2348130725051
ReplyDeleteGreat Piece of work, thank you for sharing....i disagree with the dietaty section as there is much evidence that high fatty foods, and porcessed oils, ie oil that is seprted from its source, is bad for the vascualr system which in turn cant be good for Raynauds...I will try the sypathetic nervous system methods described as they look very promising...I am alos interested in uropathy as a solution...please let me know how your progress has been.
ReplyDelete