Raynaud's Syndrome in People With Hypothyroidism

Primary and Secondary Raynaud's

Portrait of young woman with ?winter? gloves
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A feeling of cold in the hands and/or feet, or sensitivity to the cold, is a common complaint in people who have an underactive thyroid, known as hypothyroidism. Typically, experiencing the cold sensitivity and cold extremities will decrease significantly after you've received appropriate and optimal treatment for your hypothyroidism. 

However, for some people with thyroid disease, those cold-related symptoms continue. When cold hands and/or feet persist, it's best to get evaluated by your doctor as you may be experiencing another medical condition—called Raynaud's disease.

Definition of Raynaud's

Raynaud's disease refers to an interruption in the blood flow to fingers and toes (less common), due to abnormal spasms in the blood vessels.

Primary and Secondary Raynaud's

The cause of primary Raynaud's is unknown (often called Raynaud's phenomenon). This type is more common in women and may run in families.

Secondary Raynaud's implies that some underlying cause (for example, a disease, toxin, or injury) is leading to the abnormal blood vessel spasms.

Examples of diseases linked to secondary Raynaud's include:

Other conditions that directly affect the arteries (or nerves that control the arteries) in the hands and feet may cause Raynaud's, like carpal tunnel syndrome, atherosclerosis, or vasculitis.

Experiencing a Raynaud's Attack

Exposure to cold (or even emotional stress) is key to triggering a Raynaud's attack. Some common triggers for Raynaud's include:

  • Going outside during frigid temperatures
  • Holding an iced drink
  • Walking into an air-conditioned room
  • Putting your hands in the freezer
  • Putting hands under cold water

During a Raynaud's attack, the affected area typically turns white, sometimes blue, (as oxygen fails to reach the extremities). Then, as oxygen comes back into the tissues, the area turns red. 

In terms of sensations, your fingers or toes may feel cold and numb as blood flow to them is interrupted. You may feel tingling or painful throbbing, and the affected area may swell. As the attack ends and blood flow returns, fingers or toes may throb and tingle. Typically, the blood flow to the skin will remain low until the skin is rewarmed. After warming, it usually takes 15 to 20 minutes to recover normal blood flow to the skin.

Diagnosing Raynaud's

In addition to evaluation of your symptoms, your doctor may perform a cold stimulation test. In this test, a device that measures temperature is taped to your fingers, and then your hands are put into cold water. The device measures how quickly your fingers warm and return to regular temperature. A slow response can be a sign of Raynaud's. 

Another test that is sometimes done is called nailfold capillaroscopic. In this test, a drop of oil is applied to the base of your fingernail, which is then examined under a microscope to identify abnormal arteries that may be a sign of Raynaud's.

Several blood tests are also used to help diagnose Raynaud's, including: 

  • Antinuclear antibody (ANA), which looks for antibodies against cell nuclei, which can be a marker of autoimmunity
  • Erythrocyte sedimentation rate (ESR / rate), which can detect inflammation

Treatments for Raynaud's

If you have thyroid disease with Raynaud's, your first step should be to obtain optimal thyroid treatment. Another important step is to avoid or minimize cold exposure. 

Keeping your body warm, and particularly your extremities is an important preventive measure for Raynaud's. This also includes avoiding rapid and extreme temperature changes. Hats are often recommended, and thermal underwear, heavy woolen socks, and chemical hand or feet warmers in cold temperatures can provide extra protection. Wearing gloves before handling cold or frozen items and avoiding smoking (including secondhand smoke) is also recommended. 

For more severe cases, drug treatments may help. Some of the medications used for treating Raynaud's include:

  • Calcium channel blockers, such as Procardia (nifedipine) or Norvasc (amlodipine) 
  • Topical nitrates
  • The vasodilator Viagra (sildenafil)

Lastly, it's essential to make stress management a part of your daily life, because a poor response to stress is a known trigger for Raynaud's. Relaxation or stress management practices such as breathwork or meditation may be helpful to some Raynaud's sufferers. 

A Word From Verywell

While experiencing Raynaud's can be distressing and unpleasant, rest reassured there are things you can do to prevent attacks. Moreover, if you do end up needing medication, that is OK, too. You may simply require it intermittently, like during the cold months. 

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