Ten years ago, Nicole Poole, 28, started to notice that her hands and feet were almost always cold, especially in the winter. She dismissed her discomfort until 1996, when she approached her physician about her worsening symptoms. Poole’s doctor diagnosed her with Primary Raynaud’s phenomenon, a disorder that is also known as “cold hands disease” or “white finger.”
Primary Raynaud’s phenomenon affects between 5 and 15 percent of Americans, most of whom are women of child-bearing age. Primary Raynaud’s is not the result of another disease and its cause is unknown. Some experts believe that people who suffer from Raynaud’s have an irregularity related to their blood vessels’ thermal regulation. A response to cold weather and stress may cause the vessels to clamp down, keeping blood away from the skin and causing a cold, moist sensation in the hands and feet.
Prior to diagnosis, Poole thought she just had colder hands and feet than other people. “In the winter my hands and feet would become very cold very quickly, no matter how warm my socks were or how dry my feet were. It got to the point where it was painful or uncomfortable. That was what provoked me, actually, to ask the doctor about it.”
Many people with Primary Raynaud’s experience milder symptoms than Poole and never seek medical attention for their condition. She has come across people at business meetings and social events who notice the coldness and clamminess of her hands and ask her if something is wrong. When she explains her disorder, some people confide that they have the same symptoms but never thought of consulting a doctor about them.
As Poole’s experience suggests, many people don’t know what Raynaud’s phenomenon is. Most people can relate to cold fingers and toes, but what sets them apart from people with Raynaud’s is the frequency and intensity of the coldness. Poole reports cold, white feet even when she wears wool socks in the winter. She recommends wearing absorbent cotton-blend socks under the wool socks to keep the feet dry and warm, since Raynaud’s causes her feet to sweat. She also wears mittens or gloves during the winter, even when the temperature is not exceptionally low. She has noticed that putting mittens on earlier in the season, and sometimes wearing two pairs at a time, can alleviate her Raynaud’s symptoms.
Treatment for this disease is mainly common sense – if you’re cold, you should wear mittens and socks. So why should a person consult a doctor if Raynaud’s phenomenon is suspected? Because, in some patients, the disorder can become so painful and disruptive that a blood thinner may be required to counteract it. Poole is not currently taking medicine for her Raynaud’s, even though her physician recommended baby aspirin for acute episodes. She said that her pain has always been bearable and she does not want to take medication that she feels is unnecessary.
Some experts see a connection between Raynaud’s and estrogen levels; some estimates indicate that up to 25 percent of young women are affected by this disorder. In women, the level of the hormone estrogen, which apparently helps to regulate blood vessels, drops at the onset of menopause. A study published by the Annals of Internal Medicine indicated that women past menopause who took estrogen replacement therapy were more likely to have Raynaud’s than women who either did not take estrogen or took a combination of hormones.
Poole is relieved to hear that although Raynaud’s is usually seen in younger women, it seems to diminish when estrogen levels fall. “If it got worse, I’d probably have to alter some things. But it’s been pretty consistent since I noticed it and I don’t find it getting worse or better as the years go on. I’m glad to hear that it sometimes goes away.”