Raynaud's syndrome, cold, and eating disorders

As the cold season approaches, there have recently been a number of posts on feeling cold. The posts can be read here, here, and here. There's no doubt that those with eating disorders have a higher propensity to feeling cold more than others. This can be due to malnutrition, lack of sufficient body fat, or perhaps an increase in non-shivering thermogenesis.

There has not been much research indicating whether those with eating disorders have changes in this type of physiological occurrence to cold even with weight restoration or recovery. My personal feeling is that as recovery begins, the ability of cold tolerance gets somewhat better, but I'm not sure it completely ever goes away. It's sort of like the body changes permanently. That's just my own opinion through experience and talking to others.

Something else this topic reminded me of is Raynaud's Phenomenon, also known as Raynaud's Syndrome, or Secondary Raynaud's. From the Raynaud's Association webpage, Raynaud's is defined as:

Raynaud's (ray-NODES) is a disorder of the small blood vessels of the extremities, reducing blood flow. When exposed to cold, the blood vessels go into spasms, which may cause pain, numbness, throbbing and tingling. Emotional distress may also trigger such a response.

image: ohiohealth

Surprisingly, Raynaud's is more common than expected with 5-10% of the general population having this, and the prevalence higher in women than men. However, the majority of people never receive treatment due to mild symptoms or sloughing it off to just poor circulation or cold sensitivity. Raynaud's can, however, be potentially dangerous if symptoms are severe, causing ulcerations and even gangrene!

The most effected areas of Raynaud's are the fingers, toes, ears, and nose, though it can be seen in other body parts as well. Upon cold temperatures or stress, these extremities may turn white or blue. After warmth and relaxation, they will turn an exaggerated red color.

There is no formal cure for Raynaud's and treatment is limited to avoiding cold temperatures/warming up, medications (calcium channel blockers which dilate blood vessels), topical antibiotics if there are ulcers, and relaxation techniques.

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I remember in late high school and my early college years I experienced Raynaud's. At the time, I didn't have a clue about it other than my entire middle finger would turn this stark white color and lose sensation in cold temperatures. Eventually, I associated my cause of Raynaud's due to severe restriction. It's interesting, because I would show this to my parents or friends, and they never put two and two together like I did. As the eating disorder "evolved," the Raynaud's seemed to disappear as suddenly as it appeared. I don't know whether this will ever occur again, but in the back of my mind, it is an indicator that things are not right.

With experiencing this, I was also curious about whether others with eating disorders have had Raynaud's. Research is in this area is very sparse. I did find one case study about it with a young woman who presented simultaneously with both anorexia and Raynaud's. She received the standard eating disorder treatment of nutritional and counseling therapy as well as a calcium channel blocker for the Raynaud's and transdermal hormone replacement therapy for osteopenia and amenorrhea. Both anorexia and Raynaud's symptoms improved after treatment.

Case report

So I guess the take home message is that if your body extremities are turning white or various shades of blue, it is important to get it checked out whether it is simply due to an eating disorder or is idiopathic.