Wednesday, October 29, 2008

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.


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.


Cammy said...

Remember what I told J., "hypothermia is so last year, the new trend is nonshivering thermogenesis." ;)

Great information, I had heard of Reynaud's around the boards in SF, but had never looked up the details, great post!

Cammy said...

One other thing, I wonder if anyone has looked at this in relation to caffeine consumption? Caffeine is a vasoconstrictor and can make your extremities cold.

Lisa said...

Ow ow ow. Being cold hurts me but not THAT much.

Kyla said...

Hmm, it does make sense that being cold persists even after weight restoration. I am definitely not as cold as I used to be, now that I am weight-restored, but I am still colder than I ought to be. interesting post.

Kyla said...

ps those poor penguins

Tiptoe said...

Cammy, yes, I remembered your nonshivering thermogenesis comment! It was cool to find an article that somewhat talked about it.

I haven't seen research on caffeine consumption and relevance to cold extremities other than if you get cold, to avoid caffeine. It would be interesting to see if there were any correlations.

Lisa, hopefully, it'll never get to that point either.

Kyla, yep, I think you're in the same camp as many of us--colder than we really should be.

As for the penguins, hopefully, they'll find a way to get warm. :-)

Anonymous said...

I've never posted before but I figured I would pipe in since I have experienced this. For the first time last winter I noticed to of my fingers would go completely white and numb every once in a while (usually after coming in from being out in the cold). It alarmed me so I had it checked out by my doc, who diagnosed it as Raynauds. She didn't say much about it, other than it is fairly common and other than keeping my hands warm, there wasn't much else I could do.

I've never been officially diagnosed with an ED, but at the time this started happening I was restricting pretty heavily and I myself attributed the Raynaud's to this.

I haven't experienced the numb fingers since the end of the last cold season...but as we just got our first snowfall yesterday, I am wondering if it will happen again. My guess would be yes.

Tiptoe said...

Anon, thanks for sharing your experience. It's hard to say whether it will happen again this winter. It probably depends on how your eating is if it is indeed secondary to an eating disorder.

Anonymous said...

I have no conclusive proof, but from what I feel in my body, I do feel physiologically different after an eating disorder. Some things, like an abnormally low body temp, low heart rate and low blood pressure have never gone away and I suspect they never will. I don't have Raynaud's, but my extremities are almost always ice-cold to the touch.

Tiptoe said...
This comment has been removed by the author.
Tiptoe said...

Charlynn, I think a lot of us may have this. It would be fascinating research to see what the prevalence was and if there were differences.

Anonymous said...

I agree! I'd love to see some statistics on this.

M. said...

Hey, just a few quick thoughts. One: if you have raynaud's it would probably help to avoid coffee due to its vasoconstriction properties. Two: There seems to be a lot out there about natural treatment for Raynaud's and some of it talks about it being a sigh of nutritional deficits. I am a nursing student and I have Raynaud's, it seems like there is not a lot of research out there on this disease.
I had to basically bend over bakwards to get a diagnosis (I am a curious mined person, I want to know what's going on inside me) and then when i asked what I could do about it, she said to "avoid the triggers". So I am looking to move out of Alaska when I graduate.
I do know that while I may think similar to someone with an eating disorder (same fears, irrational thoughts, obsessions), I eat like a horse. That is just to say, you can be gaining weight and still be feezing.
Here's to healthy eating and warm toes.

Tiptoe said...

M., thanks so much for your comments. Interesting about the nutritional deficiencies but makes sense too, especially if someone did have an eating disorder/disordered eating. Although you point out you eat well, and have Raynaud's.

I do wish there was more research done about it, just so people would be aware.

Good luck with nursing school. I've never been to Alaska, but my boss goes every year and helps with the Quest race.

Anorexia said...

Eating disorders should be given attention .This is a serious case and might lead to anorexia consequently, death.

Anonymous said...

i have an eating disorder, not diagnosed officially, unlike my raynauds an general freezing body.
a few years ago was when i was diagnosed with raynauds, i suppose a few months after my ed first appeared, although i'd been suffering from it for several years and my hands have gone white, blue or purple in the cold ever since i was about 7. it was worse with my ed though which was why i went to the doctors.
when i realised what i was doing to myself with my ed, having lost 30lbs, i pushed myself to recover and be healthy, gaining back 20lb. i didn't realise that in that time i was so much warmer and didn't go as blue as quick till i relapsed and relost that 20lb... now i can't even step out of my front door without my hands going blue. raynauds and anorexia do not go well together. neither do raynauds and smoking and a caffiene addiction

Anonymous said...


I have had raynauds for 7 years. It started when i was 21 with one finger turning white at the tip. Now at 28 I suffer with all fingers turning white, my nose running and unless I wear thick fleece socks and sheepskin boots my feet will also turn blue/white and go numb. I get attacks everyday, however can only treat it by wrapping up warm and avoiding the cold. Temperature change and cold wind is a nightmare.

My mother had it and I expect it is inherited, however she said it disapperared after she had a baby. I don't have children but thought this was weird. It really is the strangest condition and such a mystery. I do not have an eating disorder but I do fast each week intermittently. I have weighed as much as 11s 7lb and as low as 9s2lb and still have suffered with Raynauds. I exercise regularly to try and boost circulation and although have tried nifedipine my doc has not given me any more due to my low pulse. I find coffee a vice as it helps with low pulse and is bad for Raynauds!!!! I have also had irregular periods since i was 18... even went 14 months without one!

Does anyone else suffer with low pulse, amennorea, or anything else i've described. My doc is getting me to have an ECG next week to check nothing else is wrong but I am so fed up of this ruining my life in so many ways!