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Originally published Sunday, February 24, 2008 at 12:00 AM

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Yours in Health

What to do about poor circulation in fingers

Q: Over the past 10 years, I have noticed that when it's cold out, my fingers get really cold and then turn white. Eventually, they get warm...

Special to The Seattle Times

Q: Over the past 10 years, I have noticed that when it's cold out, my fingers get really cold and then turn white. Eventually, they get warm again, but it seems to take at least 15 minutes. It's been happening more this winter when I go outside without gloves on, and it also happens when I go to the freezer section of the grocery store. My doctor told me I have Raynaud's syndrome and that I should just avoid getting cold. Is there anything else I can do?

A: Normally, when a person gets exposed to the cold, the blood vessels in his extremities, including hands and feet, constrict. If this happens too much or for too long, we call it Raynaud's syndrome. It's basically an exaggerated response of your blood vessels to getting cold, although it can also happen when people feel stressed or nervous.

Generally, with Raynaud's syndrome, fingers and toes will turn white or blue within a few minutes of being exposed to cold, often starting with the middle or index fingers. As they warm up, the fingers may turn red. It can take about 20 minutes for the skin to return to normal.

Most of the time, Raynaud's syndrome happens in otherwise healthy people, especially women. However, sometimes it is associated with other medical conditions, such as autoimmune diseases. Not everything that looks like Raynaud's really is. So if you suspect you have Raynaud's, I recommend that you see your doctor for an evaluation to be safe.

For treatment, the first step is to make some lifestyle changes. Be sure you dress warmly, wearing a hat if needed, and gloves in cold environments. If you have symptoms, try running your hands under warm water or swinging your arms like a windmill to get your circulation going. Avoid smoking, which can cause your blood vessels to clamp down more. Some medications, such as decongestants, migraine treatments and diet pills, can worsen the problem because they also cause blood vessels to constrict.

If the lifestyle measures aren't working, your doctor may recommend prescription medication. The most common are calcium channel blockers, which are also used to lower high blood pressure. They help the blood vessels to dilate and, as a result, sometimes cause people to feel dizzy or faint. For severe symptoms, there are other medications as well.

As for natural options, one study of people with Raynaud's found that taking 3.96 grams of EPA (eicosapentaenoic acid) from fish oil improved their tolerance of cold exposure and delayed the onset of symptoms.

There are two downsides, though: Too much fish oil can thin your blood, so, as usual, I wouldn't recommend taking it without talking to your doctor first. Second, researchers didn't see a benefit for people whose Raynaud's syndrome was related to other medical conditions. This may be because when Raynaud's stems from an autoimmune disease or another medical problem, it can be more severe and harder to treat.

Another study found that taking ginkgo over 10 weeks lowered the number of attacks by 56 percent. Side effects of ginkgo include bleeding and allergic reactions, so again, talk to your doctor before using it.

Dr. Astrid Pujari is a Seattle M.D. with an additional degree as a medical herbalist; she practices at the Pujari Center and teaches as part of the residency programs at Virginia Mason and Swedish/Cherry Hill hospitals. Send questions to apujari@seattletimes.com for possible use in a column. All information is intended for education and not a substitute for medical advice. Consult your doctor before following any suggestions.

Copyright © 2008 The Seattle Times Company

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About Yours in Health
Dr. Astrid Pujari is a Seattle M.D. with an additional degree as a medical herbalist; she practices at the Pujari Center and teaches as part of the residency programs at Virginia Mason and Swedish Providence hospitals.

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