Triggers and Risk Factors
Raynaud’s phenomenon attacks are usually triggered by cold temperatures or emotional stress (Herrick 2012). However, it is important to know that Raynaud’s phenomenon can be triggered not simply by exposure to cold, but also by a temperature change – for example, moving from a warm environment to an air conditioned room, and sometimes even holding a cold bottle, can trigger the events. Therefore, vasoconstriction attacks may occur at any time of the year, not only during the cold season (Goundry 2012).
Alcohol consumption and smoking may influence Raynaud’s risk. One study that included middle-aged participants found an increased risk in women with high alcohol consumption. On the other hand, moderate alcohol consumption was associated with a reduced risk in men, but it appeared that smoking could attenuate this effect. However, moderate red wine consumption reduced the risk in both men and women (Suter 2007). This may be because red wine contains phytochemicals (namely resveratrol) that support blood vessel health; although some researchers suggest this compound may be of benefit for individuals with Raynaud’s, studies have yet to evaluate its effectiveness (Simonini 2000).
Secondary Raynaud’s phenomenon appears when there is an underlying condition, and in these situations, it is always necessary to identify the causative disease. The diseases most frequently associated with Raynaud’s phenomenon are systemic sclerosis and scleroderma; Raynaud’s phenomenon may be the first indication of the primary disease in up to 90% of these cases (Devulder 2011; Harding 1998). Other conditions that can cause secondary Raynaud’s phenomenon include systemic lupus erythematosus (SLE), inflammatory muscle disease, Sjögren’s syndrome, Buerger’s disease, and vasculitis (Herrick 2012).
Raynaud’s phenomenon may also occur as a side effect of certain medications, including beta-blockers, ergotamines (used for migraines), interferon alpha, cyclosporine (a drug that suppresses the immune system), and certain chemotherapy drugs, such as vinblastine, bleomycin, and cisplatin (Vogelzang 1981; Stewart 2012). In addition, gemcitabine, a drug used to treat several cancers, was associated with ischemia in the fingers, and the authors of a 2010 study recommended caution when using this drug in patients who previously had Raynaud’s phenomenon or are known to have peripheral arterial disease (Kuhar 2010).
Other causes of Raynaud’s phenomenon include hypothyroidism (low thyroid hormone levels), carpal tunnel syndrome, certain cancers (which may increase the viscosity of the blood and make blood flow more difficult), thoracic outlet syndrome (in which nerves and blood vessels of the upper extremities are compressed between the collar bone and the first rib), atherosclerosis, frostbite, and hand-arm vibrations from operating certain machines or tools (Herrick 2012; Stewart 2012; Thompson 2012).