Cold hands: remember Raynaud’s disease

Dr Rhona MacDonald, freelance editor, (rhonamacdonald@gmail.com)

As all of northern Europe struggles through a continuous cold snap, many much relied on infrastructures, such as all forms of travel, have temporarily collapsed—a situation most prominent in the UK. Although much of the media has focused on the inability of a country’s infrastructure to cope with severe snowfalls and desperately low temperatures, what about the human body’s ability to cope? With temperatures frequently dropping to minus 10-20 degrees centigrade in countries not used to such temperature drops, population physiological changes are inevitable. After all, the health effects of thermal challenge are relative and not confined to countries within the Arctic Circle.

The effects of cold weather on health, especially those with pre-existing circulatory conditions, are well known. For example, heart attacks in the UK and USA are up to 50 % higher in the Winter than in the Summer. However, given the severity and duration of north Europe’s thermal challenge and the fact that individuals react differently to cold, people may be experiencing the physiological effects of thermal challenge, such as restricted capillaries and increased blood viscosity, for the first time. Such physiological changes can lead to a wide range of circulatory difficulties (with frostbite and hypothermia at the extremely severe end) and the risk of increased blood clotting in previously healthy individuals

Controlled thermal challenge in the clinical environment is one of the diagnostic tests for Raynaud’s disease —restricted peripheral capillaries of unknown cause or sometimes associated with connective tissue diseases such as systemic sclerosis (scleroderma) and systemic lupus erythematosis. As Raynaud’s disease is thought to be present in about 10% of western populations, especially among women, the uncontrolled thermal challenge of the current severe weather throughout northern Europe, may show the presentation of Raynaud’s disease —characteristic painful white/black/red finger tips and toes—in an individual, for the first time. There are many organisations, such as the  Raynaud’s and Scleroderma Association that provide free information and tips for keeping hands and feet warm.

Although not usually associated with an increase in mortality, as a small percentage of those thought to have Raynaud’s disease go on to develop a connective tissue disease, colds hand and feet can sometime be associated with severe morbidity—a fact worth remembering as the unusually cold weather continues to cause havoc with infrastructure and the human body.

Competing interest: RM has systemic sclerosis and Raynaud’s disease and is currently experiencing temperatures of up to -20 where she lives in Scotland.