Cold Hands, Cold Feet, Sluggish Thyroid?

A feeling of cold in the hands and/or feet -- or sensitivity to the cold -- is a common complaint in people with hypothyroidism. Typically, if you're a thyroid patient experiencing these symptoms, the cold sensitivity and cold extremities will decrease usually significantly after you've received appropriate treatment for your underactive thyroid.

But in some thyroid patients, symptoms continue. When cold hands and/or feet persist, you should be evaluated for Raynaud's syndrome. Raynaud's (sometimes also spelled Reynaud's) is also known as Raynaud's phenomenom. It's a disease that involves an interruption in the blood flow to fingers and toes (and sometimes nose and ears), due to spasms in the blood vessels.

An excellent review of the diagnostic tests for Raynaud's is featured in this Guide to Raynaud's.

Some common triggers for Raynaud's include:

• Going outside during frigid temperatures
• Holding an iced drink
• Walking into an air conditioned room
• Putting your hands in the freezer
• Putting hands under cold water
• Emotional stress

During a Raynaud's attack, the affected area typically turns white, and as oxygen fails to reach the extremities, they can turn blue. You may feel tingling or painful throbbing, and the affected area may swell. Symptoms can resolve quickly or may last for hours.

Raynaud's is a condition seen on its own, but also shows up as a "secondary" disease alongside other autoimmune diseases, including Hashimoto's disease, Graves' disease, lupus, Sjögren's Syndrome, scleroderma, and rheumatoid arthritis, among others.

Treatments

If your symptoms are due to Raynaud's, beyond proper thyroid treatment, avoiding or minimizing cold exposure is a key way to avoid symptoms. If you are a smoker, you should also stop smoking, as that is known to aggravate symptoms. Biofeedback treatments may also be a help for some patients.

Drug treatments can help, but the drugs used may have various side effects. Some of the drug treatments currently being used for Raynaud's include:

• Calcium channel blockers such as nifedipine (brand names Adalat, Nifedical, and Procardia)
• Angiotensin II inhibitors i.e., candesartan (Atacand), irbesartan (Avapro), losartan (Cozaar), and valsartan (Diovan).
• The antidepressant fluoxetine (Prozac)
• The vasodilator sildenafil (Viagra)

Sources:

Nielsen SL, et. al. "Myxoedema and Raynaud's phenomenon," Acta Endocrinol. 1982 Sep;101(1):32-4.

Pope, JE. "The diagnosis and treatment of Raynaud's phenomenon: a practical approach." Drugs. 2007;67(4):517-25.

Shagan BP, et. Al. "Raynaud's phenomenon in hypothyroidism." Angiology 1976 Jan;27(1):19-25.