Raynaud syndrome (aka Raynaud’s phenomenon, Raynaud’s disease or simply Raynaud’s) is a relatively common condition, yet many people know little about it. Indeed, it is common enough, affecting around 4% of the population; and, in many instances, the symptoms are mild enough that most people find it to be more a minor inconvenience. However, not all instances of Raynaud’s are mild, and in a lot of cases can be related to rather serious autoimmune disorders and connective tissue diseases.
What is Raynaud syndrome?
Raynaud syndrome is a medical condition where a spasm of the arteries causes episodes of reduced blood flow. The smaller arteries that supply blood to your skin narrow, which limits blood circulation to affected areas (called vasospasm). This can result in cold fingers or toes, pins and needles, color changes in the skin, pain, migraines, numbness, and a prickly feeling, swelling and stinging pain when the hands or feet are warmed. Skin sores and, in rare instances, developing gangrene are a possibility.
Cold weather, handling cold objects, smoking and anxiety can all trigger Raynaud’s. Medications such as beta-blockers, migraine medications containing sumatriptan or ergotamine, some chemotherapy agents (e.g. bleomycin), stimulant-based ADHD drugs, anthrax vaccines and some over-the-counter cold medications (usually those containing pseudoephedrine) can cause or aggravate Raynaud’s. Typical age of onset is between 15 and 30 years-old. Episodes can last anything from a few minutes to several hours. Those who live in cold climates are more susceptible to Raynaud’s.
There are two forms of Raynaud’s disease: primary and secondary.
Primary Raynaud’s – Where the disease is idiopathic, as in, the symptoms of Raynaud’s occur on their own and are not the result of another underlying condition. Primary Raynaud’s mostly affects women, and develops in their teens or young adulthood. Primary Raynaud’s is thought to be partly hereditary, although the precise cause is not fully known yet. Caffeine, nicotine, estrogen, non-selective beta-blockers and birth control pills can all be aggravating factors as well.
Secondary Raynaud’s – Also known as Raynaud’s phenomenon. Occurs due to an underlying health problem. Secondary Raynaud’s can cause complications with other conditions, and can potentially be more dangerous. Raynaud’s phenomenon can be one of the first presenting symptoms of another condition. Causes of secondary Raynaud’s include:
- Connective tissue & autoimmune diseases – Lupus, rheumatoid arthritis, Ehlers-Danlos syndrome, dermatomyositis, polymyositis, cold agglutinin disease, mixed connective tissue disease and Sjogren’s syndrome are all associated with Raynaud’s. Most people who have scleroderma – a condition that causes hardening of the skin – develop Raynaud’s.
Eating disorders such as anorexia nervosa can cause Raynaud’s.
- Diseases of the arteries, such as atherosclerosis, Buerger’s disease and primary pulmonary hypertension can all cause Raynaud’s.
- Repetitive actions and vibrations which result in overuse injuries can cause Raynaud’s.
- Multiple sclerosis.
- Carpal tunnel syndrome.
- Injuries such as fractures or frostbite.
The above is a short list of the conditions that can cause Raynaud’s syndrome.
How is Raynaud’s syndrome currently treated?
Other than avoiding the cold, some people with Raynaud’s are prescribed calcium channel blockers/agonists (e.g. NIFEdipine). In some cases prostacyclins (vasodilators used also for pulmonary arterial hypertension) such as iloprost or epoprostenol are used. Calcium blockers seem to be more effective for secondary Raynaud’s than for primary Raynaud’s. Sildenafil, aka Viagra, is also sometimes used as it is a vasodilator.
How does cannabis help for Raynaud’s disease?
There are few studies into the use of cannabis for Raynaud’s disease, but there are some anecdotal reports and an underlying logic as to some of the reasons why cannabis and cannabinoids can be used to treat Raynaud’s disease (in particular secondary Raynaud’s). These reasons include:
- Tetrahydrocannabinol (THC) acts as a vasodilator, helping open up the arteries. The terpene pinene is also potentially helpful for its vasodilatory effects.
- Raynaud’s is often associated with other autoimmune conditions, and it seems that cannabidiol (CBD) can help regulate the immune system and control the inflammation associated with a variety of autoimmune conditions.
- Both THC and CBD in small can help relieve stress and anxiety – two common triggers of Raynaud’s.
Are there any problems with using cannabis for Raynaud syndrome?
Little is known about the interactions between cannabinoids and NIFEdipine and prostacyclins. However, we do not know if there is an interaction, we do know that cannabinoids do interfere with some types of beta-blockers. CBD also affects calcium channels, so whilst there has been no contraindication discovered between cannabis and calcium channel blockers, there could possibly be some.
There is also a rare case of cannabis arteritis, where a heavy cannabis smoker with progressive Raynaud’s phenomenon had an arteriography revealing corkscrew-shaped vessels. Whether cannabinoids themselves caused this is not known, but it is known that smoke of any kind may potentially trigger a Raynaud’s episode. Vaporizing (in order to allow THC and pinene into the lungs and the bloodstream quickly) and tinctures (for longer-term relief from any pain and stress) may therefore be a better bet for the treatment of Raynaud’s.
If you suffer from Raynaud’s or have an autoimmune condition with secondary Raynaud’s and you think cannabis may help, then feel free to set up an appointment with one of the doctors at Leafwell.
Feature image from: https://commons.wikimedia.org/wiki/File:Raynaud-Syndrom.JPG. Author: Niklas D, 05/12/2011. https://commons.wikimedia.org/wiki/File:Raynaud-Syndrom.JPG. Creative Commons Attribution-Share Alike 3.0 Unported