Suggest Treatment For Symptoms Of Raynaud's Disease

Question : I know I've waited quite some time to ask, but I have noticed that my knuckles and some times my fingertips often get dark red, but it only happens when my hands are down by my side, an is more obvious in my left hands. It seems like it would be primary Reynauds, however there is never any white or blue, nor are they ever cold or tingly. Most of the time they are very warm unless it is extremely cold out. I do take 20-30mgs of Adderall daily and have for the past 12 years with occasional breaks and days off, and maybe i am just becoming aware of it as of recently. I have noticed when I don't take adderall, coffee can trigger it but not as bad, so I think it has something to do with stimulants. I just find it strange that I know many people who take ADD medications and dont have this issue. I believe im extremely healthy: eat 5-6 small meals a day, exercise 4-5 times per week, sleep atleast 7 hours a night, and drink a minimum of 1.25 gallons of water a day. I check my blood pressure regularly and its always normal - the highest it has been was 126/66 with my resting heart rate at 65. I've done tons of research on this but have not found anything even close. There is no dry skin, leasions, etc. just redness which i find embarrasing and I honestly cant help to look at my hands all the time now. I don't have a primary care doctor at the moment since i just moved so I wish to get an opinion as to what may be going on on how this may be solved (and if i should be concerned). If it probably isnt anything serious, i can probably dismiss it coming from a professional, however any thoughts and insight in regards to what this is and how i can resolve it would be greatly appreciated!

(The first picture is more severe late at night when my hands are down by my side, the right picture is how they look like more often - dont mind my mirror shot with my wife!).

Respectfully, XXXXXXX

Hi Dr. XXXXXXX

I dont have too many reports to date. I rarely get sick (last time i got sick was 3-4 years ago). Last time I did I had blood work done, i also had an MRI done last year and all was great.

To be honest I only saw a doctor when needed. I see a psych for my prescription and have told him about it and he said reynauds as well and that it isnt really dangerous and is relatively common with the use of these meds . He stated it is more annoying to deal with than it is dangerous since my hands always stay warm and my nails are healthy.

The picture on the left i sent you first was by far the worst it has ever looked. The pictures below are a little more like what they look like most of the time (usually affecting my knuckles more than my fingers which i find a little odd).

To answer some of your other questions i do not take anything else, nor do I rarely drink. I have been working on cars for the last 9 months and do wash my hands on average 10-15 times per day, while standing 8-13 hours with a 30 minute lunch. Now that you mentioned it I do find myself smoking 2-3 cigarettes while im at work, but only when im at work. I am quitting in 3 days to do real estate and plan on never smoking again - i will quit now and see if that helps if you think it will help. Does smoking exacerbate it that much even with 2-3 cigarettes?

I think it will hinder when I stop working with my hands so much, but really dont wish to stop adderall since it has helped me so freaking much. My doctor wanted to increase my dose but i refused. Thanks again for your help!

- XXXXXXX