What Causes Icy Cold Hands?

Brief Answer:
Need more information

Detailed Answer:
Hello and Welcome

I appreciate your concern

The most likely diagnosis is Raynauds Phenomenon. Raynaud phenomenon involves vasospasm of the fingers and toes and is in response to stress or cold exposure. Avoiding the stimuli and certain pharmacological treatments are present but I would like to gather some information before proceeding there. Kindly answer the following.

Do you have diabetes, hypertension and/or Peripheral Vascular disease ?
What specific medications are you currently using ?
Has this been a recent phenomenon or has this been occurring since long. Please specify the time period ?


Wishing you best of health

Thanks

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Brief Answer:
Primary Raynaud, Nifedipine

Detailed Answer:
Hello again ,

Thanks for answering the questions.

Raynaud Phenomenon would remain as the most likely diagnosis in the absence of the conditions described above. Hefty testing is available for diagnosis but clinical exam and history are sufficient for further management. If the cold hands remain cold irreversibly then you would require further evaluation of the vessels of the upper limbs via flow studies, arteriography etc.

Initially, warm gloves should be used. Identification of any toxic or occupational exposure should be done and avoided thereafter. Vasoconstricting agents like nicotine should be avoided for adequate flow.

If these lifestyle changes don't result in improvement then topical Nitroglycerine and CCB like nifedipine can be used. Nifedipine is also an antihypertensive medication and can be adjusted with respect to the dose of enalapril and carvedilol you are already using. Nifedipine would give a double benefit by serving as an antihypertensive and giving you relief w.r.t Raynaud.

If these measures also fail then causes for secondary Raynaud like hyperviscosity syndrome, cryoglobulinemia, Hepatitis B, C, Mycoplasma infection would need to be worked up. Blood thinners like warfarin, heparin or rivaroxaban wont be of much help unless you have an underlying hypercoagulabilty/clotting disorder.

Wishing you best of health.

Thanks.

Dr. Sareer Khalil

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