In depth
Raynaud's phenomenon: common questions
Gloves work in this condition, and the expensive ones don't work any better than the plain ones do. That's one of the very few clean answers anybody has here. Most of the rest of the advice people give you for Raynaud's is untested rather than disproven, which is a different thing.
What the research found.
In a randomized comparison, silver-lined gloves and ordinary gloves performed identically as each other on every measure. There was no difference in the Raynaud's condition score between types. Both of them reduced that score from 6.4 to 3.9, which is a substantial fall from something that costs very little.
One systematic review of behavior change interventions for Raynaud's phenomenon covered eight studies and a total of 495 participants. The median study size among those eight studies was just 29 people. It concluded that there's no evidence either to support or to refute the claim that those interventions work.
In one double-blind trial, the median time before cold-induced Raynaud's began rose from 31.3 minutes to 46.5 minutes. That was measured at six weeks on fish oil. The benefit was seen in primary Raynaud's rather than in secondary Raynaud's, which is the detail usually dropped when it's quoted.
DiGiacomo and colleagues, American Journal of Medicine, 1989
In a randomized placebo-controlled trial, a plant extract reduced attacks per week from 13.2 to 5.8. That's a fall of 56 percent, against 27 percent on the placebo. There were no significant differences in blood flow measures between the two groups, so the mechanism the trial proposed wasn't demonstrated.
An expert panel rated thermal biofeedback for primary Raynaud's as efficacious, which is a word worth reading with care. That rating rested on three randomized trials conducted in independent laboratories. The panel noted that the positive trials tended to be small ones, which is a caveat of its own.
Karavidas and colleagues, Applied Psychophysiology and Biofeedback, 2006
The one clean answer
Most questions in this condition come back thin, so it's worth leading with the one that doesn't do that. A randomized comparison put silver-lined gloves against ordinary gloves and found no difference between the types on the Raynaud's condition score. Both of them reduced it from 6.4 to 3.9.
That result answers two separate questions in one go. Gloves help, substantially, which is worth knowing for anyone who has wondered whether keeping warm does anything measurable at all. The expensive form doesn't help more, which answers a purchasing question directly and points squarely at the cheaper option.
The implication of it goes a good deal beyond gloves. The vascular response involves core temperature as well as local cold, so warming your body as a whole counts at least as much as warming your hands. A warm coat is doing something that a heated glove can't.
Where the evidence ends
A systematic review of behavior change interventions in Raynaud's covered eight studies and 495 participants between them. It concluded that there's no evidence to support or refute claims that they work. The median study size was 29 people, and all but one of the eight studies was at high risk of bias.
That's a different statement from saying these approaches don't work. Absent evidence and evidence of absence get conflated constantly here, and something untested isn't something disproven. It also isn't something you should be sold with confidence.
An expert panel reached a more favorable conclusion about one specific technique, rating thermal biofeedback for primary Raynaud's as efficacious on three randomized trials in independent laboratories. The panel noted the positive trials tended to be small. It also explained away a large negative randomized trial as one that didn't effectively teach handwarming skills. That last point is where a reader has to make their own judgment, and this page passes it on rather than resolving it.
The two supplement trials
Everything tested about diet in Raynaud's is two randomized trials, one from 1989 and one from 2002. Together they enrolled fewer than a hundred people. Both were positive, and neither has been repeated at a size that would settle anything.
The 1989 trial found the median time before cold-induced symptoms began rising from 31.3 minutes to 46.5 minutes at six weeks on fish oil, at a P value of 0.04. Digital blood pressures in a cold water bath were 32 mmHg higher. Five of 11 people with primary Raynaud's on fish oil couldn't be induced to develop symptoms at week 6 or 12, against 1 of 9 on olive oil.
The 2002 trial of a plant extract found attacks per week falling from 13.2 to 5.8, a 56 percent reduction against 27 percent on placebo, at a P value below 0.00001. That trial found no significant differences in blood rheology between the groups. So something reduced attacks, and the mechanism proposed to explain it wasn't demonstrated.
Primary and secondary, which is the distinction that counts
The 1989 fish oil trial found benefit in primary Raynaud's and not in secondary Raynaud's, meaning the form that accompanies a connective tissue disease. That's the most practical detail in the paper. It's also the one most often dropped when the study is quoted.
It's also the distinction that counts most clinically, whatever you decide about supplements. Secondary Raynaud's comes with a higher risk of digital ulcers, and it points at an underlying disease that's worth finding. New Raynaud's after the age of forty makes a secondary cause more likely, as do attacks affecting the two hands differently, fingertip ulcers, and an abnormal antibody test. Those are the features that turn a nuisance into something worth investigating.
Raynaud's alongside joint pain, a rash, dry eyes, or reflux describes a different problem from Raynaud's alone. Raynaud's can precede a connective tissue disease by years. That's the strongest argument for taking it seriously rather than managing it with gloves and moving on.
What to do with all of this
Keep warm all over and not only at the extremities, since the glove trial shows the score falling on either type. Stop smoking if you smoke, because that's the change with the clearest mechanism available and it acts directly on blood vessels. Those two are supported well enough to recommend without qualification.
Treat anything else as an experiment, not a treatment. Relaxation, biofeedback, and supplements may help you, the research can't say, and trying one is a personal experiment rather than following evidence. That's a legitimate thing to do as long as you know which it is, and it changes how much money and hope to invest.
The most valuable thing on this page isn't a remedy. If your Raynaud's is new after forty, affects the two hands differently, has produced a fingertip sore, or comes alongside joint pain, a rash, dry eyes, or reflux, that combination is worth an appointment. It counts more than any of the choices above.
Common misconceptions.
Myth. Expensive gloves work better.
Reality. A randomized comparison found no difference between silver-lined gloves and ordinary gloves on the Raynaud's condition score, while both reduced it from 6.4 to 3.9. The warmth is doing the work rather than the technology. That's one of the few clean purchasing answers available in this condition, and it points at the cheaper option.
Myth. Stress management is a proven treatment.
Reality. A systematic review of eight studies and 495 participants concluded there's no evidence to support or refute behavior change interventions. The median study size was 29 people and all but one study was at high risk of bias. That's a field too small to have answered its own question at all, which is a different thing from a field that answered it negatively.
Myth. Fish oil helps Raynaud's whatever kind you have.
Reality. The 1989 trial found benefit in primary Raynaud's and not in secondary Raynaud's, meaning the form that accompanies a connective tissue disease. That's the single most practical detail in the paper and it's the one usually dropped. Anyone whose Raynaud's comes with systemic sclerosis or lupus falls outside the group where the benefit appeared.
Myth. Cold hands mean I have Raynaud's.
Reality. Raynaud's is an episode of vessel spasm with a clear color change, a visible line between affected and unaffected skin, and full recovery in between. Cold hands without that picture are more likely to be cold hands. The distinction counts because one raises questions about connective tissue disease and the other doesn't.
Questions patients ask.
What helps?
Keeping warm, which has the clearest evidence of anything here. A randomized comparison of glove types found the Raynaud's condition score falling from 6.4 to 3.9 on either kind, with no difference between silver-lined and ordinary gloves. Stopping smoking has the clearest mechanism available to anyone who smokes. Beyond those two, most of what gets recommended here is untested rather than disproven.
Do relaxation and stress management work?
The answer isn't known. A systematic review of behavior change interventions covered eight studies and 495 participants and concluded there's no evidence to support or refute claims that they work. The median study size was 29 people and all but one was at a high risk of bias. That's a literature too thin to answer the question either way, which isn't the same as a negative finding.
What about biofeedback?
An expert panel reached a more favorable conclusion about it than the systematic review did about behavioral treatment generally. Thermal biofeedback for primary Raynaud's was rated efficacious on three randomized trials in independent laboratories. The panel noted the positive trials tended to be small, and explained away a large negative trial as one that didn't effectively teach handwarming skills. Whether that explanation persuades you is a fair question.
Does fish oil help?
One double-blind trial from 1989 found it did. The median time before cold-induced symptoms began rose from 31.3 minutes to 46.5 minutes at six weeks, and digital blood pressures in a cold water bath were 32 mmHg higher. Five of 11 people with primary Raynaud's on fish oil couldn't be induced to develop symptoms at week 6 or 12, against 1 of 9 on olive oil. The trial enrolled 32 people in total.
Does it matter whether my Raynaud's is primary or secondary?
For that trial it mattered a great deal. Benefit was seen in primary Raynaud's and not in secondary Raynaud's, which is the form accompanying a connective tissue disease such as systemic sclerosis or lupus. It's also the distinction that counts most clinically, because secondary Raynaud's comes with a higher risk of digital ulcers and points at an underlying disease worth finding.
How do I know which kind I have?
New Raynaud's after the age of forty makes a secondary cause more likely, as do attacks affecting the two hands differently, fingertip ulcers, and an abnormal antibody test. Raynaud's alongside joint pain, a rash, dry eyes, or reflux describes a different problem from Raynaud's alone. Those combinations are what a rheumatologist wants to hear about.
Will exercise reduce my attacks?
No trial has shown that. The nearest evidence is an interval training trial in limited cutaneous systemic sclerosis, where peak oxygen uptake rose in both exercise arms while skin oxygen tension rose with an effect size of 0.93 and a P value of 0.59, in 34 people. Exercise is worth doing for fitness and cardiovascular health, and fewer attacks isn't something this evidence promises.
What about the supplement trial from 2002?
A randomized, double-blind, placebo-controlled trial of a plant extract found attacks per week falling from 13.2 to 5.8, a 56 percent reduction against 27 percent on placebo. Attack frequency was the only outcome where treatment beat placebo significantly. There were no significant differences in blood rheology between the groups, so the mechanism the trial proposed wasn't demonstrated by it.
What should I take to my next appointment?
A photograph of an attack if you can get one, because the color change and the line between affected and unaffected skin are the most useful diagnostic features. Those two are hard to describe in words. Beyond that, when the attacks started, what sets them off, whether both hands behave alike, and whether you have joint pain, a rash, dry eyes, or reflux alongside.
References.
- Liem S; Hoekstra E; Bonte-Mineur F et al. The effect of silver fibre gloves on Raynaud’s phenomenon in patients with systemic sclerosis: a double-blind randomized crossover trial. Rheumatology. 2022;62:SI74-SI81. 10.1093/rheumatology/keac243Multicentre
- Daniels J; Pauling J; Eccleston C. Behaviour change interventions for the management of Raynaud’s phenomenon: a systematic literature review. BMJ Open. 2018;8:e024528. 10.1136/bmjopen-2018-024528Systematic literature review of RCTs with narrative synthesis
- DiGiacomo RA; Kremer JM; Shah DM. Fish-oil dietary supplementation in patients with Raynaud's phenomenon: a double-blind, controlled, prospective study. Am J Med. 1989;86:158-64. PMID 2536517Double-blind
- Muir A; Robb R; McLaren M et al. The use of Ginkgo biloba in Raynaud’s disease: a double-blind placebo-controlled trial. Vascular Medicine. 2002;7:265-267. 10.1191/1358863x02vm455oaDouble-blind
- Karavidas MK; Tsai PS; Yucha C et al. Thermal biofeedback for primary Raynaud's phenomenon: a review of the literature. Applied psychophysiology and biofeedback. 2006;31:203-16. 10.1007/s10484-006-9018-2Narrative/systematic review of 10 studies: 7 RCTs
- Mitropoulos A; Gumber A; Crank H et al. The effects of upper and lower limb exercise on the microvascular reactivity in limited cutaneous systemic sclerosis patients. Arthritis Research & Therapy. 2018;20. 10.1186/s13075-018-1605-0Randomised controlled trial
This page gathers the published research on this subject into one place. The studies behind it were published between 1989 and 2026, and every figure links to the paper it came from. Those studies were peer reviewed. This summary of them was not. Dr. Sarah Luebker is reviewing these pages one at a time and has not reached this one yet, so it carries no medical review date and nothing here is her opinion or her advice to you. Each page gets updated as she reaches it. It is here in the meantime because the science is worth having in one organized place that is easy to find and easy to read. Talk to your own clinician before acting on any of it.