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The question: My fingers get so cold that they turn blue and stay that way for several minutes and sometimes hours. I'm worried that this may be circulation-related? What is happening and what can I do?

The answer: We're all feeling the bite of this year's long, cold winter. Our fingers, toes and ears are the most vulnerable to the subzero temperatures. However, since your fingers are turning blue for an extended period of time, you may have a condition called Raynaud's phenomenon.

When we are exposed to the cold, our bodies conserve heat by decreasing blood flow to our hands and feet. In general, this is short-lived and will reverse quickly – unless you have Raynaud's.

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Symptoms of Raynaud's can include tingling and numbness in the fingers and toes, whitening of the fingers and the blue discolouration you describe. Raynaud's attacks can be triggered by exposure to cold temperatures or emotional stress. Washing dishes, or recreational activities such as fishing, golfing and gardening can also spark symptoms.

There are two kinds of Raynaud's phenomenon. In the first, known as primary Raynuad's, the cause is unknown. Secondary Raynaud's may be a symptom of a disease that affects the walls of our blood vessels such as atherosclerosis, or connective tissue disorders such as scleroderma or Sjogren's syndrome. Medications that cause blood vessel constriction can also lead to secondary Raynaud's. People who work with vibrating power tools and machinery, spend long hours typing, or are professional musicians may also develop the condition.

For most, occasional episodes of Raynaud's will not cause tissue damage. That being said, frequent attacks can result in a permanent decrease in blood flow, pain and changes to the skin over time. And while the condition is not life threatening, it can lead to significant disability and pain.

At this time, there is no cure, but there are many things that you can do to minimize the frequency of attacks.

Protect your extremities by wearing gloves and warm socks in colder weather. Use warm water and keep gloves nearby when you wash dishes. If you experience an attack, try exercises that help increase blood flow such as the "windmill," which involves swinging your arms vigorously.

Nicotine can trigger vasospasm (when blood vessels tighten and go into spasm) and worsen Raynaud's, so consider quitting or cutting back on smoking. Since stress can trigger Raynaud's, relaxation techniques can help you gain control of the situation and counter the attacks.

In some cases, medications that relax the blood vessels, such as those used to treat high blood pressure, can be taken 30 to 60 minutes prior to cold exposure. But the most important treatment for Raynaud's is minimizing triggers and keeping warm.

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Dr. Sheila Wijayasinghe is the medical director at the Immigrant Womens' Health Centre, works as a staff physician at St. Michael's Hospital in their Family Practice Unit and at Hassle Free Clinic, and established and runs an on-site clinic at Women's Habitat Shelter in Etobicoke.

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