Question: I am a 27-year-old fit and healthy woman, but almost always have cold hands and feet. I used to think it was poor circulation, but as I have run a marathon this year and cycle for more than an hour a day, I wonder why I still have this problem. During and immediately following exercise my extremities are warm, but after an hour or so they go back to stone cold. I was vegetarian for five years and still follow a near-vegetarian diet, so could I be lacking in vitamins or minerals? My problem is beginning to affect me socially as I have such icy hands I don't want to touch other people despite being naturally tactile. It is also embarrassing having such freezing feet in bed. What can I do to overcome this?
The vascular surgeon
Jonothan Earnshaw
Some of us feel the cold more than others. Your body works hard to maintain a core temperature of 37.4 degrees and when you're chilly it closes off your small arteries in the skin. This can make your extremities pale, but it's normal. If it happens a lot you could be suffering from a common condition known as Raynaud's or vasospasm, which means your arteries go into spasm in response to cold. Typically, your fingers go bright white then turn scarlet when they warm up. Vasospasm is rarely harmful, but if you're in pain you could ask your GP for a referral to a vascular surgeon. Raynaud's can be treated with vasodilators which boost circulation. Wine is one of the best natural vasodilators so a daily small glass of red won't do any harm. Your letter makes me suspect you may be over-exercising and underweight - you need fat on your body to stay warm, so my advice is to eat well and dress warmly.
· Jonothan Earnshaw, is a surgeon at Gloucestershire Royal Hospital and secretary of the Circulation Foundation (www.circulationfoundation.org.uk)
The dietician
Sue Baic
A lack of certain nutrients should not cause cold hands and feet. But a few tweaks to your diet could improve your symptoms. Omega-3 is an essential fatty acid which helps bloodflow and you get it from oily fish. In one study, people with Raynaud's were given fish oil supplements or a dummy tablet for 12 weeks. They then put their hands in different temperature water to see what effect it had on bloodflow. In the group who took fish oil supplements the symptoms were much better. If you eat fish, have two portions a week, one of which should be oily (fresh tuna, sardines, mackerel, herrings or trout). You can also buy omega-3 enriched eggs. The veggie equivalent of omega-3 is called alpha linolenic acid and good sources are walnuts, soya, tofu and green leafy veg. The vegetarian society website is worth a read (www.vegsoc.org). The other thing to watch is caffeine, as it might worsen restriction of the blood vessels.
· Sue Baic is a lecturer in nutrition at Bristol University and registered dietician at the British Dietetic Association
The sufferer
Anne Mawdsley
Your symptoms sound like Raynaud's, which I was diagnosed with in 1975. Raynaud's affects 10m people in the UK and nine out of 10 are women, though no one knows why. Exercise exacerbates it as your body diverts heat to your essential organs. The answer is to wear protective gloves and socks made with medical-grade silver wool which reflects 95 per cent of your warmth back to the skin (available from the Raynaud's & Scleroderma Association, 0800 917 2494; www.raynauds.org.uk). Scientists are working on treatments. I've just taken part in a study using Viagra to boost circulation. It helped and thankfully I didn't get any side-effects, but for now Ginkgo Biloba is a good natural alternative. Socially, be bold. If you don't want to shake hands, say so, and don't let your condition inhibit you - last year I went down the Olympic bob run in St Moritz wearing heated gloves and socks, and a sheepskin hat. A positive attitude is the best thing.
· Anne Mawdsley is chief executive and founder of the Raynaud's & Scleroderma Association
· If you have a questions for our experts, email health@observer.co.uk
