Chilblains are my diagnosis so far, from too cold, and too humid environment. Anyone else picking them up in the winter time? It's really bad cause my feet are always clammy with the Adderall.

Any cool solutions to keeping feet dry and stuff? It's cold outside where I live.

Baby powder in your socks, absorbs moisture. Alternatively, buy a stick anti persperant and use it for feet only.

I am with you on the cold/wet. Not good. We just survived one of the coldest Januarys on record. It was not fun. A whole week of sub zero temps and the highest it got all week was like -6. Yeesh!

I walk a 60 mile endurance event every year and train other walkers for it. A few things I have learned-

There is a product called Body Glide that will work similarly to using anti-perspirant on your feet but without the chemicals. Anti-perspirant will work too- it has to be a solid. You can also use petroleum jelly. I personally like the Body glide best.

Wear dry wicking socks. You can find them in the athletic area at WalMart or Target. You can often find them at any good sporting goods or out doors store. They are designed to pull sweat from your foot. I have used them for every event I have walked and they are magic.

Especially now while you have chillblains, carry an extra pair of socks with you and change them midday. This is a good time to reapply whatever you decide to use on your feet.

An alternative to Body Glide et al would be cornstarch. Take the toe of an old pantyhose and fill it with cornstarch. Place it in a plastic zip top bag. When your feet are clean and dry, pounce the bag over your foot and put on your socks.

There is an ultra fine foot powder on the market that will work nicely as well.

Try to wear a shoe that is as ventilated as you can. That will help. Any good running shoe should be ventilated enough for your purposes and yet still keep your feet reasonably warm.

While at home, change into slippers and get the shoes and socks off.

When we walk, we are doing about 20 miles a day for three consecutive days. Moisture is an issue because wet feet blister. Trust me, you don't want to walk 20 miles with a blister.

Tell us how you get on.

I've always had clammy feet - I hate it.

My advice:


Wear good quality sports socks - cotton isn't always best http://www.coolrunning.com.au/general/2005/socks.shtml
Only wear shoes when necessary

I buy my shoes from an athletics shoes store - they're expensive, but comfortable, get properly fitted and last a lifetime.


Go easy on shower products (as they all wash over your feet)
Wash and dry them properly.

Thanks for all the posts.

I've been considering a foot powder (powder just makes me think dry). I recently bought one with an anti-fungal agent (which I'm not too comfortable with), but it turns out I need to return the stuff anyway due to a misslaboling problem (concerning its storage).

My new consideration is something called "anti monkey butt powder" which is, presumably, a fairly safe powder --given that they suggest one can apply it to their bottoms and suffer no ill effects. Hopefully it doesn't smell anything remotely like baby powder, that stuff makes my nose feel sad.

My desk is right by a cold air return so my feet get a really nasty draft=(. I think I'm just goona tape it up.

Does Body Glide have an odor, and have you ever tried it on clammy hands?

Thanks for all the posts.

I've been considering a foot powder (powder just makes me think dry). I recently bought one with an anti-fungal agent (which I'm not too comfortable with), but it turns out I need to return the stuff anyway due to a misslaboling problem (concerning its storage).

My new consideration is something called "anti monkey butt powder" which is, presumably, a fairly safe powder --given that they suggest one can apply it to their bottoms and suffer no ill effects. Hopefully it doesn't smell anything remotely like baby powder, that stuff makes my nose feel sad.

My desk is right by a cold air return so my feet get a really nasty draft=(. I think I'm just goona tape it up.

Does Body Glide have an odor, and have you ever tried it on clammy hands?

Anti monkey butt powder is a basic talcum powder. I'm with you on the baby powder thing- can't take the scent. A brand called Gold Bond is another good one and is available without scent. Corn starch may be your best choice as it has no scent also and is safe for use anywhere on the body.

Closing up that cold air return is a VERY good idea. You don't need any more feet issues than you are managing now.

I can't smell Body Glide. I just checked the packaging and there is no added fragrance.

I've never tried it on clammy hands. It is formulated so that perspiration can escape naturally so I would imagine you could. An alternative is something called Bag Balm.

The Burt's Bees product line is also good. There is a fragrance but it isn't strong.

I think what you are experiencing is being caused by histamine and/or an auto-immune response. The cold may be a contributing factor, but I think its secondary. Basically its an allergic reaction to your meds. I have the same syndrome and this is what I'm concluding.

I was taking Focalin for about 9 weeks and exhibited some allergic responses. I switched to Dexedrine but have developed another set of responses.

My actual "symptoms" from each have been different but they have over-lapped. In each case I developed toe rashes of different sorts. There were definite difference in the actual circulatory manifestations. Focalin caused a more sub-dermal response and there was apurple coloration. With Dexerine its more on the surface level and its reddish. The Dexedrine response also included a brief hives type of reaction and some associated itching. The hives wasn't rash-like, it was more like a few welts.

The Focalin response seemed more acute and included more pronounced changes in my sleep patterns. But I guess my dosage when a bit higher than with Dexedrine. I've never gone above 20mg per day with either but Foaclin may be more powerful on a mg to mg basis.

What is interesting is that it seems that the stimulants may stimulate the histamine system directly so it may not be a typical allergic reaction. It also seems to indicate that its manifesting as more of an auto-immune response. But that may be typical of "drug allergies" in general.

In my case I think that different antinuclear antibodies or histamine agents were present in response to the different medications.

My responses have seemed to be dose dependent and a reduced dosage causes lessened symptoms. Conversely, an increase in dosage causes a "flare up".

Also I am very curious to know if this happens frequently but that certain people either have much reduced levels of responses - so that the same type of a response (with whatever there own manifestation may be) remains on-going but at much reduced and tolerable levels - or - that this occurs frequently but it subsides completely because its only an initial response and the person's body is able to progress to the point of not having any immunologic system response.

In other words, I am wondering to what degree we are able to distinguish between initial and transitory side effects and allergic reactions.

I suppose part of the answer would be to have testing for positive antihistone antibodies or to test for antinuclear antibodies. Either could provide strong evidence to demonstrate that the imunine system is acting in response to the medication.

In my case I think that different antinuclear antibodies or histamine agents were present in response to the different medications.

My responses have seemed to be dose dependent and a reduced dosage causes lessened symptoms. Conversely, an increase in dosage causes a "flare up".

Also I am very curious to know if this happens frequently but that certain people either have much reduced levels of responses - so that the same type of a response (with whatever there own manifestation may be) remains on-going but at much reduced and tolerable levels - or - that this occurs frequently but it subsides completely because its only an initial response and the person's body is able to progress to the point of not having any immunologic system response.

In other words, I am wondering to what degree we are able to distinguish between initial and transitory side effects and allergic reactions.

I suppose part of the answer would be to have testing for positive antihistone antibodies or to test for antinuclear antibodies. Either could provide strong evidence to demonstrate that the imunine system is acting in response to the medication. I was wondering howard, when I was on adderall my sinuses were constantly irritated and my eyes were puffy like I had a cold...it usually happened at the end of the day after my last dose...20mg x4...thank you...Patty

It is very interesting that stimulants can directly impact the histamine centers in the brain. There is also a connection between the histamine system and the endocrine (hormonal) systems.

Women are more prone to allergies and patterns with respect to their allergic responses can be linked to hormonal changes.

Raynaud syndrone (having cold extremities, usually the hands, feet or parts of the face) is more common in women than in men. It is also more common in allergy suffers than in non allergy suffers.

The Raynaud syndrone is very much the same as "chilblains". While the underlying cause is circulatory it seems that the circularity issues themselves are caused by hormonal or immunological responses.

Raynaud's Syndrome can be either just related to circulation or it exist as a more sever secondary condition involving connective tissue.

It is very interesting that stimulants can directly impact the histamine centers in the brain. There is also a connection between the histamine system and the endocrine (hormonal) systems.

Women are more prone to allergies and patterns with respect to their allergic responses can be linked to hormonal changes.

Raynaud syndrone (having cold extremities, usually the hands, feet or parts of the face) is more common in women than in men. It is also more common in allergy suffers than in non allergy suffers.

The Raynaud syndrone is very much the same as "chilblains". While the underlying cause is circulatory it seems that the circularity issues themselves are caused by hormonal or immunological responses.

Raynaud's Syndrome can be either just related to circulation or it exist as a more sever secondary condition involving connective tissue. thanks again for info ...pm u later P

The secondary form of Renaulds syndrome is much like Lupus and can apparently in some cases be related to carpal tunnel syndrome.

from various sources -
Women are three times more likely than men to develop carpal tunnel syndrome, perhaps because the carpal tunnel itself may be smaller in women than in men.

More than 90 percent of people with lupus are women.

________

More on Secondary Raynaud's Syndrome

From - http://www.medic8.com/healthguide/articles/raynauds

(excerpts with italics added)

Although secondary Raynaud's syndrome is less common than the primary form, it is often a more complex and serious disorder. Secondary means that patients have an underlying disease or condition that causes Raynaud's syndrome. Connective tissue diseases are the most common cause of secondary Raynaud's syndrome. Some of these diseases reduce blood flow to the digits by causing blood vessel walls to thicken and the vessels to constrict too easily. Raynaud's syndrome is seen in approximately 85 to 95 percent of patients with scleroderma and mixed connective tissue disease, and it is present in about one-third of patients with systemic lupus erythematosus. Raynaud's syndrome also can occur in patients who have other connective tissue diseases, including Sjögren's syndrome, dermatomyositis, and polymyositis.

Possible causes of secondary Raynaud's syndrome, other than connective tissue diseases, are carpal tunnel syndrome and obstructive arterial disease (blood vessel disease). Some drugs, including beta-blockers (used to treat high blood pressure), ergotamine preparations (used for migraine headaches), certain agents used in cancer chemotherapy, and drugs that cause vasoconstriction (such as some over-the-counter cold medications and narcotics), are linked to Raynaud's syndrome.

People with secondary Raynaud's syndrome often experience associated medical problems. The more serious problems are skin ulcers (sores) or gangrene (tissue death) in the fingers or toes. Painful ulcers and gangrene are fairly common and can be difficult to treat. In addition, a person may experience heartburn or difficulty in swallowing. These two problems are caused by weakness in the muscle of the oesophagus (the tube that takes food and liquids from the mouth to the stomach) that can occur in people with connective tissue diseases.

How Does a Doctor Diagnose Raynaud's Syndrome?

Most doctors find it fairly easy to diagnose Raynaud's syndrome but more difficult to identify the form of the disorder.

Nailfold capillaroscopy (study of capillaries under a microscope) can help the doctor distinguish between primary and secondary Raynaud's syndrome. During this test, the doctor puts a drop of oil on the patient's nailfolds, the skin at the base of the fingernail. The doctor then examines the nailfolds under a microscope to look for abnormalities of the tiny blood vessels called capillaries. If the capillaries are enlarged or deformed, the patient may have a connective tissue disease.

The doctor may also order two particular blood tests, an antinuclear antibody test (ANA) and an erythrocyte sedimentation rate (ESR). The ANA test determines whether the body is producing special proteins (antibodies) often found in people who have connective tissue diseases or other autoimmune disorders. The ESR test is a measure of inflammation in the body and tests how fast red blood cells settle out of unclotted blood. Inflammation in the body causes an elevated ESR.

I think I'm maybe linking too many things here and it may be presented in a way that is a bit simplistic. There are questions of cause and effect that vary. Also while there may be associations, there can be different origins.

I'm not trying to imply that Raynaud's syndrome or carpal tunnel syndrome are symptoms of or are indications of an auto-immune disorder. But both tpye of Raynaurd's and carpal tunnel syndrome can be caused, directly or indirectly, by an auto-immune disorder.

While an auto-immune response can occur because of exposure to stimulants, it might or not manifest itself as primary Raynauld's syndrome. A further connection to secondary Raynaud's seems less likely, but it is possible. A direct connection to carpal tunnel syndrome seems even less likely. Still, a drug allergy can result in increased sensitivity to coldness, rashes or hives as well as other responses. And these types of responses can involve the hormonal system, the the histamine system and, at least in some cases, auto-immune responses.

On the forums we are supposed to not give medical advice, so I will leave it at that -- other than to say "when you hear hoof steps, think horses not zebras (or unicorns)".

I'd really hesitate to tell someone to go get ANA or other auto-immune testing, etc. They might start worrying that they have all kinds of major conditions, when it is really tinea pedis, or something simple caused by 'sweaty feet', etc.

I get the same thing in winter.

--

I think the best advice is to see a Doctor.

--

On the forums we are supposed to not give medical advice, so I will leave it at that -- other than to say "when you hear hoof steps, think horses not zebras (or unicorns)".

I'd really hesitate to tell someone to go get ANA or other auto-immune testing, etc. They might start worrying that they have all kinds of major conditions, when it is really tinea pedis, or something simple caused by 'sweaty feet', etc.

I get the same thing in winter.

--

I think the best advice is to see a Doctor.

--

Thank you. :)

My comment regarding ANA or other auto-immune testing wasn't directed specifically toward the original poster...it was a general comment ~ more thinking out loud regarding the issue of "an allergy vs. a side effect" and how we could tell which was which. I certainly am not advocating allergic testing for any side effects that may occur.

It is my guess he could be having an allergic reaction. I'm not trying to make a determination or a diagnosis or to provide specific medical advice.

Raynaud's syndrome can fall into one of two categories. There is a big distinction between them. The link above has very good coverage on the topic.

There is also a difference between "vaso-constriction" and allergic responses that occur in the circulatory system. When a person has hives we would say that its most likely an allergic response. When its a rash its less clear. when its 'cold feet" its even less clear. But I wonder seriously if there aren't cases that are moderate or tolerable that may well be allergic responses.

It's very kind of you to be looking out for me Queens, but for some reason whenever I go to a doctor with out a self-diagnosis and supportive evidence I end up leaving sort of.. undiagnosed.. or perscribed ibuprofen. I would probably envy your doctor, mine just recently let me down (they missed ganglionic cysts on the tops of my hands causing me pain), and had no help to offer me with muscle problems / trigerfinger which I still have on my todo list. (the list goes on) --in part, it could be all my fault, I can never get my symptoms to come out complete or linear in person.


That said I love getting advice pertaining to my body from this forum, I always take them as shots in the dark (often accurate ones), but they're so much closer than the dark shots taken by my doctors (two handed lobs, like there's chinese finger traps on four of their fingers).


As it would turn out, I have, (for 4 years now) suspected I have a connective tissue disorder {clicking of my jaw, floaters in eyes, back pains from old, a newer pain in my finger, misc. large and small joint cracking = all adding up}. I'm dead tired right now and just want sleep, I still have to read this stuff again cause I'm missing connections yet(lol).


My feet progress
It's hard keeping them warm still. I have wicking socks on the list of things to get and am changing socks fanatically. I made a heat pad out of rice and a cotton sock, which is too unhygenic for long term use for me, but it's good in a pinch. I don't know where to store it, it just kinda sits on a clean piece of carpeting of a deligated region of my floor.

The chilblains are mostly healed away. What's left.. I see odd oval, um... my big toe.. it's pockedotted! Like in a cartoon. On it's underside. That is so wierd.. the other side's has two of it's own dots as well.

These dots are dr suece-red, and they slightly protrude outward (pimpulated?) upon touch they feel itched.

They've been cold lately, so I can't fully rule out pockedotted chilblains from simple cold-moisture exposure.. I don't see them anywhere else on my body, which makes me wonder, why there?

The effect of this drug on my skin in general is quite evidant. (Maybe a new thread should be started "Epidurmus and stims"?) It could be histamine related, my original theory was that it was making the surface of my skin a more ideal plays for biologicals to grow --> resulting in too many and a reaction, but that theory never added up cause my skin only seems to get dryer, and therefore you'd think the biologicals would have less food, and be less prevelant.

The stuff in bold is exagerated / caused by adderall. Other stuff might be caused by it, or might be just me, idk (give an idea of my skin type and immune responses).

::General skin:dryness, flakeyness, not-put-together Psoriases symptoms until just now (only slightly apparent on legs), lightly scratching skin (as in with a back scratcher, or with a side burn trimmer) causes serius redness. spuradic pimples (few on chest, and plenty on knees {CDisease? I'm symptomatic some.}),

::Hands: oilly apearing, dry, wiltyness, whiteness of thumb-pointer finger webbing.

Face: it flushes red for no reason sometimes. Seborrhoeic dermatitis apparent around nose,



None of this has really seemed to worth while to look into for me cause I mostly don't notice it, but if it has anything to do with 'lasting damages to my body' I'd like to look into it.

Howard, where you getting stuff that would remain local to just your toes? My stuff is just there (though I got different stuff everywhere as you can see), and that makes me think it's micro-bio related, or like you said connective tissue related I suppose, and specific toe tissue related? I think I need to re-read the posts at a later date. Thank you for them btw!

anonone -

Your body sounds like a "science experiment" gone long neglected in someone's refrigerator. :eek: ;):)

I went off a tangent in my posts so you needn't read them all. Regarding connective tissue, that's usually a long term syndrome (and is a serious condition) - I wouldn't link that to any short term allergic reaction.

QueensU_girl is right that you should consult a Dr.

But your "pimples" you describe could be hives, another allergic manifestation. The same could be true for the apparent edema you reported in yours toes a while back (the issue of puffiness around the toe nails).

My acute physical symptoms were all on my feet (generally the toes). The inflammation and circulatory conditions were different for each drug - Focalin casued areas like purple bruises - it was below the skin. And very dark purple pin-points, usually on the ends of the toes and near the surface.. Also coldness and some swelling. It seemed that the response was all related to the capillaries. There is an immune response that can deplete blood cells of oxygen or can cause localized clotting. There is another that can cause some seeping of blood between the capillary walls. The terms for these are "thrombocytopenic purpura" and "necrotizing vasculitis" - both are officially associated with Focalin.

Dexedrine was very different - it caused more of this "chilblains" condition - bright red on the surface of the skin, along with some itchiness. At one point there were several raised hives, but it wasn't hives in the form of a rash - they were individual and white with some redness at the top. All of these fall under the term "urticaria", which is a know adverse response to Dexedrine (and Adderall). When I reduced my dose they subsided. They have also responded well to an anti-histamine.

Why would these reactions occur in the feet? Mast cells are a component of the immune system. They are concentrated in the feet and hands. The mast cells can release histamine.

Histamine dilates post capillary venules, activates the endothelium, and increases blood vessel permeability. This leads to local edema (swelling), warmth, redness, and the attraction of other inflammatory cells to the site of release. It also irritates nerve endings (leading to itching or pain). Cutaneous signs of histamine release are the "flare and wheal"-reaction. The bump and redness immediately following a mosquito bite are a good example of this reaction, which occurs seconds after challenge of the mast cell by an allergen.

Prussin C, Metcalfe DD (2003). "IgE, mast cells, basophils, and eosinophils". J Allergy Clin Immunol 111 (2 Suppl): S486–94. (quoted on Wikipedia)

anonone -

Your body sounds like a "science experiment" gone long neglected in someone's refrigerator. :eek: ;):)

I went off a tangent in my posts so you needn't read them all. Regarding connective tissue, that's usually a long term syndrome (and is a serious condition) - I wouldn't link that to any short term allergic reaction.

QueensU_girl is right that you should consult a Dr.

Absolutely right on all accounts. Some how it managed to slip my mind to mention that I had a doctor appointment lined up (today) and was really looking forward to getting everything taken care of. After seeing all of my symptoms in print and noting the fact that I didn't mention the fact that I am looking forward to bringing this to the attention of an MD, I realize I sound unrealisticly out of my mind.

Unfortunatly Psychiatrists (the Dr I was set up with) are less well versed in specific stimulant side-effects in respect to how likely they are to cause apparent internal Hemorrhaging, skin abnormalities, etc. (I'm not sure what exactly I'm supposed to talk to this person about?? My 'regular doctor' sent me to him when I asked for Adderall on the ground that I asked for Adderall, but realistically, this psych. doesn't seem to be of much benefit to me.)

Luckily he was able to point me in the right direction, doctors who are good at alergic reactions are called immunologist (I think I didn't write it down).

And doctors who might know a lot about stimulant use are Neurologists (but theres only something like 50 neurologists per city so not ideal for our purposes) and Doctors of Internal Medicine who know about drugs and diseases (I think these are much more common). Eventually I'll register with an internal medicine doctor and have things looked at.


--I've got so many problems in so many posts this is rediculous, but for this post anyway, my toe things were afirmed by a doctor (walk in clinic physician i think) to be trouble due to chilblains. The hive-like things were the result of "burst blood vessles" due to getting too cold. The diagnosis stuck even though I pointed out that they were pokedoted. But he wasn't an internal medicin doctor.

Earlier, before that, when I told my psych. that I suspected a histamine reaction might be causing it he claimed, if that were the case then I would get the hives everywhere --I didn't bring up mast cells because I was picking up a hint of frustration from him, being that I was asking him so many questions that were outside of his element:o. I'll msg you a pic so you can compare my symptoms with yours since I'm getting differing diagnoses (what's the ambient temp where you are? I think they're possible at ~70 F).


Oh... now that I think about it, could histamines cause the vessles to burst and so that's why the physician was so sure it was a chilblain cause I didn't bring up the word Histamine Response with him?

Unfortunatly Psychiatrists (the Dr I was set up with) are less well versed in specific stimulant side-effects

Mine too, but he does believe me when I say I'm having a reaction. Of course I put up with it longer than I should have, but I thought it would pass on its own.


my toe things were afirmed by a doctor (walk in clinic physician i think) to be trouble due to chilblains. The hive-like things were the result of "burst blood vessles" due to getting too cold. The diagnosis stuck even though I pointed out that they were pokedoted. But he wasn't an internal medicin doctor.

Well chibaines can be caused just by cold or by an allergic reaction, which was the point QueensU_girl was making. But a doctor shouldn't rule one out just because it seems less likely. The individual raised hives (welts) are not usually caused by the cold, but I guess its possible.


Earlier, before that, when I told my psych. that I suspected a histamine reaction might be causing it he claimed, if that were the case then I would get the hives everywhere

Hives could be wide-spread or localized. Localized can be just on the arms, or the legs or calves, or the face, or the back, or some combination. But it is unusual to have them all over.

Sometimes these reactions to Adderall or Dex are just temporary.

Could the vasoconstriction that comes with Adderall use be the causal factor? I know that I have unusual cold in hands and feet and need to take extra care of them. I live in MN- that doesn't help this time of year!

I started using a petroleum jelly product on my hands and will wear at least lightweight gloves virtually all the time. This seems to help. I wear something on my feet at all times and make sure to bathe them daily or twice daily. That also helps.

Just an odd thought to throw into the mix.