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The response to the question below was authored by Marc Mitnick DPM

Purple-Blue toes

by LH

I have been going to a podiatrist for Plantar Fasciitis and slowly I am recovering. My doctor noticed my purplish-bluish hue to my toes but wasn't there on other visits to him. It doesn't happen everyday or the color pattern doesn't appear on my fingers and it is not painful at all. So I really never gave it a second thought. However, whenever my toes get that blue/purple tinge they are cold to the touch and so are my hands. My doctor says this is not normal and I have Raynaud's disease/phenomenon ?? I said it seems like I have had this condition since my early 20's now I am 45 female and it is normal for me. Again he said it is not normal and for me to take no-flush niacin vitamin supplement everyday. It will open the blood vessels and lowers blood pressure and it will be healthy. My doctor checked my ankles and the tops of my feet and said my pluses are strong. So should I be worried? He really did not give me a clear answer at the time just take the niacin. I am from a large family and nobody had this condition but me. I would like to hear what you have to say on this. Thank you, LH

Hi LH,
Technically Raynauds disease is not "normal" but it is very common, I see it in patients, particularly young females, all the time.
May I assume this occurs when your feet are exposed to cold? Secondly in true Raynauds the toe/finger will go through a series of color changes ranging from white, where the vessels are compressed and little blood is getting into the toes to a reddish blue tint when the blood vessels relax and blood begins to flow back into the toes/fingers.
If you have not noticed the blanching of your toes then there is the possibility that you do not have Raynauds and may actually have a venous problem.
To be on the safe side I would suggest you have an examination by a vascular specialist who will properly diagnose the problem.
Taking Niacin without actually having a proper diagnosis is probably a waste of time. However, if the diagnosis ends up being Raynauds disease there is no harm in taking Niacin as it may reduce the incidence of discoloration.
Marc Mitnick DPM

Comments for Purple-Blue toes

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May 12, 2016
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Should i go to the hospital yes/no
by: Shyanne robertson

Should i go to the hospital if my middle toe is purple andgreen and bleu

Yes, or at least to a doctor

Jun 08, 2012
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From my experience...
by: Minxie

I would say that u most likely have Lyme Disease. So you've had no bull's eye rash, no tick bite? That means nothing as there r many vectors of Bb (Lyme), not just the tick & most Lyme pts. never had a bull's eye rash. It is best diagnosed clinically, w/o lab tests as they aren't of much good until after the pt. has been treated w abx for a few wks. & then tests can be performed after the immune system is responding. I have had Lyme for the better part of my life & I wasn't diagnosed until age 56. I had Raynaud's, Sjogren's, FMS & CFS, plantar fasciitis, terrible back pain, neck pain, photophobia, neuropathy & many other "syndromes". I was finally diagnosed w the QRib test & treated. Good luck finding a doctor who knows what the hell he's/she's doing & isn't a condescending ass.

Dec 11, 2008
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Response for Dr. Mitnick
by: LH

Thank you for your fast answer. I did make an appointment with a venous surgeon/doctor about that purple-bluish tinge that happens in my feet. He called it"ACROCYANOSIS". A condition that makes my toes blue. A sudden spasm of tiny arteries that carry blood in the skin of my feet causing the parts to get less blood. As the blood gives up more oxygen and the red pigment of the remaining red blood cells turns blueish-purple-this gives the skin the abnormal color,nobody knows why ACROCYANOSIS develops! It is intensified by cold and is present to an equal degree in both my feet. It is not painful at all and is not a sign of a major disorder. My question doctor is why haven't I heard of this and why do other doctors refer to my condition as "Raynaud's disease"- I don't have the change of colors form white-bluish-red which is true with Raynaud's disease. ? LH

Hi LH,
The underlying cause of both conditions is basically the same; constriction of the small arteries, thus causing lack of oxygen to the area and thus the blue discoloration.
The difference between the two is that acrocyanosis is more of a permanent condition that people will have regardless of exposure to cold. It will be exacerbated by cold, but will also be present to some varying degree all the time.
Raynauds disease is usually precipitated by exposure to cold. These individuals will have normal color in their toes in warm environments.
Marc Mitnick DPM

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ADDITIONAL REFERENCES

Mayo Clinic

Johns Hopkins Medicine

MedlinePlus

Arthritis Foundation

University of Rochester Medical Center

Harvard Health

Drugs.com

American Academy of Pediatrics

Penn State Medical Center

National Institutes of Health

Columbia University Department of Rehabilitation

ScienceDirect

Stanford Health Care

Illinois Bone and Joint Institute

Mount Sinai Hospital

Institute for Chronic Pain

University of Florida Health

American Family Physician

Cedars-Sinai

University of Maryland Medical Center

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(location unknown)

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(location unknown)

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(location unknown)

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Unknown location

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Unknown location

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Florida

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Poland

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location unknown

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location unknown

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Bre

location unknown

Dr. Mitnick, Thank you so much for your reply. I did let my physician know and they took an x-ray - all is well! Also, thank you for providing this wonderful site, it is very helpful with lots of useful information! I appreciate your gift of time! God bless.

anonymous

Dr. Mitnick, Thank you, you were 100% correct. The pain finally brought me to the ER. I spent 8 days in the hospital. The Doppler you spoke of was able to show that there was no pulse in that foot. This was an arterial clot that split and traveled throughout my leg. My leg was almost amputated. I am in rough shape but have all my parts intact!! You certainly know what you are talking about. Thank you for taking the time to answer. Yours Truly!

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Poland

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Seattle, WA

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location unknown

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New Jersey

Thanks so much for answering my question. You've been more help to me than my own Dr. has been lately. Thanks again....I hope to be able to walk without pain someday.

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location unknown

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location unknown

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Evansville, IA

Dear Marc

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location unknown

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location unknown

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San Diego, CA

Dr. Mitnick, Just want to say thank you so very much for your quick response and very informative reply! After reading what you had to say, I called the doctor's office and was able to get in and see him the same day as my injury. Toe was x-rayed and luckily, it is not broken or fractured. Very badly bruised and will probably lose the toe nail. And although my toe and toe nail are still very black and blue and very sore, they ARE both starting to feel a little better. So again, thank you! I am so very happy that I came across your website. The service you provide is outstanding and immeasurable!

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Albany, NY

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location unknown

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Whichita, KS

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mark

Boston, MA

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....Keep up what your doing. Your a life saver.

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Colorado

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Colorado

Wonderful advice

by: Anonymous

This is the best site for foot problem info.

Thank you for this information. This description fits my pain and inflammation behind my 2nd toe perfectly.

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location unknown

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Canada

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location unknown

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Wisconsin

Thank you for your response. You have provided some great insight (to my question)....

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location unknown

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North Carolina

Many Thanks Dr Marc!
Thank you for your response. It sounds like a good plan to me. He did not cut the wart out first ...

KG

location unknown

Thanks again doc for having this website and we STILL need qualified Podiatrists in beautiful sunny Tampa Bay (Bradenton) Florida.

Bessie Mae

Florida

Dear Dr. Mitnick, Thank you so very much for taking your time to answer my question. You have greatly relieved my anxiety related to the continual tingly I feel in my feet. I will share your response with my podiatrist next week. God bless you for having this question and answer page on your website! Most gratefully,

Lynne T.

location unknown

Your webpage is excellent, I commend you on sharing your knowledge to the public.

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New Jersey

Thank you. you were more detailed than what others have told me they finally called from the last xrays and my son is now in a cast for 2 weeks he did have a fracture that was not noticeable.

a mom

location unknown

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Lenoir, NC

Thank you so much Doc for a quick and thorough response!

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Bellevue, WA

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Jodi

location unknown

Purple-Blue toes

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