Varicose Veins

Undeniably, heredity plays a role in varicose veins, those decidedly unattractive blue ropey knots (or squiggly red lines) you’re certain are distracting everyone from your otherwise perfect legs. Although varicose veins are rarely a serious medical problem, they can be quite uncomfortable and even painful if inflamed. Conventional medicine now offers a variety of minimally invasive outpatient surgical procedures that have virtually eliminated the more extensive surgery required in the past.

Prevention is always the best route, however. And the supplements we suggest at WholeHealth Chicago have actually been shown to strengthen arteries and veins throughout the body. Let’s see if we can help.

What are Varicose Veins?
Varicose veins are swollen, snakelike purplish veins just under the surface of the skin. Normally, as blood circulates through the body, vessels keep the flow moving in one direction because they are equipped with valves that open and shut like doors as blood passes through. But when the valves are weak and don’t shut completely, blood can seep backward and pool there, causing the vein to bulge. This condition is called a varicose vein. Varicose veins (the word “varicose” is related to one that means “wormlike” in Greek) are far more common in the legs than anywhere else, and most appear on the back of the calf or on the inside of the thighs. Many people don’t realize that hemorrhoids are varicose veins in the anus. And when they occur in the veins of a man’s scrotum, they are called varicocele.

Varicose veins are only mildly uncomfortable for most of the 40 million Americans who have them; indeed, for many, the unattractive knots of purple vessels are just a cosmetic problem.

In more advanced cases, however, the vessel walls as well as the valves are weak, and blood leaks into nearby tissues. Discomforts can then include itchy, scaly skin; ankles swollen with fluid; and a heavy or achy feeling in the legs, especially after long periods on the feet. In advanced cases, the skin over a varicose vein can break, leading to a chronically infected skin ulcer that is slow to heal.

Key Symptoms:
• Tiny “spider” or enlarged purple veins, most often on the legs.
• Leg aches, particularly after extended periods on the feet.
• Scaly, itchy skin.
• Swollen legs and ankles.
• Calf tenderness, cramping, and sensation of heaviness.

What Causes Varicose Veins?
There are two systems of veins in the legs: those deep in the muscles that carry most of the blood returning to the heart, and those just beneath the surface of the skin that feed into the deep veins.

Thanks to a series of valves stationed within the deep veins, blood usually flows in a forward direction. However, if these valves weaken, the pressure within the deep vein system can increase. This rising pressure can affect the superficial veins: Blood begins to pool in them, causing them to swell and eventually producing tiny “spider” veins or enlarged, purple varicose veins.

Why this blood circulation problem develops in certain people and not others isn’t always clear. Usually varicose veins occur because of a combination of different circumstances, including many of the ones listed below.

An inherited predisposition to the condition. This can be intensified by a lifestyle that involves standing for long periods or conversely being too sedentary.

Hormonal factors. It’s possible that female hormones may also play a role, since three out of four people with varicose veins are women.

Aging. This is also a common cause. As people grow older, the connective tissue that provides natural elastic support in the walls of the blood vessels and in the skin becomes less elastic giving the veins less support.

Pregnancy and being overweight. Both are clearly associated with a greater chance of developing varicose veins, since both conditions create extra pressure on veins.

Muscle strain in the abdominal area. Potentially caused by heavy lifting, pregnancy, or chronic constipation, straining can be a factor for varicose veins as well.

Other health conditions. Different ailments associated with varicose veins include congestive heart failure, vascular (blood vessel) problems, and liver disease.

Conventional Treatments
In most cases, varicose veins lie just beneath the surface of the skin and are no more than a nuisance or cosmetic eyesore. Sometimes they can become painfully inflamed, however, and they may even contain a small amount of clotted blood, a condition called superficial thrombophlebitis. When this occurs, a doctor will usually recommend applying cool compresses and taking a simple nonsteroidal anti-inflammatory (NSAID) medication such as ibuprofen.

It’s important to know that the tiny clots associated with superficial thrombophlebitis aren’t dangerous because they can’t travel into the deep veins that feed the heart and lungs. In contrast, when a clot actually develops in the larger deep veins in the legs, it can be a serious medical condition. Symptoms of such a clot include sudden swelling (in one leg only) along with tenderness and pain of the calf or thigh muscles.

Termed deep vein thrombosis (DVT), this condition usually requires hospitalization and blood-thinning medicines to help the body dissolve the clot. Simple diagnostic tests, such as an ultrasound blood flow study, can pinpoint the location of such a clot. Only when the cause and location are known can an appropriate treatment be selected.

In most cases, however, varicose veins are easily diagnosed and treated, and don’t have any serious implications.

Medications
Prescription medications are not typically used to treat varicose veins. However, when a superficial varicose vein becomes inflamed, doctors regularly recommend using a nonsteroidal anti-inflammatory medication, such as ibuprofen, to reduce the discomfort.

Tests and Procedures
Physicians treat varicose veins in several ways depending the severity of the condition or how painful it is.

Surgery. Larger varicose veins are often treated by tying them off (a process called ligation) or by actually removing the vein (called stripping). For less severe cases, mini-stripping techniques have also been developed in which small sections of the vein are removed. After all these procedures, the blood finds other routes within healthier veins to replace the veins (or portions of them) that have been removed.

Other procedures. One popular approach for treating the small “spider veins” close to the surface of the skin is called sclerotherapy.This involves injecting the vein with a formulation (a concentrated salt, sugar, or other solution) that causes the vein to collapse and scar itself shut.

In recent decades, less invasive alternatives to standard surgery have been developed using laser and light techniques. Most of these techniques leave less scarring than surgery and require only local anesthesia. They all work, however, by ultimately rerouting blood from painful veins to healthier ones.

One technique, called Endolaser, involves threading a laser fiber into the affected vein by means of an ultrasound-guided catheter (a thin tube). When the laser is activated, it emits bursts of light, sealing off the problem vein.

In another new and minimally invasive approach called closure technique, a catheter threaded into the defective vein delivers radio-frequency energy that prompts the vein to collapse on itself. This strategy also works by rerouting blood to healthy veins.

Treatment and Prevention
Since varicose veins are simply a cosmetic problem for most people, it usually makes sense to first try noninvasive approaches, including supplements, lifestyle changes, and certain self-care strategies. These are often quite effective at relieving or preventing symptoms.

Special support or “compression” stockings are classic treatments for varicose veins, among conventional as well as nutritionally oriented doctors. These stockings encourage good circulation in the legs and can prevent the condition from worsening. Many women wear them during the last trimester of pregnancy to prevent the development or worsening of varicose veins and hemorrhoids. They are also very effective for people who are required to stand for long periods.

The stockings act like an added layer of muscle to help keep the blood moving in the right direction. They are classified according to the pressure they exert on your legs to counteract the pull of gravity. A specialist needs to determine what size you need. Because they get stretched out over time with daily use, it’s best to replace these stockings every few months.

How Supplements Can Help
Many of the following nutrients and herbs are commonly used in Europe, where varicose veins are sometimes referred to as chronic venous insufficiency. A number of the supplements are aimed at strengthening the walls of the veins themselves, which may help to relieve symptoms. All are quite safe and can be taken on a maintenance basis. Several are sold in combination products designed specifically for vein health.

Just a reminder: If you have a serious medical condition or are taking medication, it always a good idea to check with your doctor before beginning a supplement program.

Horse chestnut seed extract reduces fluid retention, swelling, and inflammation and can be used along with gotu kola and bilberry. It is now widely available in health-food stores and other outlets as an over-the-counter supplement called Venastat. A recent German study found that horse chestnut seed extract was just as effective as compression stockings, which are often recommended but are expensive and uncomfortable.

Butcher’s broom is another herb that is frequently combined with horse chestnut to strengthen the walls of blood vessels.

Gotu kola (Centella asiatica) is an especially valuable herb for varicose veins, because it tones the connective tissue around the veins, keeps the veins flexible, and encourages blood flow. In a research study done in Italy, people taking gotu kola had measurably better vein function than those taking a placebo (dummy drug). Most of the studies on this herb have been done in Europe using a standardized extract called TTFCA (Total Triterpenic Acid Fraction of C. Asiatica).

Bilberry, an antioxidant that strengthens capillaries and improves blood flow, is a good companion to gotu kola, and these two herbs are often sold together in a combination product.

Vitamin C helps to strengthen the walls of arteries, veins, and the microscopic blood vessels between arteries and veins, called capillaries. Vitamin C is best taken with flavonoids (potent antioxidants derived from plant pigments), which enhance the way the body uses the vitamin.

Vitamin E helps blood circulation and fortifies blood vessel walls. It also works well in combination with vitamin C.

For convenience, look for products that combine several of these herbs, and take them with another combination product that teams vitamin C with flavonoids.

Self-Care Remedies
A number of behavior modification strategies–such as exercising more frequently and watching what you eat–can make a big difference in relieving or preventing the pain of varicose veins. Other lifestyle changes can even keep them from developing in the first place.

Do daily low-impact exercise that stimulates calf muscles. This might include walking, pedaling on a bike, or swimming. Even tiptoeing helps. The goal is to develop strong calf muscles that can help to push the blood in your veins along its journey to your heart, fighting gravity all the way. Low-impact exercise also helps by improving your overall circulation, and doing it regularly helps control risk factors such as constipation and being overweight.

Maintain an ideal weight for your height and age. Obesity is a risk factor for varicose veins because it puts such heavy pressure on the legs. If you’re overweight, losing those extra pounds will make a big difference in how your legs feel. By eating a diet that’s low in fat and high in filling fiber, you’ll be more likely to lose–and keep–the weight off.

Make use of cold water for toning muscles. If you have access to a pool, lake, or other cold body of water for swimming, try walking through the water for 5 to 10 minutes a day. European spas often include cold-water soaks for varicose veins, and stimulating the calf muscles with movement can only add to the benefit.

Put your legs and feet up. Do this as often as you can during the day (three or four times a day for at least 10 to 15 minutes is a good goal). And sleep with your feet elevated two to four inches at night (one way to do this is to raise the foot of the bed with blocks; another is to put your feet on pillows). The point is to get your legs elevated above your heart, so blood will be less likely to pool in the veins.

Avoid long periods of standing or sitting without a break. If your job or daily routine requires you to be on your feet a lot, stretch and exercise your legs regularly and try to sit down whenever you can. If you have a desk job, be sure to get up and move around periodically. Try flexing your ankle every few minutes to prevent blood from pooling in your calves. Alternatively, try some simple heel raises to stimulate your calf muscles and get blood flow going. Stand flat-footed; then slowly rise up onto the balls of your feet. Hold this position for five seconds; then lower your soles to the floor. Repeat 10 to 20 times.

Uncross your legs. If you have a habit of crossing your legs while sitting, break it. The veins in your legs need good circulation–the blood should be able to flow freely. Crossing them cuts off this flow and makes many of the other self-care measures that you take less effective.

Avoid tight clothes. Garments that constrict parts of the leg or torso can compress leg veins and others nearby, impeding upward circulation. Examples include commercial panty hose that is very snug around the tummy; knee-high stockings or socks with tight elastic; too-tight or high-heeled shoes; and belts, girdles, and even garter belts.

Don’t strain on the toilet. Avoid constipation and straining to produce a stool. You won’t have this problem if you eat a high-fiber diet. So stock up on whole-grain cereals and breads, and fruits and vegetables. Exercise–especially walking–will also help your bowels move.

Alternative Therapies
There are a number of alternative therapies that can help treat or prevent varicose veins.

Traditional Chinese Medicine (TCM). Practitioners of this ancient healing system believe that varicose veins are often a sign of a constitutional weakness in the spleen-pancreas energy system. According to the TCM system of healing, a range of other ills–repeated yeast infections, male infertility, prostate problems, menstrual difficulties–are often seen in tandem with varicose veins. If you are interested in traditional Chinese medicine, visit an experienced practitioner who is licensed to perform acupuncture and is qualified to dispense Chinese herbs.

Chiropractic or osteopathic medicine. From the standpoint of these treatment approaches, a mechanical imbalance in the bones and muscles of the pelvis can lead to excessive pressure and pooling of blood in the pelvic veins, which accelerates the development of varicose veins in the legs. If the varicosities are worse on one side, or developed after a difficult labor or back injury, it is reasonable to get an evaluation from a chiropractor or osteopathic physician to see if adjustments to your pelvis will help.

Homeopathy. To relieve the symptoms of varicose veins, homeopathic practitioners routinely prescribe various remedies, which are usually taken for three weeks to three months. During the diagnostic process, a skilled homeopath will also search for other remedies on an individualized basis. Certain preparations, for instance, might be created to lessen a person’s inherited tendency to develop varicose veins during stressful times, such as difficult pregnancies, injuries, or problems with blood circulation.

When to Call a Doctor

  • If walking is extremely painful.
  • If skin around the varicose veins has a brownish gray discoloration or is peeling.
  • If the skin around the veins turns red and becomes painful, a common occurrence with superficial phlebitis (vein inflammation).
  • If a sore that won’t heal appears over a varicose vein.
  • If your ankles are swollen.
  • If you develop pain deep in the calf muscles. The pain may be constant or crampy, but it is likely to come on fairly rapidly. The major risk here is a blood clot (deep vein thrombosis) in your leg. You may need to be hospitalized for treatment to dissolve the clot. Smoking, birth control pills or other hormones, or sitting still for long stretches of time (on a long airplane flight, for example) make you more susceptible. This can be a potentially life-threatening situation. Seek emergency help.

Supplement Recommendations

From David Edelberg, M.D. at WholeHealth Chicago: These are the supplements that can help you minimize the varicose veins you already have or prevent varicose veins from developing. If you don’t treat varicose veins, they generally worsen over time. You’ll need to be patient, however. Allow up to three months to see results from your supplement program.

How to take the supplements
Start with the herbs horse chestnut and butcher’s broom, along with vitamin C with flavonoids. (These supplements are frequently available in combination products.)

The herbs help to control inflammation and swelling and also to lessen the fluid accumulation that can occur in more severe cases of varicose veins. The flavonoids tune up the body’s use of vitamin C, and together these vitamins can improve blood flow and fortify the walls of the veins and arteries.

For the herbs above, you can substitute gotu kola, which is also useful for both preventing and treating varicose veins. This herb is believed to improve blood circulation, tone up the connective tissue around the veins, and keep the veins pliant. Bilberry complements gotu kola–they are often offered as a combination product.

Vitamin E enhances overall circulation. You may already be taking some of this in your daily supplement regimen.

There are a number of combination products available, containing key herbs such as horse chestnut, butcher’s broom, and gotu kola. These can be convenient and economical–just be sure you are getting an adequate dosage of each herb in whatever product you choose.

Important:
We at WholeHealth Chicago strongly recommend that everyone take a high-potency multivitamin/mineral and well-balanced antioxidant complex every day. It may be necessary to adjust the dosages outlined below to account for your own daily vitamin regimen. All of our supplement recommendations also assume you are eating a healthful diet.

Be aware that certain cautions are associated with taking individual supplements, especially if you have other medical conditions and/or you’re taking medications. Key cautions are given in the listing below, but you need to see the WholeHealth Chicago Reference Library for a comprehensive discussion of each supplement’s cautions and drug/nutrient interactions.

For product recommendations and orders click here for the Natural Apothecary or call 773-296-6700 ext. 2001.

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Patient education is an integral part of our practice. Here you will find a comprehensive collection of staff articles, descriptions of therapies and nutritional supplements, information addressing your health concerns, and the latest research on nutritional supplements and alternative therapies.

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