A bulging section of blue, twisted vein on the back of a person’s calf or thigh is a common sight. This is a varicose vein. Varicose veins run in families and are more common in women. They often ache, sometimes itch, usually cause swelling and pain in the feet and ankles, and are more obvious when standing up.
What is a varicose vein?
After the blood has delivered oxygen throughout the body, veins carry it back toward the heart. Veins have one-way valves to keep gravity from pulling the blood downward. Varicose veins affect humans because we stand upright rather than run around on all fours. This means that gravity puts pressure on the veins in the legs, and they have to work harder to pump blood back upwards to the heart. Sometimes this pressure can cause the veins to leak. Accumulated blood at these leak sites stretches the vein, and pools of it cause lumps and kinks. The veins affected are just under the skin, so you can clearly see the enlarged and twisted portions.
Besides heredity, what brings on problems?
Sometimes varicose veins first occur during pregnancy because of hormonal changes and increased pressure in the veins caused by the expanding uterus. Obesity, menopause, aging, constipation and repeated abdominal strain, as well as heavy lifting, may contribute. Long periods of standing and sitting with the legs bent and crossed make them worse.
The simplest act of standing for long periods can increase the pressure within the veins of the legs many-fold. At the end of the workday, if your legs ache and you notice edema, blood is pooling in your legs due to venous stasis. Over time, the walls of your veins are likely to become dilated and may develop defects, leading to further dilation, valvular damage, further dilation, and more valvular damage. This is the vicious cycle that generates a loss of structural integrity and gives rise to varicosities.
How are varicose veins treated?
Minor problems may improve if you take regular walks, avoid long periods of standing, don’t use high heels, and rest with your feet elevated. Your doctor may suggest wearing elastic stockings to support the veins. If so, put them on right away in the morning before blood and fluid have pooled in your feet and ankles.
In more severe cases, sclerotherapy may be recommended, which consists of injecting a solution into the varicose vein. The solution causes irritation, inflammation, and eventually scarring, which permanently blocks the vein. The body absorbs the accumulated blood from the varicose vein, and the lumps flatten out over time. A new sclerosing procedure called “Varisolve” is very successful. The procedure is cheaper than surgery and boasts that 81% of patients are completely cured, with an addtional 10% seeing significant improvements.
Another method is removal of the vein by a procedure called stripping. The vein is tied off above the varicose section. One end of a tiny wire is attached at the varicose section and the other end is threaded through the vein to a small incision at the calf or ankle. There, the wire, along with the varicose section of vein, is pulled out.
The body does not miss veins that are blocked with sclerotherapy or removed with surgery. The legs have many alternative channels for the blood to take. Problems never return in treated veins, but new varicose veins can develop in another location. Mild problems are easier to treat than severe ones, so be sure to deal with your symptoms early.
Along with a high fiber diet and regular exercise, enhancing fibrinolytic activity can help. The use of cayenne, garlic, onion, ginger, and bromelain are suggested. Also, flavonoids are useful in strengthening connective tissue (especially capillaries). They help keep tissues from falling apart. Varicose veins, hemorrhoids, bleeding between periods, and lymphedema can be aided by flavonoids. The anthocyanidins and proanthocyanidins should be supplemented as they are the strongest acting of the flavonoids. Rutin has only a little collagen-stabilizing effect. Since increasing the integrity of the wall of the vein may also reduce the risk of developing varicose veins, it appears that flavonoid-rich berries, such as hawthorne berries, cherries, blueberries, and blackberries are beneficial in the prevention and treatment of varicose veins. These berries are very rich sources of proanthocyanidins and anthocyanidins.
The most effective agents, though harder to find are aortic GAGs (glycosaminoglycans) from highly purified bovine sources. These contain dermatan sulfate, heparan sulfate, hyaluronic acid, chondroitin sulfate and other GAGs. Two double-blind studies have compared aortic GAGs to bilberry and HER (a flavonoid preparation like rutin and citrus bioflavonoids). The aortic extract produced far better results in both hemorrhoids and varicose veins.
Dosages
HER 1,000 – 3,000mg per day (better than rutin and citrus bioflavonoids).
Bilberry (Vaccinium myrtillus) (25% anthocyanosides) 80-160mg tid.
Butcher’s broom (Ruscus aculeatus) (9-11% ruscogenin) 100mg tid.
Horse chestnut (aesculus hippocastanum) extract for 50mg of escin per day.
Grape seed extract 100mg bid-tid.
Vitamin C 500-1,000gm tid with Bioflavonoids 3000-6000mg per day.
Bromelain (1,200-1,800mcu) 500-750 bid-tid.
Medical help should be sought if:
— the pain and swelling becomes extremely severe or
— you have red varicose veins
— you cut a varicose vein – see a doctor immediately.
Chronic venous insufficiency (CVI) sometimes leads to varicose veins. Symptoms of CVI include edema, enlarged veins near the skin surface, and fatigue in the legs.
Signs, symptoms & indicators of Varicose Veins
(Very/tendency to) infrequent stools
Constipation is a leading cause of varicose veins.
Leg aches with standing or leg aches
Conditions that suggest Varicose Veins
Phlebitis / Thrombophlebitis
Thrombophlebitis is common in people who have varicose veins but may be prevented as long as the patient wears support stockings, walks regularly and elevates the legs while sitting.
Varicose veins
Counter Indicators
Absence of varicose veins
Risk factors for Varicose Veins
Varicose Veins suggests the following may be present
Varicose Veins can lead to
Phlebitis / Thrombophlebitis
Thrombophlebitis is common in people who have varicose veins but may be prevented as long as the patient wears support stockings, walks regularly and elevates the legs while sitting.
Recommendations for Varicose Veins
Horse Chestnut (Aesculus hippocastanum)
A study out of West Germany, reported in the early 1980s, showed horse chestnut products affected both the collagen content and architecture of the varicose vein and helped make the veins more normal. Horse chestnut may also relieve symptoms of chronic venous insufficiency (CVI), which sometimes leads to varicose veins. Symptoms of CVI include edema, enlarged veins near the skin surface, and fatigue in the legs.
Grape Seed Extract / Resveratrol
A double-blind study of 50 people with varicose veins of the legs found that doses of 150mg per day of OPCs were more effective in reducing symptoms and signs than another natural treatment: the bioflavonoid diosmin, widely used in Europe for this condition. [Gaz Med. 1985;92: pp.96-100]
A double-blind placebo-controlled study of 71 subjects with venous insufficiency found that grape seed OPCs, taken at a dose of 100mg 3 times daily, significantly improved major symptoms, including heaviness, swelling, and leg discomfort. [La Revue de Medecine. Aug/Sept.1981;no.27–28: pp.1793-1802]
Garlic
To disperse the build-up of a protein called fibrin that makes skin near varicose veins hard and lumpy, try eating more cayenne pepper, garlic, onion, ginger (zingiber officinale), and pineapple, which contains bromelain, an enzyme that promotes the breakup of fibrin.
Vegetarian/Vegan Diet
Constipation is one of the leading causes of varicose veins, although it may initially be hard to see the connection. Constipation may restrict the blood as it returns to the torso through the deep veins in the legs. Straining to have a bowel movement closes off these veins. As the blood backs up it takes another course through superficial veins, thus the blue streaks in the legs. A diet low in fat and high in fiber is best for promoting regularity: reorganize your diet to include plenty of low-fat foods, grains, fresh fruit and vegetables. A diet tending towards vegan/raw-food generally satisfies all these requirements; vegetarians should watch their fat intake.
Weight Loss
It is important to keep your weight at your ideal level as extra body fat places strain on your legs and veins.
Increased Water Consumption
Drinking plenty of filtered water is recommended.
Alcohol Avoidance
Alcohol intake reduction is advised.
Conventional Drugs / Information
DAFLON 500 mg has a comprehensive and rigorously demonstrated mode of action, which enables it to fight simultaneously all the pathophysiological aspects of venous disease, affecting the veins, lymphatics, and microcirculation.
It prolongs the vasoconstrictor effect of noradrenaline on the vein wall, even under warm and acidotic conditions, increasing venous tone, and therefore reducing venous capacitance, distensibility, and stasis. This increases the venous return and reduces venous hyperpressure present in patients suffering from chronic venous insufficiency (CVI).
Daflon is challenging to find in the USA, but can be ordered from some foreign pharmacies, including India and Malaysia. Some locations seem to be charging too much, so please shop around. Two capsules a day should cost around one US dollar.
Aerobic Exercise
Regular aerobic exercise provides benefits for the circulatory system.
Progesterone
Topical progesterone has been reported to provide some benefit.
Massage
Regular massage from a trained massage therapist can significantly alleviate the discomfort associated with varicose veins.
Calming / Stretching Exercises
Yoga’ s stretching and relaxation techniques can be particularly beneficial for varicose veins.
Bioflavonoids
Bioflavonoids may be useful because of their reported antioxidant properties, their ability to increase the strength of the capillaries, and to regulate their permeability. Rutin, in particular, is often recommended for varicose veins.
Key
| Weak or unproven link |
| Strong or generally accepted link |
| Proven definite or direct link |
| Very strongly or absolutely counter-indicative |
| May do some good |
| Likely to help |
| Highly recommended |
Glossary
Varicose Veins
Twisted, widened veins with incompetent valves.
Menopause
The cessation of menstruation (usually not official until 12 months have passed without periods), occurring at the average age of 52. As commonly used, the word denotes the time of a woman's life, usually between the ages of 45 and 54, when periods cease and any symptoms of low estrogen levels persist, including hot flashes, insomnia, anxiety, mood swings, loss of libido and vaginal dryness. When these early menopausal symptoms subside, a woman becomes postmenopausal.
Constipation
Difficult, incomplete, or infrequent evacuation of dry, hardened feces from the bowels.
Edema
Abnormal accumulation of fluids within tissues resulting in swelling.
Fibrinolytic
Fibrinolytic activity: Clot removal.
Hemorrhoids
Varicose disorder causing painful swellings at the anus; piles.
Proanthocyanidin
Also called procyanidin, it is a powerful antioxidant that chemically belongs to the class of bioflavonoids. Pycnogenol from grape seed and pine bark extracts is an example. Berries, such as hawthorn berries, cherries, blueberries, and blackberries and, to a lesser extent, red wine, are natural sources.
Milligram
(mg): 1/1,000 of a gram by weight.
TID
Three times a day.
Vitamin C
Also known as ascorbic acid, Vitamin C is a water-soluble antioxidant vitamin essential to the body's health. When bound to other nutrients, for example calcium, it would be referred to as "calcium ascorbate". As an antioxidant, it inhibits the formation of nitrosamines (a suspected carcinogen). Vitamin C is important for maintenance of bones, teeth, collagen and blood vessels (capillaries), enhances iron absorption and red blood cell formation, helps in the utilization of carbohydrates and synthesis of fats and proteins, aids in fighting bacterial infections, and interacts with other nutrients. It is present in citrus fruits, tomatoes, berries, potatoes and fresh, green leafy vegetables.
Gram
(gm): A metric unit of weight, there being approximately 28 grams in one ounce.
MCU
Milk Clotting Unit. A dosage measurement of enzyme activity. Potencies of bromelain are based on GDUs or MCUs. One MCU equals .66 GDU.
Chronic
Usually Chronic illness: Illness extending over a long period of time.
Thrombophlebitis
Venous inflammation with formation of clots. It can occur without any symptoms until the clot reaches the lungs. However, in about half of cases, there are warning symptoms including swelling, pain and warmth in the entire calf, ankle, foot, or thigh (depending on where the involved vein is located).