Capillary Fragility

When the smallest blood vessels, capillaries, become weak, a person is said to have capillary fragility. There are no serious complications from having capillary fragility, but it may signify that a more serious, underlying problem exists. Therefore, people should consult a physician if there is bleeding in the skin.

Checklist for Capillary Fragility

Rating Nutritional Supplements Herbs
3Stars Vitamin C (for deficiency only)  
2Stars Proanthocyanidins  
1Star Flavonoids (quercetin, rutin, hesperidin)  
3Stars Reliable and relatively consistent scientific data showing a substantial health benefit.
2Stars Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
1Star An herb is primarily supported by traditional use, or the herb or supplement has little scientific support and/or minimal health benefit.

What are the symptoms of capillary fragility? Weak capillaries lead to small spots of bleeding in the skin and easy bruising. Bruises look like areas of blue to purple-colored skin that can turn yellow to dark brown over the course of a few days.

How is it treated? The conventional treatment is to manage any underlying medical condition, such as liver or kidney disease, blood disorders (e.g., hemophilia, platelet dysfunction, thrombocytopenia, leukemia, and multiple myeloma), connective tissue disorders (e.g., scurvy, Marfan’s syndrome, and Ehlers-Danlos syndrome), or the use of blood-thinning medication (e.g., aspirin and Coumadin®).

Dietary changes that may be helpful: Eating plenty of fruits and vegetables will provide more of the nutrients mentioned in the Nutritional supplements information below that support the structure of capillaries.

Nutritional supplements that may be helpful: Severe vitamin C deficiency (scurvy) is a well-recognized but uncommon cause of increased capillary fragility. Whether vitamin C supplementation can help capillary fragility in people who do not have scurvy is less clear. Patients undergoing dialysis may develop low levels of vitamin C,1 2 which can lead to capillary fragility, but giving dialysis patients 50 mg of vitamin C per day had no effect on capillary fragility in one study.3 People with kidney failure and those undergoing dialysis should not supplement with more than 100 mg per day, unless supervised by a doctor.

According to preliminary studies, vitamin C may reduce capillary weakness in diabetics, who often have low blood levels of vitamin C compared to non-diabetics.4 5 In a double-blind trial, elderly people with low vitamin C levels and capillary fragility were helped with supplementation of one gram per day of vitamin C.6

Compounds called flavonoids may help strengthen weakened capillaries. In test tube and animal studies, they have been shown to protect collagen, one of the most important components of capillary walls.7 8 A preliminary study found that proanthocyanidins (flavonoids extracted from grape seeds), 150 mg per day, increased capillary strength in people with hypertension and/or diabetes.9 A double-blind trial found a combination of two flavonoids (900 mg per day of diosmin and 100 mg per day hesperidin) for six weeks reduced symptoms of capillary fragility.10 Use of vitamin C with flavonoids, particularly quercetin, rutin, and hesperidin, is sometimes recommended for capillary fragility.11 Doctors often recommend 400 mg of rutin or quercetin three times per day or 1 gram of citrus flavonoids three times per day.

Are there any side effects or interactions? Refer to the individual supplement for information about any side effects or interactions.

References:

1. Bradley DW, Maynard JE, Webster H. Plasma and whole blood concentrations of ascorbic acid in patients undergoing long-term hemodialysis. Am J Clin Pathol 1973;60:145–7.

2. Sullivan JF, Eisenstein AB. Ascorbic acid depletion during hemodialysis. JAMA 1972;220:1697–9.

3. Tomson CR, Channon SM, Parkinson IS. Correction of subclinical ascorbate deficiency in patients receiving dialysis: effects on plasma oxalate, serum cholesterol, and capillary fragility. Clin Chim Acta 1989;180:255–64.

4. Cox BD, Butterfield WJ. Vitamin C supplements and diabetic cutaneous capillary fragility. Br Med J 1975;3:205.

5. Will JC, Byers T. Does diabetes mellitus increase the requirement for vitamin C? Nutr Rev 1996;54:193–202 [review].

6. Schorah CJ, Tormey WP, Brooks GH, et al. The effect of vitamin C supplements on body weight, serum proteins, and general health of an elderly population. Am J Clin Nutr 1981;34:871–6.

7. Schlebusch H, Kern D. Stabilization of collagen by polyphenols. Angiologica 1972;9:248–56 [in German].

8. Monboisse J, Braquet P, Randoux A, Borel J. Non-enzymatic degradation of acid-soluble calf skin collagen by superoxide ion: protective effect of flavonoids. Biochem Pharmacol 1983;32:53–8.

9. Lagrue G, Olivier-Martin F, Grillot A. A study of the effects of procyanidol oligomers on capillary resistance in hypertension and in certain nephropathies. Sem Hop 1981;57:1399–401 [in French].

10. Galley P, Thiollet M. A double-blind, placebo-controlled trial of a new veno-active flavonoid fraction (S 5682) in the treatment of symptomatic capillary fragility. Int Angiol 1993;12:69–72.

11. Bruneton J. Pharmacognosy Phytochemistry Medicinal Plants. Andover: Intercept Ltd., 1995, 277.