Varicose Veins

Veins, which return blood to the heart, contain valves that keep blood from flowing backward as a result of gravity. When these valves become weak, blood pools in the veins of the legs and causes them to bulge. These enlarged vessels are called varicose veins. Standing and sitting for long periods of time, lack of exercise, obesity, and pregnancy all tend to promote the formation of varicose veins. Sometimes varicose veins are painful, but elevating the affected leg usually brings significant relief.

Checklist for Varicose Veins

Rating Nutritional Supplements Herbs
1Star Flavonoids (hydroxyethylrutosides)
Proanthocyanidins		 Butcher’s broom
Gotu kola
Horse chestnut
Witch hazel
See also:  Homeopathic Remedies for Varicose Veins
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 varicose veins? Symptoms of varicose veins may include a dull pain, itch, or heavy sensation in the legs. The sensation is worse after prolonged standing and better when the legs are elevated. Varicose veins typically appear on the legs as dilated, tortuous veins close to the surface of the skin, and may look blue. Advanced varicose veins may cause ankle and leg swelling or skin ulcers.

How is it treated? Conventional treatment is to elevate the legs frequently, avoid prolonged standing or sitting, and wear compression stockings with supportive shoes. Other treatments include surgery to remove the vein, laser therapy, or sclerotherapy (which involves the injection of a chemical solution into the vein to cause it to close). Any skin ulcers that develop are treated with compressive bandages that contain antibiotic solutions.

Lifestyle changes that may be helpful: Keeping the legs elevated relieves pain. People with varicose veins should avoid sitting or standing for prolonged periods of time and should walk regularly.

Nutritional supplements that may be helpful: A controlled clinical trial found that oral supplementation with hydroxyethylrutosides (HR), a type of flavonoid that is derived from rutin, improved varicose veins in a group of pregnant women.1 Further research is needed to confirm the benefits observed in this preliminary trial. A typical amount of HR is 1000 mg per day.

A small, preliminary trial found that supplementation with 150 mg of proanthocyanidins per day improved the function of leg veins after a single application in people with widespread varicose veins.2 Double-blind trials are needed to determine whether extended use of proanthocyanidins can substantially improve this condition.

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

Herbs that may be helpful: Although witch hazel is known primarily for treating hemorrhoids, it may also be useful for varicose veins.3 Topical use of witch hazel to treat venous conditions is approved by the German Commission E, authorities on herbal medicine.4 Application of a witch hazel ointment three or more times per day for two or more weeks is necessary before results can be expected.

Horse chestnut seed extract can be taken orally or used as an external application for disorders of venous circulation, including varicose veins.5 Preliminary studies in humans have shown that 300 mg three times per day of a standardized extract of horse chestnut seed reduced the formation of enzymes thought to cause varicose veins.6 Topical gel or creams containing 2% aescin can be applied topically three or four time per day to the affected limb(s).

Oral supplementation with butcher’s broom 7 or gotu kola 8 may also be helpful for varicose veins.

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

References:

1. Sohn C, Jahnichen C, Bastert G. [Effectiveness of beta-hydroxyethylrutoside in patients with varicose veins in pregnancy]. Zentralbl Gynakol 1995;117:190–7 [in German].

2. Royer RJ, Schmidt CL. [Evaluation of venotropic drugs by venous gas plethysmography. A study of procyanidolic oligomers]. Sem Hop 1981;57:2009–13 [in French].

3. European Scientific Cooperative on Phytotherapy. Hamamelidis folium (Hamamelis leaf). ESCOP Monographs on the Medicinal Uses of Plant Drugs. Exeter, UK: ESCOP, 1997.

4. Blumenthal M, Busse WR, Goldberg A, et al. (eds). The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Austin, TX: American Botanical Council and Boston: Integrative Medicine Communications, 1998, 231.

5. Blumenthal M, Busse WR, Goldberg A, et al. (eds). The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Austin, TX: American Botanical Council and Boston: Integrative Medicine Communications, 1998, 149.

6. Kreysel HW, Nissen HP, Enghofer E. A possible role of lysosomal enzymes in the pathogenesis of varicosis and the reduction in their serum activity by Venostasin. Vasa 1983;12:377–82.

7. Capelli R, Nicora M, Di Perri T. Use of extract of Ruscus aculeatus in venous disease in the lower limbs. Drugs Exp Clin Res 1988;14:277–83.

8. Brinkhaus B, Linder M, Schuppan D, Hahn EG. Chemical, pharmacological and clinical profile of the East Asian medical plant Centella asiatica. Phytomed 2000;7:427–48.