Articles

Varicose Veins

Introduction

What should I know about Varicose Veins?

Varicose veins are a condition with which almost everyone past their teenage years is familiar. Whether in the form of the tiny capillary spider veins or the large distended blue rivers running under the surface of the skin and down through the legs, they are considered to be unsightly. While they can appear anywhere on the body, most cases of varicose veins occur in the legs and are caused by a malfunction in the valves in the veins in the legs that normally keep the blood flowing back to the heart. When these valves malfunction, or leak, the veins in the legs begin holding more blood than usual and become distended. Even the small capillaries are affected creating spider veins.

Some varicose veins do not cause any problems, but others can cause the legs to ache especially when standing for long periods of time. Fortunately, there are many different treatments for varicose veins which range from therapeutic to cosmetic.

Statistic

Bartholomew JR. Varicose veins: newer, better treatments available. Cleve Clin J Med. 2005 Apr;72(4):312-4, 319-21, 325-8.

    Varicose veins affect 10 to 20% of men. Varicose veins affect 25 to 33% of women.

The Varicose Vein Center, 2004.

  • 25% of people in western countries have varicose veins.

Signs and Symptoms

[span class=alert]The following list does not insure the presence of this health condition. Please see the text and your healthcare professional for more information.[/span]

Varicose veins may have no symptoms at all. Usually the veins in the legs look blue and are close to the surface, twisted or larger than normal. Sometimes there may be a feeling of heaviness in the legs or they may seem to tire easily. Swelling may occur around the ankles and the legs may ache or cramp. There may be sores on the skin especially around the ankles.

General

  • Veins in the legs may look blue and close to the surface
  • Veins may look twisted or larger than normal
  • Feeling of heaviness in the legs
  • Leg muscles may seem to tire easily
  • Swelling may occur around the ankles
  • General leg aches or leg cramping
  • Sores

Treatment Options

Conventional

Conservative measures are usually suggested as initial therapy. This would include periodic elevation of legs, avoiding long periods of standing when possible, and the use of elastic support stockings. These actions help to provide a counterbalance in the pressure in the veins. For moderate cases, a procedure called sclerotherapy may be used. In this procedure, a solution is injected into the veins and a compression bandage is applied. For more severe cases, surgery may be recommended especially if there are skin ulcers and pain associated. (1)

Nutritional Suplementation


Vitamin C

Vitamin C’s role in the production of collagen, elastin, and connective tissue has been well established. (2) , (3) , (4) Thus, there is a solid scientific rational suggesting that vitamin C would be therapeutically useful in the prevention and treatment of varicose veins.


Vitamin E

One author states that poor diet and nutritional status is primarily responsible for the increased incidence of varicose veins in Western countries. The author feels that a deficiency of vitamin E in the presence of other predisposing, triggering, or aggravating risk factors, can cause a weakening of venous cell wall structures, leading to varicose veins. (5)


Bioflavonoid

Many bioflavonoid compounds have venotonic-like activity, which enables them to improve venous integrity by decreasing capillary leakage and improving venous tone. (6) Thus, various bioflavonoid compounds might be useful in the treatment of individuals with varicose veins.

Herbal Suplementation


Horse Chestnut

Over the past few years, a number of studies have been done to test the efficacy of horse chestnut in the treatment of chronic venous insufficiencies. (7) , (8) A case observation study involving over 800 general practitioners and more than 5,000 patients with chronic venous insufficiency who were treated with standardized horse chestnut seed extract showed that horse chestnut may be considered an economical alternative to compression stocking therapy. (9)

It is reported to have the ability to support collagen structures and to allow red blood cells to penetrate into the microcapillary system, while not allowing fluids to pass out of the capillary wall, thus preventing edema. (10)


Grape Seed Extract

Proanthocyanidins (PCOs), the active constituent in grape seed, is a flavonoid-rich compound with free radical scavenging activity. Proanthocyanidins are claimed to support collagen structures and inhibit the destruction of collagen. (11) PCOs reportedly protect 1-antitripsin, a chemical that keeps enzymes for breaking down collagen, elastin, and hyaluronic acid (12) , (13) and directly inhibits these from damaging enzymes. Proanthocyanidins are believed to neutralize lipid peroxidation damage to cell membranes through their free radical activity. (14) , (15)


Gotu Kola

Gotu kola is reported to have a positive effect on tissues, specifically skin, connective tissue, lymph and mucous membranes. (16) , (17) , (18) It does not contain any caffeine and is not related in any way to kola nut. Gotu kola has been used primarily for venous insufficiency, soft tissue inflammation, and infection and for postsurgical wound healing. (19) , (20)

Diet & Lifestyle

Exercise reduces the incidence of varicose veins in pregnancy. (21)

Low fiber diet and being overweight are linked to increased incidence of varicose veins. (22)

References

  1. View Abstract: Santos J, et al. Release of mast cell mediators into the jejunum by cold pain stress in humans. Gastroenterology. Apr1998;114:4 640-8.
  2. Pauling L. How to Live Longer and Feel Better. New York: W H Freeman and Company; 1986:67-73.
  3. Ronchetti IP, et.al. Ascorbic acid and connective tissue. Subcell Biochem. 1996;25:249-64.
  4. View Abstract: Davidson JM, et al. Ascorbate differentially regulates elastin and collagen biosynthesis in vascular smooth muscle cells and skin fibroblasts by pretranslational mechanisms. J Biol Chem. Jan1997;272(1):345-52.
  5. View Abstract: Melet JJ. The importance of nutrition among the risk factors in varicose veins. Phlebologie. Jul1981;34(3):469-88.
  6. View Abstract: Ibegbuna V, et al. Venous elasticity after treatment with Daflon 500 mg. Angiology. Jan1997;48(1):45-9.
  7. Simini B. Horse-chestnut Seed Extract for Chronic Venous Insufficiency. Lancet. Apr1996;347(9009):1182-83.
  8. Vayssairat M, et al. Horse-chestnut Seed Extract for Chronic Venous Insufficiency. Lancet. Apr1996;347(9009):1182.
  9. View Abstract: Diehm C. Comparison of Leg Compression Stocking and Oral Horse-chestnut Seed Extract Therapy in Patients with Chronic Venous Insufficiency. Lancet. 1996;347(8997):292-94.
  10. View Abstract: Guillaume M, et al. Veinotonic Effect, Vascular Protection, Anti-inflammatory and Free Radical Scavenging Properties of Horse Chestnut Extract. Arzneim-Forsch/Drug Res. 1994;44(1):25-35.
  11. View Abstract: Bagchi D, et al. Oxygen Free Radical Scavenging Abilities of Vitamins C and E, and a Grape Seed Proanthocyanidin Extract in Vitro. Res Commun Mol Pathol Pharmacol. 1997;95(2):179-89.
  12. View Abstract: Robert AM, et al. The Effect of Procyanidolic Oligomers on Mesenchymal Cells in Culture. II --Attachment of Elastic Fibers to the Cells. Pathol Biol. Paris. 1990;38(6):601-07.
  13. Jonadet M, et al. Anthocyanosides Extracted from Vitis vinifera, Vaccinium myrtillus and Pinus maritimus. I. Elastase-inhibiting Activities in Vitro. II. Compared Angioprotective Activities in Vivo. J Pharm Belg. 1983;38(1):41-46.
  14. View Abstract: Robert L, et al. The Effect of Procyanidolic Oligomers on Vascular Permeability. A Study Using Quantitative Morphology. Pathol Biol. Paris. 1990;38(6):608-16.
  15. View Abstract: Zafirov D, et al. Antiexudative and Capillaritonic Effects of Procyanidines Isolated from Grape Seeds (V. vinifera). Acta Physiol Pharmacol Bulg. 1990;16(3):50-54.
  16. View Abstract: Suguna L, et al. Effects of Centella asiatica Extract on Dermal Wound Healing in Rats. Indian J Exp Biol. 1996;34(12):1208-11.
  17. View Abstract: Hausen BM. Centella asiatica (Indian Pennywort), an Effective Therapeutic But a Weak Sensitizer. Contact Dermatitis. 1993;29(4):175-79.
  18. View Abstract: Tenni R, et al. Effect of the Triterpenoid Fraction of Centella asiatica on Macromolecules of the Connective Matrix in Human Skin Fibroblast Cultures. Ital J Biochem. 1988;37(2):69-77.
  19. View Abstract: Maquart FX, et al. Stimulation of Collagen Synthesis in Fibroblast Cultures by a Triterpene Extracted from Centella asiatica. Connect Tissue Res. 1990;24(2):107-20.
  20. View Abstract: Cesarone MR, et al. The Microcirculatory Activity of Centella asiatica in Venous Insufficiency. A Double-blind Study. Minerva Cardioangiol. 1994;42(6):299-304.
  21. Carlucci D, et al. Exercise: Not Just For The Healthy. The Physician and Sports Medicine. Jul1991;19(7):46-52.
  22. View Abstract: Carpentier P, Priollet P. Epidemiology of chronic venous insufficiency. Presse Med. Feb1994;23(5):197-201.