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Chronic Venous Insufficiency Information
Chronic venous insufficiency (CVI) is poor return of blood from feet and legs back to the
heart.
CVI may occur following excessive clotting and inflammation of the leg veins, a disease
known as deep vein thrombosis. CVI also results from a simple failure of the valves in leg
veins to hold blood against gravity, leading to sluggish movement of blood out of the veins,
resulting in swollen legs.
What are the symptoms of chronic venous
insufficiency?
CVI may cause feet and calves to become swollen, often accompanied by a dull ache made
worse with prolonged standing. If CVI is allowed to progress, the skin tends to darken and
ulcers may occur. CVI often causes varicose
veins.
Medical treatments for chronic venous insufficiency
Over the counter antibiotic products that
contain bacitracin (Baciguent®), neomycin (Myciguent®), or a combination of the two
with polymyxin B (Neosporin®, Polysporin®), might be useful if skin ulcers
develop.
Topical prescription antibiotics such as mupirocin (Bactroban®) and metronidazole (MetroGel®) may be useful for the
treatment of skin ulcers.
Health care practitioners typically advise patients to elevate the legs frequently, avoid
prolonged standing or sitting, and wear graduated compression stockings with supportive shoes.
Recurrent ulceration may be surgically treated with skin grafts. Surgical repair or bypass of
the affected veins is sometimes necessary.
Lifestyle changes that may be helpful for chronic venous insufficiency
People affected by chronic venous insufficiency should not sit or stand for long periods of
time. When sitting, they should elevate their legs. Walking helps move blood out of the veins.
Wearing tight-fitting compression stockings available from pharmacies further supports the
veins.
Nutritional supplements that may be helpful for chronic venous insufficiency
Flavonoids promote venous strength and
integrity. Most trials of flavonoids in patients with CVI have used a type of flavonoid called
hydroxyethylrutoside (HR), which is derived from rutin. These double-blind and other
controlled trials have consistently shown a beneficial effect of HR in clearing leg swelling
and other signs of CVI.1 2 3 Positive results from a
double-blind trial have been obtained using 500 mg of HR taken twice per day for 12
weeks.4 In this trial, the preparation was found to add further benefit to that
provided by compression stockings commonly used to treat CVI. Similar results were obtained in
another controlled trial.5 It is unclear whether other flavonoids are as effective
as HR for CVI. HR has also been used successfully as a topical preparation for the treatment
of CVI.6
Proanthocyanidins (OPCs), a group of
flavonoids found in pine bark, grape seed,
grape skin, bilberry, cranberry, black currant, green tea, black tea, and other plants, have also been shown to
strengthen capillaries in double-blind research using as little as two 50 mg tablets per
day.7 In a double-blind trial using a total of 150 mg OPCs per day, French
researchers reported reduced symptoms for women with CVI.8 In another French
double-blind trial, supplementation with 100 mg taken three times per day resulted in benefits
within four weeks.9
Are there any side effects or interactions with Chronic Venous Insufficiency?
Refer to the individual supplement for information about any side effects or interactions.
Herbs that may be helpful for chronic venous insufficiency
According to an extensive overview of clinical trials, standardized horse chestnut seed extract, which contains the active
compound aescin, has been shown to be effective in double-blind and other controlled research,
supporting the traditional use of horse chestnut for venous problems.10 In these
trials, capsules of horse chestnut extract containing 50 mg of aescin were given two to three
times daily for CVI. The positive effect results in part from horse chestnut’s ability
to strengthen capillaries, which leads to a reduction in swelling.11
Another traditional remedy for CVI is
butcher’s broom. One double-blind trial used a combination of butcher’s broom,
the flavonoid hesperidin, and vitamin C. This was found to be better than a placebo
for treating CVI.12 In a comparison study, a product combining butcher’s
broom extract, the flavonoid hesperidin, and vitamin C was more effective than a synthetic
flavonoid product for treating CVI.13 A double-blind study, in which Butcher's
broom alone was used, has confirmed the beneficial effect of this herb.14 Clinical
trials have used one capsule, containing standardized extracts providing 15 to 30 mg of
ruscogenins, three times each day. The amount of butcher’s broom extract used in these
trials is 150 mg two times per day. Other sources recommend standardized extracts providing 15
to 30 mg of ruscogenins, given three times each day.
Gotu kola extracts, standardized to
triterpenoid content, have been found successful in small preliminary trials to treat
CVI.15 The amount of extract used in these trials ranged from 60 to 120 mg per
day.
A double-blind trial demonstrated that red vine leaf extract is effective at relieving the
symptoms and swelling associated with CVI.16 One group of participants took either
360 mg or 720 mg per day of a standardized extract for 12 weeks, and another group took a
placebo. At the end of the treatment period, those who had taken the herb experienced
significant improvement in symptoms of leg heaviness, tension sensation, tingling, and pain
compared with those who had taken the placebo. Objective measurements of leg swelling were
also significantly improved in the red vine group compared to the placebo group.
Are there any side effects or interactions with Chronic Venous Insufficiency?
Refer to the individual herb for information about any side effects or interactions.
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Copyright © 2004 Healthnotes, Inc. All rights reserved.
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The information presented in Healthnotes is for informational
purposes only. It is based on scientific studies (human, animal, or in
vitro), clinical experience, or traditional usage as cited in each article.
The results reported may not necessarily occur in all individuals. For many of
the conditions discussed, treatment with prescription or over the counter
medication is also available. Consult your doctor, practitioner, and/or
pharmacist for any health problem and before using any supplements or before
making any changes in prescribed medications.
References:
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