Q- I am in my late 20s and have developed rather ugly varicose veins in both my lower legs. I don't have any ulceration, but I also regularly develop excessive swelling in my legs and ankles around the time of my monthly period. Can you suggest anything to help, please?
A- Varicose veins-veins that have become enlarged and sometimes twisted or bulging-are not just an old people's problem. Anyone can get them, although they are more commonly seen in older women and especially in the lower legs.
Height and being overweight don't appear to play as big a role in their development as has often been assumed.
But pregnancy and having an occupation that requires a lot of standing do tend to make people more prone to the condition.
Varicose veins can cause cramp-like pain and mobility issues, but they can also be a cosmetic concern. Orthodox treatment usually includes elevating the affected limb, wearing compression stockings to increase external pressure on the vein and, in some cases, surgery. But these all have downsides: keeping the limb elevated can be impractical; compression stockings can keep the condition in check, but won't provide a cure; and surgery for varicose veins is often followed by other veins becoming varicose.
The good news is there are some effective herbal remedies that can relieve symptoms and stop the problem getting worse. They work by 'toning up' the blood vessel walls and supporting the tiny muscles that surround these vessels. There's also a herb to treat the swelling you're experiencing.
Herbs for varicose veins
Bilberry, the European blueberry (Vaccinium myrtillus) also known as whortleberry, contains flavonoid compounds known as 'anthocyanosides'-potent antioxidants that improve microcirculation and protect the vascular endothelium (cells that line the inside of blood vessels).1
Patients with varicose veins and leg ulcers given bilberry extract showed a substantial drop in capillary leakage in one study. According to the researchers, it was the anthocyanosides in the extract that were responsible for the effect.2
As bilberries can be hard to find in the UK, try taking an anthocyanin-rich bilberry supplement every day such as Healthspan's Bilberry extract (available from www.healthspan.co.uk).
Be aware, though, that anthocyanosides at high doses may enhance the action of blood thinners like warfarin and antiplatelet drugs.
Suggested daily dosage: Two 50-mg tablets
Horse chestnut (Aesculus hippocastanum) seeds have a long folk history of use in the treatment of varicose veins. The active component is aescin, which has demonstrated anti-inflammatory and venotonic (promoting venous drainage) properties. It also decreases capillary permeability by reducing the number and size of the small pores in the capillary walls on the venous side of circulation.3
A comprehensive review published in 1989 reported that horse chestnut extracts, standardized to contain 50 mg of aescin per dose, have tonic effects on veins, and decrease venous and capillary permeability. In several high-quality studies, patients' symptoms were reduced and the supplements "well tolerated".4
Ingesting raw horse chestnut seeds, bark, flowers or leaves can be toxic, but commercial supplements containing their extracts are generally safe for adults.
Try A.Vogel's Venaforce horse chestnut tablets (available from www.avogel.co.uk).
Suggested daily dosage: 1 tablet containing 50 mg aescin twice a day
Ribbed melilot (Melilotus officinalis), also known as yellow sweet clover, is featured extensively in R.F. Weiss's classic textbook of herbal medicine.5 In a study published in 1999, researchers treated more than 4,500 patients suffering from chronic venous insufficiency (where the veins cannot pump enough blood back to the heart) with 4 to 8 g of ribbed melilot extract and asked them to rate their symptoms, which included heavy-feeling legs, pain, night cramps, swelling and itching. Good or very good results were seen in 70 per cent of them.5
Try taking ribbed melilot as a tea: just stir 1-2 tsp dried herbs into a cup of boiling water and leave it to infuse for a few minutes.
Suggested daily dosage: 3-4 cups
Ginkgo biloba for swollen legs It sounds like you may be suffering from a syndrome known officially as 'idiopathic cyclic oedema', although you need to have this properly diagnosed by a qualified practitioner. Mainly affecting menstruating women, it's when substantial tissue swelling (oedema) is seen in the legs, particularly after sitting or standing for periods of time. It can also cause swelling of the face and eyelids when lying down.
It's thought to result from leakage of blood fluids from capillaries into fat and skin tissues, especially when gravity (by standing up) is added to the pressure in the vascular system. It can cause large shifts in weight from morning to evening, and result in discomfort or pain wherever the excess fluids have accumulated.
The word 'cyclic' is part of the condition's name because it's often at its worst during menstruation, which seems to apply in your case. It can also masquerade as premenstrual syndrome, or make your premenstrual syndrome worse if you're already a sufferer. It exacerbates any swelling, abdominal bloating and general physical discomfort, but doesn't usually cause the irritability and depressive symptoms usually seen in classical premenstrual syndrome.
Ginkgo biloba, or the maidenhair tree, has proved to be beneficial in idiopathic cyclic oedema.6 The Botanical Medicines desk reference devotes a whopping 58 pages to this medicinal herb and its effects on the vascular system.7
Suggested daily dosage: 40 mg standardized extract (containing 24 per cent Ginkgo flavonglycosides) three times a day
1 J Appl Phyiol, 2006; 100: 1164-70
2 Minerva Med, 1977; 68: 3565-81
3 VASA, 1983; 12: 377-82
4 Wien Med Wochenschr, 1989; 139: 385-9
5 Weiss RF. Weiss's Herbal Medicine. Beaconsfield, Bucks: Beaconsfield Publishers, 1988: 189-91
6 Altern Med Rev, 1998; 3: 54-7
7 McKenna DJ et al. Botanical Medicines: The Desk Reference for Major Herbal Supplements, 2nd edn. London: Routledge, 2002: 445-503