Expert Answers to Your Health Questions
Maybe you can help me. I’m 75, and I think I have poor circulation. Recently, my feet started hurting like the devil. I went to the doctor, and he told me it was varicose veins and to wear support hose. It did no good. I went to another doctor who told me I had blood clots that could move up and lead to a stroke. Could you tell me what to take to improve my circulation?
Stansbury responds: It is very important to distinguish between varicose veins and blood clots, so please return right away to your doctor to be sure. Blood clots can be life-threatening, and it is essential that your situation is being closely monitored by your health-care professional. Varicose veins develop slowly over time and start aching gradually. They are worse when you’re up and about and better when you’re lying down with your feet up. I am curious if this has developed gradually and if it is restricted to your feet. I also would like to know if you have extensive visible varicose veins, fluid in your feet and lower legs, puffiness or coldness.
Varicose veins can predispose you to clots, as blood returning to the heart (known as venous return) has an increased tendency to pool and coagulate. Clots may appear as painless lumps or thin, ropey veins — or may produce sudden pain, burning or cramping if they are large or in a large vessel. These symptoms would not necessarily occur in both feet at the same time. Clots can lead to phlebitis (inflammation of a vein) or can break free and reach the lungs or brain. Phlebitis usually is found in one spot, not both feet symmetrically, and with burning pain, tenderness to the touch and redness. If a sizable clot is present, physicians may prescribe a blood-thinning pharmaceutical drug, such as warfarin (Coumadin).
Are you on any heart medications or drugs? You want to make sure your symptoms aren’t the result of a drug side effect. Are your blood sugar and/or cholesterol levels elevated? Diabetics often have burning pain in just the feet, rather than the legs. Other conditions that can cause foot pain are arthritic problems and bone spurs, which are not usually difficult to distinguish from the pain that’s due to poor circulation.
Presuming this problem is due to your veins not being strong enough, I would recommend the following herbs: First and foremost, try horse chestnut (Aesculus hippocastanum). This herb is classic for varicose veins and is noted to reduce inflammation and the tendency to clot, and may improve the tone of vein walls. It can be used topically and internally — if I were in your situation, I would try both.
Hawthorn (Crataegus spp.) contains colorful bioflavonoids that are used for all kinds of cardiovascular complaints, including improving the tone and elasticity of blood vessel walls. Similar colorful bioflavonoids are found in blueberries and grapes (fruit and seeds), St. John’s wort (Hypericum perforatum), and turmeric (Curcuma longa). Bromelain, a protein-digesting substance found in pineapple, is known to reduce excessive blood clotting, reduce inflammation and inhibit the formation of scar tissue in the vessel wall, which contributes to the loss of elasticity and leads to varicose veins.
If your pain is due to severe fluid accumulation in the feet, put your legs up as often as possible and avoid sitting with your legs crossed (or even sitting in chairs with your legs hanging down) as much as possible. Sitting on the floor with your legs outstretched, or on your bed or recliner when you can, would be better. Further, you should gently rotate your feet and ankles as much as possible to help the return of fluid in your legs. For help with the pain, prepare a strong tea of witch hazel (Hamamelis virginiana). Soak a cloth in it and wrap it around your feet. Doing this two or more times a day may help relieve the pain somewhat.
Willard responds: I agree that it is essential that you go back to your doctor and get absolutely clear about what you’re dealing with. None of the potential causes of your problem are fun, but clots can be deadly and need careful management by medical professionals. Once you get a diagnosis of poor circulation, several things can be done for the condition, especially when it’s associated with swollen legs. The herbs I use the most are ginger (Zingiber officinale), garlic (Allium sativum), reishi mushroom (Ganoderma lucidum) and essential fatty acids. For varicose veins (and swollen legs), the best herb to use is horse chestnut.
Swollen legs are usually caused by chronic venous insufficiency (CVI), a condition found in 10 to 15 percent of men and 20 to 25 percent of women. This means that the veins have just become too weak to do the hard work of pumping blood to and from the heart. In North America, the therapy usually is elastic support stockings, but in Europe the therapy recommended most often is horse chestnut seed extract.
Horse chestnut seed contains 3 to 13 percent of a complex of constituents known as aescin (escin). More than 100 papers have been written on this herb. One mega study reviewed 13 clinical studies for CVI and concluded that horse chestnut seed extract was superior in all placebo-controlled studies. It was found as or more effective than other medications and was equally as effective as compression therapy (elastic support stockings), reducing edema (swelling due to fluid accumulation) by approximately 25 percent. Take 100 to 200 mg daily.
Aescin restricts edema by reducing the filtration of water and protein through the capillaries. It also appears to have a tonic effect on the circulatory system, as well as a mild diuretic effect, relieving the fluid retention that so often accompanies CVI. Just like doing exercises builds muscle tone and provides greater strength for daily activities, toning the vein system increases the veins’ ability to move blood back and forth to the heart. This ability has lead to horse chestnut’s extensive use for varicose veins, hemorrhoids, leg ulcers, deep vein thrombosis, phlebitis and frostbite. The German Commission E approves the uses of horse chestnut seed for CVI, pain and a sensation of heaviness in the legs, and nocturnal leg cramps. (See our October 2004 issue for more about the German Commission E.)
Ginger is a folk remedy for reducing the “stickiness” of blood platelets, which lowers the incidence of clots. Ginger is also one of the best herbs for blood circulation. Happily, ginger tea is a delicious way to take the herb: Just boil 5 to 10 slices of fresh gingerroot for 2 to 5 minutes in 2 to 4 cups of water. Add some honey for flavor, if you like.
Garlic and onions (Allium cepa) both have proven to be very effective in reducing blood clots, blood pressure and blood lipids. Some of the effects are due to the ability of garlic to reduce fats in the blood, but other mechanisms are also at work. I usually recommend about 1,000 mg of garlic, twice daily, or two or three raw garlic cloves, if you’d rather eat the whole food. An excellent prevention strategy is to use onions and garlic liberally in your cooking.
Reishi has been shown very effective for reducing blood clots and for healthy blood pressure. These mushrooms have the added benefit of lowering both cholesterol and triglycerides, along with improving the HDL (good cholesterol) to LDL (bad cholesterol) ratio. Try 200 mg of a 15:1 extract twice daily.
Several herbs contain essential fatty acids, which help reduce blood clotting. Three of the best are black currant, borage and hemp oils; their seed oils contain omega-3 and omega-6 essential fatty acids. Fish oils are another good source of these body-friendly fatty acids. A mixture of these oils gives a full range of the essential fatty acids. Take 2,000 mg twice daily.
Jill Stansbury has been a naturopathic physician for more than 12 years, with a private practice in Battleground, Washington. She is the chair of the Botanical Medicine Department at the National College of Naturopathic Medicine in Portland, Oregon, and the author of many books, including Herbs for Health and Healing (Publication International, 1997).
Terry Willard is a clinical herbalist, president of the Canadian Association of Herbal Practitioners and founder of the Wild Rose College of Natural Healing in Calgary, Alberta, Canada. He is the author of eight books and a CD-ROM, Interactive Herbal.
I have a friend who has hepatitis C. Can you give me some information about herbs that can help her, such as information about boosting her immune system? Anything will be helpful.
Stansbury responds: Glad to see friends helping friends. Even though huge numbers of people are being diagnosed with hepatitis C, the disease remains a bit mysterious and variable in its course.
Herbs known to support the immune system and have antiviral activity may be helpful. These include turmeric, astragalus (Astragalus membranaceus), phyllanthus (Phyllanthus spp.), licorice (Glycyrrhiza glabra) and bupleurum (Bupleurum chinense). The Good Guy in this immune-system drama is interferon, an antiviral protein produced by white blood cells that have been invaded by a virus, which then inhibits the virus’ ability to replicate itself. The leading drug used to treat hepatitis C is an “interferon-like” substance. But instead of using an interferon imitator, why not boost the levels of this warrior and let it go after the Bad Guys? Herbs noted to help promote interferon levels in the body include astragalus, chlorella (a blue-green algae), echinacea (Echinacea spp.), boneset (Eupatorium perfoliatum), licorice, shiitake mushrooms (Lentinula edodes) and dandelion roots (Taraxacum officinale).
In addition to immune or antiviral options, herbs and nutrients noted to protect the liver, reduce inflammation and reduce fatty infiltration and cirrhosis are highly recommended. These include milk thistle (Silybum marianum), Oregon grape root (Mahonia aquifolium), dandelion and turmeric. Liver-supportive foods include cabbage, beets, carrots, artichokes and radishes. Nutrients that research shows can reduce liver inflammation and cirrhosis include glutathione, SAM-e, methionine, carnitine and taurine.
The development of hepatitis C can be sudden and acute, with malaise, digestive symptoms and sky-high liver enzymes and viral load. This acute form of the disease requires an aggressive approach with a number of these herbs and supplements given at frequent dosages for one to two months. But hepatitis C also can be present with only mild symptoms — or none at all — with only minimally elevated liver enzymes. In the latter case, milk thistle and turmeric plus a nutrient or two would be my treatment choice, and I would ask the patient to check back with me in two to three months.
Overall, I am rather optimistic. Perhaps I haven’t seen the worst of the worst cases, but all of my patients, even those with significant symptoms, have done very well on a holistic protocol. I also make sure my patients are eating well and avoiding liver-inflaming fats, foods, drugs, alcohol and the like. I also suggest putting castor oil packs on the abdomen, covered with heat when possible, and as often as possible. Fresh vegetable juices are helpful, and regular salads with grated beets, carrots, cabbage and radishes are encouraged.
Willard responds: Several effective approaches are available these days for hepatitis C. Along with recommending specific lifestyle choices, I have had very good success with a supplement that combines herbs [dandelion root, milk thistle extract, black radish and burdock root (Arctium lappa)] and mushrooms (maitake, shiitake and coriolus). The mixture is available in capsule form, and I recommend taking 2 to 3 capsules two or three times a day, depending on the severity and stage of the hepatitis.
Maitake’s active components act as immunomodulators and, as such, are researched for their potential role in hepatitis, cancer and AIDS treatment. I’ve found this mushroom, which helps the body adapt to stress, very helpful for hepatitis.
Coriolus versicolor mushrooms have shown benefit in treating hepatitis. Japanese and American institutions currently are working to develop and fund an independent study of the mushroom’s active ingredients’ influence on chronic hepatitis C. This ruffled, shell-like mushroom is the main herb I have used in my clinic for hepatitis C over the last several years.
The list of studies done on shiitake is impressive. Research indicates that injections of one of the mushroom’s active constituents (lentinan) can help some people with hepatitis. Other human studies have looked at oral shiitake and found it useful for people with hepatitis.
Dandelion root, milk thistle extract, black radish and burdock root are all known to provide liver support. Beside the mushrooms and herbs, hepatitis patients should eat an organic diet that includes no fried foods, alcohol, street drugs, fast foods or foods containing preservatives, dyes and pesticides. People with hepatitis C also need to make sure they get plenty of rest and moderate exercise.
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