Inside Out: Blood Vessel Care with Herbs

From varicose veins to DVT, learn more about keeping your veins healthy.

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I spotted the first spider vein on my leg early in high school, after waterskiing with my cousin. We looked at our grandmother’s calves, lumpy and ropy with varicose veins, and my mother’s notched surgical removal scars and hoped that by the time we reached “that age” modern medicine would have better solutions.

Approximately 20 percent of all adults will get varicose veins in their lives, particularly as they age. Your risk increases if you’re female, have a family history of vascular issues, are overweight, have a job where you have to stand for long periods of time (my mom and grandmother were labor and delivery, and surgical nurses), or have a more serious underlying vascular condition such as deep vein thrombosis (DVT).

In my clinical practice of predominantly middle-aged and older women, I see quite a few people with varicose veins. It’s also a top concern of mine now that I’m in my mid-40s with the early signs. As it turns out, some of our best long-term vascular tonics come not from modern medicine but ancient herbal medicine, diet, and lifestyle. The earlier you start, the better.

Why and How Varicose Veins Develop

Arteries take the blood from the heart, out to your organs and limbs, shrinking in size until they become the tiny capillary system. After the oxygen has been released to the cells, the vessels (now known as veins) gradually increase in size again as they carry the de-oxygenated blood back to the lungs and heart. Valves in the veins help the blood keep moving back toward the heart without back flow, but over time, the miniscule muscles and valves can become less elastic. This results in blood pooling in veins, distending them and sometimes leading to plasma leakage into the surrounding tissues (known as edema). Because veins lie closer to the skin, they’re more visible. Varicose veins might feel swollen, heavy, itchy, sometimes painful. Spider veins affect more minor blood vessels and are harmless.

When to Seek Medical Attention

Most varicose veins are just annoying and unsightly, but some vascular symptoms and vein issues can become serious and require immediate medical assessment and treatment. Blood clots and DVT are rare but life-threatening. Chronic venous insufficiency (CVI) is very similar to varicose veins but can be dangerous in acute states or if caused by a clot. See a doctor immediately if you have one swollen leg calf, hyperpigmentation of the lower leg and ankle, skin ulcers, eczema-like hardening of the skin, calf pain with cramps and soreness, red or discolored skin, or your leg feels hot to the touch – these are potential symptoms of life-threatening blood clots. Bleeding veins, unexplained swelling, excessive cramping and heaviness warrant a check-up. The following herbal and natural options may help manage these more serious conditions in non-acute stages, but they usually won’t suffice in their own. Work with an herbalist or naturopath to avoid potentially dangerous herb-drug interactions, particularly alongside blood-thinning medications. It’s always a good idea to discuss your health concerns and any herbs you’re taking with your primary care practitioner, no matter how minor the situation may seem.

Herbal Support for Varicose Veins

Once varicose or spider veins form, it’s unlikely that natural approaches will bring them completely back to normal, but herbs often help reduce symptoms and further damage and manage risk factors. When we look for herbs and natural remedies that support vein health, we find two major categories: those that improve blood vessel integrity, mainly by tightening and toning, and those that support circulation and blood movement through the body.

Many of our key vein support herbs work internally or topically by tightening and toning the blood vessel lining (endothelium), improving its elasticity, closing up leaky gaps, and improving the vitality of connective tissue. Astringent tannins, anti-inflammatory bioflavonoids (which are chemically related to tannins), and other constituents are often at play. Another useful group of herbs are those that improve circulation and blood flow. These circulatory tonics include garlic, ginger, yarrow, hawthorn, and gotu kola. In truth, many of the herbs we use to support vascular health have a range of actions that can improve vascular lining while also enhancing blood flow. Natural approaches are best used daily for an extended period of time.

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Horse Chestnut Seed

(Aesculus hippocastanum) has a long history of use internally and externally for vascular issues including varicose veins, hemorrhoids, and CVI. It is among our most potent herbs for vein health, often used solo or in combination with other herbs topically and internally. A Cochrane meta-analysis of 17 human studies on horse chestnut for CVI concluded that it probably reduces lower leg volume and may reduce ankle and calf circumference. The extract reduced leg pain and edema compared to placebo. Horse chestnut’s active constituent, aescin (also called escin), appears to promote circulation, “seal” leaking capillaries and improve the elasticity of veins, reduce inflammation and swelling, and help close gaps in the vein lining. It may work as well as compression stockings (and you could certainly use both). Try 300 mg twice daily or less of standardized horse chestnut extract pill (100 mg total aescin daily). Stomach upset is common (take with food). Avoid if you’re allergic to nuts. Of the herbs listed in this article, horse chestnut is potent but also more likely to have negative side effects. Crude horse chestnut seeds are toxic and should not be consumed. Topical applications are generally safe and may also help heal venous leg ulcers.

Butcher’s broom in fall, dark, green shiny leaves on thin smooth stalks with bright red pea-sized berry.

Butcher’s Broom

(Ruscus aculeatus) root and rhizome offers similar effects as horse chestnut seed with fewer safety risks. Several human studies, mostly from Germany, confirm its use for varicose veins, CVI, and other vascular issues. After 12 weeks, patients taking butcher’s broom for CVI had reduced leg volume and heaviness compared to the placebo group. A study on the German formula Phlebodril (butcher’s broom extract, hesperidin, and vitamin C) for two weeks in varicose veins saw a trend towards improvement in venous tone and distension versus the placebo group, but they noted that this was likely too short a treatment time for dramatic improvements. Butcher’s broom can be taken as a tincture or pill with food. It can also be applied topically. A double-blind, placebo-controlled study noted that the extract in cream constricted the femoral vein within 2.5 hours.

thin yellow flowers petals growing from a small bud core. Photo taken in the fall of witch hazel with dark grey-brown knobby bark

Witch Hazel

(Hamamelis virginiana) bark contains potent astringent tannins that help to reduce inflammation and improve blood vessel integrity. This bark is best used topically and is not safe for regular internal use. Although research is limited, it has a long history of use for varicose veins and hemorrhoids (which are varicose veins in an even more uncomfortable spot). Try witch hazel as a topical alcohol extract (liniment), distilled, or decoction applied as a bath, soak, or compress.

Close-up of blue and white berry clusters among oblong smooth green leaves.

Blue-Purple Berries

Flavonoid pigments anthocyanidins and anthocyanins help gently tighten and tone blood vessels while reducing inflammation and oxidative stress, decreasing permeability and fragility, and supporting circulation. Perhaps the most famous of these are blueberry and bilberry fruits (Vaccinium spp.) and dark-purple grapes (red wine, Concord or wild fox grape juice); however, other low-sugar red, purple, blue, and black fruits are also beneficial, with several studies supporting their use for cardiovascular and overall health. Consider taking them daily fresh or frozen fruit, 100% juice or concentrate (read the ingredients list carefully to avoid less beneficial juices), powder, concentrated syrup, or solid extract.

OPCs

Oligomeric proanthocyanidins (OPCs), also called procyanidolic oligomers (PCOs), are precursors of those blue-purple pigments, also related to catechins (found in high levels in green tea) and astringent tannins. These toning, anti-inflammatory blood vessel tonics can be found in herbs and foods like hawthorn, grape skin and seeds, cranberries, Pycnogenol (a trademarked extract of French maritime pine bark), and other pine species barks. Several human trials confirm OPCs’ benefit for CVI and vascular issues including reduced leg cramps, pain, and edema (swelling, fluid retention). Four weeks of 360 mg Pycnogenol daily was more effective than 600 mg horse chestnut seed extract for patients with CVI, reducing cramps, feelings of heaviness, swelling, pain, and leg circumference. Taking 50 mg three times a day for 90 days worked as well as a blend of diosmin and hesperidin for venous leg ulcers, significantly reducing the circumference of affected limbs. In another study, a higher dose of Pycnogenol outperformed the combo for CVI at four and eight weeks. OPC sources are most popular in supplement pill form but can also be enjoyed in the diet. In fall, cook down wild “Concord” fox grapes, strain the juice through a food mill (for the freezer and no-sugar wild blueberry-grape jelly), and then tincture the seeds and skin in alcohol. Or simply eat whole wild grapes with their pucker-y seeds. Enjoy tea made with backyard white pine branches. Solid hawthorn berry extract paste can be taken daily.

Rutin

Also referred to as rutosides, this flavonoid can be found in ample amounts in buckwheat, horse chestnut and other vascular herbs, or taken in supplement form. It helps prevent damage to the blood vessel lining and reduces blood stickiness, edema, and improves capillary filtration rates. Mimi Hernandez, herbalist and executive director of the American Herbalists Guild, recommends enjoying buckwheat regularly as food or making tea with the raw or toasted dry groats

Close-up of half-circle shaped, light green leaves with ridged edges. Sun is shining through the leaves from the upper left of the photo.

Gotu Kola

(Centella asiatica): This is one of my favorite multifaceted herbs and one I personally take daily and grow in my garden. Although it’s more famous as a gentle adaptogen and brain tonic, it also has a profound ability to improve connective tissue tone and vitality throughout the body (gut repair, skin vitality, wound care, gum health…) including the blood vessels. Numerous studies support its benefits in vascular issues including CVI, improving the flexibility and lining of the blood vessels as well as microcirculation, particularly at higher doses taken for one or more months. Taking a concentrated extract three times a day (starting two days before a long flight, the day of, and the day after) reduced edema and circulatory disturbances associated with long flights of 10 hours or more compared to the placebo group. Consider gotu kola as a tincture, strongly brewed tea, or capsule. If you grow the creeping Indian plant, you can juice the aerial parts (mainly leaves) or make a smoothie-like slurry with water and better-tasting herbs (ginger, mint, sweetener) to drink. It’s generally very safe and well-tolerated and can also be applied topically.

Centered in the photo are a cluster of small white flowers with pale yellow-grey centers, that look like dense lace. Unfocused in the background are green leaves and grasses.

Yarrow

(Achillea millefolium): The leaves and flowers of this common wildflower offer a wide range of medicinal activities, but it is most famous for its effects on the blood. Almost paradoxically, it staunches bleeding wounds yet improves day-to-day blood flow and circulation. Although not as well-researched for vascular issues, it’s a popular folk remedy for topical and internal vascular issues including varicose veins, sluggish circulation, and hemorrhoids. It extracts well in hot water or alcohol for regular internal or external use.

These are just a few of our best circulatory tonics for people with varicose veins. Consider adding blood movers such as ginger, rosemary, or garlic to the blends, and if edema is present, lymphatics such as red clover flowers, alder bark, violet leaf and cleavers greens, as well as diuretics such as parsley, may help. The root of the common invasive weed Japanese knotweed may also be of use in formulas as a blood-thinner, circulatory tonic, anti-inflammatory, and for vascular lining support.

Lifestyle Tips

A healthy lifestyle is incredibly to promote blood movement and vascular tone. Don’t sit or stand too long – move regularly – walking is great! Consider regular light lymphatic massage. Elevate your legs at the end of a long day if they’re swollen, and consider wearing special compression stockings if you have bad circulation or stand regularly for long days for work (teachers, nurses, restaurant and factory workers, hair dressers…).

Tips and Ideas

• Drink 8 to 16 ounces of 100% blueberry or dark purple grape juice daily
• Eat berries daily fresh or frozen
• Apply once or twice daily: topical creams, liniments, oils, or salves infused with horse chestnut, witch hazel, yarrow, and/or other herbs mentioned above
• Move regularly throughout the day including walking, hiking, or running
• Consider taking a tincture or pill daily containing horse chestnut, gotu kola, butcher’s broom, yarrow, and/or other herbs mentioned above
• Eat a healthy, anti-inflammatory, antioxidant-rich diet full of whole foods, plants, pigments, berries, herbs, and spices

Sample Formula Ideas

Vein Support Tincture

2 parts butchers broom root tincture
2 parts gotu kola leaf tincture
1 part grape seed and skin or Japanese knotweed root tincture* (optional)
1 part hawthorn berry solid extract
1 part blueberry solid extract or syrup
½ part or less ginger and/or rosemary tincture
Combine together and take 2 to 5 ml (up to 1 teaspoon), 2-3 times per day with food.
*These tinctures are hard to find in commerce; better to make your own. See my past article on MEL online on how to make tinctures.

Topical Leg Rub

1 part gotu kola tincture
1 part yarrow or witch hazel tincture
1 part gotu kola infused oil
1 part comfrey leaf infused oil
A few drops of ginger and/or rosemary essential oil (optional)
Shake vigorously to combine (oils and waters will separate with time), then apply a small amount and rub gently into the affected area twice daily.

Resources

• Find an Herbalist: https://www.americanherbalistsguild.com
• Find a Naturopathic Doctor: https://www.naturopathic.org
• Free American Herbalists Guild Webinar taught by Mimi Hernandez on Vascular Health accessible at https://www.americanherbalistsguild.com/professional-training-webinars
• Herbs and Remedies can be found by brands like Herb Pharm, Gaia Herbs, Wise Woman Herbals, Herbalist & Alchemist, Mountain Rose Herbs, Nature’s Way, Oregon’s Wild Harvest, and Solaray

Maria Noël Groves, RH (AHG), is a registered clinical herbalist nestled in the pine forests of New Hampshire. She’s on the Mother Earth Living Advisory Board and the best-selling author of Body into Balance: An Herbal Guide to Holistic Self Care and Grow Your Own Herbal Remedies. For recipes, books, distance consults, and online classes, visit WintergreenBotanicals.com.

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