VARICOSE VEINS

Valve incompetence can lead to varicose veins. This is when the vein walls enlarge, or the valve leaflets become damaged. In this case, venous blood cannot be completely returned to the heart and some can leak back through the valve. If this stagnant venous blood accumulates it can cause bulging in the veins at the surface of the skin. Edema may also develop in the feet and ankles, which can cause further issue.

If there is poor lymphatic circulation, as is the case with edema, lactic acid and metabolic waste (ama) can build up in the lymph. This is called venous acidosis and it can cause inflammation of the vascular tissue and surrounding tissues. The swelling that comes with this inflammation aggravates the varicose veins further.

Thick, rich blood can also increase the chances of varicose veins. In this case, the heart rate increases to pump the thicker blood. This can result in greater stress on the organ and increased blood pressure, which leads to more pressure put on the veins. If there is bloating or swelling in the low abdomen, circulation can also be blocked.

As mentioned previously, varicose veins are very common during pregnancy. As mentioned this is because progesterone relaxes smooth muscle tissue, leading to the dilation of blood vessels.

Ulcers can occur where there is damage to a blood vessel. Damage to a blood vessel can lead to poor regulation of blood pressure. Smaller blood vessels, near the skin, cannot take the pressure and become fragile. Eventually they can break and an ulcer can form near the skin, which is usually painful. A spot of discoloration may appear on the skin before the ulcer forms

Where blood flow is slow and sluggish, blood clots can form, which can be dangerous. In cases of varicose veins, clots often occur close to the surface of the skin. These are called superficial thrombophlebitis. Clots can also form in deep veins, and this is an emergency condition.

Bleeding is another complication of varicose veins. This can happen if a varicose vein ruptures, due to high blood pressure and weakened vessels. This can result in significant bleeding, which can be serious and need immediate treatment.

Signs of DVT (Emergency):

• DVT can occur with no noticeable symptoms.
• Swelling in the affected leg. Rarely, there may be swelling of both legs.
• Pain in the leg, which often starts in the calf and feels like cramping or soreness.
• Red or discolored skin on the leg.
• A feeling of warmth in the affected leg.

Signs of pulmonary embolism (Emergency):

• Sudden shortness of breath.
• Chest pain or discomfort that worsens when you take a deep breath or when coughing.
• Feeling lightheaded, dizzy or fainting.
• Rapid pulse.
• Rapid breathing.
• Coughing up blood.

Seek to reduce blood pressure. Reducing blood pressure reduces pressure on the veins and valves. Blood pressure in the legs can be reduced by 1) Reducing water retention, 2) Thinning the blood, 3) Reducing inflammation, 4) Draining the lower half of the body.

Seek to improve vessel tone. Compression stockings, cold weather, astringents, and other modifications can improve vessel tone, reducing the likelihood of distension.

Avoid anything that restricts circulation This includes tight belts, tight clothing or crossing your legs. Take breaks from sitting. The sitting position, with the knees bent, kinks the blood vessels and reduces blood flow. Pressure in the abdomen can also block circulation, so it is important to avoid constipation, gas or bloating.

Keep moving. Avoid standing or sitting in one place for a long time. No matter the position, stretching and continuous movement can help keep blood flowing. Hopping on one leg contracts the lower leg muscles, the best way to move blood out of the region. If you are lying down, try leg or breathing exercises to keep the blood moving well. If you find yourself standing for long periods, keep moving and stretching your legs. Similarly, when travelling long distances, take a break to move the body.

The legs can be drained by raising them. In fact, lying down can significantly reduce the pressure put on the veins by gravity. Varicose veins are common, and painful, in the pelvic and vaginal area so it is important not to forget about your hips. Try raising the hips and legs above your heart when lying down or sleeping. If pelvic varicose veins do occur, Kegel exercises can be especially helpful. If you must sit, try putting your legs up on a chair.

Avoid heat. This is because heat dilates blood vessels, causing more blood to flow through them and, in turn, greater pressure on the veins. Keep a cool house and take a cold shower can also cause vasoconstriction, improving circulation in deep vessels.

Compression socks can apply uniform pressure on the legs. This can help veins from distending and approve the blood flow in the legs. There are several types of compression socks available:

• Thigh high: this style worked best for John's wife, Natalie, during her pregnancy. They sit above the crook of the knee so they help prevent clots in the knee area. However they sit below the pelvic floor so they do not restrict movement.
• Knee high: these caused superficial clots to form just above Natalie's knee during her second pregnancy. This length comes in several compression strengths and it can be helpful to speak with a doctor about which is best for you.
• Full-leg: these go all the way to the waist but they only compress the entire leg. John's wife noticed her skin felt cold while wearing them, during her fourth pregnancy. However they did greatly reduce the pain she experienced. A downside of this length is that they can push blood into the pelvic region and increase the risk of varices there.
• Compression underwear: these can be helpful in reducing painful vaginal clots.
• Vulvar support bands: these can greatly reduce varices in the pelvic floor.

Thin the blood. This will improve flow and reduce pressure on the heart. Sugar and refined flours can thicken the blood and should be avoided. Generally, a Kapha-reducing diet is recommended. Alongside this, strengthen liver function to keep the blood thin. When the blood cannot be filtered properly by the liver, it becomes more viscous and thick. Aloe vera is a liver-supportive blood thinner that supports proper elimination of waste. Blood thinners like turmeric can also be helpful in keeping the blood at a healthy thickness.

Clear toxins (ama) and inflammation, support the liver.

• Draining the legs helps to clears cellular waste and the byproducts of inflammation (ama) from the circulatory system.
• Increasing antioxidant intake can help reduce inflammation, as they scavenge for free radicals. Antioxidants are found in foods that are high in dietary polyphenols, including flavonoids. Some foods that are high in flavonoids include berries, red cabbage and kale. In fact, studies have shown that flavonoid drugs improve venous function. However, none have been approved for use in the US. Diosmiplex, a flavonoid medical food product, derived from oranges, is approved by the Food and Drug Administration. It is used in the management of chronic venous insufficiency.
• Alteratives can help to normalise blood chemistry, as they support proper function in the body. Some alternatives include burdock, cleavers, nettle and sarsaparilla.
• Anti-inflammatories can directly reduce inflammation of veins and the surrounding tissue. Anti-inflammatory foodsinclude green leafy veg, almonds, blueberries and fatty fish like salmon. Some herbal anti-inflammatories are cranberry, cilantro, aloe vera and rose.
• Avoid alcohol. Alcohol consumption can worsen the symptoms of varicose veins. It is a heating toxin that can irritate the liver and cause more inflammation.
• Choose a Pitta-pacifying diet. This should include cholagogues and hepatoprotectives that help support the liver in its job of detoxifying the body. This can, in turn, reduce inflammatory stress in the legs.

Astringents maintain muscle tone. Astringency can be characterised by a constriction or drawing together. This can constrict the blood vessels and maintain vessel tone. Common astringents include anantamul, witch hazel and rose. Their effects on reducing heat and redness have made these herbs popular in skin care.

Diosmin and hesperidin are phytochemicals with anti-inflammatory properties, which can reduce oxidative stress. They also support proper lymphatic drainage which is important both in preventing varicose veins and reducing pain from edema. When taken together, diosmin and hesperidin can reduce inflammation (phlebitis) and protect against blood clotting (thromboembolism).

Hesperidin is the dominant flavour in oranges and fresh orange juice contains about 30mg/100ml. Processed juice usually has higher levels because more peel is used in production. Hesperidin supports the reduction of blood pressure due to its antioxidant levels. The antioxidant action of hesperidin suppresses the production of proinflammatory proteins (cytokines). This quality also makes it antihyperlipidemic, cardioprotective and antihypertensive.

Studies on diosmin (600mg, 2x/day) taken across 3 months was shown to decrease leg circumference due to swelling. This reduction reduces pain for the subjects. Blood tests also showed fewer pro-inflammatory markers but an increase in factors necessary for the formation of new blood vessels (pro-angiogenic). This is the reason diosmin is also used for haemorrhoids and leg sores caused by poor blood flow.

The rutin present in Bitter Orange Peel also plays an important role in working with varicose veins. In particular, it adds strength to weakened blood vessels and increases their flexibility. This allows the veins to withstand any increased pressure that may occur. Tests on animals have also shown rutin's potential for preventing blood clots.

Finally, the herb also contains Vitamin C, which is known for its cooling antioxidants, support of cell health and formation of healthy veins. It is also important for the creation of collagen and elastin which keeps the veins strong and toned. The sour vitamin also has a tightening effect on the cellular lining of the vessels. This helps them keep their integrity and strength if inflammation is present.

These qualities may make Bitter Orange Peel a useful herb in cases of varicose veins. It is important to note that there is not enough clinical data to say whether it is safe to consume during pregnancy.

For these reasons, minimize common causes of varicose veins when pregnant, such as travel, standing or sitting for extended periods. Take liver herbs to support the proper clearance of hormone buildup. The best choices vary by dosha; bitters for Kapha, hepatoprotectives for Pitta and liver tonics for Vata. Check with your PCP before adopting new herbs during pregnancy.

Choose anti-estrogenic foods to support healthy hormone balance. These include cruciferous vegetables such as arugula, broccoli, cabbage and cauliflower.

Most women will see the condition begin to fade and disappear within 3 months after delivery. However, some women may experience persistent varicose veins and should consult a vascular specialist.