Oedema - A Natural Approach

The term oedema refers to the situation of too much water being retained in the tissues, usually in the extremities and usually in the subcutaneous tissue. There are many possible causes of oedema, some of which are potentially serious medical conditions such as heart or kidney problems, or even cancer in some cases. Another possible cause of oedema is the interruption of the lymph circulation; the most common cause of this is surgery involving the removal of the lymph glands, for example during a radical mastectomy. Cancerous tumours sometimes block the lymph circulation, too.

What is lymph and why is it important?

The blood circulation exists in order to transport nutrients, oxygen and also immune system components through the body, and to transport waste products (carbon dioxide and urea being the main ones) to the proper sites for eventual disposal. As part of this process, a certain fraction of the liquid portion of the blood seeps out into the tissues. There is a parallel circulation, often following a similar route to blood vessels, which returns this fluid to near the heart, where it rejoins the blood circulation; this fluid is called lymph, and contains no red blood cells - although it does contain some types of white blood cell.

As is often common in the body, the lymph circulation does double duty as part of the immune system; a major part of the immune system is contained in the lymph nodes, which are small pockets along the lymph ducts. The existence of these nodes, and their importance in the immune system, are the reason why “swollen glands” are a feature of many types of infection.

Like the venous system, the lymph system has no dedicated arrangements to pump it; of course the arteries have, in the form of the heart. The pumping of venous blood and lymph back towards the heart is accomplished as a result of contraction of the various muscles, particularly the calf muscles, and the fact that both the veins and the lymph vessels have one-way valves along their length. The fact that return of venous blood and lymph to the heart is accomplished in this manner is one of the many reasons why at least some regular exercise is a good idea.

What can go wrong?

This process can be disrupted, causing oedema, in various ways. One is physical blockage of the lymph ducts by disease or injury, or as a result of necessary surgery for other conditions; this form of oedema is called lymphoedema, and is fairly difficult to treat. Specialised forms of massage are one way in which this problem can be treated, but natural therapies for this problem are not too common.

Another way, that oedema can occur is when too much fluid leaks out of the capillaries in the first place. This occurs due to excessive permeability of the capillaries, and can be dealt with in various natural ways.

Another way that oedema occurs is when the one-way valves in the veins and lymph system are damaged; this is often caused in the same way as excessive capillary permeability and often occurs at the same time. Accordingly, I will discuss the latter two problems together.

Oedema is by no means always caused by excessive retention of fluid generally. This can happen, but is usually secondary to some serious problem such as failing kidneys or a diseased heart that is not pumping efficiently; either of these should obviously be dealt with by a professional.

Excessive Capillary Permeability

The capillaries are by definition very small vessels; this applies to all three types of capillary - arterial, venous and lymph. (Arterial and venous capillaries, of course, change gradually from one to the other; in other words, they are connected.) This means that their walls are very thin and thus susceptible to damage. This can be seen in the case of such problems as a nosebleed or bruising after a minor injury, but the capillaries are also susceptible to damage on a microscopic scale that makes them allow too much fluid through. This damage is usually caused by two things; advancing age (which is why oedema is much more common in elderly people) and lack of various nutrients. By far the most important nutrient here is vitamin C, because vitamin C is needed to create collagen; this protein is the main structural component of blood vessel walls.

Natural therapies for oedema focus on two points of failure of the normal process; return of fluid to the area of the heart, and reducing the permeability of excessively permeable capillaries.

Fluid Return Strategy

By far the simplest way of enhancing the return of lymphatic fluid to the heart is regular exercise involving particularly the leg muscles. Regular, reasonably brisk walking is good enough to achieve this. It also enhances the venous circulation, which helps with such problems as varicose veins as well. Rather more passive ways of accomplishing this are wearing of elastic stockings and elevating the feet and lower legs. Elastic stockings work quite well, but should be fitted by a professional as it is all too easy to have them so loose they do very little, or on the other hand so tight they partially cut off the circulation. Elevating feet and legs, on the other hand, can be done by anyone; using a footstool while sitting down helps, as does slightly elevating the foot of your bed. Something as simple as a couple of house bricks can help with the latter. (For reasons that will be obvious with a little thought, it’s best to use bricks with a depression in the top!)

Permeability Strategy

This strategy, which can be and probably should be used in conjunction with the return strategy, focuses on nutrition and to some extent botanicals.

Diet

The usual remarks about diet, when discussing natural remedies, apply. For the record, these include removing as far as possible processed, prepared food and artificial additives; drastically reducing consumption of refined carbohydrates such as sugar, white bread and white rice from the diet; reducing consumption of red meat; reducing consumption of fried food; and increasing the consumption of fresh or frozen vegetables, fruit, nuts, seeds and oily fish. Particularly important in the case of helping with oedema are reducing refined carbohydrates and increasing the consumption of fruit and vegetables with a strong colour. The reasons for these particular dietary changes are that excess glucose in the blood damages the blood vessels, and that vitamin C and the compounds responsible for the colour of blackberries and oranges (for example) help capillary integrity.

Nutritional Supplements

Vitamin C is absolutely essential for the maintenance of blood vessel wall integrity. Accordingly, it is probably the most important nutrient in cases where the blood vessels are damaged, such as oedema.

Bioflavonoids and proanthocyanidins are the orange/yellow and purple/dark red/ black water soluble compounds, respectively, found in fruit and some vegetables and also in such supplements as grape seed and pine bark extracts. They help the action of vitamin C to help repair capillaries.

Vitamin C and zinc are required as part of the process of forming surface cells virtually everywhere in the body, including the linings of blood vessels.

B vitamins in general help prevent the formation of toxic metabolic intermediates such as pyruvic acid and homocysteine, and also help the general metabolism which in turn helps blood vessel repair.

Vitamin E helps reduce damage to blood vessel walls by accumulation of oxidised cholesterol; it also acts as an antioxidant for cell walls, and hence protects the integrity of all tissues.

Selenium is a powerful antioxidant that helps prevent damage to various tissues, especially in conjunction with vitamin E.

A high-strength, comprehensive multivitamin/mineral would provide adequate amounts of everything except vitamin C and possibly bioflavonoids. A separate vitamin C supplement at levels of 1000-2000 mg per day would help with this; the better brands often contain bioflavonoids also.

Botanical Supplements

Gotu kola is a traditional Ayurvedic herb, but it is also quite popular in the West. It improves tissue and blood vessel wall elasticity and integrity, and can be used for varicose veins and oedema.

Butcher’s broom also strengthens blood vessel walls, and also has vasoconstrictor effects on minor vessels such as capillaries. This means that it helps considerably with oedema and can also help with varicose veins.