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Ask the Herbalist--Varicose Veins

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SPIDER VEINS
QUESTION: 
Can you please tell me what specifically what herb is used to reduce or eliminate spider veins?

ANSWER:  Most of the purple/red/bluish fruits and vegetables have what are called oligo-proanthocyanidines (OPC's) these strengthen blood vessel walls.

These are the herbs that have been used in the past for spider and varicose veins
Elderberry
Blueberry
Cinnamon
Hawthorn
Lycium or Wolfberry
Calendula Flowers
Horse Chestnut
Butchers Broom
Grape Seed
Grape Skins

Herbs that help with circulation should also be considered
Gingko
Hawthorn
Cinnamon
Cayenne
Ginger

You can get supplements that contain OPC's


VARICOSE VEINS
QUESTION:
Please inform me if grapeseed extract is effective and safe for use of treatment of varicose veins and/or spider veins. Thank you.

ANSWER: 
From the HealthCentral herb library on Grape Seed extract

http://www.healthcentral.com/home/home.cfm

Grape seed extract:
Active Ingredients 
The oil pressed from grape seeds contains a number of essential fatty acids and is rich in vitamin E compounds. 

The most interesting constituents of grape seeds are the polyphenols (catechins). These tannin compounds, also called procyanidins, leucoanthocyanins, pycnogenols, or oligomeric proanthocyanidins (OPC), are powerful antioxidants. Commercial extracts are generally standardized for OPC content. 
Grape leaves and presumably seeds also contain flavonoids, and the skin and seeds are the source of several recently identified compounds known as 5-nucleotidase inhibitors. 

Use:
Grape seed oil can be used for cooking. It has an unobtrusive flavor and a high smoking point and is rich in omega-6 fatty acids. 
Grape seed extract is used in Europe to improve circulation. It prevents oxidation of blood fats and inhibits enzymes that break down the proteins that make up blood vessels. 
Grape seed is believed to benefit cardiac and cerebral circulation. In animals it reduces capillary permeability and presumably has similar activity in humans. 
Capillaries may be fragile due to diabetes or other disorders. In four small studies, grape seed extract was better than placebo at improving peripheral circulation as well, resulting in less pain and swelling, fewer nighttime cramps, and less numbness and tingling. 
Studies have shown that grape seed extract may slow macular degeneration, improve vision stressed by computer screens or glare, and reduce myopia. Although further research is needed, the results have been promising. 
In test tube research grape seed polyphenols stop the growth of Streptococcus mutans, a bacteria that causes tooth decay. They also slow the conversion of sucrose (table sugar) into glucan, and as a consequence of both these actions, grape seed may have a role in maintaining dental health. 
Another potential benefit of grape seed extract is anti-inflammatory activity. 

Dose 
Usual dose for general health maintenance ranges from 50 to 100 mg daily. To treat illness, doses from 150 to 300 mg per day are recommended. 

From Jim Dukes website on medicinal and ethnobotanical uses of plants http://www.ars-grin.gov/cgi-bin/duke/farmacy2.pl

Grape seeds have the following constituents.

ENOTANNIN Seed: DUKE1992A :No reported activity

EPICATECHIN Seed: DUKE1992A :No reported activity

LINOLEIC-ACID Seed 33,000 - 110,000 ppm DUKE1992A

Activity Reported: Antianaphylactic, Antiarteriosclerotic, Antiarthritic, Anticoronary, Antieczemic, Antifibrinolytic, Antigranular, Antihistaminic, Antiinflammatory, Antileukotriene, Antimenorrhagic, AntiMS, Antiprostatitic, Cancer-Preventive, Carcinogenic, Hepatoprotective, Hypocholesterolemic, Immunomodulator, Insectifuge, Metastatic, Nematicide, 

OLEIC-ACID Seed 22,200 - 74,000 ppm DUKE1992A 

Activity Reported: Allergenic, Anemiagenic, Antiinflammatory, Antileukotriene, Cancer-Preventive, Choleretic, Dermatitigenic, FLavor FEMA 1-30, Hypocholesterolemic, Insectifuge, Irritant, Percutaneostimulant, Perfumery 

PALMITIC-ACID Seed 3,300 - 11,000 ppm DUKE1992A

Activity Reported: Antifibrinolytic, FLavor FEMA 1, Hemolytic, Hypercholesterolemic, Lubricant, Nematicide, Pesticide, Soap 

PROTEIN Seed 70,000 - 100,000 ppm DUKE1992A :No reported activity.

SQUALENE Seed: DUKE1992A 

Activity Reported: Antibacterial, Antitumor, Cancer-Preventive, Immunostimulant, Lipoxygenase-Inhibitor, Perfumery, Pesticide 

STEARIC-ACID Seed 1,440 - 4,800 ppm DUKE1992A 

Activity Reported: Cosmetic, FLavor, Hypocholesterolemic, Lubricant, Perfumery, Suppository 

TANNIN Seed: DUKE1992A 

Activity Reported: Anthelminthic, Antibacterial, Anticancer, Anticariogenic, Antidiarrheic, Antidysenteric, Antihepatotoxic, AntiHIV, Antihypertensive, Antilipolytic, Antimutagenic, Antinephritic, Antiophidic, Antioxidant, Antiradicular, Antirenitic, Antitumor, Antitumor-Promoter, Antiulcer, Antiviral; Cancer-Preventive, Carcinogenic, Chelator, Cyclooxygenase-Inhibitor, Glucosyl-Transferase-Inhibitor, Hepatoprotective, Immunosuppressant, Lipoxygenase-Inhibitor, MAO-Inhibitor, Ornithine-Decarboxylase-Inhibitor, Pesticide, Psychotropic, Xanthine-Oxidase-Inhibitor 

From Nutrition Science New article titled 

Phytochemicals: Nutrients Whose Time Has Come
July 2000, read it on the web at http://exchange.healthwell.com/nutritionsciencenews/nsn_backs/Jul_00/phytochemicals.cfm

..A distinct group of polyphenols known as the flavan-3-ols includes anthocyanidins, proanthocyanidins, catechins and tannins. These have been extensively studied for their antioxidant, anticancer, antitumor and cardioprotective effects.37 Hundreds of studies alone have been done on green tea catechins to assess their cardiovascular effects.38 Red wine, grape juice, pine bark and grape seed extracts have been studied for their anticlotting, antioxidant, cardiovascular and anticancer effects.39... 
references...
37. Sato M, et al. Cardioprotective effects of grape seed proanthocyanidins against ischemic reperfusion injury. J Mol Cell Cardiol 1999 
Jun;31(6):1289-97.
38. Tijburg LB, et al. Tea flavonoids and cardiovascular diseases: a review.Crit Rev Food Sci Nutr 1997;37:771-85. 
39. Renaud W, de Lorgeril M. Wine, alcohol, platelets, and the French paradox for coronary heart disease. Lancet 1992;339:1523-6.
..

Herbs which have been traditionally used for varicosities include the following:

Elder Berry, Latin named: Sambucus nigra S. canadensis, this herb is a rich source of flavonoids, and as such is strengthening and nutritive to the vascular integrity of veins, capillaries, and arteries for spider veins, varicose veins.

Nettle, Stinging Nettle, Latin Named: Urtica dioca, the leaf is useful for varicose veins, very nutritive, increase vascular integrity.

Calendula, Pot Marigold, Latin Named: Calendula officinalis The flowers are very rich in carotenoids and flavonoids which increase the integrity of veins, arteries and capillaries. This herb can be used in combination with other herbs which have been used for varicosities to build a formula.

Blueberry Fruit Latin Named: Vaccinium sp, rich source of flavonoid such as proanthocyanodins which have a strengthening effect on blood vessels, good for varicose and spider veins. Eat all fruit jams or just fruit in diet, this herb is very nutritive.

Blackberry, Latin Named: Rubus species The berries are a rich source of flavonoids which strengthen vessels and capillaries.

Collinsonia, Stone root, Rich weed, Horse balm, Latin Named: Collinsonia canadensis is a good herb for varicose veins combine with Hawthorn, Calendula and the Chinese herb Lycium fruit.

Cayenne pepper, hot pepper, bird pepper, Latin Named: Capsicum spp, C. annum, C. frutecens highly nutritious, rich source of flavanoids and carotenoids, helps with varicose veins and impaired circulation, get in diet or a couple drops a day of tincture.

Witch hazel, Latin Named: Hamamelis virginian use a strong tea in bath and soak, this herb is an astringent and helps with bruise, sprain, strains as an external application. Other astringing herbs can be used also, such as Yarrow, Oak bark, etc.

Horse Chestnut, Latin Named: Aesculus hippocastanum is good for varicosities such as hemoroids and varicose veins, moves venous congestion and increase tone of vessels, use small amount several drops of tincture.

The Chinese herb

Gou qi zi, Lycium fruit, Wolfberry, Latin Named: Lycium chinensis very rich in nutrients, flavanoids, carotenoids, helps to increase vascular integrity throughout body.

I would suggest any of the fruits or vegetables that have red/blue/purple flesh and skin would increase vessel integrity.

again from Nutrition Science News, July 2000

Herbal Treatment for Varicose Veins
by Mindy Green

See it on the web at http://exchange.healthwell.com/nutritionsciencenews/nsn_backs/Jul_00/vveins.cfm

In the body, blood pumps from the heart via arteries and returns back to the heart through veins. Down in the legs, venous blood must work against gravity; to prevent backflow, intermittent valves open for the blood and close behind it. A vein becomes varicose when valves break down or weaken, thereby putting more pressure on other valves. This can cause a cycle of damage that tends to increase with time. When valves no longer prevent backflow of venous blood, the abnormal pressure inflames the veins, blood pools, and veins become permanently dilated.
More than half the middle-age population in the United States has enlarged, twisted or bluish varicose veins. For reasons not wholly known, the condition occurs about four times more frequently in women than in men.1
The underlying causes of varicose veins are multifaceted and can include pregnancy and chronic constipation, both of which can increase venous pressure in the legs and lead to varicose veins. Overweight individuals who have less muscle and tissue tone are more likely to have weakened vein walls. Other factors are a hereditary predisposition, a lack of exercise and age. All these can be compounded by a lack of muscle tone and degenerative changes in supporting connective tissue. People in service positions who must stand on their feet for hours are most affected because their work conditions increase venous pressure.
Most varicosities are close to the skin's surface and, though they are not a severe threat to health, may hint at chronic circulatory problems. If ignored, they can become painful. Spider-web veins are tiny, dilated blood vessels just under the skin. They don't bulge like varicose veins and, though unsightly, are harmless. Deeper varicose veins can lead to stroke, heart problems or thrombophlebitis, a vein inflammation in conjunction with an obstructive blood clot formation.
Varicose veins are not confined to the legs. Hemorrhoids are varicose veins in the rectum and are much more common, frequently affecting pregnant women because of the extra pressure and weight in the perineal area. 
If a customer is concerned about varicose veins, you can recommend a number of healing herbs. The herbs can be even more effective when integrated with appropriate dietary and lifestyle changes. Some examples include increasing dietary fiber intake to prevent constipation, raising the legs for 10-minute intervals throughout the day to relieve pressure and pain on the varicosities, and raising the foot of the bed one to three inches to relieve pressure at night.
Phytotherapy
Teas or tinctures can be taken internally three to four times a day to help heal varicose veins from the inside. The actions of the medicinal plants listed here can increase vein elasticity, reduce blood-vessel fragility, stimulate circulation and reduce water retention. 
Horse chestnut (Aesculus hippocastanum) strengthens blood vessels and is an effective astringent that tones and tightens tissues.2 The herb reduces capillary fragility and swelling by regulating capillary permeability, and it helps strengthen and repair blood vessels that have lost their elasticity.3
The shiny brown fruits of this ornamental shade tree have a long history of treating varicose veins. As is the case with many herbs, horse chestnut's historical uses are being affirmed by modern research, and now some animal, clinical and in vitro studies give evidence of the herb's benefit.4 
At least two classes of compounds in horse chestnut, aesculin and aescin, may affect circulation. Both are coumarin glycosides; coumarins slow the onset of blood coagulation and are found in more than 150 species of medicinal plants. 
Aesculin thins blood and improves blood viscosity, so is thought to be endowed with vascular-protective properties.5
Aescin is a complex mixture of saponins, which are soaplike agents found in plants such as potatoes and beans that foam when cooked. Saponin compounds reduce the surface tension of liquids, and aescin itself increases the permeability of the inner vascular walls, making it easier for tissue fluids to drain into capillaries. Aescin, present at up to 13 percent in horse chestnut, is reported to have anti-inflammatory, anti-swelling and anti-exudative (oozing of fluids) properties.5 Rutin, the key flavonoid in buckwheat, and other flavonoids have long been used to treat weak capillaries and veins--and aescin is 300 times more potent than rutin.6
Commercial extracts of aescin from horse chestnut seeds also have been shown to reduce excessive clotting. Researchers at Bastyr University in Kenmore, Wash., conducted a double-blind, randomized, single-dose trial on 71 healthy individuals to assess the effects of a topical 2 percent aescin gel on experimentally induced bruises (broken blood vessels). The aescin gel reduced inflammation and tenderness in all cases over the recorded 10-hour period.7
Horse chestnut is most often used as a tincture rather than a tea and can be applied externally. It is also sold in a massage oil. The tincture and the massage oil can be combined with essential oils (see sidebar, this page). 
Horse chestnut is a fairly toxic herb that can cause vomiting and sometimes paralysis. However, cautionary notes on the internal use of this herb are conflicting. Although horse chestnut is often included in references on poisonous plants, it has high therapeutic value with low acute and chronic toxicities noted, except in children, who don't normally have varicose veins anyway. Nevertheless, this tincture should be used carefully when taken internally because the potency of commercial preparations varies widely. Some German pharmaceutical companies offer compounds specifically for internal use, often in combination with supportive herbs or nutritional substances including vitamins B and C. Since strengths and formulations vary, it is best to follow the recommended dosage on the label. Pregnant women should consult their health care practitioners before taking horse chestnut products, though the external use of gels, ointments, teas or tinctures poses no harm. Customers already using prescription anticoagulant medications should consult their health care practitioners because horse chestnut is also a weak blood thinner. 
Butcher's broom (Ruscus aculeatus) has been used historically to treat varicose veins because it is believed to improve vein tone and encourage blood flow. Research shows that both internal and topical applications may improve symptoms of poor circulation such as blood pooling in the legs, swelling and constricted blood vessels. The pharmacological activity is attributed to steroidal saponins, mainly the sugar-derivative glycosides called ruscogenin and neoruscogenin, which have vasoconstricting and anti-inflammatory effects.
In a double-blind clinical trial of 20 healthy people, a combination of ruscus extract and the flavonoid hesperidine improved the tone of varicose vein walls; the herb also reduced foot swelling.8 
A double-blind, placebo-controlled, crossover study was conducted on 30 females and 10 males between the ages of 28 and 74. The trial involved two treatment periods of two months, with a 15-day washout period. Participants took two capsules three times a day. Each capsule contained either placebo or 16.5 mg Ruscus aculeatus extract, 75 mg hesperidine and 50 mg vitamin C--a daily total of 99 mg ruscus, 450 mg hesperidine and 300 mg vitamin C. Researchers noted a significant decrease in swelling in the supplement group.9 
A tea or tincture of butcher's broom can be taken internally up to three times a day, or applied directly. Internal use should be avoided by pregnant women. 
Other astringent herbs include white oak (Quercus alba) bark and witch hazel (Hamamelis virginiana). The healing and anti-inflammatory actions of calendula (Calendula officinalis) are also well suited for treating varicose veins. These herbs can be taken as teas and used in sitz baths or used as compresses with a few drops of the essential oils added for their synergistic effects. A salve can be made of any of these herbs for treating hemorrhoids.
Other herbs stimulate peripheral circulation, thereby aiding blood flow in the legs. These include ginkgo (Ginkgo biloba), ginger (Zingiber officinalis), cayenne (Capsicum frutescens), and prickly ash (Zanthoxylum americanum). Garlic (Allium sativum), either fresh cloves or odorless standardized capsules, and bromelain from pineapple both contain enzymes that improve circulation by dissolving blood vessel fibrin that forms lumpy deposits around the veins.10-11 If water retention causes ankle or leg swelling, a diuretic such as dandelion (Taraxacum officinale) or yarrow (Achillea millefolium) is also helpful. Hawthorn (Crataegus spp.) is said to improve circulation by safely toning the heart muscle. Hawthorn also contains proanthocyanidins and anthocyanidins, which increase capillary strength and tone veins.12-14
Liver tonic and cleansing herbs such as Oregon grape (Berberis aquifolium), milk thistle (Silybum marianum), dandelion and burdock (Arctium lappa) are important for varicose vein treatment. A popular remedy is yellow dock (Rumex crispus); though not for varicose veins specifically, it is a helpful liver tonic and cleanser, and is a safe, mild laxative.
Finally, nonherbal methods can also ease the discomfort of varicose veins. Sitz baths (for hemorrhoids) or hot and cold compresses (for varicose veins in the legs) often provide the greatest immediate pain relief. Hot and cold water added to a bath in one- to three-minute intervals improves circulation and helps decongest the veins. Compression stockings also relieve the pain of varicose veins, but the stockings themselves can be a nuisance. Also, using a slantboard to raise the legs above the level of the head for 10-minute intervals several times a day can bring relief.
Even though chronic venous insufficiency is one of the more common health conditions of the adult population, it's nice to know nature offers effective remedies for its treatment. 
Mindy Green has 26 years of herbal experience and is director of educational services at the Herb Research Foundation and a faculty member at the Rocky Mountain Center for Botanical Studies, both in Boulder, Colo. She is author of Calendula (Keats, 1998).
References
1. Berkow R, editor. The Merck manual of diagnosis and therapy. 14th ed. Rahway (NJ): Merck & Co.;1982. p 560-6. 
2. Annoni F, et al. Venotonic activity of escin on the human saphenous vein. Arzneim-Forsch 1979:29;672-5. 
3. Duke J. The green pharmacy. Emmaus (PA): Rodale Press; 1997. p 539. 
4. Pittler MH, et al. Horse chestnut seed extract for chronic venous insufficiency. Arch Dermatol 1998 Nov;134:1356-60. 
5. Weiss, R. Herbal medicine. Beaconsfield (UK): AB Arcanum; 1988. p 188. 
6. Crawford AM. Horse chestnut. The Herbalist 1996 Nov;7-8.
7. Calabrese P. Report of the results of a double blind, randomized, single-dose trial of a topical 2% aescin gel versus placebo in the acute treatment of experimentally induced hematoma in volunteers. Planta Medica 1993:59.
8. Rudofsky G. Improving venous tone and capillary sealing: effect of a combination of ruscus extract and hesperidine methyl chalcone in healthy probands in heat stress. Fortschr Med 1989;107(19):52, 55-8. 
9. Cappelli R, et al. Use of extract of Ruscus aculeatus in venous disease in the lower limbs. Drugs Exp Clin Res 1988;14(4):277-83.
10. Bordia AK, et al. Effect of garlic oil on fibrinolytic activity in patient with CHD. Atherosclerosis 1977;28:155-9. 
11. Ako H, et al. Isolation of a fibrinolysis enzyme activator from commercial bromelain. Arch Int Pharmacodynamics 1981;254:157-67.
12. Gabor M. Pharmacologic effects of flavonoids on blood vessels. Angiologica 1972;9:355-74.
13. Kuhnau J. The flavonoids. A class of semi-essential food components: their role in human nutrition. World Rev Nutr Diet 1976;24:117-91.
14. Pourrat H. Anthocyanidin drugs in vascular disease. Planta Med Phytothera 1977;11:143-51.