Varicose Veins

A varicose vein is an enlarged, tortuous vessel in the venous system in filled with stagnant deoxygenated blood. Unlike the arterial system that relies upon the high pressures induced by heart contraction and the wave-like peristaltic movements of the arteries, the venous system has no independent pumping mechanism of its own, instead, relying upon a series of one way valves to direct the blood back to the heart as well as the pumping activity of muscular contraction. Deoxygenated blood is collected from tissues in venous capillaries at relative low pressures, essentially oozing out of tissues and moved along by one-way valves. The blood is then directed to superficial veins and then into the deep veins that lay next to the major arteries to direct conduct the blood to the heart. Once the blood is in the deep veins the pressure can increase dramatically through the pumping effect if muscular contraction.

Unlike the arteries that are can distend with an increase in pressure, the deep veins are constructed in such as way that it prevents distension, and thus the maintenance of these pressures ensure that the blood is directed upwards to the heart. The superficial veins however are constructed differently, and can become dilated when there is too high an increase in venous pressure, either because of an obstruction in venous flow, because muscular contraction is insufficient, or because of a failure of the one-way valves. Once a one-way valve fails, it promotes an increase in pressure in the local venous network, leading to the sequential failure of the other valves. After this process has continued for some time, the superficial veins become increasingly dilated and tortuous. (Berkow 1992)

Factors that promote the obstruction of venous flow include tight clothing around the waist and especially pregnancy, which as the fetus grows, compresses the veins that drain legs, causing an increase in pressure and the manifestation of varicosities. Hormones released during pregnancy facilitate this dynamic by making vessels more pliable. Other more serious causes include a thrombosis in the deep veins, and should be ruled out. The most common cause of varicose veins is physical inactivity, especially if it is complexed with the effects of gravity. Thus people who are required to stand for long periods without moving or completely contracting the legs of the muscles are much more prone to varicosities. Researchers have also pointed out the importance of accessory nutrients such as flavonoids that play a key role in the function and repair venous tissue (e.g. aesculin, derived from Horse Chestnut), and thus dietary deficiencies of such nutrient can be seen to promote or exacerbate this condition. While generally not all that serious of a condition, varicose veins can be very painful, and if untreated can eventually ulcerate and become infected. (Berkow 1992)

Thrombophlebitis describes the inflammation and secondary thrombosis of the small veins, as part of a local reaction to bacterial infection. Phlebothrombosis is the same as above but is not attributable to inflammation or infection. The term deep vein thrombosis is the formation of a thrombus associated with decreased cardiac output and extended bed rest, typically forming in the deep veins of the iliac and femoral veins. The primary concern in such cases is that the thrombus could embolize to the lungs. (Berkow 1992)

Holistic treatment

Besides the etiological factors mentioned above, herbalists recognize chronic abdominal and portal congestion as an important cause of an increase in venous pressure. Further, studies showing that varicosities often form in childhood suggest that not only may the condition have hereditary link, but may be related specifically to nutritional factors during childhood. Measures are thus taken to correct situations of pelvic congestion and provide the co-factors need to ensure the integrity of the blood vessels. Botanicals that exert a gentle astringing activity, act as pelvic decongestants and are rich in flavonoids are particularly warranted. Examples include Horsechestnut (Aesculus hippocastanum), Stoneroot (Collinsonia canadensis), White Dead Nettle (Lamium album), Haridra (Curcuma longa) and Scuteroot (Scutellaria baicalensis). Other botanicals that specifically improve blood vessel integrity include Hawthorn (Crataegus spp.), Bilberry (Vaccinium myrtillus), Ginkgo (Ginkgo biloba), Amalaki (Phyllanthus emblica) and Mandukaparni (Centella asiatica). Circulatory stimulants are also warranted, including Prickly Ash (Zanthoxylum spp.), Ginger (Zingiber officinalis), and Cayenne (Capsicum annuum). These botanicals can be formulated and taken internally as well as applied externally, twice daily. Where the tissues appear dry and weak, these herbs can be applied as a medicated oil, along with more generalized trophorestorative botanicals such as Huang Qi (Astragalus membranaceus), Dan Shen (Salvia miltiorrhiza), and Dang Gui (Angelica sinensis). In Chinese medicine the health of the vessels directly relates to the strength of the Spleen, and thus Spleen Qi restoratives such as Ginseng (Panax ginseng), Huang Qi (Astragalus membranaceus), Bai Zhu (Atractylodes macrocephala) and Dan Shen (Codonopsis pilosula) can be taken internally.

Given that varicosities can relate to thrombus formation, measures should also be taken to inhibit platelet aggregation and reduce the viscosity of the blood. Specific botanicals include Ginkgo (Ginkgo biloba), Garlic (Allium sativum), and Guggulu (Commiphora mukul).

Trophorestorative nutrients should also be considered, including vitamins A, C, E and zinc, as well as direct supplementation with bioflavonoids.

Hot and cold hydrotherapy can also be helpful (always ending cold), and regular exercise is recommended.