Varicose Veins Treatment, Cause - Horse Chestnut Extract
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permission from Bill Faloon of The Life Extension Foundation
| ||New Support for Varicose Veins
More than 80
million Americans, the majority of them women, have
varicose veins. This is not just a cosmetic problem,
as the appearance of varicose veins can be an early
symptom of serious vascular disease.
A Swiss pharmaceutical company introduced a popular European herbal
drug to the United
States, horse chestnut,
that is virtually unknown to Americans. This
pharmaceutical company plans to spent $7 million
advertising this natural therapy to treat a wide range
of venous disorders, and promote leg health.
chestnut's action against edema is extraordinarily
strong and long-lasting.
Horse chestnut is one
of the better-validated German herbal medications.
Doctors throughout Europe prescribe horse chestnut to
treat varicose veins, chronic venous insufficiency and
Horse chestnut is the second
most popular herb prescribed in Germany, greatly outselling
herb extracts such as echinacea and
One way that horse
chestnut functions is the possible reduction of the number and
diameter of small pores in the capillary membranes,
thus reducing the escape of fluid into the surrounding
tissues. This "sealing" effect in the
capillaries improves blood flow in the veins, and
reduces swelling of small veins in the legs.
A study published in The
Lancet (Feb 3, 1996; Vol. 347, pp-292-294) examined 240
patients with chronic venous insufficiency that caused severe
leg edema (pooling of fluid in tissues).
After 12 weeks on horse
chestnut extract, fluid volume of the leg was reduced by an
average of 43.8 milliliters, while the placebo group showed an
increase of 9.8 milliliters in fluid retention. Horse chestnut therapy compared
favorably with compression stocking therapy, which many people
find uncomfortable. Moreover, patients in the horse chestnut
group were still improving at the end of the 12-week trial,
while the effects of compression therapy leveled off after
Another mechanism by which
horse chestnut works indicates that it also could have
anti-aging effects. In addition to improving circulation,
horse chestnut inhibits an enzyme called hyaluronidase that
acid, used by skin and capillary cells as
part of the proteoglycan "jelly" to hold collagen
fibers in place. Horse chestnut inhibits the age-related
breakdown of hyaluronic acid, and by doing so stabilizes the
support structures for the veins, skin and other connective
Horse chestnut's action against
edema is extraordinarily strong and long-lasting.
A clinical trial on 35 patients
with chronic venous insufficiency measured the volume of
patients' feet while lying down and standing up. Horse
chestnut proved highly effective against foot edema in both
positions, without depressing potassium levels, as do
diuretics. Another study of edema in the leg concluded,
"The clinical benefit for the patient is present in all
everyday situations (in movement as well as sitting or
Horse Chestnut Protects Veins
The heart pumps blood
through the arteries, then into the capillaries, from
which it returns through the veins. However, the low
pressure in the veins can pose a problem in the legs,
where blood must flow upward against the pull of
gravity to reach the heart when a person is standing.
Veins have one-way valves to prevent backflow of
blood. The muscles of the calf compress the deep veins
of the leg, propelling blood upward from the legs, but
the superficial veins of the leg are not surrounded by
muscles, so blood flows through them more slowly.
The condition of
inadequate return of blood from the leg veins to the
heart is called venous insufficiency. Physiologically,
the basis is elevated blood pressure in the veins of
the leg. The main cause is backflow of blood due to
malfunction of the valves in the leg veins. In
varicose veins, the superficial leg veins lose tone,
stretching both in length and width. The
elongation of the veins forces the valves apart that
normally keep blood from flowing the wrong way,
allowing reflux of blood, especially in a standing position.
Blood pools in the veins enlarging them
even more. The legs tend to ache, feel tired and
sometimes itch. There are many theories of how
elevated venous pressure leads to edema, skin damage
and sometimes ulceration. A widely held theory is that
increased capillary permeability leads to leakage of
plasma proteins and fibrinogen, forming a "fibrin
cuff" around the capillaries. This cuff
diminishes blood supply, and the supply of oxygen and
nutrients to tissues. Edema and inflammation also
The latest research
traces these pathological changes to venous stasis --
lack of proper blood flow in the veins. It brings
about hypoxia, or diminished oxygen supply. This in
turn, leads to changes in the cells of the inner blood
vessel wall which then releases inflammatory
substances that activate neutrophils. The activated
neutrophils adhere to these cells releasing
radicals and enzymes that degrade the extracellular
matrix. A cascade of events follows to bring about
pathological changes in vein walls. The activity
of proteolytic enzymes (enzymes that break down
proteins) increases and connective tissue
in the vein wall deteriorates.
counteracts these pathological processes in many ways.
First, it helps restore vein tone, the ability of the
vein to contract dynamically to the correct size for
any given venous pressure. Secondly, horse chestnut
helps correct the increased capillary permeability.
When an inflammatory stimulus is injected into the
rat, it increases the permeability of the lympho-plasmatic
barrier, doubling the lymphatic flow. Escin, the key
active constituent in horse chestnut, counteracts this
effect, returning the permeability of the lympho-plasmatic
barrier to normal.
Thirdly, horse chestnut
inhibits two key steps in the degenerative cascade set
off by hypoxia, the decrease in ATP content and the
increase in the activity of phospholipase A(2), a
pro-inflammatory enzyme. Moreover, escin inhibits
neutrophils from adhering to hypoxic cells on the
inside vein wall.
Finally, horse chestnut
counteracts the deleterious effects of free oxygen
radicals, and helps stabilize connective tissue and
preserve the integrity of the extracellular matrix.
inhibits enzymes that degrade proteoglycans, which are
essential to the stability and function of connective
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