| | | | Other Names | | | Edema, Edemic, Dropsy, Water Retention, Retaining Water, Bloating, Fluid
Retention.
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| | | Abnormal accumulation of fluid beneath the skin is known as edema. This
leads to a puffy appearance, often to a limb, most commonly a leg. There
are many causes of edema. In some cases, the underlying problem (for
example congestive heart failure or preeclampsia of pregnancy) must be
medically treated in order for the edema to resolve. In other cases (such
as chronic venous insufficiency, edema following minor trauma, or
lymphedema resulting from damage to lymphatic vessels caused by surgery
and other medical treatments), it is possible with both conventional and
natural approaches to focus specifically on the edema. Unless edema is
clearly due to minor trauma, it should never be treated until the
underlying cause has been properly diagnosed by a healthcare professional.
The discussion below deals only with situations in which it is safe to
focus on the edema itself and not the underlying cause.
What are
the symptoms of edema? People with edema may notice that a ring on
their finger feels tighter than in the past, or they might have difficulty
in putting on shoes, especially toward the end of the day. They may also
notice a puffiness of the face around the eyes, or in the feet, ankles,
and legs. When edema is present, pressure on the skin, such as from the
elastic band on socks, may leave an indentation that is slow to disappear.
Edema of the abdomen, called ascites, may be a sign of serious underlying
disease and must be immediately evaluated by a
doctor.
Conventional Treatment Options: Conventional
treatment consists of managing the underlying condition, which may include
inadequate nutrition; liver, heart, and kidney disease; or obstruction of
blood or lymph flow. In some cases, a salt-restricted diet and water pills
(diuretics) may be recommended.
Dietary changes that may be
helpful: High salt intake should be avoided, as it tends to lead to
water retention and may worsen edema in some people. A controlled trial
found that a low-salt diet (less than 2100 mg sodium per day) resulted in
reduced water retention after two months in a group of women with
unexplained edema.1
Lifestyle changes that may be helpful:
If the edema is affecting one limb, the limb should be kept elevated
whenever possible. This allows fluid to drain more effectively from the
congested area. To decrease fluid buildup in the legs, people should avoid
sitting or standing for long periods of time without
moving.
Nutritional supplements that may be helpful: Several
double-blind trials2 3 4 5 have found that 400 mg per day of coumarin, a
flavonoid found in a variety of herbs, can improve many types of edema,
including lymphedema after surgery. However, a large double-blind trial
detected no benefit using 200 mg coumarin twice daily for six months in
women who had arm edema after mastectomy (surgical breast removal).6
(Coumarin should not be confused with the anticlotting drug
Coumadinr.)
A group of semi-synthetic flavonoids, known as
hydroxyethylrutosides, are also beneficial for some types of edema.7 One
double-blind trial found that 2 grams per day of hydroxyethylrutosides
reduced ankle and foot edema in people with venous disorders after four
weeks.8 Another double-blind trial found that 3 grams per day of
hydroxyethylrutosides significantly reduced lymphedema of the arm or leg
and lessened the associated uncomfortable symptoms.9
A combination
of the flavonoids diosmin (900 mg per day) and hesperidin (100 mg per day)
has been investigated for the treatment of a variety of venous circulation
disorders.10 However, in a double-blind trial, this combination was not
effective for lymphedema caused by breast cancer
treatments.11
Because coumarin, hydroxyethylrutosides, and diosmin
are not widely available in the United States, other flavonoids, such as
quercetin, rutin, or anthocyanosides (from bilberry), have been
substituted by doctors in an attempt to obtain similar benefits. The
effect of these other flavonoids against edema has not been well studied.
Also, optimal amounts are not known. However, in one study, quercetin in
amounts of 30-50 mg per day corrected abnormal capillary permeability
(leakiness),12 an effect that might improve edema. A similar effect has
been reported with rutin at 20 mg, three times per day.13 Doctors often
recommend 80-160 mg of a standardized extract of bilberry, three times per
day.
Whereas vitamin B6 is sometimes recommended for reducing
edema, no research has investigated its effectiveness.
Are there
any side effects or interactions? Refer to the individual supplement
for information about any side effects or interactions.
Herbs
that may be helpful: A double-blind trial found that a formula
containing butcher's broom extract, the flavonoid hesperidin, and vitamin
C, which is used in Europe to treat venous and lymphatic system disorders,
was superior to placebo for reducing lymphedema.14 The amount of butcher's
broom extract typically used is 150 mg two or three times per
day.
Herbs that stimulate the kidneys were traditionally used to
reduce edema. Herbal diuretics do not work the same way that drugs do,
thus it is unclear whether such herbs would be effective for this purpose.
Goldenrod (Solidago cnadensis) is considered one of the strongest herbal
diuretics.15 Animal studies show, at very high amounts (2 grams per 2.2
pounds of body weight), that dandelion leaves possess diuretic effects
that may be comparable to the prescription diuretic furosemide (Lasixr).16
Human clinical trials have not been completed to confirm these results.
Corn silk (Zea mays) has also long been used as a dc, though a human study
did not find that it increased urine output.17 Thus, diuretic herbs are
not yet well supported for use in reducing edema.
Aescin, isolated
from horse chestnut seed, has been shown to effectively reduce
post-surgical edema in preliminary trials.18 19 A form of aescin that is
injected into the bloodstream is often used but only under the supervision
of a qualified healthcare professional.
Horsetail has a diuretic
(urine flow increasing) action that accounts for its traditional use in
reducing mild edema. Although there is no clinical research that yet
supports its use for people with edema, the German government has approved
horsetail for this use. The volatile oils in juniper cause an increase in
urine volume and in this way can theoretically lessen edema;20 however,
there is no clinical research that yet supports its use for people with
edema.
Cleavers is one of numerous plants considered in ancient
times to act as a diuretic.21 It was therefore used to relieve edema and
to promote urine formation during bladder infections.
Are there
any side effects or interactions? Refer to the individual herb for
information about any side effects or
interactions.
References:
1. Ponce P, Mello-Gomes E.
Idiopathic edema, tubular metabolism of water and sodium. Acta Med Port
1991;4:236-41 [in Portuguese].
2. Becker HM, Niedermaier G, Orend
KH. Benzopyrone in the therapy of postreconstructive edema. A clinical
double-blind study. Fortschr Med 1985;103:593-6 [in German].
3.
Casley-Smith JR, Morgan RG, Piller NB. Treatment of lymphedema of the arms
and legs with 5,6-benzo- [a]-pyrone. N Engl J Med
1993;329:1158-63.
4. Chang TS, Gan JL, Fu KD, Huang WY. The use of
5,6 benzo-[alpha]-pyrone (coumarin) and heating by microwaves in the
treatment of chronic lymphedema of the legs. Lymphology
1996;29:106-11.
5. Casley-Smith JR, Wang CT, Casley-Smith JR,
Zi-hai C. Treatment of filarial lymphoedema and elephantiasis with
5,6-benzo-alpha-pyrone (coumarin). BMJ 1993;307:1037-41.
6.
Loprinzi CL, Kugler JW, Sloan JA, et al. Lack of effect of coumarin in
women with lymphedema after treatment for breast cancer. N Engl J Med
1999;340:346-50.
7. Wadworth AN, Faulds D. Hydroxyethylrutosides. A
review of its pharmacology, and therapeutic efficacy in venous
insufficiency and related disorders. Drugs 1992;44:1013-32
[review].
8. Renton S, Leon M, Belcaro G, Nicolaides AN. The effect
of hydroxyethylrutosides on capillary filtration in moderate venous
hypertension: a double blind study. Int Angiol 1994;13:259-62.
9.
Piller NB, Morgan RG, Casley-Smith JR. A double-blind cross over trial of
o-beta-hydroxyethyl-rutosides (benzopyrones) in the treatment of
lymphoedema of the arms and legs. Br J Plast Surg 1988;41:20-7.
10.
Struckmann JR. Clinical efficacy of micronized purified flavonoid
fraction: an overview. J Vasc Res 1999;36 Suppl 1:37-41
[review].
11. Pecking AP, Fevrier B, Wargon C, Pillion G. Efficacy
of Daflon 500 mg in the treatment of lymphedema (secondary to conventional
therapy of breast cancer). Angiology 1997;48:93-8.
12. Griffith JQ.
Clinical application of quercetin: preliminary report. J Am Pharm Assoc
1953;42:68-9.
13. Shanno RL. Rutin: a new drug for the treatment of
increased capillary fragility. Am J Med Sci 1946;211:539-43.
14.
Cluzan RV, Alliot F, Ghabboun S, Pascot M. Treatment of secondary
lymphedema of the upper limb with CYCLO 3 FORT. Lymphology
1996;29:29-35.
15. Tyler V. Herbs of Choice: The Therapeutic Use of
Phytomedicinals. New York: Pharmaceutical Products Press, 1994, 74
[review].
16. Racz-Kotilla E, Racz G, Solomon A. The action of
Taraxacum officinale extracts on the body weight and diuresis of
laboratory animals. Planta Med 1974;26:212-7.
17. Doan DD, Nguyen
NH, Doan HK, et al. Studies on the individual and combined diuretic
effects of four Vietnamese traditional herbal remedies (Zea mays, Imperata
cylindrica, Plantago major and Orthosiphon stamineus). J Ethnopharmacol
1994;36:225-31.
18. Dini D, Bianchini M, Massa T, Fassio T.
Treatment of upper limb lymphedema after mastectomy with escine and
levo-thyroxine. Minerva Med 1981;72:2319-22 [in Italian].
19.
Wilhelm K, Feldmeier C. Thermometric investigations about the efficacy of
beta-escin to reduce postoperative edema. Med Klin 1977;72:128-34 [in
German].
20. Tyler V. Herbs of Choice: The Therapeutic Use of
Phytomedicinals. New York: Pharmaceutical Products Press, 1994, 76-7
[review].
21. Mills SY. Out of the Earth: The Essential Book of
Herbal Medicine. London: Viking Arkana, 1991, 493-4.
Source: NOW
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Please Note: This Traditional Use information is provided as a courtesy only. The products indicated above may be listed in error. This information is based on Traditional and Folklore Medicine which uses natural materials to support health. This information has not been evaluated or approved by the FDA and is not based on scientific evidence from any source. These statements have not been evaluated by the Food and Drug Administration (FDA). These products are intended to support general well being and are not intended to treat, diagnose, mitigate, prevent, or cure any condition or disease. If conditions persist, please seek advice from your medical doctor.
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Edema (Dropsy) - Health - Meadowsweet Flower - Queen of Meadows - 300 mg
100 capsules
10.60 US
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Edema (Dropsy) - Health - Meadowsweet Tea
25 tea bags
11.07 US
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Edema (Dropsy) - Health - Meadowsweet Tea
50 tea bags
13.56 US
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