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Vol. II, No. 1
Herbal Transitions
1
A botanical newsletter for health care practitioners
Volume II • Number 1 Fall 1997
Varicosities
by Sharol Tilgner, N.D.
Inside this Issue
DEFINITION OF VARICOSITIES
Varicosities are enlarged, twisted, swollen veins
which may be located anywhere in the body. Most
commonly they are found on the legs (varicose
veins) or on the anus (hemorrhoids). They may be
asymptomatic or may cause aching, a feeling of
heaviness or pain. Edema may be associated with
them as well as pigmentation over the area and
ulceration. Women are affected 4 times more than
men. This disease is common in countries such as
the US where people eat a diet lacking dietary fiber
and are sedentary. When varicose veins are near
the surface they are cosmetically unappealing but
are usually not dangerous. Deeper varicose veins of
the leg are serious and can lead to thrombophlebitis,
pulmonary embolism, myocardial infarction and
stroke.
ANATOMY & PHYSIOLOGY OF VEINS
The blood is pumped around the body in vessels
called arteries and veins. The arteries carry
oxygenated blood away from the heart to the body’s
tissues while the veins carry deoxygenated blood
from the tissues back to the heart. The blood is
under more pressure as it flows away from the
heart than it is when it returns to the heart. It is quite
easy for the arterial blood to move towards the legs
since it is assisted by both the pumping action of the
heart and the pull of gravity. The blood returning
from the legs by way of the venous system has less
force behind its flow and is additionally faced with
the feat of overcoming gravity. Because of this, the
venous system has valves in it to assist the blood in
it"s movement towards the heart. The valves are
like unidirectional swinging doors attached on
HERBAL TRANSITIONS
Varicosities..................................................... p. 1
Varicosity Case Studies............................... p. 15
Market Quality Commentary..................... p. 17
Research Reviews ......................................... p.18
Calendar ........................................................ p. 19
Pacific NW Herbal Symposium 98............ p. 20
Vol. II, No. 1
Herbal Transitions
2
AGGRAVATING FACTORS
Genetic predisposition, chronic constipation, tight
clothing, sedentariness or lack of exercise,
pregnancy, obesity and aging all contribute.
Sedentariness: Standing in one place for extended
periods or sitting for long periods of time can cause
venous pooling in the lower legs since the flow of
blood is not being assisted by the muscular pump.
In addition, the weight of your legs pressing your
veins against the chair can impede the flow of blood
and crossing your legs while sitting will add to the
problem.
Tight clothing: Constrictive clothing can block the
flow of blood in the venous system adding to the
venous distention.
Chronic constipation: This can lead to hemorrhoids
although it can also be a factor in varicose veins of
the legs and groin area. While most veins have
valves to prevent back flow of blood, the veins
extending from the anus to the liver lack them.
Gravity imposes a constant burden and any
abdominal pressure makes it worse. Straining
during the lifting of a heavy object, coughing or
straining at stool can cause pressure build up in the
rectal area. Since chronic constipation causes
straining at stool, it can lead to hemorrhoids.
Liver dysfunction: The rectal veins lead to the
portal vein of the liver via the mesenteric vein; liver
dysfunction can cause a blockage in the flow of
blood from the rectal veins to the portal vein which,
in turn, can cause a back flow with possible venous
distention. Since hemorrhoids often accompany
sluggish livers, it is common in oriental medicine
and naturopathic medicine to treat the liver while
treating an individual with varicosities.
Pregnancy: Pregnant women are often plagued by
varicose veins, edema and hemorrhoids since the
woman’s legs are bearing greater weight than ever
before. At later stages of pregnancy, there also can
be compression of veins, depending on the position
of the fetus. Her blood volume will increase by 30-
40% placing an added stress on her veins and there
is an increase in the hormone, progesterone, which
will slow down her gastrointestinal tract, thereby
leading to constipation. Decreased exercise will
also add to the problem.
Herbal Transitions
Published by Wise Acres
P.O. Box 1168
Creswell, Oregon 97426
Sharol Tilgner, N.D., Editor
Lynn Buckman, Associate Editor
Deborah Fratz, Art Design
opposite sides of the vein that open solely in the
direction of the heart. This allows the blood to
progress forward while creating a tight seal blocking
the reverse blood flow. Nature has also provided
the venous system with the assistance of powerful
leg muscles and the contractions of these strong
muscles actually massage the blood back towards
the heart.
Individuals who stand or sit for a long period of
time in one position are not using this muscular
pump to aid the flow of blood, causing an increase
of venous blood to remain in the veins of the legs.
If this excess venous pressure is maintained for
prolonged periods of time, the veins can become
over-stretched which prevents the valves from
reaching each other to make a tight seal. When this
happens, there is nothing to keep the blood from
flowing backwards through the open valve.
Incompetent valves will allow more blood to build
up in the veins of the legs, causing the veins to
stretch even further with eventual valve
destruction. Incompetent or destroyed valves lead
to bulbous protrusions of the veins, especially in
the lower leg. These protrusions are known as
varicose veins. If the individual with varicose veins
stands for more than a few minutes, the venous
and capillary pressure become very high and fluid
leaks from the capillary blood into the tissues,
causing edema (fluid retention in the tissues). The
edema prevents adequate diffusion of nutritional
materials from the blood to the muscle and skin
which causes pain and weakness in the muscles.
The skin may become gangrenous and ulcerated.
Luckily, most people do not reach this stage of
ulceration. Indeed, no one ever should if they take
preventative measures.
™
Vol. II, No. 1
Herbal Transitions
3
PREVENTION OF VARICOSITIES &
TREATMENT
To assist the body’s circulation, exercise is vital.
Aerobic exercise such as walking, running, bike
riding, or cross country skiing would be best, but a
brisk 20 minute walk daily is a simple and easy
exercise.
Dietis also important. Eat simple nourishing meals.
Keep your bowels regulated by the food you eat. A
diet with 75% complex carbohydrates, 15% protein
and 10% oil is necessary for optimal health. Include
a daily minimum of one serving of green leafy
vegetables and one uncooked fruit or vegetable.
Vitamins and minerals: The following nutrients
are known to be beneficial to the structure and
integrity of the blood vessels. It is best to get nutrients
from food and use supplements as a last resort.
Foods high in that particular nutrient are listed
below.
Vitamin A (10,000 IU)
Carrots, dandelion greens, spinach, parsley,
plantain, nettles, your basic green foods and
yellow-orange vegetables, liver.
Vitamin B complex (10-100 mg)
Yeast, grains, organ meats, nuts, legumes.
Vitamin C (500-3,000 mg)
Currants, broccoli, rose hips, hawthorne berries,
parsley, brussel sprouts, green veggies.
Vitamin E (200-600 IU)
Extra virgin vegetable oils, leafy greens and
watercress, nuts in general, egg yolks, wheat
germ.
Zinc (15-30 mg)
Oysters, whole grains, brewer"s yeast, spinach,
sunflower seeds, pumpkin seeds.
Bromelain (500-750 mg TID at 1,500 MCU)
Breaks down fibrin. Found in pineapple.
Bioflavonoids (100-1000 mg)
Especially rutin, which is found in buckwheat,
Ruta (Ruta is toxic in large amounts or with
chronic use) and hesperidin. Other fruits or herbs
high in bioflavonoids are cherries, blueberries,
hawthorne berries (and other berries which are
blue-red), Saint John’s wort, Calendula, lemons,
oranges and rosehips. The bioflavonoids in these
foods reduce capillary fragility and increase the
integrity of the venous walls.
Other foods which aid the circulatory system are
okra, oats, beets, artichokes, wheat germ, green
leafy vegetables, raw garlic, onions and foods high
in lecithin, such as soybeans. These last three are
good to eat daily as they help regain and retain
elasticity in the blood vessels.
CONSTIPATION
Fiber, Fiber, and more Fiber
Remember that little saying “An apple a day
keeps the doctor away?” It applies in the case of
hemorrhoids.
Psyllium seeds
1 teaspoon seeds in 1/2 cup water, let sit 15
minutes, drink and follow with one cup water.
Use a few times per day or as often as necessary.
Can also use Pectin, Guar gum, Slippery elm, etc.
Warm lemon water
Drink a cup in the morning before breakfast.
Ginger tea
Drink one cup warm water with 1 teaspoon
The name says it all!
available in powder or convenient capsules
Contains:
• Psyllium husk and seed • Oat bran
• Bentonite clay • Fenugreek
• Slippery Elm • Yellow Dock
• Oregon grape root • Marshmallow
FIBER FLOW
™
1-800-532-5219
Wise Woman Herbals
™
Inc.
Vol. II, No. 1
Herbal Transitions
4
ginger before bed.
Laxatives
For herbs to really get the
bowels going: Yellow dock
(milder), Oregon grape,
Rhubarb, Cascara, Buckthorn,
Senna, Aloe. Most bitter herbs
will stimulate the bowels to
move.
Hot baths, hot water bottles and
abdominal massage can also
relieve constipation.
FIRST AID FOR
HEMORRHOIDS AND
VARICOSE VEINS
Baking soda
Can be applied externally, wet
or dry, to take the itch away. It
may burn or feel hot for a short
time.
Grated raw potatoes or apples
Can be applied to ease swelling
and pain.
Witch hazel, Oak bark or other
astringent herbs
Can be applied to reduce
swelling and curb bleeding.
Red rose petals
Can be made into a poultice
and applied to reduce swelling
and bleeding.
An herbal sitz bath
Use one of each of the
following:
1. An astringent herb
2. A vulnerary herb
Apple cider vinegar
Can also be used as a wash to
ease the pain of varicosities. ( I
have been told, I have not tried
it.)
Poultices, fomentations, sup-
positories
Use astringent and vulnerary
herbs.
• Achillea (Yarrow)
• Aesculus (Horse Chestnut)
• Cinnamomum (Cinnamon)
• Collinsonia (Stone root)
• Corydalis (Yellow Bleeding
Heart)
• Hamamelis (Witch Hazel)
• Glycyrrhiza (Licorice)
• Ruscus (Butcher"s Broom)
Bottoms Up Compound
Liquid Extract
(Available to physicians only)
• Achillea (Yarrow)
• Hamamelis (Witch Hazel)
• Hypericum (St. John"s Wort)
• Ruscus (Butcher"s Broom)
• Symphytum (Comfrey)
• Vitamin E
• A base of extra virgin olive oil
and beeswax
Bottoms Up Balm
Bottoms Up Capsules
• Achillea (Yarrow)
• Aesculus (Horse Chestnut)
• Cinnamomum (Cinnamon)
• Collinsonia (Stone root)
• Corydalis (Yellow Bleeding
Heart)
• Hamamelis (Witch Hazel)
• Ruscus (Butcher"s Broom)
Wise Woman Herbals
™
Inc. provides a
complete line of Bottoms Up
™
products
Vol. II, No. 1
Herbal Transitions
5
TO BE AVOIDED
Obesity, tight clothing, crossing legs, sitting or
standing for long periods, high heeled shoes (they
do not allow full natural contraction of leg muscles),
knee high stockings, constipating food, lifting heavy
objects incorrectly and straining at the toilet.
HERBS FOR VARICOSITIES
External applications
The following herbs can be used as poultices, sitz
baths, oils, suppositories or fomentations.
Witch hazel, Geranium, Oak bark, Yarrow
These plants are largely effective because of their
astringent action which causes tissue constriction,
including the veins. See astringent herbs below.
Saint John’s wort, Calendula, Ruta, Arnica
These herbs support normal venous tissue
integrity and are anti-inflammatory.
Comfrey, Slippery elm, Plantain
These plants are mucilaginous and have a
demulcent effect thereby soothing and healing
irritated mucous membranes. All three of these
plants are well known for their ability to speed
the healing process when applied to irritated
tissue.
Butcher’s broom
Ruscogenins in this plant have been shown to
inhibit inflammation and induce venous
constriction.
Internal applications(detailed descriptions of these
herbs follow this list)
Stone root, Butcher’s broom, Cinnamon, Gotu
kola, Witch hazel, Geranium, Oak bark, Yarrow,
Saint John’s wort, Calendula, Horse chestnut,
Liver herbs (see below), Cayenne, Garlic, Onion,
Ginger.
Herbs Specific For Varicose Veins
Butcher’s broom - Ruscus aculeatusin the Liliaceae
or Lily family
Part used: root
Taste/smell: soapy taste
Dosage: 1 heaping teaspoon per cup water
(decocted) or 5-30 drops 1:5 dry liquid extract, 1-3
times per day in a little water.
Use: Anti-inflammatory, vasoconstrictor, anti-
hemorrhagic. Butcher’s broom acts upon the venous
system and is used for varicosities, especially
hemorrhoids. It causes the swelling of hemorrhoidal
varices to go down and has a tonic effect on the
rectal blood vessels.
Constituents: Contains ruscogenin and
neoruscogenin which have been shown to have
anti-inflammatory and vasoconstrictive activities.
Contraindications: Information not available.
Gotu kola - Centella asiaticain the Umbelliferae or
Parsley family
Part used: whole plant
Taste/Smell: spicy, fragrant
Dosage: 1 tablespoon per cup water (infused) or 20-
60 drops of 1:1 fresh liquid extract, 1-4 times per
day.
Use: Anti-inflammatory, diuretic, laxative,
vulnerary, antiseptic, circulatory stimulant,
increases endurance and energy. Ingestion helps
prevent scarring. Gotu kola is used externally and
internally to accelerate the healing time in wounds
and ulcers. It is also used for sluggish digestion, to
MORE TIDBITS OF ADVICE
Support Stockings
Go all the way up to the hips, raise legs high for
10 minutes prior to putting them on.
Leg Massage
A 5-10 minute daily massage, working with the
flow of blood, will improve circulation.
Inverted yoga postures
The head stand, plow or shoulder stand.
Cold morning bath
Vigorously rub your entire body with a cold wet
towel, then a dry one, to improve circulation.
Sitz baths for hemorrhoids
Hot and cold alternating sitz baths. Sit in a pan of
hot water for 3 minutes, then a cold pan for 30
seconds. The water needs to cover your entire
pelvic area. Do this for 10-20 minutes, 3 times per
day. Always end with the cold treatment.
Vol. II, No. 1
Herbal Transitions
6
improve memory, high blood pressure, abscesses,
rheumatism, fever, ulcers, leprosy, general skin
eruptions, varicose veins, nervous disorders and
jaundice. It has a calming and supportive effect on
the nervous system. Centella normalizes the
metabolism of connective tissue and enhances
connective tissue by stimulating glycosaminoglycan
synthesis without
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