Varicose Veins

Winning an Uphill Battle

That marbled look might work well on a fireplace mantel or a coffee table, but when it's on your legs--no way! You'd prefer them without those blue squiggles, thank you very much.

Why is it that some people have those squiggles and others don't?

To understand that, it helps to look at how the veins function. The heart pumps blood to the lungs to pick up oxygen. Then the blood travels back to the heart to be pumped out through arteries, thus delivering oxygen throughout the body. The heart pushes blood out through the arteries with a great deal of force. And when blood is making its return trip to the heart from various parts of the body, it moves through veins.

"Veins can't rely on the same forceful pressure that arteries have to move blood," explains Robert Ginsburg, M.D., director of the cardiovascular intervention unit at the University of Colorado Health Sciences Center in Denver. "Instead they use valves that open in one direction only, toward the heart, to keep blood from flowing backward. And they rely on muscle contractions to squeeze blood in the right direction." Inefficient? Well, send your complaints to Mother Nature.

Varicose veins, those blue bulges, develop when veins can't return blood to the heart efficiently. Blood pools in the veins, making them dilate. That hinders the valves' ability to close tightly and stop backward blood flow. Eventually, veins may become permanently dilated and scarred and take on a torturous configuration similar to a road map of West Virginia.

Varicose veins are not just a cosmetic problem. They can contribute to swollen, tired legs and muscle cramps.

Some people develop varicose veins because they have inherited structural problems with the valves in the upper parts of their legs, says Joseph Pizzorno, Jr., N.D., a naturopathic physician and president of Bastyr University in Seattle. "Even if just one or two valves fail, that can put enough pressure on the lower part of a vein so that it, too, has problems," Dr. Pizzorno says.

Other people have leaky valves because their veins are simply too weak to withstand the pressure of backflowing blood.

Most doctors' nutritional advice for varicose veins is limited to "Lose weight, eat more fiber." Both of these dietary measures help reduce pressure in veins. The few doctors who go beyond this advice to recommend nutritional supplements say they're focusing on nutrients that help maintain the structural integrity of the vein wall and help reduce the possibility of blood clots in veins. Here's what these doctors recommend.

Vitamin C Helps Fragile Veins

Keeping vein walls strong is important when it comes to preventing varicose veins or keeping them from getting worse, according to medical experts. Strong vein walls can resist more pressure without dilating, which allows the veins' valves to work better.

That's where vitamin C comes in. The body needs it to manufacture two important connective tissues: collagen and elastin. Both of these fibers are used to repair and maintain veins to keep them strong and flexible, explains Dr. Pizzorno. Vitamin C, he says, may be especially important for you if you bruise easily or have broken capillaries, which may show up on your skin as tiny "spider veins."

Even more important to keeping veins and capillaries in tip-top shape may be vitamin C's first cousin, bioflavonoids. Bioflavonoids are chemical compounds often found in the same foods as vitamin C.

Dr. Pizzorno recommends 500 to 3,000 milligrams of vitamin C and 100 to 1,000 milligrams of bioflavonoids daily. These high amounts are easily obtained only with supplements. Some people experience diarrhea with as little as 1,200 milligrams of vitamin C a day, so you should discuss taking this much with your doctor.

Vitamin E Keeps Blood Flowing

While there are no studies to show that vitamin E heals varicose veins, people with varicose veins apparently do use it, hoping that it will help prevent the biggest potential complication: blood clots.

"Vitamin E helps keep platelets, blood components involved in clotting, from sticking together and from adhering to the sides of blood vessel walls," Dr. Pizzorno explains. Research shows that reducing platelet stickiness with vitamin E could help people at particularly high risk for blood-clotting problems, such as those with diabetes.

If you're going to take vitamin E, aim for 200 to 600 international units daily, suggests Dr. Pizzorno. Some research suggests that 200 international units a day is enough to reduce platelet adhesion. If you've had bleeding problems or a stroke, it's important that you talk to your doctor before starting vitamin E supplementation. If you are taking anticoagulants, you should not take vitamin E supplements.

A Trace Mineral Helps Keep Veins Strong

We all know that minerals help keep bones strong. Studies show that some minerals do the same for blood vessels, helping to build and maintain the layers of tissues that form blood vessel walls.

Copper, which we all need in small amounts, is used in the body to knit together collagen and elastin, the same connective tissues that require vitamin C.

"Copper is involved in the cross-linking between the molecules that make up these tissues," explains Leslie Klevay, M.D., Sc.D., of the U.S. Department of Agriculture Grand Forks Human Nutrition Research Center in North Dakota. Research has shown that copper-deficient animals have weakened arteries and capillaries, two of the three types of blood vessels in our bodies (the third is veins), that can bulge out under pressure.

According to Dr. Klevay, little research has been done on copper's effect on veins. But because arteries and veins have similar structures, it is quite possible that the strength of veins depends on adequate copper levels, too. This is why everyone, including people with varicose veins, should make sure that they're getting adequate amounts of this trace mineral, Dr. Klevay says.

Copper is also needed to build and repair endothelial cells, the smooth protective cells lining the insides of blood vessels, Dr. Klevay explains. Getting adequate copper appears to help protect blood vessels against microscopic tears and rough spots, caused by high blood pressure and smoking, that can lead to the buildup of cholesterol-laden plaque and to blood clots.

The Daily Value for copper is two milligrams. Your best bet for getting enough? Include whole grains, nuts and seeds, along with shellfish (especially cooked oysters) and lean red meat, in your diet, recommends Dr. Klevay.

B Vitamins May Help Stop Clots

Endothelial cells are also damaged by high blood levels of an amino acid called homocysteine. The damage has been linked to early heart disease and, more recently, to increased risk of recurrent blood clots in veins.

That's where the three Bs come in. Researchers now know that folate (the naturally occurring form of folic acid) and vitamins B₆ and B₁₂ help break down and clear homocysteine from the blood. "Deficiency of any one could lead to a high level of homocysteine," explains Jacques Genest, Jr., M.D., director of the cardiovascular genetics laboratory at the Clinical Research Institute of Montreal, a research center that has done pioneering work on homocysteine and heart disease. "We've found that 2.5 milligrams (2,500 micrograms) of folic acid or 25 milligrams of vitamin B₆ reduces homocysteine levels to normal in most people," he says.

These high amounts of folic acid and vitamin B₆ are well above the Daily Values (400 micrograms and two milligrams, respectively) and are available only through supplements. This much folic acid should be taken only under medical supervision, as amounts exceeding the Daily Value can mask symptoms of pernicious anemia, a vitamin B₁₂-deficiency disease.

Even those eating healthy diets, with two or three servings of fruits and three or four servings of vegetables a day, get only about 190 micrograms of folate daily. As for vitamin B₆, men get about 1.9 milligrams a day and women average 1.2 milligrams a day through foods such as chicken, fish, pork and eggs. Some people may need to take both, and older people and strict vegetarians may also need extra vitamin B₁₂, Dr. Genest adds. He recommends taking 2 micrograms of B₁₂ a day.