Life Extension Magazine August 1998
All About Supplements
New Therapy 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.
Earlier this year, a Swiss pharmaceutical company introduced to the United States a popular European herbal drug, 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.
Horse chestnut's action against edema is extraordinarily strong and long-lasting, and 600 times more powerful than rutin.
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 leg swelling. Horse chestnut is the second most popular herb prescribed in Germany, greatly outselling herb extracts such as echinacea and St. John's wort.
One way that horse chestnut functions is to reduce 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 four weeks.
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 degrades hyaluronic 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 tissues.
Horse chestnut's action against edema is extraordinarily strong and long-lasting. In addition, it is 600 times more powerful than rutin, according to animal studies.
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 standing)."
The key active ingredient in horse-chestnut is a substance called escin. Pharmaceutical-grade horse-chestnut extracts contain between 16 and 20 percent escin. The therapeutic dose used in clinical studies is 50 mg of escin taken two times a day. This dose is provided by one 250-mg tablet of horse chestnut extract standardized at 20 percent escin, taken every 12 hours.