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Health Protocols

Chronic Venous Disease: Varicose Veins And Venous Insufficiency


Chronic venous disease is a condition in which blood does not flow efficiently through the veins in the legs toward the heart. It can be caused by problems with the vein walls or valves, which cause blood to pool in the leg veins—a condition called venous stasis. Spider veins and varicose veins are common signs of early-stage chronic venous disease. In advanced stages, chronic venous disease can cause leg swelling, changes in skin appearance and texture, and ulcers; the more advanced condition is called chronic venous insufficiency (Eberhardt 2014; Fort 2017a; Fort 2017b; Douketis 2016b; Eklof 2009).

Up to 35% of adults in the United States have some form of venous disease, and more than 25 million American adults have varicose veins (Eberhardt 2014; Fort 2017b).

Some people may dismiss varicose veins as a mere cosmetic nuisance that accompanies normal aging (Eberhardt 2014; Gloviczki 2011). However, untreated varicose veins are associated with increased risk of deep vein thrombosis—potentially deadly blood clots in the legs (Shaydakov 2016). Therefore, varicose veins and chronic venous disease should be taken seriously even in the early stages.

Conventional treatment options for varicose veins range from conservative management with compression stockings to more invasive methods such as endovenous ablation or surgical removal of affected veins (Stucker 2016; Eberhardt 2014; Wittens 2015; Scherger 2012). These treatments provide cosmetic improvement, relieve symptoms, and may prevent complications (Douketis 2016a; Scherger 2012).

However, conventional treatments do not prevent the formation of new varicose veins: recurrence rates are as high as 33% at five years. Also, invasive therapies are associated with adverse effects including bleeding, infection, nerve damage, and blood clots (Douketis 2016a; Wittens 2015; Zhan 2014; Scherger 2012).

Fortunately, newer minimally invasive strategies for treating varicose veins have been developed, including the FDA-approved VenaSeal system. This novel procedure uses a medical grade glue, rather than heat or cutting, to seal varicose veins, allowing for rapid recovery (FDA 2015; Gibson 2017). In addition, some bioengineered skin substitutes such as Dermagraft and Apligraf have been developed to accelerate the healing of venous ulcers (Nicholas 2016; Serena 2014).

Also, several natural compounds that function as phlebotonics can be helpful in the management of chronic venous disease and varicose veins. Phlebotonics are compounds that improve circulatory function, such as horse chestnut seed extract, diosmin, pycnogenol, and Centella asiatica (Fort 2017b; Martinez-Zapata 2016).

This protocol provides an overview of chronic venous disease and its various manifestations, particularly varicose veins. This protocol also covers conventional as well as emerging treatment options for chronic venous disease, and reviews natural agents and dietary habits that support vein health.