Edema: Also Indexed as Bloating, Fluid Retention, Water Retention

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Edema: Also indexed as: Bloating, Fluid Retention, Water Retention

 

Dietary changes -Supplements -Herbs

 

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.

 

Checklist for Edema (Water Retention)

 

Rating Nutritional Supplements Herbs

Flavonoids (courmarin, hydroxyethylrutosides)

 

Flavonoids (diosmin and hesperidin combination)

 

Selenium (for lymphedema)

 

Flavonoids (quercetin)

Cleavers

 

Corn silk

 

Dandelion (leaves)

 

Goldenrod

 

Horse chestnut

 

Horsetail

 

Juniper

 

See also: Homeopathic Remedies for Edema

Reliable and relatively consistent scientific data showing a substantial health

benefit.

Contradictory, insufficient, or preliminary studies suggesting a health benefit

or minimal health benefit.

For an herb, supported by traditional use but minimal or no scientific evidence.

For a supplement, little scientific support and/or minimal health benefit.

 

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.

 

Medical treatments

Over the counter diuretics containing ammonium chloride and caffeine (Aqua-Ban®)

may be used to relieve symptoms related to edema or water retention when taken

five to six days before menses. More severe edematous conditions require medical

attention.

 

Treatment of edema with prescription medications is limited to the use of

diuretics, commonly referred to as “water pills.” Agents often used include the

thiazide diuretics, such as hydrochlorothiazide (HydroDIURIL®), indapamide

(Lozol®), and metolazone (Zaroxolyn®); loop diuretics including furosemide

(Lasix®), bumetanide (Bumex®), and torsemide (Demadex®); and potassium-sparing

diuretics, such as spironolactone (Aldactone®), triamterene (Dyazide®,

Maxzide®), and amiloride (Midamor®).

 

Commonly, 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 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 2,100 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 Coumadin®.)

 

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

 

In a preliminary study, individuals with lymphedema of the arm or head-and-neck

region were treated with approximately 230 mcg of selenium per day, in the form

of sodium selenite, for four to six weeks. A quality-of-life assessment showed

an improvement of 59%, and the circumference of the edematous arm was reduced in

10 of 12 cases.12

 

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),13 an effect that might improve edema. A similar effect

has been reported with rutin at 20 mg three times per day.14 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.15 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.16 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 (Lasix®).17 Human clinical trials have not been completed to confirm

these results. Corn silk (Zea mays) has also long been used as a diuretic,

though a human study did not find that it increased urine output.18 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.19 20 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;21 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.22 It was therefore used to relieve edema and to promote urine

formation during bladder infections.

 

http://www.evitamins.com/healthnotes/healthnotes.asp?ContentID=1210002

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