A bulging section of blue, twisted vein on the back of a person's calf or thigh is a common sight. This is a varicose vein. Varicose veins run in families and are more common in women. They often ache, sometimes itch, usually cause swelling and pain in the feet and ankles, and are more obvious when standing up. What is a varicose vein?
After the blood has delivered oxygen throughout the body, veins carry it back toward the heart. Veins have one-way valves to keep gravity from pulling the blood downward. Varicose veins affect humans because we stand upright rather than run around on all fours. This means that gravity puts pressure on the veins in the legs, and they have to work harder to pump blood back upwards to the heart. Sometimes this pressure can cause the veins to leak. Accumulated blood at these leak sites stretches the vein, and pools of it cause lumps and kinks. The veins affected are just under the skin, so you can clearly see the enlarged and twisted portions.

Besides heredity, what brings on problems?
Sometimes varicose veins first occur during pregnancy because of hormonal changes and increased pressure in the veins caused by the expanding uterus. Obesity, menopause, aging, constipation and repeated abdominal strain, as well as heavy lifting, may contribute. Long periods of standing and sitting with the legs bent and crossed make them worse.

The simplest act of standing for long periods can increase the pressure within the veins of the legs many-fold. At the end of the workday, if your legs ache and you notice edema, blood is pooling in your legs due to venous stasis. Over time, the walls of your veins are likely to become dilated and may develop defects, leading to further dilation, valvular damage, further dilation, and more valvular damage. This is the vicious cycle that generates a loss of structural integrity and gives rise to varicosities.

How are varicose veins treated?
Minor problems may improve if you take regular walks, avoid long periods of standing, don't use high heels, and rest with your feet elevated. Your doctor may suggest wearing elastic stockings to support the veins. If so, put them on right away in the morning before blood and fluid have pooled in your feet and ankles.

In more severe cases, sclerotherapy may be recommended, which consists of injecting a solution into the varicose vein. The solution causes irritation, inflammation, and eventually scarring, which permanently blocks the vein. The body absorbs the accumulated blood from the varicose vein, and the lumps flatten out over time. A new sclerosing procedure called "Varisolve" is very successful. The procedure is cheaper than surgery and boasts that 81% of patients are completely cured, with an addtional 10% seeing significant improvements.

Another method is removal of the vein by a procedure called stripping. The vein is tied off above the varicose section. One end of a tiny wire is attached at the varicose section and the other end is threaded through the vein to a small incision at the calf or ankle. There, the wire, along with the varicose section of vein, is pulled out.

The body does not miss veins that are blocked with sclerotherapy or removed with surgery. The legs have many alternative channels for the blood to take. Problems never return in treated veins, but new varicose veins can develop in another location. Mild problems are easier to treat than severe ones, so be sure to deal with your symptoms early.

Along with a high fiber diet and regular exercise, enhancing fibrinolytic activity can help. The use of cayenne, garlic, onion, ginger, and bromelain are suggested. Also, flavonoids are useful in strengthening connective tissue (especially capillaries). They help keep tissues from falling apart. Varicose veins, hemorrhoids, bleeding between periods, and lymphedema can be aided by flavonoids. The anthocyanidins and proanthocyanidins should be supplemented as they are the strongest acting of the flavonoids. Rutin has only a little collagen-stabilizing effect. Since increasing the integrity of the wall of the vein may also reduce the risk of developing varicose veins, it appears that flavonoid-rich berries, such as hawthorne berries, cherries, blueberries, and blackberries are beneficial in the prevention and treatment of varicose veins. These berries are very rich sources of proanthocyanidins and anthocyanidins.

The most effective agents, though harder to find are aortic GAGs (glycosaminoglycans) from highly purified bovine sources. These contain dermatan sulfate, heparan sulfate, hyaluronic acid, chondroitin sulfate and other GAGs. Two double-blind studies have compared aortic GAGs to bilberry and HER (a flavonoid preparation like rutin and citrus bioflavonoids). The aortic extract produced far better results in both hemorrhoids and varicose veins.

Dosages
HER 1,000 – 3,000mg per day (better than rutin and citrus bioflavonoids).
Bilberry (Vaccinium myrtillus) (25% anthocyanosides) 80-160mg tid.
Butcher’s broom (Ruscus aculeatus) (9-11% ruscogenin) 100mg tid.
Horse chestnut (aesculus hippocastanum) extract for 50mg of escin per day.
Grape seed extract 100mg bid-tid.
Vitamin C 500-1,000gm tid with Bioflavonoids 3000-6000mg per day.
Bromelain (1,200-1,800mcu) 500-750 bid-tid.

Medical help should be sought if:
-- the pain and swelling becomes extremely severe or
-- you have red varicose veins
-- you cut a varicose vein - see a doctor immediately.

Chronic venous insufficiency (CVI) sometimes leads to varicose veins. Symptoms of CVI include edema, enlarged veins near the skin surface, and fatigue in the legs.