Horse Chestnut (aesculus hippocastanum)
The herb horse chestnut acts as a lower limb circulatory tonic. Studies show that the active constituent in horse chestnut, aescin, reduces capillary permeability and improves venous tone by increasing the contractile potential of the elastic fibres in the vein wall. These properties help to improve lower limb circulation and reduce oedema (water retention). Research suggests that horse chestnut may be as effective as leg support stockings, with one study finding significantly less lower leg oedema in those using horse chestnut for 12 weeks versus those using support stockings.
The pineapple-derived enzyme bromelain facilitates the breakdown of fibrin, a substance that is deposited in the blood vessels, leading to reduced circulation and excessive clotting. In addition, fibrin deposits outside the veins can lead to a lumpy, hardened texture to the surrounding area. Individuals with varicose veins are often impaired in their ability to break down fibrin and may benefit from bromelain. Other foods that promote fibrin break-down include garlic, ginger, cayenne pepper and onion all of which are recommended in varicose veins.
Gotu Kola fcenteila asiafica)
The herb gotu kola improves blood circulation, especially in the lower limbs, primarily through its ability to improve the integrity of the connective tissue sheath that surrounds the veins. This helps to minimise vein permeability and therefore reduce oedema (water retention), whilst promoting better blood flow through the vein. These effects have led to impressive clinical results in treating both varicose veins, venous insufficiency and varicose ulcers.
OPCs (e.g. Pycnogenol, grape seed extract)
Grape seed and pine bark extract (Pycnogenol) contain high levels of oligomeric proanthocyanidins, which are powerful antioxidant compounds that appear to support vein health by improving the integrity of the connective tissue sheath that surrounds veins, primarily by supporting collagen. OPCs appear, therefore, to reduce vein permeability and the resulting lower leg oedema (water retention) associated with varicose veins. In fact placebo-controlled studies (most of them double-blind) involving a total of about 400 participants suggest that OPCs provide significant benefit for varicose veins and veinous insufficiency.
Cultures with a high fibre intake appear to have a lower incidence of varicose veins that cultures with low fibre intake (such as western societies). Apart from issues relating to vein integrity, one of the major causes of varicose veins is straining associated with bowel movements cause by a lack of fibre. The straining increases pressure in the abdomen, which obstructs the flow of blood up the legs, a factor that, over time, may weaken the vein wall and lead to varicose veins. A high fibre diet may therefore be an important factor in the prevention and treatment of varicose veins.
Varicose Veins Summary
Nutrient/Herb Typical intake range
Horse chestnut extract (30% aescin) (1)
Gotu kola1 (3)
OPCs (pycnogenol, grape seed extract) (4)
Psyllium husk fibre
250 -500mg per day
500 – 2000mg per day (away from food)
500 – 2000mg per day
30 – 200mg per day
1000 – 3000mg per day
Trans fats/fried foods
Garlic, onions, cayenne,
Fruit (especially berries)
Nuts and seeds
Take regular exercise
Avoid standing in one place for extended periods of time
Avoid straining during bowel movements
1. Do not use during pregnancy or lactation. Concurrent use with Warfarin, anticoagulants and aspirin under medical supervision only.
2. Possible interaction with Warfarin – concurrent use with medical supervision only.
3. Concurrent use with anti-diabetic medication under medical supervision.
4. Caution advised with Warfarin (theoretical)