Varicose Veins

Why it works: Venotonic & microvascular effects. MPFF (diosmin + hesperidin) reduces venous capacitance/distensibility and improves venous emptying, while also stabilising capillary permeability...

Instructions: Best-evidence regimen (MPFF / “Daflon”):. • Dose: 1000 mg once daily with food for symptoms of chronic venous disease. This is the approved/labeled dose in multiple product monogra...

Warnings: Pregnancy & breastfeeding: Product information advises avoid use during pregnancy as a precaution, a...

Studies: ESVS 2022 Clinical Practice Guidelines (Europe): Summarise 7...

Why it works: Active compounds & actions. HCSE is standardized to aescin (escin), a triterpenoid saponin that is venotonic (improves vein tone), anti-edematous (reduces capillary leakage and swe...

Instructions: Choose the right product. Use an oral extract standardized to 16–20% aescin/escin, and explicitly “esculin-free” (raw plant parts contain toxic esculin). WebMD. Typical oral dose u...

Warnings: Never ingest raw horse chestnut (seeds, bark, leaves, flowers): contains esculin, which is toxic. Us...

Studies: Cochrane Review (2012; 17 RCTs). HCSE improved leg pain (6 p...

Why it works: Venous “tone” + lymph flow. The main actives (steroidal saponins ruscogenin & neoruscogenin) have venotonic and lymphotonic actions—tightening dilated veins and improving lymphatic...

Instructions: Oral standardized extracts (most studied):. • Common clinical products use Ruscus extract + hesperidin methyl-chalcone (HMC) + vitamin C (often branded as “Cyclo 3 Fort”). The usua...

Warnings: Blood pressure / cardiovascular stimulants: Because Ruscus can constrict blood vessels, be cautious...

Studies: Randomized, double-blind, placebo-controlled trial (n=60). R...

Why it works: It powers the “calf-muscle pump.” Every step contracts your calf and foot muscles, squeezing deep veins and pushing blood upward; this reduces venous pooling and pressure—the core...

Instructions: Below is a safe, commonly used framework. If you have complications (see “Warnings”), check with your clinician first.. 1) Aerobic base (4–6 days/week). • Walking: 30–45 minutes at...

Warnings: Red-flag symptoms—get urgent medical advice: sudden leg swelling/pain/redness/warmth (possible DVT),...

Studies: Randomized/controlled training improves venous hemodynamics...

Why it works: Reduces venous hypertension & pooling. Graduated compression is tightest at the ankle and decreases up the leg, narrowing vein diameter, improving valve leaflet coaptation, and spe...

Instructions: Get properly assessed first (especially if you’ll use >20 mmHg). Exclude significant peripheral arterial disease and check skin integrity; Doppler/ABPI (ankle–brachial pressure ind...

Warnings: Peripheral arterial disease (PAD).. • Contraindicated at ABI < 0.6 (or ankle pressure ≤ 60 mmHg).. •...

Studies: Systematic review (Cochrane). Across 13 RCTs (n≈1021) in pri...

Why it works: Proposed mechanisms (physiology): Lab and translational work suggests acupuncture can trigger local nitric oxide (NO) release and vasodilation—i.e., it may transiently improve micr...

Instructions: Choose a qualified practitioner & set expectations. • Use a licensed/accredited acupuncturist who follows recognized safety codes (clean field, single-use needles, sharps disposal)...

Warnings: Do not needle directly into prominent varicosities. The vein wall is fragile; needling or deep press...

Studies: For varicose veins specifically: Evidence is limited and low...

Why it works: Venotonic + microvascular effects. GSE is rich in oligomeric proanthocyanidins (OPCs) that can reduce capillary permeability, improve venous tone, and act as antioxidants and anti-...

Instructions: Form & standardization: Choose a reputable GSE product (capsules/tablets) listing the amount of extract per dose; products often standardize to proanthocyanidins. (Third-party test...

Warnings: Bleeding risk / drug interactions. Because GSE can inhibit platelet aggregation and has potential an...

Studies: Randomized non-inferiority trial (2024). A double-blind, mul...

Why it works: Improves microcirculation & reduces capillary leakage. Standardized triterpene extracts (TECA/TTFCA) have repeatedly been shown to lower abnormally high capillary filtration and an...

Instructions: When possible, use a standardized oral extract rather than non-standardized powders/teas. Typical regimens studied:. TTFCA/TECA oral dosing:. • 60 mg twice daily (TTFCA 60 mg b.i.d...

Warnings: Liver safety: Although uncommon, rare cases of clinically apparent liver injury with jaundice have b...

Studies: Systematic review (RCTs) of Centella for CVI: Found improvem...

Why it works: Venotonic + microcirculatory effects. Pycnogenol’s oligomeric procyanidins (OPCs) have antioxidant and anti-inflammatory actions that can improve endothelial function, reduce capil...

Instructions: Common trial doses for CVI symptoms:. • 150–360 mg/day for 6–12 weeks (often split 2–3 doses/day). pycnogenol.com. • Examples: 150 mg/day alone, vs. compression stockings, or combi...

Warnings: Quality/standardization: Benefits cited are mostly with the Pycnogenol® brand; other pine-bark extra...

Studies: Phytomedicine RCT (2000): Double-blind phase + open phase in...