Edema

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Edema

Need to Know

Edema
Puffiness in your legs or other limbs may be caused by a buildup of excess fluid underneath the skin. What can you do to remedy water retention? According to research or other evidence, the following self-care steps may be helpful.
  • Try a diuretic

    Pick up an over-the-counter remedy containing ammonium and caffeine, or an herbal diuretic containing goldenrod, corn silk, horsetail, juniper, or dandelion

  • Fill up on flavonoids

    Try these natural plant pigment supplements to reduce symptoms of edema associated with venous or lymphatic conditions; take 2,000 mg a day of hydroxyethylrutosides or a daily combination of diosmin (900 mg) and hesperidin (100 mg)

  • Check out butcher’s broom

    For edema caused by venous or lymphatic disorders, take 300 to 450 mg a day of this plant extract in combination with hesperidin and vitamin C

About

About This Condition

Abnormal accumulation of fluid beneath the skin is known as edema. This leads to a puffy appearance, often in 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.

Symptoms

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.

Eating Right

The right diet is the key to managing many diseases and to improving general quality of life. For this condition, scientific research has found benefit in the following healthy eating tips.

Recommendation Why Get started
Try a low-salt diet Avoid eating too much salt, as it tends to lead to water retention and may worsen edema in some people.

Try a low-salt diet

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

Supplements

What Are "Star" Ratings?

a7_3star   Reliable and relatively consistent scientific data showing a substantial health benefit.

a7_2star   Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.

a7_1star   For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.

Our proprietary “Star-Rating” system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by the medical community, and whether studies have found them to be effective for other people.

For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.


Supplement Amount Why
Diosmin and Hesperidin
 900 mg diosmin and 100 mg per hesperidin daily 2 stars   A combination of the flavonoids diosmin and hesperidin may be effective for treating a variety of venous circulation disorders.
Selenium
 230 mcg daily 2 stars   People with lymphedema of the arm or head-and-neck region who were treated with selenium saw an improvement in quality of life and edema symptoms in one study.

2 stars  Selenium

230 mcg daily

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.4

Supplement Amount Why
Cleavers
 Refer to label instructions 1 star   Cleavers is one of numerous plants considered in ancient times to act as a diuretic. It was therefore used to relieve edema and to promote urine formation during bladder infections.

1 star  Cleavers

Cleavers is one of numerous plants considered in ancient times to act as a diuretic.5 It was therefore used to relieve edema and to promote urine formation during bladder infections.


Supplement Amount Why
Corn Silk
 Refer to label instructions 1 star   Corn silk has long been considered to have diuretic properties, which are beneficial for treating edema.

1 star  Corn Silk

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.6 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®).7 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.8 Thus, diuretic herbs are not yet well supported for use in reducing edema.

Supplement Amount Why
Dandelion
 Refer to label instructions 1 star   Dandelion leaves have diuretic effects that may be comparable to the prescription diuretics used to treat edema.

1 star  Dandelion

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.9 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®).10 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.11 Thus, diuretic herbs are not yet well supported for use in reducing edema.

Supplement Amount Why
Goldenrod
 Refer to label instructions 1 star   Herbs that stimulate the kidneys (diuretics) theoretically should help reduce edema. Goldenrod is considered one of the strongest herbal diuretics.

1 star  Goldenrod

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.24 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®).25 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.26 Thus, diuretic herbs are not yet well supported for use in reducing edema.

Supplement Amount Why
Horse Chestnut
 Refer to label instructions 1 star   An ingredient in horse chestnut seed has been shown to effectively reduce post-surgical edema in preliminary trials.

1 star  Horse Chestnut

Aescin, isolated from horse chestnut seed, has been shown to effectively reduce post-surgical edema in preliminary trials.27 , 28 A form of aescin that is injected into the bloodstream is often used but only under the supervision of a qualified healthcare professional.

Supplement Amount Why
Horsetail
 Refer to label instructions 1 star   Horsetail has a diuretic action that accounts for its traditional use in reducing mild edema.

1 star  Horsetail

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;29 however, there is no clinical research that yet supports its use for people with edema.

Supplement Amount Why
Hydroxyethylrutosides
 2,000 mg daily hydroxyethylrutosides or a daily combination of diosmin (900 mg) and hesperidin (100 mg) 1 star   Hydroxyethylrutosides is a type of flavonoid that may help reduce symptoms of edema associated with venous or lymphatic conditions.
Juniper
 Refer to label instructions 1 star   The volatile oils in juniper cause an increase in urine volume and in this way can theoretically lessen edema.

1 star  Juniper

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;30 however, there is no clinical research that yet supports its use for people with edema.

References

1. Ponce P, Mello-Gomes E. Idiopathic edema, tubular metabolism of water and sodium. Acta Med Port 1991;4:236–41 [in Portuguese].

2. Belcaro G, Cesarone MR, Ricci A, et al. Control of edema in hypertensive subjects treated with calcium antagonist (nifedipine) or angiotensin-converting enzyme inhibitors with Pycnogenol. Clin Appl Thromb Hemost 2006;12:440-4.

3. Cesarone MR, Belcaro G, Rohdewald P, et al. Prevention of edema in long flights with Pycnogenol. Clin Appl Thromb Hemost 2005;11:289-94.

4. Micke O, Bruns F, Mucke R, et al. Selenium in the treatment of radiation-associated secondary lymphedema. Int J Radiat Oncol Biol Phys 2003;56:40–9.

5. Mills SY. Out of the Earth: The Essential Book of Herbal Medicine. London: Viking Arkana, 1991, 493–4.

6. Tyler V. Herbs of Choice: The Therapeutic Use of Phytomedicinals. New York: Pharmaceutical Products Press, 1994, 74 [review].

7. Racz-Kotilla E, Racz G, Solomon A. The action of Taraxacum officinale extracts on the body weight and diuresis of laboratory animals. Planta Med 1974;26:212–7.

8. Doan DD, Nguyen NH, Doan HK, et al. Studies on the individual and combined diuretic effects of four Vietnamese traditional herbal remedies (Zea mays, Imperata cylindrica, Plantago major and Orthosiphon stamineus). J Ethnopharmacol 1994;36:225–31.

9. Tyler V. Herbs of Choice: The Therapeutic Use of Phytomedicinals. New York: Pharmaceutical Products Press, 1994, 74 [review].

10. Racz-Kotilla E, Racz G, Solomon A. The action of Taraxacum officinale extracts on the body weight and diuresis of laboratory animals. Planta Med 1974;26:212–7.

11. Doan DD, Nguyen NH, Doan HK, et al. Studies on the individual and combined diuretic effects of four Vietnamese traditional herbal remedies (Zea mays, Imperata cylindrica, Plantago major and Orthosiphon stamineus). J Ethnopharmacol 1994;36:225–31.

12. Becker HM, Niedermaier G, Orend KH. Benzopyrone in the therapy of postreconstructive edema. A clinical double-blind study. Fortschr Med 1985;103:593–6 [in German].

13. Casley-Smith JR, Morgan RG, Piller NB. Treatment of lymphedema of the arms and legs with 5,6-benzo- [a]-pyrone. N Engl J Med 1993;329:1158–63.

14. Chang TS, Gan JL, Fu KD, Huang WY. The use of 5,6 benzo-[alpha]-pyrone (coumarin) and heating by microwaves in the treatment of chronic lymphedema of the legs. Lymphology 1996;29:106–11.

15. Casley-Smith JR, Wang CT, Casley-Smith JR, Zi-hai C. Treatment of filarial lymphoedema and elephantiasis with 5,6-benzo-alpha-pyrone (coumarin). BMJ 1993;307:1037–41.

16. Loprinzi CL, Kugler JW, Sloan JA, et al. Lack of effect of coumarin in women with lymphedema after treatment for breast cancer. N Engl J Med 1999;340:346–50.

17. Wadworth AN, Faulds D. Hydroxyethylrutosides. A review of its pharmacology, and therapeutic efficacy in venous insufficiency and related disorders. Drugs 1992;44:1013–32 [review].

18. Renton S, Leon M, Belcaro G, Nicolaides AN. The effect of hydroxyethylrutosides on capillary filtration in moderate venous hypertension: a double blind study. Int Angiol 1994;13:259–62.

19. Piller NB, Morgan RG, Casley-Smith JR. A double-blind cross over trial of o-beta-hydroxyethyl-rutosides (benzopyrones) in the treatment of lymphoedema of the arms and legs. Br J Plast Surg 1988;41:20–7.

20. Struckmann JR. Clinical efficacy of micronized purified flavonoid fraction: an overview. J Vasc Res 1999;36 Suppl 1:37–41 [review].

21. Pecking AP, Fevrier B, Wargon C, Pillion G. Efficacy of Daflon 500 mg in the treatment of lymphedema (secondary to conventional therapy of breast cancer). Angiology 1997;48:93–8.

22. Griffith JQ. Clinical application of quercetin: preliminary report. J Am Pharm Assoc 1953;42:68–9.

23. Shanno RL. Rutin: a new drug for the treatment of increased capillary fragility. Am J Med Sci 1946;211:539–43.

24. Tyler V. Herbs of Choice: The Therapeutic Use of Phytomedicinals. New York: Pharmaceutical Products Press, 1994, 74 [review].

25. Racz-Kotilla E, Racz G, Solomon A. The action of Taraxacum officinale extracts on the body weight and diuresis of laboratory animals. Planta Med 1974;26:212–7.

26. Doan DD, Nguyen NH, Doan HK, et al. Studies on the individual and combined diuretic effects of four Vietnamese traditional herbal remedies (Zea mays, Imperata cylindrica, Plantago major and Orthosiphon stamineus). J Ethnopharmacol 1994;36:225–31.

27. Dini D, Bianchini M, Massa T, Fassio T. Treatment of upper limb lymphedema after mastectomy with escine and levo-thyroxine. Minerva Med 1981;72:2319–22 [in Italian].

28. Wilhelm K, Feldmeier C. Thermometric investigations about the efficacy of beta-escin to reduce postoperative edema. Med Klin 1977;72:128–34 [in German].

29. Tyler V. Herbs of Choice: The Therapeutic Use of Phytomedicinals. New York: Pharmaceutical Products Press, 1994, 76–7 [review].

30. Tyler V. Herbs of Choice: The Therapeutic Use of Phytomedicinals. New York: Pharmaceutical Products Press, 1994, 76–7 [review].

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