Preventing Phlebitis?

I am being treated for phlebitis. I am 54, female, overweight and have lots of visible veins on my legs and abdomen. What should my follow-up be once the problem clears up? Can I do water aerobics? Walking or biking? Could weight be a factor? Can you recommend a diet or supplements that would help my vascular system?

– October 14, 2010

Phlebitis is inflammation of a vein, usually in the leg, that may be caused by a blood clot within the vein (thrombophlebitis) or infection. The symptoms are redness, swelling, tenderness and pain along the course of a vein, which may be near the surface of the skin (superficial phlebitis) or deep within a muscle (deep vein thrombosis or DVT).

Risks for phlebitis are increased by long period of inactivity (such as when you’re confined to bed after surgery or sit for long stretches while driving or flying); by excess weight, pregnancy, use of birth control pills or estrogen therapy, with a family history of a blood clotting disorder, and with varicose veins and smoking.

Treatment of superficial phlebitis focuses on pain relief, reducing the swelling and preventing clot formation, as by applying heat (a warm compress) to the affected area several times a day, elevating your leg, taking a nonsteroidal anti-inflammatory drug such as Advil, Motrin or naproxen (Aleve) and using prescription-strength compression stockings (20-30 mmHg).

I discussed your question with Jacquelin Paykel, M.D., obstetrician/gynecologist and integrative medicine specialist at the Medical College of Wisconsin. She says that water aerobics, walking, and biking could help prevent further episodes of phlebitis because they promote circulation. Losing weight would also help. She recommends my anti-inflammatory diet or the DASH diet, and also suggests trying some of the following supplements to prevent recurrences:

  • Fish oil: Reduces inflammation and protects blood vessels. Dose: one to three grams daily.
  • Horse chestnut seed extract: reduces swelling and discomfort caused by varicose veins and phlebitis. Dose: 50-75 mg twice daily.
  • Ginger and turmeric: Natural anti-inflammatory agents. Dose: one 250 mg dried ginger capsule four times per day. The dose of dried turmeric root is 1-3 grams a day; the curcumin dose is 400-600mg up to three times a day.
  • Ginkgo biloba: Shown to improve blood flow in peripheral vascular disease (narrowing of blood vessels outside the heart and brain). Dose: 120-240 mg standardized leaf extract in two or three divided doses daily.

Andrew Weil, M.D.

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