Early Warnings You Need to Heed: Venous Insufficiency & Varicose Veins

That’s why I wanted to focus today’s Health Tip on what causes these vascular damage disorders, how you can get properly diagnosed, and what you can do to help improve these conditions and your overall health.

Venous insufficiency, is vascular damage affecting the veins, particularly in the legs, in which valve dysfunction leads to blood pooling and increased pressure in the veins, and a “puffiness” appearance and “doughy” texture to the legs, especially from the knee down. Varicose veins are bulging, broken veins that appear dark, twisted and/or spidery under the skin, especially on the legs from thighs down to the ankles. Hemorrhoids are another venous vascular damage that may affect as many as 50-80% of adults at one time or another.

ENDOTHELIAL INJURY: UNDERLYING CAUSE OF DAMAGE IN ALL:

• The endothelium is the inner lining of blood and lymph vessels, including arteries, veins and capillaries.
• Endothelial Injury from any cause leads to inflammation, that in turn impairs the function of the walls of the blood vessels. This creates a vicious cycle of oxidative stress with impaired blood flow, more inflammation, more injury, more oxidative stress and disease progression.
• It is the damage to the endothelial layer that sets up the conditions of all three vascular conditions I mentioned above.
• Disease progression occurs as a result of vascular dilation, increased permeability, inflammatory cell adhesion, tissue remodeling and edema (fluid retention leading to swelling and tissue distortion).  All of these factors work alongside mechanical and hemodynamic stresses to cause these vascular- damage conditions.

ENDOTHELIUM AND THE VASCULAR SYSTEM

The blood vascular system is a network of vessels that play a vital role in delivering oxygen and nutrients to the body’s cells, removing waste products, and maintaining body temperature.  The vascular system consists of arteries carrying oxygenated blood and nutrients away from the heart to tissues and organs, capillaries or tiny blood vessels that allow oxygen and nutrients to pass from the arteries into the cells and waste products to pass back into the capillaries to enter the bloodstream to be carried to larger veins that carry the deoxygenated blood and nutrient waste back to the heart. Ninety-nine percent (99%) of our vascular system is comprised of micro vessels (such as the capillaries) that make up our microvascular system. Dysfunction of these small vessels can lead to various diseases including cardiovascular, kidney and diabetes, as well as conditions such as venous insufficiency, varicose veins and hemorrhoids.

The microvasculature is not just a passive network, it’s regulated by endothelial cells which line the inside of the vessels, and help control blood flow, capillary permeability, and tissue oxygenation. When the endothelial layer is damaged, it leads to multiple adverse health effects that begin slowly and insidiously – with only the early warning signs of varicose veins, mild venous insufficiency, or hemorrhoids.  If not treated, these warnings become louder and louder until they progress to obvious disease such as heart attacks and strokes.
The endothelium is a continuous single layer of specialized endothelial cells lining the inner surface of all blood vessels and all lymphatic vessels, part of the separate but critically important lymphatic vascular system.

The surface of endothelial cells lining blood vessel lumens is covered by a thick layer called the glycocalyx, a rich matrix of glycoproteins and proteoglycans which protects the endothelium. The glycocalyx looks like tiny hair follicles that form a gel-like surface that acts as an important selective barrier to control permeability and prevent excessive leakage.

COMMON RISK FACTORS:

Endothelial damage is caused by MANY factors, including traditional cardiovascular risk factors, chronic dehydration/insufficient hydration, environmental exposures, and medical conditions like diabetes, hypothyroidism, hypogonadism, and autoimmune disorders that lead to oxidative stress, inflammation, and vascular dysfunction. Here are several major risk factors for endothelial damage:

• High blood pressure – Chronic mechanical stress damages endothelial cells, impairing function.
• High cholesterol – promotes oxidative modification of LDL, triggering inflammation and endothelial dysfunction.
• Diabetes and hyperglycemia – Elevates glucose, promotes oxidative stress, and produces advanced glycosolaytion end-products (AGEs) –all are damaging to the endothelium.
• Smoking – Introduces toxins increasing reactive oxygen species (ROS) leading to oxidative injury and inflammation.
• Obesity – Adipose tissue secrets inflammatory cytokines negatively impacting endothelial health.
• Oxidative stress – Reduces nitric oxide bioavailability and activates proinflammatory signaling
• Chronic insufficient or deficient hydration: inadequate fluid intake means oxygenated blood and nutrients cannot circulate, and inflammatory metabolic waste products cannot be removed, leading to more inflammatory and oxidative damage to the endothelial lining.
• Air pollution and particulate matter – Directly injure endothelium or activate systemic inflammation causing dysfunction.
• Heavy metals – e.g., mercury, lead, cadmium are toxic to vascular cells and promote hypertension-related endothelial injury
• Hypogonadism, hypothyroidism: impairs cardiac output, blood vessel integrity and fluid regulating pathways, leading to inflammatory and oxidative damage to the vessels.
• Aging – Natural decline in endothelial repair and increased oxidative stress with age contributes to dysfunction
• Chronic systemic infections and inflammation – Sustained immune activation damages vascular cells.
• Genetic and lifestyle factors. Family history, physical inactivity, poor diet, and chronic stress are ALL added risk factors for vascular damage conditions.

VENOUS INSUFFICIENCY – UNIQUE RISKS & SYMPTOMS TO HEED:

Varicose veins and hemorrhoids have much more obvious signs and symptoms than most people recognize for venous insufficiency, so I included specific characteristics, signs and symptoms and diagnostic tools to discuss with your physician to check for venous insufficiency:

• Swelling (edema) in the legs, ankles, or feet, often increase throughout the day.
• Achy, heavy, or painful sensation in the legs, which worsens after standing or sitting for long periods and improves with elevation.
• Cramping, throbbing, tingling, burning, or itching in the legs.
• Varicose veins—twisted, enlarged, and visible veins on the surface of the legs.
• Skin changes: discoloration (brown or reddish-brown around the ankles), irritation, thickening, hardening (lipodermatosclerosis), or leathery appearance.
• Slow-healing wounds or ulcers, typically near the ankles.
• Restless legs or muscle spasms, especially at night.
• A tight feeling in the calves.
• Fatigue in the legs.
• Skin irritation, scaling, stasis dermatitis (crusted or weepy skin).
• Indentation left after pressing on a swollen area (pitting edema).
• Prickling or abnormal sensations.
• Pain that worsens while standing and gets better when resting or elevating the legs.

Venous insufficiency symptoms can progress from mild discomfort and visible veins to severe ongoing pain, skin changes, and hard-to-heal ulcers. Early recognition and treatment are key to preventing complications.

If you suspect you have venous insufficiency, please discuss this with your physician who can order imaging such as the Duplex Ultrasound (Color-Flow Doppler) one of the most widely used, noninvasive, and the gold standard for diagnosing venous insufficiency. This test assesses blood flow, valve function, vein structure, and looks for the presence of any obstruction or reflux.  We have reports from vein clinics and vascular experts suggesting that patients who got the COVID shots and already had varicose veins are at a higher risk of deep vein thrombosis (DVT), venous insufficiency and other vascular damage conditions. So it is important to get this checked by your physician.

SUMMARY OF COVID-19’s VASCULAR DAMAGE EFFECTS:

Since 2020 with the COVID-19 viral illness and 2021 COVID-19 gene therapy injections rolled out, we have seen severe vascular damage with increased risk of blood clots (arterial and venous), pulmonary emboli, strokes, heart attacks due to clots, venous insufficiency, varicose veins and hemorrhoids. COVID-19 contributes to endothelial damage through direct viral infection of endothelial cells and an overwhelming systemic inflammatory response known as the cytokine storm. This results in widespread endothelial dysfunction, vascular inflammation, hypercoagulability, as well as direct injuries to the endothelial glycocalyx leading to increased permeability and leukocyte adhesion.

Damage from the COVID shots and boosters also occurs from ongoing spike protein production and lipid nanoparticular coatings on the mRNA itself.  That toxicity has been demonstrated to linger years since the last COVID shot or booster, leading to continued elevated d-dimer levels for many people (indicates ongoing micro-clot formation and risk of larger deadly blood clots), elevated systemic inflammatory markers and elevated spike protein antibodies.

• Endothelial cell infection and injury promoting clot formation and inflammation.
• Enhanced coagulation and thrombosis increasing DVT and venous embolism risk.
• Progression from micro blood clots or larger acute thrombosis to chronic venous insufficiency due to valve damage and impaired venous return.
• Persistent vascular inflammation and dysfunction observed in long COVID, affecting both peripheral and cerebral veins.

STRATEGIES TO SUPPORT HEALTHY ENDOTHELIUM & VESSELS

Prevention of vascular damage is key! Choices you make now make a huge difference in years to come! A comprehensive approach is required. I suggest starting with prevention by risk reduction.  Control the risk factors I mentioned above, such as weight, blood sugar, blood pressure; exercise, quit smoking, monitor daily hydration, and improve diet.  All these steps help prevent or slow microvascular and endothelial damage by reducing inflammation, oxidative stress, and improving vascular function.

Key lifestyle approaches supported by research include:

• A heart healthy diet emphasizing oxidant rich foods such as fruits, vegetables, dark leafy greens, raw nuts, and unrefined whole grains.
• Choose heart healthy fats like olive oil, avocados, and omega-3 rich fatty fish.
• Limit processed foods, refined sugars, saturated fats, and excess sodium to reduce inflammation and oxidative stress.
• The Mediterranean diet has proven benefits for improving endothelial function.
• Get regular physical exercise including aerobic activities like walking, running, swimming, and cycling that stimulate nitric oxide production and improve blood vessel flexibility.
• Strength training improves metabolic health, decreases inflammation, and supports endothelial repair.
• Guidelines suggest getting at least 150 minutes of moderate intensity exercise per week is beneficial for vascular health.
• Monitor daily hydration and be sure you are getting ½ oz to 1 oz per pound of body weight every day.  Actual number of ounces depends on your activity level – the more physically active you are with strenuous work or exercise, the closer to 1 oz per pound of body weight you need that day.  If you are sedentary, you should be adequately hydrated at ½ oz per pound of body weight. But as always, check with your doctor for any special guidelines based on your medical conditions and medicines.
• Manage stress and get adequate sleep. Chronic stress from sleep deprivation elevates cortisol and inflammatory cytokines that in turn damage the endothelium.
• Practice mindfulness techniques such as meditation, and yoga to reduce stress and improve blood flow and overall vascular function.
• Avoid smoking.  Tobacco, marijuana and other types of smoke introduce toxins and oxidative stress that damage endothelial cells.
• Limit alcohol. Excessive alcohol consumption impairs vascular function.
• Adequate supplementation with antioxidants and anti-inflammatory nutrients, especially flavonoids, are supported by research showing actions to improve vascular health, especially at the endothelial cellular level and repair damaged glycocalyx.

CITRUS BIO-FLAVONOIDS THAT SUPPORT ENDOTHELIAL HEALTH:

Diosmin and Hesperidin are natural compounds known as bioflavonoids, commonly extracted from citrus fruits. These flavonoids are widely used to treat poor blood circulation, especially in the legs. They improve venous tone and lymphatic drainage and enhance blood vessel strength and elasticity. This makes them helpful for symptoms like swelling, heaviness, or pain in the legs as well as for treating venous leg ulcers due to poor circulation in the lower limbs and minor bleeding. They work by strengthening and enhancing the elasticity of capillaries and veins, reducing inflammation, and improving both blood and lymphatic flow.

Diosmin and hesperidin, combined in the same ratio used in clinical trials is the combination found in Truth For Health’s TruMicroVascular™ are effective natural compounds for supporting vein and capillary health, and are commonly used for chronic venous insufficiency, varicose veins, and hemorrhoids.  This nutraceutical formula supports the microcirculation throughout the body and fundamentally helps maintain the structure and function of the circulatory system, especially vein strength and competence.

Diosmin has also been shown to help repair endothelial glycocalyx damage. Diosmin supports glycocalyx integrity by increasing endothelial nitric oxide synthase (eNOS) activation, reducing inflammation and leukocyte adhesion, decreasing vessel wall thickness, and increasing vessel diameter. Experimental studies show that diosmin treatment reduced glycocalyx shedding thus supporting glycocalyx preservation and endothelial function restoration.

TruMicroVascular™ contains diosmin the same well-researched, citrus-based flavonoid in a unique micronized form for enhanced absorption and bioavailability. TruMicroVascular™ contains the same ratio of diosmin to hesperidin as used in clinical trials and uses a unique micronization process to produce MPFF to improve absorption and help promote venous tone, normal lymph drainage, healthy capillary permeability, favorable microcirculation, and helps maintain venous sufficiency and these favorable results may even be achieved within two hours of administration according to some studies suggesting improvement in health-related quality-of-life parameters with the use of MPFF. (Pitsch F. Recent guidelines in chronic venous disease: the place of Daflon 500 mg Phlebolymphology. 2011;18:24-29).

Research on MPFF also suggests that its positive effects may be extended to various parts of the body. Ongoing animal studies suggest that diosmin significantly supports blood glucose and insulin levels already within the normal range and exerts favorable effects on maintaining healthy serum hemoglobin. And in human studies, results from a double-blind placebo-controlled study support the use of MPFF for maintaining healthy glucose metabolism in humans as well.

Venous Insufficiency: Diosmin is well supported by research as a beneficial treatment for venous insufficiency. Diosmin improves venous tone and elasticity which supports blood flow and reduces pooling in the veins. It also reduces inflammation, decreases edema swelling and venous leakage by maintaining a tight junction by maintaining tight and junction integrity in blood vessels helps protect endothelial cells maintains tight junction integrity and blood vessels and reduces interstitial fluid heaviness pain cramps and overall quality of life. Diosmin often combined with hesperidin has been widely used for chronic venous disorders and proven effective in clinical trials.

Varicose Veins: There are no standard anti-inflammatory drugs, including NSAIDs and corticosteroids, that have convincingly demonstrated the ability to slow or halt long term progression of varicose veins, though they may help temporarily ease symptoms such as pain and swelling.  Diosmin is well supported by research as a beneficial treatment for varicose veins for similar reasons I explained in venous insufficiency for the entire class of phlebotonics or micronized purified flavonoid fractions (MPFF),  diosmin and hesperidin.

Hemorrhoids: Diosmin helps with hemorrhoids through multiple mechanisms primarily focused on improving venous function, reducing inflammation, and enhancing lymphatic drainage. Diosmin effectively reduces hemorrhoidal symptoms such as pain, bleeding, edema and heaviness. It also helps decrease the frequency and severity of acute hemorrhoidal attacks and has been used both as a stand-alone treatment and as an adjunct adjuvant therapy before or after surgical interventions. This flavonoid is widely used in the conservative management of hemorrhoid disease.

Dr. Vliet’s BONUS Tip: Combine diosmin with glucosamine for a dynamic combination in support vascular health!

Glucosamine is a building block for glycosaminoglycans (GAGs) that compose the glycocalyx matrix.  Spplementation with glucosamine has been shown to improve glycocalyx thickness and function.  By combining diosmin’s anti-inflammatory and endothelial-protective effects with glucosamine’s substrate support for glycocalyx regeneration, you get a very powerful therapeutic synergy to treat vascular disease.

You can use a single ingredient glucosamine supplement or combine our TruMicroVascular™ with TruSynovial Support™ for premium glucosamine supplementation with the added benefit of joint support.

TruMicroVascular™ Clinical Applications:

• Supports Veins, Capillaries, and Circulation
• Helps Promote Normal Lymphatic Drainage
• Supports Antioxidant Activity
• Supports Blood Glucose Metabolism
• Supports Healthy Eicosanoid Metabolism

From what we now know about the hypercoagulation/micro blood clots and inflammation impairing the microcirculation contributing to venous conditions and causing widespread damage to larger blood vessels from the SARS-CoV-2 illness and Covid 19 mRNA injections, our nutraceutical supplement TruMicroVascular™ may be a valuable integral part of your treatment options for Long COVID and COVID Vaccine Injury. I invite you to check out our full line of vascular supplements at our Truth For Health store’s Vascular Support Formula.

CAUTION: As always, we urge you to avoid supplements without checking knowledgeable sources to evaluate your medical situation, proper lab tests to verify what is needed, and to make sure to avoid adverse interactions with prescription medicines and other supplements you take.

All Truth for Health Foundation Products Meet or Exceed cGMP Quality Standards, the highest quality standard for supplements sold in the USA.

For more information, references from studies are listed in the Product Data Sheets for each product, available on our website.  Under medical practice regulations, we are unable to answer individual medical questions or make specific individual supplement recommendations for people who are not established patients of Dr. Vliet’s independent medical practice.

I encourage you to consider our other natural medicines with our top quality, cGMP-compliant professional formulas for TruImmune™Boost, TruNAC™, TruImmunoglobulin,™ TruC with BioFlav™ (Vitamin C with complete Bioflavonoids), Tru BioD3™, TruZinc™, TruMitochondrial ™Boost and TruProBiotic™ Daily to replenish critical bifidobacteria depleted by COVID shots, viral illnesses, and antibiotic therapy.

To Your good health and improving resilience!
Elizabeth Lee Vliet, MD