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 (centella asiatica)
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)1 250 –500mg per day
Bromelain2 500 – 2000mg per day (away from food)
Gotu kola1, 3 500 – 2000mg per day
OPCs (pycnogenol, grape seed extract)4 30 – 200mg per day
Psyllium husk fibre 1000 – 3000mg per day
Trans fats/fried foods
Garlic, onions, cayenne, ginger
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)