Poor leg circulation, intermittent claudication, gangrene
Description: blockages or narrowing can develop in the arteries supplying blood to the legs and feet. This causes aching in the calves or buttocks when walking, a painful burning in the lower legs and feet sensation, especially in bed at night, and in some severe cases - gangrene. It is more common in diabetic patients.
What the doctor can do
- Physical examination includes checking the pulses in the legs, and also the heart to exclude a cardiac cause for the blockages. Blood tests and more specialised blood flow tests, ECG, and sometimes ultrasound and angiograms of the leg arteries to view the extent of the narrowing.
- Surgery: sometimes it is possible to bypass the blockage with a graft made from a vein or other tissue.
- Angioplasty - opening the arteries with balloons from the inside and then keeping them open with stents, is becoming increasingly successful, especially with some of the newer stent which are impregnated with drugs to keep the arteries open.
- Drugs: aspirin and cholesterol-lowering drugs (statins) are often used, but there are no drugs which help open the arteries. There is some evidence that an anticlotting drug Clopidigrel may improve walking distance and reduce blockages.
- Amputation may be necessary if symptoms are too severe or if gangrene develops.
What you can do
- If you have diabetes, make sure your blood sugar is well controlled.
- Make sure you are not taking any drugs which can reduce the leg circulation - these include beta blockers ( eg metoprolol), or ergotamine. Discuss with your doctor if any of the drugs you are on could affect the leg blood supply
- Cigarette smoking is guaranteed to make the circulation worse - stop smoking totally. Nicotine also reduces blood flow, so get off the patches as soon as you can too.
- Caffeine has been shown to improve circulation and can increase walking distance. There are no studies which have shown that alcohol has any effect, either good or bad, but never drink to excess.
- Look after your feet, and treat infections and cuts very carefully.
- Regular walking is helpful but stop when the pain occurs and then restart when it has gone. This encourages the development of natural bypasses, called collaterals.
- If your feet hurt or you have a burning sensation in bed at night, even though they may feel cold, take the blankets off your feet to keep them cool. It is heat in bed which causes the pain.
- These are very important because with reduced blood supply, nutrition to the feet is reduced.
- A good multivitamin/multimineral makes sure that the legs and feet have all the nutrients and minerals they require.
- Omega 3 fish oils, 1-2 grams daily, help the blood flow through the arteries and improve tissue healing.
- Calcium and magnesium, 800–1,000mg/day, can relax the muscles in the artery wall and may improve circulation.
- Ginkgo Biloba, an ancient Chinese herb is the only therapy which has been shown in reputable trials to improve circulation to the legs.
- Grape seed extract (proanthocyanidins) is a powerful antioxidant and can be protective of the tissues which have a poor circulation.
- Coenzyme Q10 - improves the energy supply to the cells and may be helpful in claudication 100mg daily. It is worth a trial for a few weeks.
- EECP - enhanced external counterpulsation. See notes on this procedure below. By regularly squeezing and releasing the legs, bypass arteries (collaterals)
can form and it may well help with the circulation. There is surprisingly little research on the topic, but it is certainl;y worth a trial. .
- Chelation therapy - Intravenous EDTA by removing the heavy metals may allow the arteries to reopen. Some people have had great success with a course of chelation, and if your doctor is looking at amputating a leg, I would encourage you to use all of the above and consider chelation.
The Nutritional supplements I use and recommend to my patients
For my Claudication patients I recommend -
USANA - Cellsentials *, Biomega, Active Calcium plus, Ginkgo, Proflavanol C, Coquinone -
Other therapiesThere are a number of other therapies which you might like to look at. They have not been specifically included with this disease because some are a form of treatment which is applicable to most diseases and many focus on the mind, body, spirit, and the universe. These include - acupuncture, Ayurvedic medicine, energy healing, homeopathy, naturopathy, prayer, visualisation and some people with this condition might like to look at these topics (I have described them more fully on another page on this website click here .) With my personal experience and reading, I do not think that I can comment of whether one or a number of these might help. They fit well with most conventional and complementary treatments and I suspect some or even all of them can be extremely powerful - if performed by an experienced practitioner. My only caveat is that if in the course of one of these therapies, you are given potions or herbs, do check with your health practitioner that they will not interfere with other treatments or drugs you are receiving.
Nutritional supplementsI believe in today's world that nutritional supplements are so necessary as to be an essential component of any form of both prevention and treatment. Not only is today's food lacking in nutrients because of the way it was grown and processed, but also most of us make the wrong choices in diet. It is virtually impossible to obtain optimal levels of most of the vitamins, minerals and other nutrients although many people try to do so, and even then fresh produce is not available all year round. *There are many quality supplements available on the market, including –Thorne, NFS, Douglas Labs, Xtend Life, True Star Health, USANA, and Metagenics. There are others, but do your due diligence before choosing one. USANA Health Sciences has added a new adjunct to its multivitamin and multi mineral called CellSentials. These are a patented blend of phyto-nutrients which they believe affects cell signaling and growth, and increases the production of preventative antioxidants within the cell. These should add to the value of the multi, so these are the multivitamin/mineral preparation I recommend.