What can be done about poor lymphatic function?
1. Decongestive therapy is THE standard of care for lipedema, which includes manual lymphatic drainage (MLD), wrapping, compression, movement, dietary recommendations, and skin care. Decongestive therapy improves skin elasticity, restores the venoarteriolar reflex, increases lymphatic drainage and transport within vessels, and reduces capillary fragility.
2. Intermittent pneumatic compression may not improve limb size over MLD alone but may be effective alone when MLD is not available.
3. Compression is most effective when tissue edema is present; in its absence, it has little effect.
4. Exercise, especially aqua lymphatic therapy (pool hydrotherapy), significantly reduces limb volume in lymphedema.
5. Whole-body vibration improves strength and bone mineral density, increases peripheral circulation and lymph flow, and raises the threshold for edema formation.
6. Selenium has proven effective for reduction of secondary lymphedema. Recommended by Dr. Karen Herbst. The maximum safe dietary intake for selenium is 600 micrograms daily.
7. Diosmin and hesperidin (flavonoids) can increase the strength of veins and capillaries. In addition, hesperidin can reduce histamine release from mast cells by strengthening the cell membrane. Diosmin dosage is 500-900 mg once or twice daily. Hesperidin is recommended by Dr. Karen Herbst in a dosage of 100 mg daily.
8. Rutin (or rutoside) (a flavanoid) can strengthen blood vessels and is used for varicose veins, internal bleeding, hemorrhoids, and to prevent strokes due to broken veins or arteries (hemorrhagic strokes). Recommended by Dr. Karen Herbst in a dosage of 500 mg twice daily.
9. Quercetin (a flavanoid) has antioxidant and anti-inflammatory effects. Dosage is 500-1000 mg once or twice daily. Recommended by Dr. Karen Herbst in a dosage of 500 mg twice daily.
10. Guaifenesin works to reduce adhesiveness and surface tension of proteins and makes them easier to be transported within and excreted from the lymph system (see also acetylcysteine). Recommended by Dr. Karen Herbst in a dosage of 600 mg to 2400 mg twice daily.
11. Acetylcysteine (or N-acetylcysteine) also reduces adhesiveness and surface tension of proteins. Recommended by Dr. Karen Herbst in a dosage of 500-600 mg once or twice daily.
12. Butcher’s broom is thought to cause vasoconstriction; it might improve circulation by preventing blood from “pooling” in veins. Recommended by Dr. Karen Herbst in a dosage of 0.5-1.5 ml three times daily.
13. Amphetamines (dextroamphetamine and phentermine) are potent central nervous system stimulants. Recommended by Dr. Herbst in a dosage of 5-60 mg daily.
14. L-arginine is converted in the body into a chemical called nitric oxide, which causes blood vessels to open wider for improved blood flow. It also stimulates release of insulin and other hormones. Recommended by Dr. Karen Herbst in a dosage of 3 grams with water three times daily.
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