Natural treatments intermittent claudication
Intermittent claudication is a medical condition characterized by severe muscle pain in the legs due to blocked arteries, commonly associated with atherosclerosis. This condition can result in cramping pain during physical activities, particularly walking, due to insufficient blood flow to the muscles. While conventional treatments often include medications and, in severe cases, surgery, various natural treatments are also proposed to alleviate symptoms and improve walking distance.
Some principal natural treatments that have shown promise include Ginkgo biloba, which may enhance circulation, L-carnitine, which aids muscle energy utilization, inositol hexaniacinate, and mesoglycan, all of which have demonstrated potential benefits in clinical trials. Other supplements such as arginine and B vitamins are suggested, although the evidence is mixed, and some may exacerbate symptoms. Additionally, diet and lifestyle changes, including exercise, play a crucial role in managing the condition. While several natural options are available, it is essential to approach their use with medical supervision to avoid potential interactions with prescribed medications. Overall, those seeking alternatives for managing intermittent claudication may find a range of natural treatments worth exploring, though they should remain well-informed and cautious.
Natural treatments intermittent claudication
- DEFINITION: Treatment of severe muscle pain caused by blocked arteries in the legs.
- PRINCIPAL PROPOSED NATURAL TREATMENTS: Ginkgo biloba, inositol hexaniacinate, L-carnitine, mesoglycan
- OTHER PROPOSED NATURAL TREATMENTS: Arginine, beta-carotene or vitamin E, or a combination of the two, policosanol, B vitamins, diet and lifestyle changes, fish oil
Introduction
In advanced stages of atherosclerosis, the arteries supplying the legs with blood may become seriously blocked—commonly, if somewhat incorrectly, known as hardening of the arteries. This can lead to severe cramping pain when walking more than a short distance because the muscles are starved for oxygen. This condition is called intermittent claudication. The intensity of intermittent claudication is often measured in the distance a person can walk without pain.
Conventional treatment for intermittent claudication consists of measures to combat atherosclerosis and the use of the drug Trental (pentoxifylline) and other medications, such as Cilostazol and various blood pressure and diabetes medications. In advanced cases, surgery to improve blood flow may be necessary.
Principal Proposed Natural Treatments
Several natural treatments may be helpful for intermittent claudication. Still, it needs to be clarified whether combining them with the medications that may be prescribed simultaneously is safe. Medical supervision is necessary for this serious disease.
Ginkgo. Many studies support the effectiveness of ginkgo for intermittent claudication. According to several double-blind, placebo-controlled trials, ginkgo can increase pain-free walking distance, presumably by improving circulation.
One study enrolled 111 persons and followed them for twenty-four weeks. Participants were measured for pain-free walking distance by walking up a 12 percent slope on a treadmill at two miles per hour. At the beginning of treatment, the placebo and ginkgo (120 milligrams [mg]) groups could walk about 350 feet without pain. At the end of the trial, although both groups had improved, the ginkgo group had improved significantly more, showing a 40 percent increase in pain-free walking distance compared to only a 20 percent improvement in the placebo group. Similar improvements were seen in a double-blind, placebo-controlled trial of sixty persons with maximum benefit from physical therapy.
Taking a higher dose of ginkgo may provide enhanced benefits in intermittent claudication. A twenty-four-week, double-blind, placebo-controlled study of seventy-four persons found that ginkgo at 240 mg per day was more effective than 120 mg per day. A 2009 review of eleven trials with 477 persons suggested that those who took ginkgo could walk farther than control subjects, but differences among the trials limit these results. However, not all studies have been positive. In another randomized trial involving sixty-two persons (averaging seventy years of age), 300 mg of ginkgo per day was no better than a placebo at improving pain-free walking distance in four months of treatment.
L-carnitine. The vitamin-like substance L-carnitine also appears to be of some benefit in intermittent claudication. Although it does not increase blood flow, carnitine appears to increase walking distance by improving muscle energy utilization. A twelve-month, double-blind, placebo-controlled trial of 485 persons with intermittent claudication evaluated the potential benefits of a special form of carnitine called propionyl-L-carnitine. Participants with relatively severe disease showed a 44 percent improvement in walking distance compared with placebo. However, no improvement was seen in those with mild disease. Benefits were seen in most other studies using L-carnitine or propionyl-L-carnitine.
Inositol hexaniacinate. The supplement inositol hexaniacinate, a special form of vitamin B3, appears to be helpful for intermittent claudication. Double-blind studies involving about four hundred persons found that the supplement can improve walking distance for people with intermittent claudication. For example, one hundred persons were given either a placebo or 4 grams of inositol hexaniacinate daily in one study. In three months, participants improved significantly in the number of steps they could take on a special device before experiencing excessive pain.
Mesoglycan. Mesoglycan is a substance found in many tissues in the body, including the joints, intestines, and the lining of blood vessels. A twenty-week, double-blind, placebo-controlled trial that enrolled 242 people evaluated the effects of mesoglycan in intermittent claudication. Significantly more participants in the mesoglycan group responded to treatment (defined as a greater than 50 percent improvement in walking distance) than in the placebo group.
Other Proposed Natural Treatments
The supplement arginine has been tried for treatment of intermittent claudication. Two poorly designed studies had suggested benefit. Still, other better-designed studies found supplementation with arginine improved walking distance and lessened symptoms related to intermittent claudication, such as leg pain. However, another very well-designed trial not only failed to find arginine effective, but the results suggested that arginine can increase symptoms of intermittent claudication.
Various antioxidants have been suggested for the treatment of intermittent claudication. However, a double-blind, placebo-controlled trial of 1,484 persons with intermittent claudication found no benefit from vitamin E (50 mg daily), beta-carotene (20 mg daily), or a combination of the two.
According to a few studies performed in Cuba, the sugarcane-derived substance policosanol is helpful for intermittent claudication. Numerous other Cuban studies reported that sugarcane policosanol lowers cholesterol. However, all these studies were performed by a single set of researchers financially connected to the product. Several independent studies that attempted to replicate the cholesterol-related results failed to find benefit. For this reason, all claims associated with policosanol are in doubt. One small study found weak preliminary evidence that lipoic acid might improve symptoms in intermittent claudication.
Other proposed treatments include evening primrose oil, caffeine, and inositol nicotinate, though insufficient evidence exists to support each of these remedies. Other proposed treatments include evening primrose oil, caffeine, and inositol nicotinate, though insufficient evidence exists to support each of these remedies. Additional proposed natural treatments include supplementation with B vitamins, which are believed to help improve circulation. B vitamins work by breaking down homocysteine, an amino acid that, when elevated, is associated with cardiovascular disease. While observational trials have shown benefits, additional clinical study is needed. Fish oil has also been recommended as a natural treatment for intermittent claudication due to its anti-inflammatory properties. Finally, diet, and especially exercise, are crucial to improving circulation and reducing the symptoms of intermittent claudication.
Herbs and Supplements to Use with Caution
Various herbs and supplements may interact adversely with drugs used to treat intermittent claudication.
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