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Hawthorn (Crataegus spp.) contains colorful bioflavonoids that are used for all kinds of cardiovascular complaints, including improving the tone and elasticity of blood vessel walls. Similar colorful bioflavonoids are found in blueberries and grapes (fruit and seeds), St. John’s wort (Hypericum perforatum), and turmeric (Curcuma longa). Bromelain, a protein-digesting substance found in pineapple, is known to reduce excessive blood clotting, reduce inflammation and inhibit the formation of scar tissue in the vessel wall, which contributes to the loss of elasticity and leads to varicose veins.

If your pain is due to severe fluid accumulation in the feet, put your legs up as often as possible and avoid sitting with your legs crossed (or even sitting in chairs with your legs hanging down) as much as possible. Sitting on the floor with your legs outstretched, or on your bed or recliner when you can, would be better. Further, you should gently rotate your feet and ankles as much as possible to help the return of fluid in your legs. For help with the pain, prepare a strong tea of witch hazel (Hamamelis virginiana). Soak a cloth in it and wrap it around your feet. Doing this two or more times a day may help relieve the pain somewhat.

Willard responds: I agree that it is essential that you go back to your doctor and get absolutely clear about what you’re dealing with. None of the potential causes of your problem are fun, but clots can be deadly and need careful management by medical professionals. Once you get a diagnosis of poor circulation, several things can be done for the condition, especially when it’s associated with swollen legs. The herbs I use the most are ginger (Zingiber officinale), garlic (Allium sativum), reishi mushroom (Ganoderma lucidum) and essential fatty acids. For varicose veins (and swollen legs), the best herb to use is horse chestnut.

Swollen legs are usually caused by chronic venous insufficiency (CVI), a condition found in 10 to 15 percent of men and 20 to 25 percent of women. This means that the veins have just become too weak to do the hard work of pumping blood to and from the heart. In North America, the therapy usually is elastic support stockings, but in Europe the therapy recommended most often is horse chestnut seed extract.

Horse chestnut seed contains 3 to 13 percent of a complex of constituents known as aescin (escin). More than 100 papers have been written on this herb. One mega study reviewed 13 clinical studies for CVI and concluded that horse chestnut seed extract was superior in all placebo-controlled studies. It was found as or more effective than other medications and was equally as effective as compression therapy (elastic support stockings), reducing edema (swelling due to fluid accumulation) by approximately 25 percent. Take 100 to 200 mg daily.

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