If the arteries in your legs are clogged by cholesterol deposits, chances are good that your legs will eventually seize up when you walk. When your leg muscles don’t get enough oxygen-rich blood for the amount of activity they’re being asked to do, the result is pain and muscle spasms. That condition is called intermittent claudication. The pain of intermittent claudication is severe when you walk. In addition, poor circulation in your legs can cause related problems, such as skin breakdown and poor wound healing.
Treatment for intermittent claudication addresses the cause: poor circulation. Your doctor will advise you to stop smoking (if you do) and lose weight (if you need to). For people who have high cholesterol, high blood pressure, or diabetes, it’s necessary to get those conditions under control as well in order to improve leg circulation.
You’ll probably need a controlled walking program or some other form of exercise that gradually trains your leg muscles to make the most of their limited oxygen supply. "I also find that older people really benefit from yoga or tai chi for this problem," says Decker Weiss, N.M.D., a naturopathic doctor at the Arizona Heart Institute in Phoenix.
In addition, Dr. Weiss and other alternative medicine doctors use herbs and nutritional supplements. If you’ve been diagnosed with intermittent claudication, talk with your doctor about trying these remedies.
Arginine and Magnesium Can Open Up Arteries
The amino acid arginine is involved in the production of nitric oxide, a chemical released by the cells lining the artery walls. Nitric oxide allows blood vessels to relax and open up, Dr. Weiss says.
A standard dose is 500 milligrams up to three times a day. If you’ve been infected by the herpesvirus, though, you should use arginine only with medical supervision, Dr. Weiss says. "In people harboring the virus, high doses of arginine can cause severe outbreaks."
Along with arginine, Dr. Weiss recommends magnesium, an essential mineral. Magnesium is known for its ability to relax the muscles that wrap around blood vessels, so it can help dilate arteries that have been clogged by cholesterol deposits.
You might have a deficiency of magnesium if you are taking drugs meant to help heart problems, such as diuretics. Some people have deficiencies if they’re taking commonly prescribed digitalis heart medications such as digitoxin (Crystodigin) or digoxin (Lanoxin). Signs of magnesium deficiency include muscle weakness, nausea, and irritability.
Most people can safely take up to 350 milligrams of supplemental magnesium, Dr. Weiss says. He recommends it in the form of magnesium orotate or glycinate.
B Vitamins Give You a Leg to Stand On
Researchers now realize that an amino acid by-product, homocysteine, can harm the insides of blood vessels, setting the stage for the cholesterol deposits that cause intermittent claudication. In one study, researchers were able to reduce high homocysteine levels using 5 milligrams of folic acid, 400 micrograms of vitamin B12, and 50 milligrams of B6. "I recommend these B vitamins to all my patients with heart or circulatory problems as part of a high-potency multivitamin or, if they have absorption problems, as injections or under-the-tongue supplements," Dr. Weiss says. This therapy should be done only under a doctor’s supervision, he adds.
Ginkgo Gets You Going
Ginkgo has a reputation for improving circulation in the brain, but it also has body-wide effects that make it useful for all sorts of circulatory problems, including intermittent claudication, Dr. Weiss says. It helps to stimulate growth of new blood vessels and improves the use of oxygen and blood sugar (glucose), the main form of energy for muscle cells.
Ginkgo also helps to reduce the stickiness of clotting components, called platelets, in the blood. When the platelets become less sticky, harmful clots are less likely to form, especially in areas where blood flow is hindered.
Ginkgo has been tested in several studies of intermittent claudication, and it has worked at least as well as pentoxifylline (Trental), a drug that is commonly prescribed for this problem. Many people in the studies found that they could walk much farther without experiencing pain when they were taking ginkgo. The supplement also improved blood flow to the limbs, which was measured using a noninvasive technique called Doppler ultrasound.
Herbalists often recommend 120 milligrams of ginkgo in divided doses of 40 milligrams three times a day. In some studies, however, people have used 160 milligrams a day with good results.
Dr. Weiss’s recommendation is lower. He prefers to use a standardized liquid extract of ginkgo, prescribing 20 drops four times a day for at least six months.
Antioxidants Act on Arteries
People with intermittent claudication usually do better in general if they are taking antioxidant nutrients such as vitamins E and C, which may help prevent the early stages of atherosclerosis (hardening of the arteries), Dr. Weiss says.
Vitamin E has a long history of use for intermittent claudication. In one study, conducted in Sweden, researchers found that they could reduce symptoms if they gave people supplementation with 300 international units (IU) a day.
For smokers, however, supplementation with vitamin E doesn’t seem to reduce the symptoms of intermittent claudication. It’s quite possible that the vitamin can’t entirely overcome the harmful effects that smoking has on your circulatory system, Dr. Weiss says. Breaking the habit comes first: Often, when people stop smoking, intermittent claudication disappears with time.
Dr. Weiss gives many of his patients with atherosclerosis 400 to 800 IU of vitamin E and 1,000 to 3,000 grams of vitamin C a day. Vitamin E helps prevent the oxidation of harmful LDL cholesterol, a first step in cholesterol blockage. Vitamin C regenerates vitamin E and also helps the cells lining the blood vessel walls to produce nitric oxide, which keeps blood vessels open and dilated.
For vitamin E, you should use natural d-alpha-tocopherol and mixed tocopherols, says Dr. Weiss.
Take Ginger and Pineapple
"Ginger can be a wonderful addition to a treatment program for intermittent claudication, especially if you also have arthralgia, or pain in your joints," Dr. Weiss says. Like ginkgo, ginger helps keep platelets from getting too sticky, so it keeps your blood flowing smoothly. "It’s also a slight vasodilator and a warming herb," Dr. Weiss says, so if you have cold feet, it might provide additional benefits.
Most research studies with ginger use about 1,000 milligrams a day of powdered gingerroot, which is about what you’d get from a ¼-inch slice of fresh root. Ginger is safe to take long-term, Dr. Weiss says.
Another common food—pineapple—also offers some relief in supplement form. The same ingredient in pineapple that prevents gelatin from setting can help the arteries in your legs stay open, Dr. Weiss says. It’s an enzyme called bromelain, which helps keep blood from clotting too readily and may also help existing clots dissolve.
"I might use this if someone with circulatory problems also has had clotting problems in their legs, such as thrombophlebitis," Dr. Weiss says. "Since bromelain also helps to reduce inflammation, I find it’s good to use after surgery or injuries," he adds.
Take bromelain between meals; otherwise, it will be used up digesting your meal. A common daily dose used in studies ranges from 60 to 160 milligrams. Dr. Weiss usually recommends much more to his patients—500 milligrams twice a day, as long as needed. With your doctor’s supervision, take note of how your body reacts.
