Several double-blind trials have found that 400 mg per day of coumarin, a flavonoid found in a variety of herbs, can improve many types of edema, including lymphedema after surgery. However, a large double-blind trial detected no benefit using 200 mg coumarin twice daily for six months in women who had arm edema after mastectomy (surgical breast removal). (Coumarin should not be confused with the anticlotting drug Coumadin®.)
A group of semi-synthetic flavonoids, known as hydroxyethylrutosides are also beneficial for some types of edema. One double-blind trial found that 2 grams per day of hydroxyethylrutosides reduced ankle and foot edema in people with venous disorders after four weeks. Another double-blind trial found that 3 grams per day of hydroxyethylrutosides significantly reduced lymphedema of the arm or leg and lessened the associated uncomfortable symptoms.
A combination of the flavonoids diosmin (900 mg per day) and hesperidin (100 mg per day) has been investigated for the treatment of a variety of venous circulation disorders. However, in a double-blind trial, this combination was not effective for lymphedema caused by breast cancer treatments.
In a preliminary study, individuals with lymphedema of the arm or head-and-neck region were treated with approximately 230 mcg of selenium per day, in the form of sodium selenite, for four to six weeks. A quality-of-life assessment showed an improvement of 59%, and the circumference of the edematous arm was reduced in 10 of 12 cases.
Because coumarin, hydroxyethylrutosides, and diosmin are not widely available in the United States, other flavonoids, such as quercetin, rutin, or anthocyanosides (from bilberry), have been substituted by doctors in an attempt to obtain similar benefits. The effect of these other flavonoids against edema has not been well studied. Also, optimal amounts are not known. However, in one study, quercetin in amounts of 30–50 mg per day corrected abnormal capillary permeability (leakiness), an effect that might improve edema. A similar effect has been reported with rutin at 20 mg three times per day. Doctors often recommend 80–160 mg of a standardized extract of bilberry, three times per day.
Whereas vitamin B6 is sometimes recommended for reducing edema, no research has investigated its effectiveness. |
