Intermittent claudication is pain in the legs caused by atherosclerosis (hardening of the arteries) of the lower extremities. Because atherosclerosis decreases the supply of blood and oxygen to the legs, people with intermittent claudication experience leg pain after walking a certain distance. The natural treatments for intermittent claudication include many of those used for atherosclerosis; these include controlling high cholesterol, managing high blood pressure, modifying dietary and lifestyle factors that might influence atherosclerosis, reducing blood sugar, and taking various nutritional supplements and herbs. Please discuss with your doctor before taking supplements since some of them may need to be monitored closely if taken at the same time as pharmaceutical medicines. In adults with diabetes, elevated hemoglobin A1c (HbA1c) levels -- an indicator of poor glucose control -- are associated with an increased risk of reduced blood flow to the legs.
Natural treatment for claudication
Gradually more studies are being published on natural ways to treat this condition without the use of prescription medications. If you want additional suggestions, see the heart disease article. Here are examples of a few dietary supplements that could be of benefit.
Omega-3 fatty acids appear to have some beneficial biochemical and
hemodynamic effects in people with intermittent claudication.
Flavonoids are helpful since they thin the blood and help improve circulation. Flavonoids are found in fruits and vegetables and are also available as supplements.
Ginkgo biloba has been studied in intermittent claudication. Daily dosage should not exceed 40 mg.
Demonstration of the efficacy of ginkgo biloba special extract EGb 761 on intermittent claudication--a placebo-controlled, double-blind multicenter trial.
A multicentric, randomized, placebo-controlled double-blind study on ginkgo biloba special extract EGb 761 (Tebonin forte) in patients suffering from peripheral occlusive arterial disease. It can be concluded from the results of this study that treatment with EGb 761 in claudication patients is very safe and causes a significant and therapeutically relevant prolongation of the patients' walking distance.
Policosanol has been evaluated.
Effects of policosanol and ticlopidine in patients with intermittent claudication: a double-blinded pilot comparative study.
Policosanol is a cholesterol-lowering substance with concomitant antiplatelet effects. The present study was undertaken to compare the effects of policosanol and ticlopidine in patients with moderately severe intermittent claudication. Twenty-eight eligible patients were randomized to policosanol 10 mg or ticlopidine 250 mg tablets twice daily (bid). Walking distances in a treadmill were assessed before and after 20 weeks of treatment. Both groups were similar at baseline. Compared with baseline, policosanol significantly increased mean values of initial (ICD) and absolute (ACD) claudication distances from 162 to 273 m and from 255 to 401 m, respectively. Ticlopidine also raised significantly ICD and ACD. Comparisons between groups did not show significant differences. After 10 weeks, policosanol significantly lowered low-density lipoprotein-cholesterol (LDL-C), total cholesterol (TC) and TC/HDL-C and raised high-density lipoprotein-cholesterol (HDL-C). Policosanol induced modest, but significant, reductions of fibrinogen levels compared with baseline and ticlopidine. It is concluded that policosanol (10 mg bid) can be as effective as ticlopidine (250 mg bid) for improving walking distances of claudicant patients.
Role of selenium mineral
The amount of selenium in a person's blood could impact their risk of developing peripheral artery disease. PAD occurs when arteries in the legs become narrowed or clogged with fatty deposits, reducing blood flow to the legs, leading to leg cramps and walking difficulty. PAD affects about 8 million Americans and is associated with significant disease and death. Dr. Eliseo Guallar, of The Johns Hopkins School of Public Health in Baltimore found that the likelihood of having PAD fell as people's blood levels of selenium increased, but that PAD risk then climbed slightly for people with the highest selenium levels. American Journal of Epidemiology, April 15, 2009
Intermittent claudication drugs
The US FDA has approved two drugs for the management of intermittent claudication: pentoxifylline and cilostazol. The mechanism of action that provides symptom relief with pentoxifylline is poorly understood but is thought to involve red blood cell deformability as well as a reduction in fibrinogen concentration, platelet adhesiveness and whole blood viscosity. Cilostazol is a potent, reversible, phosphodiesterase III inhibitor. The inhibition of phosphodiesterase allows for the increased availability of cyclic adenosine monophosphate (cAMP). cAMP mediates many agonist-induced platelet inhibitory, vasodilatory and vascular antiproliferative responses.
Two drugs are not always better than one when it comes to using blood thinners used to treat claudication in the legs. Adding a blood thinner, such as warfarin, to daily clot-preventing drugs, such as aspirin, is no better -- and sometimes more dangerous -- for preventing heart attacks, strokes and other circulatory problems in people with peripheral artery disease.
Some people spell it incorrectly as Intermittant claudication
Peripheral artery disease natural treatment
A meta-analysis of published clinical trials on Padma Basic, a Tibetan herbal formula, has concluded that the preparation is effective in providing relief for a common vascular condition - peripheral arterial disease (PAD). It was conducted on 2084 patients with PAD and is published in Atherosclerosis, the International Journal for Research and Investigation and Related Diseases, the official journal of the European Atherosclerosis Society. The scientist reviewers at the Department of Internal Medicine, Complementary Medicine, at the University Hospital in Zurich, concluded: “A total of 19 trials have reported on 2084 patients to date, 444 of which were in six controlled clinical studies on PAD. The safety profile appears to be favorable. Available evidence shows that Padma Basic (European trade name Padma 28) provides significant relief from [PAD-related] symptoms (i.e. walking distance) of a similar order of magnitude as other employed medications.” Medical experts agree that blocked blood vessels in the heart and the brain can cause heart disease and stroke; similar blockages from atherosclerotic plaque can also occur in the legs, causing pain (intermittent claudication), numbness and cramping in the thighs, calves, and buttocks. According to research published by The Sage Group, there is an overwhelming lack of awareness of PAD which afflicts 18 million Americans, compared to coronary artery disease and diabetes afflicting 13 and 18 million Americans. PAD is most frequently manifested in its early stages by pain in the legs when walking which disappears at rest. As the disease progresses in severity, claudication pain is experienced at rest, and in the later stages of PAD (critical limb ischemia) blood flow is so inadequate that ulcerations and gangrene occur. Peripheral arterial disease, caused by systemic atherosclerosis, is vastly underappreciated despite its alarming mortality rates. Mortality at 5 and 10-year periods after diagnosis of 30% and 50% respectively due to PAD is greater than that caused by coronary artery disease and stroke and is exceeded only by colorectal cancer. A safe and effective treatment would dramatically improve the lives of the millions of PAD patients. Current FDA approved drugs have shown some limited benefit to treating PAD, but often the side effects of these drugs make such treatment undesirable. In contrast, this recent meta-analysis of clinical trials with Padma Basic indicates that this Tibetan herbal formula supports healthy circulation without side effects and with the similar results to standard medications. Padma Basic is an herbal supplement consisting of 19 dried and milled herbs and spices, together with natural camphor and calcium sulfate. Padma Basic is derived from a centuries old natural traditional Tibetan herbal formula.
Circ J. Feb 1 2014. Lifestyle and Dietary Risk Factors for Peripheral Artery Disease. Peripheral artery disease (PAD) usually refers to ischemia of the lower limb vessels. Currently, the estimated number of cases in the world is 202 million. PAD is the third leading cause of atherosclerotic cardiovascular morbidity. The measurement of the ankle-brachial index (ABI) is recommended as a first-line noninvasive test for screening and diagnosis of PAD. An ABI <0.90 is an independent predictor of cardiovascular events and this measurement is useful to identify patients at moderate to high risk of cardiovascular disease. However, there is insufficient evidence to assess the benefits and harms of screening for PAD with the ABI in asymptomatic adults. Lifestyle modifications, including smoking cessation, dietary changes and physical activity, are currently the most cost-effective interventions. Inverse associations with PAD have been reported for some subtypes of dietary fats, fiber, antioxidants (vitamins E and C), folate, vitamins B6, B12 and D, flavonoids, and fruits and vegetables. A possible inverse association between better adherence to the Mediterranean diet and the risk of symptomatic PAD has also been reported in a large randomized clinical trial. Therefore, a Mediterranean-style diet could be effective in the primary and secondary prevention of PAD, although further experimental studies are needed to better clarify this association.