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, modifying dietary and lifestyle factors that might influence atherosclerosis, 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.

Natural Options for Claudication
Fish oils - Omega-3 fatty acids appear to have some beneficial biochemical and hemodynamic effects in people with intermittent claudication.
Flavonoids are helpful in intermittent claudication 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 60 mg.
Policosanol has been evaluated, see the study below.

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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.

Diabetes and Claudication or Peripheral Artery Disease
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, a condition known as peripheral arterial disease (PAD).

Claudication Research Update
Effects of policosanol and ticlopidine in patients with intermittent claudication: a double-blinded pilot comparative study.
Angiology. 2004 Jul-Aug;55(4):361-71.
Policosanol is a cholesterol-lowering drug with concomitant antiplatelet effects. The present study was undertaken to compare the effects of policosanol and ticlopidine in patients with moderately severe intermittent claudication. The study had a 4-week baseline step, followed by a 20-week double-blinded, randomized treatment period. Twenty-eight eligible patients were randomized to policosanol 10 mg or ticlopidine 250 mg tablets twice daily (bid). Walking distances in a treadmill (constant speed 3.2 km/hr, slope 10 degrees, temperature 25 degrees C) were assessed before and after 20 weeks of treatment. Both groups were similar at baseline. Compared with baseline, policosanol significantly increased (p < 0.01) mean values of initial (ICD) and absolute (ACD) claudication distances from 162.1 to 273.2 m and from 255.8 to 401.0 m, respectively. Ticlopidine also raised significantly ICD (166.2 to 266.3 m) and ACD (252.9 to 386.4 m). Comparisons between groups did not show significant differences. Policosanol, but not ticlopidine, significantly but modestly, increased the ankle/arm pressure ratio. After 10 weeks, policosanol significantly (p < 0.001) lowered low-density lipoprotein-cholesterol (LDL-C), total cholesterol (TC) and TC/HDL-C and raised (p < 0.05) high-density lipoprotein-cholesterol (HDL-C). At study completion, policosanol lowered LDL-C (30.2%), TC (16.9%), and TC/HDL-C (33.9%), increased (p < 0.01) HDL-C (+31.7%), and left triglycerides unchanged. Ticlopidine did not affect the lipid profile variable. Policosanol induced modest, but significant, reductions (p < 0.01) of fibrinogen levels compared with baseline and ticlopidine. Treatments were well tolerated and did not impair safety indicators. Three ticlopidine patients (21.4%) withdrew from the trial, only 1 owing to a serious adverse experience (AE) (unstable angina). Three other ticlopidine patients experienced mild AE (headache, diarrhea, and acidity). It is concluded that policosanol (10 mg bid) can be as effective as ticlopidine (250 mg bid) for improving walking distances of claudicant patients, and it could be advantageous for the global risk of these individuals owing to its cholesterol-lowering effects. This study is, however, just a pilot comparison, so that further studies in larger sample sizes are needed for definitive conclusions of the comparative effects of both drugs on patients with intermittent claudication.

Demonstration of the efficacy of ginkgo biloba special extract EGb 761 on intermittent claudication--a placebo-controlled, double-blind multicenter trial.
Vasa. 1998 May;27(2):106-10.
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. CONCLUSIONS: 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.


Some people spell intermittent claudication incorrectly as Intermittant claudication

tongkat ali is a sexual stimulant
saw palmetto is a supplement for prostate health
curcumin is an extract from turmeric
serrapeptase is a proteolytic enzyme

Peripheral Artery Disease
A meta-analysis of 19 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). The meta-analysis was conducted on 2084 patients with PAD and is published in the current issue of 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 14-18 million Americans, compared to coronary artery disease and diabetes afflicting 12.6 and 17 million Americans. Furthermore less than 20% of patients are actually diagnosed.

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, 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® (Melzer 2006) 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.