Sun
19
Apr
Intermittent Claudication
The arteries supplying the legs with blood may become seriously blocked in advanced stages of atherosclerosis (hardening of the arteries). This can lead to severe, crampy pain when you walk more than a short distance,because the muscles are starved for oxygen, a condition called intermittent claudication. The intensity of intermittent claudication is often measured in the distance a person can walk without pain.
Conventional treatment for intermittent claudication consists of measures to combat atherosclerosis, the drug Trental (pentoxifylline), and other medications. In advanced cases, surgery to improve blood flow may be necessary.
Conventional treatment for intermittent claudication consists of measures to combat atherosclerosis, the drug Trental (pentoxifylline), and other medications. In advanced cases, surgery to improve blood flow may be necessary.
Treatment
Principal Proposed Treatments for Intermittent Claudication:
A number of natural treatments may be helpful, but it isnt clear whether it is safe to combine them with the medications that may be prescribed at the same time. Medical supervision is definitely necessary for this serious disease.
Ginkgo
According to eight double-blind placebo-controlled trials, ginkgo can significantly increase pain-free walking distance, presumably by increasing circulation.
One study enrolled 111 patients and followed them for 24 weeks.Participants were measured for pain-free walking distance by walking up a 12% slope on a treadmill at 2 miles an hour. At the beginning of treatment, both the placebo and ginkgo (120 mg) groups were able to walk about 350 feet without pain.
At the end of the trial, although both groups had improved (the power of placebo is amazing!), the ginkgo group had improved significantly more, showing about a 40% increase in pain-free walking distance as compared to only a 20% improvement in the placebo group.
Similar improvements were also seen in a double-blind placebo-controlled trial of 60 individuals who had achieved maximum benefit from physical therapy.
Taking a higher dose of ginkgo may provide enhanced benefits in intermittent claudication. A 24-week double-blind placebo-controlled study of 74 individuals found that ginkgo at a dose of 240 mg per day was more effective than 120 mg per day.
For more information, including dosage and safety issues, see the full ginkgo article.
L-Carnitine
The vitamin-like substance L-carnitine also appears to be of some benefit in intermittent claudication. Although it does not increase blood flow, carnitine appears to increase walking distance by improving energy utilization in the muscles.
A 12-month double-blind placebo-controlled trial of 485 individuals with intermittent claudication evaluated the potential benefits of a special form of carnitine called propionyl-L-carnitine.Participants with relatively severe disease showed a 44% improvement in walking distance as compared to placebo. However, no improvement was seen in those with mild disease. Benefits were seen in most, but not all, other studies using L-carnitine or propionyl-L-carnitine.
For more information, including dosage and safety issues, see the full carnitine article.
Inositol Hexaniacinate
The supplement inositol hexaniacinate, a special form of vitamin B3, appears to be helpful for intermittent claudication. Double-blind studies involving a total of about 400 individuals have found that it can improve walking distance for people with intermittent claudication. For example, in one study, 100 individuals were given either placebo or 4 g of inositol hexaniacinate daily. Over a period of 3 months, participants improved significantly in the number of steps they could take on a special device before experiencing excessive pain.
For more information, including dosage and safety issues, see the full vitamin B3 article.
Policosanol
A waxy substance extracted from sugarcane, policosanol is best known as a treatment for high cholesterol. However, it seems to be helpful for intermittent claudication as well.
A 2-year double-blind placebo-controlled study of 56 individuals found that treatment with policosanol (10 mg twice daily) improved walking distance by more than 50% at 6 months, and the benefits increased over the course of the study.
Similar results were seen in a 6-month double-blind placebo-controlled study of 62 individuals.
Some policosanol products on the market use beeswax as the source instead of sugarcane. However, there is some controversy over whether these products are actually effective.
Policosanols benefits in this condition are presumed due to its effects on platelet aggregation. It seems to prevent platelet aggregation to about the same extent as aspirin at 100 mg per day.
For more information, including dosage and safety issues, see the full policosanol article.
Mesoglycan
Mesoglycan is a substance found in many tissues in the body, including the joints, intestines, and the lining of blood vessels. A 20-week, double-blind, placebo-controlled trial that enrolled 242 individuals evaluated the effects of mesoglycan in intermittent claudication. Significantly more participants in the mesoglycan group responded to treatment (defined as a greater than 50% improvement in walking distance) than in the placebo group. For more information, including dosage and safety issues, see the full article on mesoglycan.
Arginine
The supplement arginine may be able to improve walking distance for people with intermittent claudication. In a double-blind study of 41 individuals, 2 weeks of treatment with a high dose of arginine, improved walking distance by 66%, no benefits were seen in the placebo group or a low-dose arginine group.
Good results were also seen in another study, although its convoluted design makes interpreting the results somewhat difficult.
For more information, including dosage and safety issues, see the full article on arginine.
Antioxidants
A double-blind placebo-controlled trial of 1,484 individuals with intermittent claudication found no benefit from vitamin E (50 mg daily), beta-carotene (20 mg daily), or a combination of the two.
A number of natural treatments may be helpful, but it isnt clear whether it is safe to combine them with the medications that may be prescribed at the same time. Medical supervision is definitely necessary for this serious disease.
Ginkgo
According to eight double-blind placebo-controlled trials, ginkgo can significantly increase pain-free walking distance, presumably by increasing circulation.
One study enrolled 111 patients and followed them for 24 weeks.Participants were measured for pain-free walking distance by walking up a 12% slope on a treadmill at 2 miles an hour. At the beginning of treatment, both the placebo and ginkgo (120 mg) groups were able to walk about 350 feet without pain.
At the end of the trial, although both groups had improved (the power of placebo is amazing!), the ginkgo group had improved significantly more, showing about a 40% increase in pain-free walking distance as compared to only a 20% improvement in the placebo group.
Similar improvements were also seen in a double-blind placebo-controlled trial of 60 individuals who had achieved maximum benefit from physical therapy.
Taking a higher dose of ginkgo may provide enhanced benefits in intermittent claudication. A 24-week double-blind placebo-controlled study of 74 individuals found that ginkgo at a dose of 240 mg per day was more effective than 120 mg per day.
For more information, including dosage and safety issues, see the full ginkgo article.
L-Carnitine
The vitamin-like substance L-carnitine also appears to be of some benefit in intermittent claudication. Although it does not increase blood flow, carnitine appears to increase walking distance by improving energy utilization in the muscles.
A 12-month double-blind placebo-controlled trial of 485 individuals with intermittent claudication evaluated the potential benefits of a special form of carnitine called propionyl-L-carnitine.Participants with relatively severe disease showed a 44% improvement in walking distance as compared to placebo. However, no improvement was seen in those with mild disease. Benefits were seen in most, but not all, other studies using L-carnitine or propionyl-L-carnitine.
For more information, including dosage and safety issues, see the full carnitine article.
Inositol Hexaniacinate
The supplement inositol hexaniacinate, a special form of vitamin B3, appears to be helpful for intermittent claudication. Double-blind studies involving a total of about 400 individuals have found that it can improve walking distance for people with intermittent claudication. For example, in one study, 100 individuals were given either placebo or 4 g of inositol hexaniacinate daily. Over a period of 3 months, participants improved significantly in the number of steps they could take on a special device before experiencing excessive pain.
For more information, including dosage and safety issues, see the full vitamin B3 article.
Policosanol
A waxy substance extracted from sugarcane, policosanol is best known as a treatment for high cholesterol. However, it seems to be helpful for intermittent claudication as well.
A 2-year double-blind placebo-controlled study of 56 individuals found that treatment with policosanol (10 mg twice daily) improved walking distance by more than 50% at 6 months, and the benefits increased over the course of the study.
Similar results were seen in a 6-month double-blind placebo-controlled study of 62 individuals.
Some policosanol products on the market use beeswax as the source instead of sugarcane. However, there is some controversy over whether these products are actually effective.
Policosanols benefits in this condition are presumed due to its effects on platelet aggregation. It seems to prevent platelet aggregation to about the same extent as aspirin at 100 mg per day.
For more information, including dosage and safety issues, see the full policosanol article.
Mesoglycan
Mesoglycan is a substance found in many tissues in the body, including the joints, intestines, and the lining of blood vessels. A 20-week, double-blind, placebo-controlled trial that enrolled 242 individuals evaluated the effects of mesoglycan in intermittent claudication. Significantly more participants in the mesoglycan group responded to treatment (defined as a greater than 50% improvement in walking distance) than in the placebo group. For more information, including dosage and safety issues, see the full article on mesoglycan.
Arginine
The supplement arginine may be able to improve walking distance for people with intermittent claudication. In a double-blind study of 41 individuals, 2 weeks of treatment with a high dose of arginine, improved walking distance by 66%, no benefits were seen in the placebo group or a low-dose arginine group.
Good results were also seen in another study, although its convoluted design makes interpreting the results somewhat difficult.
For more information, including dosage and safety issues, see the full article on arginine.
Antioxidants
A double-blind placebo-controlled trial of 1,484 individuals with intermittent claudication found no benefit from vitamin E (50 mg daily), beta-carotene (20 mg daily), or a combination of the two.