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.
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.