Peripheral vascular disease (PVD) is a condition characterised by narrowing of the arteries which supply blood to the legs. Mild cases of PVD may cause nothing more serious than sluggish circulation and cold feet. However, as the disease progresses it may give rise to more serious complications such as ulcers and pain in the calf muscles on walking. Ultimately, PVD can give rise to gangrene and may necessitate the amputation of toes, the foot or lower leg. Last month, the medical journal Circulation published a study which found that PVD is associated with low levels of vitamin C in the body. This research throws up the possibility that ensuring a good intake of vitamin C may help prevent or slow down the development of PVD. If this is the case, then vitamin C actually represents just one of a range of natural approaches which may be of use in PVD. Here, we look at some of the most effective treatments for this important condition.

The arteries in the body supply blood to the organs. In time, arteries can become increasingly blocked with a fat-like substance in a process known as ‘atherosclerosis’. Atherosclerosis in the arteries supplying blood to the heart muscle may lead to angina (heart pain) and heart attack, while atherosclerosis in the vessels supplying blood to the brain may ultimately lead to stroke. When atherosclerosis affects the arteries in the legs, PVD is the result. One of the common manifestations of this condition is ‘intermittent claudication’. Here, walking tends to cause the calf muscles to become starved of oxygen leading to pain and aching here. The discomfort tends to come on during exertion, but is usually relieved on resting. Treatment options for PVD are limited, and mainly revolve around the expansion of the narrowed portions of artery with a balloon (angioplasty) or surgery.

Scientific studies have consistently shown that regular exercise has the ability to reduce disability caused by intermittent claudication. In one study published last year in the Journal of Vascular Surgery, three-times weekly sessions of treadmill walking, gradually increasing in duration over several weeks, led to a very significant increase in walking distance in sufferers of intermittent claudication. Walking is thought to stimulate the opening of blood vessels in the lower legs. Other beneficial effects of exercise may include a reduction in the development of atherosclerosis and healthy muscle changes.

The recent research linking low levels of vitamin C to an increased risk of PVD throws up exciting possibilities for the prevention and treatment of this condition. Quite how vitamin C may exert a protective effect is not known for sure. The authors of the study suggest that vitamin C’s anti-inflammatory effect might help reduce the tendency to atheroslerosis. Another theory is that, through its antioxidant effect, vitamin C protects cholesterol from damaging changes (oxidation) which make it much more likely to sediment out on the artery wall. One more theory was put forward to Nobel Prize winner and ardent vitamin C advocate Linus Pauling. Vitamin C is known to be very important to keep the lining of the arteries strong and healthy. Pauling believed that a lack of vitamin C could lead to damage and leakiness of the artery walls. He suggested that in an effort to repair the damage, the body deposits fat on the artery wall - the basic process which leads to atherosclerosis. 500 - 1000 mg of vitamin C, twice a day is likely to offer protection if taken in the long term.

Another nutrient which may help in PVD is vitamin E. Several studies show that vitamin E may reduce the tendency for sufferers of PVD to experience intermittent claudication. As with vitamin C, quite how vitamin E exerts its beneficial effect is not known. However, vitamin E has been shown to ‘thin’ the blood, and this may help it pass more effectively through narrowed vessels. Individuals with intermittent claudication may benefit from doses of between 400 - 1000 IU of vitamin E per day.

The World of herbal medicine offers a variety of approaches to the treatment of PVD. The herb Ginkgo biloba, renowned for its blood-flow enhancing effect, is one of the mainstay natural treatments for intermittent claudication. Last year, a review of six published studies which examined the effect of Ginkgo biloba in intermittent claudication concluded that at a dose of between 120 and 160 mg of standardised extract per day, Ginkgo led to a significant increase in the distance sufferers could walk. Garlic at a dose of 800 mg per day has also been shown to increase walking distance in individuals with intermittent claudication. It has been suggested that this effect is related to garlic blood-thinning properties. Both Ginkgo and garlic may take several weeks before the benefits become apparent.

Another scientifically proven treatment for intermittent claudication is Padma 28. This remedy is a blend of 20 Tibetan herbs which has been used in Europe (principally Switzerland) to treat PVD for almost 25 years. Padma 28 was the subject of a study involving more than 900 intermittent claudication sufferers published in 1993. This study found that two capsules of Padma 28, taken twice a day, led to very significant increases in walking distance compared to inactive medication (placebo). Padma 28 is available in health food stores.

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