Peripheral Vascular Disease

Rating	Nutritional Supplements	Herbs
	Inositol hexaniacinate
	Copper (for abdominal aortic aneurysm) Folic acid (for thromboangiitis obliterans)
Reliable and relatively consistent scientific data showing a substantial health benefit. Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit. For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support and/or minimal health benefit.

What are the symptoms of peripheral vascular disease?

People with peripheral vascular disease may have symptoms of pain, aching, cramping, or fatigue of the muscles in the affected leg that are relieved by rest and worsened by elevation. Other people with peripheral vascular disease may have swollen feet and ankles accompanied by a dull ache made worse with prolonged standing and relieved by elevation. People with chronic peripheral vascular disease may have darkened areas of skin, leg ulcers, and varicose veins.

Lifestyle changes that may be helpful for peripheral vascular disease

People with TAO are usually heavy smokers, and this is considered a major cause of the disease.³ It is important for people with TAO to quit smoking.

Nutritional supplements that may be helpful for peripheral vascular disease

As with other vascular diseases, people with TAO are more likely to have high levels of homocysteine and low levels of folic acid.⁴ However, no research has tested folic acid as prevention or treatment for this disease.

One controlled study compared a type of niacin (vitamin B3) known as inositol hexaniacinate to the drug pyridinolcarbamate for the treatment of skin ulcers caused by PVD.⁵ A placebo was not included in this trial, and both 1.2 grams daily of inositol hexaniacinate and 1.5 grams daily of the drug produced beneficial results in about half of the patients.

As in many vascular diseases, people with AAA often have abnormal cholesterol and triglyceride levels,⁶ and their blood vessel walls contain evidence of free radical damage.^{7 8} However, it is not known whether lowering blood fats or taking free radical-destroying antioxidants will reduce the risk of AAA. The arterial walls of AAA are depleted of large molecules related to cartilage, including chondroitin sulfate,^{9 10} but no research has investigated whether supplements of chondroitin sulfate might help prevent problems with AAA. Copper is required for normal artery structure.¹¹ Animal studies have shown that copper deficiency leads to weak aortic walls¹² and rupture of the aorta.¹³ Combating deficiency with copper supplements prevented rupture in an animal study.¹⁴ Copper deficiency in humans with AAA has been suggested in some studies,^{15 16} but not in others.^{17 18 19} No studies have been done using copper supplements to prevent or manage aneurysms.

Are there any side effects or interactions with peripheral vascular disease?

Refer to the individual supplement for information about any side effects or interactions.

Holistic approaches that may be helpful for peripheral vascular disease
Intravenous chelation therapy has been reported to be an effective treatment for PVD.^{20 21} A partially controlled study reported improvements after ten chelation treatments.²² However, two double-blind studies found no difference between chelation therapy and a placebo in patients with intermittent claudication.^{23 24}

Preliminary reports suggest acupuncture may reduce pain and improve blood flow in TAO,^{25 26} but controlled studies are needed to better evaluate these claims.