LymphLink Question Corner - Archived from April-June 2003
Linda-Anne Kahn, HHP, CLT-LANA
Q: I have been told that I have lipedema in both my legs and want to know if there are any dietary factors that can help me. I am overweight and feel tired and sluggish most of the time. My legs ache and feel heavy and my feet are swollen. How is this different to lymphedema?
A: Lipedema is a condition that is different to lymphedema. Lipedema is a chronic disease of excess fatty tissue accumulating in both legs and extending from the pelvis to the lower abdomen. The upper arms are affected in a small percentage of patients. The fibers in the fatty tissue multiply and thicken which also gives rise to an increase in connective tissue pressure, and eventually hardening of the collagen fibers. There is a feeling of heaviness and unlike lymphedema, this type of edema is painful in advanced stages and the legs bruise easily. This condition usually affects women. The feet are not affected in patients with lipedema, but the feet and toes become edematous in patients with lymphedema. Patients with lipedema are not at-risk for infections as lymphedema patients are.
It sounds as though you have a condition called lipo-lymphedema, a condition in which lymphedema occurs as a secondary effect of lipedema. If the patient becomes overweight, the excess fatty tissue causes a compression of the superficial lymph vessels and thus affects the functioning of the lymph system. In patients who are able to maintain normal body weight lipedema can remain unchanged for many years. Many patients who have lipedema become overweight and it becomes difficult to lose weight. There are many forms of aerobic exercise that are best avoided, such as aerobics classes and jogging. Swimming, yoga and Tai Chi would be important for you to do to assist in lymph flow and to burn calories.
For bruising I suggest you take bioflavonoids to help strengthen the capillary walls, as well as to have an anti-oxidant effect. In patients with lipedema, there is often an inability of the body to digest certain fats, in particular long chain fatty acids. Long chain fatty acids are absorbed by the lacteals (part of the lymphatic system) in the small intestine. Thus are absorbed into the lymphatic system. Once digested long chain fatty acids go on to be stored in adipose tissue to be used later. There is belief that medium fatty acids (MCT) in the diet can help to alleviate the problem. Medium chain fatty acids bypass the intestines and are absorbed by the liver. They are easily absorbed and unlike other fats, they put little strain on the digestive system and provide a quick source of energy. Medium chain fatty acids are digested and absorbed quickly and with minimal effort. Because of this, there is less strain on the pancreas, liver and the digestive system. Pure virgin cold pressed coconut oil is a medium fatty acid. Caprylic acid is a medium chain fatty acid derived from coconut oil found to exhibit antifungal properties on contact with the fungus. Once absorbed, caprylic acid is no longer antifungal but is then metabolized to produce energy. Caprylic acid is produced in the body in small amounts and is a natural component of coconut oil, palm nut oil, butterfat and other vegetable and animal sources. It is synthesized from caprylic alcohol (octanol) found in coconut oil. A diet high in vegetables, fish, fruit and whole grains and omega fatty acids is advised. Try to avoid refined carbohydrates and sugar, as well as limit intake of sodium.
Q: I get recurring infections on my lymphedemic arm, as well as on my side. Are there any natural therapies that I can use to help as a preventative measure?
A: Cellulitis (infection) is a common complication with lymphedema patients because of the breakdown of the skin function. The skin's acid film of protection is destroyed in edematous tissue and the immunity in the skin is lowered. Patients can go on low dose antibiotic therapy as a prophylactic measure. There is a Chinese herb called Astragulus that helps the immune system and helps fight off infection. A licensed Chinese practitioner can help you with combinations of herbs for the immune system. Echinacea and goldenseal can be taken as these herbs may assist with production of white blood cells. Essential oils of lemon (anti-infectious), tea tree (anti-viral) and Laurel (Immunostimulant and anti-fungal) blended in a base of calendula oil, centenella asiatica (anti-inflammatory) or hazelnut oil and gently massaged onto the affected area can have an effect on the immune system. Consult with a qualified Clinical Aromatherapist. There are other herbal combinations that are said to help produce T killer cells and white blood cells.
Q: I have lymphedema of the leg. I have just received a gift certificate for a Day Spa for several therapies. Are there any precautions I need to take?
A: You need to inform your massage therapist that you have lymphedema. You should not go into the steam room or sauna. Request that the therapist avoid deep massage on your affected areas as this could cause a filtration of fluids into your tissue and create more swelling. You should be careful if you have a therapy that is to be done in a thalassotherapy tub. The water should be body temperature and you should not be in the tub for more than 20 minutes. Great care needs to be taken with the underwater hose. The pressure should be gentle.
Please address questions to: Editor c/o NLN, 116 New Montgomery Street, Suite 235, San Francisco, CA 94105 or e-mail: nln [at] ymphnet [dot] org (firstname.lastname@example.org). Deadlines for submissions (for the following issue) are: Feb 15, May 15, Aug 15, Nov 15.