EDEMA - THE WATER BALANCING ACT

Q. My feet and ankles are starting to swell up a lot. I drink a lot of water, I do not eat a lot of salty foods and my job keeps me moving around for the good part of the day. I understand that swelling may mean my heart is no longer functioning the way it should be. Should I be concerned?

A. Edema may be a normal and very treatable symptom for many individuals. But, if it is a persistent problem that seems to be worsening and it is not relieved by elevating the feet, Or, if you are noticing significant edema around the eyes, in the legs, and hands, you many want to speak to your healthcare professional, so they can rule out more serious conditions that may be causing fluid retention.

The (Water) Balancing Act
In order for us to function at our optimal level, the water content of our bodies should be about 70%. This makes the job of regulating our water balance extremely important. The kidneys take on most of this responsibility along with the help of anti-diuretic hormone (ADH), also called vasopressin. Vasopressin is secreted by the pituitary gland to prevent excessive loss of water from the kidneys, basically a message to the kidneys to hold on to water in order to preserve optimal functioning of the body and prevent dehydration. Edema is more or less a symptom of a malfunction in this process. Once the body has enough water and the kidneys can begin excreting or flushing water normally, vasopressin should turn off. In the case of edema, this shut off mechanism malfunctions and we continue to retain water when it is no longer needed.

Common Causes of Edema
Edema can be a very benign, transient and treatable problem in many cases. It is common to experience some edema when travelling on an air plane for long distances, in fact, prolonged sitting or standing of any sort can cause some mild swelling. Dietary habits can also play a role. A diet high in salt, for example, can lead to some excess water retention (more on this below). Extremely hot weather and sweating can also cause swelling in the hands and feet of some individuals. Edema is also a very common symptom in late pregnancy, as well as a cyclical symptom for some women, often resolving itself within the first day or two after menstruation begins. Certain medications may also be responsible for excess fluid retention.

Edema as a symptom of more serious underlying conditions
Individuals with heart, kidney and often liver pathologies (or with a family history of these problems) are most often at risk for more serious causes of fluid retention. In these individuals, edema could be a sign of increased blood pressure (also increasing risk of stroke), reduced cardiac output (in the case of congestive heart failure), impaired kidney function (as can be seen in kidney disease), or loss of important proteins, like albumin, in the urine( which can be caused by diseases of either the liver or kidney). In these individuals, prolonged edema causes blood circulation to decrease. This reduced circulation can also lead to pain, affecting muscles and joints. Varicose veins and thrombophlebitis (inflammation of the veins) are also common causes of edema, caused by a deficient venous return of blood due to venous insufficiency or obstruction. Compression stockings which support the healthy flow of venous blood back to the heart, can be quite useful in treating cases of venous insufficiency.

Dietary and Lifestyle Factors affecting Edema
There are some very simple dietary and lifestyle suggestions that can promote healthy elimination of excess water. Although this may seem backward, one of the most important things you can do is to increase your water intake, both through food and drink. Water encourages regular diuresis (an increase in the production and expulsion of urine). Foods high in water include celery, melons, grapes, carrots and spinach, or other green leafy vegetables. Similarly, try to limit your intake of sodium in the diet. High sodium can lead to excess water retention. Watch for canned or prepared and processed foods, as these are often high in sodium. Refined foods, such as white breads, pastas, and refined sugars (baked goods, fruit juices, pop), as well as alcohol, can also lead to water retention. Exercise! Movement of any sort that is increasing heart rate is helping to support the movement of fluid from the extremities back to the heart, therefore reducing edema.

Nutraceuticals for the relief of Edema
CoQ10 is so important to the cardiovascular system in general, including in the case of congestive heart failure. CoQ10 supplies the heart cells with oxygen for overall improved function. L-Arginine is a very effective way to naturally lower blood pressure. It helps to dilate blood vessels, optimizing blood flow both to and from the heart. Taurine can also be quite helpful in treating edema due to cardiovascular deficiencies. In terms of healthy liver function, N-acetyl cysteine (NAC), milk thistle and curcumin are all potent antioxidants with an affinity for the liver, helping to detoxify and in some cases even regenerate liver cells. Horse chestnut is a well-known remedy for chronic venous insufficiency, helping to support the integrity of the vein walls. Herbal diuretics, such as Bearberry (Uva Ursi), Dandelion, Juniper and parsley have also been used to treat and prevent fluid retention leading to edema.

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