~ Sep 09 A Prescription for Beautiful and Healthy Legs

By Robert Haas, MS

A European Citrus-Based Product Restores Shapeliness and Health to Swollen and Painful Legs

For the last 30 years, millions of European women have been using a doctor-prescribed citrus fruit extract to attain healthier, smoother, and shapelier legs.

Now, US women have access to the same European wonder drug, available without a doctor's prescription as a nutraceutical product, called micronized diosmin. Micronized diosmin has been clinically proven to produce healthier-looking legs by healing swollen ankles, spider and varicose veins, and leg ulcers.

While current US drug treatments for cosmetic improvement in the legs have not achieved good clinical efficacy, micronized diosmin has enjoyed an outstanding 30-year record of research testing and success in Europe.1

In this article, you'll learn about the new nonprescription form of the European drug, micronized diosmin, and discover how it can enhance the appearance of the legs by reducing ankle swelling, improving the appearance of varicose and spider veins, and restoring healthy vascular function in people suffering from chronic venous disorders.

Micronized Diosmin Restores Healthy Function to Stressed-Out Legs

Age and gravity are the enemies of healthy veins. Over time, leg veins may become weakened, twisted, dilated, and thickened. Blood may flow backwards and collect in the vein, causing it to swell. Aside from the visible, unsightly cosmetic issues, spider veins and varicose veins cause pain and itching, while scratching them can lead to ulcerations. Mainstream doctors treat these swollen and unsightly veins with lasers, radiofrequency ablation, and surgery.

Micronized diosmin prolongs the vasoconstrictor effect of noradrenalin on the vein wall and by doing so, increases venous tone, thereby reducing the blood pooling that can lead to swollen leg veins.4

With micronized diosmin, people who suffer from swollen veins may be able to avoid expensive medical procedures, and research has shown that those who must undergo such procedures may see improved clinical outcomes when it is used pre- and post-operatively.

In a study of 245 patients with varicose vein disease who underwent surgical removal of affected veins, those given micronized diosmin pre- and post-therapy (two weeks before and for 30 consecutive days after surgery) achieved measurable reduction in postoperative hematomas, pain severity, and limb heaviness, as well as better exercise tolerance and improved quality of life scores.5

Protection Against Varicose Veins

The role of the legs' venous system is to return deoxygenated blood from the lower extremities to the heart. To counterbalance the effect of gravity, leg veins are equipped with a series of one-way valves that prevent the return of blood flow to the feet. In people with healthy venous valves, each contraction of the calf muscles pumps venous blood toward the heart. As valves become damaged, they allow retrograde flow of blood toward the feet, leading to hypertension in the veins and further complications linked to progression of chronic venous disease. This leads to damage of the venous wall, the appearance of varicose veins, and further damage leading to the progression of venous disease.

Micronized Diosmin: The First Nutraceutical for Beautiful Legs

Diosmin is a naturally occurring hesperidin bioflavonoid. Pharmaceutical grade diosmin is extracted from the rinds of sweet oranges. The sweet orange, a hybrid of the pomelo and tangerine, was originally cultivated in southeast Asia. It was then brought to Spain in the ninth century and later to Florida by Spanish explorers during the 1500s.

The most clinically effective diosmin is micronized, which means it has undergone a scientifically controlled process to reduce the size of standard particles in order to increase its bio-availability and to achieve rapid relief of symptoms and to accelerate healing.2,3

For the estimated 12 to 25 million people in the United States who suffer with "cankles" (loss of definition between calves and ankles due to swelling) and unsightly and painful varicose veins and spider veins, micronized diosmin may offer a safe and effective non-surgical treatment option.

Studies show that micronized diosmin protects the one-way venous valves from leukocyte-induced inflammation and destruction.6 Micronized diosmin also increases venous tone and reduces venous stretching and blood pooling.7 This increases blood flow toward the heart and reduces venous high blood pressure present in patients suffering from chronic venous disease.

Dangers of Chronic Venous Insufficiency (CVI)

If your legs feel heavy, tired, or achy, or if you feel pain in your legs shortly after walking, you might have chronic venous insufficiency (CVI).

CVI is caused by a deterioration of the one-way flaps in veins designed to keep blood flowing toward the heart. With each step taken, venous flaps serve as leaflet valves that maintain blood flow in the proper direction. As leg muscles relax, the venous valves close, preventing blood from flowing back down the leg.

CVI generally affects deep veins in the leg. Varicose veins can also contribute to CVI. Doctors treat CVI with compression bandaging, drugs, sclerotherapy (injections), and surgery. The process of venous wall stretching and dilation is painful and generally leads to leg heaviness and a sensation of swelling.

Although generally not life-threatening, CVI can decrease quality of life; left untreated, it can lead to serious medical conditions including phlebitis, the inflammatory venous condition that afflicted President Richard Nixon, and deep vein thrombosis (DVT), suffered by Vice-President Dan Quayle as a result of extended air travel. DVT can cause a potentially life-threatening blood clot.

Risk factors for CVI include being in a profession that involves standing or sitting for long periods of time, age, gender (women older than 50 are more prone than men to CVI), being pregnant, physical activity, smoking, body fatness, height (taller people are at greater risk) and a family history of varicose veins.

Studies using micronized diosmin for the treatment of CVI reveal that in as little as 30 days, most patients suffering from this condition see significant improvement in pain, sensation of swelling, and cramps.8,9

A multicenter international trial, conducted in 23 countries over two years, in which 5,052 symptomatic patients were enrolled, evaluated the efficacy of micronized diosmin in the treatment of chronic venous insufficiency.9 Researchers noted continuous clinical improvement throughout the study, as well as improvements in quality-of-life scores for participants.

Diosmin Blocks The Primary Cause of All Chronic Venous Disease

Researchers recently discovered that the interaction between white blood cells (leukocytes) and the venous endothelium (inner layer of vein wall) is the process underlying all clinical manifestations of chronic venous disease. Thanks to its unique action in inhibiting this leukocyte-endothelial interaction, micronized diosmin is the only nutraceutical treatment shown to be effective and protective against the progression of chronic venous disease.

What You Need to Know: Micronized Diosmin

  • Millions of European women have used micronized diosmin to achieve smoother, shapelier, and more slender looking legs. Now, diosmin is available in the US as a dietary supplement.

  • Micronized diosmin improves the symptoms and appearance of varicose and spider veins, heavy leg syndrome, and chronic venous insufficiency (CVI).

  • Micronized diosmin reduces pain and swelling in the legs and ankles, helping the legs feel lighter and ultimately look better.

  • Micronized diosmin alleviates the acute and chronic pain and swelling of hemorrhoids.

  • Venous leg ulcers show marked improvement with micronized diosmin.

  • Micronized diosmin helps relieve lymphedema that can occur after treatment for breast cancer.

  • Micronized diosmin has an outstanding safety record, however, pregnant women and people taking prescription medications should check with a doctor before using it.

Leukocyte-endothelium interaction is caused by the expression of adhesion molecules on the surface of leukocytes and endothelial cells. As a result of this interaction, leukocytes release proteolytic enzymes and other toxic components, producing a massive inflammatory response in small veins and capillaries. This leads to the accumulation of red blood cells, fluids, and proteins that cause ankle swelling (edema) and inflammation.10 Over time, this inflammatory process may cause leg veins and the skin to ulcerate.

Diosmin protects capillaries and the microcirculation from inflammation and vascular-destructive compounds while inhibiting white blood cell activation, migration, and adhesion. Likewise, micronized diosmin prevents tissue damage to blood vessel valves; preventing venous blood backflow. Micronized diosmin is the only treatment that is effective in protecting patients from the symptoms of chronic venous disease from the earliest stages up to the most severe stages.11-14

After reviewing a number of medical studies using micronized diosmin, one researcher concluded that micronized diosmin should be "the first-line treatment for edema and symptoms of CVI at any stage of the disease" and recommended its use "in conjunction with sclerotherapy, surgery, and/or compression therapy or as an alternative treatment when other treatments are not indicated or not feasible."7

Why You Should Use Only Micronized Diosmin

Micronization is a technique that reduces the size of particles and therefore improves the rate of dissolution and absorption of otherwise poorly soluble drugs and other compounds.

One problem with most diosmin products on the market has been their poor absorption and poor bioavailability, which leads to the necessity of taking extremely high doses in order to obtain even modest clinical efficacy.

The bioavailability of a compound is defined as the amount of the administered dose that reaches the systemic circulation (bloodstream). It is a widely accepted pharmacologic principle that the smaller the particles of a compound administered by the oral route, the higher the rate of dissolution and absorption of that product.

For this reason, clinical studies only use micronized diosmin, which means that the manufacturer has subjected the diosmin to a high-tech grinding process with a jet of air at supersonic velocities, reducing the size of standard diosmin particles from 37 µm to less than 2 µm. Thanks to its unique form, micronized diosmin products are at least 30% more bioavailable, which may increase their clinical efficacy over nonmicronized, ordinary diosmin products.3

Healing Venous Leg Ulcers with Micronized Diosmin

Venous ulcers affect 500,000 Americans every year and account for 80 to 90% of all leg ulcers. They typically occur in people with a history of leg swelling, varicose veins, or a history of blood clots in either the superficial or the deep veins of the legs. Ulcers may affect one or both legs.

Healing Venous Leg Ulcers with Micronized Diosmin

Venous ulcers can occur on either side of the lower leg, usually above the ankle and below the knee. A shallow wound with a reddish base develops when the leg veins' valves become damaged and fail to adequately move blood back toward the heart. Some ulcers can be covered with pale yellow fibrous tissue and exude pus and extracellular fluid if the ulcer becomes infected.

Studies show that micronized diosmin helps heal leg ulcerations by inhibiting the synthesis of inflammatory prostaglandins and free radicals.15 Micronized diosmin also decreases microvascular leakage and inhibits white blood cell trapping and migration.16 One study found that treatment with micronized diosmin led to complete healing of infected leg ulcers.17

A multicenter, randomized, controlled trial tested micronized diosmin in addition to standard compression stocking therapy versus placebo for two months in patients with leg ulcers.18 The study group consisted of 140 men and women ranging in age from 18 to 85 years who were undergoing standardized local care of leg ulcer. A significantly larger number of patients (47% in the diosmin group vs. 28% in the placebo group) experienced complete healing of venous ulcers at the end of six months.

Micronized Diosmin for Lymphedema

  • Lymphedema is an abnormal swelling that occurs when a blockage in the lymphatic system prevents the lymph fluid in an arm or leg from draining adequately.

  • Micronized diosmin has been shown to improve lymphatic drainage by promoting lymphatic contractions, by increasing the number of functional lymphatic capillaries, and by decreasing the diameter of lymphatic capillaries and the intralymphatic pressure.14,21,22

  • One study analyzed micronized diosmin as a treatment for upper-limb lymphedema secondary to conventional therapy for breast cancer. Results showed improvement of all symptoms and reduction of arm swelling.23

  • Another study suggested a beneficial therapeutic activity of micronized diosmin in female breast cancer patients affected with severe lymphedema secondary to conventional breast cancer therapies.24

A number of randomized prospective studies using diosmin as an adjunct to conventional treatment demonstrate the efficacy of the supplement in helping to heal leg ulcers. In a research review, conventional treatment (compression and local care) in addition to a daily dose of diosmin was compared with conventional treatment plus placebo or with conventional treatment alone. The results showed a clear benefit of adjunctive micronized diosmin treatment over conventional therapy alone.10 These results confirm that venous ulcer healing is accelerated by adjunctive treatment with diosmin.


Micronized diosmin is the most widely used drug (used by tens of millions of European women) to achieve shapelier, smoother and more well-defined looking legs. Micronized diosmin rapidly improves the symptoms and appearance of varicose and spider veins.

Of all the drugs used clinically for leg swelling reduction, only micronized diosmin has shown to be effective in clinical trials involving leg swelling (edema) associated with venous disorders. Edema creates unsightly 'cankles,' a term used to denote the loss of contour between calves and ankles.

Micronized diosmin is the only oral treatment shown to be effective from the earliest symptoms of chronic venous disease up to the most severe stages. Micronized diosmin is highly effective at improving the appearance of cosmetically unattractive venous disorders, including varicose veins, spider veins, leg ulcers, and swollen ankles.

Micronized diosmin possesses a unique and clinically proven mode of action that addresses all the disabling aspects of venous disease affecting the veins, lymph glands, and microcirculation. In patients suffering from CVI, diosmin provides significant relief from pain, heavy legs, and cramps.

No other oral medication except micronized diosmin has ever been shown to relieve the symptoms or reactionary bleeding experienced by patients after hemorrhoidectomy. Diosmin also provides relief from lymphedema following conventional treatment for breast cancer.

Micronized diosmin enjoys an outstanding safety record unrivaled by any other drug used to treat venous disorders.The overwhelming majority of published studies show that diosmin is generally nontoxic at recommended doses, including studies involving pregnancy, and is relatively free from drug interactions. However, those who are pregnant or who take any prescription medications should check with a physician before taking micronized diosmin.

Preparation "D" (Diosmin) For Hemorrhoids

  • Inflamed hemorrhoids have been called the 'varicose veins' of the anus and rectum.

  • A number of large clinical trials have shown micronized diosmin to be effective in mitigating the acute and chronic symptoms associated with inflamed hemorrhoids.

  • A double-blind, placebo-controlled study of 120 patients showed improvement of pain, discharge, swelling, and bleeding when treated with micronized diosmin twice a day for two months.19

  • No oral medication besides micronized diosmin has ever been shown to reduce the pain, tenesmus, pruritus, or reactionary bleeding that patients may experience after hemorrhoidectomy (surgical treatment of hemorrhoids).

  • A study involving pregnant women with acute hemorrhoids who were treated with micronized diosmin for eight weeks before delivery and four weeks after delivery showed that micronized diosmin was both effective and safe for mother and fetus.20

References . . .
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