This is also known as idiopathic oedema. ‘Oedema’ is the medical term for swelling, ‘idiopathic’ means that the cause is unknown and is just a clever way of doctors disguising their ignorance. Though there are a variety of causes, the commonest is simply the retention of salt and water in the subcutaneous tissues. This shows up particularly in the feet, in the fingers and sometimes in the abdomen. In severe cases the face may be affected.
It is well known that fluid retention is much more common in women and is very often worse in the premenstrual phase. Some studies have shown that it can be associated with fatigue and a tendency to depression, but before deciding that the swelling is simply ‘idiopathic’, care should be taken to exclude other causes.
• Consider the possible causes of swelling including heart failure (see page 233), underactive thyroid (see page 417), kidney failure, swelling due to blocked lymphatic drainage following infection, or possibly due to a familial disorder.
• If simple idiopathic oedema is diagnosed a low-salt diet is recommended, and this should always be the first line of treatment. Careful studies conducted by doctors at Charing Cross Hospital in London clearly demonstrated that a restriction of sodium (salt) leads almost always to clearance of idiopathic oedema. Our bodies are composed of 70 per cent water, and the reason we retain fluid is because each cell in the body has a mechanism to balance sodium and other minerals. It is primarily sodium that governs the retention of water and it seems that some women are particularly unable to tolerate large amounts of salt in the diet. Our western diet has become laden with salt, with intakes some ten to 50 times our actual requirements.
• Prescribe diuretics if all else fails. This is very much a poor option and a last resort, although it is indeed a common treatment. Low-dose mild diuretics often do not produce lasting benefit as the body adjusts to the effects on their chemistry
• Be vigilant with a low-salt diet (see page 449), as we consume far more salt than we need and most of the sodium salt in our diet comes from hidden sources rather than added salt in cooking or at the table. This will mean doing without crisps, other salted savoury snacks, bacon, sauasages and greatly limiting the intake of bread.
• Avoid wheat if you also suffer with abdominal bloating. This might indicate a food sensitivity. When the body perceives a food as ‘toxic’ it may accumulate fluid in the cells.
• Fluid restriction is not required although it is inadvisable to drink very large amounts. Watch out for some mineral waters which actually contain significant amounts of sodium, and choose those rich in calcium and magnesium if possible.
• Lose weight if you need to.
• Restrict your alcohol intake to no more than two units per day.
• Follow the The Very Nutritious Diet (see page 437). High intakes of magnesium and potassium will help the body get the balance of sodium right.
• Take supplements of magnesium and multi-vitamins (see Premenstrual Syndrome, page 394, for further advice).
• Ginkgo biloba has been used in the treatment of oedema due to its ability to improve circulation, particularly to the extremities. Ginkgo should not be taken if you have been prescribed anti-coagulant medication or you are pregnant.
• Put your feet up. Lying down aids clearance of fluid from the legs and also the body’s ability to pass it out in the urine.
• Have a cup of coffee? This has modest diuretic effects. Perhaps a cup of coffee first thing in the morning, whilst putting your feet up for a couple of hours to read the newspaper, may help you to offload some of the fluid that has accumulated overnight. FLUID RETENTION 205 Complementary therapies Most herbal remedies have diuretic properties, so see a qualified herbalist for advice. A homeopathic remedy, Agis mel, is traditionally used to treat this sort of problem. These avenues are worth exploring but will not replace the need for a low-salt diet. Manual lymphatic drainage is a useful therapy in conjunction with dietary modification, but you must consult a professionally trained practitioner.
Alison was a 38-year-old welfare worker with two children who suffered severe water retention which made her life a misery. She felt swollen and tired for two weeks each month which was severely disrupting her life.
‘For two weeks before my period each month, with unrelenting regularity, my body would begin to swell. Within days, my middle swelled up so much that I looked at least five months pregnant. My waist would increase by inches and my face puffed up. My eyelids felt tight and my breasts sore because of the swelling. I could hardly fit into my bra, and even walking felt uncomfortable. Every month I’d be so bloated, I felt like a pudding and everything was an effort. I was lethargic and lacking in energy. My doctor prescribed progesterone suppositories which made me feel even more bloated. When I returned to ask for further help he told me I needed to see a psychiatrist. I felt insulted as I knew that my symptoms were not psychological. I went off and tried to help myself with vitamin B6 and evening primrose oil. They did help a bit, but not significantly. My doctor’s reaction had put me off trying to get help, so I struggled on for another couple of years. My husband read an article in the newspaper relating to the work of the WNAS in which one of the patients reported symptoms similar to mine. I wrote off immediately to ask for help. The detailed questionnaire and diet diary arrived shortly after and I set about completing it. The WNAS worked out a programme for me that involved cutting out chocolate bars, which I used to crave, and bread, tea and coffee had to go too. Instead I was asked to concentrate on fresh foods. Every day I had to eat lots of vegetables, salad and fruit. I drank herbal tea and fruit juice, and small amounts of decaffeinated coffee. As well as the fresh foods, I had to take vitamins and minerals to help speed up my recovery and to exercise regularly. I had a constant headache for the first week and felt sluggish. Once the first two weeks were over I felt smashing. Within two 206 THE NATURAL HEALTH BIBLE months I was really feeling slim and positive. The bloating disappeared and my breasts were no longer tender. Six years on now I’m still full of energy, my skin looks smooth, my nails no longer split and break, and I no longer have cravings for food. I am two stones slimmer now without dieting, I’m more confident and can honestly say that I feel like a different person, I’m really amazed.’
“Six years on now I’m still full of energy, my skin looks smooth, my nails no longer split and break, and I no longer have cravings for food. I am two stones slimmer now without dieting, I’m more confident and can honestly say that I feel like a different person, I’m really amazed.”
Alison