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Category: Medical
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I am a 45 years old women who has edema problem in both of

Customer Question

I am a 45 years old women who has edema problem in both of my legs. The water retention builds up on my legs (particularly calves area) towards the end of everyday causing the skin to stretch and the legs feeling very heavy and painful. My weight increases about 2 kg at the end of the day, compared to the morning, due to this water retention. The water retention will reduce once I leave the legs up at the end of the day when I sleep.

The problem has been with me for more than 12 months and I have seen several doctors and tried many remedies.

My full body check confirmed that my heart, liver, kidney functions are all normal. I had done the Hormonal test which shows that my progesterone is low. Progesterone cream has been dispensed but there was no improvement after 3 months of usage. Ultrasound has also been done on both legs revealing that the veins are healthy and not the cause of it. Nevertheless, I have done Sclerotherapy in an attempt to treat the veins in both legs.

I have done manual lymphatic drainage massage over 10 sessions which helps immediately but the water retention returns the next day. Compression stockings (Class 1) work fine initially for the first few weeks but does not work anymore. I have also tried taking Green Tea, Dandelion supplements, Dafflon etc but to no avail.

In summary, none of the above has worked except Lasix, which provides only a temporary relief for the symptoms.

Please advise:
- What could be the cause of this?
- What further test I need to do to help determine the cause?
- Any medication or supplement that can help with the situation?
- What type of doctor (specialty) I should consult for my case?
Submitted: 4 years ago.
Category: Medical
Expert:  Dr. Das, MD replied 4 years ago.

Welcome and thank you for your question.

- What is your blood pressure?

- What is your height and weight?

- Are you on any medicines for any cause?
Customer: replied 4 years ago.

Blood Pressure is 100/65

Height / Weight is 1.62cn / 46kg

No, I am not on any other medication.

Expert:  Dr. Das, MD replied 4 years ago.

Thank you for the additional information.

All of the common causes for leg edema has already been ruled out in your case.

But there are two uncommon cause for leg edema in women after the age of 40 years.

One of them is idiopathic edema. Idiopathic means ' of unknown cause'. It is suspected that patients with idiopathic edema appear to have a leak in the capillaries (tiny peripheral blood vessels that connect the arteries with the veins) so that fluid passes from the blood vessels into the surrounding interstitial space. This causes salt retention by the kidneys. So diuterics which prevent salt retention helps in controlling the condition.

The second cause of leg edema where no specific cause can be identified is early pulmonary hypertension. The pulmonary arteries are the arteries which connect the heart to the lungs. Leg edema may be the first symptom of this condition , even when no other features in the heart or lungs can be detected.

Please ask your doctor to run tests like pulmonary funciton tests, a holter ECG, Xrays of the chest and ventilation-perfusion or V/Q scanning to exclude chronic thromboembolic pulmonary hypertension.

A cardiologist will help detect pulmonary hypertension.

I hope this helps.

Customer: replied 4 years ago.

Dear Doc


I have done ECG and Xrays etc on a yearly test, and the doctors are ruling out potential pulmonary hypertension. It appears that idiopathic edema could be a most likely condition.


I would like to know what treatment / surgery / medication / supplements I can take to reduce or treat this?


Also, would there be long term side effects taking Lasix? My doctor is not keen for me to take this as she believes this will cause water loss in the entire body instead of just the legs, which is not ideal.


Expert:  Dr.M.D.Mazumdar replied 4 years ago.

I am Dr.Mazumdar. You have opted out of working with Dr. Das . Would you like me to work with you or would you like to opt him in and continue working with him?
Customer: replied 4 years ago.

I will work with you.


By the way, to clarify, my water retention is mainly in the calves and gets worst through the day. Swelling at my feet is not very serious.

My job is desk bound and I do not need to stand or walk too much.


Let me know if you need more clarifications.

Expert:  Dr.M.D.Mazumdar replied 4 years ago.
Thank you.

It is believed that idiopathic edema may be due to damage to the endothelial layer of the blood vessels by the fluctuating blood sugar level seen in pre-diabetics. It would be a good idea for you to get a GTT done ( Glucose tolerance test).

Another cause for IE is beleived to be due to emotional stress. Stress causes increased output of a hormone known as alsosterone which cna then lead to water retention. So one of the treatments is the use of an anti-anxiety drug. Lifestyle changes and also meditation, listening to soothing music, daily exercise etc can also be relaxing.

Yes, there are side effects to taking Lasix for a long time - it can cause deficiency of potassium, depletion of blood vlume in the blood vessels, muscle cramps, increase in blood sugar etc. it can also lead to a dependency on Lasix. It is not good to be on Lasix for more than 3 weeks.

I hope this helps.
Customer: replied 4 years ago.

Thanks, yes, GTT was done and aldosterone, progesterone tests done. All normal.


I am frustrated as I have done many blood tests and taken different supplements but none work effectively nor found an answer to the cause.


I was hoping that there are stronger supplements that I can use to help with the symptoms. Any recommendations?

Expert:  Dr.M.D.Mazumdar replied 4 years ago.
I am afraid that supplements will not help.

But anti-anxiety medicines like Dextroamphetamine may help to a great extent since idiopathic edema is seen usually in people with emotional stress.

i hope this helps.
Expert:  Shantal-Mod replied 4 years ago.

The Professional has left an answer to your question. Please remember to rate your answer once you are satisfied.

Thank you for your patience,

Expert:  Dr. Phil, MD replied 4 years ago.
Hello. I'm Dr. Phil, licensed and practicing internist. Excellent service is my goal.

Hi do you need help with this question?
Expert:  Shantal-Mod replied 4 years ago.

There is another Professional ready to assist you, please let me know whether you wish to continue or if you would like me to close your question.

Thank you for your patience,