There are many over-the-counter supplements and several medications available by prescription which have been found to aid in both inflammation and lymph flow. This content is presented for information only and is not prescribed. Please consult with your physician or other health provider before taking supplements.
Index of Supplements A-F
Acetylcysteine — see N-acetylcysteine
Alpha-lipoic acid
Amitriptyline
Amphetamine
Arnica
Ashwagandha
Astragalus
Barley
Berberine
Boswellia
Brazil Nuts — see Selenium
Bromelain
Butcher’s broom
Capsaicin
Coenzyme Q10
Conjugated linoleic acid
Curcumin
Dandelion root
Dextroamphetamine — see Amphetamine
Diindolylmethane (DIM)
Dimethyl sulfoxide (DMSO)
Diosmin
Diosmiplex (Vasculera)
Eleuthro root
Epigallocatechin gallate (EGCG)
Fish oil — see Omega-3
Prescription Savings Programs
Supplements G-M
Supplements N-Z
Research
Al-Wardat, M., Alwardat, N., Lou De Santis, G., Zomparelli, S., et al. (2021). The association between serum vitamin D and mood disorders in a cohort of lipedema patients. Hormone Molecular Biology and Clinical Investigation.
Cannataro, R., & Cione, E. (2022). Nutritional supplements and lipedema: Scientific and rational use. Nutraceuticals.
Flores, T., Kerschbaumer, C., Jaklin, F., Glisic, C., et al. (2024). High-volume liposuction in lipedema patients: Effects on serum vitamin D. Journal of Clinical Medicine.
Zmitek, K., Zmitek, J., Hristov, H., Rogl Butina, M., et al. (2024). The effects of dietary supplementation with collagen and vitamin C and their combination with hyaluronic acid on skin density, texture and other parameters: A randomised, double-blind, placebo-controlled trial. Nutrients.
About Supplements in the US
US supplements are poorly standardized, often contaminated, usually not evidence based, and unregulated. Herbs and other supplements are not required to meet standards of safety, efficacy, and consistency, and their use has important implications for clinical care. The continuing availability of such products in the United States results in large part from the 1994 Dietary Supplement and Health Education Act, which created a protective new category for the approximately 20,000 vitamins, minerals, herbs, and other agents sold as supplements before October 1994. Spurred by supplement industry lobbying, the act protects supplements from government scrutiny and mandates that the US Food and Drug Administration prove harm before distribution of a product can be regulated.
Cassileth, B., & Vickers, A. (2005). High prevalence of complementary and alternative medicine use among cancer patients: Implications for research and clinical care. Journal of Clinical Oncology.
Which brands are good?
I’m always stumped as to which brands of supplements to select. There are so many, and are they good? I never know. So I searched for “multivitamins” and combined a list from what I consider good sources, and those are listed below. Others’ lists were not in any way identical, so I left those out. The same brands kept popping up, and these are listed below.
Amazon Elements
FullWell
Future Kind
Garden of Life
HUM Nutrition
Klean Athlete
HUM Nutrition
Life Extension
MegaFood
Nature Made
New Chapter
Nordic Naturals
NOW
Olly
Ora Organic
Persona Nutrition
Pure Encapsulations
Ritual
SmartyPants
Thorne
Ajmera, A., & McGrane, K. (2024). 11 best vitamin brands in 2024, chosen by experts and tested by our staff. Healthline.
Burdeos, J. (2024). Best vitamin brands of 2024, according to experts. Forbes Health.
Fletcher, J., Iavarone, S., & Zorzan, N. (2024). 12 best vitamin brands and how to choose. Medical News Today.
Kane, T. (2024). The 10 best vitamin brands of 2024. Verywell Fit.
Pflugradt, S. (2023). The top 5 vitamin brands you can trust. Livestrong.
Learn More
Bad mix: Blood thinners and NSAIDs | Harvard Health Publishing
Cancer therapy interactions with foods and dietary supplements — Health professional version | National Cancer Institute
Cancer therapy interactions with foods and dietary supplements — Patient version | National Cancer Institute
Caution with these supplements when you have a heavy metal burden | Naturheilpraxis
Dietary supplement fact sheets | National Institutes of Health
Ginger should be avoided when taking certain medications or having certain health conditions | Healthy and Natural World
Prostate cancer, nutrition, and dietary supplements — Health professional version | National Cancer Institute
Prostate cancer, nutrition, and dietary supplements — Patient version | National Cancer Institute
Recommended supplements and medications PDF | Dr. Karen Herbst, May 2019
U.S. National Library of Medicine Database | National Institutes of Health
Acetylcysteine — see N-acetylcysteine
Alpha-lipoic acid
Alpha-lipoic acid is an antioxidant that fights free radicals. It is particularly useful to lipedema and lymphedema patients because it is both water-soluble and fat-soluble, so it can work effectively throughout the body.
Supports mitochondrial health.
Research
Liu, R., Huang, S., Shi, H., Chang, S., et al. (2022). Alpha-lipoic acid protects against aortic aneurysm and dissection by improving vascular smooth muscle cell function. Web MD. Life Sciences.
Alpha-lipoic acid: Uses, side effects, and more. (n.d.). Web MD.
Nicolson, G. (2014). Mitochondrial dysfunction and chronic disease: Treatment with natural supplements. Integrative Medicine.
Amitriptyline
Amitriptyline [brand names ELAVIL, ENDEP, VANATRIP] is available by prescription and belongs to a class of drugs called tricyclic antidepressants. It is prescribed for depression and is also used to treat eating disorders, post-herpetic neuralgia (burning, stabbing pains or aches after shingles infections), and to prevent migraine headaches. It works on the central nervous system to increase the levels of certain chemical messengers (neurotransmitters) that communicate between brain cells and help regulate mood. It is usually taken one to four times a day and should be taken exactly as directed at around the same time(s) every day.
Amitriptyline can cause dizziness and drowsiness during the first few hours after you take it. The most common side effects can include: confusion, numbness and tingling in the arms and legs, headache, nausea, constipation or diarrhea, dry mouth, blurred vision, skin rash, swelling of the face and tongue, and unexpected weight gain or loss. Serious side effects can include heart attack (symptoms of chest pain, shortness of breath, pain or pressure in the chest or upper body), stroke (symptoms of weakness in one part or side of the body, slurred speech), seizures, withdrawal (symptoms of headache, nausea, trouble sleeping, depression, mood swings), increases or decreases in blood sugar, suicidal thoughts or actions, and orthostatic hypotension (sudden drop in blood pressure when standing). AMITRIPTYLINE SHOULD NOT BE TAKEN AFTER A RECENT HEART ATTACK.
Taking certain drugs with amitriptyline may cause serious side effects. These drugs should not be taken within 14 days of taking amitriptyline: cisapride [PROPULSID], monoamine oxidase inhibitors (MAOIs), including isocarboxazid [MARPLAN], linezolid [ZYVOX], methylene blue injection, phenelzine [NARDIL], selegiline [ELDEPRYL, EMSAM, ZELAPAR], tranylcypromine [PARNATE], and rasagiline [AZILECT], which can lead to seizures or even death, and quinidine [QUINIDEX], which can increase the amount of amitriptyline in your body, leading to dangerous side effects. Taking amitriptyline with other certain drugs raises your risk of the negative side effects: topiramate [TOPAMAX, QUDEXY XR, TOPIRAGEN, TROKENDI XR], cimetidine [TAGAMET], anticholinergic drugs (diphenhydramine [BENADRYL, BANOPHEN, ZZZQUIL], oxybutynin [DITROPAN], solifenacin [VESICARE], olanzapine [ZYPREXA]), neuroleptic drugs (clozapine [CLOZARIL, FAZACLO, CLOPINE], risperidone [RISPERDAL], haloperidol [HALDOL]), disulfiram [ANTABUSE], guanethidine [ISMELIN], ipratropium [ATROVENT], medications for irregular heartbeats such as flecainide [TAMBOCOR] and propafenone [RYTHMOL], phenobarbital [BELLATAL, SOLFOTON], and selective serotonin reuptake inhibitors (SSRIs) such as citalopram [CELEXA], fluvoxamine [LUVOX], paroxetine [PAXIL], sertraline [ZOLOFT], and fluoxetine [PROZAC, SARAFEM]. Consuming alcohol while taking amitriptyline raises your risk of serious side effects, including extreme drowsiness.
If amitriptyline is suddenly discontinued, withdrawal side effects such as depression, nausea, headache, and tiredness can occur. In order for amitriptyline to work well, a certain blood level is required to be maintained at all times. Symptoms of an overdose include: irregular heart rhythm, severely low heart rate, convulsions, hallucinations, confusion, and stiff muscles.
Recommended by Dr. Karen Herbst at 75 mg to 150 mg by mouth daily.
Amitriptyline. (2024). Drugs.com.
Amitriptyline. (2022). Medical News Today.
Amitriptyline. (2021). Medline Plus. National Library of Medicine.
Amphetamine
Sympathomimetics like amphetamine or phentermine binds to adrenergic receptors that induce lipolysis. Adrenergic receptors are located on lymphatic and blood vessels.
Amphetamine salts [brand names ADDERALL, MYDAYIS] and dextroamphetamine [brand names DEXEDRINE, PROCENTRA, ZENZEDI, DEXTROSTAT, LIQUADD]
Dextroamphetamine is a central nervous system stimulant and affects chemicals in the brain and nerves that contribute to hyperactivity and impulse control. It is used to treat narcolepsy and attention deficit hyperactivity disorder.
Dextroamphetamine should not be taken in the presence of glaucoma, overactive thyroid, severe agitation, moderate to severe high blood pressure, heart disease or coronary artery disease, or a history of drug or alcohol addiction. This medicine may be habit-forming and is a drug of abuse. CNS stimulants have caused stroke, heart attack and sudden death in people with high blood pressure, heart disease or heart defect.
These drugs should not be taken within 14 days of taking dextroamphetamine: monoamine oxidase inhibitors (MAOIs), including isocarboxazid [MARPLAN], linezolid [ZYVOX], methylene blue injection, phenelzine [NARDIL], selegiline [ELDEPRYL, EMSAM, ZELAPAR], tranylcypromine [PARNATE], and rasagiline [AZILECT].
Call your doctor right away if you have: signs of heart problems–chest pain, feeling light-headed or short of breath; signs of psychosis–paranoia, aggression, new behavior problems, seeing or hearing things that are not real; signs of circulation problems–unexplained wounds on your fingers or toes.
Some medicines can interact with dextroamphetamine and cause a serious condition called serotonin syndrome. Be sure your doctor knows if you also take opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson’s disease, migraine headaches, serious infections, or prevention of nausea and vomiting. Ask your doctor before making any changes in how or when you take your medications.
Stimulants have caused stroke, heart attack, and sudden death in certain people. Tell your doctor if you have:
heart problems or a congenital heart defect;
high blood pressure; or
a family history of heart disease or sudden death.
To make sure this medicine is safe for you, tell your doctor if you or anyone in your family has ever had:
depression, mental illness, bipolar disorder, psychosis, or suicidal thoughts or actions;
motor tics (muscle twitches) or Tourette’s syndrome;
seizures or epilepsy;
an abnormal brain wave test (EEG); or
blood circulation problems in the hands or feet.
amphetamine salts
phentermine
Phentermine recommended by Dr. Karen Herbst at 15 mg to 37.5 mg by mouth daily.
Amphetamine. (2023). Drugs.com.
Amphetamine. (2021). Medline Plus. National Library of Medicine.
Newman, T. (2017). Uses and risks of amphetamine. Medical News Today.
Arnica
Ashwagandha
Research
An overview on ashwagandha: A rasayana (rejuvenator) of ayurveda | N. Singh, M. Bhalla, P. de Jager and M. Gilca (2011)
About Ashwagandha
Health benefits of ashwagandha, based on research | Healthline
Astragalus
About Astragalus
Astragalus | National Institutes of Health
Barley
Berberine
Berberine has been shown to lower blood sugar, cause weight loss and improve heart health, to name a few.
Berberine is a bioactive compound that can be extracted from several different plants, including a group of shrubs called Berberis. It belongs to a class of compounds called alkaloids. It has a yellow color and has often been used as a dye.
Berberine has a long history of use in traditional Chinese medicine, where it was used to treat various ailments.
Many studies show that berberine can significantly reduce blood sugar levels in individuals with type 2 diabetes.
Berberine seems to work via multiple different mechanisms: 1) it decreases insulin resistance, making the blood sugar lowering hormone insulin more effective; 2) it increases glycolysis, helping the body break down sugars inside cells; 3) it decreases sugar production in the liver; 4) it slows the breakdown of carbohydrates in the gut; and 5) it increases the number of beneficial bacteria in the gut. According to a big review of 14 studies, berberine is as effective as oral diabetes drugs, including metformin [GLUCOPHAGE, GLUMETZA, RIOMET], glipizide [GLUCOTROL], and rosiglitazone [AVANDIA].
Recommended by Dr. Karen Herbst at 500 mg by mouth two to three times daily.
Berberine. (2024). Medline Plus. National Library of Medicine.
Berberine: Uses, side effects, and more. (n.d.). WebMD.
Gunnars, K. (2017). Berberine: A powerful supplement with many benefits. Healthline.
Hill, A. (2020). What is berberine? Healthline.
Boswellia
Boswellia is another potent anti-inflammatory agent. Clinical trials have demonstrated its effectiveness in reducing pain and improving physical function in osteoarthritis patients. Boswellia extracts have been compared favorably with standard NSAID treatments in terms of efficacy, with fewer side effects.
Brazil nuts — see Selenium
Bromelain
About Bromelain
Bromelain | National Center for Complementary and Integrative Health
Butcher’s broom
Butcher’s broom contains flavonoids that treat chronic venous insufficiency as well as reduce welling in the legs.
Recommended by Dr. Karen Herbst.
Butcher’s broom. (2023). Drugs.com.
Butcher’s broom. (2020). Memorial Sloan Kettering Cancer Center.
Butcher’s broom. (n.d.). Web MD.
Wong, C. (2021). Verywell Health. What is butcher’s broom?
Capsaicin
Capsaicin, the active component in chili peppers, is used in topical creams to reduce pain. It works by depleting substance P, a neuropeptide involved in pain transmission. Clinical studies have shown that capsaicin cream can be effective in reducing pain in conditions like osteoarthritis and neuropathic pain.
Coenzyme Q10
Coenzyme Q10 (also known as CoQ10 and ubiquinone) has antioxidant properties that prevent tissue damage.
_____
CoQ10 is a compound whose job is to help cells generate energy. Although you can find it in supplement form at the store or online (more on that later), it is naturally produced by the body.
Your body stores this compound in the mitochondria of your cells. The mitochondria use CoQ10 to generate energy (ATP) and protect cells from damage and disease.
Unfortunately, however, as you age, the production of CoQ10 declines. It also declines with chronic stress, toxin exposures, and certain medications. The decreased amount of CoQ10 in your cells contributes to the gradual loss of energy that most of us experience in our thirties and beyond.
If you think you are deficient in Coenzyme Q10—and if you are in your thirties or older, you’re probably right—you can increase your intake through both choosing CoQ10-rich foods and high-quality supplementation.
There are a number of foods that are high in the compound, including
Organ meats like heart, liver, and kidney
Wild-caught cold-water fish like trout, herring, and mackerel
Vegetables like spinach, cauliflower, and broccoli
Fruits like strawberries and oranges
Nuts and seeds
Even with a healthy diet, however, it can be hard to get all of the nutrients you need through food alone. If you want to beef up your CoQ10 intake, consider taking a high-quality supplement. When it comes to dosage, I find most people do well with between 100mg and 200mg daily.
There are a few cases where taking CoQ10 supplements could be risky—for instance, people on blood thinners or thyroid medication. Always check with your doctor or Functional Medicine practitioner before starting a supplement or if you have questions or concerns about taking any supplement.
Sources:
https://pubmed.ncbi.nlm.nih.gov/25791371/
https://pubmed.ncbi.nlm.nih.gov/24586567/
Supports mitochondrial health.
About Coenzyme Q10
Coenzyme Q10 | National Center for Complementary and Integrative Health
Coenzyme Q10 — Health professional version | National Cancer Institute
Coenzyme Q10 — Patient version | National Cancer Institute
Bauer, B. (n.d.). Chronic fatigue: Can a natural remedy boost my energy? Mayo Clinic.
Coenzyme Q10. (2023). Drugs.com.
Eske, J. (2019). What are the benefits of CoQ10? Medical News Today.
Nicolson, G. (2014). Mitochondrial dysfunction and chronic disease: Treatment with natural supplements. Integrative Medicine.
Primary coenzyme Q10 deficiency. (2020). Medline Plus. National Library of Medicine.
Conjugated linoleic acid
Conjugated linoleic acid (also known as CLA) has been shown to decrease the volume of adipocytes (fat cells) and thereby reduce body fat.
Curcumin
About Curcumin
Curcumin (curcuma, turmeric) and cancer — Health professional version | National Cancer Institute
Curcumin (curcuma, turmeric) and cancer — Patient version | National Cancer Institute
Dandelion root
Dandelion root supports healthy liver function.
About Dandelion Root
Dandelion | National Center for Complementary and Integrative Health
Dextroamphetamine — see Amphetamine
Diindolylmethane (DIM)
About Diindolylmethane (DIM)
Health benefits of DIM | Web MD
Dimethyl sulfoxide (DMSO)
About Dimethyl sulfoxide (DMSO)
Sari, E., Bakar, B., Dincel, G. C., & Budak Yildiran, F. A. (2017). Effects of DMSO on a rabbit ear hypertrophic scar model: A controlled randomized experimental study. Journal of plastic, reconstructive & aesthetic surgery : JPRAS, 70(4), 509–517. https://doi.org/10.1016/j.bjps.2017.01.006
Diosmin
Plants contain a large number of flavonoids, and diosmin, a flavone glycoside, is a flavonoid found in citrus fruits. Diosmin was first found in 1925 in the wort plant and has since been used as a natural treatment for hemorrhoids, varicose veins, venous insufficiency, leg ulcers, and other circulatory issues.
The most commonly-used and widely-studied venoactive drug (VAD) is micronized purified flavonoid fraction (MPFF), which has found to be effective at all stages of chronic venous disease (CVD). It has been shown to significantly reduce leg pain and leg heaviness and swelling, as well as ankle edema and functional discomfort. Experiments employing animal models of CVD have demonstrated that MPFF has anti-inflammatory and venotonic effects at the microvalve level.
Diosmin is a VAD that works on blood vessels in a variety of ways to improve circulation. It improves lymphatic drainage and microcirculation–as well as venous tone and suppleness. It is often used to improve vascular health and in the treatment of chronic venous insufficiency and hemorrhoids when combined with other flavonoids, particularly hesperidin.
Because of its characteristics, diosmin is a good therapeutic treatment for a variety of disorders. It has antioxidant and anticancer characteristics and scavenges oxygen free radicals, lowering oxidative stress levels–it reduces oxidative stress by altering the activity of particular enzymes and promotes apoptosis in a variety of cancer cell lines via several ways. Diosmin also has anti-diabetic and mild anti-bacterial properties. It has the ability to lower the levels of numerous inflammation markers and helps alleviate the consequences of diabetes, such as neuropathy and dyslipidemia.
Recommended by Dr. Karen Herbst, 500 mg to 900 mg by mouth once or twice daily.
“The complex diosmin + hesperidin (90% diosmin and 10% other flavonoids expressed as hesperidin) has also been widely studied; it appears to be less powerful and effective than Venoruton® [oxerutins] and pycnogenol in patients with chronic venous insufficiency; it is definitely less potent than pycnogenol alone and needs a dosage some 10 times higher than pycnogenol.”
— From the research paper Management of varicose veins and chronic venous insufficiency in a comparative registry with nine venoactive products in comparison with stockings.
Belcaro, G., et al. (2017). Management of varicose veins and chronic venous insufficiency in a comparative registry with nine venoactive products in comparison with stockings. The International Journal of Angiology.
Davidson, K. (2020). Diosmin: Benefits, dosage, side effects, and more. Healthline.
Diosmin. (n.d.) Drugs.com.
Diosmin. (n.d.) Healthline.
Diosmin. (n.d.) National Library of Medicine.
Diosmin. (n.d.). WebMD.
Huwait, E., and Mobashir, M. (2022). Potential and therapeutic roles of diosmin in human diseases. Biomedicines.
Diosmiplex [Vasculera]
Vasculera [diosmiplex] is a prescription medical food containing purified diosmin (MPFF), a high-quality ingredient that has been designated “generally recognized as safe” (GRAS), the highest standard of safety. Diosmin (MPFF) is a flavonoid isolated from hesperidin, found in citrus, that restores the body’s microcirculatory balance.
Recommended by Dr. Karen Herbst.
Save on Vasculera. $132 for 3 months’ supply.
Primus Care Direct is a hassle-free, mail-order pharmacy service where patients can get their Vasculera prescription for $49 for a 30-day supply or $132 for a 90-day supply ($44 per month), Medicare patients included. This is the lowest possible price available and includes free home delivery. If you have insurance coverage for prescription medical foods, you may pay even less. Vasculera Prescribing Information
Blink Pharmacy Plus also offers a discount on Vasculera.
Eleuthro root
Trace mineral which supports healthy functioning of the adrenal glands.
Eleuthro. (2022). Medline Plus. National Library of Medicine.
Epigallocatechin gallate (EGCG)
Supports mitochondrial health.
Brownstein, A. (2024). EGCG: One of green tea’s most prominent antioxidants. Verywell Health.
Hill, A. (2024). Epigallocatechin gallate: Benefits, dosage, and safety. Healthline.
Mokra, D., Joskova, M., & Mokry, J. (2022). Therapeutic effects of green tea polyphenol (‒)-epigallocatechin-3-gallate (EGCG) in relation to molecular pathways controlling inflammation, oxidative stress, and apoptosis. International Journal of Molecular Sciences.
Nagle, D., Ferreira, D., & Zhou, Y. (2006). Epigallocatechin-3-gallate (EGCG): Chemical and biomedical perspectives. Phytochemistry.