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Wellness Foods + Supplements 3/2021

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Venous health Another

Venous health Another product that was compared to the effects of Pycnogenol ® on symptoms of CVI patients was an extract of grape leaves (Antistax ® ) (13). Ankle swelling and dermal blood perfusion were significantly more improved after 8 weeks of Pycnogenol ® supplementation in comparison with grape leaf extract supplementation. A 12-month registry study investigated the effects of 9 different products on the symptoms of venous insufficiency (14). Pycnogenol ® , oxerutine (Venoruton ® ), troxerutin, the complex of diosmin and hesperidin (Daflon ® ), Antistax ® , bilberry extract (Mirtoselect ® ), escin, and the combination of Venoruton ® and Pycnogenol ® were compared with elastic compression. The best results regarding edema decrease were observed with elastic compression, Pycnogenol ® , Venoruton ® and the combination thereof. A very common condition that develops during pregnancy are varicose veins, which can occur from weakened or damaged valves in the veins. A 12-month study with women presenting with varicose veins after their second pregnancy compared the use of compression stockings alone or in combination with Pycnogenol ® supplementation (16). Signs and symptoms such as heavy legs, pain while standing, restless legs and bruises were all significantly decreased when co-supplementing with Pycnogenol ® in comparison to use of compression only. Cramps and vein areas, as well as the percentage of symptom-free subjects were decreased more importantly after Pycnogenol ® intake as well. Normalized platelet activity and reduction of thrombotic complications Blood platelet activation and aggregation can lead to the formation of a blood clot and possibly to deep venous thrombosis. In a 6-year follow-up, different managements regarding the development of post-thrombotic syndrome (PTS) and recurrent deep venous thrombosis (r-DVT) were evaluated in patients after a deep venous thrombosis (17). Post thrombotic syndrome is a potential long-term complication of deep venous thrombosis with symptoms of venous insufficiency such as leg pain, leg heaviness, limb swelling, ulcers or skin discoloration (35). The effects of Pycnogenol ® supplementation in combination with elastic compression were compared to compression only, compression together with Aspirin, Ticlopidine and Sulodexide supplementation. Pycnogenol ® showed the safest and most effective results, particularly for post-thrombotic syndrome. compression stockings for one year led to a reduction of the venous pressure of 12.8 %. Regarding edema and thrombosis-related symptoms (pain, restless limbs, subjective swelling, skin alterations), Pycnogenol ® was found to provide greater relief than compression stockings. The results again point to an even better symptom relief after wearing compression stockings and supplementing with Pycnogenol ® in addition. A 12-month study on retinal vein thrombosis could show that Pycnogenol ® supplementation decreased the occurrence of retinal edema and the incidence of new retinal vein thrombosis more importantly than Aspirin (19). Pycnogenol ® showed to lower blood platelet aggregation by increasing the production of endothelial NO (20, 22). In healthy smoking individuals, who have pathologically increased blood platelet activity, Pycnogenol ® has been shown to reduce platelet aggregation to the level of non-smokers after supplementation with Pycnogenol ® for 2 months (20). However, normal platelet function was not further decreased in healthy nonsmokers. A double-blind placebo-controlled study with cardiovascular patients taking aspirin confirmed that Pycnogenol ® intake does not further decrease platelet activity (21). In another study, Pycnogenol ® prevented platelet hyperactivity in heavy smokers but did not influence bleeding time, as compared to a group taking aspirin, in which the time of bleeding was significantly increased from 167 to 236 seconds (22). In addition, Pycnogenol ® supplementation showed to significantly decrease the occurrence of recurrent deep vein thrombosis by 66 % after 6 years. Another one-year study on post thrombotic syndrome investigated the differences in efficiency between Pycnogenol ® supplementation and compression stockings in individuals who suffered a single episode of deep vein thrombosis (18). In these patients, venous pressure was reduced by 8.6 % after one year of Pycnogenol ® supplementation, compared to a reduction of 6.8 % with only compression. The combination of Pycnogenol ® and 18 No. 3 November/December 2021

Venous health Improved microcirculation Impaired valves in the legs of CVI patients cause venous stasis leading to high venous pressure. Microcirculatory capillaries can’t tolerate high hydrostatic pressure and the resulting dysfunctional microcirculation can contribute to tissue damage and ulceration (36-38). Pycnogenol ® has been shown to improve the microcirculation perfusion system (14, 23-27). In several clinical studies the levels of oxygen and carbon dioxide in the tissues under the skin, the diameter of micro vessels in fingernails, as well as the blood flow velocity were measured to investigate the effects of Pycnogenol ® on microcirculation in patients with microangiopathy resulting from chronic artery diseases, diabetes or chronic venous insufficiency (23-27). The increase in diameter of micro vessels at the fingertips was much higher in Pycnogenol ® supplemented patients than in the control group, all suffering from a coronary artery disease (23). Patients with diabetic microangiopathy, who took Pycnogenol ® for 6 weeks had better oxygenized tissues, whereas the carbon dioxide levels were decreased compared with control patients (24). This study suggested that Pycnogenol ® can counteract enhanced capillary filtration leaking by improving microcirculation. Another measure for capillary leaking is the rate of ankle swelling, which was significantly reduced after supplementation with Pycnogenol ® in diabetic patients with microangiopathy (27). Furthermore, in a 12-month comparative study, Pycnogenol ® was shown to significantly improve microcirculation by 43 %, decrease the edema score by 53 % and improve oxygen (+13 %) and carbon dioxide levels (–10 %) in patients with moderate to severe signs and symptoms of CVI, outperforming seven other venoactive products (14). Improved endothelial function One of the key properties of Pycnogenol ® is its effect on endothelial health (28-34). The most important vascular mediator and major cardiovascular signaling molecule in the endothelium, is the nitric oxide (NO). NO contributes to optimal blood flow by relaxing blood vessel walls, when necessary, for a more fluid blood flow. In addition, NO helps prevent blood platelet aggregation, thus reducing the risk of thrombosis (39). Aging or conditions such as hypertension, athero- Pycnogenol ® supplementation in combination with local application showed to support microcirculation and the healing of venous ulcers in CVI patients. Oxygenation, detoxification and nutrient supply were improved after taking Pycnogenol ® , leading to reduced ulcer size by 88 % in 6 weeks, compared to a reduction of 69 % in control patients (25). A healthy microcirculation is tightly connected to vascular permeability and capillary filtration. Pycnogenol ® was demonstrated to improve retinal microcirculation and to help capillary filtration and the resulting edema in a clinical study with diabetic patients suffering from retinopathy (26). Retinal edema, assessed by measuring the retinal thickness, was signifi cantly reduced in patients taking Pycnogenol ® . Trusted Science GELITA AG Uferstr. 7 69412 Eberbach Germany

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