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Oct-Dec 2012: Medication and Nutrition

Lymphlink Question Corner - Archived from Oct-Dec 2012

By:  Marcia Beck, ACNS-BC, CLT-LANA, Truman Medical Centers, Kansas City, MO

Q: Is there a special diet that can help reduce the swelling from my lymphedema?

A: There has been more interest in nutrition with chronic conditions, including lymphedema, however there is not a specific “diet” identified in reducing the swelling in lymphedema. 

Being overweight or obese has long been thought to increase the risk for lymphedema, or make the treatment of lymphedema more difficult. There are not many strong research studies regarding nutrition and lymphedema, and most reports are done with upper extremity, breast cancer survivors. However, there are a few studies, such as the Iowa Women’s Health Study (Ahmed, R; et al, 2011), which identify that obesity, worse general health, and more advanced cancer were associated with lymphedema and related arm symptoms in breast cancer survivors. Ridner and Dietrich’s study of self-reported comorbid conditions (2008 Oncology Nursing Forum) identify that approximately 35% of study participants with lymphedema reported three or more comorbid conditions, with obesity, hypertension and arthritis the most frequently reported. 

Obesity has become a national health issue, affecting more chronic conditions such as heart disease and diabetes. So, in addition to benefiting lymphedema treatment and management, strategies to promote weight loss, such as physical activity and healthy eating may have other health benefits and improve a person’s quality of life.

The NLN recently updated the Position Paper on Lymphedema Risk Reduction Practices (May 2012), which is available on our website. It is stated that “we encourage people to maintain a normal body weight, and seek professional help to lose weight” (www.lymphnet.org/pdfDocs/nlnriskreduction.pdf). With increasing interest in this topic, we hope to bring more articles about diet and weight management to upcoming LymphLink issues.

Q: Isn’t there a medication that can cure or treat lymphedema?

A: Just as there is no simple ‘blood test’ to diagnose lymphedema, there is no ‘magic’ drug or medication made to treat lymphedema. Diuretic medications, or ‘water pills’, have sometimes been recommended but are not effective in lymphedema treatment, and could actually make the lymphedema worse. It is important to note, however, that diuretics may be needed for other conditions, such as heart failure or high blood pressure. If you have been on medications for other conditions and are diagnosed with lymphedema, you should not stop taking diuretics or any of your medications until you check with your physician or health care provider (HCP). 

You may have heard of medications that cure or treat lymphatic filariasis. Filariasis is caused by parasitic worms that survive in human hosts. This disease is usually found in tropical areas of the world. There are about 120 million people affected in approximately 80 countries. This disease is transmitted when a mosquito bites an infected person and then goes on to bite/infect others. The worms live and grow in the lymphatic system, causing damage resulting in lymphedema, elephantiasis and frequent inflammation and infection of the lymph vessels. The goal of these drugs is to eliminate the parasitic worms, so the transmission of the disease by mosquitoes can be interrupted. 

In 1997, the World Health Assembly (WHA) adopted a resolution to eliminate lymphatic filariasis as a public health problem. Donations of medications from the two major drug companies resulted in more than 1.9 billion treatments provided. This has been a great public health achievement. The World Health Organization is working toward elimination of lymphatic filariasis by 2020. 

Some people do not think of dietary supplements or things that can be purchased without a prescription as medications, and often do not report taking supplements or natural products to their physician or HCP. With increased information available via the World Wide Web, many products are promoted as ‘natural treatments or remedies’. Unfortunately, these products have not been well researched, and are not controlled by the Food and Drug Administration to ensure safety and dosage standards. Many of these products can interfere with prescribed medications; it is important that you inform your physician or HCP of all supplements and over the counter (OTC) medications you are or considering taking. 

The NLN’s Position Paper on “The Diagnosis and Treatment of Lymphedema” clearly states that lymphedema should not be treated exclusively with medications or dietary supplements. This document also provides more details of medication (pharmaceutical) approaches, including a review of supplements, beginning on page 9 of that document www.lymphnet.org/pdfDocs/nlntreatment.pdf.

marcia [dot] beck [at] tmcmed [dot] org (marcia [dot] beck [at] tmcmed [dot] org)