Edema (also known as dropsy or fluid retention) is swelling caused by the accumulation of abnormally large amounts of fluid in the spaces between the body's cells. It is a symptom rather than a disease or disorder. Widespread, long-term edema can indicate a serious underlying disorder.

These will vary and may include the following.

• Swollen limbs (possibly accompanied by pain, redness, heat)
• Facial puffiness; abdominal bloating
• Shortness of breath, extreme difficulty breathing, coughing up blood
• Sudden change in mental state or coma
• Muscle aches and pains

Imbalance in the body's fluid transfer can be caused by the following.

• Sitting or standing for long periods
• Certain medications
• Hormonal changes during menstruation and pregnancy
• Infection or injury to a blood vessel; blood clots; varicose veins
• Allergies to food or insect bites
• Kidney, heart, liver, or thyroid disease
• High or low blood pressure; high salt intake
• Brain tumor or head injury
• Exposure to high altitudes or heat, especially when combined with heavy physical exertion

Your health care provider will look for varicose veins, blood clots, wounds, or infections. An X ray, computed tomography scan, magnetic resonance imaging, urine test, or blood test may be necessary. Edema caused by organ failure or high altitude sickness may require hospitalization.

Complete decongestive therapy (CDT) involves compression bandages and pressure "sleeves" tightened over swollen limbs to help force fluid through other channels for re-absorption by the body. Other options include a salt-reduction diet, daily exercise, resting with legs elevated above heart level, wearing support hose, and massage.

• Medication for your underlying disorder—consult your provider
• Diuretics—for example, loop diuretics or potassium-sparing diuretics; reduce body fluid levels but also deplete important vitamins and minerals, which can result in loss of bone mass; various other possibly serious side effects
• Morphine—reduces congestion and anxiety with pulmonary edema

Surgery may be required to remove fat and fluid deposits associated with a certain type of edema called lipedema, or to repair damaged veins or lymphatic glands to reestablish lymph and blood flow.

The following nutritional and herbal support guidelines may help relieve edema, but the underlying cause must be addressed.

• Eliminating food allergens from your diet decreases inflammation.
• A low-salt, high-protein diet may help edema. (However, you should not eat a high-protein diet if you have kidney disease.) You should also reduce your intake of sugar and refined carbohydrates.
• If you use diuretics, add more potassium to your diet.
• Natural diuretics: asparagus, parsley, beets, grapes, green beans, leafy greens, pineapple, pumpkin, onion, leeks, and garlic.
• Vitamin B6 (50 to 100 mg per day) is a diuretic. The B vitamin thiamine may be supplemented (200 mg per day).
• Vitamins C (250 to 500 mg two times per day), E (400 to 800 IU per day), and coenzyme Q10 (50 to 100 mg two times per day)
• Potassium aspartate (20 mg per day) if you are using diuretics
• Magnesium (200 mg two to three times per day) and calcium (1,000 mg per day) help maintain fluid exchange in the body.

Herbs may be used as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Teas should be made with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots.

An herbal diuretic is best taken as a cooled tea (4 to 6 cups per day), although a tincture may also be used (30 to 60 drops four times a day). Combine three of these herbs with equal parts of two to three additional herbs from the following categories, as indicated: cleavers (Galium aparine), yarrow (Achillea millefolium), oatstraw (Avena sativa), elder (Sambucus nigra), red clover (Trifolium pratense), and red root (Ceonothus americanus)

For cyclic edema, such as swelling from menstruation:

• Ginkgo (Ginkgo biloba) strengthens the integrity of blood vessels.
• Bilberry (Vaccinium myrtillus) is a gentle diuretic.
• Topical applications of creams containing one or more of the following may help strengthen your blood vessels: horse chestnut (Aesculus hippocastanum), butcher's broom (Ruscus asuleatus), sweet clover (Melilotus officinalis), and rue (Ruta graveolens).

Homeopathy may be useful as a supportive therapy.

• Dry skin brushing. Before bathing, briskly brush the entire skin surface with a rough washcloth, loofa, or soft brush. Begin at your feet and work up. Always stroke in the direction of your heart.
• Cold compresses made with yarrow tea.
• Contrast hydrotherapy involves alternating hot and cold applications. Alternate three minutes hot with one minute cold. Repeat three times to complete one set. Do two to three sets per day.

Acupuncture may improve fluid balance.

Therapeutic massage can assist with lymph drainage.

Excessive fluid retention during pregnancy (toxemia) is potentially dangerous to both you and your baby.

Balch JF, Balch PA. Prescription for Nutritional Healing. Garden City Park, NY: Avery Publishing Group; 1997.

Bartram T. Encyclopedia of Herbal Medicine. Dorset, England: Grace Publishers; 1995:73, 155, 156, 188.

Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Boston, Mass: Integrative Medicine Communications; 1998:424, 425, 429.

Mayo Foundation for Medical Education and Research. Available at http://www.healthanswers.com/

MDX Health Digest. Available at http://www.thriveonline.com/

Mindell E, Hopkins V. Prescription Alternatives. New Canaan, Conn: Keats Publishing Inc; 1998.

Vanderbilt University Medical Center. Available at http://www.mc.vanderbilt.edu/

Weiss RF. Herbal Medicines. Beaconsfield, England: Beaconsfield Publishers, Ltd; 1988:188-191, 241.