Many women who have lipedema are diagnosed with the following conditions, as they are found very often to accompany lipedema.
Can’t find what you’re looking for? Have info to add to the site?
Want to add your story or write about a subject related to lipedema to educate others?
Please contact me today. Sharing our collective knowledge greatly benefits our community. There are many ways to get involved.
The site is constantly being updated. Thanks for your patience!
Chronic Venous Insufficiency
Chronic venous insufficiency (CVI) is a condition that occurs when the venous wall and/or valves in the leg veins are not working effectively, making it difficult for blood to return to the heart from the legs. CVI causes blood to “pool” or collect in these veins.
Veins return blood to the heart from all the body’s organs. To reach the heart, the blood needs to flow upward from the veins in the legs. Calf muscles and the muscles in the feet need to contract with each step to squeeze the veins and push the blood upward. To keep the blood flowing up, and not back down, the veins contain one-way valves.
CVI occurs when these valves become damaged, allowing the blood to leak backward. Valve damage may occur as the result of aging, extended sitting or standing or a combination of aging and reduced mobility. When the veins and valves are weakened to the point where it is difficult for the blood to flow up to the heart, blood pressure in the veins stays elevated for long periods of time, leading to CVI.
Signs of CVI are present in 20% of patients with lipedema, known as phlebolipedema. Swelling in patients with chronic venous insufficiency is not symmetrical and indents with pressure. In addition, patients’ legs develop a rust-like stain on their inner ankles as well as dry skin and a rash known as eczema. The combination of lipedema, chronic venous insufficiency and lymphedema is known as phlebolipolymphedema.
Impaired lymphatics tax lipedema patients’ venous circulation. Weak capillaries.
CVI can impair the outcome of surgery due to fluid retention, and many surgeons recommend correction of dysfunctional veins prior to liposuction.
Skin care is important for patients with lipedema complicated by lymphedema or chronic venous insufficiency. Regular application of moisture creams avoids dry skin, thus reducing the risk of infection (cellulitis).
Purified horse chestnut seed extract contains escin (aescin). Escin appears to promote blood circulation through the veins and thereby reduce swelling and inflammation of the legs. It is believed that escin works by “sealing” leaking capillaries, improving the elastic strength of veins, preventing the release of enzymes that damage the blood vessels, and blocking other various physiological events that lead to vein damage.
Ruscogenin, one of the major constituents of the plant Butcher’s broom, has demonstrated anti-inflammatory effects. It also contains other saponins which cause constriction of arteries and veins. Clinical studies revealed efficacy of butcher broom extracts in controlling lymphedema and chronic venous insufficiency.
Butcher’s Broom. (2020, February 24). Memorial Sloan Kettering Cancer Center. https://www.mskcc.org/cancer-care/integrative-medicine/herbs/butcher-broom
Canning, C., & Bartholomew, J. (2018). Lipedema. Vascular Medicine 2018, Vol. 23(1) 88–90.
Chronic Venous Insufficiency. (n.d). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/16872-chronic-venous-insufficiency-cvi
Underland, V., Saeerdal, I., & Nilsen, E. (2012). Cochrane summary of findings: Horse chestnut seed extract
for chronic venous insufficiency. Global Advances in Health and Medicine, Vol. 1(1) 122-123.
Wong, C. (2021, April 08). What is Butcher’s broom? Very Well Health. https://www.verywellhealth.com/butchers-broom-for-chronic-venous-insufficiency-89426
More About Chronic Venous Insufficiency
Chronic Venous Insufficiency – Dr. Thomas Wright
Chronic Venous Insufficiency and Lipedema – Dr. Lindy McHutchison
Diet for Venous Insufficiency: How to Manage Venous Insufficiency – Fatty Liver Disease
Interaction of Veins and Lymphatics with Lipedema – Dr. Thomas Wright
Understanding Lipedema and Venous Insufficiency – Dr. Thomas Wright
This product was recently forward to me. Endocalyx Pro helps optimize the structure of the capillaries, which allows them to exchange oxygen and carbon dioxide, nutrients and waste more efficiently. PLEASE NOTE: This is not an endorsement for this product, and this site has no relationship to this product.
National Human Genome Research Institute (2012, June 27). About Dercum Disease. https://www.genome.gov/Genetic-Disorders/Dercum-Disease
More About Dercum’s Disease
Adiposis Dolorosa – Genetic and Rare Diseases Information Center
Adiposis Dolorosa (Dercum’s Disease) – Medscape
Dercum’s Disease Resources – Dercum’s Resources
Dercum’s Disease White Paper PDF – Dr. Karen Herbst
Learn more about EDS at the Ehlers-Danlos Society.
National Human Genome Research Institute (n.d.). Ehlers-Danlos Syndrome.
Yew, K., Kamps-Schmitt, K., & Borge, R. (2021, Apr 15). Hypermobile Ehlers-Danlos Syndrome and hypermobility spectrum disorders. American Family Physician. 2021 Apr 15;103(8):481-492. https://www.aafp.org/afp/2021/0415/p481.html
More About Ehlers-Danlos Syndromes
Diagnostic Criteria for Hypermobile Ehlers-Danlos Syndrome (hEDS) PDF – The Ehlers-Danlos Society
Ehlers-Danlos Support UK
Ehlers-Danlos Syndrome: A Multidisciplinary Approach PDF – J. Jacobs, et al
Ehlers-Danlos Syndromes Healthcare Providers’ Education – Chronic Pain Partners
Ehlers-Danlos Syndromes New Zealand
Gastrointestinal Symptoms in EDS – Dr. Adam Farmer VIDEO – The Ehlers-Danlos Society
How to Assess Joint Mobility Using the Beighton Score PDF – The Ehlers-Danlos Society
Living with ADHD, EDS, and HSD – Dr. James Kustow VIDEO – The Ehlers-Danlos Society
Nutritional, Therapeutic Strategy for Ehlers–Danlos Syndrome – Chronic Pain Partners
The School Toolkit for Joint Hypermobility Syndrome and Ehlers-Danlos Syndromes – The School Toolkit
Should There be an Increased Focus on Lipedema, the Lymphatic System, and Adipose Tissue Fibrosis in Ehlers-Danlos Syndrome, Fibromyalgia and ME/CFS? – Health Rising
Vereniging Ehlers-Danlos Patienten
See Additional Therapies
More About Fibrosis
10 Things Individuals With Lymphedema Need to Know About Fibrosis PDF – Lymphatic Education and Research Network
Lipedema And The Relationship To Both Fascia And Inflammation – Schierling Chiropractic
Dr. Herbst recommends Tirosint levothyroxine sodium thyroid medication capsules.
Hashimoto’s disease. (n.d.). Mayo clinic. https://www.mayoclinic.org/diseases-conditions/hashimotos-disease/symptoms-causes/syc-20351855
More About Hashimoto’s Thyroiditis
The fat pads which develop as the disease progresses cause our gaits to change. Per research by Dr. Josef Stutz, patients usually develop a valgus gait to compensate for the fat pads. Some of us, however, develop a varus gait due to especially enlarged fat pads medially to the knees.
This creates wear on our joints, to the point that hips, knees and ankles are adversely affected, even going as far as to cause meniscal and ligamental tears. Add to that the weight of the lip nodules and lymph fluid caught within the tissues combined with affected joints, and mobility is adversely affected in late stages.
A functional capacity evaluation (FCE) evaluates an individual’s capacity to perform work activities related to his or her participation in employment. The FCE process compares the individual’s health status, and body functions and structures to the demands of the job and the work environment. An FCE’s primary purpose is to evaluate a person’s ability to participate in work, although other instrumental activities of daily living that support work performance may also be evaluated. FCEs are usually conducted by occupational therapists, based on their education and training.
The FCE may be used to determine:
– Goals for rehabilitation or readiness for discharge planning
– Ability to safely return to work status
– Work ability status for vocational rehabilitation
– Workers’ compensation case settlement
– Disability status
– Ability to meet job demands as part of a hiring process
– Ability to meet the demands of other activities
The components of the FCE will vary based on the purpose of the assessment. The FCE typically begins with a client interview, medical record review, and musculoskeletal screening. Functional testing may include graded material-handling activities such as lifting, carrying, pushing, and pulling; and positional tolerance activities such as sitting, standing, walking, balancing, reaching, stooping, kneeling, crouching, crawling, object handling/manipulation, fingering, hand grasping, and hand manipulation. Pain monitoring is frequently performed during the FCE to document client-reported levels of pain during various activities as well as to manage pain. The FCE may also include evaluation of an individual’s hand dexterity, hand coordination, endurance, and other job-specific functions.
The FCE report includes an overall physical demand level, a summary of job-specific physical abilities, a summary of performance consistency and overall voluntary effort, job match information, adaptations to enhance performance, and treatment recommendations, if requested. FCEs are done on a one-on-one basis and may range in length from 4 to 6 hours. The FCE may take place over 2 consecutive days.
Functional Capacity Evaluation. (n.d.). American Occupational Therapy Association. https://www.aota.org/about-occupational-therapy/professionals/wi/capacity-eval.aspx
Stutz, J., & Wald, S. (2011, Jan). Liposuction of lipedema to prevent later joint complications. Vasomed, 23, 2-6.
More About Joint Misalignment
Liposuction of Lipedema to Prevent Later Joint Complications PDF – Dr. Josef Stutz
How Lipedema Can Cause Mobility Issues – Dr. Thomas Wright
Lower Extremity Functioning Scale PDF – Emory Healthcare
The Physical and Emotional Effects of Lipedema VIDEO – Dr. Josef Stutz
Mast Cell Activation Syndrome
MCAS is a condition in which the patient experiences repeated episodes of the symptoms of anaphylaxis – allergic symptoms such as hives, swelling, low blood pressure, difficulty breathing and severe diarrhea. High levels of mast cell mediators are released during those episodes. The episodes respond to treatment with inhibitors or blockers of mast cell mediators. The episodes are called “idiopathic” which means that the mechanism is unknown – that is, not caused by allergic antibody or secondary to other known conditions that activate normal mast cells. Learn more about MCAS at the Mast Cell Disease Society.
The itchiness which accompanies using vibration plates is usually lymph fluid being fluidized from fast twitch muscle contraction. To remedy this, try off-plate muscle contraction (lower then upper body) to move lymph to exit the body, such as chair squats or leg lifts or swings, then wall or counter pushups or planks.
Antihistamines are a class of agents that block histamine release from histamine-1 receptors and are mostly used to treat allergies or cold and flu symptoms. Histamine-1 receptors are located in the airways, blood vessels and gastrointestinal tract (stomach and esophagus). Stimulation of these receptors can lead to conditions such as a skin rash or inflammation, a narrowing of the airways (bronchoconstriction), hay fever, or motion sickness. Histamine-1 receptors are also found in the brain and spinal cord, and stimulation of these receptors makes you more awake and alert. Sedating antihistamines oppose the effects of histamine on H1 receptors in your brain, which is why they cause sedation and drowsiness.
Histamine-1 receptors are located in the airways, blood vessels and gastrointestinal tract (stomach and esophagus). Stimulation of these receptors can lead to conditions such as a skin rash or inflammation, a narrowing of the airways (bronchoconstriction), hay fever, or motion sickness. Histamine-1 receptors are also found in the brain and spinal cord, and stimulation of these receptors makes you more awake and alert. Sedating antihistamines oppose the effects of histamine on H1 receptors in your brain, which is why they cause sedation and drowsiness.
Antihistamines can be classified into two main categories: first-generation and second-generation. First-generation antihistamines were developed more than seventy years ago. They act on histamine receptors in the brain and spinal cord and in the rest of the body (called the periphery). They also act on muscarinic, alpha-adrenergic, and serotonin receptors. This means that first-generation antihistamines are more likely to cause side effects such as sedation, dry mouth, dizziness, low blood pressure, and a rapid heart-beat. They are also more likely than second-generation antihistamines to impair a person’s ability to drive or operate machinery. Second-generation antihistamines were developed in the 1980s and are much less sedating. They act on histamine-1 receptors in the periphery and are unlikely to penetrate the brain. Most second-generation antihistamines do not cause drowsiness.
First-generation antihistamines include: brompheniramine (Bromax, Lodrane), carbinoxamine maleate (Karbinal ER), chlorpheniramine (Chlor-Trimeton), clemastine (Tavist), diphenhydramine (Benadryl), hydroxyzine (Atarax, Vistaril), and triprolidine (Tripohist). Second-generation antihistamines include: azelastine nasal spray (Astelin), cetirizine (Zyrtec), desloratadine (Clarinex), fexofenadine (Allegra), levocetirizine (Xyzal), loratadine (Alavert, Claritin), and olopatadine nasal spray (Patanase).
Another way to control histamine is through H2 blockers in the gut. Histamine stimulates cells in the stomach lining to make hydrochloric acid. H2 blockers bind to histamine receptors in the stomach, reducing the amount of acid that the lining secretes, and therefore lessening allergic symptoms. There are several on the market: cimetidine (Tagamet), nizatidine (Axid, Tazac), and famotidine (Pepcid).
Once formed, histamine is broken down by an enzyme called diamine oxidase (DAO) in the digestive tract. Digestive issues such as leaky gut and gluten intolerance or any other inflammatory process in the gut simply adds to the inability to breakdown dietary histamine since deficiencies in DAO and/or methyl groups also increases symptoms of histamine intolerance.
In April 2020, the Food and Drug Administration requested that all forms of ranitidine (Zantac) be removed from the U.S. market. They made this recommendation because unacceptable levels of NDMA, a probable carcinogen, were present in some ranitidine products.
Conners, K. (n.d.). High histamine food list for your histamine-free diet. Conners Clinic. https://www.connersclinic.com/high-histamine-foods-list
Fookes, C. (2019, February 5). Antihistamines. Drugs.com. https://www.drugs.com/drug-class/antihistamines.html
Mast cell activation syndrome. (n.d.). American Academy of Allergy, Asthma & Immunology. https://www.aaaai.org/conditions-and-treatments/related-conditions/mcas
Villines, Z. (2020, January 27). What to know about H2 blockers. Medical News Today. https://www.medicalnewstoday.com/articles/h2-blockers#types
Dempsey, T. (2022, April 28). Vitamin D: A fresh perspective. Dr. Tanian Dempsey. https://www.drtaniadempsey.com/post/vitamin-d-a-fresh-perspective
SAMe supplements mast cell stabilizer?
Sources of Histamine
Avoid from these high histamine foods: alcohol (fermented beverages, especially wine, champagne and beer), avocados, chickpeas, most citrus fruits, cured meats (bacon, hot dogs, luncheon meats, pepperoni, salami), dried fruit (apricots, dates, figs, prunes, raisins), eggplant, fermented foods and drinks (kefir, kombucha, sauerkraut, soy sauce, vinegar, yogurt), matured cheeses (asiago, banon, bleu, brandaske, camembert, castelo branco, cheddar, emmentaler, gouda, goat cheese, gorgonzola, gruyere, parmigiano), mushrooms, nuts (cashews, peanuts, walnuts), pickled or canned foods, processed meats, ready meals, salty snacks, shellfish, smoked meat products (anchovies, ham, mackerel, mahi-mahi, sardines, salami, sausages, tuna), soured foods (buttermilk, soured bread, sour cream, sour milk), soy beans, spinach, sweets (with preservatives and artificial colorings), tofu, tomatoes, vinegar-containing foods (mayonnaise, olives, pickles), and yeast products. Overripe fruits and refrigerated leftovers also contain high levels of histamine due to the face that bacteria produce excess histamine.
Histamine liberators are foods that themselves are low in histamines. However, they help release histamines in other foods and are good to limit in your diet: additives (benzoate, food dyes, glutamate, nitrites, sulfites), beans, chocolates and cocoa, citrus fruits (kiwi, lemon, lime, pineapple, plums), nuts, papaya, tomatoes, and wheat germ.
Diamine oxidase (DAO) blockers are foods that have the ability to prevent diamine oxidase enzymes from breaking down histamine in your body. Consider removing these from your diet as well: alcohol, black tea, energy drinks, green tea, and mate tea. It should be noted that N-acetylcysteine is also a DAO inhibitor.
Quercetin is a mast cell stabilizer. Cilantro, basil, thyme, ginger, onion, mangosteen, and nigella sativa are natural H1 blockers. Holy basil and ginger are natural H2 blockers.
For people with MCAS, the stabilizing influence of vitamin D is essential. While it is difficult in many cases to determine the exact cause of MCAS, vitamin D deficiency may play a role. Without the soothing signals from vitamin D to calm mediator production, mast cells are vulnerable to inappropriate activation and chronic release of inflammatory and allergic mediators.
What are the Dangers of Chelated Copper Supplements?
Supplements for Histamine Intolerance
Histamine Intolerance: Methylation, the Gut, and Copper
DAO Deficiency and Histamine
Medications That Cause Histamine Intolerance Symptoms
Zinc Depletion and Histamine Intolerance
What Are Chelated Minerals, and Do They Have Benefits?
Histamine Intolerance (Closed for Privacy) – Facebook
Epinephrine Injection Savings Offers
Amedra Adrenaclick epinephrine injection auto-injector (EpiPen alternative)
Amneal generic epinephrine injection auto-injector (EpiPen alternative) Savings Coupon
Kaleo Auvi-Q epinephrine injection auto-injector (EpiPen alternative) Savings Offer and Patient Assistance Program
Mylan EpiPen epinephrine injection auto-injector Savings Programs
More About Mast Cell Activation Syndrome
3 Easy Steps to Clean Histamine from Your Body – Conners Clinic
12 Tips for Living With Mast Cell Activation Syndrome – Dr. Bruce Hoffman
The Best MCAS Supplements & Diet: 3 Steps to Calm a Flare – Dr. Lauryn Lax
Healing Histamine Blog – Healing Histamine
Histamine Hack: Here’s How to Safely Eat Fermented Foods – Body Ecology
Mast Cell Activation Syndrome Can Present as Depression, Anxiety, or Brain Fog – Psychology Today
Mast Cell Activation Syndrome Questions Answered – Dr. Tania Dempsey
Mast Cell Activation Syndrome: Symptoms and Solutions – Dr. David Jockers
The Mast Cell Disease Society COVID-19 Statement – The Mast Cell Disease Society
Nambudripad Allergy Elimination Techniques – NAET
Natural Treatments for Mast Cell Activation Syndrome – Hoffman Centre
Salicylate Sensitivity Food Guide – Salicylate Sensitivity
What is the Best Antihistamine for Itching? – Walrus
What is Histamine? – Healing Histamine
What is Histamine Intolerance and How Can You Address It? – Mast Cell 360
What to Eat (and NOT eat!) with Mast Cell Activation Syndrome – Going Beyond Low Histamine Lists – Mast Cell 360
When to Suspect MCAD – Oh Twist
More About Meralgia Paresthetica
Meralgia Paresthetica – Mayo Clinic
Nonalcoholic Fatty Liver Disease
More About Nonalcoholic Fatty Liver Disease
Choline – WebMD
Are Choline and Inositol Helpful for Fatty Liver Disease? – Fatty Liver Disease.com
Choline – National Institutes of Health
Choline – Its potential role in nonalcoholic fatty liver disease and the case for human and bacterial genes PDF – J. Sherriff, T. O’Sullivan, C. Properzi, J. Oddo, & L. Adams
Choline metabolism provides novel insights into nonalcoholic fatty liver disease and its progression PDF – K. Corbin & S. Zeisel
Choline’s role in maintaining liver function – New evidence for epigenetic mechanisms PDF – M. Mehedint & S. Zeisel
The Lipedema Diet: Foods to Eat and Foods to Avoid If You Have Lipedema – Fatty Liver Disease
Nonalcoholic Fatty Liver Disease – Johns Hopkins Medicine
Nonalcoholic Fatty Liver Disease – Mayo Clinic
Unfortunately, there are so many ways in which lip patients have pain. Many patients have what is termed “painful fat” due to the lipedema nodules which have developed under the skin; this causes the skin to be painful to the touch and is caused by poor lymphatic flow, the primary cause for lipedema, and therefore the buildup of fluid pressing on nerves.
Chronic venous insufficiency (see above) frequently accompanies lipedema and creates a lot of pain for patients, and a vein exam would be a good recommendation for those patients experiencing pain. Joint deformities (see above) are also a possibility in those patients in the later stages who have painful joints; due to the lack of diagnosis or treatment at an early stage, this is an unfortunate and very real occurrence in many patients, whose joints have been adversely affected due to years of improper gait and the weight of advancing lipedema tissue development.
Ehlers-Danlos syndromes (see above) are another comorbidity frequently seen in lipedema patients.
Need shoes with good support? Have plantar fasciitis? Heel spurs? Sesamoiditis? Foot pain? Try these recommended shoes and/or insoles: Asics. Brooks. Fit Flops. Hoka. Keen Footwear. Kenkoh Massage Sandals. Marlou Shoes. New Balance. Ryka Shoes. San Antonio Shoes. Saucony. Superfeet Insoles. Taos Footwear. Vionic Shoes.
Postural Orthostatic Tachycardia Syndrome
Postural orthostatic tachycardia syndrome. (n.d.). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/16560-postural-orthostatic-tachycardia-syndrome-pots
Postural orthostatic tachycardia syndrome. (n.d.). Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/conditions-and-diseases/postural-orthostatic-tachycardia-syndrome-pots
National Institutes of Health. (n.d.). Postural orthostatic tachycardia syndrome. Genetic and Rare Diseases Information Center. https://rarediseases.info.nih.gov/diseases/9597/postural-orthostatic-tachycardia-syndrome
More About Postural Orthostatic Tachycardia Syndrome
Postural Tachycardia Syndrome WEBINARS REQUIRES MEMBERSHIP TO VIEW – Ehlers-Danlos Support UK
Excess lipedema fat on the buttocks, hips, thighs and lower legs changes the gait of women with lipedema, resulting in stress on the joints, especially the knees, often causing knock knees, an antalgic gait (an abnormal pattern of walking secondary to pain that ultimately causes a limp), and overpronation of the feet. These issues can be caused, enhanced, and exacerbated by hypermobility (see the sections Ehlers Danlos Syndromes and Joint Misalignment above).
Sesamoiditis is an inflammation of the sesamoid bones in the ball of the foot and the tendons they are embedded in. It is a specific kind of tendonitis which occurs in the ball of the foot. The tendons in the ball of the foot have small sesamoid bones embedded in them, and these bones can become inflamed along with the tendons. The two pea-sized sesamoid bones sit under the big toe joint, where they provide leverage when the tendons load weight onto the ball of the foot.
Sesamoiditis is usually caused by overuse of the tendons that interact with the sesamoid bones in the foot. People who have very high arches or very flat feet or who walk with an inward roll (overpronation) can get it just from walking. Rarely, it can also be a side effect of gout. Symptoms can include pain under the big toe, difficulty bending the big toe, difficulty bearing weight or walking, swelling, redness, and bruising.
Avoid sesamoiditis by wearing comfortable shoes and custom orthotics, especially with high arches or flat feet. Orthotic footwear can help deflect pressure away from the big toe joint (see the section Pain above, Need shoes with good support?).
Sanchez-De la Torre, Y., Wadeea, R., Rosas, V., & Herbst, K. (2018). Lipedema: friend and foe. Hormone molecular biology and clinical investigation, 33(1).
More About Sesamoiditis
Sesamoiditis – Cleveland Clinic
Benign paroxysmal positional vertigo
Wilson Temperature Syndrome
Golden, S. (2018, August 22). Wilson’s temperature syndrome vs. hypothyroidism: The difference and why it matters. Natural Healthcare Solutions. https://drseangolden.wordpress.com/2018/08/22/wilsons-temperature-syndrome-vs-hypothyroidism-the-difference-and-why-it-matters/
Ross, D., & Lee, S. (2019, April). Wilson temperature syndrome. Hormone Health Network. https://www.hormone.org/diseases-and-conditions/wilsons-temperature-syndrome
More About Wilson Temperature Syndrome
More About Comorbidities
4 Reasons BMI is Dangerously Flawed – Dr. Thomas Wright
Lipedema Fat and BMI – Dr. Thomas Wright & Dr. Karen Herbst
Medical Gaslighting: How to Recognize It and What to Do About It – Thrive with Hives
Relative Fat Mass Explained & Calculator – MD App