Medical Resources

There are many over-the-counter supplements and several medications available by prescription which have been found to aid in the treatment of lipedema.

See Supplements N to Z

See Prescription Savings

More About Supplements

Bad mix: Blood thinners and NSAIDs – Harvard Health Publishing
Caution with these supplements when you have a heavy metal burden – Naturheilpraxis
Dietary Supplement Fact Sheets – National Institutes of Health
Recommended Supplements – Dr. Marcia Byrd
Recommended Supplements and Medications – Dr. Karen Herbst, May 2019
U.S. National Library of Medicine Database – National Institutes of Health

Medications & Supplements to Avoid with Lipedema

Beta blockers are used in the treatment of cardiac health but can cause fluid retention.
Calcium channel blockers are used in the treatment of hypertension but can cause fluid retention.
Clonidine is used in the treatment of hypertension but can cause fluid retention.
Furosemide is used in the treatment of edema but concentrates proteins in interstitial organs, eventually halting fluid flux. Aldactone and hydrochlorothiazide have less adverse effects in women with lipedema.
Gabapentin is used for pain control but can cause fluid retention.
Non-steroidal anti-inflammatory drugs (NSAIDs) are used for pain control but can cause fluid retention.
Oral corticosteroids are used to reduce inflammation but can weaken tissue and cause fluid retention and rebound inflammation. Oral corticosteroids should be used when medically necessary. Nasal or inhaled corticosteroids have less effect on lipedema tissue.
Sex hormones are used for hormone replacement but can cause fluid retention and are implicated to effect the development of lipedema.
Thiazolidinediones are used in the treatment of diabetes but can cause increases in subcutaneous fat tissue and fluid retention.

Herbst, K., (2019, Dec 13). Subcutaneous adipose tissue diseases: Dercum disease lipedema, familial multiple lipomatosis, and Madelung disease. EndoText, 1-46.

Where to Purchase

Beyond Health
Ethical Nutrition
Pure Encapsulations
Woodstock Vitamins

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.


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). DO NOT TAKE AMITRIPTYLINE 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, 75 mg to 150 mg by mouth daily.

Amitriptyline. (2017, Apr 5). Medical News Today.
National Library of Medicine. (2021, Jan 22). Amitriptyline. Medline Plus.
Sinha, S. (2020, Jul 9). Amitriptyline.


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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

Dextroamphetamine (amphetamine salts) recommended by Dr. Karen Herbt, 5 to 60 mg by mouth daily. Phentermine recommended by Dr. Karen Herbst, 15 to 37.5 mg by mouth daily.

Durbin, K. (2020, Dec 28). Amphetamine.
Multum, C. (2021, Jun 30). Dextroamphetamine.
National Library of Medicine. (2021, Jan 22). Amphetamine. Medline Plus.
Newman, T. (2017, Dec 22). Uses and risks of amphetamine. Medical News Today.


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Recommended by Dr. Karen Herbst, 3 gm to 12 gm by mouth daily. Mix 1/4 cup with 2 to 4 tablespoons of lemon or orange juice daily.


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, glipizide and rosiglitazone.

Recommended by Dr. Karen Herbst, 500 mg by mouth two to three times daily.

Berberine. (n.d.). WebMD.
Hill, A. (2020, Aug 6). Berberine. Healthline.
Gunnars, K. (2017, Jan 14). Berberine – A powerful supplement with many benefits. Healthline.
National Library of Medicine. (2021, Jan 29). Berberine. Medline Plus.


(also known as β-hydroxybutyrate, exogenous ketones, ketone salts)

Beta-hydroxybutyrate. (n.d.). WebMD.

Brazil nuts – see Selenium


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Butcher’s broom

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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. (2021, Oct 4).
Butcher’s Broom. (2020, Feb 24). Memorial Sloan Kettering Cancer Center.
Butchers Broom. (n.d.). WebMD.
Wong, C. (2021, Apr 08). What is Butcher’s broom? Very Well Health.

Coenzyme Q10

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Coenzyme Q10 (also known as CoQ10 and ubiquinone) has antioxidant properties that prevent tissue damage.

Recommended by Dr. Karen Herbst, 100 to 600 mg by mouth daily. To minimize adverse effects when taking a dosage greater than 100 mg daily, divide the daily dose into two or three doses.

Bauer, B. (n.d.). Chronic fatigue: Can a natural remedy boost my energy? Mayo Clinic.
Coenzyme Q10. (n.d.).
Eske, J. (2019, Jan 8). What are the benefits of CoQ10? Medical News Today.
National Library of Medicine. (2020, Aug 18). Primary coenzyme Q10 deficiency. Medline Plus.

Conjugated linoleic acid

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Conjugated linoleic acid (CLA) has been shown to decrease the volume of adipocytes (fat cells) and thereby reduce body fat.


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Dandelion root

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Dandelion root supports healthy liver function.

Dextroamphetamine – see Amphetamine


Diosmin is a flavonoid most commonly found in citrus fruits. Flavonoids are plant compounds that have antioxidant properties and protect your body from inflammation and unstable molecules called free radicals. It has been used since 1969 as a natural therapy to treat various venous conditions, such as hemorrhoids, varicose veins, venous insufficiency, leg ulcers, and other circulatory issues.

Diosmin is often combined with micronized purified flavonoid fraction (MPFF), a group of flavonoids that includes disomentin, hesperidin, linarin, and isorhoifolin. Most diosmin supplements contain 90% diosmin with 10% hesperidin and are labeled MPFF. In most cases, the terms “diosmin” and “MPFF” are used interchangeably.

Diosmin may interact with the following medications: anticoagulants, anticonvulsants, antihistamines, muscle relaxants, non-steroidal anti-inflammatory drugs, and acetaminophen and may inhibit various liver enzymes responsible for metabolizing the above medications. This can result in your medications working less effectively and may be dangerous for those with bleeding disorders by preventing proper blood clotting. Diosmin may also interact with certain herbal supplements, including fenugreek, feverfew, garlic, ginger, ginkgo, ginseng, and turmeric, due to their involvement in blood thinning.

Recommended by Dr. Karen Herbst, 500 mg to 900 mg by mouth once or twice daily.

Davidson, K. (2020, Apr 30) Diosmin: Benefits, dosage, side effects, and more. Healthline.
Diosmin. (n.d.) WebMD.

Diosmiplex – see Vasculera

Eleuthro root

Coming soon!
Trace mineral which supports healthy functioning of the adrenal glands.

Exogenous ketones – see Beta-hydroxybutyrate

Fish oil – see Omega-3


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Recommended by Dr. Karen Herbst, 300 to 3600 mg by mouth daily.

Durbin, K. (2020, Jun 7).
Leonard, J. (2018, Nov 14). Gabapentin: What to know. Medical News Today.
National Library of Medicine. (2021, Jan 22). Gabapentin. Medline Plus.

Glitazones – see Thiazolidinediones


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Lipedema patients often have elevated concentrations of protein concentrates. Guaifenesin works by helping to break up coagulated protein in adipose tissue.

Mucinex is a popular brand of guaifenesin, and only Mucinex Expectorant should be purchased for treatment of lipedema. Mucinex DM also contains dextromethorphan, which is a cough suppressant, which affects signals in the brain that trigger the cough reflex. Taking dextromethorphan with MAO inhibitors can cause serious (and possibly fatal) drug reactions. Mucinex Sinus Max contains dextromethorphan and also phenylephrine, which is a vasopressor, which constricts (narrows) blood vessels, thereby increasing blood pressure. Taking phenylephrine with MAO inhibitors can also cause serious drug reactions. Only guaifenesin is necessary to break up protein bonds, so only the guaifenesin component is needed.

In Australia, Giafen is the equivalent of Mucinex. It contains the same ingredients, pharmacological group, and treatment options as analogue and is available at pharmacies.

All salicylates, including aspirin, block the benefits of guaifenesin. Salicylates are readily absorbed through the skin and intestine when introduced from medications and supplements including plants oils, gels and extracts. Patients must screen all medications (prescription, over-the-counter, supplements, vitamins) and every single product applied to the skin, including orally.

Recommended by Dr. Karen Herbst, 600 mg by mouth twice daily. May take up to 2400 mg daily.

Multum, C. (2021, May 19). Phenylephrine.
Durbin, K. (2022, Feb 22). Dextromethorphan.
Guaifenesin. (n.d.). DrugBank Online.
How Mucinex works in treating lipedema. (n.d.). Byrd Aesthetic.
National Library of Medicine. (2021, Jan 22). Guaifenesin. Medline Plus.

Guaifenesin Protocol


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Recommended by Dr. Karen Herbst, 100 mg by mouth daily.

Horse chestnut seed extract

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Horse Chestnut Seed Extract strengthens the lymphatic system, reduces swelling, and helps treat chronic venous insufficiency.

Recommended by Dr. Karen Herbst, 300-450 mg by mouth twice daily.

Per Dr. Herbst, the HCSE gel Venaforce works similarly to the oral form. Apply to affected areas 2 times daily.

Horse chestnut. (2020, Oct). National Center for Complementary and Integrative Health.
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.


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Recommended by Dr. Karen Herbst, 125 to 500 mL by mouth daily.

Ketone salts – see Beta-hydroxybutyrate


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Recommended by Dr. Karen Herbst, 50 to 75 mg by mouth three times daily (up to 300 mg daily) or 200 mg extended-release form by mouth daily.

National Library of Medicine. (2021, Jan 22). Ketoprofen. Medline Plus.


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Recommended by Dr. Karen Herbst, instill 1 drop into eye twice daily.

National Library of Medicine. (2021, Jan 22). Ketotifen opthalmic. Medline Plus.


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Recommended by Dr. Karen Herbst, 3 grams three times daily, mixed in water.

National Library of Medicine. (2021, Jan 29). L-arginine. Medline Plus.


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Recommended by Dr. Karen Herbst; drinking the juice of one lemon in water daily.

“A highly-effective way to detoxify the body is to drink two 16-ounce glasses of water on an empty stomach after you wake up, squeezing half of a freshly cut lemon into each glass. The lemon juice activates the water, making it better able to latch onto toxins in your body and flush them out. This is especially effective for cleansing your liver, which works all night while you’re asleep to gather and purge toxins from your body. When you wake up, it’s primed to be hydrated and flushed clean with activated water. After you drink the water, give your liver half an hour to clean up. You can then eat breakfast. If you make this into a routine, your health will improve dramatically over time. For an extra boost, add a teaspoon of raw honey and a teaspoon of freshly grated ginger to the lemon water. Your liver will draw in the honey to restore its glucose reserves, purging deep toxins at the same time to make room.”

― Anthony William, Medical Medium: Secrets Behind Chronic and Mystery Illness and How to Finally Heal


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For mast cell disorder.


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Recommended by Dr. Karen Herbst, no more than 350 mg by mouth daily.

Bauer, B. (n.d.). Chronic fatigue: Can a natural remedy boost my energy? Mayo Clinic.
Hill, A. (2019, Nov 21). 10 interesting types of magnesium. Healthline.
National Institutes of Health. (2020, Sep 25). Magnesium. Office of Dietary Supplements.
National Library of Medicine. (2021, Feb 8). Magnesium deficiency. Medline Plus.


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Dr. Herbst uses metformin to lower inflammation and break up fibrosis.

Milk Thistle

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Milk thistle supports healthy liver function.


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Mucinex – see Guaifenesin

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