A Mediterranean shrub whose underground parts contain compounds that tighten vein walls and appear to make small blood vessels less leaky. Its clearest effect is relief of the daily burden of failing leg veins: heaviness, aching, tiredness, tingling and evening swelling. Measured swelling falls modestly. The underlying disease does not change. Well tolerated; most evidence used a three-ingredient product. (Full Review)
| Marker | Target | Why |
|---|---|---|
| Alanine aminotransferase | <25 U/L (men), <20 U/L (women) | Detects the rare reported liver injury |
| Aspartate aminotransferase | <25 U/L | Contextualises any alanine aminotransferase rise |
| Fasting glucose | 75–86 mg/dL | Baseline for metabolic decompensation in diabetes |
| Glycated haemoglobin | <5.4% | Tracks average glucose over the prior 3 months |
| Potassium | 4.0–4.5 mmol/L | The published ketoacidosis case involved high potassium |
| High-sensitivity C-reactive protein | <1.0 mg/L | Inflammatory load tracks with vein disease severity |
| Ankle circumference | No established target; ≥0.5 cm reduction at 12 weeks vs own evening baseline | The primary objective measure of treatment effect |
Cadence: Ankle circumference and symptom ratings at baseline, 4 and 12 weeks; liver enzymes at baseline and 8 weeks; daily glucose for the first fortnight in diabetes; then annual liver enzymes and 6-monthly limb reassessment.