The arteries supplying the legs with blood may become seriously blocked in advanced stages of ]]>atherosclerosis]]> (commonly, if somewhat incorrectly, known as hardening of the arteries). This can lead to severe, crampy pain when you walk more than a short distance because the muscles are starved for oxygen. This condition is called intermittent claudication. The intensity of intermittent claudication is often measured in the distance a person can walk without pain.

Conventional treatment for intermittent claudication consists of measures to combat atherosclerosis, the drug Trental (pentoxifylline), and other medications. In advanced cases, surgery to improve blood flow may be necessary.


Principal Proposed Natural Treatments

A number of natural treatments may be helpful for intermittent claudication, but it isn't clear whether it is safe to combine them with the medications that may be prescribed at the same time. Medical supervision is definitely necessary for this serious disease.


Many, but no all, studies support the effectiveness of ginko for intermittent claudication. According to 9 double-blind, placebo-controlled]]> trials, ginkgo can significantly increase pain-free walking distance, ]]>1,34]]> presumably by increasing circulation.

One study enrolled 111 patients and followed them for 24 weeks. ]]>2]]> Participants were measured for pain-free walking distance by walking up a 12% slope on a treadmill at 2 miles an hour. At the beginning of treatment, both the placebo and ginkgo (120 mg) groups were able to walk about 350 feet without pain. At the end of the trial, although both groups had improved (the power of placebo is amazing!), the ginkgo group had improved significantly more, showing about a 40% increase in pain-free walking distance as compared to only a 20% improvement in the placebo group.

Similar improvements were also seen in a double-blind, placebo-controlled trial of 60 individuals who had achieved maximum benefit from physical therapy. ]]>3]]>

Taking a higher dose of ginkgo may provide enhanced benefits in intermittent claudication. A 24-week, double-blind, placebo-controlled study of 74 individuals found that ginkgo at a dose of 240 mg per day was more effective than 120 mg per day. ]]>4]]>

However, not all studies have been positive. In another randomized trail involving 62 individuals (averaging 70 years of age), 300 mg of ginko per day was no better than placebo at improving pain-free walking distance over 4 months of treatment. ]]>35]]>

For more information, including dosage and safety issues, see the full ]]>Ginkgo]]> article.


The vitamin-like substance L-carnitine also appears to be of some benefit in intermittent claudication. Although it does not increase blood flow, carnitine appears to increase walking distance by improving energy utilization in the muscles. ]]>5]]>

A 12-month, double-blind, placebo-controlled trial of 485 individuals with intermittent claudication evaluated the potential benefits of a special form of carnitine called propionyl-L-carnitine. ]]>6]]> Participants with relatively severe disease showed a 44% improvement in walking distance as compared to placebo. However, no improvement was seen in those with mild disease. Benefits were seen in most, but not all, other studies using L-carnitine or propionyl-L-carnitine. ]]>7-16]]>

For more information, including dosage and safety issues, see the full ]]>Carnitine]]> article.

Inositol Hexaniacinate

The supplement inositol hexaniacinate, a special form of vitamin B 3 , appears to be helpful for intermittent claudication. Double-blind studies involving a total of about 400 individuals have found that it can improve walking distance for people with intermittent claudication. ]]>17-20]]> For example, in one study, 100 individuals were given either placebo or 4 g of inositol hexaniacinate daily. ]]>21]]> Over a period of 3 months, participants improved significantly in the number of steps they could take on a special device before experiencing excessive pain.

For more information, including dosage and safety issues, see the full ]]> Vitamin B 3]]> article.


Mesoglycan is a substance found in many tissues in the body, including the joints, intestines, and the lining of blood vessels. A 20-week, double-blind, placebo-controlled trial that enrolled 242 individuals evaluated the effects of mesoglycan in intermittent claudication. ]]>28]]> Significantly more participants in the mesoglycan group responded to treatment (defined as a greater than 50% improvement in walking distance) than in the placebo group. For more information, including dosage and safety issues, see the full article on ]]>Mesoglycan]]> .


Other Proposed Natural Treatments

The supplement arginine]]> has been tried for treatment of intermittent claudication. A couple of poorly designed studies had suggested benefit. ]]>29,30]]> However, the most recent, largest, and best-designed trial not only failed to find arginine effective, the results suggested that arginine can actually increase symptoms of intermittent claudication. ]]>32]]>

Various antioxidants have been suggested for the treatment of intermittent claudication. However, a double-blind, placebo-controlled trial of 1,484 individuals with intermittent claudication found no benefit from vitamin E (50 mg daily), beta-carotene (20 mg daily), or a combination of the two. ]]>27]]>

According to a few studies performed in Cuba, the sugarcane-derived substance ]]>policosanol]]> is helpful for intermittent claudication. ]]>22, 23, 31]]> Numerous other Cuban studies reported that sugarcane policosanol lowers cholesterol. However, all these studies were performed by a single set of researchers, and they are financially connected to the product. Several independent studies that attempted to replicate the cholesterol related results failed to find benefit. For this reason, all claims associated with policosanol are in doubt.

See the full ]]>Policosanol]]> article for more information.

One small study found weak preliminary evidence that ]]>lipoic acid]]> might improve symptoms in intermittent claudication. ]]>33]]>


Herbs and Supplements to Use Only With Caution

Various herbs and supplements may interact adversely with drugs used to treat intermittent claudication. For more information on this potential risk, see the individual drug article in the Drug Interactions]]> section of this database.