What causes fluid retention?
Water retention (also known as fluid retention, puffiness, swelling, oedema etc.) affects a large number of women and, to a lesser extent, men. Water retention occurs when the veins and lymph vessels can not effectively remove water from the tissues.
Water retention can manifest occasionally (e.g. in the summer heat and/or if standing for long periods of time) or it may be chronic, and symptoms can range from mild (e.g. cellulite; puffiness typically manifesting on the calves, thighs, hips, arms and face) to severe (medical water retention / lymphedema).
If you are on your feet or sit down all day, you most probably experience leg stiffness and pain, as well as fluid retention. This is due either:
- to tension build up on your calf, thigh and hip muscles
- poor functioning of the leg veins
- inadequate leg lymph drainage.
Your calf, thigh and hip muscle fibres can go into a spasm either due to inactivity (e.g. sitting down all day) or due to continuous, static contraction (e.g. standing up all day). The other two causes of heavy, tired, swollen legs, i.e. lymphatic and vein dysfunction, are caused by several factors, the most important of which are described below.
15 physiological reasons to develop fluid retention
There are several factors that cause water retention, the most important of which being:
- Vein wall / lymphatic vessel wall weakness and fragility: veins walls are partially damaged, and herniate or leak blood into the tissues
- Poor muscle tone of the vein walls: veins walls cannot effectively pump blood upwards
- Valve failure on veins and lymph vessels: vein valves herniate leading to blood or lymph pooling or even flowing downwards
- Low interstitial fluid turnover due to dehydration: tissues hold on to their water due to water scarcity, therefore water doesn't even leave the tissues
- High blood viscosity / coagulation: makes blood flow through small veins and capillaries difficult
- Constipation: obstructs blood and lymph flow in the abdominal area leading blood and lymph pooling on the legs
- Pregnancy: works in the same way as constipation; in addition increases fluid retention of fluid due to excess estrogen production
- Chronic low-grade inflammation: all inflammation by definition increases water retention
- Impact injury: damage to veins and lymph vessels
- Congestive heart failure: the heart cannot process blood fast enough and water is literally dumped in the tissues to reduce heart load (contraindication to lymphatic drainage massage, the heart itself must be treated first)
- Kidney dysfunction: the kidneys retain sodium and water which then accumulates in the tissues
- Post-operative lymph gland removal / other injury to the lymphatics, veins and lymph glands: removed glands call for special techniques to remove excess water from tissues (manual lymph drainage, specialised bandaging)
- Excessive estrogen in the system: causes water retention
- Excessive cortisol in the system: causes water retention
- Albumin (blood protein) shortage: water cannot be carried away from the tissues to the blood due to the lack of this transporting protein
Lifestyle and genetics are responsible for most of the above physical changes that lead to fluid retention
There are several reasons for the deterioration of function and integrity of the lymph vessels and veins.
Heredity (our genes) is one factor we think we cannot affect, but this could not be further from the truth. "Bad" genes usually need bad lifestyle to be expressed, and vice versa, "good" genes need a good lifestyle to be fully expressed. This practically means that you even if you have excellent genes, a poor lifestyle based on stress, inactivity and junk food, will still lead to fluid retention. Or, on the other hand, even you have poor genes, an excellent lifestyle will probably lead to very little or no water retention.
So lifestyle is what turns on or off your good or bad genes. Furthermore, it is the only thing you can change, so instead of blaming your genes try to optimise lifestyle in order not to suffer from water retention.
15 lifestyle factors that typically lead to water retention, switching off "good" genes and turning on "bad" genes
- Lack of blood vessel nourishing nutrients: protein, antioxidants, polyphenols/flavonoids and highly unsaturated fatty acids (HUFAs)
- Toxins, anti-nutrients and inflammation-producing foods that damage the blood and lymph vessels or impair their natural function: saturated fat, oxidised fatty acids, hydrogenated fats, sugar, excessive alcohol and highly processed foods
- Prolonged standing up, sitting down or crossing of the knees
- Food intolerances or allergies that lead to low grade chronic inflammation
- Leaky gut syndrome that allows undigested food particles, bacterial toxins and other substances to enter the circulation and irritate/inflame the lymph and blood vessels
- The contraceptive pill or other hormonal contraception, such as patches, injections etc. that increase blood viscosity and therefore capillary blood flow
- Lack of sleep, that causes vein wall muscular tension and impairs vessel tissue repair
- Inactivity / lack of exercise, essential for lymphatic and vein function; constipation that causes vein and lymph vessel obstruction
- Pregnancy (works in the same way as constipation, but in addition leads to extra fluid retention due to the action of oestrogen)
- Smoking that causes vasoconstriction and blood vessel damage
- Excessive caffeine in the long run leads to low tissue water turnover and therefore toxin and waste product accumulation and poor lymph drainage
- Not drinking enough water has exactly the same effect as excessive caffeine has on your tissues, i.e. poor fluid drainage leading to water retention
- Certain medicines, especially cortisone (corticosteroids), lead to water retention due to their action on the kidney, blood vessels and other tissues of the body
- Chronic stress has the same effect as cortisone drugs, just milder, as it leads to excessive and chronic cortisol release
- Excessive weight puts an enormous pressure on your vessels, as well as contributing to low grade inflammation.
As you can see, with today's unhealthy lifestyle, there are plenty of reasons to develop fluid retention, and therefore it's no wonder that most women suffer from it to a greater or lesser degree. The good news is that, since fluid retention is caused by an unnatural lifestyle, it can also be reduced by following a natural lifestyle and working with natural treatments.
What is the connection between water retention and cellulite?
Most of the factors that cause fluid retention may also cause loss of skin firmness, low-grade inflammation, connective tissue fibrosis and superficial fat accumulation, literally affecting all aspects of cellulite, so usually fluid retention is inherently linked to the problem of cellulite for most women.
Treatments that deal only with water retention (such as lymphatic massage) may not be able to reduce cellulite though, because cellulite is more than water retention. However, a good cellulite treatment should always effectively address fluid retention as well as all the other aspects of cellulite.
20 tips on how to reduce water retention
Some causes of water retention may not be able to be treated, as in the case of congestive heart failure, surgical removal of lymph glands after cancer, or genetic conditions. However, there are several things you can do to address most of the causes of fluid retention:
- The most popular solution to the problem, manual lymphatic drainage (MLD) does help drain the excess lymph from the legs to the upper body and to the heart, but without doing anything to help your body become better at draining that excess fluid itself in the future. So you are left with the need to have weekly treatments year in, year out.
- Normal massage (such as swedish massage, holistic massage etc) and sports massage (also known as deep tissue massage or remedial massage) also help a bit, but they don't directly affect the veins and lymph vessels.
- Lymphatic stimulation massage is stronger than the very mild MLD massage and in addition to help drain excess lymph it also stimulates the lymph and blood vessels, thereby offering a more all-round therapeutic effect
- Keeping your legs elevated when you lie down and sleep is a good idea, as well as putting your legs on a stool when you sit down.
- Wearing compression garments (also known as compression tights or compression socks) offers some temporary help but it is not a good idea to use them in the long term as constant compression inhibits arterial flow and insulates your superficial tissues from mechanical stimulation, so in the long run may cause connective tissue deterioration and blood / lymphatic vessel weakening.
- Applying a gel or cream that contains high concentrations of circulation supporting active ingredients, such as escin, esculoside from horse chestnut extract, ruscogenins from butcher's broom extract, proanthocyanidins from cranberries, centella asiatica / gotu kola extract and polyphenols pine bark extract can be of help.
- The same herbal extracts mentioned above can also be taken internally, in the form of supplements. Several diuretic herbal teas, such as dandelion leaf tea, can also be of help, but their effectiveness is a bit limited.
- Exercising regularly is probably the best thing you can do to reduce water retention. Muscle contraction stimulates your blood and lymph vessel walls to contract rhythmically, thereby boosting lymph flow and venous return (the return of blood to the heart via the veins).
- Swimming in particular helps boost circulation without any of the negative side effects of gravity that can reduce the effectiveness of walking or running on some people.
- Vibration platform training is the best method to support your collagen structures in your body, which include blood vessel walls, not just ligaments, tendons and muscles.
- Cold showers - and especially hot and cold showers - boost circulation, although they should better be confined to the legs only in the winter months to avoid catching a cold. People with cardiovascular disease should also be careful before using hot and cold showers.
- Eating a diet rich in polyphenols, vitamin C and anti-oaxidants - such as berries, cocoa, citrus fruits and vegetables - and oily fish is essential. Oily fish omega-3 highly unsaturated fatty acids (HUFAs) reduce blood coagulation and make your blood vessels more elastic. Vitamin C and polyphenols help support the blood vessel walls and also improve blood vessel contraction. Natural anti-inflammatory phytochemicals (plant chemicals), such as curcumin found in turmeric also help with water retention by moderating inflammation.
- Avoiding sugar, refined carbs and nasty fats (basically fried and hydrogenated fats) is probably the best preventative measure you can take against water retention
- Try to lose weight: the more weight you carry the more difficult it is to drain water from your legs!
- Stop, or at least try to reduce, smoking! Smoking causes damage in your blood and lymph vessel walls, making them less efficient in pumping blood and lymph.
- Drink plenty of water! Two to three litres is ideal for women while for men two to four litres is recommended, depending on body size.
- Consult a good nutritionist if you suffer from constipation or leaky gut syndrome. Milled flax seeds with plenty of water twice a day are ideal for constipation, while strong probiotics (5 billion organisms or more per capsule per day) and 5g of or more per day of glutamine powder can be of immense help with leaky gut syndrome (always consult your doctor or nutritionist first)!
- Avoid alcohol, which worsens water retention, by it's effect on the liver and blood vessels
- Avoid excessive caffeine. One or two cups per day are fine, but seven or 10 cups a day, that some of my patients take, will lead to water retention in the long run.
- Try an elimination diet if you suffer from food intolerances. This involves the elimination of known food that cause intolerance for at least three months, until your immune cells "forget" the offending antigens and the gradual reintroduction of those foods (food allergies can not be eliminated in this way, as the immune response responsible for them is permanent, i.e. the immune cells do not "forget" those antigens). To find out what foods cause you food intolerances you can do a food intolerance blood test, usually provided by nutritionists. BTW, do not fall for the hocus-pocus, misleadingly called "biofeedback" tests, that involve measuring your electrical resistance to homeopathic samples of foods: there is zero evidence to be found on their effectiveness on any peer-reviewed science journal.
By all means, the list above is not exhaustive, but it covers most of the measures you can take to tackle water retention.