WHY DO MY ANKLES SWELL UP?
Kathleen Gallardo, LMT
As a licensed massage therapist, I frequently see people whose ankles are swollen. Often they are “puffy” all over. I can help them on a short term basis by directing the excess tissue fluid into the lymph system, for filtration and removal. Conversely, I also talk to them about why their body is holding too much water.
Edema is the medical term for “Water Retention”. Dorland’s Medical Dictionary, 25th Ed., defines edema as “the presence of abnormally large amounts of fluid in the intercellular tissue spaces of the body.” The condition is an example of fluid imbalance and may be caused by disturbances in the interchange between blood plasma and interstitial compartments. Translation: the clear liquids of your body are getting stuck in the tissues instead of entering the lymph system for return to the blood.
The clear liquids of your body start their cycle as the plasma part of your blood. Plasma makes up approximately 55% of the volume of your blood and it carries nutrition and hormonal messages to your cells. Plasma leaves the blood when it gets down to the capillary size arteries. At that time, the clear liquids are called Interstitial Fluid (IF). The IF goes in and out of the cell membranes and delivers the nutrition and messages to the cells while picking up waste products of cell metabolism. The Interstitial Fluid is supposed to enter the lymph system and return to the heart. Then, with every pump of the heart, 20% of the blood goes into the kidneys to have the waste products filtered and excreted from the body through urine.
Guyton and Hall’s textbook of Medical Physiology explains 3 reasons for edema:
The adrenal gland may be problematic if you have sodium retention. Each kidney has an adrenal gland sitting on top of it and sending hormonal messages about sodium balance. The hormone aldosterone signals the kidneys to retain sodium and release potassium to your urine to maintain balance. If a miss-communication happens and too much aldosterone is produced, you can retain too much sodium which additionally retains water.
Water retention can be caused by poor function of the heart muscle, such as congestive heart failure. Doctors often look at someone with edema in their ankles and think of heart disease because of this reason. Uncontrolled high blood pressure can also cause be a cause. An important point to remember is that pregnancy can cause ankle swelling as well, but for a different reason.
Perhaps your liver is not producing enough of the protein called albumin. Albumin attracts the Interstitial Fluid to enter the lymph system. Why might your liver fail to produce albumin? Is your liver damaged because of excess alcohol consumption? Is it congested due to poor dietary intake? Do you eat enough quality protein to provide the liver needed raw material to make albumin? Participation in a liver cleanse and alteration of dietary intake may improve function and alleviate this cause.
Retaining water is an indicator of physiological imbalance. This may be modified, or an indication of a greater problem. When you take a diuretic, you are treating a symptom, but not curing the problem. If your ankles swell, if your eyes face, and hands are puffy, you are “retaining water”. If you can press your finger into your skin and a dimple remains, (pitting edema) you are “retaining water.”
For two weeks, cut out alcohol, eat more protein, and take a whole food B-complex vitamin (in the mornings) to assist your adrenal glands. If edema remains, you may need to see an internist for further consideration.
Edema is the medical term for “Water Retention”. Dorland’s Medical Dictionary, 25th Ed., defines edema as “the presence of abnormally large amounts of fluid in the intercellular tissue spaces of the body.” The condition is an example of fluid imbalance and may be caused by disturbances in the interchange between blood plasma and interstitial compartments. Translation: the clear liquids of your body are getting stuck in the tissues instead of entering the lymph system for return to the blood.
The clear liquids of your body start their cycle as the plasma part of your blood. Plasma makes up approximately 55% of the volume of your blood and it carries nutrition and hormonal messages to your cells. Plasma leaves the blood when it gets down to the capillary size arteries. At that time, the clear liquids are called Interstitial Fluid (IF). The IF goes in and out of the cell membranes and delivers the nutrition and messages to the cells while picking up waste products of cell metabolism. The Interstitial Fluid is supposed to enter the lymph system and return to the heart. Then, with every pump of the heart, 20% of the blood goes into the kidneys to have the waste products filtered and excreted from the body through urine.
Guyton and Hall’s textbook of Medical Physiology explains 3 reasons for edema:
- Retention of electrolytes, especially sodium (Na+), in the intracellular fluid as a result of increased aldosterone secretion.
- An increase in capillary blood pressure. Normally, fluid is drawn from the tissue spaces into the venous end of a tissue capillary because of the low venous pressure and the relatively high water pulling force of the plasma proteins. This balance is upset by anything that increases the capillary hydrostatic pressure.
- A decrease in the concentration of plasma proteins.
The adrenal gland may be problematic if you have sodium retention. Each kidney has an adrenal gland sitting on top of it and sending hormonal messages about sodium balance. The hormone aldosterone signals the kidneys to retain sodium and release potassium to your urine to maintain balance. If a miss-communication happens and too much aldosterone is produced, you can retain too much sodium which additionally retains water.
Water retention can be caused by poor function of the heart muscle, such as congestive heart failure. Doctors often look at someone with edema in their ankles and think of heart disease because of this reason. Uncontrolled high blood pressure can also cause be a cause. An important point to remember is that pregnancy can cause ankle swelling as well, but for a different reason.
Perhaps your liver is not producing enough of the protein called albumin. Albumin attracts the Interstitial Fluid to enter the lymph system. Why might your liver fail to produce albumin? Is your liver damaged because of excess alcohol consumption? Is it congested due to poor dietary intake? Do you eat enough quality protein to provide the liver needed raw material to make albumin? Participation in a liver cleanse and alteration of dietary intake may improve function and alleviate this cause.
Retaining water is an indicator of physiological imbalance. This may be modified, or an indication of a greater problem. When you take a diuretic, you are treating a symptom, but not curing the problem. If your ankles swell, if your eyes face, and hands are puffy, you are “retaining water”. If you can press your finger into your skin and a dimple remains, (pitting edema) you are “retaining water.”
For two weeks, cut out alcohol, eat more protein, and take a whole food B-complex vitamin (in the mornings) to assist your adrenal glands. If edema remains, you may need to see an internist for further consideration.
Labels: edema, Gallardo, swelling, water retention
