Supplements for varicose veins target venous tone, capillary permeability, and inflammation. They're most useful for early-stage symptoms; advanced varicosities typically require sclerotherapy or surgical intervention. No supplement removes varicose veins: the NHS recommends keeping active, raising your legs and, where needed, compression stockings or specialist treatment such as endothermal ablation.
- Horse chestnut seed extract (standardised to aescin; the key trial used 50 mg aescin twice a day): The best-studied option. A Cochrane review found it improves leg pain, swelling and itching in chronic venous insufficiency, and one 12-week trial found it about as effective as compression stockings for lower-leg swelling.
- MPFF (micronised diosmin 900 mg + hesperidin 100 mg a day): The flavonoid combination used in many European vein trials. A Cochrane review of phlebotonics found they probably reduce swelling slightly but make little or no difference to quality of life.
- Red vine leaf extract (360–720 mg a day in trials): Reduced lower-leg volume compared with placebo in a 12-week trial. Grape vine fruit or grape seed extracts are different materials.
- Butcher's broom (with hesperidin methyl chalcone and vitamin C): A meta-analysis of this combination found small reductions in leg pain and heaviness.
- Gotu kola: A review of 8 trials found better microcirculation, but most studies were poorly reported.
- Horse chestnut without aescin standardization (potency varies dramatically)
- Unstandardized herbal blends with unclear doses
- Products claiming to "dissolve" varicose veins — not physiologically possible
- Products replacing compression stocking use for severe venous insufficiency
Extract standardization (especially aescin content in horse chestnut), dose fidelity to European phlebology guidelines, third-party testing, and accurate labeling. Products that overpromise cosmetic improvement of established varicosities score lower.