Treatments

This page isn’t pretty, but it’s designed to just be a summary of the treatments available. I’m not here to reinvent the wheel, there’s plenty of info on the web for all of these, and you can find reaserch papers in my research library. 

Food and Nutrition

Focuses on whole foods, fruits, vegetables, and healthy fats while limiting processed foods, sugar, and inflammatory substances.

    • Research Summary: Well-established for overall health benefits, with some evidence suggesting potential benefits for reducing inflammation associated with lipoedema.

  • High in healthy fats, moderate in protein, and very low in carbohydrates.
    • Research Summary: Limited research specifically on lipoedema, but may offer some benefits by improving insulin sensitivity and reducing inflammation.

The Ketogenic Solution for Lymphatic Disorders

By Leslyn Keith, this book is a guide for lymphatic professionals who want to incorporate the ketogenic diet into their practice. It includes the author’s methods and the results of a 2017 study she published.
  • Keto for Lymphoedema and Lipoedema: By Kimmi Katte
  • This eating approach emphasizes protein intake while restricting carbohydrates to help manage blood sugar levels and potentially reduce inflammation.
    • Research Summary: Some evidence suggests potential benefits for weight management, which can be beneficial for some individuals with lipoedema.

A Histamine-Restricted Diet eliminates or limits foods high in histamine, to potentially reduce inflammation and improve symptoms.

    • Research Summary: Limited research specifically on lipoedema, but may be beneficial for some individuals with histamine intolerance. I found enough research linking mast cell activation and histamine issues to lipoedema to convince me that this diet is worth including. It was the hallmark of my own dietary approach and I experienced results within days.

Lymphatic Support

Graduated compression garments that apply varying levels of pressure to the limbs. These come in various ‘strengths’ and generally it’s recommended that patients with lipoedema use Class II medical compression. There’s also a lot of recommendation to use custom ‘flat knit’ compression garments (extremely expensive), but I have done fine with normal round knit. I buy from Amazon for about $30.

    • Research: Well-established for reducing swelling and improving lymphatic drainage.

  • Professional MLD: Specialized massage techniques designed to improve lymphatic flow.
    • Research: Some evidence suggests potential benefits for reducing swelling and improving lymphatic drainage.
  • Self-Massage: Techniques individuals can learn to perform themselves to improve lymphatic flow.
    • Research: Limited research specifically on self-massage for lipoedema, but may offer some benefits when performed correctly.
    • Pneumatic Compression Systems: Devices that use air pressure to massage the limbs, aiding in lymphatic drainage. I love pneumatic compression, particularly after leg day in the gym, it’s so relaxing. But I find that it’s effects only last a couple of days so I rarely book a session.
    • Research Summary: Growing evidence supports their effectiveness in reducing swelling and improving lymphatic flow

    A Histamine-Restricted Diet eliminates or limits foods high in histamine, to potentially reduce inflammation and improve symptoms.

      • Research: Limited research specifically on lipoedema, but may be beneficial for some individuals with histamine intolerance. I found enough research linking mast cell activation and histamine issues to lipoedema to convince me that this diet is worth including. It was the hallmark of my own dietary approach and I experienced results within days.

    Non-surgical treatments

    • Shockwave Therapy: Uses high-energy sound waves to stimulate tissue repair and reduce pain.
      • Research: Limited research specifically on shockwave therapy for lipoedema, but may offer some benefits for pain management
    • Ultrasound Cavitation: Uses ultrasound waves to break down fat cells.
      • Research: Limited research specifically on ultrasound cavitation for lipoedema, and its effectiveness is debated.

    Exercise

    Low impact to protect the joints, and many of these imporve lympatic flow.

    • Trampolining: Low-impact exercise that can improve lymphatic flow and overall fitness.
      • Research: Limited research specifically on trampolining for lipoedema, but may offer some benefits for cardiovascular health and lymphatic function.

    • Vibration Plates: Whole-body vibration therapy that may improve circulation and lymphatic drainage.
      • Research: Limited research specifically on vibration plates for lipoedema, but may offer some benefits for reducing muscle tension and improving circulation.

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    The Role of Physical Exercise as a Therapeutic Tool to Improve Lipedema: A Consensus Statement from the Italian Society of Motor and Sports Sciences (Società Italiana di Scienze Motorie e Sportive, SISMeS) and the Italian Society of Phlebology (Società Italiana di Flebologia, SIF)

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    Skin Care

    Some of these also improve lymphatic flow. [Your content goes here. Edit or remove this text inline or in the module Content settings. You can also style every aspect of this content in the module Design settings and even apply custom CSS to this text in the module Advanced settings].

    • Regular dry brushing can help stimulate circulation and lymphatic drainage.
      • Research: Limited research specifically on dry brushing for lipoedema, but may offer some benefits for skin health and circulation.

    • Keeping the skin hydrated is essential for maintaining skin health and reducing discomfort.
      • Research: Essential for maintaining skin health and preventing dryness and irritation.

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    Surgical Solutions

    The two key surgical options appear to be Tumescent Liposuction and Water Assisted Liposuction (WAL), preferred due to their gentler lymph-sparing approach. One thing I really liked about surgery research was the number of stage 1 and 2 patients included.

    Tumescent liposuction in particular looks to a safe an effective method of treatment that produces better results in younger patients with earlier stage disease compared with more severe disease in older patients.

    Several studies have shown that liposuction significantly reduced sensitivity to pain and pressure as well as the tendency to hematoma.10 Improving mobility after the procedure leads to an increase in energy turnover, which can contribute to further weight loss.8 Several studies describe a significant improvement in the quality of life due to the suction of the pathological fat tissue, which can still be demonstrated eight years after the intervention.10,11

    Traditional liposuction that uses general anesthesia, radio frequencies, ultrasound, or lasers are possibly damaging to the lymphatic vessels, and as such are not an option for Lipedema patients, either. However, Lymph-sparing liposuction is safe, and gentle on the lymphatic system, and the use of local tumescent anesthesia reduces the risk of complications. Generally, the most painful areas should be treated first, starting high on the legs and then moving downward in future surgeries.

    One aspect that I couldn’t find a lot of information about was the likelihood of lipoedema appearing in other parts of the body after a surgery – this is one of the reasons I’m not considering surgery as an option yet.

    • Lymph-sparing liposuction using local tumescent anesthesia appears to be the most effective approach for lipoedema, with significant improvement in pain, quality of life and leg size.

    • Tumescent anesthesia is a special form of local anesthesia in which large amounts of an anesthetic solution (a physiological solution with local anesthetics and epinephrine) are introduced into the subcutaneous adipose tissue. This local anesthesia swells the adipose cells and constricts vessels, and makes large areas of the skin insensitive to pain –  surgical interventions can be carried out without an additional anesthetic procedure.2

    • The effectiveness of liposuction using tumescent anesthesia is based on the fact, that beside subtotal removement of fat, the capillaries, including the well-known leaky vessels in lipedema, can be removed. This results in no, or far less bruises for the patients after the liposuction and leads to the suppression of angiogenesis and subsequently adipogenesis at the cellular level.23,24 That explains the sustainable impact as described by Baumgartner and Schmeller.

    • Examination of adipose tissue using lymphoscintigraphy and immunohistochemistry after liposuction has demonstrated no significant damage to lymphatic vessels using tumescent local anesthesia compared with traditional liposuction techniques using general anesthesia.

    • TL is a safe an effective method of treatment, and the results of therapy are better in younger patients with earlier stage disease compared with more severe disease in older patients.

    Water Assisted Liposuction [WAL, Body Jet Lipo, and Aqua Shape] has also been shown to offer significant improvement of symptoms, mobility and quality of life. Water Assisted Liposuction uses pressurized tumescent solution to dislodge the fat from surrounding connective tissue and vessels. Theoretically, water assisted liposuction should be even gentler than the tumescent liposuction with small cannula. 

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