Today, we are going to talk about a paper that came out of the University of Calabria in Italy by Roberto Cannataro and Erika Cione. The paper is titled, Nutritional Supplements and Lipedema: Scientific and Rational Use. It was published in the journal Nutraceuticals in September 2022.
This review paper aims to explore the evidence of various supplements that may have a favorable impact on the management of lipedema symptoms.
Why Explore Supplements?
The inflammatory aspect of lipedema increases pain and other symptoms that make this condition difficult to manage and requires a multifaceted approach, in which supplements may play a vital role. The authors discuss how lipedema treatments can be very expensive and, in some countries, the burden of the majority of the cost is placed on the patient. If supplements are found to be effective, this may be a less costly option for many women.
The authors discuss how supplementation has become more popular of late, largely due to the improved marketing of products to the general public. Unfortunately, limited oversight and poor regulation can lead to inferior products and improper usage which may result in failure to realize the promised effects at best and serious adverse events at worst. Therefore, the authors have attempted to present and summarize what is said about supplements in the scientific literature about how they may benefit characteristics or symptoms of lipedema.
What do the authors recommend?
The authors recommend supplements that are strongly supported in the literature and suggest that supplements with weaker evidence are worth exploring. The authors also state those supplements that they do not recommend using. All of their recommendations can be found in an easy reference table along with suggested dosages. It is highly recommended that you consult with your healthcare provider before taking any supplements to make sure there won’t be any unfavorable interactions with other medications you are taking or other conditions you may have.
The authors report that the evidence is strong for the use of Vitamin C due to its anti-oxidant effects and its action that may improve the building of collagen. These biochemicals may be helpful in reducing inflammation as well as supporting connective tissue deficits that may be present in lipedema. The authors used Vitamin C in conjunction with a ketogenic diet in a case report with a patient with lipedema with favorable results.
Omega 3 Fatty Acids
Supplementation with omega-3 fatty acids, specifically DHA and EPA is recommended by the authors due to the strength of evidence. This essential nutrient has been shown to be highly effective in reducing inflammation and pain as well as improving the health of adipocytes (fat cells) in obese subjects. The authors also used this supplement in the case report I referred to earlier. The foods highest in DHA and EPA are marine sources, including fish and algae, but added supplementation may be helpful for lipedema.
Polyphenols also have an anti-oxidant action and may be beneficial for lipedema. There are over 8,000 polyphenols that can be found in both plant and animal-sourced foods. The highest levels are found in plants, but it will be important to make sure that you tolerate other chemicals that are also found in a particular food source of polyphenols. The highest levels of polyphenols are found in berries, cocoa, coffee, tea, and certain spices such as turmeric.
Although not studied specifically in its use with lipedema, diets rich in polyphenols along with supplementation with this nutrient have been shown to manage pain and inflammation in other conditions such as osteoarthritis, rheumatoid arthritis, and polycystic ovary syndrome. For this reason, the authors place this supplement in the weaker evidence category, but worth exploring by individual patients.
Although Vitamin D has multiple actions that may benefit the management of lipedema symptoms, there has not been any study specifically on its use for lipedema. This may still be a valuable supplement to take if you are found to be deficient, as many people in the general population are. For this reason, the authors placed vitamin D in the weaker evidence category, but definitely worth exploring with your healthcare provider if you need it.
Although not discussed in this paper, I think it is worth mentioning that in a previous paper comparing vitamin D levels in patients with lipedema, lymphedema, and healthy controls, those diagnosed with lipedema were found to have the lowest levels with 77.5% of lipedema subjects either insufficient or deficient in vitamin D.
This micronutrient has known benefits on nerve health as well as modulating pain, so although not studied with lipedema patients specifically, this may be a beneficial supplement to take. This is placed in the weaker evidence category and is worth exploring with your healthcare provider. It is also important to note that vitamin B12 can only be found in animal-sourced foods, so supplementation with its micronutrient may be important if you follow an eating plan that is primarily or solely plant-based.
Although this micronutrient is used often by patients with lipedema, it has not been found to have actions that specifically address lipedema symptoms. This is another nutrient that most in the general population have less than optimal levels of however, so maybe worth exploring with your healthcare provider.
Although one study found patients with lipo-lymphedema to be deficient in selenium, there is no indication that this is any lower than the levels found in the general population, placing this supplement in the weaker evidence category. However, selenium has immune and anti-inflammatory effects that may be useful for managing lipedema symptoms, making it worth discussing this nutrient with your healthcare provider.
Edema Modulating Agents (serrapeptase & bromelain)
These are supplements that may help control swelling. The authors have placed them in the not suggested category due to the lack of convincing evidence for their effectiveness for lipedema or, in the case of serrapeptase, two documented moderate to severe adverse effects.
Let’s break down each of these edema-modulating agents.
Although the specific action is not completely clear or proven, serrapeptase is an enzyme that can break down proteins and fibrins in the tissues, which may help with reducing the swelling that may be present in many women with lipedema. Because there has not been research that tested the effects of serrapeptase on lipedema symptoms as well as some moderate to severe adverse reactions with use noted in the literature, the authors recommend extra caution with the use of this supplement.
This is an enzyme that is found in high amounts in pineapples and also has been shown to break down proteins and fibrin. Bromelain also may be helpful as an anti-inflammatory and anti-microbial agent. There has been a great deal of study with bromelain and it appears to be safe, but it has not yet been examined for its effectiveness for lipedema. Also of note, if you are using a low carbohydrate or ketogenic diet, pineapples have a very high sugar content. Thus, if after discussion with your healthcare provider, you decide to increase your intake of bromelain, it may work better for you to get this micronutrient in supplement form instead of from pineapples.
Despite several papers discussing the use of this supplement for lipedema and venous disease, the authors are unconvinced that it should be used. They have placed it in the not suggested category, but there are no adverse effects noted in the literature, so you may still want to discuss Butcher’s Broom as a potential option for you with your healthcare provider.
This paper is important for women with lipedema because it may provide you with additional options for better management of your lipedema. Certainly, no supplementation will counteract unhealthy eating, but if you are already reducing your carbohydrate intake and removing foods in your diet that seem to increase your inflammation and pain, supplementation with guidance from your healthcare provider may be very helpful.
For more updates on the latest research regarding lipedema, check out Lipedema Simplified’s Flash Briefings. It’s our daily mini-podcast where we share tips, tools, and research pertaining to Lipedema.