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Chronic venous insufficiency (CVI): How to keep your veins healthy and detect symptoms early

Do you often have heavy legs in the evenings – as if someone had poured lead into them? You may be ignoring the swelling in your ankles, but it could be a sign of a widespread, silent disease: chronic venous insufficiency. In this article, you'll learn how to recognize the early signs, what exactly is happening in your veins – and what you can do about it.


Table of contents


  • What is chronic venous insufficiency?

  • How does CVI develop?

  • Typical symptoms of CVI

  • The three stages of CVI

  • Diagnosis by the phlebologist

  • Treatment options

  • Nutrition & supplements for vein health

  • Coaching integration in everyday life

  • 7 warning signs you should take seriously

  • Conclusion

  • Sources


What is chronic venous insufficiency?


Chronic venous insufficiency (CVI) is a disease of the leg veins. It occurs when blood is no longer efficiently transported back to the heart, but instead accumulates in the veins. Often, the cause is defective venous valves, which act like check valves to direct blood upwards. If these valves are damaged, the blood flows backward – sometimes with dramatic consequences.


How does CVI develop?


The most common causes are:

  • Weakness of the venous valves : They lose their backflow barrier

  • Lack of exercise : Without a muscle pump, there is no pressure to return the blood

  • Long periods of standing or sitting : particularly critical in everyday working life

  • Obesity : Increases pressure on the venous system

  • Hormonal factors : e.g. pregnancy or hormonal contraceptives

  • Genetic predisposition : Often familial


Typical symptoms of CVI


  • Feeling of heaviness and tension in the legs (especially in the evening)

  • Swelling of the ankles

  • Visible varicose veins or spider veins

  • Skin discoloration (brownish-reddish)

  • Itching, eczema on the lower legs

  • In severe cases: "open leg" (ulcus cruris)


The three stages of CVI


Stage I: Reversible swelling and tension after exercise

Stage II: Persistent edema, skin discoloration, and eczema

Stage III: Hardened skin, open ulcers, severely reduced quality of life


Diagnosis by the phlebologist


A specialized phlebologist typically uses duplex sonography , a combination of imaging and Doppler ultrasound. Other procedures include:

  • Light reflection rheography (LRR)

  • Photoplethysmography (PPG)

  • D-dimer test for suspected thrombosis


Treatment options


Conservative measures

  • Compression therapy: Medical stockings, tailored to stage

  • Movement: Activation of the calf muscle pump (e.g. foot rocking)

  • Positioning: Elevate legs to relieve pressure

  • Skin care: Moisturizing creams for itching and eczema


Drug treatment

  • Vein-tonizing phytotherapeutics : e.g. horse chestnut, red vine leaves, flavonoids

  • Anticoagulants : If there is a risk of thrombosis


Surgical & interventional procedures

  • Sclerotherapy : obliteration of small veins with injection

  • Stripping : Surgical removal of defective veins

  • Endovenous laser or radiowave therapy


Nutrition & supplements for vein health


A vein-friendly diet should include:

  • Vitamin C & OPC (e.g. from grape seeds) : Support collagen formation and vascular stability

  • Zinc & Copper : Important for connective tissue and repair processes

  • Omega-3 fatty acids : have an inflammation-modulating effect

  • Bioflavonoids (e.g. from citrus fruits) : Promote microcirculation


Recommended intake (guidelines):

  • OPC : 100–200 mg/day

  • Vitamin C : 500–1,000 mg/day

  • Omega-3 : 1–2 g EPA/DHA daily

🛈 Please note: These recommendations are based on literature and do not replace individual advice.


Coaching integration in everyday life


Vein strengthening measures are firmly integrated into VMC coaching:

  • Daily micro-movements (foot tapping, tiptoe standing)

  • Vein exercises in the morning

  • OPC + vitamin C treatment in the reset phase

  • Cold-warm alternating showers for toning

  • Blackroll training for calf relaxation

These elements are automatically adjusted in the daily schedule when CVI risks are detected.


7 warning signs you should take seriously


  1. Evening swelling of the ankles

  2. Feeling of tension in the lower legs after sitting

  3. Visible spider veins or varicose veins

  4. Discolored skin around the ankles

  5. Itching or redness on the legs

  6. Nighttime calf cramps

  7. Feeling of cold or heat in the legs without any external cause


Conclusion: It is never too early to protect your veins


CVI is a gradual disease—but also one you can actively influence. Exercise, a targeted diet, and a careful eye on your legs make all the difference. If you're already feeling the first signs, now's the right time to take action.

Tip: If you are also interested in topics such as varicose veins, phlebitis or thrombosis, read on in our article “What your legs tell you about your health”.


Sources

Disclaimer: No Medical Advice Our blog articles are intended for general informational purposes only and do not replace professional medical advice, diagnosis, or treatment. The content is based on thorough research and scientific sources, but should not be interpreted as medical recommendations. Always consult a qualified healthcare provider regarding any health-related concerns.

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