The circulatory system and its vast network of arteries, veins and smaller blood vessels touch every single part of the body — every organ, every system — to help keep it running.
Dr. Yu-Ming Ni, a cardiologist at MemorialCare Heart and Vascular Institute with Orange Coast Medical Center in Fountain Valley, California, explains that the circulatory system is made up of arteries and veins that carry blood, nutrients, oxygen and waste products, such as carbon dioxide, to and from the various tissues of the body. “The circulatory system has two parts to it: There’s the arteries that deliver these nutrients, and then the veins that clear the waste products away.”
While this system usually does a great job getting blood — and the nutrients and oxygen it contains — to the farthest reaches of the body, sometimes circulation can be compromised.
“Poor circulation refers to a number of different things, but in general, looking at it from a bird’s eye view, poor circulation is when blood flow is reduced or inadequate to a certain part of the body,” says Dr. Rigved Tadwalkar, a board-certified cardiologist with Providence Saint John’s Health Center in Santa Monica, California.
When this happens, those tissues that are being fed by the blood vessels don’t get the optimal amount of blood, which means they’re not receiving the right volume of nutrients, oxygen or waste removal, depending on the blood vessel. If the veins are involved, waste products can back up in the affected area, leading to inflammation and swelling.
Poor circulation can also affect the lymphatic system, Tadwalkar says. “This is the system in the body that’s responsible for transporting lymph, which is a fluid made of white blood cells, particularly lymphocytes and fluid from the intestines,” he explains. Circulation in the lymphatic system can be reduced after radiation treatment or removal of lymph nodes as part of cancer treatment.
[READ: How Poor Posture Can Harm Your Health.]
Causes of Poor Circulation
Poor circulation can occur for a number of reasons. Contributing factors include:
— Smoking. The Centers for Disease Control and Prevention reports that chemicals in cigarette smoke cause the cells that line the inside of the blood vessels to become inflamed and swell. This can lead to a narrowing of the blood vessels and cardiovascular diseases, including poor circulation. “There are many people who have had to lose their fingers and toes from frequent smoking because of poor circulation, and this is really a serious problem,” Ni says.
— Diabetes. Diabetes is a condition characterized by high blood sugar levels. Over time, these high levels of glucose in the blood can damage the lining of the blood vessels, leading to narrowing and inflammation that can impede normal circulation. Diabetes also increases the risk of peripheral arterial disease, which is an abnormal narrowing of the arteries, usually in the legs and feet. People with diabetes are urged to pay close attention to their feet and seek treatment for any wounds that develop because poor circulation in the feet can lead to slower wound healing and potentially the loss of digits.
— High cholesterol. Having high cholesterol levels can lead to plaque building up in blood vessels. Over time, this plaque can narrow the vessel, causing circulation to slow down or be impeded altogether.
— High blood pressure. “High blood pressure makes it a challenge for the heart to pump,” Ni explains. Over time, that added force in the circulatory system can weaken the blood vessels and make them less elastic, which can lead to a decrease in the flow of blood around the body. High blood pressure is also associated with higher levels of cholesterol and plaque buildup in blood vessels.
— Atherosclerosis. Also called hardening of the arteries, atherosclerosis causes a narrowing of the arteries that can lead to poor circulation. Narrowing of the arteries can reduce blood flow to the brain.
— Obesity or being overweight. People with obesity are at higher risk of developing high blood pressure, heart disease and type 2 diabetes, all of which can lead to poor circulation.
— Raynaud’s syndrome. Also called Raynaud’s phenomenon, this condition occurs when the blood vessels in the extremities narrow and restrict blood flow. It’s an “abnormal response to cold or stress or potentially even tobacco use,” Tadwalkar says. It can cause discoloration, coolness and tingling, typically in the fingers, but it can also occur in the ears, toes, nose, knees and nipples.
— Autoimmune disorders. Some autoimmune conditions, including rheumatoid arthritis and lupus, can lead to a condition called vasculitis, in which the blood vessels become inflamed. Over time, these inflamed blood vessels can weaken and narrow, obstructing the normal flow of blood.
— Immobility. For some people, sitting still for too long can lead to circulatory problems. For example, taking a long-haul flight where you’re sitting immobile for an extended period of time in cramped quarters can sometimes disrupt normal circulation, particularly to the lower limbs. Immobility can also be a factor in the development of deep vein thrombosis and other conditions that block circulation.
— Oral contraceptive use. For some women, birth control pills can lead to an increased risk of blood clots, strokes and heart attack. This risk is compounded significantly if you smoke as well.
— Heart failure. Heart failure occurs when your heart is not functioning properly. Also called congestive heart failure, this condition means the heart can’t keep up with the body’s need for blood flow. This can lead to a backup of blood and fluid in and around the heart.
— Deep vein thrombosis. This condition, also known as DVT, occurs when a blood clot develops in the deep veins in the legs and causes swelling and pain. If the clot dislodges and moves out of its original position, a condition called thromboembolism, it can cause a heart attack, pulmonary embolism or stroke.
[See: Best Exercises for Heart Disease Patients.]
Signs and Symptoms of Poor Circulation
Because there are many conditions related to poor circulation, there can also be a variety of signs or symptoms of poor circulation to look out for. Some common ones include:
— Tingling or numbness in the skin. Feeling pins and needles or a pinching sensation can be related to poor circulation. This symptom can also be related to nerve problems, such as those caused by diabetes.
— Feeling cold. Reduced blood flow can cause you to feel cold in the fingers, toes, hands and feet as warming blood struggles to reach these areas.
— Color changes in the skin. “The skin may turn pale, red, purple or, in severe cases, turn black,” says Dr. Cindy Wang, a cardiologist with El Camino Health in Mountain View, California.
— Pain in the affected area. Blocked arteries can lead to pain in the arms or legs, which Wang says can become worse when you’re moving and can improve with rest. Inadequate blood flow in the legs can cause pain in the feet and could lead to loss of toes or even the leg in severe cases.
— Swelling in the affected area. Blood clots can cause swelling of the arms or legs, Wang says. In some people, edema, or swelling in the feet, ankles and lower legs, can be a sign of circulatory problems. “People can even have swelling in their belly” as a result of poor circulation, Ni adds.
— Bulging or varicose veins. Narrowed or blocked blood vessels can lead to a backup of blood and fluid in certain areas, which can lead to localized swelling. Varicose veins, which are twisted and enlarged veins near the skin’s surface, may also develop.
— Shortness of breath at rest, fatigue or chest pain. When heart failure is contributing to a circulation issue, you may find that you’re easily out of breath, very tired or have pain in the chest. Tadwalkar says that noticeable or sudden-onset shortness of breath is a serious symptom that should be evaluated by a health care professional as soon as possible.
— Muscle cramping. “With peripheral arterial disease, especially of the lower leg, muscle cramping or pain in the calves can be common,” Tadwalkar says. This may happen more often when you’re exerting yourself, such as during a workout or while walking. Ni adds that the occasional leg cramp is normal, but “if you notice a consistent pattern, that every time you go two or three blocks, for example, you get a leg cramp or leg spasm, that might be a sign of poor circulation in the artery.” Wang also notes that “if there is inadequate blood flow to the downstream tissues, there can be injury to the muscles.” In addition, she says, poor heart function “can lead to lack of blood flow to the entire body.”
[See: 6 Signs You’re Having a Heart Attack.]
Diagnosing Poor Circulation
If you develop symptoms that could signal a circulation issue, it’s important to see your health care provider for evaluation. Starting with your primary care provider is a great way to go, and you may be referred to a cardiologist, depending on what’s happening. Tadwalkar adds that if symptoms have come on suddenly, “over a relatively short time or the course of a day” for example, “that might be a medical emergency and you should be evaluated urgently.”
When evaluating possible circulatory issues, “because of the systemic nature of this condition, a physician is going to be very comprehensive and methodical about how they’re going to look at the situation,” Tadwalkar says. Starting with a thorough medical history and physical exam, you’ll also be tested using one or more modalities, including:
— A blood test. While a blood test may not be able to provide a lot of insight about where or how severely circulation may be impeded in the body, “it can be a tipoff about certain types of conditions, such as inflammatory diseases like rheumatoid arthritis,” Tadwalkar says. Your doctor will use a blood draw to look for signs of diabetes, high cholesterol and other conditions that could contribute to poor circulation. Your doctor may also look for signs of a genetic predisposition for blood-clotting conditions.
— A stress test. This test helps your doctor get a better look at how the arteries in the heart are working. A stress test typically involves walking on a treadmill or riding a stationary bike while your doctor or a technician monitors your heart rhythm, breathing and blood pressure. In some cases, your doctor may give you a drug that mimics the effect of exercise to see how your heart responds.
— Ankle-brachial index. If the circulation issue is in your arms or legs, your doctor can use a test called ankle-brachial index, or ABI, that compares the blood pressure in the arms to the pressure in the legs. Your doctor will take your blood pressure in an artery of the ankle and then divide that by the blood pressure from an artery in the arm. This formula gives a ratio number, and if it’s less than 0.9, it could mean you have peripheral arterial disease. Ni says this is a good test but isn’t done often enough. “It’s something that I think is really helpful as an initial test to understand whether someone has poor blood flow in the legs.”
— A venous ultrasound. This test “assesses for blood clots in the veins of the extremities,” Wang says. It uses sound waves to create images of the veins in the body. With that image, your doctor can determine if there are any obstructions.
— Doppler ultrasound. This test is very similar to the venous ultrasound and may be conducted as part of that test. This special ultrasound technique measures how materials in the body move, which can help pinpoint circulation problems in the arteries and veins.
— A CT angiography. Also called computed tomography angiography, this imaging test is used to “map arterial pathways and look for blockages,” Wang says. To conduct the test, you’ll be injected with a special contrast dye that makes blood vessels easier to see on the resulting image. “Angiography is the gold standard test to evaluate for any plaque and narrowing veins and arteries.”
How to Improve Circulation
Treatment for poor circulation will depend on the specific cause of the problem. There are three broad ways to increase blood flow if you have poor circulation. These include:
— Lifestyle changes.
— Medications.
— Surgery.
— Compression, elevation and movement.
Lifestyle changes
Wang says that all patients being treated for circulation issues need to change their lifestyle. These patients “need to exercise and eat healthy,” she says. “I recommend lots of vegetables and walking 30 minutes per day.” If you smoke, you should stop as soon as possible.
In addition, reducing stress can also help reduce blood pressure and in turn help with circulatory issues. Tadwalkar notes that in situations where Raynaud’s disease is a factor, avoiding exposure to cold can also help reduce symptoms and severity of the problem.
If obesity is a factor in your situation, your doctor may recommend you lose some weight because this will relieve some pressure on the circulatory system. If you have diabetes, you’ll be advised to keep your blood sugars tightly controlled.
Ni adds that “exercise is probably one of the most important treatments. It’s free, it’s easy and it works wonders for blood flow to the legs.” He strongly recommends an exercise regimen of at least 30 minutes per day every day for people with circulatory problems “to help strengthen the flow of blood through the legs.”
Any kind of cardiovascular exercise will do, he says, such as fast walking, jogging, running, swimming, cycling or boxing. The idea is to exert yourself to the levels where you could talk, but you can’t sing, he adds. The more you move, the more your blood moves too.
Medications
Blood thinners and/or blood pressure medications are commonly used in treating conditions that cause poor circulation. Blood thinners help prevent blood clots, and blood pressure medications help relax blood vessels to keep the blood moving.
Tadwalkar says that calcium channel blockers, which are used to treat high blood pressure, can be helpful in treating conditions that cause vasoconstriction, or narrowing of the blood vessels.
Cholesterol-lowering medications are also often used in these situations because they can help prevent plaque buildup in blood vessels; this buildup can narrow the vessels and impede normal blood flow.
Surgery
Depending on the exact cause, your doctor may recommend a surgical intervention called angioplasty. In this procedure, a small balloon is inserted into the narrowed blood vessel and gently expanded to push the plaque obstruction out of the way.
A stent, which is a small mesh tube-like device inserted into a blood vessel to prop it open, may also be placed inside the obstructed blood vessel.
If varicose veins are involved, your doctor may advise their removal. The body will redirect blood flow around the impacted area via healthy blood vessels nearby.
Another potential recommendation is arterial bypass, a surgery used to redirect blood around the blocked and/or narrowed vessels.
Compression, elevation and movement
Wearing compression socks — if you have peripheral arterial disease, for example — can help support the vessels in the lower extremities to function normally. These socks are often a good idea for those with circulatory problems when traveling on a long-haul flight.
Elevating the affected limb above the heart can also alleviate swelling or pain, as gravity helps pull excess blood and fluid away from the obstructed vessel. Similarly, staying active and avoiding sitting still for too long can help keep your blood moving and prevent blood clots from forming.
Talk to Your Doctor
Lastly, Wang says, “you must take care of your general health in order to have healthy arteries and veins. I always tell people if you have concerns, always bring it up with your doctor.”
Tadwalkar agrees. “If there is a concern, it’s important to bring it to the attention of a medical professional.” He says the earlier you bring it up, the better. “Anytime we talk about disease in the human body, but especially with vascular disease, prevention is always better” than intervening later. “If disease progresses, there are options, but those options become a little bit more invasive and challenging as the disease progresses and may lead to some degree of permanent damage.” In contrast, early intervention can halt and even sometimes reverse the disease course.
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The Most Common Signs of Poor Circulation and How to Improve Them originally appeared on usnews.com
Update 01/18/23: This story was previously published at an earlier date and has been updated with new information.
