Capillary Fragility

What you need to know

Deal with delicate capillaries by uncovering the cause—bleeding beneath the skin may signal a serious condition. According to research or other evidence, the following self-care steps may be helpful:

Seek support from C
Consult a knowledgeable doctor to find out if you need to increase your vitamin C intake to prevent a deficiency associated with capillary fragility

Get to know proanthocyanidins
Increase capillary strength by taking 150 mg a day of these powerful plant nutrients

Go for a check-up
Visit your doctor to find out whether your capillary fragility is the result of a treatable medical problem

These recommendations are not comprehensive and are not intended to replace the advice of your doctor or chemist. Continue reading the full capillary fragility article for more in-depth, fully-referenced information on medicines, vitamins, herbs, and dietary and lifestyle changes that may be helpful.

About capillary fragility

When the smallest blood vessels, capillaries, become weak, a person has capillary fragility.

There are no serious complications from having capillary fragility, but it may signify that a more serious, underlying problem exists. Therefore, people should consult a physician if there is bleeding in the skin.

Product ratings for capillary fragility

Rating	Nutritional Supplements	Herbs
	Vitamin C (for deficiency only)
	Proanthocyanidins
	Flavonoids (quercetin, rutin, hesperidin)
Reliable and relatively consistent scientific data showing a substantial health benefit. Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit. For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support and/or minimal health benefit.

What are the symptoms?

Weak capillaries lead to small spots of bleeding in the skin and easy bruising. Bruises look like areas of blue to purple-coloured skin that can turn yellow to dark brown over the course of a few days.

Dietary changes that may be helpful

Eating plenty of fruits and vegetables will provide more of the nutrients mentioned in the Nutritional supplements information below that support the structure of capillaries.

Other therapies

The primary focus in the treatment of capillary fragility is the diagnosis and management of any underlying medical condition. Conditions such as liver or kidney disease; blood disorders, such as haemophilia, platelet dysfunction, thrombocytopenia, leukaemia, and multiple myeloma; connective tissue disorders including scurvy, Marfan’s syndrome, and Ehlers-Danlos syndrome; or the use of blood-thinning medication, such as aspirin (Bayer®, Ecotrin®, Bufferin®) and warfarin (Coumadin®), should be considered.

Vitamins that may be helpful

Severe vitamin C deficiency (scurvy) is a well-recognized but uncommon cause of increased capillary fragility. Whether vitamin C supplementation can help capillary fragility in people who do not have scurvy is less clear. Patients undergoing dialysis may develop low levels of vitamin C,¹ ² which can lead to capillary fragility, but giving dialysis patients 50 mg of vitamin C per day had no effect on capillary fragility in one study.³ People with kidney failure and those undergoing dialysis should not supplement with more than 100 mg per day, unless supervised by a doctor.

According to preliminary studies, vitamin C may reduce capillary weakness in diabetics, who often have low blood levels of vitamin C compared to non-diabetics.⁴ ⁵ In a double-blind trial, elderly people with low vitamin C levels and capillary fragility were helped with supplementation of one gram per day of vitamin C.⁶

Compounds called flavonoids may help strengthen weakened capillaries. In test tube and animal studies, they have been shown to protect collagen, one of the most important components of capillary walls.⁷ ⁸ A preliminary study found that proanthocyanidins (flavonoids extracted from grape seeds), 150 mg per day, increased capillary strength in people with hypertension and/or diabetes.⁹ A double-blind trial found a combination of two flavonoids (900 mg per day of diosmin and 100 mg per day hesperidin) for six weeks reduced symptoms of capillary fragility.¹⁰ Use of vitamin C with flavonoids, particularly quercetin, rutin, and hesperidin, is sometimes recommended for capillary fragility.¹¹ Doctors often recommend 400 mg of rutin or quercetin three times per day or 1 gram of citrus flavonoids three times per day.

Are there any side effects or interactions?
Refer to the individual supplement for information about any side effects or interactions.

References

1. Bradley DW, Maynard JE, Webster H. Plasma and whole blood concentrations of ascorbic acid in patients undergoing long-term hemodialysis. Am J Clin Pathol 1973;60:145–7.

2. Sullivan JF, Eisenstein AB. Ascorbic acid depletion during hemodialysis. JAMA 1972;220:1697–9.

3. Tomson CR, Channon SM, Parkinson IS. Correction of subclinical ascorbate deficiency in patients receiving dialysis: effects on plasma oxalate, serum cholesterol, and capillary fragility. Clin Chim Acta 1989;180:255–64.

4. Cox BD, Butterfield WJ. Vitamin C supplements and diabetic cutaneous capillary fragility. Br Med J 1975;3:205.

5. Will JC, Byers T. Does diabetes mellitus increase the requirement for vitamin C? Nutr Rev 1996;54:193–202 [review].

6. Schorah CJ, Tormey WP, Brooks GH, et al. The effect of vitamin C supplements on body weight, serum proteins, and general health of an elderly population. Am J Clin Nutr 1981;34:871–6.

7. Schlebusch H, Kern D. Stabilization of collagen by polyphenols. Angiologica 1972;9:248–56 [in German].

8. Monboisse J, Braquet P, Randoux A, Borel J. Non-enzymatic degradation of acid-soluble calf skin collagen by superoxide ion: protective effect of flavonoids. Biochem Pharmacol 1983;32:53–8.

9. Lagrue G, Olivier-Martin F, Grillot A. A study of the effects of procyanidol oligomers on capillary resistance in hypertension and in certain nephropathies. Sem Hop 1981;57:1399–401 [in French].

10. Galley P, Thiollet M. A double-blind, placebo-controlled trial of a new veno-active flavonoid fraction (S 5682) in the treatment of symptomatic capillary fragility. Int Angiol 1993;12:69–72.

11. Bruneton J. Pharmacognosy Phytochemistry Medicinal Plants. Andover: Intercept Ltd., 1995, 277.

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The information presented in Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or chemist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires September 2008.

2007-09-01