A patient recently visited my office, complaining of puffy calves, ankles and feet. We quickly discovered the cause—she had spent more than seven hours sitting on a flight returning from Europe. Other common causes of edema (water accumulation) in the calves, ankles and/or feet include dehydration, prolonged standing or excessive exposure to extreme temperatures (hot or cold). In these cases, the swelling lasts just a few hours or a day or two.

But edema also can be a symptom of more serious conditions, such as congestive heart failure, circulatory problems or kidney disease. Congestive heart failure leads to sodium retention, which causes an accumulation of fluid in the body. In kidney disease, salt and water retention may lead to swelling in the lower legs, the face and eventually the entire body.

If you have swollen legs and/or feet for more than two days, see your doctor. If you've recently had surgery or the swelling is only on one side or accompanied by skin discoloration, pain or heat, call your doctor's office and ask to be seen immediately. You may have a blood clot or an infection-both can be life-threatening. Other causes of edema...

  • Chronic disease. Most people who have heart, circulatory or kidney problems benefit from taking a diuretic, a type of medication that helps your body eliminate water via the urine. Most conventional doctors prescribe a synthetic diuretic, such as hydrochlorothiazide (Microzide) or furosemide (Lasix). Because these drugs can raise cholesterol and triglyceride levels, I recommend dandelion instead. The root and leaf of dandelion are commonly used to treat liver disease, but the leaf alone is one of nature's best diuretics. Dandelion also reduces lipid (fat) levels and improves HDL "good" cholesterol.

What to do: Drink three eight ounce cups of dandelion leaf tea per day until the swelling subsides. To prepare the tea, use two teaspoons of dried leaf or two tea bags per cup of boiling water. Steep covered for six minutes, and strain before drinking. If you prefer tincture, use ¼ teaspoon in two ounces of water, two times per day, at least 15 minutes before or after meals. Dandelion is safe and can be used on a regular basis. If you take blood-pressure medications or want to substitute dandelion for another diuretic, alert your doctor so he/she can monitor any interactions and help you determine the proper dose for you.

  • Dehydration. If your feet and legs swell when you get overheated, travel by plane, drink alcohol or several cups of coffee or eat salty food, water is your best medicine. The puffiness can indicate that your body is dehydrated and that it's trying to retain water. What to do: Drink at least ½ ounce of water per pound of body weight per day. Elevate your lower legs for 10 minutes each hour, and walk for 10 minutes once every two waking hours. The swelling should subside within a day.

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