FAQ

Questions and answers

Intermittent claudication is a condition caused by reduced circulation to the legs. You experience pain in larger muscle groups, such as the calves and sometimes in the gluteal muscles and around the hip joint when walking. The pain goes away with rest. The most common cause is smoking.

There are many conditions that cause pain when walking. The typical thing about window-gazing disease is that the pain disappears completely within 5 minutes. If it persists longer or does not disappear completely, it is highly likely that other conditions fully or partially explain the problems.

It indicates that there is an imbalance between the energy produced and the energy that is being used at the moment. You get “sour” in the muscles. Physiologically, it is the same that everyone can experience during a major physical effort, regardless of whether you have circulation problems or not

The symptoms can be alleviated even if the vascular changes underlying the problems remain unchanged. Exercise is most central to this improvement. Weight loss or offloading the body weight on the arms results in less work for the legs and thereby longer walking distance. Support for increased own production of nitric oxide can be another way to alleviate the symptoms. The INO effervescent tablet is a possibility, but the same effect as this effervescent tablet can be achieved by eating a kilo of arugula.

You can prevent the progression of the disease in various ways, for example by stopping smoking. One should also have a healthy diet. Be treated with platelet inhibitors and cholesterol-lowering medications. If you have diabetes or high blood pressure, it is of great value if these diseases are well regulated

Intermittent Claudication usually only leads to impaired walking ability. If you do not have diabetes, the probability that you will avoid amputation during your lifetime is more than 95%. This risk is almost “negligible”. If you have diabetes and window gazing syndrome in combination, the risk increases.
In the case of impending gangrene or as it is also called critical ischemia, you have a more severely impaired circulation. This condition can manifest itself as pain in the lying position or the appearance of spontaneous ulcers on the lower legs or feet. Then you need to seek medical help to determine if something needs to be done to strengthen the circulation. At that point, INO effervescent tablets are absolutely not an option, but urgent medical help is the only choice.
If you are in doubt about the degree of circulatory impairment you have, you should also first seek medical help to have this assessment done.

Pain when walking can be caused by a wide range of diseases in the tissues, apart from the blood vessels, that are found in the bones. This means diseases related to muscles, bones, joints, ligaments, connective tissue, etc. A fairly common condition outside the bones is narrowing of the spinal cord (spinal stenosis). It produces symptoms that are very similar to the window viewer’s disease. In this condition, it usually feels better for pain relief to sit down and lean slightly forward. It is not as good to simply stop and remain upright. The pain in spinal stenosis usually does not disappear completely or it takes clearly longer than the 5 minutes before it is possibly gone.

All interventions in blood vessels are associated with risk. On most occasions it goes very well, but on individual occasions it doesn’t go as you hope and then you can even get worse. This applies even if everyone has done their best. In other words, there is no need to make a mistake if things go less well. There are studies that show that exercise can be just as good as, for example, “blowing up balloons”. It is therefore recommended to first try all of the above to improve the symptoms before considering any intervention. It is better to be improved without taking risks than to take a risk that may not produce a superior result even if everything goes as hoped.

There are no restrictions on trying INO regardless of the medications you use or the type of food you eat. This includes blood-thinning medication. The improved circulation with INO does not mean increased risk of bleeding.

Erney Mattsson
Professor och Överläkare i kärlkirurgi

Mer Information

Intermittent Claudication  as it is called in medical language is a disease where the important prevention work has been neglected, says the Swedish Heart Lung Organization “Riksforbundet”.

That’s why we offer INO, a nitric oxide enhancer to try to help patients get a better functional capacity. Nitric oxide is a well-known vasodilator which means it opens the blood vessels to improve blood circulation and is therefore perfect for intermittent claudication

According to the National Heart and Lung Association: “Intermittent claudication means fatigue and pain in the legs in connection with walking. 

It may appear that they stop to look in the neighbors’ windows, but it is a necessary rest break to relieve the pain that occurs with physical activity. You will find more information from the Heart Lung Association about window gazing disease.

According to the Swedish Heart and Lung Association, window gazing disease is caused by arteriosclerosis.
They say that “the disease is caused just like in a heart attack by atherosclerosis and involves impaired blood circulation in the legs.”

More from the Heart Lung Association: “Narrowing of the arteries in the legs prevents the oxygenated blood from reaching the muscles, which gives rise to pain.

In addition to impaired walking ability and limited mobility, the ability to perform daily activities can be negatively affected. In case of pronounced problems, vascular surgical treatment with endovascular balloon dilation or open surgery is offered.

Treatment that is required to stop the development of the disease and which is also highlighted in all guidelines and studies is lifestyle change and physical activity.

herbal throbbing in the arteries of the legs indication

It is scientifically well established that narrowings in the arteries of the legs can be an early indication of an increased risk of future cardiovascular mortality. Treating the disease with drugs and lifestyle changes is therefore very important.

It’s about the same kind of changes as for the risk of a heart attack: start exercising, stop smoking and eat more healthily.”

The Heart Lung Association states that “it is scientifically well established that narrowings in the arteries of the legs can be an early indication of an increased risk of future cardiovascular mortality. Treating the disease with drugs and changing lifestyle is therefore very important.

It’s about the same kind of changes as for the risk of a heart attack: start exercising, stop smoking and eat more healthily.”

Intermittent Claudication means that you have angina in the legs. It is also called Peripheral arterial disease, PAD.

The most common symptom is cramping pain in the calves, which occurs after the person has walked a certain distance. When resting, the pain disappears after a few minutes.

If the vascular narrowing is higher up, pain may occur in the thigh. It is common for the muscles to feel stiff and weak. A sign that the disease has worsened is pain in the lower legs or in the feet even when resting, especially when lying down. It can be alleviated if you sit up and support your feet on the floor because the blood flow then increases to the lower part of the legs.

The disease is often caused by smoking. Quitting smoking is crucial to reducing the risk of leg angina.

It is also important to be physically active. Regular walks are a good way to prevent angina in the legs. When you feel pain, try to walk a little further before resting. Ideally, you should walk for half an hour at least three times a week.

Toe raises are also a good way to exercise the calf muscles. Blood flow can be improved by exercise, and in the long run, new blood vessels can form that lead the blood past the narrowed blood vessel. The muscle cells are trained to use the blood flow that still exists in a better way. Regular training for six months can increase the walking distance.

In addition, it can be helpful to enhance nitric oxide in various ways to open blood vessels and improve blood circulation. One way to boost nitric oxide is to take INO effervescent tablets (1 per day).

Studies show that nitric oxide-enhancing supplements have significantly increased walking distance in patients with intermittent claudication.

In addition to the recommendations mentioned above, it can be helpful to enhance nitric oxide in various ways to open blood vessels and improve blood circulation. One way to try to boost nitric oxide is to take INO effervescent tablets (1 per day).

Studies show that nitric oxide boosting supplements have significantly increased walking distance in patients with Intermittent Claudication.

We don’t promise improvements for everyone but it’s worth a try, and if you find INO helpful, we hope you can give us feedback and share your experiences so that others suffering from intermittent claudication might hear about something that have been helpful to you and thereby find help themselves.

Heart-Lung Association writes that “Periheral arterial disease includes narrowings in the pulse arteries in the legs. It is divided into claudication pain and those with critical ischemia. Many also have narrowings that do not cause any symptoms.”

What is leg PAD?
on their website it is described as follows: “Peripheral artery disease includes narrowing of the arteries to the legs and in the legs, and is divided into those with claudication pain and those with critical ischemia.”

Intermittent Claudication – angina in the legs
“In case of intermittent claudication, angina in the legs, it can hurt the legs when you strain them, for example walking a shorter distance. This is due to constrictions in the vessels, which makes it difficult for the blood to pass to the muscles, which then receive too little blood to be able to work properly. Many also have strictures that do not cause any symptoms.”

They also say that: “In critical ischemia, you have such pronounced constrictions in the vessels that the feet and legs do not get the blood they need even at rest. Then you get pain even when you are not moving and risk getting wounds that are difficult to heal.”

ATTENTION! If you have symptoms of critical ischemia, then INO is not for you, but then you need to see a doctor.

According to the Heart Lung Association’s website; “Smoking is the most common cause of bone artery disease. Diabetes, high blood fats, high blood pressure, and obesity also play a role in the development of the disease. Heredity also plays a role in the disease, which increases with age and is very rare under the age of 50. The narrowing of the arteries are due to atherosclerosis, or atherosclerosis, which is an inflammatory process in which the vessel walls become stiff and thick-walled, preventing normal blood flow. It is the same process seen in the coronary arteries of the heart in coronary artery disease, which leads to spasms in the heart and heart attacks.”

This is what the Heart Lung Association tells us about the most common symptoms of leg artery disease: “The main symptom of angina in the legs is a cramp-like pain in the calf muscles when you have walked a distance, almost the same distance each time and often a little shorter when going uphill. The pain increases and eventually becomes so intense that you are forced to stop and rest. The pain then disappears within a few minutes and you can continue to walk a little further. It is also common for the muscles to feel stiff and weak.”

With critical ischemia, you also have pain at rest, especially in the foot and especially when lying down. The pain is often relieved somewhat by putting the foot down on the floor or sitting up so that the foot is lower than the rest of the body. Hard-to-heal painful wounds belong to the picture in critical ischemia.”

There are various ways to control the disease and slow its progression.

On the Heart Lung Association’s website it is stated that possible treatments include:

“Smoking cessation: If you smoke, the most important part of treatment is to stop smoking.”

“Physical exercise: Exercise in the form of walking is part of the basic treatment.”

“When you get sore, try to walk a bit more before you rest. Ideally, you should walk for at least half an hour at least three times a week. The more you walk, the better. Toe raises are a good way to exercise the calf muscles. Poles are a good tool when you’re out and about. Regular training for six months usually increases the distance you can walk significantly.”

“It is the problems from the heart that will determine how much you can exert yourself if you have angina in both the heart and the legs. It is usually easier to exercise together with others. Feel free to get help from, for example, a physiotherapist.”

What does the Heart Lung Association say about medical treatment?

“Medical treatment includes blood pressure-lowering, cholesterol-lowering and mild blood-thinning, so-called anti-platelet medications. Any diabetes must of course also be treated.”

“If you have narrowing of the arteries in your legs, you often have vascular disease in other parts of the body such as the heart and the carotid arteries that supply the brain and it is important to reduce the risk of heart attack and stroke in every way. Having low blood pressure and low cholesterol levels is very important regardless if you can reach the goals with lifestyle changes or with medication.”

Operations (from the Heart Lung Association)
“Some surgical intervention is often needed if you have what is known as critical ischemia, meaning complaints such as pain at rest and/or intractable wounds. The goal of surgery is to improve blood flow to the foot.”

Bypass
“

“In a bypass operation, the surgeon sews in a new vessel that brings the blood past the obstruction in the narrowed vessel.” A superficial vein from the bone or artificial material is usually used for the new vessel. Sometimes it is enough to clear out the stored constrictions.”

Balloon Dilation – PCI
“The most common, however, is to do a balloon dilation of a narrowing in a similar way as in the coronary arteries of the heart.

A thin plastic tube called a catheter is inserted through the groin to the narrowed area.

A balloon attached to the plastic tube is inflated and the narrowing is widened.

Balloon dilation of a stricture. A thin plastic tube called a catheter is inserted through the groin to the narrowed area. A balloon attached to the plastic tube is inflated and the narrowing is widened.

If the narrowing springs back, you may need to use a so-called stent. The stent is a fine tube of metal mesh.

In moderate cases of angina pectoris in the legs, no vascular surgery is usually performed, but smoking cessation and walking training are the most important and effective part of the long-term treatment.

It is also the most sustainable treatment because then you reverse the entire disease process and is also included when you are treated surgically.

Hard-to-heal wounds, amputation
Sometimes the disease has progressed so far that it is not possible to perform a bypass operation or balloon dilation.

For example, if you have severe pain, long-term wounds on the foot that do not heal or the beginning of gangrene, and the surgical options to improve circulation have been exhausted, the situation may actually improve after an amputation.”

You can find more information at: www.hjart-lung.se, which is the official website of the Heart Lung Association in Sweden.

INO offers a new type of approach: Boost of nitric oxide that opens the blood vessels. It is naturally controlled by your body and is the most effective where it is needed, so you don’t get side effects such as “redness in the face”. INO effervescent tablets have been developed especially with poor blood circulation and intermittent claudication in mind.