Each capsule contains Horse Chestnut (Aesculus hippocastanum) seed extract, standardized to 20% aescin 260 mg Butcher’;s Broom (Ruscus aculateus) extract standardized to 20% esterolic heterosides 100 mg Bilberry (Vaccinium myrtilis) extract standardized to not less than 25% anthocyanidin content 100 mg Recommended Dosage: Two capsules per day Horse Chestnut (Aesculus hippocastanum) seed extract Horse chestnut has been used traditionally to treat varicose veins and hemorrhoids. The major active ingredient is believed to be aescin, which has anti-edema and anti-inflammatory activity. Horse chestnut extract standardized to 50 mg of aescin has been shown to: Exert tonic effects on the veins Decrease in capillary and venous permeability[1]. In several double blind studies horse chestnut extract has been shown to improve: Edema-related conditions in venous diseases of the legs Chronic venous insufficiency Increase the tonic effect of the saphenous vein[2]. Edema- related conditions showed significant improvement with a 22% decrease in capillary filtration coefficient, 3 hours after administration of a standardized dose[3]. There was also a decrease in serum lysosomal glyocsaminoglycan hydrolases[4] of 25%- 30%. (Patients with varicose veins had elevated enzyme levels).   Butcher’s Broom (Ruscus aculateus) extract Many animal studies have been conducted which show the efficacy of Butcher’s Broom in protecting against capillary leakage[5]. In a cross-over double blind study using a mixture of Ruscus aculeatus extract, hesperidin and ascorbic acid with a 2 month treatment period, there was significant change in plethysmographic parameters[6]. Other studies support these findings[7] (The N. Weindorf study used only a two-week period and the changes were not as large as the other studies). Topical application of Ruscus aculeatus extract in a randomized, double-blind study of 18 healthy volunteers, showed a median decrease in the diameter of the femoral vein of 1.25 mm. This occurred within 2.5 hours of application of a cream containing 64-96 mg of Ruscus extract[8].   Bilberry (Vaccinium myrtilis) extract Vaccinium myrtilis extract has been shown[9] to produce in patients with varicose veins and ulcerative dermatitis a substantial decrease in capillary leakage. The anthocyanosides present protect damaged capillary walls by: Stabilizing membrane phospholipids and thus increasing the stability of the endothelium barrier Increasing the biosynthesis of mucopolysaccharides, which form the pericapillary sheath The net effect is a less permeable capillary and hence decreased outflow of blood into the surrounding tissues Studies[10] done in rabbits and cats also demonstrate the ability of Vaccinium myrtilis extract to decrease capillary permeability and reduce capillary edema. The reduction off capillary permeability was found to be longer lasting than that of rutin in the doses used. [1] G. Hitzenberger, Wien Med Wochenshr, 139(17): 385-9, 1989 [2] F. Anoni et al, Arzneim Forsch, 29:672-5, 1975 [3] H. Bisler et al, Dtsch Med Wochenschr 111(35): 1321-9, 1986 [4] H. W. Kreysel, H.P. Nissen and E. Enghoffer, VASA, 12:377-82, 1983 [5] E. Bouskela, F. Z. Cyrino and G. Marcelon, J Cardiovasc Pharm, 22(2): 225-30, 1993; E. Bouskela, F. Z. Cyrino and G. Marcelon, J Cardiovasc Pharm, 24(2): 281-5, 1994; E. Bouskela, F. Z. Cyrino and G. Marcelon, J Cardiovasc Pharm, 22(2): 221-4, 1993 [6] R. Capelli, M. Nicora and T. Di Perri, Drugs Exp Clin Res, 14(4): 277-83, 1988 [7] G. Rudofsky, Fortschr Med, 107(19):55-8, 1989;N. Wiendorf and U. Shultz-Erhrenburg, Z Hautkrf, 62(1): 28-38, 1987 [8] D. Berg, Fortschr Med, 108(24): 473-6, 1990 [9] E. Mian, S. B. Curri, A. Lietti and E. Bombardelli, Minerva Med, 68 (52) : 35365-81, 1977 [10] A. Lietti, A. Cristoni and M. Picci, Arzneim Forsch, 26 (5), 829-32, 1976