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First Treatments Steps for Lipedema

Conservative Treatment

Once you have been diagnosed with Lipedema your first steps should be to start these conservative non invasive treatment. These measures serve as the backbone of successful control of Lipedema and its symptoms.

  • Light compression: Bioflect Compression
  • Manual Lymph Drainage Massages and compression pumps
  • Supplements: Vasculera 630mg (Diosmin 600mg), Selenium 400mcg, Vitamin D 3000-5000 IU Daily.
  • OPTIONAL: Prescriptions: Mucinex (Guaifenesin), Amphetamine, N-Acetyl Cysteine.
  • Diet Changes: Anti-Inflammatory Diet (Modified Mediterranean Diet).


  • Eat: Vegetables, fruits, nuts, seeds, legumes, potatoes, gluten free whole grains, herbs, spices, fish, seafood and extra virgin olive oil.
  • Eat in Moderation: Poultry, eggs and yogurt.
  • Eat Only Rarely: Red meat and dairy, except yogurt.
  • Don’t Eat: Sugar-sweetened beverages, added sugars, processed meat, refined grains, refined oils and other highly processed foods.


Background and Rationale for supplements for Lipedema.

Selenium: Selenium has been shown to decrease edema in tissue in two placebo controlled trials for post-mastectomy and head and neck radiation. [1, 2] Selenium has anti-inflammatory effects and anti-oxidant effects. It lowers oxygen radical production in part by increasing glutathione peroxidase and thioredoxin reductase. The US National Research Council has defined the individual maximum safe dietary intake for selenium as 600μg daily. Supplements may be difficult to obtain and a good source of selenium are brazil nuts. Two brazil nuts a day will be sufficient for most people.

Vitamin D3: Most patients with lipedema are vitamin D deficient. Vitamin D is essential for proper immune function, bone, muscle and nerve health. [ Personal communication with Karen Herbst PhD. MD. ] US Recommend Daily Allowance RDA for Vitamin for adults is 800IU. For patient who are vitamin D3 deficient three to four times the RDA is necessary to restore normal levels of Vitamin D3.

Diosmin: It is the principal ingredient in the prescription supplement Vasculera. Diosmin is a bio-flavonoid that is extracted from citrus fruits. Diosmin is the nutritional supplement that has the highest quality of evidence for its effectiveness on a broad range of vein and lymphatic problems. It can also be synthesized from a closely related citrus flavonoid hesperidin. Diosmin has veno-tonic and lympho-tonic, anti-inflammatory, and antioxidant properties.

Diosmin is useful in varicose veins, chronic venous insufficiency, hemorrhoids, venous ulcer healing, and lymphedema and lipedema. RELIEF which stands for Reflux assEssment and quality of Life Improvement with micronized Flavonoids was a large multicenter randomized study that showed many benefits to varicose vein symptoms and disease for patients taking 450mg of micronized Diosmin plus 50 mg of micronized Hesperidin for six months. [3]


Diet Recommendations and Rationale for Lipedema

The diet sometimes called RAD [ Rare Adipose Disorder] diet is a modification of the Mediterranean diet. The diet emphasizes low glycemic index by avoiding refined and processed starches especially sugars, white rice, and mashed potatoes. A Cochrane Review has shown this type of diet best for weight loss. It is also recommended to be gluten free or low gluten [ avoiding wheat, rye and barley] because this is a common cause of gut inflammation.

The diet emphasizes fish, nuts, beans and whole grains. The diet emphasizes fats such as omega-3 and coconut oil high in medium chain fatty acids as those are anti-inflammatory and fat burning. The diet focuses on high fiber both for its help in weight loss and the pre-biotic effect of fiber and whole foods.

1 Micke, O., Bruns, F., Schäfer, U., Kisters, K., Hesselmann, S., and Willich, N. (2000) Selenium in the treatment of acute and chronic lymphedema. Trace Elements and Electrolytes 17, 206-209

2 Kasseroller, R. G., and Schrauzer, G. N. (2000) Treatment of secondary lymphedema of the arm with physical decongestive therapy and sodium selenite: a review. Am J Ther 7, 273-279

3 [link here] shows the effectiveness of Diosmin Diosmin significantly improved symptoms such as leg pain, heaviness, and cramps. Diosmin also improved leg edema or swelling and decreased leg circumference. Other studies have shown Diosmin improved venous ulcer healing, hemorrhoids, and lymphedema. [Citation]


Contact Your Physician Today

Once you know you have lipedema these conservative are the best way to start to control your symptoms of lipedema. They should be combined with an exercise program that preferably is easy on the joints. Some exercise programs can give the added benefit of promoting lymph circulation such as water exercises

Before starting an exercise program, it is always best to check with your doctor. They can help you make an exercise plan is safe and that will help you manage and treat your symptoms, as well as provide other treatment options such as decongestive therapy. Contact us today for more information about the first steps for treatment of lipedema or for more information on exercise and other lipedema treatments.

For more information on Lipedema please visit Blog for some valuable information.

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Meet Dr. Wright

Dr. Wright

Meet Dr. Thomas Wright, medical director of Laser Lipo and Vein Center. Dr. Wright is a board certified Phlebologist and cosmetic surgery specialist, with over 15 years of practicing experience. A graduate of the University of Missouri Columbia medical program, Dr. Wright was one of the first two hundred surgeons to become a diplomate in Phlebology.

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* Results May Vary From Person to Person