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From The December 2000 Issue of Nutrition Science News
A Well-Oiled Machine
Jill Stansbury, N.D.
The little-studied and underappreciated lymph system keeps internal fluids flowing and contributes mightily to immune function
The human body, firm and fibrous, is actually composed of between 60 and 70 percent fluid. Keeping fluids flowing cleanly throughout the body and preventing fluids from stagnating is up to the lymphatic system. This complex network manages significant portions of internal waste, pathogen defense and immunity protection. Its work begins when cells generate waste from their metabolic functions and those by-products are excreted into the extracellular spaces. This cellular waste is transported via lymph vessels to lymph nodes, which process the impurities and eventually empty the now-healthy fluids into the blood system. Considering the vital role the lymph system plays in waste elimination, as well as fluid distribution, immune function and metabolic regulation, it is surprising that other than checking for gross lymph node abnormalities and enlargements, Western medicine pays little attention to the lymph system. The lymphatic system deserves more, because the loss of proper lymphatic function can cause waste accumulation and fluid stagnation in the tissues, which results in conditions such as tonsillitis, appendicitis and fibrocystic breasts.1 Fortunately, a number of lifestyle choices and select botanicals can contribute to an optimally functioning lymph system.
The lymph system is comprised of lymph nodes and the extensive lymphatic vessels that connect them (see illustration, opposite page). Lymph nodes are small, bean-shaped organs with a loose mesh of reticular tissue. Enmeshed in this tissue are two types of white blood cells, lymphocytes and macrophages. These white blood cells migrate from the thymus and bone marrow by the billions via blood circulation to ultimately arrive at the secondary lymphoid organs: the lymph nodes, spleen, and mucosal tissues of the digestive, respiratory, urinary and genital organs. Lymphocytes can migrate freely in and out of lymphoid tissues and may circulate between different organs via lymphatic channels. Lymphocytes reach every cell of the body, carried in lymphatic channels to every organ and tissue.
Lymph channels and cells in the digestive tract and organs are collectively referred to as "gut-associated lymphoid tissue," or GALT, and serve to identify and sequester offensive substances that have been orally ingested. Lymphatic channels, tissues and cells within the mucous membranes are collectively referred to as "mucosa-associated lymphoid tissue" or MALT. Mucosal lymphatic tissue is highly specialized, interacting with both the arteriovenous capillary bed as well as airborne or ingested material.
Lymphatic Stagnation and Pathology
Localized infections can cause minor or significant swelling of the lymph nodes and affected lymphatic channels.2 Swelling indicates a high level of activity during infection. Infections of these channels can manifest as hot, tender, swollen skin with red streaks near the enlarged lymph nodes. When lymphatic drainage in a body quadrant is impaired, the limb within that quadrant may develop lymphedema, which is an engorged and swollen appearance caused by fluid stagnation.
Lymphatic stagnation occurs when the amount of fluid, cells and waste exceeds the body's capacity to remove them. Inflammation, infection and cellular oxidation, as well as dietary or airborne allergens and toxins, increase the amount of metabolic waste needing to be cleared from cells. The sheer volume of processed waste often exceeds the liver and kidneys' ability to cleanse, and hence this waste accumulates in blood and lymphatic channels.
Long-term fluid stagnation in the lymphatic channels causes the fragile valves in the channels to fail, creating a fluid backflow and compounding the problem.3 Stasis of this protein- and mineral-rich lymphatic fluid can eventually lead to fibrosis of the lymphatic channels and surrounding tissues. In extreme cases, this leads to lymphangitis and cellulitis, which are inflammatory conditions of the lymphatic channels and surrounding cells and tissues. Capillary beds may become seeded with pathogenic material not carried away by the lymph channels, resulting in blood poisoning or life-threatening septicemia. Fluid stagnation also can cause lymphatic pain, or lymphangina, when lymph nodes become enlarged and the capsules surrounding the nodes are stretched.
Lymph fluid stagnation not only causes tissue swelling, but also causes cells and organs to become awash in cellular waste products, leading to abnormal osmotic balances and pressures. Cellular membranes have micropores that are selectively permeable, meaning the cell chooses to admit some substances while disallowing or actively pumping away others. The permeability is affected by the concentrations of substances dissolved in the intra- and extracellular fluid. If a substance reaches a certain threshold concentration, the cell is forced to admit it, thereby preventing desired nutrients entry. Organs near the lymphatic stagnation have greater difficulty receiving nutrients and eliminating wastes and will also stagnate. For example, lymphatic organs such as the tonsils and appendix may become enlarged and inflamed as lymphatic flow becomes insufficient. In response, the elimination organs — liver, bowels, skin and especially kidneys — may try to compensate for lymphatic insufficiency and help the body remove waste and fluid. The breasts, being surrounded by lymph nodes and channels, may also develop abnormal fluid accumulation and stagnation.
Long-term lymphatic stagnation has been linked to numerous conditions in which tissue swelling exists. Invasive techniques such as surgery can be avoided by promoting proper lymph drainage and circulation, thereby preventing inflammation. Three common conditions that result from improper lymph function are tonsillitis, appendicitis and fibrocystic breast disease.
Tonsillitis Tonsils are composed of lymphatic tissue and sit like sentries on either side of the throat to guard against ingested or inhaled intruders. Chronic tonsillitis, or inflammation of the tonsils, may indicate inefficient lymphatic drainage in these tissues.4,5 Furthermore, tonsillar enlargement is a sign that the tonsils are being overworked and lymphatic stagnation is occurring in the surrounding neck, ear and jawbone nodes. Long-term liver, kidney and immune-system support, along with measures to facilitate lymphatic drainage, will often improve the situation without surgery.
Appendicitis Inflammation and infection of the appendix is usually preceded by liver burden, bowel toxemia and constipation caused by lymphatic stagnation. Enlargement of lymph nodes in the groin is another symptom.2,6 Although these symptoms may be the result of other conditions such as cancer, once those are ruled out it is wise to consider lymphatic stagnation as a cause. Although heroic measures such as emergency surgery are sometimes necessary, removing an inflamed appendix will not fix the underlying pathology. Any individual with acute appendicitis should undergo follow-up therapy to improve liver and intestinal function as well as to improve abdominal lymphatic circulation. Appendicitis may be largely preventable by maintaining optimal bowel function.
Fibrocystic Breast Disease In naturopathic medicine, fibrocystic breast disease is viewed as a sign of hyperestrogenism or poor estrogen metabolism in the liver.7,8 Clearly, hormones play a role in the disease, as the cyclical nature of the complaint attests. Individuals who take hormones, such as in birth control pills, may develop fibrocystic breasts as a result of excess estrogen in the body and the liver's inability to conjugate and excrete it.9,10 Breast pain and cysts are also common side effects of postmenopausal hormone replacement therapy. These hormones are known to inhibit bile flow within the liver and gallbladder — a condition that can ultimately contribute to lymph stagnation.2 In other words, if the liver is unable to properly remove wastes from the bloodstream, wastes accumulate and contribute to hyperestrogenism and, in turn, fibrocystic breasts.
Methods and Lymphogogues
Herbs, sound diet and exercise may improve lymphatic circulation, especially in the liver, gastrointestinal system and capillary bed. Reducing infectious and inflammatory processes, as well as the metabolic and cellular debris they generate, may also improve lymphatic flow.
One of the best ways to promote circulation and support lymphatic flow is to stimulate the body through massage. Exercise also improves both blood and lymphatic circulation. In fact, jumping on a trampoline is thought to be especially beneficial for improving lymphatic flow because the motion helps to mechanically move lymph fluid through the lymph vessels.3,11 Saunas and other methods of hydrotherapy also can increase dynamic circulation through the blood vessels and lymphatic channels as well as promote elimination via the skin.
In moderation, sunlight also may enhance lymph flow by stimulating peripheral circulation and promoting the synthesis of vitamin D, which travels to the kidneys and helps them to excrete wastes. Both actions benefit lymphatic drainage.
Lymphogogues are botanicals that help the lymphatic system clear congestion and accumulated fluids or wastes from tissues, thereby reducing the risk of many infectious, inflammatory, cystic and glandular pathologies. By helping to remove excessive fluids, these botanicals prevent stagnation and cyst formation in the breasts and kidneys as well as fluid in the limbs, and help relieve abdominal bloating. The following are commonly used lymphogogues.
Agrimony(Agrimonia eupatoria) is known as a gentle gastrointestinal and urinary tract stimulant and an astringent that tones eliminative passages and mucous membranes. This herb is used to treat insufficient digestive secretions and enlarged contractile organs. Traditionally, it has been particularly effective in elderly patients when used to restore vitality to debilitated tissues.8
Cleavers or Bedstraw(Galium aparine) is a renal and lymphatic tonic rich in mineral salts. This nourishing plant is a diuretic, blood purifier and connective-
tissue tonic.12-14
Horse chestnut(Aesculus hippocastanum) is said to improve venous return and thereby reduce lymphatic congestion. Compounds found in horse chestnut have anti-inflammatory and strengthening effects on blood-vessel walls.12
Nettle (Urtica urens, U. dioica) is a nourishing tonic herb that is used as a renal purifier, mineral source, lymphatic stimulant and anti-inflammatory. Older herb books have reported nettle to be used by people with tuberculosis, lung infections, lymphatic stagnation and scrofulous disease. Because of its high mineral content, nettle is also useful for patients with anemia, malnutrition and rickets.16,17
Poke root(Phytolacca decandra) is believed to promote the removal of catabolic wastes and products of fatty degeneration. This herb is especially recommended for congestion of watery fluid and glandular tissues, specifically when the enlarged lymph node or organ is firm and hard. Poke root has traditionally helped reduce inflammation in cases of tonsillitis, mastitis, ovaritis, orchitis, pruritis and uterine fibroids. It also has been used topically for goiter, mastitis and lymphatic engorgement. Poke root is a strong, caustic and potentially deadly herb and should be used only by skilled herbalists and physicians.4,14
Pot marigold (Calendula officinalis) is used to treat infections, inflammation and skin or mucous membrane injury. Calendula has also been shown to be effective for treating infection, inflammation and slow-healing tissues. Calendula may help heal wounds by enhancing circulatory and lymphatic flow in the skin and mucosal surfaces.17
Purple coneflower(Echinacea angustifolia, E. purpurea) has long been used for infections and as a detoxifying herb to reduce disease-producing waste material in the system.4,13,17
Redroot or new jersey tea (Ceanothus americanus) is recommended for swollen tissues with a damp boggy character and for catarrh and excessive secretions. Redroot reportedly relieves congestion in the spleen and is said to be specific for splenomegaly (spleen enlargement) and malaria.4
Wild indigo(Baptisia tinctoria) is a stimulating, potentially caustic plant used to treat chronic infections. This herb contains immune-enhancing polysaccharides and is indicated for chronic tonsillitis, tissue dampness, congested unhealthy tissues with purplish discoloration, foul breath and infectious secretions.14
Wild iris (Iris versicolor) is traditionally used for lymphatic enlargement and congestion, especially when the conditions are caused by poor elimination and liver dysfunction or involve lymphatic swelling and cysts that feel watery and boggy. Historically been used to treat uterine fibroids, thyroid enlargement and splenic enlargement. It is thought to be an alterative herb specific for deranged glandular secretion and lymphatic activity. Since iris is caustic and cathartic, it should be used only by skilled clinicians.15
Keep It Flowing
Although proper lymphatic activity is one of the foundations of health, it is often overlooked in Western medicine. Much more difficult to visualize than the circulatory system, and much less studied than other branches of the immune system, the elusive lymphatic system appears to have been better understood in philosophy and given more attention in ancient times. Clearly, the lymphatic system can significantly affect health. Counsel customers to keep lymphatic fluid clean and flowing by eating well, exercising and using herbs to maintain optimal liver, kidney and circulatory health.
Jill Stansbury, N.D., maintains a private practice in Battleground, Wash., where she specializes in botanical and natural therapies.
References
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2. Merck Manual 15th Ed.: Rahway (NJ): Merck, Sharp and Dohme Research Laboratories; 1987. p 51.
3. Mills S. The essential book of herbal medicine. Middlesex, England: Penguin Books; 1991. p 96.
4. Priest AW, Priest LR. Herbal medication: a clinical and dispensary handbook. Essex, England: L.N. Fowler and Co. Ltd. 1982. p 72, 74-5, 84.
5. Keville K. Herbs for health and healing. Emmaus (PA): Rodale Press; 1998. p 107.
6. Krupp C. Current medical diagnosis and treatment. Los Altos (CA): Lange Medical Publications; 1984.
7. Murray M, Pizzorno J. Enclyclopedia of natural medicine. Rocklin (CA) Prima Publishing; 1998. p 457.
8. Weiss RF. Herbal medicine. AB Arcanum; 1988. Beaconsfield, England: p 188, 261,321.
9. Golinger RC. Hormones and the pathophysiology of fibrocystic breast mastopathy. Surg Gynecol Obstet, 1978;46:273.
10. Livolsi V, et al. Fibrocystic breast disease in oral contraceptive users: histopathoepithelial atypia. NEJM 1978;299:381.
11. Willard T. Textbook of modern herbology. Calgary, Canada: Progressive Publishing; 1988.
12. Commission E Monographs, published by the Federal Deaprtment of Health, Germany.
13. Wren RC, Potters new cyclopeadia of botanical drugs and preparations. Essex, England: CW Danieal Company Ltd; 1988. p 5, 79.
14. Ellingwood F. Materia medica and therapeutics. Cincinnati, (OH): Llyod Publishing; 1928. p 444, 458.
15. Duke J. The green pharmacy. Emmaus (PA): Rodell Press; 1997. 539.
16. Tyler ML, Homeopathic drug pictures. Fremont (CA): Jain Publishing; 1998. p 231-5, 449-52.
17. Mills S, Bone K. Principles and practices of phytotherapy, Kent, England: Churchill Livingstone; 2000. p 487, 493-4, 496.
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