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Unpacking Lipedema: What Is It and How to Improve It

Lipedema is a condition that predominantly affects women. It affects up to 11% of the female population. It is a condition that you may not have heard of. However, you may have seen it in individuals or your body. Here's what it is and how you can improve it.

What Is Lipedema?

An image of legs with Lipedema and varicose veinsLipedema is a condition that results in a buildup of fat cells in the lower part of the body, including the buttocks, thighs, and calves. Over time, it can also affect the upper arms. The fat cells distribute themselves irregularly, appearing nodular and feeling like rice.

Lipedema may sound similar to the condition of lymphedema. However, these two conditions are different. Lymph fluid is a fluid your body produces that removes bacteria, viruses, and waste products. Lymphedema is when the lymph fluid cannot drain properly, leading to a buildup of lymph fluid.  While these two conditions are different, there is a link between them. With lipedema, the build-up in fat cells can, over time, block the blood vessels. This results in the lymph fluid being unable to drain adequately, causing lymphedema.

Lipedema is classified into four stages: stage one is the early stage and stage four is the late stage.

Stage One of Lipedema

The individual's skin is smooth to the touch. However, a healthcare professional can feel nodules of enlarged fat during an examination. There may be some pain and bruising.

Stage Two of Lipedema

The skin's surface becomes uneven, and it develops dimples and indentations, similar to the pattern of a mattress. The amount of fat in stage two increases from stage one.

Stage Three of Lipedema

The fat tissue starts to thicken, and due to the thickening and inflammation, the individual starts to develop large extensions of skin and fat that make the legs look like columns. These extensions put pressure on the individual's joints and can affect mobility. The thickening of the tissues causes a reduction in the blood and lymph flow out of the fatty tissue. This causes the protrusion to continue to grow.

Stage Four of Lipedema

The reduction in lymph flow causes lymphedema, and the two occur simultaneously.

What Causes Lipedema?

The cause of lipedema is unknown. However, there are theories as to why lipedema occurs.

Doctors suspect genetics increase the risk, as 60% of individuals with the condition have a family member who has the condition.

Hormones also are thought to play a role. During puberty, pregnancy, and menopause, there are fluctuations in the hormones estrogen and progesterone. This fluctuation, especially the fluctuation of estrogen, is thought to increase the risk of lipedema occurring. In males with lipedema, it was found that testosterone levels were low, whilst estrogen levels were high.

What Can You Do About Lipedema?

Many remedies can be used to relieve symptoms of lipedema and delay the progression.

Massage

When you think of massage, you may think of the relaxing massage in a day spa. This form of massage, however, is slightly different. It is a form of manual lymphatic drainage that aims to increase the movement of lymph fluid in your body.

The pressure is light to medium, and the massage therapist will apply long strokes to the skin to help increase the movement of the lymph fluid. This can help to reduce the lymph fluid from building up in your tissue and can help reduce swelling that can occur during lipedema.

Lymphatic drainage massage can be practiced by yourself. However, receiving this form of massage from a certified practitioner is best for optimal results.

Compression

An image of a person putting compression stockings onCompression works similarly to massage and prevents the build-up of lymph fluid. Not only does compression therapy reduce the build-up of lymph fluid, but it also helps to:

  • Improve distorted shapes of limbs
  • Improves mobility
  • Reduce inflammation and pain

Compression garments include socks, stockings, and shorts that cover the mid-thigh. These garments apply pressure to the body part to which they are applied. Compression garments can be made from different types of materials and can apply different amounts of pressure. For a garment to be medical grade, it needs to apply a specific amount of pressure. Healthcare practitioners recommend these garments.

These garments can be worn continuously or, depending on the individual and the stage of lipedema they are experiencing, can be worn at night. Compression garments designed to be worn at night are thicker than garments designed to be worn during the day and have extra padding to help break up thickened tissue. As they are thicker and padded, it can take time for the wearer to get used to wearing the garment.

Using compression garments can involve trial and error as you try out different pressures and different forms of garments. It would be best if you used a lower-pressure garment initially and then increase it to a higher pressure as you get used to it.

Pneumatic Compression Pump

A pneumatic compression pump is another form of compression therapy that can relieve lipedema. It consists of sleeves that cover your legs. These sleeves then inflate with air. Once the sleeves inflate, the pressure increases. Gently massage your legs and encourage the movement of the lymph fluid. This pump can be used daily and can provide relief from pain. It is beneficial, especially for individuals experiencing lipedema with lymphedema.

Exercise

Exercise has multiple benefits for individuals currently experiencing lipedema. Some of these benefits include:

  • Improves the movement of lymph fluid around the body
  • Increases blood flow
  • Increases the amount of oxygen to muscles
  • Reduces inflammation
  • Weight management
  • Stimulates the release of brain hormones, enhancing mental health

Aerobic and strength training are two forms of exercise that can help relieve symptoms of lipedema. Aerobic exercises focus on heart health and general fitness, while strength training focuses on increasing muscle mass. Both forms of exercise help improve the movement of lymph in your body and are recommended. If you are unsure how to start exercising, a healthcare professional specializing in exercise can help design a training program.

Note that if you have certain health conditions, like advanced adrenal fatigue, it is important to start very gently with exercise to avoid causing a cortisol spike and overworking your body.

Weight Loss

A heavier weight increases the risk of developing lipedema. It was found that 85% of lipedema patients were obese. Lipedema is an abnormal accumulation of fat cells. If the weight increases, the chances of more fat cells are higher, and more symptoms, such as inflammation, can occur. By managing your weight, you can manage the number of fat cells, reducing the condition's progression.

Nutrition is important in weight management and can help reduce additional fat cells. Nutrition focusing on drinking water daily, including more fruits and vegetables, reducing processed foods and saturated fats, and increasing your consumption of unsaturated fats, specifically fish oils, can help reduce inflammation. Certain spices, such as turmeric and garlic, have anti-inflammatory properties, and including them in your diet can help reduce inflammation.

Skin Care

An image of a woman in the shower washing her legsIn lipedema, the skin affected can become stretched and thin or, on the other hand, feel thicker. These changes in the skin increase the risk of infection. To prevent this, it’s important to practice good skin care, which includes cleaning, checking, and moisturizing.

Cleaning

Cleaning your skin helps to remove bacteria that can cause infection. When you clean the part of your body experiencing lipedema, be careful and pay attention to skin folds and the skin between the toes. Once cleaned, dry the area gently.

Check

After cleaning, it is important to check the skin and check for signs of infection. These signs include redness, scratches, and bites. Clean the skin and apply appropriate care to the area if the skin becomes damaged. Contact your healthcare provider if the area is red and shows signs of infection.

Moisturizing

After checking the skin for signs of infection, moisturizing it can help hydrate it and prevent it from cracking. When you moisturize, apply it gently, being aware of the skin folds and the skin between the toes.

Liposuction

One of the final remedies for lipedema is liposuction, which involves the surgical removal of inflamed fat cells. This procedure can help individuals experiencing lipedema, especially in the advanced stages, experience relief from the pain and inflammation caused by the fat cells.

Lipedema and Adrenal Fatigue Syndrome (AFS)

Adrenal Fatigue Syndrome (AFS) is a group of symptoms individuals experience as a result of chronic stress. When you experience stress, your adrenal glands, two glands above your kidneys, release stress hormones. These stress hormones help your body to respond and adapt to the stress.

During chronic stress, the adrenal glands become depleted, and the stress hormones released are reduced. This then results in the individual experiencing symptoms such as weight gain, sleep problems, and mental health disturbances.

The NeuroEndoMetabolic (NEM) stress response supports your adrenal glands. This NEM system comprises six circuits of related organ systems, including the inflammation circuit. This circuit includes the immune system, gastrointestinal tract, and gut microbiome.

During AFS, the inflammation circuit can become imbalanced, causing an increase in mast cells. These cells are part of the immune system, and an increase in them can cause bumps in the skin, pain, and an increase in inflammation. This can exacerbate lipedema.

Not only does AFS affect lipedema, but lipedema can also affect AFS. An increase in fat can increase the amount of hormones the adrenal glands produce. Since lipedema is an accumulation of fat cells, this can increase the number of hormones produced. This increase in hormones increases the chances of the adrenal glands becoming depleted, increasing the risk of AFS developing.

Cautions With Lipedema and AFS

If you are currently experiencing lipedema and AFS, it is important to exercise caution when choosing remedies. During AFS, your body can become sensitive to external products, including the material of compression garments and pumps.

An image of a woman exercisingHigh-intensity exercise can also increase cortisol levels and cause an adrenal crash, so only gentle exercises are recommended with AFS.

Chatting with your healthcare provider is important if you are currently experiencing lipedema with AFS. Your provider can help design a plan that can provide relief from AFS and lipedema without your body experiencing severe reactions.

Final Thoughts

Multiple remedies can help provide relief from lipedema. These remedies are best when used together and can slow the progression of lipedema and reduce the pain and inflammation.

If you are experiencing lipedema and need help finding ways to manage it that support your overall health, you can chat with our team at +1 (626) 571-1234.

© Copyright 2023 Michael Lam, M.D. All Rights Reserved.

Dr. Lam’s Key Question

Whilst being overweight or obese increases the risk of lipedema, it is only a risk factor. Lipedema can occur in individuals of normal weight. Another risk factor for lipedema is fluctuating hormones. This risk factor can result in individuals of a normal weight experiencing lipedema.

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