Fluid Retention in the Legs, Feet, Arms, and Hands symptoms, causes and treatment

Fluid retention in the legs, feet, arms, and hands is medically called edema. Edema is swelling that occurs when too much fluid gets trapped in the tissues of the body, particularly the skin.

Table of Medications

  • Furosemide
  • Lasix
  • Hydrochlorothiazide
  • Spironolactone
  • Aldactazide
  • Bumex
  • Demadex
  • Torsemide
  • Bumetanide
  • Aldactone

Overview

There are many causes and types of edema. Pedal edema causes swelling in the feet while pulmonary edema affects the lungs. This condition starts slowly, but its onset could be sudden. While fluid retention in the legs, feet, arms, and hands is a common problem, it could be a sign of a serious condition.

The following are some key facts about edema:

  • Edema happens when excess fluids stay within the tissues of the body.
  • There is usually an underlying condition or disease.
  • Symptoms depend on the cause.
  • Edema normally develops gradually.
  • Medications are available to treat edema.

Fluid retention in the legs, feet, arms, and hands, or edema refers to puffiness and swelling in various areas of the body. It most often occurs in the skin, especially on the hands, arms, ankles, legs, and feet. Edema can also affect the muscles, lungs, bowels, brain, and eyes. The condition mainly affects older adults and pregnant women, but anyone can experience edema.

Causes

Fluid retention in the legs, feet, arms, and hands or edema can result from a variety of problems such as infection, circulatory problems, malnutrition, tissue death, total body fluid overload, kidney disease, and electrolyte problems. 

The balance and regulation of fluid in the body are very complex. The cause of edema is the small blood vessels in the body, or capillaries, which leak fluid into the tissues surrounding them. The excess fluid is the cause of the swelling of the tissues.

The cause of fluid leaking into the surrounding tissues could be the result of several mechanisms, including:

  1. Too much pressure in the blood vessels
  2. An external force in the blood vessel results in the fluid to be drawn out
  3. The blood vessel’s wall is damaged and cannot maintain equilibrium, resulting in a fluid loss.

Each of these three mechanisms may be associated with a variety of diseases or conditions including:

Heart failure

If one or both of the lower chambers of the heart cannot properly pump blood, the blood can accumulate in the limbs, causing fluid retention in the legs, feet, arms, and hands or edema.

Kidney damage or kidney disease

An individual with a kidney disorder may be unable to eliminate enough sodium and fluid from the blood, which increases the pressure on the body’s blood vessels, causing a leak out of the liquid. Swelling may also occur around the eyes and legs.

Damage to the glomeruli or capillaries in the kidneys that filter waste and excess fluids from the blood, may result in nephrotic syndrome. One symptom of this syndrome is a low level of the protein albumin in the blood.  This can lead to edema.

Liver disease

Liver diseases such as cirrhosis can affect liver function. They can lead to changes in the liver’s secretion of fluid-regulating chemicals and hormones while also reducing the production of protein. This causes fluid to leak out of blood vessels into the surrounding tissues.

Cirrhosis increases pressure within the portal vein, the large vein carrying blood from the intestines, pancreas, and spleen into the liver. Edema can result in the legs and abdominal cavity.

Certain medications

Some medications may increase the risk of fluid retention in the legs, feet, arms, and hands, including:

  • Vasodilators, or drugs that open the blood vessels
  • Non-steroidal anti-inflammatory drugs
  • Calcium channel blockers
  • Some chemotherapy drugs
  • Estrogens
  • Some diabetes drugs, such as thiazolidinediones

Pregnancy

During pregnancy, the body releases hormones that encourage fluid retention. Pregnant women tend to retain more sodium and water than usual. The face, hands, lower limbs, and feet of a pregnant woman may swell.

When a woman rests in a reclined position during pregnancy, the uterus may press on a vein known – the inferior vena cava, obstructing the femoral veins that may result in edema.

During pregnancy, the blood clots more easily, increasing the risk of deep venous thrombosis, another cause of edema.

Eclampsia, resulting from pregnancy-induced hypertension, can also cause edema.

Dietary factors

Several dietary factors impact a person’s risk of edema, including:

  • Consuming too much salt in people who are susceptible to develop edema
  • Malnutrition, where edema can result from low protein levels in the blood
  • Low consumption of vitamin B1, B6, and B5.

Diabetes

Complications of diabetes include:

  • Cardiovascular disease
  • Acute liver failure
  • Acute renal failure
  • Protein-losing enteropathy, an intestinal condition that causes loss of protein

Diabetic macular edema is the swelling of the retina in diabetes.

Allergies

Insect bites and some foods may cause swelling of the skin or face in people who are allergic or sensitive to them. Severe swelling can be a sign of anaphylaxis. Swelling in the throat can close a person’s airway, making him unable to breathe. This is a medical emergency.

Problems with extremities

  • A blood clot – A blockage, such as clotting of the blood in the vein, can prevent the flow of blood. When there is pressure in the vein, fluids may start to leak into the tissues, causing edema.
  • A cyst, tumor, or growth – A lump may cause edema if it is pressing against a vein or a lymph duct. With the buildup of pressure, fluids can start leaking into the surrounding tissues.
  • Varicose veins – They usually occur when the valves are damaged, with pressure increasing in the veins, causing the veins to bulge. The increased pressure increases also the risk of fluids leaking into the surrounding tissues.
  • Lymphedema – The lymphatic system assists in removing excess fluid from the tissues. When the system is damaged, such as those resulting from infection or surgery, can result in edema.

Miscellaneous conditions

  • Prolonged immobility – People who are immobilized for an extended period may develop edema in their skin. This can be because of the pooled fluid in gravity-dependent areas and the antidiuretic hormones released from the pituitary.
  • High altitude – High altitude, combined with physical exertion, can increase the risk. Mountain sickness may cause high-altitude pulmonary edema or high-altitude cerebral edema.
  • Burns and sunburn -The skin reacts to a burn by retaining fluid, causing localized swelling.
  • Infection or inflammation – Tissues that are inflamed or infected can become swollen. This is usually very noticeable in the skin.
  • Menstruation or pre-menstruation – Hormone levels are fluctuating during the menstrual cycle. Levels of progesterone are lower during the pre-menstrual days, which may cause fluid retention.
  • The contraceptive pill – Medications that include estrogen may result in fluid retention. It is common for women to put on weight after starting pills.
  • Menopause – Hormone fluctuation around menopause can result in fluid retention. The same may be triggered by hormone replacement therapy.
  • Thyroid disease – Thyroid problems may cause hormonal imbalances which can lead to edema.

Diagnosis

To find out the cause of your edema, your doctor will perform first a physical exam and ask you questions about your medical history. The information is often enough to determine the underlying cause of your edema. In some cases, ultrasound exams, X-rays, blood tests and urine tests, and magnetic resonance imaging may be used to find out the cause of your edema.

Treatment

Mild edema typically goes away on its own, or with the help of you raising the affected limb higher than your heart.

More serious cases of edema may be treated with drugs that help the body expel excess fluids in the form of urine – diuretics. Furosemide or Lasix is the most common diuretics.  It is up to your doctor to determine which medication to use based on your personal medical history.

Long-term management of edema focuses on the treatment of the underlying cause of the swelling. In cases where edema is caused by medication use, your doctor may change or adjust your prescription.

Your doctor may also suggest that you:

  • Try a low-salt diet – Do not consume more than 2,300 mg of sodium a day.
  • Medication – Your doctor may prescribe a water pill or diuretic to help your body get rid of extra sodium and fluid through urination.
  • Raise your feet – Lie down with your feet above the level of your heart several times a day to move fluid out of your feet and ankles.
  • Wear compression stockings – Special stockings gently squeeze your lower legs to help keep your blood circulate.

Risks of Having Fluid Retention in the Legs, Feet, Arms, and Hands

During pregnancy, the body retains more water and sodium than usual because of the fluid needed by the fetus and placenta. This can increase the risk of developing edema.

The risk of edema may increase when you take certain medications, such as:

When to Seek Medical Attention

Fluid retention in the legs, feet, arms, and hands could be a sign of a more serious disorder, such as a blood clot or heart disease. Seek medical care immediately when there is leg swelling for no clear reason or when you have chest pain, difficulty breathing, or other warning signs of a blood clot or a serious heart condition.

Call for emergency medical care if you have leg swelling and any of the following symptoms, which may indicate a blood clot in your lungs or a serious heart condition:

  • Chest pain
  • Difficulty breathing
  • Fainting or dizziness
  • Coughing blood
  • Shortness of breath with exertion or lying flat in bed.

Nonemergency problems related to swelling need prompt medical care. Call your doctor and schedule an appointment so he could examine you and determine the underlying cause of your swelling.

Sources:

https://www.medicalnewstoday.com/articles/159111.php

https://www.mayoclinic.org/diseases-conditions/edema/symptoms-causes/syc-20366493

https://www.webmd.com/diet/why-am-i-retaining-water#1

https://www.emedicinehealth.com/edema/article_em.htm

Overview

 The drug is used to cure and prevent osteoporosis among sufferers. It is likewise used among patients with Paget’s disease.

What is Alendronate?

Alendronate is an oral medicine that is available as a tablet, effervescent tablet, and oral solution. The medication is available as a branded drug under the name Binosto and Fosamax. It is also sold as a generic drug. Alendronate is used to cure osteoporosis and Paget’s disease among patients.

Usage of Alendronate

Alendronate is utilized to cure and treat osteoporosis. With this, your bones can turn weak and thin and easily break. The medicine can also cure Paget’s disease. In this ailment, the bones can become weak and soft, and eventually, it can become painful and all deformed as well as break easily. Alendronate is a valuable part of any combination therapy, which is potent when coupled with Vitamin D and Calcium supplements.

Alendronate – How It Works

Alendronate is a part of a class of drugs widely known as Bisphosphonates. It is a type of medicine that is a class of medications that work in the same way for muscle cramps and weak stream. The drugs are used to treat osteoporosis and Paget’s disease. Alendronate works by inhibiting the sudden thinning and breakdown of the bone. This helps improve bone density and helps the bones stay strong and avoid breaking.

Side Effects

The most common Alendronate side effects are as follows:

If the effects are rather mild, they can go away quickly in a couple of days or weeks. But, if the symptoms are rather severe, or where they are severe, contact your doctor right away.

Alendronate Serious Side Effects

Contact your physician or pharmacist immediately if you experience any of the following serious side effects. Call for emergency medical assistance if you experience any life-threatening symptoms. The serious side effects of Alendronate are as follows:

Erosions or ulcers of the esophagus, the symptoms are as follows:

  • Problem swallowing
  • Heartburns
  • Pain when swallowing
  • Chest pain 
  • Bloody vomit
  • Bloody stools

Bone death of jaw. Here are the symptoms:

  • Loosen teeth
  • Swollen gums
  • Poor healing of the jaw
  • Heavy feeling in the jaw

Unusual breaking of bones in the legs and hips. It can include:

  • Dull pain in the hips
  • Pain in the groin
  • Pain in the thigh area

Hypocalcemia or Low Calcium. The symptoms are:

  • Numb fingers
  • Numb toes
  • Numbness in the mouth area
  • Muscle cramps
  • Severe joint pains

Dosage and Administration

The dosage information provided here is for the Alendronate tablet. The dosages and drug form may not be added here. The dosage, drug type, and how often the drug is taken will depend on the patients:

  •  Age
  • Condition treated
  • Severity of condition
  • Other medical conditions
  • How the patient reacts to the first dose

Dosage for Osteoporosis

Alendronate Tablet

  •  Tablet
  •  Variants of 5mg, 10mg, 35mg, 40mg, and 70mg

Alendronate Oral Solution

  • 70mg/75ml

Fosamax Tablet

  • Tablet
  • 70 mg strength

Binosto Effervescent Tablet

  • 70 mg strength

Adult Dosage (18 years and older)

  • 70 milligrams once a week or 10 milligrams once a day for treatment
  • 35 milligrams once a week or 5 milligrams once a day

Child Dosage (0–17 years old)

  • The drug should not be used by individuals who are 18 years old and younger.

Storage

Different medications require different storage requirements. Always read the product label found on the packaging on how to properly store your Alendronate medication. Keep your medication away from pets and children’s reach at all times.

Never flush out your medication down the toilet or the drain unless when you are told to do so. Follow proper ways of discarding your medication found on the product packaging when no longer in need or when the product expires. Ask your doctor or pharmacist for proper waste disposal.

Drug Interaction

Alendronate tablet interacts with other medications, vitamins, or herbal supplements. The interaction occurs when a substance changes the way the medicine works. This can be dangerous and hinder the medicines from working well. To avoid any interactions, the physician will manage your medications. Make sure you inform your doctor about all the vitamins, supplements, and medicines you are taking. Check how the drug can interact with something you are taking.

Here are the drugs that can result in interactions with the Alendronate drug.

Interactions that can heighten side effects:

Taking Alendronate tablet with some drugs can result in more side effects, here is the list of these drugs:

  • Aspirin
  • NSAIDs or non-steroidal anti-inflammatory drugs

You can have more upper gastrointestinal side effects like ulcers in our esophagus area. Ask the physician if it is safe for you to take these drugs.

Interactions can make the drug Alendronate less effective. Whenever used with some drugs, it cannot work well to treat your condition. Alendronate in the body can be decreased. Here are some drugs:

  • Iron
  • Magnesium
  • Calcium supplements
  • Antacids

The drugs mentioned above can reduce how the medication absorbs in the body. You should let at least 30 minutes to pass after taking your alendronate another oral medication.

Warnings and Precautions

Food Warning

Take this drug on an empty stomach with a glass of water. Never take with coffee, tea, juice, soda, or mineral water. Doing so can minimize the level of the drug’s potency in the body. It can also heighten certain side effects. Wait at least 30 minuted before you eat or drink something.

Alcohol Warning

Alcohol can heighten the risk of some side effects on your stomach from taking alendronate. When you intend to drink alcohol, ask your doctor first about it. They can monitor and assess your stomach problems.

Allergy warning

The medication alendronate can lead to some very severe allergic reactions. Symptoms of its side effects can include:

  • Skin rashes
  • Hives
  • Swollen face
  • Swollen lips
  • Swollen tongue
  • Problems breathing

Whenever you experience any allergic reaction, call your doctor or the local poison center in your area without delay. When the symptoms you experience are rather severe, call for emergency medical assistance or dial 911. Never attempt to take this medication ever again if you have ever had any allergic reactions to the drug. Taking it once again can be dangerous and can even lead to death.

Warnings for Certain Users

For those with problems in their esophagus, never take this medication. You will be more likely to have severe side effects like erosions or ulcers in the esophagus area.

For patients with very low calcium blood levels, the physician must provide you calcium medications before starting to take this medicine. Taking Alendronate can only make your health condition worse.

For patients with severe kidney problems, well for those with kidney problems or a history of kidney ailment, you should not be able to clear this from your body. So, you should avoid taking Alendronate altogether.

Pregnant Women

For pregnant women, Alendronate is a regulated category C pregnancy drug. It can only mean two things:

  • There are no enough studies made on humans to be sure how Alendronate can impact the unborn child.
  • The research revealed that in animals, adverse effects occur to the fetus when the mother took the medication.

Always make sure to ask your doctor if you intend to become pregnant or already pregnant. The Alendronate can be used when the potential advantage justifies the risk to the unborn child.

Those who are breastfeeding must consult with their doctor first if they can use Alendronate while breastfeeding. It is not known whether Alendronate can pass into breast milk. When it does, it can lead to some serious side effects to the nursing baby. Ask your doctor or pharmacist if you are breastfeeding a baby and intend to take the medication. They will decide whether you should stop taking the medication altogether.

Senior citizen patients who have kidney problems or who have weakened kidneys must not take Alendronate too. This medication can lead the body to process certain medicines very slowly. This can result in other problems as the drug will stay in the body for an extended period, and it raises your risk to other side effects.

Pediatric patients are refrained from using this medication. It is not for use by patients 18 years old and below.

Overdose and Contraindications

When someone you know has overdosed or has severe symptoms like trouble breathing, passing out, or more, call a doctor or pharmacist for immediate medical assistance. You can also call on the poison control center immediately. Residents from the USA can call on their local poison control center for assistance. Severe symptoms of overdose can include persistent nausea, vomiting, diarrhea, stomach pain, or cramps. Never share this medication with another person even if they have symptoms similar to you.

The drug has been prescribed for your condition only. Never take any other pain reliever for your urinary tract problem unless you have consulted with your doctor. A different drug may be needed under this circumstance.