Foot Edema: Causes, Concerns, and Solutions - Internal Medicine

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Foot edema, or swelling in the feet, can be a common issue that arises from various causes. Understanding the underlying reasons for edema is crucial for effective management and treatment. In your case, it seems that you have been experiencing this condition for about six months, with symptoms worsening during periods of prolonged sitting and reduced physical activity.

Causes of Foot Edema
1. Prolonged Sitting or Standing: One of the most common causes of foot edema is prolonged periods of inactivity, such as sitting for long hours, which can lead to fluid accumulation in the lower extremities due to gravity. This is particularly relevant in your case, as you mentioned that your symptoms became more pronounced during remote teaching.

2. Weight Gain: Being overweight can contribute to edema. Excess weight can put additional pressure on the veins in your legs, making it harder for blood to return to the heart, which can lead to fluid buildup in the feet and ankles.

3. Dietary Factors: High salt intake can lead to fluid retention, exacerbating edema. If your diet has included a lot of processed foods or salty snacks, this could be a contributing factor.

4. Medical Conditions: While your recent blood tests showed normal liver and kidney function, it’s important to consider other potential medical issues. Conditions such as heart failure, venous insufficiency, or even certain medications can lead to edema. The glomerular filtration rate (GFR) you mentioned is slightly lower than the normal range (which is typically above 90 mL/min), but it is still within a generally acceptable range. However, it’s essential to monitor kidney function over time.

5. Hormonal Changes: Hormonal fluctuations, particularly in women, can lead to temporary edema. This is often seen during menstrual cycles or pregnancy.

6. Underlying Heart Issues: Your traditional Chinese medicine practitioner mentioned that your heart might be "weak." While this is a more holistic perspective, it’s worth considering that heart conditions can lead to fluid retention. If you have any symptoms like shortness of breath, fatigue, or chest pain, it would be prudent to consult a healthcare provider.


Recommendations
1. Increase Physical Activity: Since you noted that your activity level has decreased, try to incorporate more movement into your daily routine. Simple exercises like walking, stretching, or even ankle pumps can help improve circulation and reduce swelling.

2. Elevate Your Feet: Whenever possible, elevate your feet above heart level to help reduce swelling. This can be particularly effective when sitting or lying down.

3. Monitor Your Diet: Pay attention to your salt intake and try to consume a balanced diet rich in fruits, vegetables, and whole grains. Staying hydrated is also essential, as it helps maintain fluid balance in the body.

4. Compression Stockings: Consider using compression stockings, which can help reduce swelling by providing support to the veins in your legs.

5. Regular Check-Ups: Since you have a history of edema, it’s important to have regular check-ups with your healthcare provider. They can monitor your kidney function and overall health to ensure that there are no underlying issues contributing to your symptoms.

6. Consult a Specialist: If your symptoms persist or worsen, consider consulting a specialist, such as a cardiologist or a nephrologist, to rule out any serious conditions.

In summary, while your foot edema may be related to lifestyle factors such as prolonged sitting and weight, it’s essential to keep an eye on your overall health. Regular monitoring and lifestyle adjustments can significantly improve your symptoms and quality of life. If you have any concerns, don’t hesitate to reach out to your healthcare provider for further evaluation and guidance.