Abstract:  Lymphoedema Cause 
The real “why” or lowest common denominator of all lymphoedema is often overlooked or missed yet is of extreme importance when considering lymphoedema treatment options. 

Research indicates the causes activating lymphoedema swelling can be many and varied. An accidental bump; an insect bite; an operation; radiation therapy, or cancer therapy. Any of these things can be the trigger to cause lymphatic dysfunction to subsequently cause lymphoedema.  

This page explains the ‘why' and common denominator causing all lymphoedema swelling. It shows the simplicity and real objective for all lymphoedema reduction and control procedures regardless of the trigger.

The common denominator of all Lymphoedema.
The common denominator of all lymphoedema (regardless of cause) is the accumulation of excess (plasma) proteins in the interstitial fluids contained in soft tissues of the body, under normal load conditions, and over a prolonged and indefinite period of time due to insufficiency of the lymphatics. Remove the excess proteins and the lymphoedema will reduce. This hypothesis was put forward by Willoughby (UK 1970) and proved by Casley-Smith J.R and Casley-Smith J. (Australia 1980) (4) 

To explain, in every living person proteins are deposited from the capillary ends of the blood circulation system into body tissues. Proteins are messengers to instruct you body what it must do to survive. 

The percentage of protein inside the blood is greater than the percentage level of protein in the body tissues. As proteins by their osmotic action act like a magnet for water, this percentage difference then forms the basis for fluid exchange between the blood circulatory system and the body tissues.. Proteins control how much fluid is retained in your body tissues..

Proteins are an integral part of your body function. Eating less protein will not reduce oedema. 

Once protein has performed its task in the body tissues, any excess protein should be removed and returned back into the blood circulation by the lymphatic drainage system. This way proper equilibrium between blood and tissue protein levels are maintained.

What causes lymphoedema?

Soft tissues of the body functioning within normal parameters contain in their interstitial fluids an optimal level of 2% of protein. The level of protein in interstitial fluids contained in the tissues of the body should be approximately one fourth of that found in blood plasma ⁽⁶⁾.  

The lymphatic system is the primary drainage system responsible for maintaining equilibrium of protein in interstitial fluids. It is helped by a secondary system of macrophages which phagocyse (eat up or dissolve) excess protein.

When due to lymphatic dysfunction, levels of protein in interstitial fluids become greater than 2%, which also causes macrophage inactivity, swelling and oedema will occour in body tissues. This swelling and oedema is resultant from the osmotic action of excess trapped protein in the body tissues caused by lymphatic dysfunction..

Conclusion: Lymphoedema is caused by an accumulation of (plasma) protein greater than 2% of interstitial fluids contained in the soft tissues of the body. The cause of accumulated excess protein in the interstitial fluids is resultant from lymphatic dysfunction or lymphatic insufficiency and cessation of macrophage activity from protein overload for a prolonged period of time where lymphoedema swelling is apparent.

It is only by returning the level of proteins back to a ratio of 2% in interstitial tissue fluids will the oedema in Lymphoedema be controlled. This is the real and main objective for all Lymphoedema control procedures. This website provides information and resources to help and assist you achieve this objective. 

© Copyright June 2009 Poppy Lane Skin Care & Lymphoedema Clinic, Lansvale. N.S.W. 2166 Australia.  
Last Update 22nd June 2009. 

For more detailed information go to the Lymphoedema control page

References:
1. Casley - Smith JR "Benzo pyrones in lymph.dema" Int Angiol, 1997 in press
2. Casley-Smith JR & Judith R "High Protein Oedema and the Benzo Pyrones, Lippincott Sydney & Balt (1986) History of Lymphatics & Lymphoedema; Chap1, p2 
3. C.R O'Kennedy, R.D Thorns, N.Y Wiley, "Coumarin - 'Biology, Application and modes of action".1997a: 143 - 184
4. Casley-Smith JR & Judith R "Modern Treatment for Lymphoedema "Fifth Edition (Pg 233) Bowden Printing, Adelaide
5.  Robert Twycross, Karen James & Jacquelyne Todd. "Lymphoedema" Ausmed Publications P/L. ISBN 0 9579876 68.
6. Eldra Pearl Solomon, Linda R. Berg, Diana W. Martin.  “Biology”, Fifth Edition,  Saunders College Publishing, Orlando Florida , USA . ISBN: 0-03-022299-0.  Internal Transport 42 p925.

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