About Lymphedema

illustration of the lymph system

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Your lymphatic system is crucial to keeping your body healthy and functioning.  It is a vast series of nodes, organs, and vessels that transports fluid throughout your body, removes waste products from cellular functions, and plays a crucial role in your immune system by identifying and responding to infections.

Lymphedema develops when the nodes and/or vessels become damaged and/or overloaded with lymphatic fluid.  When this occurs, the affected part of the body will swell with lymphatic fluid and possibly become painful, disfigured, heavy, and be more prone to infection or decreased ability to heal wounds.  

There are multiple conditions that can result in the development of
lymphedema or chronic edema.

Secondary Lymphedema


Visual comparison of the right arm swollen and the left arm normal

Secondary Lymphedema can develop due to damage to the lymphatic system, such as cancer surgery or radiation therapy.  Cancer cells use the lymphatic system to spread to other parts of the body.  Unfortunately, life-saving surgeries to remove tumors will also involve removal of lymph nodes from the area to determine the degree of cancer spread.  This removal of lymph nodes can result in lymphedema of the area in which the lymph nodes drained.  In addition, radiation therapy can also damage the lymph nodes and vessels that drain a particular part of your body.

Visual Comparison of one leg being swollen and the other normal

Primary Lymphedema


Primary Lymphedema is a developmental abnormality of the lymphatic system that does not allow it to function properly in a certain area of your body.  

Chronic Lymphedema


Chronic Edema can also result from having too much fluid in the body or fluid overload that can be due to poor functioning of the heart, kidney, or liver.  This type of chronic edema can progress very quickly and will need to be followed closely by your physician.  This type of edema usually affects both legs equally.  



Phlebolymphedema is the combination of insufficiencies of both the lymphatic and venous system.  If the veins and their valves are no longer able to pump fluid back to the heart, called venous insufficiency, the lymphatic system will compensate for a period of time.  However, the long-term strain on the lymphatic system will result in damage of the lymphatic system as well,  resulting in swelling in the legs.  Phlebolymphedema can also develop due to blood clots that damage the veins.   Without treatment and over time, phlebolymphedema will have a darker pigmentation on the lower half of the legs. 

Other Conditions


There are other conditions that can cause lymphedema due to the blockage of lymphatic flow out of a part of the body.    Obesity can hinder lymphatic flow out of the legs and can also damage of the lymphatic vessels and veins.  Scar tissue from surgeries or accidents can block the flow of lymphatic fluid out of areas. 

Diet For Lymphedema

The idea of using diet for lymphedema therapy is rapidly gaining ground, and the Ketogenic Solution for Lymphatic Disorders book was written to help those with lymphatic disorders implement a ketogenic diet as an effective treatment.

Dr. Keith has extensive experience in helping her patients lose weight and dramatically reduce lymphatic swelling by showing them how to switch their standard diet to a low-carb, high-fat way of eating. Her methods and the results of a 2017 study she published in which she and her colleagues showed the positive effect the diet had on treatment outcomes are included in the book.

At Central Coast Lymphedema and Wound Center

our providers can help you manage lymphedema and avoid complications from all the above causes of lymphedema or chronic edemas.  If left untreated, lymphedema can progress.  We use the lymphedema staging classification developed by the International Society of Lymphology.

Stage 0

You may notice a heavy feeling in the affected area but not see any physical changes.

Stage 1   

  • The limb becomes enlarged or swollen.
  • Swelling improves at night and worsens during the day.
  • Elevating your limb helps temporarily reduce swelling.
  • If you push your finger on the affected area, it leaves an indentation. This type of swelling is known as pitting edema and results from fluid collection.

Stage 2   

  • Pitting subsides, and the skin takes on a sponge-like appearance. 
  • The swelling no longer changes from morning to night, and elevation does not help. This problem happens because the swelling is no longer from fluid, but from the formation of scar tissue.

Stage 3   

  • The skin is dry and flaky.
  • Fluid-filled blisters may form, which can increase the chance of infection.
  • The swollen, heavy limb may become difficult to move, affecting normal function and activities.