Many people have worries about their circulation. This test is to be used as an approximate guide to determine the relative condition of a person's circulation. It is not a substitute for medical advice .It is based on the experience of one General Practitioner and should not be considered to represent the view of the medical profession at large.

Add up the points and see which category you fall into.

For each individual question the following scale applies:

normal 0-1

possible problem 2-3

seek advice/significant problem 4

veins

Swelling of ankles after sitting still (eg. On a plane, bus, car) for one hour (2)

After 3 hours (bus/plane) (1)

After 6 hours (0)

Some small veins visible over lower legs (thread veins) (1)

Many visible thread veins around the ankle (2)

Veins tender if knocked (1)

Pain in legs and swelling of ankles after normal activities (nb veins often become less uncomfortable when they become visible) (2)

Visible veins (tree roots) and swelling apparent immediately or soon after standing (2)

Visible veins as above but with eczema/dry skin around ankle and or with brownish discoloration of the skin and possibly skin ulceration (4)

Risk factors

Occupation, which involves prolonged periods standing in one position (hairdresser/guardsman) (2)

Oral contraceptive pill/pregnancy/-+family history of thrombosis/immobility/sedentary occupation/past history of thrombosis/ (2) for each

Microcirculation.

Occasional tingling in fingers in the night and if sat for long periods (0)

Hands and feet go cold in cold weather with one or more fingers going white but no loss of feeling in fingers and fingers return to normal if gloves worn. (1)

Feet/hands go numb if legs crossed for awhile or arm held in odd position eg behind head when asleep (0)

Menopausal hot flushes (0)

Red spiders on face esp. on nose and cheeks (telangiectasia) normal (1)

Slightly raised round well circumscribed bright red spots on trunk/arms/legs in absence of any symptoms of illness normal (Campbell de Morgan spots) (0)

Raynauds syndrome: fingers go white on exposure to cold even when in gloves.

Associated with some loss of sensation in fingers (2)

Use of vibrating tools. e.g. jack hammer (2)

Modified Allen's Test: Clench the fist tightly so the knuckles go white and keep it clenched for 40 seconds. Release and count how quickly the hand flushes back with colour. Smokers and those with poor circulation may find it takes their hands longer than 6 seconds to go back to normal.

Takes more than

3 seconds to return to normal (1)

6 seconds to return to normal (2)

Takes 10 seconds or more (4)

Smokers (4)

Ulceration/loss of sensation over fingertips (4)

Painful ulcers developing over lower legs (4)

Arteries

Family history of premature death or limb amputation due to arterial disease (Heart disease/stroke/aneurysm) (2)

Diabetes (2)

High blood pressure (2)

Night cramps: (1)

Pain in legs usually calves when walking, usually comes on after a set distance and subsides on rest(Intermittent claudication) (4)

Cold hands / feet all the time even in warm weather. sits by fire sometimes burns (4)

Cold hands/feet (1)

Buttock pain when walking-sometimes an indicator of Buergers disease (severe damage to the arteries especially in younger men associated with smoking) (4)

Maximum score would be about 60.

0 - 8 Complacency is never healthy but you're obviously in good shape with nothing to worry about.

9 - 20 Your circulation is not too bad but if you don't start looking after yourself now, you could be in trouble in later life.

20 - 30 Your circulation is already affecting your health and will continue to do so unless you make some lifestyle changes.

30+ - This is not a good thing.Have you checked your pulse recently?. If you haven't already, you should ask your Doctor for advice when you next go to see them.

· How to improve your Score

Depending on how well you fared, you may wish to improve your score.Firstly if you smoke stop.If you can't stop cut down.If you drink more than the safe recommended level for men (28 units per week)or for women (21 units per week) cut down on your intake.Whilst small amounts of Cabernet Sauvignon red wine may be good for the circulation larger amounts of alcohol can have a damaging effect. A good diet,regular exercise and correct supplementation can all help.Some people with a strong family history of circulatory problems take a regular Aspirin 75mg .This thins the blood but be aware that some people are allergic to aspirin and others can suffer from bleeding from the stomach.Taken long term it can also thin the blood to a degree which can cause complications with surgery for instance so make sure you let your GP know if you are buying aspirin over the counter.

· Diet.

Foods rich in anti-oxidants will help to improve circulation. Oxidants or free radicals are dangerous particles that cause microscopic destruction of the body's tissues and cells. Anti-oxidants can help to combat this damage and support the processes of healthy blood clotting.

Experts recommend 5 helpings of anti-oxidant rich foods a day. Fruit and vegetables have a naturally high content, especially berries (strawberries, raspberries, blueberries), red grapes, plums, kale, spinach, sprouts and broccoli.

You should also remember to drink plenty of fluids (2 pints a day) so as not to become dehydrated. Without an adequate supply of fluids and in particular water, circulation will become sluggish. Likewise you should restrict your intake of caffeine and alcohol, as these will have a diuretic effect, draining the body of fluids.

· Exercise

One of the main reasons why our circulation begins to suffer is because we deprive ourselves of sufficient exercise. Daily physical activity strengthens the body's heart and lungs and increases the flexibility of blood vessel walls. It increases the resting width of blood vessels making it easier for them to supply blood to the tissues at all times.It can also help to lower blood pressure and reduce the risk of cardio-vascular complaints.

Try to exercise for at least 20 - 30 minutes a day. Activities such as walking, swimming or jogging enable the muscles in the legs to push blood up the vein. By increasing your heart rate through exercise you are also making the blood pump faster around the body and so unblocking any sluggish vein valves through increased pressure.

Try not to stand in one position for too long. If regular exercise is not an option, bounce up and down on the balls of your feet. This will exercise the muscles in your calf, increasing circulation and blood flow to the heart.You can find some simple exercises on another page

Supplementation:

Correct supplementation can also help to maintain healthy circulation.

30 years of scientific research show that Pycnogenol, made from French maritime pine bark extract, is probably the world's most powerful anti-oxidant.

It binds with free radicals in the body, neutralising and stabilising them. This enhances capillary resistance and encourages correct platelet formation in the blood, helping to prevent blood from clotting.

Pycnogenol costs from £9.95 for a month's supply and is available nation-wide, or by mail order from Pharma Nord UK Ltd on 0800 591 756.