Better Circulation—Why You Need It & How to Improve It

04/13/2022 | 6 min. read

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Your cardiovascular system is truly miraculous. It begins with a muscular pump that beats more than 100,000 times a day, pumping nine to 11 pints of blood that carry oxygen, nutrients, hormones, and other life-sustaining substances to your cells. Plus, it includes tens of thousands of miles of arteries, veins, and capillaries, reaching every corner of your body. 

Discussions of cardiovascular disease often focus on the heart, since it is the engine that drives the whole system. Yet, even with a well-functioning heart, clogged, narrowed blood vessels or thick, sticky blood will impair blood flow. 

How Poor Circulation Affects You 

Poor circulation deprives your cells and tissues of essential oxygen and nutrients. Conditions associated with restricted blood flow include:

  • Angina and shortness of breath, which are symptoms of coronary artery disease, are signs that your heart is not getting enough oxygen-rich blood. Most heart attacks occur when a blood clot blocks blood flow in a narrowed coronary artery. 
  • Peripheral artery disease, often accompanied by pain and cramping in the legs, is due to poor blood flow to the lower extremities.
  • Strokes, including transient ischemic attacks (TIAs or mini-strokes), are caused by disruptions in blood flow to areas of the brain. 
  • Heart failure is another casualty, as the heart must work harder to move blood through constricted vessels. Over time, this takes a toll on the heart muscle. 
  • Vascular dementia, which frequently occurs in conjunction with Alzheimer's disease, is related to impaired blood flow in the brain and, in some cases, a history of mini-strokes.
  • Erectile dysfunction may have several causes, but the most common is inadequate blood flow to the penis. 
  • Diabetes affects blood circulation by damaging the blood vessels. Diabetic complications, including neuropathy, slow-healing ulcers on the lower extremities, and kidney disease, are related to reduced blood flow. 

Other symptoms of poor circulation include cold hands and feet, numbness and tingling in the hands and feet, and edema or swelling due to an accumulation of fluids, usually in the feet, ankles, and legs. 

What Causes Poor Circulation? 

Just as corroded pipes clogged with mineral deposits restrict water flow, blood flow is reduced through damaged blood vessels. 

The underlying problem is atherosclerosis: the buildup of lipid-filled plaques and calcium in the artery walls. In addition to narrowing and hardening the “pipes,” which reduces blood flow, some plaques are prone to rupturing. When this happens, blood clots are formed that may completely block blood flow and cause a heart attack or stroke.

Blood characteristics also affect circulation. Healthy blood has the consistency of red wine. Thin and fluid, it flows freely through the arteries, veins, and the tiniest capillaries where nutrient and oxygen exchange take place. When blood is more viscous (thicker and stickier), there is more resistance against the blood vessels and circulation is impaired. There is also a tendency for platelets to aggregate, or clump together, and form potentially dangerous blood clots.

Poor Blood Flow Has 3 Main Culprits 

Good circulation requires addressing the root causes of atherosclerosis and sluggish blood. Let’s look at three primary culprits and what you can do to maintain healthy, flexible blood vessels and optimal blood flow.

Endothelial Dysfunction

Atherosclerosis begins with damage to the endothelium, the single layer of cells that lines the inner surfaces of the arteries, veins, and capillaries. In addition to serving as a protective barrier between the blood and the underlying vessels, the vascular endothelium produces an important vasodilator that has a profound effect on blood flow. 

Nitric oxide (NO) is a signaling molecule that relaxes and dilates the blood vessels. This enables them to expand when extra blood flow is needed or constrict to divert blood to specific areas. NO also plays a central role in blood pressure regulation. 

The arteries’ ability to dilate is of utmost importance. In fact, flow-mediated dilation (FMD)—a test that measures an artery’s ability to dilate—is a gold standard for evaluating endothelial function and vascular health. 

The initial endothelial injury could be the stress of elevated blood pressure, toxins in smoke, a high-sugar diet, or other risk factors. Whatever the cause, it triggers an inflammatory response that ravages the endothelium and sets atherosclerosis in motion. 


Chronic inflammation is the most significant risk factor for endothelial dysfunction. In addition to setting the stage for atherosclerosis and impairing blood flow, inflammation is a factor in most of the chronic diseases that plague us today. 

Inflammation can have many underlying causes, ranging from infections and inflammatory diseases to genetic disorders like hemochromatosis. Yet, the most common culprits are lifestyle related. What you eat, your activity level, and other modifiable risk factors have a tremendous influence on your body’s inflammatory burden.

Thick, Sticky Blood 

The viscosity, or relative thickness, of the blood itself is an overlooked cause of poor circulation. Healthy blood is thin, flows easily, and is free of superfluous clots. Thick, sticky blood, on the other hand, is prone to forming clots that impede blood flow. 

Hyper-viscous blood may be a consequence of an inherited clotting disorder or a serious disease, but many of the same lifestyle factors that promote inflammation—and inflammation itself—also contribute to sluggish blood.  

How to Achieve Better Circulation & Blood Flow

  • Weight loss: According to Mayo Clinic cardiologist Stephen Kopecky, MD, every pound of fat you gain adds five additional miles of blood vessels. That may be a stretch, but it is no exaggeration that excess body fat puts a lot of stress on your heart and blood vessels. Fat cells also release inflammatory chemicals that damage the arteries. Plus, obesity increases insulin resistance, which is linked with elevated blood sugar and blood pressure. 
  • Regular exercise: Exercise affects blood flow by increasing your heart rate, which moves more blood through your vessels. It also supports endothelial function and helps to prevent weight gain, lower blood pressure, and reduce blood sugar.
  • Healthy diet: The Pan-Asian Modified Mediterranean (PAMM) diet, which is centered around nutrient-dense, anti-inflammatory foods, is one of the best diets for blood flow and heart health. It includes wild-caught salmon, berries, beets, leafy greens, and other foods with proven benefits for circulation. Sugar is not a part of the PAMM diet, as it is terribly damaging to the endothelium and can lead to insulin resistance.
  • Blood sugar control: Diabetes is another risk factor. High levels of glucose in the blood trigger a spike in insulin that damages the endothelium. (The same thing happens when you eat sugar, which is why it is discouraged on the PAMM diet.) Weight loss, a low-carb diet, and physical activity plus supplemental berberine and chromium are excellent natural therapies for controlling blood sugar. 
  • Blood pressure management: High blood pressure places undue stress on the arteries and the endothelium. Endothelial damage reduces NO production, promotes plaque buildup, and drives blood pressure ever higher. That’s why high blood pressure causes circulation problems and increases the risk of heart attack and stroke.
  • Targeted supplements: There are several supplements that specifically target endothelial function, inflammation, and blood clotting. They include vitamin K2 to prevent arterial calcification, B-complex vitamins to protect the endothelium, omega-3s to improve blood viscosity, and various botanicals to curb inflammation.
Dr. Stephen Sinatra

Meet Dr. Stephen Sinatra

A true pioneer, Dr. Sinatra spent more than 40 years in clinical practice, including serving as an attending physician and chief of cardiology at Manchester Memorial Hospital, then going on to formulate his advanced line of heart health supplements. His integrative approach to heart health has changed the lives of hundreds of thousands.

More About Dr. Stephen Sinatra