Facial Puffiness and a Tendency to Swell

Q My blood tests are normal and my kidneys are fine, but I keep swelling. Does that mean there is no cause?

A. Normal tests mean dangerous causes have been excluded. It does not mean the swelling is gone. Swelling at this stage is a matter of the pace of circulation and metabolism, which numbers rarely reveal.

Q How do I tell swelling from the kidneys, heart or thyroid apart from simply swelling easily?

A. Breathlessness, or finding it harder to breathe when lying down, points to the heart; reduced urine output, marked puffiness around the eyes, or foamy urine points to the kidneys. Feeling the cold with fatigue, constipation and weight gain calls for thyroid testing. Swelling that rises and falls with the time of day and with meals, without those signs, is the common type.

Q I have swollen easily since childhood. Is this simply my constitution for life?

A. There is an inborn tendency, but it is not unchangeable. How much you swell and how long it lasts vary greatly with daily conditions. In fact, swelling is usually the first thing to respond to care.

Q Along with swelling I have cold hands and feet, constant fatigue, and it worsens before my period. Are they connected?

A. They often arise together from the same problem of circulation and metabolism. When flow does not reach the periphery, the hands and feet turn cold while fluid remains in the tissues. Hormonal change before a period amplifies that tendency once more.

Q Is there anything I can try at home?

A. Take a warm bath or foot bath every other day, warm enough to bring a sweat to the face. It helps pooled fluid leave through the sweat glands. In the evening, raise your legs above heart level for 10 to 15 minutes and the next morning feels notably lighter.

Q In weeks when I sleep badly my face swells much more. Does sleep matter here too?

A. Poor sleep disturbs the rhythm that regulates water and salt, so morning puffiness increases. Sleeping position and timing matter as well. A pattern of late nights and late mornings makes swelling your default state.

Q When does swelling mean going to a hospital first?

A. Sudden swelling of one limb with pain or heat, breathlessness or difficulty breathing when lying down, and a clear drop in urine output all need immediate care. The same applies to rapid weight gain over a few days, or marked puffiness around the eyes with foamy urine. Sudden swelling with headache during pregnancy must be assessed without delay.

Q Can I buy something over the counter to reduce swelling? I have also been prescribed a diuretic before.

A. We do not recommend repeatedly using diuretic products on your own. Electrolytes leave along with the water, which can bring dizziness, muscle cramps and exhaustion. If a diuretic has been prescribed, keep taking it and tell us at your visit.

Q I take blood pressure medication and a diuretic. Can I take herbal medicine alongside them?

A. In most cases yes, but you must tell us everything you are taking. For those on diuretics or medication for the kidneys or heart, we adjust the intensity so body water does not shift too quickly. Do not stop existing medication on your own.

Q How soon after starting care does the swelling go down?

A. Swelling usually responds before weight does. Many people find their face lighter in the morning and their clothes fitting differently within the first few weeks. Actual reduction in body fat appears later than that.

Q My face is puffy every morning. What is happening in my body?

A. Fluid is pooling between the tissues instead of staying within the blood vessels. Lying down overnight draws fluid towards the face, so the face puffs in the morning; standing all day leaves the legs swollen by evening. Where you swell and when is the first clue to the cause.

Q I felt I swell even from drinking water, so I cut back — and it got worse. Why?

A. When you reduce fluid, the body holds on to water instead. The moment it senses a shortage, elimination slows further. The more easily you swell, the more the direction should be to drink enough and release it well.

Q After a salty meal my weight is up two or three kilograms the next day. Did I really gain that much fat overnight?

A. No amount of fat is added that fast. Most of it is the weight of water your body is holding. With excess salt, the body retains more water to balance the concentration.

Q Which foods make swelling worse?

A. Salty meals — soups, noodle dishes, processed and delivery food — matter most. Late-night eating and alcohol come straight back as puffiness the next morning. Sweets and wheat create digestive stagnation and worsen swelling indirectly.

Q How much water should I drink, and how?

A. Around two litres a day, divided through the daytime hours, is the baseline. Small amounts often beats a large amount at once for elimination. Reducing intake from two hours before bed leaves the face less puffy in the morning.

Q I work in Dong-gu, Incheon. How often should I come in?

A. Early on we check body composition and swelling every two weeks and adjust the intensity. If acupuncture and moxibustion are combined we suggest one or two visits a week, adjusted to your circumstances. At the first visit we set a realistic plan around your work schedule.

Q In what order does the clinic manage swelling?

A. We first screen for danger signs and read your body composition to see how fluid is distributed. Early on we focus on releasing pooled surplus fluid through urine and sweat, then reduce digestive stagnation so circulation is not blocked. Finally we lift metabolism and activity to build a state where fluid no longer pools.

Q Teas and supplements for swelling only work on the day. Why?

A. Draining water temporarily and building a body where water does not pool are different things. Increasing elimination reduces that day's swelling while the cause remains. So within days you return to the same state.