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horse chestnut
What Is It?
Health Benefits
Forms
Dosage Information
Guidelines for Use
General Interaction
Possible Side Effects
Cautions


What Is It?

Every autumn, the shady horse chestnut tree (Aesculus hippocastanum) produces prickly fruits containing one to three large seeds, or "nuts." In the 1800s, European doctors figured out that an extract made from these seeds could help treat varicose veins, hemorrhoids, and other disorders caused by fragile veins and sluggish circulation.

Today, horse chestnut seed extract is still used for these conditions and is particularly popular in Germany, where it ranks among the most common prescription herbal remedies (after ginkgo biloba and St. John's wort).

The horse chestnut is also known as the Spanish chestnut. Never take the seeds right off the tree to make a home remedy; the seeds (and other parts of the tree) are poisonous. To be safe, they must be carefully treated to extract the active ingredient.

Also, don't confuse seeds from the horse chestnut with seeds ("nuts") of the sweet chestnut (Castanea vesca), a tree that bears delicious chestnuts, ideal for roasting and stuffing into holiday turkeys.

Health Benefits

Scientists examining the seeds of the horse chestnut identified the main therapeutic ingredient, aescin, which is sometimes described as a group of chemically related substances called "escin."

Aescin reduces inflammation and tones up vein walls, allowing blood to flow back to the heart more easily. It appears to accomplish this by plugging up minute holes and microscopic leaks in the tiniest blood vessels, the venules, and in the capillaries. In reinforcing the strength of veins, horse chestnut is believed to also promote their elasticity and prevent swelling and long-term damage to them.

Specifically, horse chestnut seed extract may help to:

  • Treat the discomforts of varicose veins and other leg vein problems. Symptoms of varicose veins and the closely related condition known as chronic venous insufficiency--swollen legs, pain, and heaviness in the legs, and calf cramps (especially at night)--may well subside with horse chestnut treatment. In parts of Europe, the herbal extract has been intensively studied for this use in particular, with numerous clinical trials cited in the medical literature.

    For example, a 1996 study involving 240 patients, reported that horse chestnut seed extract (aescin, 50 mg twice a day) provided the same relief from lower leg swelling (edema) as compression (support) stockings. Such stockings are typically considered the primary treatment for varicose veins and venous insufficiency, so the fact that the horse chestnut seed extract could perform with similar effectiveness was significant.

    Investigators who reviewed the findings of 13 clinical trials done on the extract concluded it was clearly better than a placebo (dummy drug or sugar pill) in relieving vein-related leg problems such as varicose veins. The analysis was published in a 1998 issue of the well-known scientific journal Archives of Dermatology.

  • Reduce hemorrhoids. Painful and inflamed hemorrhoids may subside with horse chestnut seed extract for the same reasons that the remedy is so effective for varicose veins. By strengthening and toning the body's veins, as well as actually lessening swelling and fluid retention in the body, the hemorrhoid--a swollen vein itself--will be more likely to recede.

    German health authorities approve of horse chestnut seed extract for hemorrhoids.

  • Forms

    • powder
    • ointment
    • lotion
    • liquid
    • gel
    • cream
    • capsule

    Dosage Information

    Special tips:

    --Only use horse chestnut seed products standardized to contain 50 mg aescin per dose.

    --Oral formulations have been much more intensively researched than topical formulations such as gels and ointments, which have recently become available in the United States. It's not clear whether the topical forms are as effective.

    For varicose veins or hemorrhoids: Take a 250 mg standardized extract capsule twice a day, or 1 teaspoon liquid extract twice a day. There are also topical formulations that can be applied two or three times a day; these may aid hemorrhoids especially.

    Guidelines for Use

  • If stomach upset develops, try taking horse chestnut with food or in the form of a timed-release product, which delays the release of the extract until the capsule has passed through most of the stomach.

  • A tea can be made with horse chestnut leaves, which also contain aescin, but there isn't as much evidence to support the effectiveness and safety of leaf preparations.

  • General Interaction

    Horse chestnut may interfere with the action of anticoagulants (blood-thinners) such as warfarin (Coumadin), intensifying the effect of the medication and increasing the risk of bleeding.

    Possible Side Effects

  • Some people experience mild gastrointestinal upset when taking horse chestnut seed extract on an empty stomach.

  • Sensitivity or allergic reactions include headache, dizziness, and itching. Stop taking the extract and consult your doctor if any of these occur.

  • Cautions

  • Only use specially prepared extracts of horse chestnut seeds. Manufacturers remove the toxins found naturally in the seeds from extract products. (The extract should be standardized to a uniform concentration of aescin.)

  • Horse chestnut seed extract products have been safely used in Germany for decades. As long as the product is properly prepared, the risk of adverse reactions and complications appears to be quite low.

  • If you have any type of liver or kidney problem, consult your doctor before taking horse chestnut seed extract.

  • Don't use horse chestnut during pregnancy or while breast-feeding.

  • Date Published: 04/18/2005
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