Scientific Names of Horse-Chestnut Seed:
Aesculus hippocastanum L. [Fam. Hippocastanaceae]
Forms:
Standardized aescin (saponin) extract.
Traditional Usage:
– Anti-inflammatory
– Astringent
– Capillary Strengthening
– Chronic Venous Insufficiency
– Diarrhea
– Edema
– Fever
– Hemorrhoids
– Leg Vein Health
– Phlebitis
– Poor Circulation
– Prostate Enlargement
– Prostatitis
– Varicose Veins
– Vascular Disorders
– Wrinkles
Overview:
Horse-chestnut seed, Aesculus hippocastanum L. [Fam. Hippocastanaceae], has traditionally been used for treating varicose veins, hemorrhoids, phlebitis, poor circulation, prostate enlargement, diarrhea and fever. In Europe, certain horse-chestnut seed extracts are believed to prevent thrombosis and thought to help strengthen weak veins and arteries. Seed extracts are also used to treat gastritis, gastro-enteritis and prostatitis. Externally, an astringent wash made from the leaves and roasted chestnuts of this tree are used for treating wrinkles. Japanese scientists tested 65 plant extracts and found seven to have strong enough antioxidant activity to be potent against wrinkles. Horse-chestnut and witch hazel were singled out as the best. Both of these are strong antioxidants. A recent review of the medical literature found that for treating chronic venous insufficiency there is convincing evidence for the effectiveness of oral horse chestnut seed extract. A meta-analysis of four trials (involving 239 patients) suggested a significant reduction in leg volume with the use of horse-chestnut seed extract compared with placebo. One trial indicated that horse-chestnut seed extract might be as effective as treatment with compression stockings. Leg pain was assessed in six placebo-controlled trials that reported a significant reduction of leg pain in the horse-chestnut seed extract groups compared with the placebo groups. Researchers noted that adverse effects were usually mild and infrequent. It was concluded that horse-chestnut seed extract is an efficacious and safe short-term treatment for chronic venous insufficiency. A controlled double-blind trial involving 40 patients over 4 weeks confirmed the anti-edema effects and beneficial influence on subjective parameters (pain, tiredness, feelings of tension and pruritus in the legs) of a horse chestnut extract. A randomized, placebo-controlled, double-blind cross-over trial of 22 patients with chronic venous insufficiency concluded that 1200mg horse-chestnut extract (standardized to 100mg aescin) had an anti-edema effect via a decrease in transcapillary filtration.
Active Ingredients:
Horse-chestnut seeds contain: Approximately 13% saponins, collectively referred to as aescin including alpha and beta aescin as the major glycosides; the coumarins aesculetin, fraxin (fraxetin glucoside), scopolin; flavonoids including flavonol (kaempferol and quercetin) glycosides such as astragalin, isoquercetrin, rutin, leucocyanidin (quercetin derivative); tannins and epicatechin; allantoin; amino acids (adenine, adenosine, guanine); choline; citric acid; and phytosterols.
Suggested Amount:
The recommended dosage of horse-chestnut seed is 0.2-1.0 gram taken three times daily. Caution: Standardized extracts should be taken exactly according to label directions.
Drug Interactions:
Horse-chestnut may interfere with anti-coagulant/coagulant therapy (coumarin constituents). Horse-chestnut reinforces warfarin action by heterogeneous mechanisms. Products should thus not be used in patients on oral anticoagulant and/or antiplatelet therapy. Also, aescin, the main saponin component of horse-chestnut, binds to plasma protein and may affect the binding of other drugs.
Contraindications:
Horse-chestnut is contraindicated during pregnancy and lactation and is also contraindicated for patients with existing kidney or liver damage. Horse-chestnut reinforces warfarin action by heterogeneous mechanisms and should thus not be used in patients on oral anticoagulant and/or antiplatelet therapy.
Side Effects:
When taken orally in recommended dosages, researchers have noted that adverse effects from horse-chestnut seed extract are usually mild and infrequent. Horse-chestnut’s saponins (soap-like compounds) may irritate the gastro-intestinal tract. Saponins are known to cause hemolysis (destruction of blood cells) but are not usually absorbed from the gastro-intestinal tract following oral administration. However, taking high dosages (above the recommended levels) is not recommended. It has been shown in animal studies that large doses of aescin given to animals rapidly causes death due to massive hemolysis. Two cases of kidney damage have been noted in the medical literature and were stated as probably due to the ingestion of high doses of aescin. In Japan, where horse-chestnut extracts are used as an anti-inflammatory drug after surgery or trauma, liver injury has been described in a male patient who received an intramuscular injection of a proprietary product containing horse-chestnut. Horse-chestnut extracts should not be taken in this manner -safety can only be assured with horse-chestnut extracts taken orally. In the case of this male patient, liver function tests showed a mild abnormality and a diagnosis of giant cell tumour of bone (grade 2) by bone biopsy was made. Other side-effects stated to have been reported for the product include shock, spasm, mild nausea, vomiting and urticaria. [Takegoshi K. et al. 1986. A case of VenoplantR-induced hepatic injury. Gastroenterol Japonica 21: 62-65].
References:
Duke, J. 1997: The Green Pharmacy, The Ultimate Compendium of Natural Remedies from the World’s Foremost Authority on Healing and Herbs. Pp. 307; 539-540; 554-555. Rodale Press.
Foster S, and Duke JA. 1990. Horse-chestnut in Medicinal Plants. Houghton Mifflin Co., New York, NY, p. 264.
Koch R. Comparative study of Venostasin and Pycnogenol in chronic venous insufficiency. Phytother Res. 2002 Mar; 16 Suppl 1: S1-5.
Newall CA, Anderson LA, and Phillipson JD. 1996. Uva-Ursi. In Herbal Medicines. A Guide for Health Care Professionals. The Pharmaceutical Press, London, pp. 166-167.
