The Health Benefits of Horse Chestnut

This herb is purported to help varicose veins and hemorrhoids

horse chestnut (aesculus)
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Horse chestnut (Aesculus hippocastanum) is a type of tree that grows throughout the Northern Hemisphere. In herbal and folk medicine, horse chestnut seed, leaves, bark, and flowers have long been used to relieve symptoms, such as swelling and inflammation and to strengthen blood vessel walls.

Health claims for horse chestnut include the treatment of the following problems:

  • Circulatory disorders
  • Diarrhea
  • Hemorrhoids
  • Varicose veins

Horse chestnut contains a compound called aescin, which has been found to produce an anti-inflammatory effect. The unprocessed seeds, leaves, bark, and flowers also contain esculin, which is poisonous and may increase the risk of bleeding. (Aescin is a different compound and is considered to be safe.) Properly processing horse chestnut seed extract removes esculin.

Health Benefits

There have been studies in people on horse chestnut for chronic venous insufficiency (CVI). A condition in which the veins don't efficiently return blood from the legs to the heart, CVI is linked to problems like varicose veins, ankle swelling, and nighttime leg cramping. Very little research has been done on horse chestnut for other conditions.

Chronic Venous Insufficiency

Research suggests that horse chestnut seed extract may be useful in treating CVI. In a systematic review of 12 clinical trials published in 2012, for instance, horse chestnut seed extract improved leg pain, swelling, and itching in people with CVI when taken for a short time. Researchers concluded that "the evidence presented suggests that horse chestnut seed extract is an efficacious and safe short‐term treatment for CVI." One trial indicated that horse chestnut may be as effective as treatment with compression stockings. Adverse events were usually mild and infrequent.

Varicose Veins and Hemorrhoids

Hemorrhoids are actually a form of varicose veins and horse chestnut is used to treat them as well. One double-blind, placebo-controlled study of 80 people in 2001 found that the use of 40 milligrams of aescin three times a day produced noticeable subjective improvements after a week and objective improvements after two weeks. A review published that same year concluded that supplementation with horse chestnut "may prevent time-consuming, painful, and expensive complications of varicose veins and hemorrhoids." That said, according to the National Center for Complementary and Alternative Medicine, there's not enough scientific evidence to support the use of horse chestnut seed, leaf, or bark for any conditions besides CVI.

Selection, Preparation, & Storage

Never ingest any part of the horse chestnut tree. Poisoning from the fresh, unprocessed herb—for instance, by drinking tea made of the leaves or twigs—has proven deadly in children.

Instead, buy a commercial supplement. Manufacturers of horse chestnut products remove the toxic component, esculin. These products appear to be safe, as there have been few reports of harmful side effects despite being widely used in Europe.

Most supplements are standardized to contain 50 milligrams of aescin. The most common dosage is 50 milligrams of aescin two or three times a day.

To prevent gastrointestinal upset, choose a delayed-release formulation.

Possible Side Effects

Horse chestnut extract may produce a number of adverse effects, including itching, nausea, or gastrointestinal upset, muscle spasm, and headache.

In order to ensure the safe use of horse chestnut, make sure to consult your physician if you're considering using the herb to treat CVI or any other chronic health condition.

People with kidney or liver disease and bleeding disorders should avoid horse chestnut. Horse chestnut should not be combined with aspirin, Plavix (clopidogrel), Ticlid (ticlopidine), Trental (pentoxifylline), Coumadin (warfarin), and other anticoagulant or anti-platelet ("blood-thinning") drugs unless under medical supervision as it may increase the effect of these medications.

Keep in mind that supplements haven't been tested for safety and due to the fact that dietary supplements are largely unregulated, the content of some products may differ from what is specified on the product label. Note, too, that the safety of supplements in pregnant women, nursing mothers, children, and those with medical conditions or who are taking medications hasn't been established.

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