Horse chestnut Aescin.Horse Chestnut Extract.
Article Content:
- .Botanical Basic Data of Horse chestnut.Aesculus hippocastanum.
- .Narrative Hisdtory of Horse chestnut.Aesculuc,Aesculus hippocastanum.
- .Description of Horse chestnut.Aesculus hippocastanum..
- .Active constituents and mechanism of aescin from horsechestnut.
- .Historical and Scientifical use of Horse chestnut.
- .Indications,Combinations and Dosage of Horse chestnut.
- .Safety and Toxicity Study.
- .Research Update:Horse chestnut and aescin.
Indications,Combinations and Dosage of Horse chestnut.
The unique actions of Horse Chestnut are on the vessels of the circulatory system. It seems to increase the strength and tone of the veinsin particular. It may be used internally to aid the body in the treatment of problems such as phlebitis, inflammation in the veins, varicosity and haemorrhoids. Externally it may be used as a lotion for the same conditions as well as for leg ulcers. King's Dispensatory gives the following specific indications and uses: visceral neuralgia, due to congestion; soreness of the whole body, with vascular fullness, throbbing, andgeneral malaise; throbbing, fullness, and aching in the hepatic region; rectal uneasiness with burning or aching pain; sense of constriction, with itching; large, purple pile-tumors; uneasy sensations and reflex disturbances depending upon haemorrhoids or rectal vascular engorgement.
Combinations of Horse chestnut:Other cardiovascular tonics such as Hawthorn, Linden, Ginkgo and Yarrow.
Properties:Anti-oxidant, anti-inflammatory, anti-rheumatic, analgesic, astringent, econgestant, expectorant, febrifuge, tonic, vasoprotective, venous tonic.
Indicated for:Chest pain, chronic venous insufficiency, frostbite, haemorrhoids, hardening of the arteries, improving connective tissue tone, leg ulcers, lung conditions (embolisms, infarction, thrombosis), lymphedema, neuralgia, oedema, phlebitis, rheumatism, sprains and other injuries, swollen ankles, varicose veins, varicose eczema, venous stasis.
Preparations and Dosage of Horse chestnut(Aesculus hippocastanum):
Infusion: pour a cup of boiling water onto l-2 teaspoonfuls of the dried fruit and leave to infuse for l0-l5 minutes. This should be drunk three times a day or used as a lotion. Tincture: take l-4 ml ofthe tincture three times a day.
How much is usually taken? For treatment of chronic venous insufficiency horse chestnut seed extracts standardized for aescin content (16 to 20%), 300 mg two to three times per day, are recommended. Tincture, 1-4 ml taken three times per day, can be used though it is questionable whether a significant amount of aescin can be absorbed this way.Gels or creams containing 2% aescin can be applied topically three or four times per day for hemorrhoids, skin ulcers, varicose veins, sports injuries, and trauma of other kinds.
Are there any side effects or interactions? Internal use of horse chestnut seed extracts standardized for aescin at recommended amounts is generally safe. However, in rare cases oral intake of horse chestnut may cause itching, nausea, and upset stomach.11 Based on reports of worsening kidney function in people with kidney disease who received intravenous aescin, horse chestnut should be avoided by anyone with kidney disease.People with liver disease should also avoid the use of horse chestnut. There are no known reasons to avoid horse chestnut during pregnancy.Topically, horse chestnut has been associated with rare cases of allergic skin reactions. Circulation disorders and trauma associated with swelling may be the sign of a serious condition. Therefore, a healthcare professional should be consulted before self-treating with horse chestnut.
Dosage and Administrations
The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.
Standardization:Standardization involves measuring the amount of certain chemicals in products to try to make different preparations similar to each other. It is not always known if the chemicals being measured are the "active" ingredients. Horse chestnut seed extract (HCSE) products are often standardized to contain 16% to 20% triterpene glycosides calculated as escin (aescin) content.
Adults (18 years and older):
Oral (by mouth): 300 milligrams every 12 hours, for up to 12 weeks (containing 50 to 75 milligrams of escin per dose), has been taken by mouth. A dose of 600mg of chestnut seed extract per day has also been studied.
Topical (on the skin): A gel preparation of horse chestnut applied to the skin has been studied for bruising, without clear benefits.
Intravenous (through a vein)/intramuscular (injected into a muscle): Severe allergic reaction (anaphylactic shock) has been reported with intravenous use. Horse chestnut leaf has been associated with liver inflammation (hepatitis) after injection into muscle.
Children (younger than 18 years):
There is not enough scientific evidence to recommend use of horse chestnut in children. Deaths have been reported in children who ate raw horse chestnut seeds or tea made from horse chestnut leaves and twigs.
Safety and Side Effects:
Allergies :Horse chestnut seed extract (HCSE) may cause an allergic reaction in patients with known allergy to horse chestnuts, esculin,or any of its ingredients (flavonoids, biosides, trisides of quertins, and oligosacharides including 1-ketose and 2-ketose). Anaphylactic shock (severe allergic reaction) has been reported with intravenous (through the vein) use.
Side Effects and Warnings:
Unprocessed horse chestnut seeds, leaves, bark, and flowers contain esculin, which has been associated with significant toxicity and death. Symptoms found with horse chestnut poisoning may include vomiting, diarrhea, headache, confusion, weakness, muscle twitching, poor coordination, coma or paralysis. Horse chestnut seed extract (HCSE) standardized to escin content should not contain significant levels of esculin, and should not have the same risks.
Standardized HCSE is generally considered to be safe in adults at recommended doses for short periods of time. Stomach upset, muscular (calf) spasm, headache, dizziness, nausea and itching have been reported. Contact skin irritation (dermatitis) has been reported following application of HCSE to the skin.
Based on animal study, HCSE may cause lowered blood sugar. Caution is advised in patients with diabetes or hypoglycemia, and in those taking drugs, herbs, or supplements that affect blood sugar. Serum glucose levels may need to be monitored by a qualified healthcare provider, and medication adjustments may be necessary.
In theory, horse chestnut may increase the risk of bleeding due to the hydroxycoumarin content of esculin. Properly extracted HCSE should not contain esculin, and therefore should not carry this risk. However, caution is advised in patients with bleeding disorders or taking drugs that may increase the risk of bleeding. Monitoring is recommended and dosing adjustments may be necessary. There is a case report of liver toxicity associated with horse chestnut leaf that resolved after discontinuing the product. Kidney toxicity when high doses of escin were injected have been reported. Aflatoxins, considered to be cancer-causing agents, have been identified in commercial skin products containing horse chestnut, but not in HCSE.
Pregnancy and Breastfeeding:There is not enough scientific research to recommend the safe use of horse chestnut or HCSE during pregnancy and lactation. One small study of pregnant women treated with HCSE did not report serious adverse effects after two weeks.
Interactions with Drugs:
In theory, due to its esculin constituents, horse chestnut (but not horse chestnut seed extract, which when properly prepared does not contain esculin) may theoretically increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants ("blood thinners") such as warfarin (Coumadin) or heparin, anti-platelet drugs such as clopidogrel (Plavix), and non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin, Advil) or naproxen (Naprosyn, Aleve).
In theory, and based on limited animal study, horse chestnut seed extract (HCSE) may have an additive effect when taken with drugs that cause hypoglycemia (low blood sugar levels). Caution is advised when using medications that may also lower blood sugar. Patients taking drugs for diabetes by mouth or insulin should be monitored closely by a qualified healthcare provider. Medication adjustments may be necessary.
Escin in HCSE may theoretically interfere with protein-bound drugs such as phenytoin (Dilantin), warfarin (Coumadin) or amiodarone (Cordarone), although no cases are reported in the available literature.
Interactions with Herbs and Dietary Supplements:
In theory, due to its esculin constituents, horse chestnut (but not horse chestnut seed extract, which when properly prepared does not contain esculin) may theoretically increase the risk of bleeding when taken with herbs or supplements that increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba , and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases. Some examples include: alfalfa, American ginseng, angelica, anise, Arnica montana , asafetida, aspen bark, bilberry, birch, black cohosh, bladderwrack, bogbean, boldo, borage seed oil, bromelain, capsicum, cat's claw, celery, chamomile, chaparral, clove, coleus, cordyceps, danshen, devil's claw, dong quai, evening primrose, fenugreek, feverfew, flaxseed/flax powder (not a concern with flaxseed oil), ginger, grapefruit juice, grapeseed, green tea, guggul, gymnestra, horseradish, licorice root, lovage root, male fern, meadowsweet, nordihydroguairetic acid (NDGA), onion, papain, Panax ginseng, parsley, passionflower, poplar, prickly Ash, propolis, quassia, red clover, reishi, Siberian ginseng, sweet clover, rue, sweet birch, sweet clover, turmeric , vitamin E, white willow, wild carrot, wild lettuce, willow, wintergreen, and yucca.
In theory, and based on limited animal study, horse chestnut seed extract may have an additive effect when taken with other herbs or supplements that may lower blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment. Possible examples include: Aloe vera, American ginseng, bilberry, bitter melon, burdock,fenugreek, fish oil, gymnema, marshmallow, milk thistle, Panax ginseng, rosemary, Siberian ginseng, stinging nettle and white horehound. Agents that may raise blood sugar levels include: Arginine, cocoa, and ephedra (when combined with caffeine).
Reference:
1.Horse chestnut Aescin.Horse Chestnut Extract.
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