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Horse Chestnut

What is horse chestnut? What is it used for?

Horse chestnut is a tree originally grown in Asia and northern Greece, but now cultivated in Europe and North America. The tree produces fruits that are made up of a spiny capsule that resembles a walnut. Each capsule contains between one and three seeds, which are known as horse chestnuts. In addition to the seeds, the leaves and bark of the horse chestnut tree are used medicinally.

The active ingredient in horse chestnut seeds is aescin, a substance shown to promote circulation of the blood through the veins. It also acts as an anti-inflammatory, and has been shown to reduce swelling and edema following injury, particularly following surgery or head injuries.

Horse chestnut extracts can be applied either topically or internally. Double-blind studies have found that oral extracts can help people with venous insufficiency and varicose veins, while topical extracts have been beneficial to people with postsurgical edema.

How much horse chestnut should I take?

Many practitioners recommend 50-75 mg of a horse chestnut extract that has been standardized for aescin content. For tinctures, 1-4ml TID is recommended, although there are some questions about the amount of aescin that can be absorbed this way.

What forms of horse chestnut are available?

The most common forms of horse chestnut are extracts, which can be delivered topically or orally. Tinctures and gels are also available.

What can happen if I take too much horse chestnut? Are there any interactions I should be aware of? What precautions should I take?

Internal use of standardized horse chestnut extracts at recommended amounts is considered generally safe, although there have been occasional reports of itching, nausea and upset stomach associated with this product. It should not be taken by patients suffering from kidney or liver damage, and it should not be taken while pregnant unless recommended by a doctor.

Topical horse chestnut products may cause an allergic skin reaction. In addition, certain medications, such as heparin, warfarin and ticlopidine, may interact with horse chestnut.

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References

  • Chandler RF. Horse chestnut. Canadian Pharm J Jul/Aug 1993:297,300.
  • Diehm C, Trampish HJ, Lange S, Schmidt C. Comparison of leg compression stocking and oral horse chestnut seed extract therapy in patients with chronic venous insufficiency. Lancet 1996;347:292—4.
  • Dittler MH, Ernst E. Horse chestnut seed extract for chronic venous insufficiency: a criteria-based systematic review. Arch Dermatol 1998;134:1356—60.
  • Guillaume M, Padioleau F. Venotonic effect, vascular protection, anti-inflammatory and free radical scavenging properties of horse chestnut extract. Arzneim-Forsch Drug Res 1994;44:25—35.
  • Weiss RF. Herbal Medicine. Gothenburg, Sweden: Ab Arcanum and Beaconsfield, UK: Beaconsfield Publishers Ltd., 1988:188—9.


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