Horse Chestnut (Aesculus hippocastanum)

Horse Chestnut: Medical Uses

Horse chestnut is used to improve circulation for varicose veins and to treat leg cramps and hemorrhoids.

Historical Uses

Historically, horse chestnut seeds were used as an anticoagulant and for nocturnal leg cramps.

Growth

The deciduous horse chestnut tree grows in the northern hemisphere. It prefers well-drained soil and sun or partial shade.

Part Used

• Seed extract

Major Chemical Compounds

• Triterpenic saponin aescin

Horse Chestnut: Clinical Uses

Horse chestnut is used to improve circulation and to treat leg cramps, varicose veins, hemorrhoids, and chronic venous insufficiency. It is approved by the German Commission E for “chronic venous insufficiency”.

Mechanism of Action

Horse chestnut has anti-inflammatory effects. It also reduces capillary permeability, protects the integrity of the veins, and reduces levels of leukocytes and proteoglycan hydrolases in limbs affected by chronic venous insufficiency.

Horse Chestnut: Dosage

Seed extract: 300 mg twice daily, standardized to contain 15 to 21 percent aescin. Some studies used 50 mg of aescin per capsule twice a day. Do not make tea out of raw, unprocessed horse chestnut seeds.

Gel or lotion: Apply 2 percent aescin gel or lotion topically four times a day to bruises, strains, sprains, and varicose veins.

Side Effects

Horse chestnut may cause nausea, stomach complaints, and itching.

Contraindications

• Do not use horse chestnut with anticoagulants or if patient has kidney or liver disease.

• Do not apply gel to broken skin.

• Do not make tea out of raw, unprocessed horse chestnut seeds.

Herb-Drug Interactions

None are known.

Pregnancy and Breast-Feeding

Avoid use in pregnant and breast-feeding women.

Summary of Studies

Calabrese & Preston (1993). This study is a double-blind, randomized, single-dose trial of topical 2 percent aescin gel in subjects with hematomas. Results: Bruises healed more quickly in subjects who had horse chestnut applied topically compared with those who received placebo.

Pittler & Ernst (1998). This is a meta-analysis of 13 studies. Results: Horse chestnut was superior to placebo in improving symptoms of chronic venous insufficiency.

Warnings

  • • Horse chestnut may cause nausea, stomach complaints, or itching.
  • • Don’t use horse chestnut if you take a blood thinner or if you have kidney or liver disease.
  • • Don’t apply gel or lotion to broken skin.
  • • Don’t make tea out of raw, unprocessed horse chestnut seeds.
  • • Avoid use during pregnancy and breast-feeding.