Horse Chestnut
Botanical name: Aesculus hippocastanum
© Steven Foster
Parts used and where grown
The horse chestnut tree is native to Asia and northern Greece, but it is now cultivated in many areas of Europe and North America. The tree produces fruits that are made up of a spiny capsule containing one to three large seeds, known as horse chestnuts. Traditionally, many of the aerial parts of the horse chestnut tree, including the seeds, leaves, and bark, were used in medicinal preparations. Modern extracts of horse chestnut are usually made from the seeds, which are high in the active constituent aescin (also known as escin).
Horse chestnut has been used in connection with the following conditions (refer to the individual health concern for complete information):
| Science Ratings | Health Concerns |
|---|---|
 |
Chronic venous insufficiency |
 |
Hemorrhoids Sprains and Strains (topical) Wound healing (topical) |
 |
Edema (water retention) Varicose veins |
| Reliable
and relatively consistent scientific data showing a substantial health benefit. Contradictory, insufficient, or preliminary studies
suggesting a health benefit or minimal health benefit. For an herb, supported by traditional use but minimal
or no scientific evidence. For a supplement, little scientific support and/or minimal health
benefit. |
|
Historical or traditional use (may or may not be supported by scientific studies)
Horse chestnut leaves have been used by herbalists as a cough remedy and to reduce fevers.1 The leaves were also believed to reduce pain and inflammation of arthritis and rheumatism. In traditional herbal medicine, poultices of the seeds have been used topically to treat skin ulcers and skin cancer. Other uses include the internal and external application for problems of venous circulation, including varicose veins and hemorrhoids.
Active constituents
The seeds are the source of a saponin known as aescin, which has been shown to promote circulation through the veins.2 Aescin fosters normal tone in the walls of the veins, thereby promoting return of blood to the heart. This has made both topical and internal horse chestnut extracts popular in Europe for the treatment of chronic venous insufficiency and, to a lesser extent, varicose veins. Aescin also possesses anti-inflammatory properties and has been shown to reduce edema (swelling with fluid) following trauma, particularly following sports injury, surgery, and head injury.3 4 A topical aescin preparation is very popular in Europe for the treatment of acute sprains during sporting events. Horse chestnuts also contain flavonoids, sterols, and tannins.
Double-blind and preliminary clinical trials have shown that oral horse chestnut extracts reduce the symptoms of chronic venous insufficiency, including swelling and pain.5 6 Those suffering edema after surgery have also found relief from topical application of horse chestnut extracts, according to preliminary studies.7
How much is usually taken?
For treatment of chronic venous insufficiency horse chestnut seed extracts standardized for aescin content (16–20%), 300 mg two to three times per day, are recommended.8 9 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.10 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.12 13 People with liver disease should also avoid the use of horse chestnut. There are no known reasons to avoid horse chestnut during pregnancy.14 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.
Are there any drug
interactions?
Certain medicines may interact with horse chestnut. Refer to drug interactions for a list of those medicines.
References
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The information presented in Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires September 2008.