Horse Chestnut

Aesculus hippocastanum

What is Horse Chestnut?

European horsechestnut, buckeye, and conker tree. It is in the species of flowering plant in the soapberry and lychee family Sapindaceae. The main active component in horse chestnut extract is aescin.

What are the benefits of Horse Chestnut?

Historically, horse chestnut seed extract was used for joint pain, bladder and gastrointestinal problems, fever, leg cramps, and other conditions. There is some evidence for horsechestnut being used successfully in irritable bowel disease [i]. There is also evidence for use in relieving haemorrhoids [ii].

Anti-inflammatory actions

Results from studies suggest that aescin has an anti-inflammatory effect, whereby its mechanisms may be correlated with major inflammatory pathways in the body such as the GC receptor/NF-κB signalling pathway [iii]. The excellent tolerability of aescin in studies indicates it is of clinical benefit in patients with conditions resulting in chronic venous insufficiency, haemorrhoids or swelling of limbs [iv].

Varicose veins and chronic venous insufficiency

Chronic venous insufficiency (CVI) results from poor blood flow in the veins in the lower legs. Symptoms of CVI can include swelling of the legs (known as oedema), pain or cramping in the legs, enlarged, twisted veins (varicose veins), ulcers on the legs, weakness in the legs and itching of associated area. The compound aescin in horse chestnut has multiple medicinal properties which are helpful in alleviating symptoms of chronic venous insufficiency.

Several randomised controlled trails show improvements in chronic venous insufficiency with horsechestnut [v] [vi]. In a review of 19 studies, symptoms such as leg pain, swelling, and itchy legs were seen to improve [vii]. In another review it was concluded that the extract offers a real alternative in the treatment of patients with mild to moderate venous insufficiency [viii].

Horsechestnut is thought to help improve varicose veins via improving blood flow to the area, attenuating the inflammation response, stimulating immune response for tissue repair, reducing the damage to the veins and helping to prevent the release of growth factors, associated with progression of the condition [ix] [x].

Specific use for varicocele

Some research has been done on horse chestnut seed extract for male infertility associated with varicocele (a swelling of veins inside the scrotum) [xi] [xii]. This action may make it an effective application for infertility related to varicocele [xiii].

Antioxidant content

Antioxidants are compounds that can help prevent cell damage caused by unstable molecules called free radicals. Such damage can lead to DNA damage causing chronic diseases and conditions.

Horsechestnut seed contains antioxidant compounds such as flavonoids, including quercetin and kaempferol [xiv]. Horsechestnut seed extract in its natural form was found to have greater antioxidant effects than aescin alone [xv].

Safety

Toxicity

The raw seeds, bark, flowers, and leaves of horse chestnut are unsafe because they contain a toxic component. Standardised horse chestnut seed extracts, from which this component has been removed, appear to be safe for short-term use [xix].

Rare side effects include dizziness, nausea, and digestive upsets in some people.

Avoid use during pregnancy and lactation.

Interactions

Chestnut may interact with anticoagulants and anti-diabetics, and caution is advised in patients taking these drugs.

Recommended For

Varicose Veins , Inflammation

[i] Hawrelak, J.A. Wohlmuth, H. Pattinson, M. et al. ‘Western herbal medicines in the treatment of irritable bowel syndrome: a systematic review and meta-analysis’. Complementary Therapies in Medicine. 48:102233.

[ii] MacKay, D. (2001) ‘Hemorrhoids and varicose veins: a review of treatment options’. Alternative Medicine Review. 6(2):126-40.

[iii] Wang, H. Zhang, L. Jiang, N. et al. (2013) ‘Anti-inflammatory effects of escin are correlated with the glucocorticoid receptor/NF-κB signaling pathway, but not the COX/PGF2α signalling pathway'. Experimental and Therapeutic Medicine. 6(2):419-422.

[iv] Sirtori, C.R. (2001) ‘Aescin: pharmacology, pharmacokinetics and therapeutic profile’. Pharmacology Research. 44(3):183-93.

[v] Pittler, M.H. & Ernst, E. (2012) ‘Horse chestnut seed extract for chronic venous insufficiency’. Cochrane Database Systematic Reviews. 14;11(11):CD003230.

[vi] Methlie, C.B. & Schjøtt, J. (2009) ‘Hestekastanje - naturlegemiddel mot venøs insuffisiens [Horse chestnut--remedy for chronic venous insufficiency]’. Tidsskr Nor Laegeforen. 26;129(5):420-2.

[vii] Dudek-Makuch, M. & Studzińska-Sroka, E. (2015) ‘Horse chestnut – efficacy and safety in chronic venous insufficiency: an overview’ Revista Brasileira de Farmacognosia. 25 (5), pp. 533-541.

[viii] Suter, A. Bommer, S. & Rechner, J. (2006) ‘Treatment of patients with venous insufficiency with fresh plant horse chestnut seed extract: a review of 5 clinical studies’. Advances in Therapy. 23(1):179-90

[ix] Frick, R.W. (2000) ‘Three treatments for chronic venous insufficiency: escin, hydroxyethylrutoside, and Daflon’. Angiology. 51(3):197-205.

[x] Raffetto, J.D. & Khalil, R.A. (2011 ‘)Ca(2+)-dependent contraction by the saponoside escin in rat vena cava: implications in venotonic treatment of varicose veins’. Journal of Vascular Surgery. 54(2):489-96.

[xi] Tian, R.H. Ma, M. Zhu, Y. et al. (2014) ‘Effects of aescin on testicular repairment in rats with experimentally induced varicocele’. Andrologia. 46(5):504-12.

[xii] Fang, Y. Zhao, L. Yan, F. et al. (2010) ‘Escin improves sperm quality in male patients with varicocele-associated infertility’. Phytomedicine. 17(3-4):192-196.

[xiii] Calogero, A.E. Condorelli, R.A. Russo, G.I. et al. (2017) ‘Conservative Nonhormonal Options for the Treatment of Male Infertility: Antibiotics, Anti-Inflammatory Drugs, and Antioxidants’. BioMed Research International. 2017:4650182.

[xiv] Kapusta, I. Janda, B. Szajwaj, B. et al. (2007) ‘Flavonoids in horse chestnut (Aesculus hippocastanum) seeds and powdered waste water byproducts’. Journal of Agricultural and Food Chemistry. 55(21):8485-90

[xv] Vašková, J. Fejerčáková, A. Mojžišová, G. et al. (2015) ‘Antioxidant potential of Aesculus hippocastanum extract and escin against reactive oxygen and nitrogen species’. European Review for Medical and Pharmacological Science.19(5):879-86.

[xvi] Zhou, X.Y. Fu, F.H. Li, Z. et al. (2009) ‘Escin, a natural mixture of triterpene saponins, exhibits antitumor activity against hepatocellular carcinoma. Planta Med’.75(15):1580-5.

[xvii] Harikumar, K.B. Sung, B, Pandey, M.K. et al. (2010) ‘Escin, a pentacyclic triterpene, chemosensitizes human tumor cells through inhibition of nuclear factor-kappaB signaling pathway’. Molecular Pharmacology. 77(5):818-27.

[xviii] Çiftçi, G.A. Işcan, A. & Kutlu, M. (2015) ‘Escin reduces cell proliferation and induces apoptosis on glioma and lung adenocarcinoma cell lines’. Cytotechnology. 67(5):893-904.

[xix] Hardin, J. (1974) ‘Human Poisoning from Native and Cultivated Plants’. Durham, NC: Duke University Press.