Horse chestnut

Aesculus hippocastanum
 Aesculus
hippocastanum
• Aescule
• Buckeye
• Chestnut
• Castaño de Indias
• Graine de marronier d’inde
• Escine
• Eschilo
• Hippocastani semen
• Spanish chestnut
(Braun & Cohen 2010, p.608)
• Conker tree
(Wikipedia 2011)
 Sapindaceae
(soapberry family)
Members of this family include:
• Maple
• Lychee (and other tropical fruits)
• Guarana
(Wikipedia 2011)
 Parts used
medicinally
• Seed (Bone 2007, p.47)
• Less commonly:
• Bark
• Flowers
• Leaves
(Braun & Cohen 2010, p.608, Hoffman
2003, p.524)
Active constituents
• Triterpenoid saponins (aescin)
• Flavonoids
(Bone 2007, p.47)
• Coumarin derivatives
• Tannins
• Sterols
• Fatty acids
(Hoffman 2003, p.524),
• Quinines
• Sugars
(Braun & Cohen 2010, p.608)
Body system
affinities
• Cardiovascular
Herbal Actions
• Venotonic
• Anti-oedema
• Anti-inflammatory
(Bone 2007, p.47)
• Antioxidant,
• Anti-ageing
(Braun & Cohen 2010, p.609),
• Astringent
(Hoffman 1996, p.54)
 Therapeutic
applications
• Vasoprotection / normalisation of
vascular permeability
– Horse chestnut appears to prevent
activation of leukocytes, inhibiting
the activity of lysozomal enzymes
and preventing the degradation of
vascular walls (Pitter & Ernst 2004).
– A. hippocastanum also promotes
human endothelial cell proliferation
in vitro in a dose-dependent manner,
promoting venous wall maintenance
as well as protection (Fallier-Becker
et al. 2002).
Chronic venous
insufficincy
• Chronic venous insufficiency or
CVI is a medical condition where
the veins cannot pump enough
oxygen-poor blood back to the
heart.
• It is sometimes referred to as an
"impaired musculovenous pump",
this is due to damaged or
incompetent valves as may occur
after deep vein thrombosis (when
the disease is called post-
thrombotic syndrome) or phlebitis.
(Marieb 2010, p.734)
 Therapeutic
applications (cont.)
• Anti-oedema
– By inhibiting vascular wall
degradation horse chestnut reduces
excessive fluid exudation through
capillary walls. Specific animal
studies found horse chestnut
reduced both inflammatory and
lymphatic oedema (Guillaume &
Padioleau 1994).
– Aescin also appears to have a mild
diuretic effect, which likely aids in
resolving oedema (Mills & Bone
2000, p.450).
 Therapeutic
applications (cont.)
• Anti-ageing
• Studies (Fujimura et al. 2006a,
2006b) of the efficacy of topical
preparations showed that
contraction forces can be
induced in fibroblasts in ageing
skin. A controlled trial found
that an eye gel with 3% horse
chestnut extract produced a
significant reduction in “wrinkle
scores” around corners of eyes
and on lower eyelids (Fujimura
et al. 2006a).
Clinical uses and
studies
• A review of 5 clinical trials of
treatment of chronic venous
insufficiency (CVI) with horse
chestnut extract demonstrated a
reduction in leg pain, leg volume
(oedema), heaviness and itching
(Suter at al. 2006).
Clinical uses and
studies (cont.)
• A Cochrane review of 17 RCTs
concluded that signs and
symptoms of CVI improve when
treatment with horse chestnut
extract is undertaken when
compared to placebo (Pittler &
Ernst 2004).
Clinical uses and
studies (cont.)
• A case observational study (n>5000)
reported that symptoms of pain,
tiredness, tension and swelling in the
leg, as well as pruritis and tendency
to oedema as improved markedly or
disappeared altogether.
• Compliance was also better than
compression therapy (Greeske &
Pohlmann 1996).
Clinical uses and
studies (cont.)
• Aescin was shown to reduce
both symptoms (82% vs. 32%
placebo) and swelling (87% vs.
38% placebo) of haemorrhoids
in a placebo-controlled double
blind study (Sirtori 2001).
 Synergists
• For varicose veins, haemorrhoids
(internally) – Gotu kola, butcher’s broom,
grape seed
• For varicose veins, haemorrhoids
(topically) – Witch hazel, gotu kola,
arnica, agrimony
• For varicose ulcer – Grape seed,
andrographis
• For venous insufficiency – Gotu kola,
grape seed
• For restless leg syndrome, leg cramps,
night cramps – Gotu kola
• For easy bruising – Bilberry, grape seed
• For spider veins – Bilberry, butcher’s
broom, grape seed
(Bone 2007)
Contraindications /
warnings
• Do not apply directly to
broken/ulcerated skin
• Saponins can cause or
exacerbate gastro-oesophageal
reflux (use enteric-coated, solid
dose to avoid reflux)
• Raw seeds, bark, flowers and
leaves may be toxic
(Braun & Cohen 2010, p.611)
• Seeds contain coumarin
derivatives, potential interaction
with anticoagulant medications
(Hoffmann 2003, p.524)
 Dosages
• 15 to 35 mL/week (1:2 liquid)
• 2.4 to 3.6 g/day (tablet)
 Habitat
• Aesculus hippocastanum is
native to a small area in the
mountains of the Balkans in
southeast Europe, in small areas
in northern Greece, Albania, the
Republic of Macedonia, Serbia,
and Bulgaria. It is widely
cultivated throughout the
temperate world.
(Euro+Med Plantbase Project
2010)
Traditional uses
• Horsechestnut seeds and bark
have been used extensively in
European traditional medicine
since the 16th century,
specifically for:
– rheumatism
– neuralgia
– conditions of venous congestion
– haemorrhoids
– rectal neuralgia
– proctitis
(Mills & Bone 2000, p.448, Felter
1983, p.406)
Traditional uses
• Greive (2010) states specifically
that:
• “The bark has tonic, narcotic and
febrifuge properties and is used
in intermittent fevers... As an
external application to ulcers,
this infusion has also been used
with success. The fruits have
been employed in the treatment
of rheumatism and neuralgia,
and also in rectal complaints and
for haemorrhoids.”
 Folklore
• The most famous use for the
Horse chestnut tree is for the
game of Conkers:
Herbal energetics
• Dry
• Warm
(Hall 2001, p.189)
Mental / emotional
• The horse chestnut person is
thickest and strongest around
the thighs and lower torso. They
are physically active and love to
go hiking or climbing. They are
also “frighteningly jolly”.
Mental / emotional
(cont.)
• Horse chestnut forms the basis
of 2 Bach flower remedies:
Chestnut Bud and White
Chestnut
Chestnut bud
• Chestnut Bud key symptom is
repeating the same mistakes over
and over.
• The positive Chestnut Bud person is
mentally flexible and able to learn
easily with a greater focus on
ingesting current experiences and
lessons. Their greatest strength
comes from seeing their own
weaknesses from a distance, as
others see them.
White chestnut
• The negative White Chestnut person
has constant, negative mental
chatter.
• Mental fatigue is a hallmark and this
person often suffers from
depression, mental fatigue and
frontal lobe headaches.
• The positive aspect of this Bach
remedy is shown with clarity of
thought, vision and purpose.
 References
• Bone, K 2007, The Ultimate Herbal Compendium: A
Desktop Guide For Herbal Prescribers, Phytotherapy
Press, Warwick
• Braun, L & Cohen, M 2010, Herbs and Natural
Supplements: An Evidence-based Guide. 3rd Edition,
Churchill Livingstone
• Euro+Med Plantbase Project 2010, Aesculus
hippocastanum, viewed 2/8/2011,
<http://ww2.bgbm.org/_EuroPlusMed/PTaxonDetail.asp?
NameId=24982&PTRefFk=500000>
• Fallier-Becker, P, Borner, M & Weiser, M 2002,
Proliferation modulating effect of Aesculus
hippocastanum, Coenzyme Q10 and Heparsuis on
endothelial cells, Biol Med, 31(1), pp.10-14
• Felter, HW 1983, The eclectic material medica,
pharmacology and therapeutic, (1922), Reprinted by
Eclectic Medical Publications
• Fujimura, T et al. 2006a, A horse chestnut extract, which
induces contraction forces in fibroblasts, is a potent anti-
ageing ingredient, J Cosmet Sci, 57(5), pp.369-76
• Fujimura, T et al. 2006b, Horse chestnut extract induces
contraction forces in fibroblasts through activation of
rho/rho kinase, Biol Pharm Bull, 29(6), pp.1075-81
 References
• Greeske, K & Pohlmann, PK 1996, Horse chestnut seed
extract: an effective therapy principle in practice: Drug
therapy of chronic venous insufficiency, Fortschr Med,
114(15), pp.196-200
• Grieve, M 2010, A Modern Herbal, viewed 2/8/2010, <
http://botanical.com/botanical/mgmh/mgmh.html>
• Guillaume, M & Padioleau, F 1994, Veinotonic effect,
vascular protection, anti-inflammatory and free radical
scavenging properties of horse chestnut extract,
Arzneimittelforschung, 44(1), pp.25-35
• Hall, D 2001, Dorothy Hall’s Herbal Medicine, Wild &
Woolley, Glebe
• Hoffman, D 1996, The Complete Illustrated Holistic
Herbal, Element Books
• Hoffman, D 2003, Medical Herbalism: the science and
practice of herbal medicine, Healing Arts Press
• Mills, S & Bone, K 2000, Principles & Practices of
Phytotherapy, Harcourt Publishers
• Pitter, M & Ernst, E 2004, Horse chestnut seed extract for
chronic venous insufficiency, Arch Dermatol, 134(11),
pp.1356-60
• Scheffer, M 1990, Bach Flower Therapy: Theory and
Practice, Thorsons Publishing, London
 References
• Sirtori, CR 2001, Aescin: pharmacology,
pharmacokinetics and therapeutic profile, Pharmacol
Res, 44(3), pp.183-93
• Suter, A et al. 2006, Treatment of patients with venous
insufficiency with fresh plant horse chestnut seed
extract: a review of 5 clinical studies, Adv Ther, 23(1),
pp.179-90
• Ashton Conker Club 2010, The History of Ashton
Conker Club, viewed 2/8/2011,
<http://www.worldconkerchampionships.com/html/conk
ers_history.html>
• Wikipedia 2011, Aesculus hippocastanum, viewed
19/3/2011, <http://en.wikipedia.org/wiki/Horse-
chestnut_%28tree%29 >