Flavonoids, Coumarins, Triterpenoid saponins, Aescin
Horse chestnut is so-called because of the erroneous belief that eating the nuts relieved chest congestion in horses. In truth, however, horse chestnuts contain a compound called esculin that is toxic to horses, although deer and other animals appear to be able to neutralize this substance and eat the nuts without consequence.
Due to safety concerns, horse chestnuts are generally used to make infusions, balms and ointments for topical use only. If you have liver or kidney disease, you should not use horse chestnut. Horse chestnut can be toxic if taken internally. Do not put lotion or gel on broken skin. Consult your health care provider before beginning use of any herb.
The seed extract standardized to around 20 percent aescin (escin) is used for its venotonic effect, vascular protection, anti-
inflammatory and free radical scavenging properties. Primary
indication is chronic venous insufficiency. A recent Cochrane
Review found the evidence suggests that Horse Chestnut
Seed Extract is an efficacious and safe short-term treatment
for chronic venous insufficiency.
Aescin reduces fluid leaks to surrounding tissue by reducing
both the number and size of membrane pores in the veins.
Safety in medical use
Two preparations are considered; whole horsechestnut extract
(whole HCE) and purified β-aescin. Historically, whole HCE
has been used both for oral and IV routes (as of year 2001).
The rate of adverse effects are low, in a large German study,
0.6%, consisting mainly of gastrointestinal symptoms.
Dizziness, headache and itching have been reported. One serious safety issue is rare cases of acute anaphylactic reactions, presumably in a context of whole HCE. Purified β-aescin would be expected to have a better safety profile.
Another is the risk of acute renal failure, "when patients, who had undergone cardiac surgery were given high doses of horse chestnut extract i.v. for postoperative oedema. The phenomenon was dose dependent as no alteration in renal function was recorded with 340 μg kg−1, mild renal function impairment developed with 360 μg kg−1 and acute renal failure with 510 μg kg−1".This almost certainly took place in a context of whole HCE.
Three clinical trials were since performed to assess the effects of aescin on renal function. A total of 83 subjects were studied; 18 healthy volunteers given 10 or 20 mg iv. for 6 days, 40 in-patients with normal renal function given 10 mg iv. two times per day (except two children given 0.2 mg/kg), 12 patients with cerebral oedema and normal renal function given a massive iv. dose on the day of surgery (49.2 ± 19.3 mg) and 15.4 ± 9.4 mg daily for the following 10 days and 13 patients with impaired renal function due to glomerulonephritis or pyelonephritis, who were given 20–25 mg iv. daily for 6 days. "In all studies renal function was monitored daily resorting to the usual tests of renal function: BUN, serum creatinine, creatinine clearance, urinalysis. In a selected number of cases paraaminohippurate and labelled EDTA clearance were also measured. No signs of development of renal impairment in the patients with normal renal function or of worsening of renal function in the patients with renal impairment were recorded." It is concluded that aescin has excellent tolerability in a clinical setting.
Raw Horse Chestnut seed, leaf, bark and flower are toxic due to the presence of esculin and should not be ingested. Horse chestnut seed is classified by the FDA as an unsafe herb. The glycoside and saponin constituents are considered toxic.
Aesculus hippocastanum is used in Bach flower remedies. When the buds are used it is referred to as "chestnut bud" and when the flowers are used it is referred to as "white chestnut".
Likely effective for...
• Varicose veins and other circulatory problems (chronic venous insufficiency). Taking horse chestnut seed extract can reduce some symptoms of poor blood circulation, such as varicose veins, pain, tiredness, swelling in the legs, itching, and water retention.Insufficient evidence to rate effectiveness for...
• Hemorrhoids., Diarrhea, Fever, Cough, Enlarged prostate, Eczema, Menstrual pain.
• Soft tissue swelling from bone fracture and sprains, arthritis, joint pain, and other conditions.
• Other conditions. NOT FOR INTERNAL USE