Horse chestnut extract product health benefit
November 23 2015 by
Ray Sahelian, M.D.

Almost unknown in America, horse chestnut extract is a staple of European herbalism. Horse chestnut is rich in saponins and flavones, which modern research has shown help support the normal integrity of the vascular system and connective tissue. Extract from seeds and bark of horse chestnut (Aesculus hippocastanum) is used as an herbal medicine against chronic venous insufficiency.

What's in Horse Chestnut extract?
The herb contains beta-aescin and many flavonoids.

Varicose vein information
Diseases of the venous system are widespread disorders sometimes associated with modern civilization and are among the major concerns of social and occupational medicine.
Compression stocking therapy and horse chestnut seed extract therapy are alternative therapies for patients with edema resulting from chronic venous insufficiency.
   Simple genetics may explain why some people get varicose veins, the unsightly, painful bulges that appear on the legs when blood pools in the veins. Researchers based in Scotland report that people whose mother, father, brother or sister has varicose veins are more likely than those with no family history to develop the condition. There is conflicting reports as to whether there is a relationship between varicose vein risk and certain lifestyle factors such as diet, smoking and mobility at work. Men and women who are relatively tall and women who were obese were also more likely to show signs of varicose veins than others.

Cochrane Database Syst Rev. 2012. Horse chestnut seed extract for chronic venous insufficiency. The evidence presented suggests that HCSE is an efficacious and safe short-term treatment for CVI.

Phytother Res. 2013. Antiproliferative and antiangiogenic properties of horse chestnut extract.

Horse chestnut seed extract for chronic venous insufficiency.
Cochrane Database Syst Rev. 2004.
Conservative therapy of chronic venous insufficiency (CVI) consists largely of compression treatment. However, this often causes discomfort and has been associated with poor compliance. To review the evidence from rigorous clinical trials assessing the efficacy and safety of oral horse chestnut seed extract versus placebo, or other treatments for CVI. Randomised controlled trials (RCTs) of horse chestnut seed extract for chronic venous insufficiency. Manufacturers of horse chestnut seed extract preparations and experts on the subject were contacted for published and unpublished material. Studies were included if they compared oral horse chestnut seed extract mono-preparations with placebo, or other treatments, in patients with CVI. Trials assessing horse chestnut seed extract as one of several active components in a combination preparation, or as a part of a combination treatment, were excluded. Overall, there appeared to be an improvement in CVI related signs and symptoms with horse chestnut seed extract compared with placebo. Leg pain was assessed in seven placebo-controlled trials. Six reported a significant reduction of leg pain in the horse chestnut seed extract groups compared with the placebo groups, while another reported a statistically significant improvement compared with baseline. Meta-analysis of five trials (n = 289) suggested a significant reduction in favor of horse chestnut seed extract compared with placebo. One trial indicated that horse chestnut seed extract may be as effective as compression stockings at reducing leg volume. Adverse events were usually mild and infrequent. The evidence presented implies that horse chestnut seed extract is an efficacious and safe short-term treatment for CVI. However, several caveats exist and more rigorous studies are required to assess the efficacy of this treatment option.

Horse Chestnut Extract research
The aim of this study was to compare the efficacy of Venostasin (600 mg of horse chestnut seed extract) and 360 mg of Pycnogenol (French maritime pine bark extract) in the treatment of chronic venous insufficiency (CVI). Pycnogenol was found to be more efficacious than Venostasin for the treatment of CVI. Those taking the pycnogenol had a reduction in leg pain and swelling.

Adverse reactions
J Emerg Med. 2012. Life-threatening rupture of a renal angiomyolipoma in a patient taking over-the-counter horse chestnut seed extract. We demonstrate a potentially life-threatening association between HSCE-containing products and renal AML, highlighting the risk associated with HSCE-induced anticoagulation.

Horse Chestnut Research
Eur Rev Med Pharmacol Sci. 2015. Antioxidant potential of Aesculus hippocastanum extract and escin against reactive oxygen and nitrogen species. Antioxidant, anti-inflammatory and venoconstrictor properties have been attributed to extracts from Aesculus hippocastanum. These unusual and diverse properties may be possibly basically linked with ability to scavenge free radicals.

Horse chestnut extract :a multidisciplinary clinical review.
J Herb Pharmcother. 2002.
Horse chestnut seed extract is widely used in Europe for the management of chronic venous insufficiency (CVI). Although traditionally recommended for a variety of medical conditions, CVI is the only indication for which there is strong supportive scientific evidence. Review of the literature reveals 14 randomized controlled trials, of which seven are methodologically of high quality, albeit limited by small sample sizes and short durations. These studies support the superiority of horse chestnut over placebo, and suggest equivalence to compression stockings and to oral oxerutins. In the future, a longer and adequately powered randomized trial is warranted to compare horse chestnut to standard of care, and to further assess safety and long-term efficacy. There are no data to suggest that horse chestnut flower, raw seed, branch bark, or leaf are effective for any indication, and it is recommended that these products not be used, as they are known to be toxic when ingested.

Rational therapy of chronic venous insufficiency --chances and limits of the therapeutic use of horse chestnut seeds extract.
BMC Cardiovasc Disord. 2001.
We report two clinical studies performed in patients with early and advanced chronic venous insufficiency. In both, compression therapy and oral therapy with horse chestnut seeds extracts were compared to placebo. The published study in early CVI (Grade I) showed both to be superior to placebo and to be equivalent to each other in reducing lower leg volume, a measure for edema. In the study, in advanced CVI (Grade II and IIIa), compression appeared to be superior to placebo, whereas horse-chestnut was not. Horse-chestnut fared better in Grade II than in Grade IIIa patients. These results are discussed in the light of data from an in vitro model, where horse-chestnut has been able to close the intercellular gaps in the venular endothelium. Not fully specified factors lead to an opening of these gaps, resulting in edema as well as in local coagulation and thrombosis. The subsequent inflammation keeps these gaps open and initiates and maintains a chronic disease process, which may be the starting point of CVI. Due to its ability to close the venular endothelial gaps, horse chestnut seems to be a suitable and protecting therapy during the early stages of CVI. In later more severe stages compression therapy is indicated. Taking into account the observed negative impact of compression on quality of life, pharmacological CVI therapy should start early to avoid progress and to spare patients compression therapy.

I noticed that products that are made to treat spider-veins usually contain either horse chestnut (capsules or creams), or vitamin k (creams for topical use). Horse chestnut is a blood thinner, whereas vitamin k is essential for blood clotting. It therefore seems to me that the effects of these two supplements might be contradictory but still they are both used for the same purpose. I'd like to ask how is this possible.
   This is a good question. Spider veins are unsightly, and sometimes uncomfortable, enlargement of smaller veins closest to the skin surface, and appear in clusters of red, blue or purple veins. Most often spider veins occur on the legs but can also be seen on the face and elsewhere on the body. Horse chestnut works by improving the capillary wall and integrity of the vascular system, it may have blood thinning ability but it also has the ability to protect the strength of the veins. Vitamin K supplements help to clot the blood better in those who are deficient in the vitamin, which is not that common.  We don't know the rational of adding vitamin K to horse chestnut since most people don't need it.  Perhaps you could ask the company that formulates it and they can provide their thoughts on this and may provide an answer that we are not aware of.

Full Spectrum Horse Chestnut, 300 mg
Planetary Formulas

Full Spectrum Horse Chestnut delivers a minimum of 20% aescin, the primary extract in horse chestnut for assuring potency.

To insure a healthy vascular system, increase dietary intake of flavonoid-rich foods such as vegetables, onions, grapes and blueberries. Avoid excessive periods of standing or sitting, and exercise regularly.

Buy Horse Chestnut supplement or to see hundreds of high quality products

Supplement Facts:
Calcium 55 mg
Horse Chestnut Seed Extract 300 mg
   Standardized to 20% Aescin
   Yielding 60 mg Aescin

Suggested Use: One horse chestnut tablet, two times daily between meals, or as recommended by your health care professional.