Horse chestnut

Authors: Prof. Dr. med. Peter Altmeyer, Prof. Dr. med. Martina Bacharach-Buhles

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Last updated on: 15.07.2021

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Synonym(s)

Aesculus hippocastanum; Chestnut; Gout tree; Horse and sow chestnut

Definition
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The horse chestnut is a deciduous tree up to 35 m tall with a dense arching crown and strong trunk that can live up to 200 years. Thick, conical, sticky buds form in spring. The large leaves are 5- to 7-fingered and sit on long stalks. The fruits ripen in September/October.

Aesculus hippocastanum is the parent plant of the official preparations of:

  • Hippocastani semen the horse chestnut seed
  • Flores Hippocastani the horse chestnut flowers
  • Hippocastanifolium (Folia Hippocastani) the horse chestnut leaves
  • Oleum Hippocastani the horse chestnut oil
  • Cortex Hippocastani the horse chestnut bark.

Horse chestnut seeds in the form of standardised dry extracts as rational phytotherapy (well established use) for the treatment of chronic venous insufficiency (CVI) with its typical symptoms (swollen legs, varicose veins, heavy and tired legs, pain, itching, muscle tension and calf cramps).

ESCOP: For chronic venous insufficiency and varicose veinsCommission
E: For chronic venous insufficiency (pain and heaviness in the legs, cramps in the calves, itching, swelling of the legs).

According to the HMPC, horse chestnut bark is traditionally used for CVI and haemorrhoids.

General information
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Only horse chestnut seeds in the form of finished medicinal products standardised to triterpene saponins (aescin) with appropriate dosage information count as rational phytotherapy (HMPC) orally for chronic (long-term) venous insufficiency, swollen legs, varicose veins, feeling of heaviness in the legs, pain, tiredness, itching, tension and cramps in the calves.

Traditionally used orally or locally for discomfort and heaviness of the legs associated with minor circulatory problems in the veins, to relieve bruising, local swelling and hematomas.

A paste made from the seeds is said to help with gout and rheumatic complaints (gout tree).

Extracts from the seeds are also used in medicine today. They contain a mixture of active plant substances, with aescin, a complex of biologically active triterpene saponins, being the best-known main active ingredient. Aescin is said to have vascular sealing, venous toning and anti-edematous effects. Aesculin, a glycosidic coumarin derivative, is also attributed with venous tonifying effects. Preparations of horse chestnut extract are prescribed for cardiac and venous oedema as well as for pain and heaviness in the lower extremities. Their efficacy has been proven in various studies.

Already in the 19th century the fluorescence of aesculin, was reported. In 1929, the German chemist Paul Krais observed that textile goods (wool and flax fibers) appeared optically brightened after treatment with aesculin. Derived from aesculin was 4-methylumbelliferone, the first industrially produced optical brightener.

Glacial ointments for sunburn may contain extracts from their buds.

"Chestnut Bud" is the name given to the essence of horse chestnut buds in Bach flower therapy.

The bark was formerly used to treat fever. Externally, flowers and leaves in various preparation forms are used for painful injuries/sprains, bruises, oedema, varicose veins, spinal pain, circulatory problems, palpitations and runny nose.

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Complication(s)
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oral administration: headache, stomach discomfort, nausea and itching.

with local application: possibly itching

General therapy
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For horse chestnut seeds (Hippocastani semen) the quality is defined in the European Pharmacopoeia (Ph. Eur.), for horse chestnut bark (Hippocastani cortex) no pharmacopoeia quality description is available.

Preparations: e.g. Antistax®, Venoplant retard®, Aescorin® N ointment, Venoplant®.

Aescorin® N Ointment, Anisan® Hemorrhoidal Ointment S, Arthrodynat® Ointment, Eye Drops Stulln® mono, Intradermi® Fluid N, Trauma-cyl Ointment, Varicylum® S Ointment, Venen-Fluid, Venostasin® N Ointment, Venotrulan® Ointment

Note(s)
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Leaves, recipes for chestnut leaf, blossom and bark teas, chestnut blossom essence (as bath additives), chestnut spirit, chestnut extract, tincture and mash are available in health food shops and pharmacies.

Allergologically, the pollen of the chestnuts does not play a significant role.

Literature
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  1. 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: 170-190
  2. https://www.ema.europa.eu/en/medicines/herbal/hippocastani-semen