Horse Chestnut

LATIN NAME: Aesculus hippocastanum

FAMILY NAME: Hippocastanaceae

As a boy growing up around Raleigh, North Carolina, I loved to forage through the woods and wetlands for all manner of treasures from the wild. Sometimes I went alone, and sometimes with friends. But always, when we passed the native American horse chestnut trees (buckeyes) growing on the margins of the swamps and the European horse chestnuts cultivated there, we would pocket the shiny brown nuts. Legend was they would bring us good luck. And we believed.

Some 60 years later, as an adult living in Maryland, I'm still not sure where the horse chestnut got its reputation for good fortune. Maybe it worked, though. I'm still going strong. And my many years as a botanist have taken me, sometimes fortuitously, around the globe to learn about plants.

In recent years, I've learned a lot more about the horse chestnut, too. It is renowned for its value as a medicinal herb, especially by Europeans, who use it topically and internally to prevent and treat varicose veins and other peripheral vascular conditions.

My wife, Peg, and I both suffer from vascular problems now that we're seniors. Incidence seems to increase with age. I have a number of unsightly spiderlike lines called telangiectases. Peg is more bothered by edema in her legs and the blue rivulets so characteristic of varicose veins.

Peg has gone the traditional route recently, buying expensive compression stockings to help with circulation. But I'm looking to my six-acre herbal vineyard, where I grow an American relative of the native European horse chestnut. I don't pluck the nuts for medicinal purposes. Rather, I cultivate the tree to teach others about the herb­­and to remind myself to take the standardized capsules I keep in the house.

Have they worked for me? My spider veins are still there, but I haven't developed varicose veins or chronic venous insufficiency, a condition that causes swelling, aches, and fatigue in the legs. I think horse chestnut is helping me stave them off.

Recently, I ordered an Aesculus hippocastanum tree from Europe, which I will add to my garden. I probably won't crush its nuts to make medicine. Standardized formulas simply are more reliable. But I may put one in my pocket.

What Horse Chestnut Is and What It Can Do

Aesculus hippocastanum is a tall tree native to Albania, Bulgaria, Greece, and Yugoslavia. It is widely cultivated elsewhere, especially in western Europe. In the newsletter Alternative Medicine Alert, Philippe O. Szapary and Michael D. Cirigliano, both M.D.'s, say the European species was introduced to the United States as a shade tree in 1740.

It has pretty white flowers and leaves that are digitate. If you put out your hand and spread your fingers, you get an idea of the leaves' shape. The nuts, about an inch or two in diameter, are peeled and mashed for their pulp, which is rich in bioactive ingredients. The bark, flowers, and leaves also contain medicinal properties.

A European Nut of Choice

To my knowledge, only the European horse chestnut has been studied for its medicinal value, mostly by the Germans and the French. Of 12 other varieties, seven are native to the United States--including the well-known Ohio buckeye--and five to India and Asia. I have found no solid studies to show whether any of the dozen contain the same phytochemicals or produce similar responses.

The European nut is high in aescin, a compound that builds up vein walls, and rutin, which helps maintain the integrity of capillaries. Aescin and rutin work synergistically with other active chemicals to reduce inflammation and pain and improve circulation. That's why horse chestnut is in Duke's Dozen.

If you've never heard of horse chestnut, or haven't heard much, that's probably because it's just gaining attention in the United States. People often are surprised when I tell them that horse chestnut is a medicinal plant. Like me, many learned as children that the nut is poisonous. I think its toxic nature may have been exaggerated, although it may be mildly poisonous if high quantities are ingested before processing.

Unlike the sweet chestnut--no relation and actually from the oak family--the somewhat bitter-tasting horse chestnut is not considered a food plant. But in some countries, horse chestnut is being made into flour as a source of edible starches. A 1996 issue of the Italian journal dedicated to the study of medicinal plants, Fitoterapia, notes that the scientific name Aesculus means nutrient, or edible.

I think standardized formulas are quite safe, although I strongly advise against crushing and nibbling the unprocessed nuts. There is still some controversy about whether the raw nuts are edible. Play it safe and don't experiment with questionable plants.

Commission E (a German panel of experts roughly equivalent to the U.S. Food and Drug Administration) approves standardized horse chestnut for treatment of pathological conditions of the veins of the legs, including pain and a sensation of heaviness, nocturnal cramping of the calves, pruritis, and swelling. Along with many herbalists, I interpret that to include varicose and spider veins, within the broad definition of chronic venous insufficiency.

Today, horse chestnut is popular throughout Europe for the treatment and prevention of those conditions, and for hemorrhoids--which are no more than varicose veins of the anus and rectum. Ointments containing horse chestnut also are used to soothe sports injuries, such as strains and sprains. Some research indicates that horse chestnut may even be valuable in the treatment of wrinkles, hair loss, cellulite, backache, and arthritis.

How Horse Chestnut Can Help

horse chestnut has a variety of popular applications. Here are some of the best documented:

Hemorrhoids. These swollen veins of the anus and lower rectum stretch under pressure, sometimes causing pain, itching, and the appearance of bright red blood on the stool or toilet paper, the National Digestive Diseases Information Clearinghouse reports.

Hemorrhoids are common, especially during pregnancy, because of pressure from the fetus, says the clearinghouse, an office of the NIH. Other potential causes include chronic diarrhea or constipation and straining to have a bowel movement, it says. About half of women and men get hemorrhoids by age 50. For some, the condition is hereditary.

Traditional treatments include warm baths, ice packs, hemorrhoidal creams or suppositories, and regular consumption of dietary fiber and nonalcoholic beverages. Sometimes, hemorrhoids must be treated surgically, says the NIH.

One of the earliest studies on horse chestnut, done way back in 1896, demonstrated its usefulness in treating hemorrhoids, using an alcoholate of the nut to show its anesthetic and anti-inflammatory activity in treating varicosis, in general, and hemorrhoids, in particular. More than a century later, Europeans are still convinced. Many reach for standardized horse chestnut to treat hemorrhoids. I'd try it too, if I had this condition.

Varicose veins (and other peripheral vascular conditions). The tortuous blue varicose veins that appear just under the skin, most often in the leg below the knee, are easy to spot. Too easy, for many who suffer from them.

Not only do varicose veins look unattractive, but they can throb, itch, cramp, ache, burn, and feel heavy and uncomfortable, according to the National Heart, Lung, and Blood Institute, an office of the National Institutes of Health (NIH). The legs may swell, too; varicose means "swollen."

varicose veins sometimes run in families. They may be aggravated by excess weight, hormonal changes such as pregnancy, or tight clothing that limits circulation, the NIH says. Women experience them more often than do men.

Normally, oxygen-carrying blood travels through our veins, back to the heart. Valves in the veins keep blood from flowing backward. When the valves don't work or are weak, blood pools in our veins, the NIH says. These pools stretch the veins, which become swollen.

There is no cure for varicose veins. Exercise helps boost circulation, while elevating the legs during rest relieves discomfort, the NIH says. Women can wear support or compression stockings, as Peg did for a while, to help push blood toward the heart. Other traditional options include surgery, injecting a solution to diminish the veins or zapping them with lasers for cosmetic improvement.

With spider veins, compression is standard treatment, although a solution also can be injected to eliminate them.

I'll reach for horse chestnut before trying expensive cosmetic treatments.

A study out of West Germany, reported in the early 1980s, showed one commercial horse chestnut product affected both the collagen content and architecture of the varicose vein and helped make the veins more normal.

horse chestnut may also relieve symptoms of chronic venous insufficiency (CVI), which sometimes leads to varicose veins. Symptoms of CVI include edema, enlarged veins near the skin surface, and fatigue in the legs. Standing or walking aggravates symptoms. Sitting and elevating the feet usually helps.

Sometimes, my legs ache after I've been on them a while. I exercise to build muscle and improve my circulation, but I want to do all that I can to prevent CVI. That's another reason I supplement with horse chestnut. And the science is in my corner. Denise Webb, Ph.D., an associate editor of Environmental Nutrition newsletter, reported on a review of 13 studies on horse chestnut for CVI that showed the seed extract worked better than a placebo and as well as standard medications at reducing symptoms.

How to Take It and How Much

A few years ago, it was hard to find horse chestnut in the United States. Now, capsules and tinctures are readily available. At least one supplement containing the seed extract is marketed on U.S. television. Ointments, too, are becoming easier to buy as this medicinal plant gains acceptance in America. Here are suggested uses, based on my research and experience.

Hemorrhoids. Again, an ointment may be used topically to treat swelling, pain, and itching. You also can use standardized tinctures or capsules, following the directions on the label. I think it would be safe--if not doubly effective--to use both.

You might even add Hoffman's infusion (below), drinking it or applying it topically. He recommends it for hemorrhoids, too.

Varicose veins, spider veins, and CVI. Buy standardized capsules and tinctures and follow label directions. I try to take four capsules a day, although sometimes I miss. My standardized 257-milligram capsules contain 18 to 27 percent aescin.

Most studies have looked at the plant's use internally. But there is some evidence that applying an ointment to the affected area may help, too. Why not try both?

David Hoffman, a British-trained medical herbalist, author of several good books including The Herbal Handbook, and an authority I respect, recommends making an infusion, if you can find the dried fruit. Pour boiling water onto 1 or 2 teaspoonfuls and let it infuse for about 15 minutes. Drink three times daily for varicosities, or apply it as a lotion.

Useful Combinations

Here are some remedies you can try, with or without standardized horse chestnut.

Butcher's broom and buckwheat. Both contain rutin, the same capillary-protector that's in horse chestnut. Buckwheat is made into a flour typically sold as a pancake mix. Both are marketed as extracts and teas for treating varicose veins.

Compression stockings. You don't have to give up on conventional therapies. Studies show that wearing compression stockings or support hose can help lessen symptoms of varicose veins by keeping the blood flowing toward the heart. Commission E recommends using support hose or other treatments prescribed by your doctor, along with horse chestnut.

Exercise. I've chosen gardening and walking for my moderate exercise program. They give me a chance to enjoy nature. Whatever forms you choose, exercise will help build muscle, improve circulation, and keep down your weight--all preventive strategies for peripheral vascular problems. It will help diminish symptoms, too.

Ginkgo. In addition to improving memory, ginkgo boosts circulation. Extracts have been promoted lately as topical agents, which may help prevent or ease varicose and spider veins, CVI, and even hemorrhoids. Perhaps ginkgo would help me remember to take my horse chestnut.

A high-fiber diet. Eating lots of fiber--fruits, vegetables, and whole grains--along with plenty of nonalcoholic beverages, such as juice and water, lessens your chances of becoming constipated, a condition that contributes to hemorrhoids.

Violets and pansies. I used to pick violets and pansies--edible sources of rutin--from my garden and eat them as part of my strategy to prevent CVI and spider and varicose veins. I calculated I would need about 1 large pansy or 10 violets to get all the rutin I need. If you're foraging in your own backyard, that's about 100 Johnny-jump-ups. In my experience, they're perfectly safe to eat; I have sampled them all. Just be sure you know what you're picking.

Witch hazel. Sold over-the-counter for treatment of hemorrhoids, witch hazel has antiseptic and astringent properties that may ease symptoms. Try using it topically, along with your standardized horse chestnut capsules or tincture.

ALL IN THE FAMILY: BUCKWHEAT Buckwheat is not, strictly speaking, a relative of horse chestnut. But I've included it here because it is one of the best sources of those capillary-strengthening compounds, rutins. Many Americans are only familiar with buckwheat as a pancake ingredient, whose flour is readily available in health food and grocery stores. But buckwheat is more than a tasty batter. What Buckwheat Is and What It Can Do This native of Asia and northern and southern Europe resembles a morning glory, with triangular leaves. It grows in a clambering fashion and puts forth clusters of smaller, attractive, greenish-white flowers. In Canada, it is cultivated and used as a crop for flour. There, and in the United States, it also has been grown for soil conservation. One friend of mine is growing buckwheat sprouts, which have a nice, almost citruslike twang, he says. Stephen Facciola, author of Cornucopia--A Source Book of Edible Plants, says hulled kernels or groats are used in breakfast cereals, kasha, and polenta. Buckwheat flour is made into breads and used as a thickener for gravies. Seedlings, called buckwheat lettuce, are eaten in salads and available in health food stores. A beer may be brewed from the grain and distilled into fine liquor