Butcher's broom: benefits, dosage, contraindications
Other name(s)
Butcher's broom
Scientific name(s)
Ruscus aculeatus
Family or group:
Plants
Active ingredients:
Ruscogenin
Neoruscogenin
Saponins
Flavonoids
Sterols
Coumarins
Indications
Scoring methodology
EFSA approval.
Venous insufficiency ✪✪✪✪✪
Butcher's broom is most often used to relieve the symptoms of chronic venous insufficiency (CVI), notably ankle edema, itching, tightness and leg cramps. Animal and clinical studies confirm its effectiveness in CVI, and the German Commission E has approved butcher's broom as an adjunctive treatment for this condition. Taking butcher's broom root extract in combination with hesperidin and vitamin C (Cyclo 3 Fort, Laboratoires Pierre Fabre) can reduce edema, fatigue, pain, paresthesia, pruritus and tired legs in people with chronic venous insufficiency. The recommended dose of butcher's broom in the form of dried root in capsules, tablets or tea is 500 to 1000 mg three times a day. A specific combination of 150 mg butcher's broom root extract, 150 mg hesperidin methyl chalcone (HMC) and 100 mg vitamin C per capsule (Cyclo 3 Fort) has been used as 1 capsule twice a day for 2-3 months, 1-2 capsules three times a day for 1 month, or 1 capsule three times a day for 1 month followed by twice daily for 2 months.
Posologie
Oral: root
1500 - 3000 mg
powder
Synergies
Meta-analysis of clinical trials of Cyclo 3 Fort in the treatment of chronic venous insufficiency
Efficacy of Ruscus extract, HMC and vitamin C, constituents of Cyclo 3 fort®, on improving individual venous symptoms and edema: a systematic review and meta-analysis of randomized double-blind placebo-controlled trials
An open-label, randomized multicenter study comparing the efficacy and safety of Cyclo 3 Fort versus hydroxyethyl rutoside in chronic venous lymphatic insufficiency
Edema ✪✪✪✪✪
Clinical trials have shown that butcher's broom appears useful for a wide variety of edemas and circulatory disorders of the venous system. Some trials involved extracts combined with butcher's broom as a major component. Many studies are small and some are poorly designed, but the overall result supports butcher's broom's ability to reduce the swelling and discomfort associated with primary and secondary edema. Indeed, it has positive effects on pregnancy-related venous insufficiency, varicose veins, lymphedema, ankle swelling and breast tenderness in premenstrual syndrome, edema secondary to treatment with calcium channel antagonists for hypertension, and swelling secondary to soft tissue injury. Preliminary clinical research in women with arm lymphedema after breast cancer treatment shows that taking a specific combination of butcher's broom root extract 150 mg, hesperidin methyl chalcone 150 mg and vitamin C 100 mg per capsule, at a dose of 3 capsules orally three times a day for 90 days, reduces arm edema and improves mobility and heaviness. Edema was reduced by about 13% compared with placebo. A meta-analysis of three randomized, double-blind crossover studies on various products concluded that butcher's broom both increases venous tone and reduces capillary filtration, resulting in increased lymphatic flow in patients with edema.
Posologie
Oral: root
1350 mg
standardized extract
Synergies
Rudofsky G. Effect of Ruscus extract on the capillary filtration rate. In: Vanhoute PM, ed. Return Circulation and Norepinephrine: An Update. Paris, France: John Libbey Eurotext; 1991:219-224.
Jimenez Cossio JA, Magallon Ortin PJ, Capilla Montes MT, Coya Vina J. Therapeutic effect of Ruscus extract in lymphedemas of the extremities. In: Vanhoutte PM, ed. Return Circulation and Norepinephrine: An Update. Paris, France: John Libbey Eurotext; 1991:111-119
Cluzan RV, Alliotl F, Ghabboun S, et al. Treatment of lymphedema of the upper arm after previous treatment for breast cancer. Lymphology 1996;29:29-35.
Lagrue G, Behar A, Chaabane A, Laurent J. Edema induced by calcium antagonists. Effects of Ruscus extract on clinical and biological parameters. In: Vanhoute PM, ed. Return Circulation and Norepinephrine: An Update. Paris, France: John Libbey Eurotext; 1991:105-109
Premenstrual syndrome ✪✪✪✪✪
In a randomized double-blind trial involving women with premenstrual syndrome, butcher's broom quickly reduced mastalgia and mood disturbances with a trend toward improvement in ankle edema. A dose of 37.5 mg twice daily for 3 months was used.
Posologie
Oral: root
75 mg
standardized extract
Hemorrhoids ✪✪✪✪✪
The German Commission E has approved butcher's broom as a treatment for hemorrhoids. In an open multicenter study involving 124 patients with hemorrhoids, 69% of patients and 75% of treating physicians rated the combined butcher's broom extract (Cyclo 3 Fort) as having good or excellent efficacy. Ninety-two percent of physicians rated the treatment as safe and well tolerated. Significant positive effects were observed after 7 days of treatment. Although controlled trials are warranted, butcher's broom may be a useful treatment for patients with hemorrhoids.
Posologie
Oral: root
1500 - 3000 mg
powder
Synergies
Varicose veins ✪✪✪✪✪
Preliminary uncontrolled observations in 12 men aged 34 to 75 years with varicose veins suggest that taking, per capsule, 150 mg of butcher's broom root extract, 150 mg of hesperidin methyl chalcone, and 100 mg of vitamin C (Cyclo 3 Fort) orally at a dose of 3 capsules in the morning on the first day, followed by one capsule three times daily for 5 to 7 days, decreases the diameter of certain leg veins when standing and increases flow in these veins.
Posologie
Oral: root
450 mg
standardized extract
Synergies
Diabetic retinopathy ✪✪✪✪✪
Butcher's broom has been found to be as effective as troxerutin for microangiopathic complications, including diabetic retinopathy, in 60 patients with type 2 diabetes.
Posologie
Oral: root
1500 - 3000 mg
powder
Properties
Vascular effect
Butcher's broom appears to have a protective effect on capillaries, the vascular endothelium, and smooth muscle, reducing capillary fragility and strengthening blood vessels. In addition, R. aculeatus protects the vascular system from hypoxia by inhibiting hypoxia-induced activation of endothelial cells. Indeed, hypoxia-induced activation of endothelial cells can be a cause of venous disease. On the other hand, ruscogenin, a constituent of butcher's broom, has anti-elastase activity, reducing elastin degradation by elastase in the walls of blood vessels, which leads to a decrease in capillary permeability. In animal research, R. aculeatus extract has a constrictor effect comparable to that of norepinephrine on lymphatic vessels, thereby increasing the return of peripheral lymph to the heart. In vitro, R. aculeatus extract has a relaxing effect on vascular tissue exposed to norepinephrine and PGF (prostaglandin F). This effect is inhibited by atropine. It likely induces the release of vasoactive factors from the vascular endothelium.
Usages associés
Venotonic
Butcher's broom causes venous constriction by directly activating post-junctional adrenergic alpha-1 and alpha-2 receptors and by releasing stored epinephrine through displacement of adrenergic nerve endings from the vascular wall. This reduces venous capacitance and the pooling of blood in the legs. Animal research shows that intravenous administration of root and rhizome extracts causes constriction of venules without affecting arterioles or mean arterial pressure. This venular constriction can be blocked by the alpha-1 antagonist (prazosin), the alpha-2 antagonist (rauwolscine) and the calcium channel blocker (diltiazem).
Usages associés
Anti-inflammatory
Animal research shows that ruscogenin, a constituent of butcher's broom, has anti-inflammatory activity. It appears to prevent leukocyte migration by inhibiting the pro-inflammatory cytokine TNF-alpha (tumor necrosis factor-alpha) and reducing the expression of intracellular adhesion molecule-1 (ICAM-1). Root and rhizome extracts have partial agonist activity at muscarinic M1 and M3 receptors, which contribute to the anti-inflammatory activity
Antimicrobial
Butcher's broom has shown very weak activity against Candida albicans.
Safe dosage
Adults 18 years and older: 1500 mg - 3000 mg (powder)
Therapeutic dosing should be based on a ruscogenin content of 16.5 to 33 mg two to three times per day. Standardized extracts are preferred for therapeutic use because they allow more precise dosing. Recommendations for other forms of butcher's broom are as follows: - Dried root in capsules, tablets, or tea: 500 to 1000 mg three times a day - Tincture (1:5): 2 to 4 mL three times a day - Fluid extract (1:1): 1 to 2 mL three times a day
Interactions
Médicaments
Alpha-adrenergic agonist: moderate interaction
Butcher's broom has alpha-adrenergic agonist effects. Theoretically, it could have additive effects with alpha-adrenergic agonist medications.
Alpha-adrenergic antagonist: moderate interaction
Butcher's broom has alpha-adrenergic agonist effects. Theoretically, this could reduce the effects of medications with alpha-adrenergic antagonist properties.
Precautions
Pregnant women: avoid
Avoid use due to a lack of reliable and sufficient information.
Breastfeeding women: avoid
Avoid use due to a lack of reliable and sufficient information.
