Hawthorn: benefits, dosage, contraindications
Other name(s)
white thorn
Scientific name(s)
Crataegus oxyacantha, Crataegus monogyna
Family or group:
Plants
Active ingredients:
Flavonoids
Oligo-Proanthocyanidins
Caffeic acid
Ursolic acid
Indications
Scoring methodology
EFSA approval.
Heart disorders ✪✪✪✪✪
Hawthorn is traditionally used to relieve the symptoms of temporary cardiac disorders of nervous origin, for example: palpitations, increased heart rate due to mild anxiety.nnThe German Commission E and ESCOP approve the use of the leaves with flowers of hawthorn for patients presenting symptoms of heart failure at stage II as described by the New York Heart Association. The EMA recommends these uses after exclusion of serious cases by a physician.nnNew York Heart Association classification of functional capacity:nnClass I. Patients with heart disease but without limitation of physical activity. Ordinary physical activity does not cause undue fatigue, palpitations, dyspnea, or chest pain.nnClass II. Patients with heart disease resulting in a slight limitation of physical activity. They are comfortable at rest. Ordinary physical activity results in fatigue, palpitations, dyspnea, or chest pain.nnNote that extracts should be prepared with a defined content of oligomeric procyanidins or flavonoids, from 160 to 900 mg per day.nn
Posologie
Orally: flowering tops, buds
240 - 900 mg
Adults
gemmotherapy, dry extract
Crataegus special extract WS 1442 induces an endothelium-dependent, NO-mediated vasorelaxation via eNOS-phosphorylation at serine 1177.
The efficacy and safety of Crataegus extract WS 1442 in patients with heart failure: the SPICE trial.
A novel approach to prevent endothelial hyperpermeability: the Crataegus extract WS® 1442 targets the cAMP/Rap1 pathway.
A randomized double-blind, placebo-controlled clinical trial of a standardized extract of fresh Crataegus berries (Crataegisan) in the treatment of patients with congestive heart failure NYHA II.
[Crataegus Special Extract WS 1442. Objective assessment of effectiveness in patients with heart failure (NYHA II)].
[Hawthorn extract WS 1442 in the treatment of patients with heart failure and LVEF of 25%-35%].
E/S/C/O/P: 2nd Edition of the ESCOP Monographs
Hawthorn extract for treating chronic heart failure.
European Union herbal monograph on Crataegus spp., folium cum flore
Congestive heart failure ✪✪✪✪✪
In clinical studies, hydroalcoholic extracts of hawthorn were shown to be effective in improving symptoms associated with stage I and II heart failure, notably by improving exercise tolerance and increasing left ventricular ejection fraction. Several American clinical studies show that taking specific extracts of hawthorn leaves and flowers at 240-600 mg/day improves exercise tolerance, reduces subjective symptoms, and decreases the risk of death in patients with stage II heart failure. In these studies, the maximal effect was generally observed after 6 to 12 weeks of treatment. Another clinical trial shows that hawthorn extract at 1800 mg/day combined with diuretic therapy improves exercise tolerance and reduces the subjective symptoms of stage III heart failure. In this study, the maximal effect was generally observed after 16 weeks of treatment. Also, a combination of hawthorn and passionflower extracts for 6 weeks improved walking distance, exercise tolerance, and cholesterol levels compared with placebo. However, other large-scale clinical trials in patients with stage II or III heart failure taking a hawthorn extract at 900 mg per day for 24 months, in combination with conventional therapy, do not significantly reduce hospitalization due to progressive heart failure, nonfatal myocardial infarction, or cardiac death.
Posologie
Oral use: flowering tops, buds
600 - 1800 mg
6 weeks
Adults
gemmotherapy, dry extract
Synergies
Crataegus special extract WS 1442 induces an endothelium-dependent, NO-mediated vasorelaxation via eNOS-phosphorylation at serine 1177.
The efficacy and safety of Crataegus extract WS 1442 in patients with heart failure: the SPICE trial.
A novel approach to prevent endothelial hyperpermeability: the Crataegus extract WS® 1442 targets the cAMP/Rap1 pathway.
A randomized double-blind, placebo-controlled clinical trial of a standardized extract of fresh Crataegus berries (Crataegisan) in the treatment of patients with congestive heart failure NYHA II.
[Crataegus Special Extract WS 1442. Assessment of objective effectiveness in patients with heart failure (NYHA II)].
[Hawthorn extract WS 1442 in the treatment of patients with heart failure and LVEF of 25%-35%].
Hawthorn extract for treating chronic heart failure.
Hypotension ✪✪✪✪✪
Hawthorn helps regulate blood pressure. In cases of hypotension, it helps increase it. In cases of hypertension, it also has a regulatory effect. A clinical trial conducted in diabetic hypertensive patients shows that taking a hawthorn extract at 1200 mg per day for 16 weeks significantly reduces diastolic blood pressure compared with placebo.
Posologie
Oral use: buds, flowering tops
1200 mg
16 weeks
Adults
Gemmotherapy, dry extract
Effect of hawthorn standardized extract on flow-mediated dilation in prehypertensive and mildly hypertensive adults: a randomized, controlled crossover trial.
Effect of hawthorn standardized extract on flow-mediated dilation in prehypertensive and mildly hypertensive adults: a randomized, controlled crossover trial
Practical guide to family gemmotherapy - Dr. MAX TETAU
Anxiety ✪✪✪✪✪
Hawthorn is recommended for stressed individuals: rapid pulse, labile arterial hypertension, anxiety with cardiac somatization, sleep disturbances. Preliminary clinical research suggests that hawthorn, combined with magnesium and Escholtzia, may be useful in the treatment of mild-to-moderate anxiety disorders.
Posologie
Oral: flowering tops, buds
240 - 900 mg
Adults
gemmotherapy, dry extract
Synergies
European Union herbal monograph on Crataegus spp., folium cum flore
A combination of plant extracts in the treatment of outpatients with adjustment disorder with anxious mood: controlled study versus placebo
Nervousness ✪✪✪✪✪
The effects of hawthorn on nervousness have only been evaluated in a single study, in combination with magnesium and Escholtzia (Eschscholtzia californica).
Posologie
Oral: flowering tops, buds
240 - 900 mg
Adults
gemmotherapy, dry extract
Synergies
European Union herbal monograph on Crataegus spp., folium cum flore
Angina pectoris ✪✪✪✪✪
In a clinical trial, patients suffering from angina pectoris and chronically taking beta-adrenergic receptor inhibitors received a hawthorn extract of 100 mg three times a day for 4 weeks.nnPatients reported a significant improvement in angina symptoms compared with the placebo group.nn
Posologie
Oral: flowering tops, buds
300 mg
Adults
Gemmotherapy, dry extract
Cognitive performance ✪✪✪✪✪
Hawthorn acts on the brain through the autonomic nervous system, ensuring better cerebral circulation. Traditionally prescribed in gemmotherapy for symptoms of cognitive slowing.nnClinically, a single dose of 25 drops of a medicine combining camphor and a hawthorn berry extract marketed under the name KARODIN® was shown to be superior to placebo for improving the cognitive performance of elderly patients, as measured by visuomotor speed and information processing capacity. nnThis effect is more likely due to the improvement in blood pressure rather than a direct effect on the brain.nn
Posologie
Oral: buds
50 drops
Adults
Gemmotherapy, dry extract
D-camphor-crataegus berry extract combination increases blood pressure and cognitive functioning in the elderly - a randomized, placebo-controlled, double-blind study
Practical guide to family gemmotherapy - Dr. MAX TETAU
The effects of repeated administration of camphor-crataegus berry extract combination on blood pressure and on attentional performance - a randomized, placebo-controlled, double-blind study
Sleep disorders ✪✪✪✪✪
Hawthorn is traditionally used for the relief of mild symptoms of mental stress and to promote sleep.nnTraditional use of hawthorn reports a sedative, anxiolytic effect that reduces aggressiveness as well as body temperature, which helps prepare for sleep.nn
Posologie
By mouth: flowering tops, buds
240 - 900 mg
Adults
Gemmotherapy, dry extract
Properties
Cardiotonic action
Hawthorn acts on the myocardium by strengthening the force of contraction and increasing blood flow in the coronary arteries, which improves blood circulation to the heart while reducing its oxygen consumption. The cardiotonic properties of hawthorn are attributed to an increased membrane permeability to calcium and to the inhibition of phosphodiesterase, which leads to an increase in coronary blood flow, vasodilation and positive effects on cardiac contractility. It also helps reduce arrhythmic events by decreasing adrenergic stimulation. Hawthorn extracts also improve endothelial function and strengthen its barrier role. This action could be particularly interesting in conditions such as atherosclerosis or heart failure.
Usages associés
SAFETY AND EFFECTS OF CRATAEGUS EXTRACT WS 1442 AND NORDIC WALKING ON LIPID PROFILE AND ENDOTHELIAL FUNCTION: A RANDOMIZED, PARTIALLY BLINDED PILOT STUDY IN OVERWEIGHT VOLUNTEERS
Hawthorn
A novel approach to prevent endothelial hyperpermeability: the Crataegus extract WS® 1442 targets the cAMP/Rap1 pathway
[Crataegus Special Extract WS 1442. Assessment of objective effectiveness in patients with heart failure (NYHA II)].
Sedative
Procyanidins are thought to be responsible for the mildly sedative effects of hawthorn. Indeed, hawthorn may act on the sympathetic nervous system (responsible for preparing the body for action) by calming it. This use has long been known, as it is traditionally used to reduce nervous excitability and to prepare for sleep.
Usages associés
Antihypertensive
Hawthorn appears to have hypotensive activity, according to preliminary research. It appears to cause peripheral vasodilation and induce arterial relaxation. Procyanidins appear to be responsible for this effect.nn
Usages associés
Safe dosage
Adults aged 12 years and older: 300 mg - 900 mg (dry extract)
Dosage for an adult depends on the formulation of hawthorn extracts:nn- Infusion: 1 to 2 g per 150 ml of water, 3 times a day.nn- Powder: 2 to 5 g per day.nn- Standardized dry extract (2% flavonoids): 300 mg to 900 mg per day.nn- Tincture (1:5): 1 ml to 2 ml, 3 times a day.nn- Gemmotherapy: 50 drops (or according to laboratory instructions).nn
Interactions
Médicaments
Nitrates: strong interaction
Some evidence suggests that hawthorn may lower blood pressure due to its vasodilatory effects. In theory, using hawthorn with nitrates could cause additional coronary vasodilation.
PDE-5 inhibitor: strong interaction
Hawthorn may inhibit phosphodiesterase-5 (PDE-5) and cause vasodilation. Theoretically, simultaneous use of PDE-5 inhibitors and hawthorn could lead to additional vasodilation and hypotension. PDE-5 inhibitors include sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra).
Precautions
Children up to 12 years: avoid
Use in children and adolescents under 12 years is not recommended.nn
Breastfeeding women: avoid
Avoid the use of hawthorn due to a lack of reliable and sufficient information.nn
Contraindications
Pregnant women: prohibited
In vivo and in vitro evidence of uterine activity has been reported; therefore, hawthorn should not be used during pregnancy unless advised otherwise by a physician.nn
