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Horse Chestnut for Veins and Vein Disease

One of the most common questions that I am asked is whether or not herbal supplements are useful for treatment of vein diseases. Perhaps the most popular of these supplements is horse chestnut.  I thought I should address this issue in a blog post.

Horse chestnut is an extract of seeds from the horse chestnut tree.  The active ingredient is aescin.  You should never eat horse chestnuts directly from the tree as they can be poisonous.  It is sold as 100 mg or 300 mg pills.  The dose is 300 mg twice a day.  It can be purchased as a supplement.  As with many natural and herbal remedies the manufacture of the capsules is not monitored by an outside agency and it is difficult to say which preparation is the best one.

How does horse chestnut for veins and vein diseases work?  There are no definitive studies to answer this question.  A paper from the National Library of Medicine states: “Horse chestnut contains a substance that thins the blood. It also makes it harder for fluid to leak out of veins and capillaries and weakly promotes fluid loss through the urine to help prevent water retention (edema).”

Does horse chestnut for veins work?  There are three randomized studies of horse chestnut that suggest that it may be useful for varicose veins.  However, a review of 17 trials of this treatment found no significant benefit to horse chestnut. 

Is horse chestnut for vein diseases safe?  It’s been approved for many years in Germany without significant side effects.  In the same paper from National Library of Medicine it is rated as “Likely Safe”.  It should not be taken if you are pregnant or have diabetes, GI disease, liver disease, a latex allergy or kidney disease.  It should not be taken if you are on Lithium, diabetes medications or medications that slow blood clotting.

So, what’s the bottom line in using horse chestnut for vein diseases?  It should not be used for spider veins.  There is no evidence that it works for this problem.  There is some contradictory evidence that it works for varicose veins.  Its effects are modest, probably not much better than compression hose and its effects are not long lasting.  Stop taking it and any beneficial effect goes away.  Remember it has some side effects and medication interactions so you should consult your doctor prior to starting it.  It’s not a magic bullet and if you want to get rid of your varicose veins it’s best to consult a phlebologist (vein specialist) for more definitive therapy.

Oh, and remember never take the raw form.  Don’t eat the seeds because they are poisonous.

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Horse Chestnut for Veins and Vein Disease
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