Hawthorn

Hawthorn

What Is It?

Hawthorn (Crataegus monogyna, Crataegus laevigata) is a flowering shrub or tree of the Rosaceae (rose) family. It is known to develop and thrive in temperate regions throughout the world.

How Does It Work in the Body?

Derived from the flower, leaves, and fruits of the plant, hawthorn is also known in Asia as Shan Zha. It is used in traditional Chinese medicine to improve digestion and treat heart problems. Hawthorn also has a long history in European medicine as a heart tonic.  

Studies in the lab suggest a range of anti-inflammation, heart-protective, and digestion-improving properties. Studies in humans show benefits in patients with congestive heart failure although a few trials did not.  

More studies are needed to confirm safety and effectiveness of hawthorn. In addition, it should not be used in place of conventional heart failure therapies and its use should be monitored by the treating physician What Is It Used for?

In traditional Chinese medicine, hawthorn fruits are used for relieving indigestion and promoting stomach function, improving blood circulation, and removing blood stasis; however, clinical studies are lacking.

In European herbal medicine, hawthorn flowers have been used as an astringent, antispasmodic, cardiotonic, and diuretic; hawthorn has been thought to aid as a hypotensive and/or anti-atherosclerotic agent; data are conflicting. More research is needed.

In some studies, hawthorn extract used as add-on therapy was found to be beneficial in heart failure patients. More definitive data are needed.

Precautions/Side Effects:

Generally, hawthorn is well tolerated. However, individuals may experience dizziness (most common) and nausea, cardiac and gastrointestinal complaints (infrequent and mild) with use [1].

Overdose can potentially cause hypotension and irregular heartbeat (arrhythmia) [1].

Evidence for and Against:

In a study on 2681 patients suffering from congestive heart failure, the administration of hawthorn extract (900 mg/day) for 6 months showed no positive clinical effects in inflammation, oxidative stress, neurohormones, functional capacity, and quality-of-life measures, but modest change in left ventricular ejection fraction was found.  

However, according to the findings of Trexler et al., 160 mg of hawthorn supplementation in adult subjects for a week could not influence electrocardiographic indices.

Mocini et al. showed that 5 mL of hawthorn fruit extract after each meal in male and female patients with gastroesophageal reflux disease controlled the main symptoms over 4 weeks, as well as causing a 94.2% and 93.5% alleviation in regurgitation and heartburn, respectively.  

Dosage:

The recommended daily dose of hawthorn is 160–900 mg of a native water-ethanol extract of the leaves or flowers (equivalent to 30–169 mg of epicatechin or 3.5–19.8 mg of flavonoids) administered in two or three doses.  

At therapeutic dosages, hawthorn may cause a mild rash, headache, sweating, dizziness, palpitations, sleepiness, agitation, and gastrointestinal symptoms.  

Interactions:

Use of hawthorn with phosphodiesterase-5 inhibitors (e.g., sildenafil, tadalafil) may lead to hypotension.

Because hawthorn can be used to help with hypertension, it may interact with drugs used to treat high blood pressure (e.g., beta blockers such as atenolol, calcium channel blockers such as diltiazem) and result in hypotension.

Taking hawthorn along with digoxin and/or nitrates may increase the effects of such cardiogenic drugs and increase the risk of cardiotoxic side effects.