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Using of Hagedorn

Scientific Name: Hawthorn

Other Names: Crataegus laevigata, Crataegus monogyna, Crataegus oxyacantha, Hagedorn, Haw, Hedgethorn, Mayblossom, Maybush, Mayflower, Whitethorn

Who is this for?

Mainly, hawthorn is taken orally to relieve chronic heart conditions — primarily congestive heart failure, but also angina and arrhythmias. Chemicals in hawthorn may act directly on the heart muscle to increase the force of heartbeats and on the blood vessels to relax the arteries around the heart. It may also lengthen the time that the heart rests between beats. Hawthorn may also work indirectly by widening blood vessels close to the surface of the skin. As a result, it may also help to lower blood pressure. Due to its multiple effects on the heart, hawthorn should not be taken before its use has been discussed with a doctor.

Chemicals in hawthorn may have other effects, as well. Based on the observation that hawthorn produces a mild soothing effect, it may be used occasionally to treat anxiety and insomnia. No clinical studies have been published to prove or disprove hawthorn's soothing effect, however. In animal studies, hawthorn has also appeared to lower cholesterol levels both by reducing the production of cholesterol and by increasing the breakdown of cholesterol by the body. One small study conducted in humans seemed to show similar cholesterol-lowering results, but further research is needed to verify these results.

When should I be careful taking it?

Hawthorn may relax the muscles in the uterus. This loss of uterine muscle tone may lead to a miscarriage. Therefore, pregnant women are advised to avoid taking hawthorn.

Precautions

Chemicals in hawthorn have been shown to increase the force and decrease the rate of heartbeats. Because either effect could worsen heart conditions, individuals with heart disease should take hawthorn only with the approval of their healthcare providers.

Very little information is available on how hawthorn might affect an infant or a small child. Therefore, its use is not recommended while breast-feeding or during early childhood.

What side effects should I watch for?

In rare cases, hawthorn has been reported to cause rapid or erratic heartbeat. While no major consequences due to these effects have been reported in medical literature, heart conditions possibly may be worsened by taking hawthorn.

Less Severe Side Effects

Hawthorn has also been reported to cause:

  • Dizziness
  • Headache
  • Insomnia
  • Nausea
  • Sweating

If it is applied to the skin, hawthorn may cause a rash at the site of application.

What interactions should I watch for?

Prescription Drugs

Hawthorn has an effect on the heart that is similar to the effect of digoxin, a drug used to increase the force and reduce the rate of heartbeats. If hawthorn and digoxin are taken together, heartbeats may become too forceful or too slow, possibly causing dangerous changes in heart rhythm.

Some drugs used for asthma, heart conditions, or other reasons can affect heart rhythm. Because hawthorn can change the force and rate of heart beats, it may increase the risk of side effects from drugs such as:

  • albuterol
  • clonidine (Catapres)
  • theophylline and related drugs for asthma
  • Viagra

Herbal Products

If hawthorn is taken at the same time as other herbs that also affect the heart, potentially dangerous changes in heart function may result. Herbal products with heart effects include:

  • European mistletoe
  • Ginger (in large doses)
  • Motherwort
  • Panax ginseng
  • Pleurisy root
  • Squill

Some interactions between herbal products and medications can be more severe than others. The best way for you to avoid harmful interactions is to tell your doctor and/or pharmacist what medications you are currently taking, including any over-the-counter products, vitamins, and herbals.

Should I take it?

Several species of hawthorn grow as bushy shrubs or small trees that were often planted as fences or hedgerows in northern Europe. Now found growing throughout mild climate areas of North Africa, West Asia, Europe, and North America; hawthorn adapts to a wide range of growing conditions. A member of the rose family of plants, hawthorn has fragrant white or pink blooms that are sometimes called mayflowers. Its blossoms are followed by fruits, resembling cherries, that may be eaten fresh or dried, used in cooking, made into jam, or brewed into wine. The wood of hawthorn, known for its durability, is often used to make handles for tools.

For use in medicine, hawthorn leaves and flowers are collected, dried, and powdered. The powder is then made into capsules or tablets or added to beverages or soft foods. Occasionally, hawthorn fruits are used topically to relieve itching. In the past, a poultice of hawthorn leaves was applied to skin sores and a wash was made from hawthorn fruits because it was thought to treat frostbite. Currently, hawthorn is rarely used topically.

Hawthorn is much more accepted as a medicine in Europe than it is in the United States. In Germany, hawthorn is approved for the treatment of heart failure by the German Commission E, the German governmental agency that evaluates the safety and effectiveness of herbal products. The United States does not have a comparable agency to evaluate herbal products.

Dosage and Administration

Hawthorn products are often standardized for their content of chemicals known as bioflavonoids or oligomeric procyanidins. Standardization by the manufacturer should assure the same amount of active ingredient in every batch of the commercial preparation. Standardized hawthorn should have 2.2% bioflavonoids or 18.75% oligomeric procyanidins.

Recommended dosing for hawthorn varies depending on the condition being treated and the product being used. If you decide to take hawthorn, follow the directions on the package you purchase. Taking hawthorn for 2 months or longer may be necessary before maximum effects are seen.

Summary

The main current use of hawthorn is to treat congestive heart failure, but it may have some effectiveness for other chronic heart conditions, as well. Preliminary evidence from animal studies seems to show that hawthorn may also help to lower cholesterol levels.

Risks

Due to possible effects on the uterus, pregnant women should not take hawthorn. Small children and women who are breast-feeding should also avoid taking it. Individuals with heart conditions should use hawthorn only with the supervision of a medical professional.

Side Effects

Oral hawthorn products may cause fast or irregular heartbeats. Oral products have also been associated with dizziness, headaches, insomnia, and nausea. If it is used topically, hawthorn may cause a rash where it is applied.

Interactions

Hawthorn may increase the risk of changes in heart function if it is taken with:

  • albuterol
  • caffeine
  • digoxin
  • drugs and herbals that affect the heart
  • theophylline and related drugs for asthma
  • Viagra

References

American Botanical Council. Hawthorn for congestive heart failure. HerbalGram. 1995;34:11.

Anon: Hawthorn. In: DerMarderosian A, Beutler JA, eds. Facts and Comparisons: The Review of Natural Products. St. Louis, MO, Facts and Comparisons. June 1999.

Belz GG, Butzer R, Gaus W, Loew D. Camphor-Crataegus berry extract combination dose-dependently reduces tilt induced fall in blood pressure in orthostatic hypotension. Phytomedicine. 2002;9(7):581-588.

Blumenthal M, Gruenwald J, Hall T, Rister RS, eds. The Complete German Commission E Monographs. Austin, Texas: American Botanical Council; 1998.

Brown DJ. High dose hawthorn fruit extract for advanced congestive heart failure. HerbalGram. 2003;57:24-25 and 28.

Chase C. Small trial shows hawthorn leaf and flower extract is effective in early-stage congestive heart failure. HerbalGram. 2002;56:23.

Chase C. Hawthorn extract in mild, essential hypertension. American Botanical Council HerbClip. July 27, 2002.

Degenring FH, Suter A, Weber M, Saller R. A randomised double blind placebo controlled clinical trial of a standardised extract of fresh Crataegus berries (Crataegisan) in the treatment of patients with congestive heart failure NYHA II. Phytomedicine. 2003;10(5):363-369.

Fong HH, Bauman JL. Hawthorn. Journal of Cardiovascular Nursing. 2002;16(4):1-8.

Fugh-Berman A. Herbs and dietary supplements in the prevention and treatment of cardiovascular disease. Preventive Cardiology. 2000;3(1):24-32.

Garjani A, Nazemiyeh H, Maleki N, Valizadeh H. Effects of extracts from flowering tops of Crataegus meyeri A. Pojark. on ischaemic arrhythmias in anaesthetized rats. Phytotherapy Research. 2000;14(6):428-431.

Haughton C. Crataegus oxyacanthoides (Thuill.). Revised September 23, 2002. Available at: : http://www.purplesage.org.uk/profiles/hawthorn.htm. Accessed March 28, 2003.

HealthNotes, Inc. Hawthorn. 2002. Available at: http://www.mycustompak.com/healthNotes/Herb/Hawthorn.htm Accessed March 28, 2003.

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Jellin JM, Gregory P, Batz F, Hitchens K, et al, eds. Pharmacist's Letter/Prescriber's Letter. Natural Medicines Comprehensive Database, 3rd Edition. Stockton CA: Therapeutic Research Facility, 2000.

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Miller AL. Botanical influences on cardiovascular disease. Alternative Medical Review. 1998;3(6):422-431.

Miller LG. Herbal medicinals: selected clinical considerations focusing on known or potential drug-herb interactions. Archives of Internal Medicine. 1998;158(20):2200-2211.

Oliff HS. Hawthorn berry tincture lowers LDL cholesterol in rats. American Botanical Council HerbClip. January 6, 2001.

Pittler MH, Schmidt K, Ernst E. Hawthorn extract for treating chronic heart failure: meta-analysis of randomized trials. American Journal of Medicine. 2003;114(8):665-674.

Quettier-Deleu C, Voiselle G, Fruchart JC, et al. Hawthorn extracts inhibit LDL oxidation. Pharmazie. 2003;58(8):577-581.

Rajendran S, Deepalakshmi PD, Parasakthy K, Devaraj H, and Devaraj S Niranjali. Effect of tincture of Crataegus on the LDL-receptor activity of hepatic plasma membrane of rats fed an atherogenic diet. Atherosclerosis. 123 (1996):235-241.

Rietbrock N, Hamel M, Hempel B, Mitrovic V, Schmidt T, Wolf GK. Actions of standardized extracts of Crataegus berries on exercise tolerance and quality of life in patients with congestive heart failure [Article in German]. Arzneimittelforschung. 2001;51(10):793-798.

Rigelsky JM, Sweet BV. Hawthorn: pharmacology and therapeutic uses. American Journal of Health Systems Pharmacists. 2002;59(5):417-422.

Schroder D, Weiser M, Klein P. Efficacy of a homeopathic Crataegus preparation compared with usual therapy for mild (NYHA II) cardiac insufficiency: results of an observational cohort study. European Journal of Heart Failure. 2003;5(3):319-326.

Schulman RN. Hawthorn leaf and flower extract shown effective in early stage congestive heart failure in small trial. American Botanical Council HerbClip. April 23, 2002.

Schussler M, Holzl J, Fricke U. Myocardial effects of flavonoids from Crataegus species. Arzneimittelforschung. 1995;45(8):843-845.

Tankanow R, Tamer HR, Streetman DS, et al. Interaction study between digoxin and a preparation of hawthorn (Crataegus oxyacantha). Journal of Clinical Pharmacology. 2003;43(6):637-642.

Tarleton A. Re: Benefits of hawthorn in heart disease. American Botanical Council HerbClip. June 3, 1998.

Tauchert M. Efficacy and safety of crataegus extract WS 1442 in comparison with placebo in patients with chronic stable New York Heart Association class-III heart failure. American Heart Journal. 2002;143(5):910-915.

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Veveris M, Koch E, Chatterjee SS. Crataegus special extract WS 1442 improves cardiac function and reduces infarct size in a rat model of prolonged coronary ischemia and reperfusion. Life Sciences. 2004;74(15):1945-1955.

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Walker, AF, Marakis G, Morris AP, Robinson PA. Promising hypotensive effect of hawthorn extract: a randomized double-blind pilot study of mild, essential hypertension. Phytotherapy Research. 2002;16(1):48-54.

Weikl A, Assmus KD, Neukum-Schmidt A, Schmitz J, Zapfe G, Noh HS, Siegrist J. Crataegus Special Extract WS 1442. Assessment of objective effectiveness in patients with heart failure (NYHA II) [Article in German]. Fortschritte Der Medizin. 1996;114(24):291-296.

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Zhang Z, Chang Q, Zhu M, Huang Y, Ho WK, Chen Z. Characterization of antioxidants present in hawthorn fruits. Journal of Nutritional Biochemistry. 2001;12(3):144-152.

Zhang Z, Ho WK, Huang Y, James AE, Lam LW, Chen ZY. Hawthorn fruit is hypolipidemic in rabbits fed a high cholesterol diet. Journal of Nutrition. 2002;132(1):5-10.


(Note: The above information is not intended to replace the advice of your physician, pharmacist, or other healthcare professional. It is not meant to indicate that the use of the product is safe, appropriate, or effective for you.)

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