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On-line Ramsthorn

Scientific Name: Rhamnus cathartica

Other Names: Common Buckthorn, Hartshorn, Highwaythorn, Purging Buckthorn, Ramsthorn, Waythorn

Who is this for?

When taken by mouth, juice from hartshorn berries causes a laxative effect. The berries contain chemicals that stimulate intestinal movement to promote the emptying of intestinal contents. Because hartshorn's effects can be quite strong, it is also known as a cathartic or purgative.

When should I be careful taking it?

Hartshorn works by irritating slightly the lining of the gastrointestinal tract. For most individuals, this irritation is minor. However, it can worsen inflammatory bowel conditions such as Crohn's disease and irritable bowel syndrome. In addition, hartshorn can complicate blocked bowels. Therefore individuals who have inflammatory bowel conditions or who have had bowel blockages should not use hartshorn.

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

Precautions

If hartshorn is used in high doses or for prolonged periods of time, it can lead to reduced potassium levels in the body. Low potassium levels can result in muscle weakness and potentially dangerous changes in heart rhythm.

What side effects should I watch for?

In laboratory animals, the long-term use of hartshorn and similar natural laxatives has been associated with an increased risk of colon cancer. Evidence from human studies is inconclusive, however. Until more is known, the use of hartshorn should be limited to 10 days or less.

Less Severe Side Effects

Taking hartshorn can cause abdominal pain or cramping, diarrhea, dry mouth, and nausea.

What interactions should I watch for?

Prescription Drugs

Both hartshorn and diuretic drugs ("water pills") can reduce potassium levels in the body. If they are taken at the same time, potassium may become too low possibly leading to muscle weakness and potentially dangerous changes in heart rhythm.

Corticosteroid drugs also may promote the loss of potassium from the body. It is best not to take hartshorn and oral corticosteroids at the same time. Corticosteroids are used for a wide range of inflammatory conditions including arthritis, asthma, cancer, eye conditions, and skin infections. Commonly prescribed oral corticosteroids include:

  • dexamethasone (Decadron)
  • hydrocortisone
  • methylprednisolone (Medrol)
  • prednisolone
  • prednisone (Deltasone, Orasone)

Hartshorn can increase the risk of side effects such as dizziness, headache, heart rhythm changes, nausea, slow pulse, vision changes, and vomiting from digoxin (Lanoxin). Hartshorn should not be taken with digoxin.

Hartshorn shortens the time that intestinal contents stay in the body. In theory, the effects of other drugs that are absorbed in the intestines may be reduced.

Non-prescription Drugs

Taking hartshorn at the same time as a commercial laxative may increase laxative effects and the risk of potassium loss from the body. In general, it is not recommended to use both hartshorn and another laxative at the same time.

Herbal Products

Both hartshorn and extremely large amounts of licorice can promote the loss of potassium from the body, potentially causing muscle weakness and changes in heart rhythm. The amounts of licorice ordinarily consumed as candy are not thought to be large enough to present a problem if hartshorn is taken as directed.

Hartshorn possibly could increase the laxative effects of other herbal laxatives including:

  • Aloe
  • Alder Buckthorn
  • Cascara
  • Castor oil
  • Rhubarb
  • Senna
  • Yellow dock

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?

Native to the wooded areas of Europe, hartshorn has spread to northern Africa, western Asia, and eastern North America. It grows as a shrub or bushy tree that is usually between 6 and 18 feet tall. Its smaller branches end in spikes or large thorns. In late spring, hartshorn bears clusters of small white, yellow, or greenish flowers that are followed by pea-sized berries, which turn dark purple or black when they ripen in the fall. Hartshorn berries are used in medicine — either dried or crushed to produce strong-smelling, bitter-tasting juice. Fresh hartshorn juice is green or yellow-green, but it darkens to a purple-red color with age.

Bark and unripe berries from hartshorn are used to make yellow-green dyes. Ripe berries yield a green-brown color called sap green that is used in paints.

Dosage and Administration

Note: Hartshorn should be used only as long as needed to produce a soft stool. It should not be taken for longer than 7 to 10 days at a time. Its use should be limited to no more than once or tice a year, as well,

Dried hartshorn berries and the juice of fresh hartshorn berries contain a chemical called glucofrangulin A, which belongs to the chemical class of anthraquinones. Dosing recommendations for hartshorn are not consistent. However, in Germany the recommended dose range is 20 mg to 30 mg of glucofrangulin A. Hartshorn tea is made by soaking 2,000 mg to 4,000 mg (2 grams to 4 grams) of the dried berries in about 5 ounces of boiling water for 10 to 15 minutes and then straining out the solid particles. Either the tea or juice can be taken by mouth once in the evening and then again, only if needed, the following morning.

Summary

Dried hartshorn berries and hartshorn berry juice are used as laxatives.

Risks

Due to its irritating effect on the gastrointestinal tract, hartshorn should not be used by individuals with inflammatory bowel diseases. Children under the age of 12 and pregnant or breast-feeding women should also avoid its use, as should those who have or have had intestinal blockages.

Hartshorn should not be used for longer than 10 days at a time.

Side Effects

Prolonged use of hartshorn may increase the risk of colon cancer. Side effects commonly associated with its use include cramps, diarrhea, and nausea.

Interactions

If hartshorn is taken at the same time as water pills, oral corticosteroids, or large amounts of licorice, potassium levels in the body may get too low. If it is taken at the same time as digoxin, hartshorn could increase the risk of digoxin's side effects. Hartshorn can increase the laxative effects and the risk of low potassium levels if it is taken with laxative medications or herbals.

References

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

Converse CK. Element Stewardship Abstract for Rhamnus cathartica, Rhamnus frangula (syn. Frangula alnus). The Nature Conservancy. No Date Given. Available at: http://tncweeds.ucdavis.edu/esadocs/documnts/franaln.html Accessed April 29, 2003.

Felter HW, Lloyd JU. Rhamnus cathartica.Buckthorn. King's American Dispensatory. Available at: http://www.ibiblio.org/herbmed/eclectic/kings/rhamnus-cath.html Accessed April 29, 2003.

Grieve M. Buckthorn (common). In: A Modern Herbal. New York: Dover Publishers, 1971. Available at: http://www.botanical.com/botanical/mgmh/b/buckth80.html Posted 1995. Accessed December 9, 2002.

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.

Nusko G, Schneider B, Schneider I, Wittekind CH, Hahn EG. Anthranoid laxative use is not a risk factor for colorectal neoplasia: results of a prospective case control study. Gut. 2000;46(5):651-655.

Siegers CP, von Hertzberg-Lottin E, Otte M, Schneider B. Anthranoid laxative abuse—a risk for colorectal cancer? Gut. 1993;34(8):1099-1101.

van Gorkom BA, de Vries EG, Karrenbeld A, Kleibeuker JH. Review article: anthranoid laxatives and their potential carcinogenic effects. Alimentary Pharmacology and Therapeutics. 1999;13(4):443-452.

Wieseler S. Common buckthorn. Plant Conservation Alliance, Alien Plant Working Group. National Park Service. U.S. Department of the Interior. April 22, 1999. Available at: http://www.nps.gov/plants/alien/fact/rhca1.htm Accessed April 22, 2003.


(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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