Horse Chestnut Supplement Review

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Horse Chestnut
  Evaluated for:
Effectiveness Rating Effectiveness Rating
Venous insufficiency (leg edema)
+2 (Moderate Evidence)
+1 (Slight Evidence)


  • Horse chestnut comes from the large seeds of the horse chestnut tree, which is closely related to Ohio buckeye. It has been commonly used in Europe since the 19th century to treat hemorrhoids and today it is widely used in Europe and Japan to treat chronic venous insufficiency (varicose veins).
  • Horse chestnut seed extracts are anti-inflammatory and venotonic, reducing symptoms of venous insufficiency such as leg pain, swelling, itching, and fatigue. This effect may be comparable to compression stocking therapy.
  • There is a strong supportive scientific evidence for treatment of a widespread disorder of venous insufficiency.
  • When prepared properly, horse chestnut is safe, with relatively few side effects and no reports of serious harmful side effects.


  • There is no evidence for long-term benefit from horse chestnut extract. Testing has only been done for up to 12 months.
  • Side effects from improper preparation (using other parts of the plant) include vomiting, liver toxicity, stupor, coma, and muscle weakness.

Pregnant women, children, and those with low blood sugars, should not take horse chestnut. Other parts of the horse chestnut plant are toxic when not prepared properly, and esculin can cause death when not removed in the seed preparation. Horse chestnut can interact with antidiabetic agents, hepatotoxic agents, anticoagulants, lithium and those with latex allergies.

CONCLUSION:We conclude that horse chestnut is a safe and effective product for the treatment of chronic venous insufficiency. While it shows promise for treating hemorrhoids, there is not enough evidence for us to support its use.

“Horse Chestnut.” Natural Standard –The Authority on Integrative Medicine. Natural Standard, 2013.
“Horse Chestnut.” Natural Medicines Comprehensive Database. Therapeutic Research Faculty, 2013. 8 November 2013.

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