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Horse Chestnut and Edema

Horse chestnut is a useful herb that is known to treat various health conditions, including edema.
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Edema is the buildup of abnormal levels of fluid in the circulatory system and the tissues between the body’s cells. It is often caused by eating too much salt and not drinking enough water. 

This fluid retention may also be caused by kidney and bladder infections, heart problems, oral contraceptives, adrenal exhaustion, hypothyroidism, protein hormonal changes, obesity, or lack of exercise. 

There are several over the counter diuretics available to treat edema by encouraging the kidneys to filter more waste and excess fluid from your body. 

People who prefer herbal remedies may opt for various herbs that have diuretic-like properties. Horse chestnut is a potent herb, known to reduce edema. But, is it really effective? Let’s find out. 

How Does It Work?

Clinically known as Aesculus hippocastanum, horse chestnut seed extract is commonly used in Europe to treat chronic venous insufficiency. The effects of chronic venous insufficiency include leg swelling, edema, varicose veins, and itching. 

Horse chestnut reduces fluid retention by working on the connective tissue barricade between blood vessels and tissue. 

Horse chestnut seed is used to improve circulation and promote the health of the blood vessels. It makes it harder for fluid to leak out of veins and capillaries. It also promotes fluid loss through the urine to prevent water retention

Horse chestnut contains escin and esculin compounds that protect blood vessels and help prevent fluid retention. It contains antioxidant compounds that strengthen weak or fragile veins. 

It has anti-inflammatory and antiseptic properties that help reduce inflammation, swelling, and pain associated with edema. 

Aescin and Aesculin

Aesculin is a glucoside with moderate diuretic activity. Unlike aescin, it produces its diuretic effect in the kidneys where it promotes the loss sodium and potassium alongside fluids.

Because it is a coumarin derivative, it increases bleeding time and is responsible for the interference of horse chestnut extract with drugs used in anticoagulation therapy.

70% of Horse chestnut extract is aescin. Aescin is a mixture of triterpene saponins.

It is the major group of bioactive ingredients in horse chestnut extract and so responsible for most of the medicinal properties of the herb. Such medicinal properties include anti-inflammatory, vasoprotective and vasoconstrictor effects.

Aescin has already been shown to be effective for treating chronic venous insufficiency which is a medical condition in which oxygen-poor blood is not extensively pumped back to the heart.  Chronic venous insufficiency is often a symptom or presentation of peripheral edema especially pedal or leg edema.

Aescin is present both in the alpha and beta forms in horse chestnut. The beta aescin is the more biologically active of the two molecules. 

How Aescin reduces Edema
  • Increasing vascular resistance by improving the tone of the walls of the vein to prevent them from becoming distended and varicose
  • Acting on the barrier between connective tissues and blood vessels to prevent fluid retention
  • Reducing the permeability of the walls of the veins and so inhibiting fluid leakage while promoting its reabsorption into the circulatory system

To improve the tone of the walls of blood vessels, aescin causes selective permeability in the vascular membrane. This means that there is an increased sensitivity to ions such as calcium and other molecules such as serotonin.

The overall result is that the contractility of the vein walls is improved while their permeability is reduced.

Aescin is particularly effective in addressing edema resulting from immediate inflammatory response. It inhibits the cascade of biochemical reactions leading to inflammation and the leakage of vein and capillaries.

To seal off the blood vessels and prevent fluid from leaking into the spaces between cells, aescin inhibits two enzymes: hyaluronidase and elastase. These two enzymes are involved in the depletion of the building blocks of capillary walls.

Aescin reduces the catabolism of the proteoglycans (a mucopolysaccharide) making up the walls of these blood vessels so that their syntheses can overtake the rate at which they are broken down.

Case Studies

A study conducted at the Universities of Plymouth and Exeter in England in 2006, examined years of studies and performed a meta-analysis on the effectiveness of horse chestnut in reducing leg swelling and pain. 

It was found that this herbal remedy was successful in treating leg pain when the horse chestnut extract was taken as a supplement for 2 to 16 weeks. 

Another study suggested that horse chestnut extract was as effective as compression stockings to reduce edema, although the study was not double-blind.

The effectiveness of horse chestnut extract especially its aescin content in the treatment of post-operative edema was the subject of two studies.

Post-operative edema usually presents as fluid retention in specific parts of the body (mostly in the lower limbs) after a surgical procedure.

In the first study, 72 patients were involved. Each of them had had a surgical operation to remove hernia or a torn meniscus or surgery for fracture of the lower leg. They were divided into two groups with one group receiving aescin.

Aescin was administered by intravenous injection before and after surgery. The group receiving aescin experienced very little edema post-surgery and in such cases, the edema was swiftly resolved.

The second study was broader and included patients who were to undergo different types of surgery ranging from amputation to facial surgery. These patients were also divided into two groups with one group receiving 10 mg aescin two times daily while the other group received no aescin.

The results showed a rapid improvement in post-operative edema in the group of patients receiving aescin while this type of edema took longer to disappear in the patients who received no treatment.

Other studies of the effectiveness of aescin are also published. They report similar positive outcomes for post-operative edema including those in which oral aescin was used.

Are There Any Side Effects?

You should not use raw or unprocessed horse chestnut extracts as they contain esculin, which is poisonous. 

When properly processed, horse chestnut seed extract with little or no esculin is generally safe when used for short periods of time. 

Higher doses or use of extended periods might cause some side effects such as itching, nausea, or gastrointestinal upset. 

You must tell your health care provider about any complementary and alternative practices you use before taking this herbal remedy. 

Are There Any Drug Interactions?

You should avoid taking horse chestnut along with diabetes medications as this might cause your blood sugar to go too low. The herb may interact with the following medications: 

Glimepiride, glyburide, insulin, pioglitazone, rosiglitazone, chlorpropamide, glipizide, tolbutamide, and others. 

You should also avoid anticoagulant / antiplatelet drugs if you are already taking horse chestnut. It might interact with the following medications: 

Aspirin, clopidogrel, diclofenac, ibuprofen, naproxen, dalteparin, enoxaparin, heparin, warfarin, and others. 

Try A Natural Supplement – Capisette 

If you are looking for a natural fluid retention remedy that contains horse chestnut extracts then consider taking Capisette. This effective remedy replenishes the body with lost nutrients and helps reduce edema.

Next Article: Water Retention and Ginkgo
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