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Hawthorn fruit extract

Also known as: Crataegus laevigata, Hawthorn fruit extract, Hawthorn berry extract, Crataegus monogyna

Overview

Hawthorn fruit extract is derived from the berries, leaves, and flowers of the hawthorn plant, primarily *Crataegus monogyna* or *Crataegus laevigata*, native to Europe, Asia, and North Africa. It is widely used as a dietary supplement, primarily for its cardiovascular benefits, particularly in the management of chronic heart failure and hypertension. The extract is rich in bioactive compounds such as flavonoids, polyphenols, and oligomeric procyanidins, which are believed to be responsible for its therapeutic effects. Research on hawthorn extract is moderately mature, with several clinical trials and meta-analyses supporting its efficacy in improving heart function and reducing symptoms in patients with mild to moderate heart failure.

Benefits

Hawthorn extract has demonstrated significant benefits for cardiovascular health, particularly in patients with chronic heart failure (NYHA classes I to III). A meta-analysis showed that it increased maximal workload tolerance by approximately 7 watts (95% CI: 3 to 11 watts) and decreased the pressure-heart rate product by about 20 units (95% CI: -32 to -8), indicating improved cardiac efficiency. Patients also reported significant improvements in symptoms such as dyspnea and fatigue. These benefits are typically observed within weeks of treatment initiation, with most studies lasting six to eight weeks. Beyond heart failure, hawthorn may also contribute to cardiovascular protection through secondary effects like serum lipid-lowering and anti-oxidative properties, although the evidence for these effects is less robust than for heart failure management. The overall quality of evidence, particularly from randomized controlled trials and meta-analyses, is good, supporting its use as an adjunctive therapy.

How it works

Hawthorn extracts exert their cardioprotective effects through multiple biological pathways. The primary mechanisms involve improving cardiac function, reducing oxidative stress, and potentially modulating lipid metabolism. Key bioactive components, such as flavonoids and oligomeric procyanidins, are thought to influence these processes. Specifically, hawthorn may reduce serum lipid levels, inhibit lipid absorption, and promote cholesterol efflux, contributing to overall cardiovascular health. It interacts with the cardiovascular system by enhancing myocardial contractility and improving blood flow, thereby reducing the workload on the heart. While specific data on the absorption and bioavailability of all active compounds are limited, the standardized extracts are generally well-tolerated and effective.

Side effects

Hawthorn extract is generally considered safe when used as directed. Common side effects, though rare, may include mild gastrointestinal complaints such as nausea, dizziness, and mild digestive upset, occurring in less than 5% of users. Uncommon side effects (1-5%) may include cardiac complaints, although these are infrequent. No significant rare side effects (less than 1%) have been consistently documented. However, hawthorn can potentially interact with cardiovascular medications, including digoxin, beta-blockers, calcium channel blockers, and nitrates, by either potentiating their effects or interfering with their metabolism. Therefore, caution is advised for individuals taking such medications, and medical supervision is recommended. Hawthorn is contraindicated for pregnant or breastfeeding women due to insufficient safety data. Patients with severe heart conditions should also exercise caution and consult a healthcare professional before use.

Dosage

The optimal dosage for hawthorn extract typically ranges from 500 mg to 1,000 mg per day, usually divided into two or three doses. Most clinical studies have utilized standardized extracts containing either 18.75% oligomeric procyanidins or 2.2% flavonoids to ensure consistent potency. The minimum effective dose is generally within this range. While a maximum safe dose is not well-defined, doses exceeding 1,000 mg per day have not been extensively studied. It is recommended to take hawthorn extract with meals to minimize potential gastrointestinal side effects. Standardized extracts are preferred over crude preparations for their consistent composition and predictable effects. The bioavailability of hawthorn's active compounds may be influenced by other nutrients or medications, but no specific cofactors are required for its efficacy.

FAQs

Can hawthorn replace my heart medication?

No, hawthorn is not a replacement for conventional heart failure treatment. It should be used as an adjunctive therapy under medical supervision, especially if you have existing heart conditions or are taking other medications.

What are the most common side effects of hawthorn?

Common side effects are rare but may include mild nausea, dizziness, and gastrointestinal complaints. If you experience any adverse effects, consult your healthcare provider.

How long does it take to see benefits from hawthorn?

Benefits, such as improved exercise tolerance and symptom relief in heart failure patients, are typically observed within weeks of consistent treatment, with most studies showing effects within six to eight weeks.

Should I take hawthorn with food?

Yes, it is generally recommended to take hawthorn extract with meals. This can help minimize any potential gastrointestinal side effects and may aid in absorption.

Are there any drug interactions I should be aware of?

Yes, hawthorn can potentially interact with cardiovascular medications like digoxin, beta-blockers, calcium channel blockers, and nitrates. Always consult your doctor before starting hawthorn, especially if you are on heart medications.

Research Sources

https://pubmed.ncbi.nlm.nih.gov/12798455/ – This meta-analysis evaluated the efficacy of hawthorn extract in 632 patients with chronic heart failure. It found that hawthorn significantly improved maximal workload tolerance and reduced the pressure-heart rate product compared to placebo. The study supports hawthorn as a high-quality adjunctive treatment, though it noted limitations in long-term data.
https://www.aafp.org/pubs/afp/issues/2010/0215/p465.html – This systematic review provides a comprehensive overview of hawthorn extracts, highlighting their cardioprotective properties and ability to improve symptoms in heart failure patients. While it offers valuable insights, it also points out the need for more long-term studies to fully understand hawthorn's sustained effects.
https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2020.00118/full – This review article explores the mechanisms of action of hawthorn extracts, focusing on their serum lipid-lowering and anti-oxidative properties. It suggests that these properties contribute to overall cardiovascular protection, providing a deeper understanding of how hawthorn benefits the heart, although much of the data is preclinical.