Hawthorn: Powerful Heart Medication

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Hawthorn LATIN NAME: Crataegus monogyna FAMILY NAME: Rosaceae http://www.mothernature.com/Library/Bookshelf/Books/54/9.cfm My genes require that I put certain herbs at the top of my herbal hit parade. I take celery seed to prevent the gout that plagues all the Duke boys, myself included. I take echinacea and garlic as a precaution against colon cancer, which killed my father and two uncles. But there's no history of heart disease in my family tree, so it may seem odd that I rank hawthorn high in the pantheon of Duke's Dozen. My wife Peggy, on the other hand, does have a genetic predisposition to heart disease, since both of her parents suffered heart problems. At first glance, hawthorn probably belongs more in her medicine chest than mine. But after mulling it over, I decided to add hawthorn to my list of essential herbs. You see, my genes alone don't tell the whole story. Unlike my parents, I smoked like a chimney--three packs a day for nearly 30 years. Even though I kicked the habit way back in 1971, I'm sure the smoking took its toll on my lungs and heart. Good genes or not, a heart attack may be on the horizon. Add to that the stress of day-to-day living. Even though I'm retired, I'm probably under more stress now than in all the years I worked as a botanist for the U.S. Department of Agriculture. I'm always under the pressure of writing deadlines (this book was no exception), and I give over 200 lectures a year. Racing to the airport, then to the hotel, then to the lecture hall, and then back again to the airport sure takes a toll on the ticker. My trips to the Amazon aren't stress-free, either. Heat, frustration, overexertion, and local political problems all combine to create conditions ripe for a coronary. Add to that my penchant for adventure, like the time I ignored my shaman's advice and waded through knee-deep waters in a flooded black lagoon. Electric eels, stingrays, and anacondas lurked below the surface. Just sharing the same space with an anaconda is enough to bring on heart failure. But whenever I visit my doctor, he doesn't seem concerned. My electrocardiograms (EKGs) have never raised so much as an eyebrow, let alone an alarm. Still, an ounce of hawthorn is worth a pound of cure. It's loaded with heart-smart oligomeric procyanidins (OPCs) and bioflavonoids, which can help keep your heart rhythm regular and prevent a variety of heart problems. I take hawthorn anytime my stress levels are elevated. And I'd take it religiously if I had a mild heart condition. DR. DUKE'S NOTES Hawthorn is often grown as an ornamental hedge in England. What Hawthorn Is and What It Can Do Hawthorn in a deciduous flowering shrub with small thorns, stocky branches, and small, red, oval fruits that look a lot like crabapples. You'll find it residing along roadsides, in fields, and in wooded areas throughout Europe and in parts of North America, mainly in the Northeast but also south beyond the Carolinas and west at least as far as Oklahoma. The hawthorn bush can soar as high as 40 feet. There are at least 200 species of hawthorn, and I don't know a trained botanist--let alone a gardener, herbalist, chemist, pharmacist, or physician--who can tell them apart. The fruit is tart to the taste. I sampled several species last year at the Colonial Garden in Plymouth, Massachusetts, and I've tried even tastier fruit at the Coker Arboretum at my alma mater, the University of North Carolina. Native Americans ate many species of Crataegus. Today, though, naturopathic physicians usually don't recommend eating the wild fruit raw. While I consider them food plants and eat them raw and fresh--in moderation--any time I come across one that tastes good, I can't endorse the practice for anyone else (except for close family and friends). A safer bet is to eat the fruit dried or cooked, perhaps as a jelly. The fruit can also be brewed into a heady wine, and its young leaves and white flowers steeped to make a tea. Interestingly, hawthorn contains many of the same compounds as common teas, including black, green, and oolong teas, promoted these days for a variety of health benefits. But the standardized capsule is what I recommend for heart health. DR. DUKE'S NOTES In northern China, vendors sell crataegus fruits on sticks. They're coated with a sweet sugar syrup, like our candy apples. I've eaten one. It was good. Probably oversweetened. Help for Your Heart Germany's prestigious Commission E, a panel of experts roughly equivalent to the U.S. Food and Drug Administration, has approved hawthorn for a number of heart problems. It's widely used in Europe for treating angina, which causes chest pains and is brought on by blockage in the arteries. Varro E. Tyler, Ph.D., Sc.D., professor emeritus of pharmacognosy at Perdue University, discusses hawthorn's heart-health benefits in his excellent book, Herbs of Choice. The OPCs in hawthorn, he explains, have beta-blocking activities. (Beta-blockers are drugs prescribed to increase coronary blood flow and help lower blood pressure and heart rate, stopping arrhythmias.) Hawthorn also contains flavonoids, compounds that open up the coronary arteries. It appears to stabilize heart rhythm, decrease palpitations brought on by anxiety, increase exercise tolerance, reduce blood pressure, and lower cholesterol levels. In their book The Natural Pharmacy, Skye W. Lininger and his colleagues say thathawthorn "may" improve blood flow through the coronary arteries. Because hawthorn is a powerful heart medication, I'd advise erring on the side of caution. Literature from some leading British and German research scientists suggests that hawthorn is not suitable for self-medication. True! No one should try to treat a serious heart condition on his or her own. Before you take hawthorn, talk to your doctor. But I do recommend the tasty species as a preventive food for the strong of heart. FROM MY SCIENCE NOTEBOOK Modern science validates hawthorn's centuries-old use as an effective means of strengthening the heart and staving off cardiac problems. Hawthorn activity is due primarily to proanthocyanidins and flavonoids, including quercetin, hyperoside, vitexin, vitexin-rhamnoside, and rutin. Flavonoids are a large class of pigments found in plants that protect blood vessels, aid in circulation, stimulate bile production, and lower cholesterol levels. Proanthocyanidins are one of 12 classes of flavonoids. Oligomeric proanthocyanidins (OPCs) are one type of proanthocyanidin. The cardioprotective effects of proanthocyanidins have been supported by recent studies of red wine and grape seeds. How Hawthorn Can Help Hawthorn can be used to treat a variety of health problems and, according to European clinical experience, is safe to use over extended periods of time. Here are some of the conditions for which it's shown to be effective: Good Heart Health Hawthorn seems to be helpful for a variety of cardiac problems. Angina pectoris. Caused by a deficient blood supply to the heart, symptoms of angina include tightness, pressure, or burning in the chest, and pain that may radiate to the left shoulder, down the left arm, and to the back or jaw. Exercise can exacerbate the problem, since it puts extra pressure on the arteries as they try to deliver more oxygen-rich blood to the muscles. Similarly, stress, fear, and anger all get the heart pumping faster, and they too can bring on angina. The nutrients magnesium and niacin, found in fruits and vegetables including hawthorn, have been long recommended for treating angina. People deficient in these nutrients can get them from hawthorn and other supplements. Research supports the use of hawthorn for treating angina. In their book, Herbal Medicines: A Guide for Health-care Professionals, authors Carol Newall, Linda Anderson, and J. David Phillipson report that German researchers gave 60 angina patients 60 milligrams of hawthorn three times daily, with positive results. Arrhythmia. Cardiac arrhythmia is an irregular beating of the heart. If the heart races more than 100 beats per minute, the condition is called tachycardia. A heartbeat slower than 60 beats per minute is known as bradycardia. Abnormal heart rhythm can result in atrial arrhythmia, a "pooling" of blood if the heart can't pump it from its upper chambers, which can lead to clotting, heart attack, or stroke. Ventricular arrhythmia affects the lower chambers in the heart, leading to ventricular fibrillation, a condition in which the heart flutters weakly instead of pumping powerfully. A significant number of fatal heart attacks are attributed to ventricular fibrillation. Studies have shown that hawthorn extracts administered to rabbits have a beneficial effect on arrhythmia. I've heard one report that hawthorn can induce arrhythmias, but I don't put much stock in this single, isolated finding. A single reported case just doesn't win the race! Still, it's advisable to check with your doctor. Atherosclerosis. This heart condition results when cholesterol, lipids, and calcium deposits clog the arteries. It's the most common form of arteriosclerosis, in which vessels become diseased--they thicken, harden, and lose elasticity. Arteriosclerosis is a leading cause of death in the United States, and family history isn't the only determining factor in developing this condition. A sedentary lifestyle, high cholesterol, obesity, cigarette smoking, and stress all play a part. While you can't change your genes, you can change your lifestyle. Call a halt to bad habits, get off your duff and exercise, and eat a heart-healthy diet full of OPC-laden fruits, including dried or cooked hawthorn, prunes, strawberries, rosehips, peaches, crabapples, pears, and blackberries. All are members of the rose family, along with cherries, plums, chokecherries, wineberries, cloudberries, and apricots. Doctors often recommend aspirin, a blood thinner, to prevent a second heart attack. Hawthorn, too, has blood-thinning properties--in fact, it reportedly contains at least seven known blood thinners. Cardiovascular insufficiency. This is a broad term for the inadequate performance of the heart and blood vessels. People who have it report reduced performance in cardiovascular activities, shortness of breath, and swelling of the ankles. In one German study, researchers treated 136 patients with cardiovascular insufficiency and found that their condition improved, with minimal risk. Dyspnea. Breathing difficulty and chest pain can be caused by circulation disturbances or blood that lacks sufficient oxygen. According to Potter's New Cyclopaedia of Botanical Drugs and Preparations, clinical trials in Japan showed that 80 patients given hawthorn fruits and leaves showed improvement in dyspnea, edema, and cardiac function. Edema. Edema causes bloating, swelling, and inflammation among patients with heart problems, which is one reason why diuretics are often prescribed for heart patients. Hawthorn is blessed with at least nine antiedemics. In Herbal Medicinals: A Clinician's Guide, Miller and Murray share an interesting case study of a 62-year-old man with congestive heart failure. An herbalist recommended that he take hawthorn, which reportedly lessened his edema and improved his physical endurance. High blood pressure. Hawthorn contains at least three antihypertensives, which help keep blood pressure from rising. Lucinda G. Miller, Pharm.D., and Wallace Murray, authors of Herbal Medicinals: A Clinician's Guide report that hawthorn expands blood vessels, lowering blood pressure and reducing the heart's workload. High cholesterol. High cholesterol can lead to serious complications including cardiovascular disease, a major health problem in the United States responsible for the most deaths, the largest number of hospitalizations, and the greatest number of pharmaceutical prescriptions. The best way to prevent heart problems, of course, is to keep your heart strong and healthy with regular exercise and a low-fat, low-cholesterol diet. I would also look to hawthorn. A study from the biochemistry department at the University of Madras, India, shows that a tincture of hawthorn berries can help ward off high blood cholesterol and atherosclerosis. Attention-Deficit Hyperactivity Disorder While hawthorn is best-known as a heart-helper, there is some indication that it may be useful in treating attention-deficit hyperactivity disorder (ADHD), a condition marked by an inability to stay focused and attentive, and a particular problem among children. David Winston, a noted East Coast herbalist, tells me that he uses hawthorn not only for heart problems but also for ADHD. While he prefers to work with a solid extract of the fruit of the European species, Crataegus monogyna, he says he's happy with any of the native American species that have white flowers, believing them to be almost as effective as European hawthorns. He believes these flowers have even more biologically active effects than the fruits. His "Focus Formula" for ADHD includes oats, fresh lemon balm, dried hawthorn fruit and flower, dried autumn ginkgo leaf, and fresh skullcap herb. The drug Ritalin is widely prescribed to treat ADHD in children--far too widely, in my opinion. Instead, I'd try making a hawthorn sauce, just as I'd make an applesauce, and spice it up with cinnamon. I'll bet that kids like it better. A CASE IN POINT Hawthorn Successes I've heard many success stories from people who've tried hawthorn. Here are two: Christopher Hobbs, author of Handmade Medicines, recently told me about his father, Ken, a botanist and former university professor. Ken had a massive heart attack when he was 48 years old. During his recovery, he started taking hawthorn, and his doctor was amazed at his progress. Today, Ken is 78 and still takes hawthorn faithfully. His circulation has improved, and his heart is strong and steady. And a registered nurse who's a frequent guest on my Peruvian eco-tours told me that hawthorn changed her family's life. She has weaned her husband off his heart medication and put him on hawthorn and linden instead. She persuaded her father to take hawthorn for cardiomyopathy. And she recommended hawthorn as a natural diuretic to her younger sister, who has insulin-dependent diabetes and suffered an allergic reaction to a prescription diuretic. How to Take It and How Much Hawthorn is available in several forms: fresh, dried, liquid extracts, tinctures, powders, and capsules. I think everyone should make the fruit part of a healthy diet, in cooked or dried form--not raw (even though I eat it raw). Our hungrier ancestors probably ate any ripe hawthorn berry they encountered. If you take the dried fruit, a suggested dosage is 0.3 to 1 gram per day. Standardized extracts of hawthorn, in my view, may be taken by people with minor heart problems, but let me reiterate: Talk to your doctor before you take hawthorn. It's very important that you take the right kind of standardized extract at the appropriate daily dosage, extracts containing 1.8 percent vitexin-4-rhamnosides or 10 percent OPCs in dosages of 120 to 240 milligrams three times per day. Useful Combinations Naturopaths and nutritionists often recommend other heart-wise herbs, vitamins, and nutrients along with hawthorn. Angelica. Calcium deposits in the arteries can lead to heart complications. Angelica can help. This natural calcium antagonist reportedly contains at least 15 calcium-blocking compounds. Two have been shown to have better calcium-fighting functions that Verapamil, an angina medication. This kind of data prompted me to cook up a concoction called "Angelade." The primary ingredient is juiced angelica, along with other foods that contain calcium blockers including carrot, celery, fennel, parsley, and parsnip (for the recipe, see page 75). Animal musk. My good friends Albert Leung, Ph.D., and nationally known herbalist Steven Foster, authors of several useful books including my favorite, Encyclopedia of Common Natural Ingredients, report that clinical trials of musk in China showed improvement in about 74 percent of heart patients--a track record as good or better than the prescription medication nitroglycerin. To clarify: This is animal musk, not the vegetable musks from the mallow family. As an herbalist, I don't work with musk myself. Celery juice. Tip back a cold glass of celery juice. In one study of rats fed a high-fat diet for eight weeks, those given a celery juice supplement showed lowered total cholesterol, LDL, and triglycerides, a fatty substance in the blood that is also an important factor in the development of heart disease. Clinical trials in the United States showed that the equivalent of four stalks of celery lowered blood pressure. Pineapple enzyme. California herbalist Kathi Keville, whom I greatly admire, says that more than 400 research papers--most of them from Germany--have been devoted to the medicinal uses of bromelain , an enzyme found in pineapple. One such study, done in the early 1970s, showed that angina patients who took bromelain enjoyed relief from their symptoms within 4 to 90 days, depending on the seriousness of their condition. Their heart problems returned when they stopped taking the enzyme. Walnuts. Walnuts and other nuts high in monounsaturated fatty acids, such as almonds, filberts, macademias, pistachios, pecans, and the delicious avocado fruit, may lower cholesterol, helping to keep the heart strong. Research has shown that a diet with 20 percent of calories from walnuts lowered total cholesterol by 12 percent and low-density lipoprotein (LDL), often called "bad cholesterol," by 16 percent. Herbal combination. Dr. Leung and Foster also suggest Canada balsam, cassia, cinnamon, and turmeric for heart and chest pain. Nutrient combination. Studies support a combination of four nutrients to treat heart disease: I-carnitine, Coenzyme Q10, magnesium, and vitamin E. A suggested preventive dose is 1,000 milligrams per day of I-carnitine, 100 milligrams of CoQ10, 800 milligrams of magnesium, and 800 IU (international units) of vitamin E. Supplements are recommended, since it's tough to get these levels even from eating the best of my plants. HERB LORE AND MORE Hawthorn has a long history as a heart tonic in herbal folklore. Europeans, Chinese, and Native American peoples used the herb as a cardiac medication, brewed as a tea or taken in tincture form. The Cherokees also used an infusion of the bark to prevent heart spasms. Besides heart conditions, hawthorn tea was also taken to soothe sore throats and as a natural diuretic for kidney disorders. Native Americans often treated rheumatism with hawthorn, and its flowers and berries were gathered for their astringent properties.. Today, traditional Chinese practitioners still use hawthorn as an aid in the digestion of fatty foods. Caution: Contraindications, Interactions, and Side Effects Hawthorn is considered extremely safe even when used over long periods of time. For the most part (with the exception noted below), there are no known interactions with prescription heart medications or other types of drugs. Still, it bears repeating that you should consult your doctor before using hawthorn, and keep the following possible side effects in mind. Fatigue. Known but rarely reported side effects of hawthorn include fatigue, possibly accompanied by nausea, rash, and sweating. Depression. Flower extracts may act as a mild depressant. Pregnancy alert. I always caution that all medicines, both herbal and pharmaceutical, be avoided unless approved by your obstetrician. Having said that, I wouldn't discourage my own pregnant daughter from using hawthorn in food form--cautiously--if she had a heart condition. I'd also suggest other members of the rose family, including apples and crabapples, as they're almost certainly safer than prescription drugs. Pharmaceutical alert. Studies suggest that in the early stages of heart disease, hawthorn is more effective than the commonly prescribed digitalis, a drug derived from the herb foxglove, and has fewer side effects. However, if you're on digitalis, you should never try hawthorn or any herbal medication without consulting your doctor. Hawthorn may make digitalis more active. A CASE IN POINT The Frantic Father The caller sounded desperately worried. He had a question about using hawthorn for cardiac arrhythmia, a condition in which the heart beats irregularly, typically racing ahead or skipping a beat. Cardiac arrhythmias can lead to potentially fatal heart attacks. I expected him to tell me that he himself had been diagnosed with the condition, which usually occurs in adults over age 50. But he explained that the person with the problem was his little girl, only 6 years old. Calcium channel-blockers--the medication customarily prescribed for this condition--weren't working for his daughter, he told me. My first thought was, "Oh no! He's going to ask me to prescribe an herbal medication over the phone." This is something I never do--and I'd certainly never reconsider in a condition as serious as a cardiac disorder in a child. To my relief, he wasn't looking for an herbal prescription. His daughter's doctor, he said, had already turned to the alternative medicine chest, suggesting a regimen including hawthorn, Coenzyme Q10, and magnesium. Research has shown that all three help the heart. The alternative approach, the father reported, was working for his young daughter. But he was concerned about hawthorn's toxic effects if used over a long period of time. I scoured my herbal database, reviewed the literature, and faxed him all the evidence I could muster. Turns out, hawthorn seems to be safe even for long-term use. I found no links between hawthorn and heart attacks. I did find one isolated report to the effect that hawthorn can induce arrhythmias, and I felt obligated to tell him about it, but I frankly don't place too much stock in it. If it were my daughter, I sure would rather give her hawthorn than a pharmaceutically synthetic calcium channel-blocker. It certainly worked for my caller, since his daughter got better. http://www.mothernature.com/Library/Bookshelf/Books/54/9.cfm_________________JoAnn Guest mrsjoguest DietaryTipsForHBP http://www.geocities.com/mrsjoguest