HAWTHORN CRATAEGUS SPP

HAWTHORN (Crataegus spp.) +++

Synonyms:
- C. laevigata (Poir.) DC; C. oxyacantha L., C. monogyna Jacq. C. oxyacantha L. var. praecox hort. ex Loudon.

Taxonomic Quagmire: A subset of American advocates of phytomedicine argue that we should emulate the Standard of Excellence of the German Commission E. Which one? Two came out in 1998, purporting to be authentic English presentations of the Commission E conclusions. Blumenthals very careful book (KOM in my HDR) approves only hawthorn leaf with flower (defining hawthorn as dried flowering twig tips of C. laevigata or C. monogyna, or other members of the genus) and only for decreasing cardiac output as described in functional Stage II of NYHA. The other, edited by Joerg Gruenwald, also an editor of Blumenthals Book, in his Herbal PDR (PHR) approves Crataegus species (not specifying either C. laevigata or C. monogyna), white thorn flowers, leaves, fruit, and various mixtures of plant parts for the same indication. My interpretation; these two and a few other species of the huge and taxonomically difficult Crataegus genus which contains some 200 - 300 species. But then we had sequelae to these first two volumes. In 2000, Blumenthal et al. (BGB) say that hawthorn refers to the fruit, leaf, and/or flower of the genus Crataegus (usually C. laevigata syn. C. oxyacantha) and C. monogyna. That can be interpreted at least two ways, but I take it to mean both species. I refer those interested in the German gyrations involved to the BGB. Conversely, Gruenwald in his Edition 2 (PH2) narrows his definition, mentioning only English hawthorn, which the Herbal PDR Edition 2 equate to Crataegus laevigata, with no discussion of the distinction between the species. I frankly doubt that the writers of these Germanic gyrations can tell the difference between species of hawthorn, especially after they have been reduced to powders or tinctures. I doubt that Gruenwald, nor anyone else, can prove that these researches were done on C. laevigata. In citing my CRC Handbook (Duke, 1985), Gruenwald cites an entry that was referred to C. oxyacantha. But I too, in 1985, was no surer of Crataegus taxonomy than I am today, hence, they are combined.

Activities (Hawthorn) :
- Antiaggregant (1; PNC); Antianginal (1; CAN; SKY); Antiarrhythmic (2; CAN; MAB; PH2); Antiatherosclerotic (1; MAB); Anticapillary Fragility (1; FNF; MAB; PH2); Antiedemic (1; PNC); Antiinflammatory (1; COX; MAB; PH2; WAM); Antioxidant (1; CAN; MAB; PH2; SKY); Antisclerotic (1; PNC); Antiseborrheic (f; MAB); Antithromboxane (1; MAB); Astringent (1; MAB; CRC); Bitter (f; PED); cAMP-Phosphodiesterase Inhibitor (1; MAB); Cardioprotective (1; MAB); Cardiotonic (2; APA; BGB; CRC; FAD; MAB; PH2; PNC; WAM); CNS Depressant (1; CAN); Collagen-Sparing (1; MAB; PH2); Coronary Vasodilator (1; FAD; PED; PH2); Cyanogenetic (1; CRC); Depurative (f; CRC); Digestive (f; PED); Diuretic (1; APA; CRC); Fumitory (f; CRC); Hepatoprotective (1; MAB); Hypertensive (f; PED); Hypocholesterolemic (1; APA; PH2); Hypoglycemic (1; APA); Hypotensive (1; BGB; CAN; FAD; MAB; PH2); Hypotriglyceridemic (1; MAB); Myocardioprotectant (1; MAB); Negative Bathmotropic (2; KOM); Negative Chronotropic (1; PH2); Nervine (1; WAM); Pancreaprotective (1; MAB); Phosphodiesterase Inhibitor (1; MAB; PH2); Positive Chronotropic (2; KOM); Positive Dromotropic (2; KOM); Positive Inotropic (2; KOM; PH2); Sedative (1; CAN; PHR; PH2; PNC); Stomachic (f; CRC); Tonic (f; CRC); Vasodilator (1; APA; BGB; CAN).

Indications (Hawthorn) :
- Acne (1; MAB); Alzheimers (1; COX); Anemia (1; MAB); Angina (2; APA; FAD; FEL; PH2; SKY); Atherosclerosis (2; BGB; FAD; CRC; MAB; SKY); Arrhythmia (2; APA; CAN; MAB; PH2; WAM); Arthrosis (1; COX; PH2); Bradycardia (1; BGB; PHR; PH2); Buergers Disease (f; BGB; CAN); Cancer (1; COX); Capillary Fragility (1; FNF; MAB; PH2); Cardiopathy (2; MAB; PH2); Cardiovascular Insufficiency (2; CAN; SKY); Cor Pulmonale (1; PH2); CVI (f; FEL); Dermatosis (1; WAM); Dropsy (f; CRC); Dyspnea (1; APA; CRC; MAB; PNC); Edema (1; APA; PNC); Erythema (1; MAB); Fatigue (1; BGB); Gingivosis (1; WAM); Heart (f; CRC); High Blood Pressure (2; BGB; CAN; CRC; FAD; MAB; PH2; SKY); High Cholesterol (1; APA; MAB; PH2); Hyperactivity (1; WAM); Hypertrophy (f; CRC); Inflammation (1; COX; MAB; PH2; WAM); Insomnia (1; APA; CAN; PHR; PH2; PNC); Ischemia (1; PH2); Low Blood Pressure (f; PED); Myocardiosis (f; CAN); Nephrosis (f; CRC; MAB); Nervousness (1; CAN; PHR; PH2; PNC); Palpitation (1; APA); Seborrhea (1; MAB); Sore Throat (f; CRC; MAB); Stasis (f; PH2); Stress (1; BGB; WAM); Swelling (1; PNC); Tachycardia (f; CAN; MAB); Valvular Insufficiency (f; CRC); Water Retention (1; APA; CRC). Interpretations by both Blumenthal et al. and Gruenwald et al. (1998) of Commission E are simple, and almost identical for a change, for decreasing cardiac output as described in functional Stage II of NYHA. Nothing more, nothing less.

Dosages (Hawthorn) :
- 1 tsp (1.8 g) chopped leaf and/or flower 2 - 3 ×/day, for a few weeks (APA); 1.5 - 3.5 g dry flower, leaf, fruit/day (MAB); 4 - 5 g fruit/day (SKY); 2 - 6 tsp fresh fruit (PED); 1 - 3 g dry fruit (PED); 0.3 - 1 g dry fruit, or in tea, 3 ×/day (CAN); 2 g dry fruit:10 ml alcohol/10 ml water (PED); average daily dose (5 g) in 1-g increments or 160 - 900 mg extract (standardized to flavonoids or procyanidins) in 3 doses (PH2); 0.5 - 1 ml liquid extract (PNC); 0.5 - 1 ml liquid extract (1:1 in 25% ethanol) 3 ×/day (CAN); 3 - 6 ml fluid leaf extract (1:2) (MAB); 3 - 7 ml fluid fruit extract (1:2) (MAB); 4 - 5 ml tincture 3 ×/day (SKY); 1 tsp tincture morning and night for several weeks (APA); 7.5 - 15 ml leaf tincture (1:5) (MAB); 7.5 - 17.5 ml fruit tincture (1:5) (MAB); 1 - 2 ml herbal tincture (1:5 in 45% ethanol) 3 ×/day (CAN); 2 - 3 (450 mg) capsules (StX to contain 100 mg certified potency hawthorn extract with a minimum of preferred 1.8 mg vitexins, including vitexin-2''-O-rhamnoside, synergistically combined in a base of Hawthorn Berry powder) with a large glass of water (NH); 80 - 160 mg StX 3 ×/day; 80 - 500 mg StX 2 - 3 ×/day 2.2% bioflavonoids, or 18.75% OPCs (SKY).

Contraindications, Interactions, and Side Effects (Hawthorn) :
- Class 1 (AHP). May potentiate digitalis (AHP) and other cardiac medicines (WAM). Can interfere with cardiac, hypertensive, and hypotensive therapies. Not suitable for self medication (CAN). Contrast that with Lininger et al., Hawthorn is extremely safe for long term use ... No known interactions with prescription cardiac medications or other drugs ... No known contraindications ... during pregnancy or lactation (SKY). Hazards and/or side effects not known for proper therapeutic dosages (PH2). Not for children under 12 years old (PH2). CAN cautions that because of uterine activity, in vivo and in vitro, its use in pregnancy and lactation is to be avoided. Not for use during first trimester of pregnancy (PH2). LRNP (January 1994), admitting that low doses are usually devoid of adverse effects, says that high doses may induce hypotension (that can be good in hypertension) and sedation (which can be good in insomnia). Side effects reported include fatigue, nausea, rash, and sweating (CAN). The tyramine content might suggest avoidance of MAOIs. High dose may be arrhythmogenic, hypotensive, sedative, tremorigenic, and vertigogenic (PH2). Still, in combination with beta-blockers may cause a hypertensive effect (PH2). May potentiate other cardiac drugs! Heres a speculative template that could double the size of any nitpickological compilation, Herbs with this activity (and count the activities in my compilation) may or may not potentiate pharmaceuticals with the same activity. The presence of ACE-inhibitors, beta-blockers, calcium-channel blockers, and diuretics makes this herb a safer offering in my book, than the four separate pharmaceuticals belonging to those A, B, C, and D recommendations for cardiopathy. Roots, leaves, and flowers all contain cardioactive compounds (CRC). One paper cited in Mitchell and Rook notes that corneal scratches with the thorns led to blindness in 88 of 132 Irish accidents. With cyanogenic and cardioactive compounds, not to mention tannin, scattered throughout the plant, it should not be taken lightly (CRC). The presence of oleanolic and ursolic acids (COX-2 inhibitors) may be equally significant in Alzheimers disease, arthrosis, and cancer. With isolated guinea pig heart muscle, luteolin-7-glucoside increased coronary flow 186%, hyperoside 66%, and rutin 66% (PH2). All also demonstrated positive inotropic and negative chronotropic. Im lucky enough to have a
bearing 4-seeded C. monosperma (oxymoron intended). When juiced, the fruits gelled almost instantaneously, suggesting a large quantity of anticancer pectin.

Extracts (Hawthorn) :
- Hawthorn extracts increase coronary flow, and reduce blood pressure and peripheral resistance. Hypotensive action attributed to vasodilation. Extracts, via OPCs, have betablocking activities, the more OPC, the more beta-blocking. Extracts administered to rabbits exhibit prophylactic antiarrhythmic activities. Flower extracts induce mild CNS-depressant activities; e.g., increased sleeping time and decreased motility. Extracts antioxidant and antiperoxidant (CAN). The hawthorns cardiotropic effect is caused by increased membrane permeability for calcium as well as the inhibition of phosphodiesterase with an increase in intracellular cAMP concentrations. This leads to increased coronary and myocardial circulatory perfusion and reduced peripheral vascular resistance (PHR). Lininger et al. say that it may improve coronary artery blood flow and contractions of the heart muscle. It may inhibit ACE, and reduce production of angiotensin II (SKY). Japanese clinical trials of 80 patients given fruits and leaves show clinical improvement in cardiac function, dyspnea, and edema (PNC). German clinical studies of 60 patients with stable angina receiving 60 mg hawthorn 3 ×/day showed increased coronary perfusion and economized myocardial oxygen consumption (CAN). Isolated constituents (mainly flavonoids) have LD50s of 50 - 2600 mg/kg ivn, 6000 mg/kg orl in animals (CAN). Oral toxicity of hawthorn 6000 mg/kg
orally (MAB). At 900 mg/day, hawthorn extract compared favorably with Captopril (37.5 mg/day) in treating patients with Stage II cardiac insufficiency (BGB).