Hawthorn

Effects and Benefits

Core Identification

Common Names:
- Hawthorn
- Hawthorne
- Haw
- May blossom
- Mayflower
- Whitethorn
- Thornapple
- English hawthorn

Latin Name: Crataegus oxyacantha, C. laevigata, C. monogyna (and other species)

Category: Herb

Uses

Traditional Uses

• Heart tonic and cardiovascular support - European tradition dating to Dioscorides (1st century CE)
• Digestive aid and food digestion support - Traditional Chinese Medicine
• General debility and bladder problems - Native American tribes (various Crataegus species)
• Emotional heart support for grief and heartbreak - European folk medicine

Modern Uses

• Mild heart failure (NYHA Stage II) - Improves cardiac output, exercise tolerance, and reduces symptoms | Research quality: Strong
• Key findings: Multiple randomized controlled trials show hawthorn extract (240-900 mg/day) improves ejection fraction, exercise tolerance, and reduces subjective symptoms; maximum effect typically seen after 6-12 weeks

• Source citations: Tauchert 2002; Schmidt et al. 1994; Zapfe 2001; Pittler et al. 2003 meta-analysis

• Hypertension - Lowers resting diastolic blood pressure with additional anxiolytic effects | Research quality: Moderate

• Key findings: Randomized double-blind placebo-controlled study showed significant reduction in resting diastolic blood pressure

• Source citations: Walker et al. 2002; Asgary et al. 2003

• Angina pectoris - Improves coronary blood flow and reduces oxygen demand | Research quality: Moderate

• Key findings: Clinical study showed hawthorn extract (equivalent to 900 mg/day dried herb for 3 weeks) improved pathology in angina patients

• Source citations: Bone, Kerry - A Clinical Guide to Blending Liquid Herbs

• Cardiac arrhythmias - Prolongs effective refractory period, reducing arrhythmia risk | Research quality: Moderate

• Key findings: Postmarketing surveillance showed excellent results with reduced incidence of arrhythmias; hawthorn prolongs ERP

• Source citations: WRCHM - Western Materia Medica I; Weikl et al. 1996

• Atherosclerosis and cholesterol - Hypolipidemic activity helps break down fat deposits | Research quality: Moderate

• Key findings: Tincture of Crataegus reduced LDL-receptor activity in hepatic plasma membrane of rats fed atherogenic diet

• Source citations: Rajendran et al. 1996; Shanthi et al. 1994

• Poor peripheral circulation - Vasodilatory effects improve blood flow to extremities | Research quality: Moderate

• Key findings: Hawthorn demonstrated peripheral vasodilatory activity; useful for intermittent claudication and Raynaud's phenomenon
• Source citations: DK - Herbal Remedies; Mills and Bone 2000

Active Compounds

Primary Active Ingredients:
- Oligomeric procyanidins (OPCs) - Positive inotropic and beta-adrenoceptor blocking activities; cardioprotective antioxidant effects
- Flavonoid glycosides (quercitin, hyperoside, vitexin, kaempferol, rutin) - Vasodilatory effects on peripheral and coronary circulation; some fractions positively inotropic, others negatively chronotropic
- Proanthocyanidins (epicatechin, catechin) - Collagen-stabilizing activity; powerful antioxidants
- Amines - Positive inotropic property with peripheral vasoconstrictor effects
- Cyanogenetic glycosides - Sedative activity upon cardiac function, increasing vagal tone and slowing heart rhythm
- Triterpenoids (ursolic acid, oleanolic acid) - COX-2 inhibitors; ursolic acid may interact with digitaloid binding site

Dosage Information

Standard Dosage:
- Form: Standardized extract (leaf and flower)
- Amount: 160-450 mg per day
- Frequency: Once or twice daily

Therapeutic Dosage:
- Form: Standardized extract
- Amount: 450-900 mg per day (corresponding to 3.5-20 mg flavonoids or 15-28 mg OPCs)
- Purpose: Heart failure (NYHA Stage II), hypertension, angina
- Duration: Minimum 6-12 weeks to see full benefit; can be used long-term

Maximum Safe Dosage:
- Daily maximum: 1800 mg/day (used in NYHA Stage III trials with diuretic therapy)
- Warning threshold: Higher doses in advanced heart failure showed no additional benefit and possible harm in SPICE trial

Bioavailability Notes:
- Flowers contain highest concentration of flavonoids
- Leaves and flowers now preferred over berries alone for cardiovascular use due to higher procyanidin content
- Berries traditionally used and still effective, particularly for digestive support
- Water-ethanol extracts (as used in German studies) are standard

How to Take It

Timing:
- Can be taken any time of day
- May be taken with or without food
- Consistent daily use required for therapeutic effect
- Best results seen after 6-12 weeks of continuous use

Synergies - What It Works Well With

Complementary Supplements:
1. Linden (Tilia) - Both support cardiovascular health | Combined calming and heart-tonic effect
2. Passion flower - Studied together for dyspnea in NYHA Stage II | Combined anxiolytic and cardiac support
3. Motherwort - Traditional heart and emotional support combination | Synergistic for grief-related heart symptoms
4. Yarrow - Complementary cardiovascular herbs | Enhanced circulatory support
5. Lemon balm - Calming nervine that pairs well for stress-related heart conditions | Emotional heart support
6. CoQ10 - Both support cardiac energy metabolism | Enhanced mitochondrial function in heart cells

Avoidance - What NOT to Combine With

Supplement Interactions:
1. Other hypotensive herbs in high doses - Additive blood pressure lowering | Risk of excessive hypotension

Drug Interactions:
1. Digoxin and cardiac glycosides - Hawthorn potentiates their activity | Risk of toxicity and enhanced effects | Severity level: Severe
2. Beta-blockers - Hawthorn has beta-adrenoceptor blocking activity | Additive effects may cause excessive heart rate reduction | Severity level: Moderate
3. Antihypertensive medications - Additive blood pressure lowering effects | Risk of precipitous drop in blood pressure | Severity level: Moderate to Severe
4. Vasodilators (nitrates) - Both dilate blood vessels | Enhanced hypotensive effect | Severity level: Moderate
5. Phosphodiesterase inhibitors - Hawthorn inhibits phosphodiesterase | Potential additive effects | Severity level: Moderate

Food Interactions:
- No significant food interactions documented
- Alcohol may enhance sedative effects

Safety Information

Contraindications:
- Pregnancy - should not be taken
- Severe heart failure (NYHA Stage III-IV) without medical supervision
- Known hypersensitivity to hawthorn or other Rosaceae family plants

Side Effects:
- Generally very well-tolerated in clinical trials
- Rare: nausea, fatigue, dermatitis, headache, mild digestive upset
- Acute toxicity symptoms (at very high doses in research): bradycardia, respiratory depression

Long-Term Use:
- Considered safe for long-term use as a heart tonic
- Clinical trials have used hawthorn safely for up to 24 months
- Best viewed as a daily tonic that works through nourishing mechanism rather than drug-like chemical changes
- Monitor blood pressure regularly if using long-term

Special Precautions:
- Surgery: Discontinue 1-2 weeks before surgery due to blood pressure effects
- Pregnancy: Not recommended
- Breastfeeding: Insufficient safety data; avoid use
- Children: Limited data; use under practitioner guidance
- Elderly: Well-studied in geriatric patients; shown to improve heart rate variability
- If taking heart medications: Use only under supervision of healthcare provider; do not discontinue medications without medical guidance

Primary Uses At-a-Glance

Primary: Heart failure support (NYHA Stage II), blood pressure regulation, angina relief, cardiac arrhythmias, circulatory tonic

Secondary: Atherosclerosis prevention, cholesterol support, poor peripheral circulation, anxiety with heart symptoms, emotional heart support (grief), connective tissue support

Sources

Local Library:
- WRCHM - Western Materia Medica I.pdf
- Bone, Kerry - A Clinical Guide to Blending Liquid Herbs.pdf
- Balch, Phyllis - Prescription for Herbal Healing.epub
- Hopman, Ellen Evert - A Druid's Herbal of Sacred Tree Medicine.epub
- DK - 2007 Herbal Remedies.pdf
- Simon, David - The Chopra Center Herbal Handbook.epub
- de la Forêt, Rosalee - Alchemy of Herbs.epub
- Pursell, J.J. - The Herbal Apothecary.epub
- Bruton-Seal, Julie - The Big Book of Backyard Medicine.epub
- Duke, James A. - Handbook of Medicinal Herbs.epub
- Gladstar, Rosemary - Medicinal Herbs.epub
- Lust, John - The Herb Book.epub
- Lust, John - The Natural Remedy Bible.epub
- Grogan, Barbara Brownell - Healing Herbs Handbook.epub
- Brewer, Sarah - TDT Encyclopedia of Vitamins.epub
- Newton, Anna - Herbs for Home Treatment.epub
- Mars, Brigitte - The Home Reference to Holistic Health and Healing.epub

General Knowledge:
- German Commission E Monographs
- ESCOP (European Scientific Cooperative on Phytotherapy) recommendations
- Clinical trials: Tauchert 2002, Schmidt et al. 1994, Zapfe 2001, Walker et al. 2002, Pittler et al. 2003, SPICE trial (Holubarsch et al. 2008)