Written by: Emily Cartwright (2015)
Editor: Raffael Dudler (Dudler Herbal July 2016).
(We acknowledge and thank Lincoln College for their support in sharing this monograph for educational purposes).
The Crataegus genus is part of the Rosaceae family (Epel, 2013, p 91). Members of the Rosaceae family have alternate leafs, which vary from simple, palmate or pinnate. Members of Crataegus spp (Davies, 2000, p 8) grow in almost all temperate regions of the world and even though it prefers full sunlight it will grow in most conditions. Crataegus spp. can be found growing on abandoned fields, overgrazed pastures, hedgerows and in forests. Mature trees (Woodland Trust) can reach a height of 15cm and are recognisable from their dense, thorny twigs. The leaves tend to be toothed lobes and their flowers are hermaphrodite, white or occasionally pink and are beautifully scented. Once pollinated, they then develop into red fruits known as Haws.
The phytochemical constituents for Crataegus spp are Flavoniods, phenolic acids and tannins and amines (Bartram, 1998, p. 215). Some of the key constituents of Crataegus.laevigata and Crataegus.monogyna are Flavonoids, oligomeric procyanidins amines, catechols, carboxylic and triterpene acids (Bone et al., 2012, p 672).
The therapeutics effects of flavonoids are antioxidant, antiviral, anti-inflammatory. It is proven to support the heart and the circulatory system as well as strengthen the capillaries (Pengelly, 2004), whereby flavonoids provide antioxidant action that defends body against damage from free radicals’ molecules that are generated during normal metabolic processes. Excessive production of these free radicals can cause damage to cells and their components, and are thought to have a key role in the enhancing the ageing process and age-related diseases. Antioxidants activity works by cleaning or ‘mopping up’ free radicals in the cells, to reducing cell damage that can cause disease such as heart disease (EUFIC, 2016).
The parts of the Crataegus species that are used medicinally (Bartram, 1998, p 215) are the dried flowers, leaves and fruits.
Crataegus species – the two species most commonly used in Western herbalism (Davies, 2000, p. 6) are Crataegus oxyacantha – also known as Crataegus laevigata and its family relative Crataegus monogyna. They are both known as English Hawthorn but Crataegus laevigata is also known as Midland Hawthorn or May.
Its traditional uses within medicine go back to the first century CE (Davies, 2000, pp .12 – 13) where Greek herbalist Dioscorides first referred to Hawthorn as Crataegus Oxuakantha. It has been documented that the Crataegus spp was used traditionally as a diuretic for the treatment of kidney/bladder stones, dropsy and the berries with their astringent properties were seen to be effective in the treatment against diarrhoea.
Modern scientific findings show the Crataegus spp as a beneficial cardiac herb (Williamson and Wren, 2003, p 210) (cardiac tonic, hypotensive, coronary and peripheral vasodilator, anti-arrhythmic and anti-sclerotic). Crataegus spp., has beneficial impact on the heart and the circulatory system (Bartram, 1998, p. 215) increasing blood flow through the heart and throughout the body. It is also as vasodilator helping to dilate all the blood vessels (Davies, 2000, p. 18) which this can potentially help to prevent a wide range of diseases and conditions such as arteriosclerosis.
As an anti-arrhythmic it helps to normalize and gently strengthens the contractions of the cardiac muscle and its hypotensive actions help to balance low blood pressure due to the plant chemical triperpene acids which provides hypotensive properties.
It’s hypotensive effects can be proven in a randomized double blind placebo controlled study. Eighty patients suffering both Type 2 Diabetes and hypertension were given a Hawthorn extract of 1200mg twice daily for the course of 16 weeks. Apart from their usual diabetic medication of insulin and hypoglycemic medicine nothing else was administered. The results showed a modest reduction in diastolic blood pressure in those that had taken the hawthorn extract. (Tassell et al.,2010).
However there is more than just the heart and circulatory system that Crataegus spp can benefit medicinally. It is also known to be an anti-spasmodic helping to relieve muscle tension in the uterus, intestines and other areas of built up congestion which could in turn cause contractions and constriction (Davies, 2000, pp. 18 – 19). It can also be beneficial to suffer those that water retention and bloating before a period.
Other traditional uses were to be :
aiding digestion; anxiolytic – helping to relieve anxiety and stress; helping against insomnia; a minor neuro-tonic disorders (Bruneton & Hatton, 2003, p. 398).
Based on results of many recorded clinical trials, experience of professionally qualified medical herbalists and the low incidences of side effects experienced by patients taking Crataegus spp it should be used for a wealth of known diseases especially treatment of cardiovascular disease. In addition it benefits in calming nervous tension, insomnia and is an efficient diuretic for the bladder and kidneys (Davies, 2000, p. 20).
Crataegus monogyna and Crataegus.laevigata contain a plant chemical called rutin (which is a flavonoid), the herb is able to help re-elasticate the blood vessel walls and also helps to rebuild collagen fibers that maintain healthy outer layers of the vessels.
It has benefits for the skin and used in cosmetic products increasing hydration and elasticity of the skin (Bone et al., 2012, p. 671) and anti-seborrhoeic activities so used
topically (Bone et al., 2012, p 671).
There are few safety precautions for the use of the Crataegus spp.. One ‘in vitro’ study suggested that Crataegus spp “May interfere with one specific method of serum digoxin assay” (Bone et al., 2012, p. 682) This suggests that precaution should be taken and discussed with a qualified medical herbalist or practitioner so they can safely co-administer Crataegus spp if it is deemed as safe to do so.
The dosage is as follows:
Powdered leaf and flower – 200-500mg twice daily
Dry extract – 160mm-900mg corresponding to 3.5-20 mg total flavonoids
Powdered berry – 0.3 – 1g three times daily (Williamson & Wren, 2003, p.210)
Bartram, T. (1998) Bartram’s Encyclopedia of Herbal Medicine, United Kingdom, Constable and Robinson.
Bone, K., Mills, S., Dixon, M. & Blumenthal, M. (2012) Principles and Practice of Phytotherapy: Modern Herbal Medicine, 2nd edition, Edinburgh, Churchill Livingstone/Elsevier.
Bruneton, J. & Hatton, C.K. (2008) Pharmacognosy, Phytochemistry, Medicinal plants, 2nd edition, Londres.
Davies, J.R. (2000) Hawthorn: Cratageus Oxycantha: A Step-by-Step Guide. Boston, MA, Element Books.
Elpel, T.J. (2013) Botany in a Day: The Patterns Method of Plant Identification, United States, HOPS Press.
EUFIC (2016) Flavonoids and heart disease (EUFIC) [on line] Available at: http://www.eufic.org/page/en/show/latest-science-news/fftid/flavonoid-heart-disease/ [Accessed: 2015].
Pengelly, A. (2004) The Constituents of Medicinal Plants: An Introduction to the Chemistry and Therapeutics of Herbal Medicines, 2nd edition, United Kingdom, CABI Publishing.
Tassell, M.C., Kingston, R., Gilroy, D., Lehane, M., Furey, A. (2010) ‘Hawthorn (Crataegus spp.) in the treatment of cardiovascular disease’, 4(7).
The Woodland Trust (no date) [on line]
Available at: http://www.woodlandtrust.org.uk/visiting-woods/trees-woods-and-wildlife/british-trees/native-trees/hawthorn/ [Accessed 2015].
Williamson, E.M. & Wren, R.C. (2003) Potter’s herbal encyclopedia: the most modern and practical book for all those interested in the scientific as well as the traditional use of herbs in medicine, 2nd Edition, United Kingdom, C.W. Daniel Company.