Hawthorn (Crataegus)
The traditional heart herb of European folk medicine. Modest but real benefit in mild heart failure and as a gentle cardio-tonic.
Moderate evidence as adjunct in mild-to-moderate (NYHA II) heart failure — improved exercise tolerance, ejection fraction, and symptoms. Modest evidence for mild hypertension and angina. Effects: 6–12 weeks.
Hawthorn is a thorny tree whose berries, leaves, and flowers have been used for cardiovascular conditions in European herbal medicine for centuries. Its active flavonoids and oligomeric procyanidins improve coronary blood flow, increase cardiac contractility, and have mild ACE-inhibitor-like activity. The strongest evidence is in mild-to-moderate heart failure (NYHA class II) — the SPICE trial and others showed improved exercise tolerance and symptom relief as adjunct therapy. Used more broadly for mild hypertension, palpitations, and general 'cardiotonic' support. Gentle and slow-acting; not for acute cardiovascular events.
- Form
- Standardised hawthorn leaf and flower extract (WS 1442 — Crataegutt — the form used in most trials). Standardised to oligomeric procyanidins (OPCs).
- Dose
- 300–900 mg/day of standardised extract. Heart failure trials use 900 mg/day (split).
- Timing
- With food. Split AM/PM.
- Schedule
- Daily, ongoing. Effects accumulate over months.
- Side effects
- Generally very well-tolerated. Mild GI upset, headache, dizziness. Sleep disturbance in some.
- Interactions
- Cardiac medications — additive effect with digoxin, beta-blockers, calcium channel blockers, ACE inhibitors. Antihypertensives — additive BP lowering. Discuss with cardiologist if you're on heart medications.
- Contraindications
- Severe heart failure (use only under cardiology supervision). Pregnancy / breastfeeding. Pre-surgery (stop 1–2 weeks before).
- Lab markers
- Blood pressure, resting heart rate, exercise tolerance. Echocardiogram (ejection fraction) in heart failure.
- Food sources
- Hawthorn berries are edible (somewhat astringent) and used in traditional jellies and tonics in parts of Europe and Asia.
Pairs with
CoQ10 / Ubiquinol (cardiac function — classic pairing in heart failure protocols). Magnesium taurate, L-carnitine (cardiac stack). Garlic (BP support).
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