Butcher's Broom: Benefits, Dosage, Contraindications

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Ruscus aculeatus (Butcher's Broom) is an evergreen shrub native to Mediterranean Europe and Africa. It has stiff leaves that end with one sharp thorn. Its berries remain attached to the plant throughout the winter. The root, the part used in medicine, is thick, usually 2 to 4 inches long, with many woody rootlets growing on its underside. The main active ingredients of Butcher's Broom are the steroidal saponins ruscogenin and neoruscogenin (up to 6%). The plant also contains other sapogenins and steroidal saponins (such as ruscine and ruscoside), fatty acids, sterols, flavonoids, coumarins, sparteine, tyramine, and glycolic acid. The use of Butcher's Broom in ancient times is not well known. During antiquity, it was known by Dioscorides for its diuretic and anti-edematous virtues. It is traditionally known as anti-gout. Its use for circulatory disorders is recent.

Other name(s) 

Fragon

Scientific name(s)

Ruscus aculeatus

Family or group: 

Plants

Active ingredients:

Ruscogenin

Neoruscogenin

Saponins

Flavonoids

Sterols

Coumarins


Indications

Rating methodology

EFSA approval.

Several clinical trials (> 2) randomized controlled with double blind, including a significant number of patients (>100) with consistently positive outcomes for the indication.
Several clinical trials (> 2) randomized controlled with double blind, and including a significant number of patients (>100) with positive outcomes for the indication.
One or more randomized studies or multiple cohorts or epidemiological studies with positive outcomes for the indication.
Clinical studies exist but are uncontrolled, with conclusions that may be positive or contradictory.
Lack of clinical studies to date that can demonstrate the indication.


Chronic Venous Insufficiency
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Butcher's Broom is most often used to relieve symptoms of CVI, including ankle edema, itching, tension, and cramps in the legs. Animal and clinical studies confirm its effectiveness in CVI, and the German Commission E has approved Butcher's Broom as adjunctive treatment for this condition. Taking Butcher's Broom root extract in combination with hesperidin and vitamin C (Cyclo 3 Fort, Laboratoires Pierre Fabre) may reduce edema, fatigue, pain, paresthesia, itching, and tired legs in people suffering from chronic venous insufficiency. Recommendations for Butcher's Broom in the form of dried root in capsules, tablets, or tea is 500 to 1000 mg three times a day. A specific combination of Butcher's Broom root extract 150 mg, hesperidin methyl chalcone 150 mg, and vitamin C 100 mg per capsule (Cyclo 3 Fort) has been used at 1 capsule twice a day for 2-3 months, 1-2 capsules three times a day for 1 month, or 1 capsule three times a day for 1 month followed by twice a day for 2 months.

Posologie

posologieOrally: root

posologie1500 - 3000 mg

formulationpowder


Synergies


Edema
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Trials have shown that Butcher's Broom seems useful for a wide variety of edemas and circulatory disorders of the venous system. Some trials focused on combined extracts with Butcher's Broom as a major component. Many studies are small and some are poorly designed, but the overall result confirms Butcher's Broom's ability to reduce swelling and discomfort associated with primary and secondary edema. Indeed, it has positive effects on pregnancy-related venous insufficiency, varicose veins, lymphedema, ankle swelling, and breast tenderness in premenstrual syndrome, edema secondary to hypertension-calcium channel blocker treatment, and swelling secondary to soft tissue injury. Preliminary clinical research in women with arm lymphedema after breast cancer treatment shows that taking a specific combination of Butcher's Broom root extract 150 mg, hesperidin methyl chalcone 150 mg, and vitamin C 100 mg per capsule, at a dose of 3 capsules orally three times a day for 90 days, reduces arm edema and improves mobility and heaviness. Edema was reduced by about 13% compared to placebo. A meta-analysis of three crossover, double-blind randomized studies on various products concluded that Butcher's Broom increases both venous tone and reduces capillary filtration, leading to an increase in lymphatic flow in patients with edema.

Posologie

posologieOrally: root

posologie1350 mg

formulationstandardized extract


Synergies


Premenstrual Syndrome
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In a double-blind randomized trial involving women with premenstrual syndrome, butcher's broom quickly reduced mastalgia and mood disorders with a trend toward improvement in ankle edema. A dose of 37.5 mg twice a day for 3 months was used.

Posologie

posologieOral: root

posologie75 mg

formulationstandardized extract


Hemorrhoids
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The German Commission E has approved butcher's broom as a treatment for hemorrhoids. In an open multicenter study involving 124 patients with hemorrhoids, 69% of patients and 75% of treating physicians rated the combined butcher's broom extract (Cyclo 3 Fort) as having good or excellent efficacy. Ninety-two percent of physicians rated the treatment as safe and well tolerated. Significant positive effects were observed after 7 days of treatment. Although controlled trials are warranted, butcher's broom may be a useful treatment for patients with hemorrhoids.

Posologie

posologieOral: root

posologie1500 - 3000 mg

formulationpowder


Synergies


Varicose Veins
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Preliminary uncontrolled observations in 12 men aged 34 to 75 with varicose veins suggest that taking butcher's broom root extract 150 mg, hesperidin methyl chalcone 150 mg, and vitamin C 100 mg per capsule (Cyclo 3 Fort) orally at a dose of 3 capsules in the morning on the first day, followed by one capsule three times a day for 5 to 7 days, decreases the diameter of some leg veins in the standing position and increases flows in these veins.

Posologie

posologieOral: root

posologie450 mg

formulationstandardized extract


Synergies


Diabetic Retinopathy
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Butcher's broom was found to be as effective as troxerutin for microangiopathic complications, including diabetic retinopathy, in 60 patients with type 2 diabetes.

Posologie

posologieOral: root

posologie1500 - 3000 mg

formulationpowder


Properties


Vascular Effect

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Butcher's Broom seems to have a protective effect on capillaries, the vascular endothelium, and smooth muscles, reducing capillary fragility and strengthening blood vessels. Moreover, R. aculeatus protects the vascular system from hypoxia by inhibiting the activation of endothelial cells due to hypoxia. Indeed, the activation of endothelial cells induced by hypoxia may be a cause of venous disease. Additionally, ruscogenin, a component of Butcher's Broom, has anti-elastase activity, reducing the degradation of elastin by elastase in the walls of blood vessels, which leads to a decrease in capillary permeability. In animal research, R. aculeatus extract has a constrictor effect comparable to noradrenaline on lymphatic conduits, thus increasing peripheral lymph return to the heart. In vitro, R. aculeatus extract has a relaxing effect on vascular material subjected to noradrenaline and PGF (prostaglandin F). This effect is inhibited by atropine. It probably induces the release of vasoactive factors from the vascular endothelium.

Usages associés

Edema, Diabetic retinopathy

Venotonic

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Butcher's Broom causes venous constriction by directly activating post-junctional adrenergic alpha-1 and alpha-2 receptors and releasing stored epinephrine by displacing adrenergic nerve endings of the vascular wall. This reduces venous capacity and blood accumulation in the legs. Animal research shows that intravenous administration of root and rhizome extracts causes constriction of venules without affecting arterioles or mean arterial pressure. This venular constriction can be blocked by alpha-1 antagonist (prazosin), alpha-2 antagonist (rauwolscine), and calcium channel blocker (diltiazem).

Usages associés

Chronic venous insufficiency, Varicose veins, Edema, Hemorrhoids

Anti-inflammatory

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Animal research indicates that ruscogenin, a component of Butcher's Broom, has anti-inflammatory activity. It seems to prevent leukocyte migration by inhibiting the pro-inflammatory cytokine TNF-alpha (tumor necrosis factor-alpha) and reducing the expression of the intracellular adhesion molecule-1 (ICAM-1). Root and rhizome extracts have partial agonist activity on muscarinic M1 and M3 receptors, contributing to anti-inflammatory activity.


Antimicrobial

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Butcher's Broom has shown very weak activity against Candida albicans.


Safety dosage

Adult 18 years and older: 1500 mg - 3000 mg (powder)

The therapeutic dosage should be based on the ruscogenins content, ranging from 16.5 to 33 mg two to three times a day. Standardized extracts are preferred for therapeutic use as they allow more precise dosages. Recommendations for other forms of butcher's broom are as follows: - Dried root in capsules, tablets, or tea: 500 to 1000 mg three times a day - Tincture (1:5): 2 to 4 mL three times a day - Fluid extract (1:1): 1 to 2 mL three times a day


Interactions

Médicaments

alpha-adrenergic agonist: moderate interaction

Butcher's broom has alpha-adrenergic agonist effects. Theoretically, it could have additive effects with alpha-adrenergic agonist drugs.

alpha-adrenergic antagonist: moderate interaction

Butcher's broom has alpha-adrenergic agonist effects. Theoretically, it could reduce the effects of drugs with alpha-adrenergic antagonist properties.


Precautions

Pregnant women: avoid

Avoid use due to a lack of reliable and sufficient information.

Nursing women: avoid

Avoid use due to lack of reliable and sufficient information.