How It Works
Bottom Line: The effects of butcher's broom in the human body have not been fully studied, but it has shown some benefit in patients with chronic venous insufficiency of the legs.
Butcher's broom is a root extract. It contains chemicals called saponins that scientists think cause constriction of arteries and veins. Butcher's broom may also reduce inflammation and increase lymphatic flow, but these effects have not been fully confirmed in humans.
Purported Uses
To treat circulatory disorders such as chronic venous insufficiency
A few clinical trials show that products containing butcher's broom can help improve the symptoms of chronic venous insufficiency, but the long-term safety and effectiveness of these products are not known.
To treat constipation
No scientific evidence supports this use.
To treat hemorrhoids
Butcher's broom is known to have effects on veins in general, but it is not known what effect they would have on the swollen veins that cause hemorrhoids. There is no proof from clinical trials that butcher's broom can treat hemorrhoids.
To reduce inflammation
No scientific evidence supports this use.
To relieve leg cramps
No scientific evidence supports this use.
To treat lymphedema
One clinical trial showed that Cyclo 3 Fort, a butcher's broom product, reduced lymphedema in women who had undergone therapy for breast cancer. No other evidence supports this use.
To promote urination
No scientific evidence supports this use.
To treat varicose veins
Although some clinical trials show that butcher's broom can help improve the symptoms of other disorders of the veins, there is no proof from clinical trials that this herb can treat varicose veins.
Research Evidence
Lymphedema from breast cancer treatment
Lymphedema of the arms is a common side effect of breast cancer treatment. Fifty-seven patients were randomly assigned to take a butcher's broom product called Cyclo 3 Fort or a placebo pill every day to observe the effect on their arm lymphedema. All of the women also underwent manual lymphatic drainage twice a week for at least one month. After three months, women taking Cyclo 3 Fort had a significantly greater decrease in arm edema, especially in the forearm, than women taking the placebo. This supports the use of Cyclo 3 Fort for reducing lymphedema, but women taking this supplement reported some minor side effects.
Chronic venous insufficiency
RAES is a product that contains butcher's broom, hesperidin (a fruit extract) and ascorbic acid (vitamin C). 40 patients followed the following crossover study design: they took RAES or a placebo pill for two months, then had no treatment for 15 days (to "wash out" the effects), and switched to the other therapy (RAES or placebo pill) for the next two months. This way, the researchers could see how each person reacted to both RAES and placebo at different times. Overall, the patients' conditions improved throughout the study, moreso when they were taking RAES.
In a randomized controlled trial, 148 women with chronic venous insufficiency were divided into two groups. One group took butcher's broom capsules (total ~75 mg daily), and the other group took a placebo pill. After 12 weeks, women taking butcher's broom had improvements in leg volume, circumference of the lower leg and ankle, symptoms and quality of life compared to the placebo group. There were few side effects. However, this results of this study are not applicable to men with chronic venous insufficiency, nor do they tell us if butcher's broom is safe and effective when taken for longer than three months.
Warnings
This product is regulated by the F.D.A. as a dietary supplement. Unlike approved drugs, supplements are not required to be manufactured under specific standardized conditions. This product may not contain the labeled amount or may be contaminated. In addition, it may not have been tested for safety or effectiveness.
Do Not Take If
You are taking a monoamine oxidase inhibitor (MAO-I) (Because butcher's broom contains tyramine, it can cause adverse effects when combined with MAO-Is such as phenylzine (Nardil®) or tranylcypromine (Parnate®)).
You are taking warfarin or other blood thinners (Butcher's broom may cause an increased risk of bleeding).
Side Effects
Diarrhea has been frequently reported with the product Cyclo-3, but is less common with use of other formulations of butcher's broom.
Scientific Name
Ruscus aculeatus
Common Name
Box holly, sweet broom, knee holly, pettigree, jew's myrtle, thorny fragon
Clinical Summary
Derived from the root of the plant. Taken orally or applied topically, this herb has been used for varicose veins, hemorrhoids, and lymphedema
(1) (2) (3).
Ruscogenin, one of the major constituents of Butcher's broom, demonstrated anti-inflammatory effects in vivo
(10). Clinical studies have revealed efficacy of Butcher broom extracts in controlling lymphedema and chronic venous insufficiency
(4) (5) (6) (8) (9).
Cyclo-3, a product that contains extract of butcher's broom as main ingredient, has been reported to cause diarrhea and abdominal discomfort
(7). Butcher's broom may interact with MAO inhibitors (phenylzine (Nardil®), tranylcypromine (Parnate®)) and possibly anticoagulants.
Purported uses
Circulatory disorders
Constipation
Hemorrhoids
Inflammation
Leg cramps
Lymphedema
Promote urination
Varicose veins
Constituents
Steroidal saponins (neoruscogenin ruscogenin)
Flavonoids
Tetracosanoic acid
Chrysophanic acid
Sitosterol, campesterol and stigmasterol
Coumarins
Sparteine
Tyramine
Glycolic acid
(1)
Mechanism of Action
Butcher's broom steroidal saponins may be responsible for stimulating the post-junctional alpha-adrenergic receptors of the smooth muscle cells of the vascular wall and produce vasoconstriction. It may also have anti-inflammatory effects and increase lymphatic flow (2). Ruscogenin, one of the major components exerts anti-inflammatory effects (10) possibly by inhibiting TNF-alpha-induced over expression of ICAM-1 both at the mRNA and protein levels. It also suppressed NF-kappaB activation considerably by decreasing NF-kappaB p65 translocation and DNA binding activity (10).
Adverse Reactions
Common: Diarrhea has been frequently reported with the product Cyclo-3, but is less common with use of other formulations of butcher's broom
(7).
Herb-Drug Interactions
Monoamine Oxidase Inhibitors (MAO-I): Due to the tyramine constituent in butcher's broom avoid concurrent use with MAO-I such as phenylzine (Nardil®), tranylcypromine (Parnate®).
Anticoagulants / Antiplatelets: Butcher's broom contains coumarins that may inhibit platelet activity and potentiate response to anticoagulants.
Literature Summary and Critique
References
- Blumenthal M, et al. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Austin: American Botanical Council; 1998.
- Foster S, et al. Tyler's Honest Herbal: A Sensible Guide to the Use of Herbs and Related Remedies, 3rd ed. New York: Haworth Herbal Press; 1993.
- Blumenthal M, et al. Herbal Medicine Expanded Commission E Monographs, 1st ed. Austin: American Botanical Council; 2000.
- Vanscheidt W, et al. Efficacy and safety of a Butcher's broom preparation (Ruscus aculeatus L. extract) compared to placebo in patients suffering from chronic venous insufficiency. Arzneimittelforschung 2002;52:243-50.
- Cluzan RV, et al. Treatment of secondary lymphedema of the upper limb with CYCLO 3 FORT. Lymphology 1996 Mar;29(1):29-35.
- Cappelli R, Nicora M, DiPerri T. Use of extract of Ruscus aculeatus in venous disease in the lower limbs. Drugs Exp Clin Res 1988;14(4):277-83.
- Thomas-Anterion C, et al. Unexplained chronic diarrhea, apropos of 4 new cases under Cyclo 3 fort and review of the literature. Rev Med Interne 1993 Apr;14(4):215-7. Review.
- Boyle P, Diehm C, Robertson C. Meta-analysis of clinical trials of Cyclo 3 Fort in the treatment of chronic venous insufficiency. Int Angiol. 2003 Sep;22(3):250-62.
- Guex JJ, Enriquez Vega DM, et al. Assessment of quality of life in Mexican patients suffering from chronic venous disorder - impact of oral Ruscus aculeatus-hesperidin-methyl-chalcone-ascorbic acid treatment - 'QUALITY Study'. Phlebology. 2009 Aug;24(4):157-65.
- Huang YL, Kou JP, Ma L, et al. Possible mechanism of the anti-inflammatory activity of ruscogenin: role of intercellular adhesion molecule-1 and nuclear factor-kappaB. J Pharmacol Sci. 2008 Oct;108(2):198-205.
