Butcher's Broom

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Butcher's Broom

Common Names

  • Box holly
  • Sweet broom; Knee holly; Pettigree
  • Jew's myrtle
  • Thorny fragon

For Patients & Caregivers

How It Works

Studies show benefit of Butcher’s broom in patients with chronic venous insufficiency of the legs.

Butcher’s broom 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
    Small clinical studies have shown 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
    Evidence is lacking to support this claim.
  • To treat hemorrhoids
    Evidence is lacking to support this claim.
  • To reduce inflammation
    Lab studies show that compounds in butcher’s broom have anti-inflammatory effects.
  • To relieve leg cramps
    Evidence is lacking to support this claim.
  • To treat lymphedema
    One clinical study showed that Cyclo 3 Fort, a butcher’s broom product, reduced lymphedema in women who had undergone therapy for breast cancer.
  • To promote urination
    Evidence is lacking to support this claim.
Do Not Take If
  • You have diabetes (butcher’s broom was reported to cause diabetic ketoacidosis, characterized by high levels of compounds called ketones in the blood.)
Side Effects
  • Diarrhea has been reported with the product Cyclo-3, but is less common with use of other formulations of butcher’s broom.
  • Papulo‐erythematous pruritic eruption on legs, which spread within a few days to the entire skin, and produced oedema of the eyelids: In a 30-year-old pregnant woman following use of vasoconstrictor cream, containing butcher’s broom extract, for treatment of varices.
  • Pruritic erythematous lesions: In a 34-year-old woman following the local application of a haemorrhoid treatment cream containing ruscogenin. Several months later, she experienced a generalized eczematous cutaneous eruption the day after topical application of an anti‐cellulite product, containing ruscogenin, on the lower limbs.
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For Healthcare Professionals

Scientific Name
Ruscus aculeatus
Clinical Summary

Butcher’s broom is a short evergreen shrub of the Liliaceae family. Both the leaves and rhizome of the plant are believed to have diuretic and mild laxative properties. The plant extracts are widely used to treat varicose veins, hemorrhoids, and lymphedema.

Ruscogenin, one of the major constituents of the plant, demonstrated anti-inflammatory effects in vivo (10). Small clinical studies revealed efficacy of butcher broom extracts in controlling lymphedema and chronic venous insufficiency (4) (5) (6) (8) (9) (11).

Purported Uses
  • Circulatory disorders
  • Constipation
  • Hemorrhoids
  • Inflammation
  • Leg cramps
  • Lymphedema
  • Promote urination
  • Varicose veins
Mechanism of Action

Ruscogenin, one of the major components of butcher’s broom, exerts anti-inflammatory effects (10) likely by inhibiting TNF-alpha-induced over expression of ICAM-1 both at the mRNA and protein levels. It also suppresses NF-kappaB activation by decreasing NF-kappaB p65 translocation and DNA binding activity (10). In another study, ruscogenin was shown to inhibt elastase, one of the enzyme systems involved in the turnover of the main components of the perivascular amorphous substance (15).

The phenolic compounds and saponins isolated from butcher’s broom decreased the thrombin-induced hyperpermeability of human microvascular endothelial cells (HMEC-1) in vitro (16).

Contraindications
  • Diabetes: Diabetic ketoacidosis has been reported in a 39-year-old diabetic woman 5 days after consuming butcher’s broom for mild ankle swelling. Her condition stabilized following conventional treatment with intravenous fluid, insulin, and calcium gluconate (17).

Adverse Reactions
  • Diarrhea has been frequently reported with the product Cyclo-3, but is less common with use of other formulations of butcher’s broom. (7)
  • Papulo‐erythematous pruritic eruption on legs, which spread within a few days to the entire skin, and produced oedema of the eyelids: In a 30-year-old pregnant woman following use of vasoconstrictor cream, containing butcher’s broom extract, for treatment of varices (18).
  • Pruritic erythematous lesions: In a 34-year-old woman following the local application of a haemorrhoid treatment cream containing ruscogenin. Several months later, she experienced a generalized eczematous cutaneous eruption the day after topical application of an anti‐cellulite product, containing ruscogenin, on the lower limbs (19).
Dosage (OneMSK Only)
References
  1. Blumenthal M, et al. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Austin: American Botanical Council; 1998.

  2. 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.

  3. Blumenthal M, et al. Herbal Medicine Expanded Commission E Monographs, 1st ed. Austin: American Botanical Council; 2000.

  4. Cluzan RV, et al. Treatment of secondary lymphedema of the upper limb with CYCLO 3 FORT. Lymphology 1996 Mar;29(1):29-35.

  5. 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.

  6. 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.

  7. 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.

  8. De Marino S, Festa C, Zollo F, Iorizzi M. Novel steroidal components from the underground parts of Ruscus aculeatus L. Molecules. 2012 Nov 26;17(12):14002-14.

  9. Longo L, Vasapollo G. Determination of anthocyanins in Ruscus aculeatus L. berries. J Agric Food Chem. 2005 Jan 26;53(2):475-9.

  10. Barbič M, Schmidt TJ, Jürgenliemk G. Novel phenyl-1-benzoxepinols from butcher’s broom (Rusci rhizoma). Chem Biodivers. 2012 Jun;9(6):1077-83.

  11. Barbič M, Willer EA, Rothenhöfer M, Heilmann J, Fürst R, Jürgenliemk G. Spirostanol saponins and esculin from Rusci rhizoma reduce the thrombin-induced hyperpermeability of endothelial cells. Phytochemistry. 2013 Jun;90:106-13.

  12. Sadarmin PP, Timperley J. An unusual case of Butcher’s Broom precipitating diabetic ketoacidosis. J Emerg Med. 2013 Sep;45(3):e63-5.

  13. Landa N, Aguirre A, Goday J, Ratón JA, Díaz-Pérez JL. Allergic contact dermatitis from a vasoconstrictor cream. Contact Dermatitis. 1990 May;22(5):290-1.

  14. Ramírez-Hernández M, García-Sellés J, Mérida-Fernández C, Martínez-Escribano JA. Allergic contact dermatitis to ruscogenins. Contact Dermatitis. 2006 Jan;54(1):60.

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