Butcher’s Broom

• 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
    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.
  • To reduce inflammation
    Lab studies show that compounds in butcher’s broom have anti-inflammatory effects.
  • 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.
  • To promote urination
    There are no studies to validate 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.
• 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. Today, 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⁾. Clinical studies revealed efficacy of butcher broom extracts in controlling lymphedema and chronic venous insufficiency ^{(4) (5) (6) (8) (9) (11)}.

  Cyclo-3, a product that contains a butcher’s broom extract as the main ingredient, was reported to cause diarrhea and abdominal discomfort ⁽⁷⁾.

• 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 considerably by decreasing NF-kappaB p65 translocation and DNA binding activity ⁽¹⁰⁾. In another in vitro 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⁾

• 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, 3^rd ed. New York: Haworth Herbal Press; 1993.

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

  4. 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.

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

  6. 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.

  7. 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.

  8. 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.

  9. Guex JJ, Enriquez Vega DM, Avril L, Boussetta S, Taïeb C. 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.

  10. 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.

  11. Guex JJ, Avril L, Enrici E, et al. Quality of life improvement in Latin American patients suffering from chronic venous disorder using a combination of Ruscus aculeatus and hesperidin methyl-chalcone and ascorbic acid (quality study). Int Angiol. 2010 Dec;29(6):525-32.

  12. 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.

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

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

  15. Facino RM, Carini M, Stefani R, Aldini G, Saibene L. Anti-elastase and anti-hyaluronidase activities of saponins and sapogenins from Hedera helix, Aesculus hippocastanum, and Ruscus aculeatus: factors contributing to their efficacy in the treatment of venous insufficiency. Arch Pharm (Weinheim). 1995 Oct;328(10):720-4.

  16. 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.

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