Evidence review
Butcher's Broom for Varicose Veins
Ruscus aculeatus
The short answer
Promising clinical evidencePossibly, for symptoms, but the evidence is thinner than it looks. One 12-week trial of butcher’s broom alone in 166 women found slightly less leg swelling and heaviness than with placebo, and Europe’s regulator still rates the herb as traditional use only. Most of the stronger-looking evidence is for a combination pill that adds hesperidin methyl chalcone and vitamin C. Neither removes varicose veins, and the combination can cause diarrhea.
5 key studies reviewed
Updated October 22, 2026
Key points
-
01
Eases symptoms, not the veins
Trials measured heaviness, aching, swelling, and ankle size. None showed that varicose veins shrink or disappear, which takes a procedure such as endothermal ablation.
-
02
Only one trial of the herb alone
In 166 German women, a butcher’s broom extract reduced leg volume by about 20 ml more than placebo over 12 weeks and eased heavy, tired legs, but pain and quality of life did not improve more than with placebo.
-
03
Most evidence is for a combination
Cyclo 3 Fort adds hesperidin methyl chalcone and vitamin C. Meta-analyses found less pain, heaviness, and swelling, but most trials were small and decades old, and its maker funded the 2017 review.
-
04
Traditional use only in Europe
The European Medicines Agency (EMA) accepts butcher’s broom only as a traditional remedy for heavy legs, judging the single trial not convincing. Horse chestnut extract has a higher rating.
-
05
Diarrhea, skin allergy, and diabetes
The combination pill has caused chronic diarrhea and lymphocytic colitis, and creams can cause skin allergy. Avoid it in pregnancy and breastfeeding, and check with a doctor first if you have diabetes.
Butcher’s broom may ease the heaviness, aching, and swelling that often come with varicose veins, but it will not make the veins themselves go away, and the evidence is thinner than many product labels suggest. Europe’s regulators found only one clinical trial of butcher’s broom on its own: in 166 women with chronic venous insufficiency, a standardized root extract reduced leg swelling slightly more than a placebo (dummy pill) over 12 weeks and eased heavy, tired legs. Most of the other research tested Cyclo 3 Fort, a combination pill that adds hesperidin methyl chalcone, a modified citrus flavonoid, and vitamin C. Reviews of that combination are favorable and European vascular surgeons say vein medicines like it should be considered for symptoms, but its trials were mostly small and decades old, and the main 2017 review was funded by its maker. The European Medicines Agency (EMA) accepts butcher’s broom on its own only as a traditional remedy for heavy legs.
Varicose veins are swollen, twisted veins, usually on the legs, caused by faulty valves that let blood pool and stretch the vein. When they cause symptoms such as aching, heavy or swollen legs, itching, or skin changes, doctors call the condition chronic venous insufficiency (CVI), part of a broader group called chronic venous disease. Butcher’s broom (Ruscus aculeatus) is a low, spiny evergreen shrub from the Mediterranean and western Europe; the medicine is made from its underground stem and roots, which contain steroid-like saponins called ruscogenins. It is sold in Europe as a traditional herbal medicine and in combination products such as Cyclo 3 Fort, and in the United States as a dietary supplement. It is not the same plant as Scotch broom, a yellow-flowered shrub with different chemistry.
This page goes through the single-herb trial and the combination studies, including who ran and paid for them; what regulators, guidelines, and reviews conclude; how butcher’s broom compares with horse chestnut and with standard care such as vein procedures and compression stockings; the doses and products tested; and who should avoid it. Nothing here is medical advice. Varicose veins that cause symptoms deserve a proper assessment, usually with an ultrasound scan, and sudden swelling or pain in one leg, a bleeding vein, or a sore that will not heal needs prompt medical care.
02 The trials
Key studies
The trials and reviews that carry the most weight for this question, with the product and dose each one tested. Results apply to the preparation studied.
-
Vanscheidt et al., 2002
Randomized, double-blind, placebo-controlled trial at 10 German centers; four of eight authors from GlaxoSmithKline Consumer Healthcare
- Who
- 166 women aged 30 to 89 with chronic venous insufficiency (Widmer grade I or II); 148 analyzed
- What and how much
- Fagorutin Ruscus capsules: 36–37.5 mg of dry rhizome extract (about 4.5 mg total ruscogenins) twice daily
- How long
- 12 weeks after a 2-week placebo run-in
Leg volume fell with the extract and stayed roughly unchanged with placebo; the difference was 16.5 ml at 8 weeks and 20.5 ml at 12 weeks. Ankle and calf circumference, heavy tired legs, and tension improved more than with placebo, while pain, tingling, and quality of life did not differ. Adverse events were 22 with the extract and 26 with placebo. EMA assessors noted missing protocol details and rated the evidence low.
-
Kakkos and Allaert, 2017
Systematic review and meta-analysis of 10 double-blind placebo-controlled trials; funded by Laboratoires Pierre Fabre
- Who
- 719 people with chronic venous disease, CEAP clinical class C2 to C5
- What and how much
- Mostly branded Ruscus products such as Cyclo 3 Fort and Phlebodril that add hesperidin methyl chalcone and vitamin C; one trial of Ruscus alone
- How long
- Trials of 15 days to 14 weeks, published 1976 to 2002
Less leg pain (risk ratio 0.35; number needed to treat 5), heaviness (0.26; NNT 2.4), feeling of swelling (0.53; NNT 4), and tingling (0.27; NNT 1.8), plus smaller ankle circumference and leg or foot volume. The pain, heaviness, fatigue, and swelling analyses each pooled one to five trials with 60 to 217 people, and swelling results varied widely between trials.
-
Boyle, Diehm, and Robertson, 2003
Meta-analysis of 20 placebo-controlled double-blind trials, 5 trials against another drug, and 6 single-arm studies
- Who
- Data on 10,246 people with chronic venous insufficiency
- What and how much
- Cyclo 3 Fort: Ruscus root extract 150 mg, hesperidin methyl chalcone 150 mg, and vitamin C 100 mg per capsule
- How long
- Varied between studies
On a 0–3 severity scale, the combination reduced pain by 0.44 points, heaviness by 0.53, cramps by 0.26, and tingling by 0.29 more than placebo, and lowered venous capacity. Reductions in calf and ankle circumference were not statistically significant. The authors acknowledged variable data quality and small samples in some studies.
-
Parrado and Buzzi, 1999
Randomized, double-blind, placebo-controlled trial
- Who
- 60 outpatients with uncomplicated chronic venous insufficiency in Buenos Aires, Argentina
- What and how much
- Cyclo 3 Fort, two capsules a day, or placebo
- How long
- 60 days
Symptoms and ankle circumference fell with the combination. Investigators rated efficacy excellent in 15 of 30 patients on Cyclo 3 Fort versus 4 of 30 on placebo; tolerability was rated poor in 2 of 30. Funding is not stated in the abstract.
-
Aguilar Peralta et al., 2007
Open, multicenter study with no placebo or comparison group
- Who
- 124 outpatients with chronic venous insufficiency, 89% women, mean age 52.5
- What and how much
- Ruscus extract 150 mg, hesperidin methyl chalcone 150 mg, and vitamin C 100 mg, two capsules a day
- How long
- 8 weeks
The share reporting intense pain fell from 79% to 20% and intense heaviness from 85% to 12% within two weeks, and capillary changes on skin microscopy improved. Without a comparison group, these changes cannot be separated from placebo effects or natural ups and downs in symptoms.
03 Evidence
What the research shows
Our rating for Butcher's Broom for Varicose Veins, based on the studies below.
The only well-reported trial of butcher’s broom alone is by Vanscheidt and colleagues (Arzneimittel-Forschung 2002). At 10 centers in Germany, 166 women aged 30 to 89 with early to moderate CVI (Widmer grade I or II) took a placebo for two weeks and were then randomized to Fagorutin Ruscus capsules or placebo twice a day for 12 weeks. Each capsule held 36 to 37.5 mg of a concentrated rhizome extract, about 4.5 mg of total ruscogenins, in line with the older German Commission E dose. The main outcome was the change in foot and lower leg volume, measured by water displacement. Of the 148 women analyzed, those on the extract had about 16.5 ml less leg volume than the placebo group at 8 weeks and 20.5 ml less at 12 weeks, along with smaller ankle and calf circumference and less heaviness, tiredness, and tension. Pain and tingling did not differ significantly, and a quality-of-life questionnaire showed no change in either group. Four of the eight authors worked for GlaxoSmithKline Consumer Healthcare. EMA’s assessors credited the trial for testing butcher’s broom alone but listed weaknesses: no published protocol or sample-size calculation, 18 randomized women excluded from the analysis without explanation, an uncertain amount of missing data, and testing guidelines for vein drugs that the lead author himself wrote and published after the study began. They judged the evidence low, noted that men were not studied and that effects beyond 12 weeks are unknown, and kept butcher’s broom as a traditional-use herb. The extract tested, made with 60% methanol, is also not one of the preparations listed in EMA’s monograph.
Most other trials tested combinations. Cyclo 3 Fort, made by the French company Pierre Fabre and first developed in 1959, contains 150 mg of butcher’s broom root extract, 150 mg of hesperidin methyl chalcone, and 100 mg of vitamin C per capsule. Boyle, Diehm, and Robertson (International Angiology 2003) pooled every trial and study of it they could find: 20 placebo-controlled double-blind trials, 5 trials against another drug, and 6 studies with no comparison group, covering 10,246 people. On a 0–3 symptom scale, Cyclo 3 Fort reduced pain by 0.44 points, heaviness by 0.53, cramps by 0.26, and tingling by 0.29 more than placebo, and reduced the amount of blood the leg veins hold. Smaller calf and ankle measurements did not reach statistical significance, and a 2025 review described the analysis as inconclusive on swelling. The authors acknowledged variable data quality and small samples in some studies. One example is Parrado and Buzzi’s trial (Clinical Drug Investigation 1999): 60 patients in Buenos Aires took two capsules of Cyclo 3 Fort or placebo daily for 60 days, and symptoms and ankle circumference improved more with the combination. Some studies are weaker still. Aguilar Peralta and colleagues (International Angiology 2007) gave the combination to 124 patients for eight weeks with no comparison group and reported that intense pain and heaviness largely disappeared within two weeks, a result that cannot be separated from a placebo effect.
The main recent analysis is by Kakkos and Allaert (International Angiology 2017), funded by Laboratoires Pierre Fabre. It included 10 double-blind placebo-controlled trials with 719 people, eight of them published between 1976 and 1990, lasting 15 days to 14 weeks, with 35 to 166 participants each. Most tested branded products, including Cyclo 3, Cyclo 3 Fort, and Phlebodril (butcher’s broom with trimethyl hesperidin chalcone, another name for hesperidin methyl chalcone, and vitamin C); one product added blackcurrant extract, and only Vanscheidt’s trial is described as testing butcher’s broom alone. Compared with placebo, the products reduced leg pain (one extra person helped for every five treated, the number needed to treat), heaviness (about one in 2.4), the feeling of swelling (one in 4), and tingling, and they reduced ankle circumference and leg or foot volume. The individual analyses were small, though: the pain, heaviness, fatigue, and swelling results each came from one to five trials with 60 to 217 people, and the swelling results varied widely between trials. The authors rated the evidence mostly high quality and concluded that Ruscus extracts are highly effective. Because most of the data come from combination products, the results cannot show how much butcher’s broom itself contributes.
Expert bodies are split. The European Society for Vascular Surgery (ESVS) 2022 guideline makes one general recommendation for all venoactive drugs (medicines aimed at vein symptoms), class IIa with level A evidence: they should be considered for people with symptomatic chronic venous disease who are not having a procedure, are waiting for one, or still have symptoms or swelling afterward, choosing each drug on its own evidence. It cites the Kakkos meta-analysis for Ruscus extracts and points to the low cost and rare, usually mild side effects of these drugs as a group. A 2025 review by Gloviczki and colleagues (Journal of Vascular Surgery: Venous and Lymphatic Disorders) found that micronized purified flavonoid fraction (MPFF), a citrus flavonoid medicine, and the Ruscus, hesperidin methyl chalcone, and vitamin C combination had the strongest evidence among vein medicines, mostly graded level A. These assessments are not fully independent: vascular surgeon Stavros Kakkos co-authored the 2017 meta-analysis, co-chaired the ESVS guideline, and co-wrote the 2025 review, in which two other authors disclosed ties to a supplement company. Others are more skeptical. EMA’s assessment report notes that France’s National Authority for Health reassessed all vein tonics with marketing authorization there, including Ruscus with hesperidin methyl chalcone, and concluded that their efficacy was minor and the evidence poor. The UK’s National Institute for Health and Care Excellence (NICE) does not include any vein medicine or supplement in its varicose vein guideline; it recommends referral to a vascular service, a duplex ultrasound scan, and endothermal ablation first, with compression stockings only for people who cannot have a procedure.
How butcher’s broom might work is mostly known from laboratory and animal studies. EMA’s assessors describe extracts that make veins contract by stimulating alpha-adrenergic receptors, the same receptors that adrenaline and noradrenaline act on, and that also contract lymphatic vessels in animals, which could reduce fluid pooling in the legs; they note that the clinical relevance of these findings has not been confirmed. By comparison, horse chestnut seed extract has a Cochrane review of 17 trials behind it and is accepted by EMA as well-established for CVI symptoms, a higher rating than butcher’s broom on its own. Open questions remain: whether butcher’s broom alone helps men and people with more advanced disease, whether any benefit lasts beyond three months, how much the herb contributes to the combination products, and how either compares with vein procedures.
04 In practice
How it was taken in studies
EMA’s traditional-use monograph covers only products taken by mouth, for adults. Its daily amounts are 350 mg of powdered root three times a day; 150 to 200 mg of a water-based dry extract per dose, up to 450 mg a day; 86 mg of an 80% ethanol extract once or twice a day; or 45 mg of a 96% ethanol extract twice a day. The trial of butcher’s broom alone used about 37 mg of a different, more concentrated extract twice a day, roughly 9 mg of total ruscogenins daily, which EMA’s assessors noted matches the older German target of 7 to 11 mg of ruscogenins a day. The Cyclo 3 Fort studies described above gave two capsules a day. EMA advises seeing a doctor if symptoms last more than two weeks while using the product. Supplement labels vary widely, so look for one that names Ruscus aculeatus root or rhizome and states its extract or ruscogenin content, and remember that a single-herb capsule is not the same product as the combination pill most trials used.
Butcher’s broom works best, if at all, as one part of a plan. The NHS advises keeping to a healthy weight, walking or other regular exercise, raising the legs when resting, avoiding long periods of standing or sitting, not smoking, and moisturizing dry, itchy skin over the veins. If a vein specialist offers a procedure or compression stockings, an herb is not a replacement; NICE recommends endothermal ablation as the first treatment for symptomatic varicose veins with faulty valves in the main surface veins, then foam sclerotherapy or surgery, and stockings only when a procedure is unsuitable. Stockings are not suitable for everyone, especially people with narrowed leg arteries, so get them fitted with advice.
If you try butcher’s broom, judge it on your symptoms. Note how heavy, achy, or swollen your legs feel at the end of the day before you start and again after a few weeks; the trials ran 15 days to 14 weeks, and EMA’s two-week rule means persistent symptoms should be checked by a doctor rather than simply treated for longer. If nothing has changed, there is little reason to continue. Avoid unlabeled “vein support” blends that mix butcher’s broom with horse chestnut and several other ingredients, because they make it impossible to tell which ingredient helped or caused a side effect. Butcher’s broom creams and gels are sold in some countries, but EMA’s monograph does not cover skin use, there are no good trials of them for varicose veins, and they have caused allergic skin reactions.
05 Caution
Before you try butcher's broom
In the trial of butcher’s broom alone, side effects were no more common than with placebo: 22 adverse events in the extract group and 26 with placebo, including a few calf cramps in each. EMA’s monograph lists no known side effects for its traditional preparations, but its assessors found two real concerns in the wider literature. The first is gut problems with combination pills. A 2025 review lists acidity, stomach pain, and diarrhea with the Ruscus, hesperidin methyl chalcone, and vitamin C combination, and French doctors have reported chronic watery diarrhea with Cyclo 3 Fort, sometimes with lymphocytic colitis, an inflammation of the bowel lining seen only under the microscope. In one report by Beaugerie and colleagues (Gut 1994), three women aged 67 to 80 developed five to ten watery stools a day after two to eight weeks of Cyclo 3 Fort; the diarrhea stopped within two days of stopping the pill and returned within eight hours when it was restarted. EMA notes that these reports involve combinations, so the role of butcher’s broom itself is unclear. Stop the product and see a doctor if you develop diarrhea that persists.
The second concern is skin allergy from products applied to the skin. EMA’s assessors describe allergic contact eczema from hemorrhoid creams, vein creams, and cosmetic creams containing butcher’s broom or ruscogenins, confirmed by skin testing, including a rash that spread over the whole body in a pregnant woman. All cleared up after the product was stopped and the rash was treated. Do not apply butcher’s broom products to broken or inflamed skin, and stop if a rash appears.
Do not use butcher’s broom if you are allergic to it, and EMA does not recommend it under 18 or in pregnancy or breastfeeding because safety has not been established. Memorial Sloan Kettering Cancer Center (MSKCC) advises people with diabetes not to take it after a case report of diabetic ketoacidosis, a dangerous complication of high blood sugar, in a 39-year-old woman five days after she started butcher’s broom for ankle swelling; EMA’s assessors considered the report too sparse to draw conclusions, but it is reason to talk to your doctor first. No drug interactions have been reported, but because extracts act on alpha-adrenergic receptors, EMA’s assessors consider interactions plausible with medicines that boost or block the same system, which includes some decongestants and the alpha-blockers used for blood pressure or prostate symptoms, so check with a pharmacist if you take these.
Some leg problems need medical care rather than a supplement. EMA advises seeing a doctor before using butcher’s broom if you have inflamed skin, hardened patches under the skin, ulcers, sudden swelling of one or both legs, or heart or kidney failure, because leg swelling can come from these conditions. Throbbing pain and swelling in one leg, especially in the calf or thigh, with red or darkened skin, can be a deep vein thrombosis (DVT), a blood clot that needs urgent assessment, and shortness of breath or chest pain with it is an emergency. A bleeding varicose vein needs urgent help, and a sore on the leg that has not healed within two weeks, hard and painful veins, or skin changes over the veins should be checked by a doctor.
06 Questions
Frequently Asked Questions
It may ease the symptoms a little. In one 12-week trial of 166 women, butcher’s broom extract reduced leg swelling by about 20 ml more than placebo and eased heavy, tired legs, but pain and quality of life did not improve more than with placebo. Most other studies tested a combination pill with hesperidin methyl chalcone and vitamin C. Europe’s regulator accepts the herb only as a traditional remedy for heavy legs. Our guide to herbs for varicose veins compares it with other options.
No. The trials measured leg heaviness, aching, swelling, and ankle size, not whether veins shrank or disappeared, and once a vein valve fails the vein does not return to normal on its own. Procedures such as endothermal ablation, foam sclerotherapy, or surgery are what close or remove varicose veins, and NICE recommends referral to a vascular service for veins that cause symptoms.
No. Cyclo 3 Fort contains 150 mg of butcher’s broom extract plus 150 mg of hesperidin methyl chalcone and 100 mg of vitamin C per capsule, and most of the research behind butcher’s broom, including the 2003 and 2017 meta-analyses, tested this or similar combinations. A single-herb butcher’s broom capsule has only one trial of its own. The combination has been linked to chronic diarrhea, which is less commonly reported with other butcher’s broom products.
For the herb on its own, the evidence favors horse chestnut. A Cochrane review of 17 trials found standardized horse chestnut seed extract reduced leg pain and swelling, and EMA accepts it as well-established, while butcher’s broom alone has one trial and only traditional-use status. The butcher’s broom combination pill has a larger body of positive but mostly older research, and its main 2017 review was funded by the maker. Our varicose veins guide covers both.
EMA’s traditional-use amounts for adults include 350 mg of powdered root three times a day or specified dry extracts, such as 150 to 200 mg of a water extract per dose up to 450 mg a day. The single-herb trial used about 37 mg of a concentrated extract twice a day, and the Cyclo 3 Fort trials described here used two capsules a day. EMA advises seeing a doctor if symptoms last more than two weeks. Choose a product that names the root extract and its strength.
In the single-herb trial, side effects were no more common than with placebo. The combination pill can cause stomach upset and, rarely, chronic diarrhea with lymphocytic colitis, and creams can cause allergic rashes. Avoid it in pregnancy, while breastfeeding, and under 18, and talk to your doctor first if you have diabetes, after a case of diabetic ketoacidosis. Ask a pharmacist if you take alpha-blockers or decongestants.
Walking, keeping to a healthy weight, raising your legs, and avoiding long periods of standing help symptoms, and compression stockings or a vein procedure may be offered after an ultrasound scan. Among herbs, horse chestnut has the strongest evidence, while pine bark and gotu kola extracts have smaller or weaker studies. Sudden swelling or pain in one leg needs urgent assessment for a blood clot.
07 References
Sources
These references support the claims on this page. They are not an endorsement of any product. The butcher's broom monograph carries its own full source list.
-
Efficacy and safety of a Butcher’s broom preparation (Ruscus aculeatus L. extract) compared to placebo in patients suffering from chronic venous insufficiency
Arzneimittel-Forschung (PubMed 12040966), 2002
Vanscheidt et al.: 166 women with CVI, 148 analyzed; Fagorutin Ruscus or placebo for 12 weeks; leg volume −16.5 ml and −20.5 ml versus placebo at 8 and 12 weeks; heavy tired legs and tension improved; 22 versus 26 adverse events; four authors from GlaxoSmithKline Consumer Healthcare.
-
Efficacy of Ruscus extract, HMC and vitamin C, constituents of Cyclo 3 fort®, on improving individual venous symptoms and edema: a systematic review and meta-analysis of randomized double-blind placebo-controlled trials
International Angiology (PubMed 28225220), 2017
Kakkos and Allaert: 10 RCTs, 719 patients; pain RR 0.35 (NNT 5), heaviness RR 0.26 (NNT 2.4), feeling of swelling RR 0.53 (NNT 4), paresthesia RR 0.27 (NNT 1.8); reduced ankle circumference and leg or foot volume; funded by Laboratoires Pierre Fabre (full text).
-
Meta-analysis of clinical trials of Cyclo 3 Fort in the treatment of chronic venous insufficiency
International Angiology (PubMed 14612852), 2003
Boyle, Diehm, and Robertson: 20 placebo-controlled RCTs, 5 comparator trials, 6 single-arm studies, 10,246 subjects; pain −0.44, heaviness −0.53, cramps −0.26, paresthesia −0.29 points versus placebo; calf and ankle circumference changes not significant; variable data quality.
-
A Study of the Efficacy and Tolerability of a Preparation Containing Ruscus aculeatus in the Treatment of Chronic Venous Insufficiency of the Lower Limbs
Clinical Drug Investigation (Springer), 1999
Parrado and Buzzi: 60 patients, Cyclo 3 Fort two capsules daily or placebo for 60 days; symptoms and ankle circumference improved; efficacy excellent in 15 of 30 versus 4 of 30.
-
Clinical Perspectives and Management of Edema in Chronic Venous Disease—What about Ruscus?
Medicines (PMC9331752), 2022
Bihari et al.: Cyclo 3 Fort made by Pierre Fabre, first developed in 1959; summary of Parrado trial results; authors disclosed honoraria or funding from Pierre Fabre, which funded medical writing.
-
The role of venoactive compounds in the treatment of chronic venous disease
Journal of Vascular Surgery: Venous and Lymphatic Disorders (PubMed 40348378), 2025
Gloviczki et al.: MPFF and Ruscus extract with hesperidin methyl chalcone and ascorbic acid had the highest, mostly level A, evidence; Boyle meta-analysis inconclusive on edema; combination adverse events acidity, epigastralgia, diarrhea; two authors disclosed ties to VitasupportMD.
-
European Society for Vascular Surgery (ESVS) 2022 Clinical Practice Guidelines on the Management of Chronic Venous Disease of the Lower Limbs
European Journal of Vascular and Endovascular Surgery (PubMed 35027279), 2022
De Maeseneer, Kakkos, et al.: Recommendation 14, venoactive drugs should be considered for symptomatic chronic venous disease when not undergoing, awaiting, or after intervention (class IIa, level A); Ruscus extracts summarized from Kakkos 2017.
-
European Union herbal monograph on Ruscus aculeatus L., rhizoma (Revision 1)
European Medicines Agency (EMA/HMPC/188804/2017), 2018
Traditional use only, oral solid forms, for heavy legs from minor venous disturbances and hemorrhoid itching; doses for powder and three dry extracts; see a doctor after 2 weeks; not under 18 or in pregnancy and lactation; undesirable effects none known; no interactions reported.
-
Assessment report on Ruscus aculeatus L. rhizoma (Revision 1)
European Medicines Agency (EMA/HMPC/188805/2017), 2018
Critique of Vanscheidt 2002 and its low level of evidence; alpha-adrenergic mechanism; diarrhea and lymphocytic colitis with oral combinations; contact dermatitis with topical products; French National Authority for Health judged vein tonics of minor efficacy.
-
Butcher’s Broom
Memorial Sloan Kettering Cancer Center, About Herbs, 2023
Small studies suggest benefit for CVI symptoms; long-term safety unknown; diarrhea frequent with Cyclo 3 and less common with other formulations; contact dermatitis from creams; do not take with diabetes.
-
Drug induced lymphocytic colitis
Gut (PubMed 8150360), 1994
Beaugerie et al.: three women aged 67–80 with chronic watery diarrhea and lymphocytic colitis after 2–8 weeks of Cyclo 3 Fort; diarrhea stopped within two days of withdrawal and recurred within eight hours of rechallenge.
-
An unusual case of Butcher’s Broom precipitating diabetic ketoacidosis
Journal of Emergency Medicine (PubMed 23849361), 2013
Sadarmin and Timperley: diabetic ketoacidosis in a 39-year-old woman five days after starting butcher’s broom for mild ankle swelling; recovered with intravenous fluids, insulin, and calcium gluconate.
-
Varicose veins: diagnosis and management (CG168)
National Institute for Health and Care Excellence (NICE), 2013
Refer bleeding varicose veins immediately and symptomatic veins, skin changes, superficial vein thrombosis, and ulcers to a vascular service; duplex ultrasound; endothermal ablation first; compression hosiery only if interventional treatment is unsuitable.
-
Varicose veins
NHS, 2026
Self-care advice; see a GP for painful or swollen legs, a sore not healed after 2 weeks, or worsening veins; urgent help for bleeding veins; endothermal ablation usually first choice; stockings not suitable with arterial problems.
-
DVT (deep vein thrombosis)
NHS, 2026
Symptoms include throbbing pain and swelling in one leg and red or darkened skin; get urgent help, and call 999 with shortness of breath or chest pain.
Other herbs reviewed for varicose veins
- Horse Chestnut for Varicose Veins Good clinical evidence