Ruscus aculeatus

Ruscus aculeatus is an herb commonly referred to as Butcher's Broom due to its hard roots and (supposed) antibacterial properties being traditionally used to clean the cutting boards of butchers. It also holds traditional medicinal uses, which maily focus around improving blood flow in the veins by contracting them. The uses associated with this 'venotropic' action include reducing leg swelling and edema, treating chronic venous insufficiency, and treating or preventing hemhorroids.

The plant itself contains a variety of saponin structures, of which the active ones are not fully elucidated but are thought to be a collection of similar saponins known as the ruscogenins and neoruscogenins. These are present in high levels in the plant's vertical root (rhizome) and tend to be standardized for supplementation.

In regards to the plant's actions, it seems to increase the activity of noradrenaline at the level of the synapse where it contacts veins via acting through its alpha receptors.

Human evidence is limited, as while there is a large amount of evidence and a meta-analysis on a formulation of which contains this herb it is confounded by the inclusion of hesperidin methylchalcone (commonly added to venotropic agents). There are only two human studies using the herb in isolation, and the one investigating the major claim appears to support its traditional usage.

While limited evidence suggests it is effective, advocacy of the supplement is in part limited by a lack of replication with the herb in isolation as well as insufficient safety testing in humans.

Supplementation of ruscus aculeatus tends to use the rhizome (vertical root above the ground) of the plant, and when using this extract it tends to be at concentrations above 10-fold (10:1) to 20-fold (20:1), in order to concentrate the main bioactives which are the ruscogenins.

In the above extract range, doses of 37.5mg are taken twice daily to total 75mg daily. This equates to approximately 750-1,500mg of the rhizome's unextracted dry weight daily.

There is not enough evidence to suggest whether it is better to take ruscus aculeatus on an empty stomach or with a meal, and while the above dosing appears effective there is not enough evidence to suggest if it is the optimal dosage.

The Human Effect Matrix looks at human studies (it excludes animal and in vitro studies) to tell you what effects ruscus aculeatus has on your body, and how strong these effects are.

Grade	Level of Evidence [show legend]
	Robust research conducted with repeated double-blind clinical trials
	Multiple studies where at least two are double-blind and placebo controlled
	Single double-blind study or multiple cohort studies
	Uncontrolled or observational studies only

Level of Evidence ? The amount of high quality evidence. The more evidence, the more we can trust the results.	Outcome	Magnitude of effect ? The direction and size of the supplement's impact on each outcome. Some supplements can have an increasing effect, others have a decreasing effect, and others have no effect.	Consistency of research results ? Scientific research does not always agree. HIGH or VERY HIGH means that most of the scientific research agrees.	Notes
	Chronic Venous Insufficiency	Minor	- See study	Ruscus aculeatus appears to be more effective than placebo for treating chronic venous insufficiency, although the degree of benefit relative to other treatments is not established.
	Leg Swelling	Minor	- See study	Secondary to its venotropic actions in persons with chronic venous insufficiency, supplementation of ruscus aculeatus appears to reduce leg swelling and edema (thigh and ankle).
	Subjective Well-Being	-	- See study	Despite improving symptoms of chronic venous insufficiency in the afflicted persons, supplementation failed to lead to an increase in quality of life relative to placebo.
	HDL-C	Notable	- See study	A fairly notable increase in HDL-C (23%) in the lone (but not placebo controlled) study with ruscus aculeatus, requires replication
	HbA1c	Notable	- See study	The decrease in HbA1c noted in this pilot study (15.6%) was fairly marked and requires replication.
	Blood Glucose	Minor	- See study	A reduction reaching 10.2% blood glucose has been noted with continual supplementation of ruscus aculeatus in type II diabetic persons in this non-placebo controlled study; requires replication.
	Fructosamine	Minor	- See study	A 7.8% reduction in fructosamine has been noted with supplementation of ruscus aculeatus in diabetic persons.
	Total Cholesterol	Minor	- See study	A decrease in total cholesterol (9.4%) has been noted in diabetic persons alongside an increase in HDL-C. Requires replication.
	Triglycerides	-	- See study	No significant influence on circulating triglycerides in diabetic persons given ruscus aculeatus supplementation.
	Visual Acuity	-	- See study	The improvement in visual acuity seen with supplementation of this herb failed to reach statistical significance in diabetic persons with retinopathy.