RED CLOVER

Published on 22/06/2015 by admin

Filed under Complementary Medicine

Last modified 22/04/2025

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RED CLOVER

Botanical name: Trifolium pratense

Family name: Leguminosae

Synonyms: Meadow clover, purple clover, trefoil

Part used: Flowering tops and leaf

MAJOR CHEMICAL CONSTITUENTS

Isoflavondoids including biochanin A, daidzein, formononetin, genistein, and others; flavonoids including kaempferol, quercetin and others; coumarins; carbohydrates, saponins, salicylic acid, and trace vitamins and minerals.

PRINCIPAL USES

• Prevention and treatment of menopausal symptoms including hot flashes and vaginal dryness
• Hormone replacement therapy substitute
• Prevention and treatment of osteoporosis
• Hypercholesterolemia
• Acne and chronic skin disease

TRADITIONAL AND HISTORICAL USES

Red clover has been used traditionally as an alterative or “blood purifying” herb. As such, it has been included in the treatment of acute and chronic skin diseases, including acne, eczema, and psoriasis, and it is commonly found in herbal formulae for treating cancer, including the infamous Hoxsey formula. Numerous so-called “trifolium compounds” were marketed as blood purifiers to “help clear the body of toxins.” Red clover was listed in the National Formulary as a skin remedy until 1946. It has also been used traditionally for the treatment of upper respiratory conditions including acute and chronic cough, asthma, and pertussis. In recent years it has become an exceedingly popular herb for the treatment of menopausal complaints including hot flashes, vaginal dryness, and osteoporosis.

CLINICAL INDICATIONS

Red clover is one of the most popular herbal products in Europe and the United States for the prevention and treatment of menopausal complaints, particularly hot flashes. It is also used to prevent and treat vaginal dryness, osteoporosis, and hypercholesterolemia. Promensil, a commonly used red clover product, is used in many of the red clover clinical trials.

IN VITRO, ANIMAL, AND CLINICAL DATA

Results of human clinical trials to date are conflicting. High-quality human clinical trials supporting the use of red clover (for any conditions) are limited. A small number of positive trials suggest a reduction in menopausal symptoms, particularly hot flashes; improved bone density; reduction in serum lipids; and improvement in arterial compliance. However, study designs have often been weak or contain methodologic flaws including lack of power calculations, unclear statistical significance versus placebo, small sample sizes, lack of control groups, and lack of dietary records to account

image

Red clover (Trifolium pratense).

Photo by Martin Wall.

for other dietary isoflavones that might confound study results.

MECHANISMS OF ACTION

The basis of action of this herb is its phytoestrogen constituents, which exhibit both agonist and antagonist binding with endogenous estrogen receptors.

RATINGS

• Botanical Safety Handbook Class 2b and 2d rating: Not to be used in pregnancy

PREPARATIONS USED CLINICALLY

• Dried blossoms and aerial parts
• Tincture
• Isoflavone extracts

DOSAGE

• Dried blossoms: 4 g in infusion 3x daily
• Tincture: 1.5 to 3 mL 3x daily
• Red clover isoflavones: 40 to 160 mg red clover isoflavones daily

SAFETY INFORMATION: HERB DRUG INTERACTIONS, TOXICITY, AND CONTRAINDICATIONS

Red clover is widely used in Europe and the United States for the prevention and treatment of menopausal complaints with a very high safety profile. Although there are a limited number of human clinical trials using this herb, even those looking at effects up to a year show excellent tolerance and no significant adverse effects. It is theoretically contraindicated for women taking HRT due to possible competition with the drugs. Red clover has also been contraindicated with heparin, ticlopidine, and warfarin, based on its coumadin content. However, unless red clover herb is fermented, it is unexpected to have any anticoagulant effects.

It is unclear whether red clover is safe for consumption by women with a history of estrogen-receptor (ER) positive cancer. Although it may have competitive binding effects with stronger endogenous estrogens, and thus may actually reduce risks associated with elevated estrogen levels, an in vitro study demonstrated that red clover was equipotent to estradiol in its ability to stimulate cell proliferation in estrogen receptor–positive breast cancer cells. Regular consumption of soy has been associated with a decreased risk of breast cancer, but the results cannot necessarily be extrapolated, as soy contains additional compounds not found in red clover. Further, isoflavones can variably act as ER agonists or antagonists. Until more conclusive evidence is available, it is possible for women with a history of ER positive breast cancer to avoid using red clover.

Concerns have also arisen over the safety of consuming red clover due to the risk of uterine cancer associated with unopposed estrogen. Preliminary studies of less than 6 months have found no increases in endometrial thickness based on ultrasound examination. No changes in GnRH, SHBG, FSH, LH, vaginal cytology, or endometrial thickness have been seen in studies of women taking the red clover compared with placebo, even over 1 year. Nonetheless, as with those with breast cancer, women with a history of endometrial hyperplasia might be prudent to avoid regular consumption of red clover supplements.

USE IN PREGNANCY AND LACTATION

Because of its estrogenic properties, red clover is not recommended for regular or high-dose consumption during pregnancy and lactation. Infertility and abortion have been observed in cattle grazing extensively on red clover. The Botanical Safety Handbook Class 2b rating, not to be used in pregnancy

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BLACK COHOSH Pregnancy and Botanical Medicine Use and Safety ST. JOHN’S WORT History of Herbal Medicines for Women Pregnancy: Third Trimester Vaginal Infections and Sexually Transmitted Diseases