Hawthorn Berry Benefits: What the Research Says

Hawthorn berries are the small red fruits of the hawthorn tree, and they’ve been used for centuries in both European and Chinese traditional medicine, mostly for the heart and for digestion. Today you’ll find hawthorn in capsules, teas and even some pre-workout and “fat burner” blends, usually with a claim that it supports healthy blood flow. So what are the real hawthorn berry benefits, and what does the research actually show?

Summary

The best-studied use of hawthorn is as an add-on for chronic heart failure, where older trials found modest improvements in symptoms and exercise capacity, but larger, more recent trials found no clear benefit. Small trials suggest hawthorn may lower blood pressure slightly. Most of the human heart research used extracts of the leaves and flowers rather than the berries. Claims about hawthorn berry benefits for cholesterol, weight, hair growth and “blood flow” rest on animal studies, multi-herb products, or a small human trial that found no effect on blood vessels. Hawthorn can interact with heart medicines, so it’s not something to start on your own if you have a heart condition.

What is hawthorn?

Hawthorn (Crataegus) is a flowering shrub or small tree in the rose family that grows in temperate regions around the world [1]. Several species are used medicinally, including English hawthorn (Crataegus monogyna and C. laevigata) in Europe and Chinese hawthorn (Crataegus pinnatifida), known in China as shanzha [1, 2].

Chinese hawthorn fruit has been used as both a food and a medicine in China for more than 2,000 years, traditionally to help with indigestion (especially after rich, meaty meals), high blood fats and “blood stasis” (a traditional Chinese medicine idea of poor circulation) [2]. In Europe, hawthorn has long been used as a heart tonic [3]. The berries, leaves and flowers are all used [3], and that matters: most of the human heart research tested extracts made from the leaves and flowers, not the berries alone [4].

Hawthorn is rich in plant compounds called flavonoids, part of the broad polyphenol family also found in grapes, cocoa and tea [2]. Lab and animal studies suggest these compounds have a range of effects, including on blood fats and inflammation [2], but lab results don’t always translate into health benefits in people.

Hawthorn and your heart: what the trials show

Heart failure

Heart failure means the heart doesn’t pump as well as it should, which can cause shortness of breath, tiredness and swelling. Germany’s Commission E (an expert panel that assessed herbal medicines) approved hawthorn leaf and flower extracts for milder heart failure [4].

A 2008 Cochrane review (a highly regarded type of evidence summary) looked at 14 trials of hawthorn leaf and flower extract that were double-blind (neither participants nor researchers knew who got what) and placebo-controlled (compared with a dummy pill). In most of them, hawthorn was added on top of usual heart medicines. Ten trials with 855 people could be pooled. In the 380 people whose maximal workload on exercise tests was measured, hawthorn improved it by about 5 watts compared with placebo, and symptoms such as shortness of breath and fatigue also improved [4]. However, the trials gave almost no information on what matters most: heart attacks, hospital stays and deaths. Side effects were infrequent and mild [4].

Two more recent trials, including the large SPICE trial, were less encouraging:

• The SPICE trial gave 2,681 people with mild to moderate heart failure and a weakened heart pump either a standardized hawthorn extract (WS 1442, a branded leaf and flower extract made to a consistent strength, 900 mg a day) or a placebo for two years, on top of their usual medicines. Hawthorn didn’t significantly delay the first cardiac event (27.9% vs 28.9% had one), and the small drop in cardiac deaths wasn’t statistically significant, meaning it could have been due to chance. Side effects were similar in both groups [5].
• The HERB CHF trial in the US gave 120 people with heart failure 450 mg of hawthorn extract twice a day or placebo for six months. Hawthorn didn’t improve walking distance, quality of life or other measures of how well people functioned, and more side effects were reported in the hawthorn group, although most weren’t heart-related [6]. A separate retrospective analysis (a look back at data already collected) of the same trial even found that people taking hawthorn were more likely to have their heart failure worsen early in the study [7].

The US National Center for Complementary and Integrative Health (NCCIH) sums up the evidence on hawthorn for heart failure as “conflicting” [1]. Heart failure is a serious condition, and hawthorn is not a replacement for prescribed treatment.

Blood pressure

Hawthorn has a folk reputation for lowering blood pressure. A 2025 meta-analysis (a study that pools results from several trials) combined six small placebo-controlled trials with 428 people with high blood pressure. Over 10 weeks to six months, hawthorn lowered systolic blood pressure (the top number) by about 6.7 mmHg (millimeters of mercury, the unit used for blood pressure) more than placebo. The drop in diastolic pressure (the bottom number) wasn’t statistically significant across all the trials [8].

There are important caveats. Only one of the seven trials the reviewers assessed had a low risk of bias (a low chance that flaws in the study design skewed the results), the products and doses varied a lot (250 to 1,200 mg a day), and many studies didn’t even report exactly which hawthorn species or plant part they used. The authors called the drop in systolic pressure clinically meaningful, but concluded that hawthorn’s effect isn’t strong enough to treat high blood pressure on its own and that larger, independent trials are needed [8]. One of the pooled trials was in people with heart failure rather than high blood pressure alone [8].

One of the trials included gave 79 people with type 2 diabetes, most of whom were already on blood pressure medicines, 1,200 mg of hawthorn extract a day or placebo for 16 weeks. Diastolic pressure fell by about 2.6 mmHg with hawthorn and stayed about the same with placebo, a small but statistically significant difference; systolic pressure didn’t differ between the groups [9].

Does hawthorn improve blood flow?

Pre-workout products often say hawthorn “promotes healthy blood flow.” One idea is that hawthorn helps blood vessels relax by boosting nitric oxide, a molecule that widens arteries. A small US trial tested this directly in 21 adults with slightly raised blood pressure. Participants took placebo and three daily doses of hawthorn extract (1,000, 1,500 and 2,500 mg a day, split into two doses), each for 3½ days, in random order. The researchers found no dose-related effect on flow-mediated dilation (an ultrasound measure of how well an artery widens) or on blood pressure [10].

We couldn’t find any trials showing that hawthorn improves workouts, “pump” or performance in healthy people. If blood flow during exercise is what you’re after, L-citrulline has more human research on blood flow and exercise.

Other hawthorn berry benefits: cholesterol, weight and hair

Cholesterol

Chinese hawthorn fruit is traditionally used to lower blood fats [2]. In a rat model of atherosclerosis (hardened, narrowed arteries, created with a high-fat diet plus injections), a purified extract of Chinese hawthorn fruit lowered total cholesterol, triglycerides (another type of blood fat) and LDL (“bad”) cholesterol, raised HDL (“good”) cholesterol and reduced artery thickening [11]. That’s promising, but it’s an animal study.

In people, the evidence mostly comes from traditional Chinese medicine formulas that contain hawthorn along with other herbs. A 2024 meta-analysis of 14 trials compared these formulas with standard cholesterol drugs. The reviewers reported favorable results for total cholesterol, triglycerides and HDL, but the formulas lowered LDL cholesterol less than standard drugs, and some trials had methodological weaknesses [12]. Because these were multi-herb formulas, the results can’t be credited to hawthorn alone. For another plant-based option with more direct human research, see our look at citrus bergamot and cholesterol.

Weight and body fat

Hawthorn appears in some “fat burners,” but NCCIH says there isn’t any evidence that hawthorn affects weight loss [1]. One 12-week Korean trial in 105 overweight adults tested a mixture of Chinese hawthorn leaf extract and citrus peel extract. Body fat percentage, measured by DXA scans (a type of low-dose X-ray), fell more with the mixture than with placebo, and body weight dropped slightly too [13]. Because the product combined two ingredients and this is a single trial, it doesn’t show that hawthorn on its own helps with weight.

Hair growth

An earlier version of this article said Chinese hawthorn might help prevent hair loss. That was based on a mouse study in which an oral Chinese hawthorn extract (50 mg per kg of body weight a day) pushed hair follicles into their growth phase, and the extract also helped human dermal papilla cells (cells at the base of the hair follicle that control hair growth) multiply in a lab dish [14]. No human trials have tested hawthorn for hair loss, so this remains an interesting early finding, not a reason to take it.

Digestion and anxiety

Hawthorn has been used for indigestion in traditional Chinese medicine, but clinical studies are lacking [3]. NCCIH also says it’s unclear whether hawthorn affects anxiety [1].

How much hawthorn do studies use?

There’s no official recommended dose. For reference, the doses used in research include:

• Heart failure: 900 mg a day of the standardized leaf and flower extract WS 1442, taken as 450 mg twice a day in one trial [5, 6].
• Blood pressure: 250 to 1,200 mg a day of various hawthorn preparations [8].

Products vary widely in species, plant part and strength, so a capsule of “hawthorn berry powder” may be quite different from the extracts used in trials.

Side effects, safety and drug interactions

Hawthorn is generally well tolerated in short-term studies [3]. Reported side effects include dizziness, nausea, vomiting, diarrhea and muscle pain [1], as well as heart-related and digestive complaints [4]. Some things to know:

• Long-term safety: NCCIH notes that no studies have tested whether it’s safe to use hawthorn for more than 16 weeks [1], although the two-year SPICE trial reported similar side effects with hawthorn and placebo [5].
• Heart medicines: because hawthorn may affect the heart and blood pressure, Memorial Sloan Kettering Cancer Center (MSKCC) advises that people taking heart failure medicines use it only under a doctor’s supervision [3]. Lab data suggest hawthorn could interfere with digoxin, a heart medicine; a small study in 8 healthy volunteers found no change in digoxin levels over three weeks, but that small study in healthy people can’t rule out problems in people with heart disease [3, 15].
• Blood thinners: a lab study suggests hawthorn might add to the side effects of blood-thinning medicines (anticoagulants and antiplatelets); whether this matters in people isn’t known [3].
• Too much: overdose can cause low blood pressure and an irregular heartbeat [3].
• Pregnancy and breastfeeding: little is known about safety [1], and MSKCC advises not taking hawthorn during pregnancy [3].
• Look-alike products: in 2024 the US Food and Drug Administration (FDA) warned that some products sold as tejocote root (Mexican hawthorn) actually contained yellow oleander, a toxic plant [1].

If you have any heart condition or take medicine for your heart or blood pressure, talk to your doctor before trying hawthorn.

The bottom line on hawthorn berry benefits

Hawthorn has a long traditional history and some real human research behind it, mostly for the heart. Older trials of leaf and flower extracts found modest improvements in symptoms and exercise capacity in people with heart failure, but the largest and most recent trials found no clear benefit on the outcomes that matter most. Small trials suggest hawthorn may lower systolic blood pressure by a few points, though the studies are small and variable. Claims about cholesterol, weight loss, hair growth and better blood flow during workouts rest mainly on animal studies, multi-herb products or no evidence at all. Hawthorn is generally well tolerated, but it can interact with heart medicines, so check with your doctor first. If you’re interested in another plant extract studied for blood pressure and circulation, see our article on pine bark extract.

This article is for general information only and isn’t medical advice. Talk to your doctor or another qualified health professional before starting a new supplement. See our medical disclaimer.

References

1. National Center for Complementary and Integrative Health (NCCIH). Hawthorn: Usefulness and Safety. Last updated April 2025. https://www.nccih.nih.gov/health/hawthorn
2. Zhang SY, Sun XL, Yang XL, Shi PL, Xu LC, Guo QM. Botany, traditional uses, phytochemistry and pharmacological activity of Crataegus pinnatifida (Chinese hawthorn): a review. J Pharm Pharmacol. 2022;74(11):1507–1545. doi:10.1093/jpp/rgac050
3. Memorial Sloan Kettering Cancer Center. About Herbs: Hawthorn. Last updated June 3, 2022. https://www.mskcc.org/cancer-care/integrative-medicine/herbs/hawthorn
4. Pittler MH, Guo R, Ernst E. Hawthorn extract for treating chronic heart failure. Cochrane Database Syst Rev. 2008;(1):CD005312. doi:10.1002/14651858.CD005312.pub2
5. Holubarsch CJF, Colucci WS, Meinertz T, Gaus W, Tendera M; SPICE Study Group. The efficacy and safety of Crataegus extract WS 1442 in patients with heart failure: the SPICE trial. Eur J Heart Fail. 2008;10(12):1255–1263. doi:10.1016/j.ejheart.2008.10.004
6. Zick SM, Vautaw BM, Gillespie B, Aaronson KD. Hawthorn Extract Randomized Blinded Chronic Heart Failure (HERB CHF) trial. Eur J Heart Fail. 2009;11(10):990–999. doi:10.1093/eurjhf/hfp116
7. Zick SM, Gillespie B, Aaronson KD. The effect of Crataegus oxycantha Special Extract WS 1442 on clinical progression in patients with mild to moderate symptoms of heart failure. Eur J Heart Fail. 2008;10(6):587–593. doi:10.1016/j.ejheart.2008.04.008
8. Szikora Z, Mátyus RO, Szabó BV, Csupor D, Tóth B. Hawthorn (Crataegus spp.) clinically significantly reduces blood pressure in hypertension: a meta-analysis of randomized placebo-controlled clinical trials. Pharmaceuticals (Basel). 2025;18(7):1027. doi:10.3390/ph18071027
9. Walker AF, Marakis G, Simpson E, et al. Hypotensive effects of hawthorn for patients with diabetes taking prescription drugs: a randomised controlled trial. Br J Gen Pract. 2006;56(527):437–443. PubMed 16762125
10. Asher GN, Viera AJ, Weaver MA, Dominik R, Caughey M, Hinderliter AL. Effect of hawthorn standardized extract on flow mediated dilation in prehypertensive and mildly hypertensive adults: a randomized, controlled cross-over trial. BMC Complement Altern Med. 2012;12:26. doi:10.1186/1472-6882-12-26
11. Zhang J, Liang R, Wang L, et al. Effects of an aqueous extract of Crataegus pinnatifida Bge. var. major N.E.Br. fruit on experimental atherosclerosis in rats. J Ethnopharmacol. 2013;148(2):563–569. doi:10.1016/j.jep.2013.04.053
12. Zhou X, Chen C, Gao Z, Qian Z, Miao J. Efficacy of traditional Chinese medicine containing hawthorn for hyperlipidemia: a systematic review and meta-analysis. Toxicol Res (Camb). 2024;13(2):tfae035. doi:10.1093/toxres/tfae035
13. Song J, Kim DY, Lee HS, Rhee SY, Lim H. Efficacy of Crataegus extract mixture on body fat and lipid profiles in overweight adults: a 12-week, randomized, double-blind, placebo-controlled trial. Nutrients. 2024;16(4):494. doi:10.3390/nu16040494
14. Shin HS, Lee JM, Park SY, Yang JE, Kim JH, Yi TH. Hair growth activity of Crataegus pinnatifida on C57BL/6 mouse model. Phytother Res. 2013;27(9):1352–1357. doi:10.1002/ptr.4870
15. Tankanow R, Tamer HR, Streetman DS, et al. Interaction study between digoxin and a preparation of hawthorn (Crataegus oxyacantha). J Clin Pharmacol. 2003;43(6):637–642. PubMed 12817526