InfoSynergy
Coenzyme Q10
Both are used in cardiovascular support stacks, especially for cardiac energy and symptoms.
Recommendation: Reasonable only as adjunctive support; do not change heart medications without clinician input.
Hawthorn (Crataegus)
Herb ·Moderate evidence ·Reviewed May 2026
Hawthorn is a traditional cardiotonic herb studied mainly as adjunctive support in mild heart failure and for blood pressure. Evidence suggests possible symptom improvement in some heart failure populations, but it must not replace medical heart failure therapy. Because it can affect blood pressure, heart rhythm symptoms, and cardiac drugs, clinician oversight is important for anyone with cardiovascular disease.
What it's good for
What to watch for
The bottom line
Evidence rating moderate. Most-documented uses: may improve exercise tolerance or symptoms in mild heart failure as adjunctive care, may modestly lower blood pressure, supports endothelial and coronary circulation markers. 3 sources indexed (2006–2008), with 3 interaction records on file.
The science
How it works, mechanistically.
Core mechanism
Hawthorn leaf, flower, and berry contain oligomeric procyanidins, flavonoids, and triterpenes that may improve endothelial nitric oxide signaling, coronary blood flow, mild vasodilation, and myocardial contractility. Some data suggest antioxidant effects and inhibition of angiotensin-converting enzyme activity. These same cardiovascular actions create interaction concerns with antihypertensives, nitrates, beta blockers, digoxin, and heart failure regimens.1,3
Class
Cardiotonic flavonoid and procyanidin herb
Found in food
Hawthorn berries as food or tea, Hawthorn leaf and flower tea
Low-status signs
None - hawthorn is not an essential nutrient and has no deficiency state
Absorption
Water-soluble; take with food
Dosing
Dosing & protocol.
Common range
300-1,800 mg/day standardized leaf and flower extract, often standardized to oligomeric procyanidins or flavonoids
Recommended form
Standardized Crataegus leaf and flower extract such as WS 1442 or equivalent
Take with meals to improve tolerability. Cardiovascular effects may develop gradually over weeks.
Forms
Forms & what to buy.
Ranked by evidence and value.
Standardized Leaf and Flower Extract Recommended
Best matches heart failure and blood pressure trials when standardized. Take with meals.
Hawthorn Berry Capsule
Traditional form but less aligned with WS 1442-type evidence. Take with meals.
Hawthorn Tea or Tincture
Variable potency and dosing. Use consistently and avoid medication self-adjustment.
Cost
What it actually costs.
Real-world pricing across three quality tiers. Assumes Standardized hawthorn extract capsule.
BudgetBest value
$4 /mo
$0.12 per dose
Mid
$11 /mo
$0.35 per dose
Premium
$27 /mo
$0.90 per dose
Clinically studied standardized extracts are more expensive than berry powders. Updated 2026-06-04.
Goals
Goal-based dosing.
Blood Pressure Support
Dose: 300-900 mg/day extract3
Timing: With meals
Monitor home blood pressure and dizziness.
Adjunct Heart Failure Symptom Support
Dose: 900-1,800 mg/day extract1,2
Timing: Divided with meals
Only as an adjunct to prescribed therapy, never as a replacement.
Endothelial Circulation Support
Dose: 300-600 mg/day extract
Timing: With meals
Benefits are gradual and should be paired with risk-factor management.
Lab work
Markers to track.
What to test, the optimal window inside the conventional range, and how long a response takes.
Systolic Blood Pressure SBP
May modestly lower blood pressure in some users.3,1
Optimal
100–119 mmHg
Conventional
90–120 mmHg
Responds in
2-8 weeks
90optimal120
Use validated home measurements or clinician readings; monitor for dizziness if combined with antihypertensive strategies.
Diastolic blood pressurePulse pressureResting heart rate
Why people use it
Symptoms it's matched to.
Where this appears in the symptom-to-supplement map, ranked by relevance.
Poor exercise tolerance in heart failure
50% relevance
May improve symptoms as adjunctive support in some mild heart failure trials.1,2
CardiometabolicModerate evidenceClinically studied extract
Requires clinician management.
Elevated blood pressure
45% relevance
May support vasodilation and endothelial function.3
CardiometabolicEmerging evidenceStandardized extract
Monitor measured blood pressure.
Cold hands and poor circulation
28% relevance
Traditional circulation support, but direct evidence for this symptom is limited.
CardiometabolicInsufficient evidenceLeaf and flower extract
Rule out vascular disease if persistent.
Safety
Full safety detail.
Side effects
- Dizziness or low blood pressure
- Nausea or stomach upset
- Headache
- Palpitations in susceptible users
- Sedation in some users
Contraindications
- Heart failure, arrhythmia, angina, or significant cardiovascular disease without clinician supervision1,2
- Use with digoxin, nitrates, beta blockers, calcium channel blockers, or antihypertensive drugs without clinician guidance
- Pregnancy and breastfeeding due to insufficient safety data1,2
- Scheduled surgery or unstable blood pressure3
Interactions
Interaction records.
ModerateCaution
Garlic Extract
Both may lower blood pressure and affect platelet activity.
Recommendation: Monitor blood pressure and bleeding risk, especially before surgery.
InfoSynergy
Fish Oil
Fish oil may complement cardiovascular risk support, though direct hawthorn-fish oil trials are lacking.
Recommendation: Use standard doses and monitor bleeding risk at high fish oil intake.
Sources
Sources, by evidence tier.
Numbered references. Citations throughout the page link here.
Meta-analyses & systematic reviews
1- 1Hawthorn extract for treating chronic heart failureNeeds reviewNo linkPittler MH et al. · Cochrane Database of Systematic Reviews · 2008
Adjunctive hawthorn improved some symptoms and physiologic measures in chronic heart failure trials, but evidence quality and safety context require caution.
Randomized controlled trials
2- 2The efficacy and safety of Crataegus extract WS 1442 in patients with heart failure: The SPICE trialNeeds reviewNo linkHolubarsch CJF et al. · European Journal of Heart Failure · 2008
WS 1442 was evaluated as add-on therapy and had mixed outcomes, with signals in some subgroups.
- 3Hypotensive effects of hawthorn for patients with diabetes taking prescription drugs: a randomised controlled trialNeeds reviewNo linkWalker AF et al. · British Journal of General Practice · 2006
Hawthorn extract reduced diastolic blood pressure in a small diabetes population taking prescribed drugs.
Keep exploring
Deep dives & adjacent profiles.
This page is educational. Do not start, stop, or change a supplement or medication based on it without checking with a qualified healthcare professional.
Use this with your stack
Hawthorn (Crataegus) in NutriStack.
Add it to your stack, see how it interacts with everything else you take, and get a Stack Score that updates the moment it does.