Take a Ride on the Wild Side: History and Traditional Uses

Trifolium pratense, commonly known as red clover, is a perennial plant originating from Central Asia, Europe and Africa (All 4 Natural Health, 2010). It was naturalized to North America and Australia upon the discovery of its medicinal purposes, and has been used since the 19^th century (All 4 Natural Health, 2010). Historically, it has been part of herbal treatments in traditional Chinese Medicine, Russian and Western folk medicine, and Native Indian remedies (Herbs for Menopause, 2010.) It was commonly used for the treatment of respiratory illnesses, cancer, skin conditions and blood “purification” (University of Maryland Medical Center (UMMC), 2006.) Red clover was believed to help expel mucus and reduce inflammation of the lungs; thus it was used to treat bronchitis, whooping cough, asthma and irritated throats (UMMC, 2006.) Furthermore, ancient healers believed that elevated toxins in the blood were the source of all disease and red clover was used as a blood purifier (Herbs for Menopause, 2010.) It was believed to remove toxins by expelling surplus fluids, improving circulation and thinning the blood (UMMC, 2006.) In addition, red clover was believed to aid the healing of wounds and to treat various skin conditions such as psoriasis, eczema as well as insect bites (All 4 Natural Health, 2010).

Red clover was prepared in a variety of ways, depending on the nature of the problematic condition. Usually it was consumed as a tea, with the dried flowers soaked in hot water to release their therapeutic properties (UMMC, 2006.) Other times the flower heads were ground and mixed in with several other herbs to produce an ointment for external application (Herbs2000, 2010.) 

Red clover tea
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Red clover ointment
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For those who are interested, here is the recipe for traditional Indian tea:

INDIAN TEA OR ESSIAC

• 3 oz (90 g) red clover flowers
• 3 oz (90 g) wood sorrel flowers
• 3 oz (90 g) common burdock root
• 1 oz (30 g) kelp
• 1 oz (30 g) slippery elm powder
• 1 oz (30 g) Canada thistle head

Combine all the plants.
Boil 1 t (5 ml) of the mixture in 1 cup (250 ml) water for 5 minutes. Drink 3 cups (750 ml) per day for 1 to 3 months. This is the closest recipe to the original famous North American Indian tea used to fight cancer. It is also an excellent lymphatic and blood depurative.

(Information copied directly from http://www.herbs2000.com/herbs/herbs_red_clover.htm)

Not just a Pretty Face: Active Compounds and Preparations

Red clover is a multifaceted herb that has various important nutrients and minerals, which are key to its beneficial effects. Some of these essential compounds include vitamins A, B-12, C, E and K, as well as calcium, iron and magnesium (All 4 Natural Health, 2010).  The main compounds that have been implicated in red clover’s valuable results are isoflavones (Terzic et al., 2009). Isoflavones are a type of phytoestrogen, which are chemicals substances produced in plants that have structural and functional similarity to the hormone estrogen (Terzic et al., 2009) There are four different isoflavones found in red clover: genistein, biochanin A, daidzein and formononetin (Terzic et al., 2009). These compounds have been implicated in the management of menopausal symptoms, osteoporosis, cancer and cardiovascular health (MD idea, 2010.)

Four isoflavones found in Red clover - Formononetin, Daidzien, Biochanin A and Genistein

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Depending on the particular condition needing treatment, red clover can be prepared in numerous ways including teas, ointments, liquid extracts and tablets. The main prescription for red clover, however, is in the form of a tablet containing a standardized 40 mg of extracted isoflavones, such as in the current Promensil tablets (Herbs for Menopause, 2010.)

Promensil - treatment for menopause

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Why take Promensil?

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For more information on dosage recommendations and preparations of red clover please visit http://www.all4naturalhealth.com/red-clover-uses.html

Current Uses - What does the science say?

Nowadays, red clover is used to treat for the same conditions as in the past. Its main uses include improvements in cardiovascular health, relief of menopausal symptoms, cancer prevention, treatment of skin conditions and relief from respiratory distress (National Center for Complementary and Alternative Medicine, 2010.) Most research, however, has focused on the effects of red clover on menopause symptoms management – namely in reducing hot flashes, improving blood lipid composition and production of blood clots, and slowing bone density loss associated with osteoporosis (UMMC, 2006.)

Symptoms of Menopause
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Estrogen is known to have beneficial effects on blood lipid composition by decreasing cholesterol levels, a known risk factor associated with the development of cardiovascular disease (Terzic et al., 2009). In menopause, however, estrogen levels tend to drop, leading to an increased risk of cardiovascular complications (Chedruai et al, 2008.)

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Isoflavones, which act as alternatives to estrogen, are believed to improve blood lipid composition (Chedraui et al, 2008.) Chedraui et al. (2008) conducted an experiment examining whether red clover isoflavones had statistically significant impacts on the lipid composition in postmenopausal women. The experiment was conducted as a randomized, double-blind, placebo-controlled trial consisting of 53 women who were either assigned to the administration of a 40mg isoflavone supplement tablet twice daily or to an identical placebo pill for 90 days. The primary endpoints included total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), lipoprotein A and triglycerides. The study also compared women in regards to body mass index (BMI), where a BMI greater than 25 was considered overweight. The results indicate that, for overweight women, the isoflavone supplements significantly decreased the TC, LDL and lipoprotein A levels compared to women with a BMI of under 25. No significant results were found for HDL levels. While these results do seem rather important, there are several methodological flaws in this study, one of which is the lack of dietary restrictions and guidelines. This is a potential confounding variable, particularly if the two groups had statistically significant differences in isoflavone consumption. In addition, the sample size was too small to have generalizeable results. While this study does have potentially important implications, its flaws question the results’ validity.

Bone density loss in osteoporosis

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As was mentioned earlier, one of health implications of menopause is a reduction in bone density and the resulting development of osteoporosis in women (UMMC, 2006.) In a study conducted by Atkinson et al. (2004), 205 women between the ages of 49-65 were enrolled in a randomized, double-blind, placebo-controlled study investigating the effects of red clover isoflavone supplements on bone density and composition, and biochemical indicators of bone restructuring. The women were either assigned to the intake of an isoflavone supplement (see Table 1 for isoflavone composition) or a placebo tablet for a period of one year. Urine test, blood test and full body X-ray absorptiometry measurements, as well as diet records, were completed at baseline and at12 months. The results indicated that the isoflavone treatment group had lower levels of bone loss compared to the placebo group for both hip and spinal regions. However, differences in bone composition and density were only statistically significant for the spine. The difference with respect to biochemical markers was also barely significant. This study has quite a sound methodological setup, with no major flaws. Taking everything into consideration, this study suggests that isoflavone consumption may very well have an effect on bone composition in women.

Thus, while there is hopeful evidence for the benefits of isoflavones in improving menopausal symptoms and various health outcomes, significantly more research is needed in order to have a definite answer.

Table 1.

Promensil Tablet – Isoflavone composition
Isoflavone	Amount
Biochanin A	26 mg
Formononetin	16 mg
Genistein	1 mg
Daidzein	0.5 mg

Table 1. The isoflavone composition of Promensil tablets as specified by Atkinson et al, 2004.

Just to be Safe: Adverse Reactions, Cautions, Cross Drug and Herb Interactions

Red clover is not recommended during pregnancy
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To date, there have been no documented adverse reactions to red clover consumption (Terzic et al., 2009). However, due to the estrogenic properties of isoflavones, several cautions have been recommended. Individuals with hormone-dependant illnesses should not take red clover – this includes women with uterine, breast or ovarian cancer, fibromyoma and endometriosis, as well as men with prostate cancer (MD idea, 2010.) These recommendations are based on the understanding that isoflavones mimic the effects of estrogen and certain conditions may develop or be exacerbated with elevated levels of estrogen. Red clover consumption is also not recommended in pregnant women, as animal studies on red clover have documented the development of abnormal fetuses (MD idea, 2010.)

Red clover may interact with estrogen-based treatments, such as birth control pills and hormone replacement therapy, to increase estrogens levels beyond recommended limits (UMMC, 2006.) Furthermore it may interfere with the activity of Tamoxifen, a drug used to block estrogen receptors in breast tissue to prevent tumor growth in breast cancer patients (National Cancer Institute, 2010.) Red clover may also interact with anti-coagulant drugs such as Warfarin, Heparin and Ticlopidine, leading to abnormal bleeding and bruising (TrueStar Health, 2010.) Other herbs and supplements that also have anti-coagulant properties, such as garlic, ginger and vitamin E, may act to further exacerbate these potential disorders (UMMC, 2006.)

Alesse, a type of birth control pill

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Tamoxifen, a cancer-fighting drughttp://sandyhutchenscancerprevention.com/wp-content/uploads/2010/02/tamoxifen.jpg

Garlic, a natural anti-coagulant

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References

All 4 Natural Health. (2010.) Red clover Herb – History and Information. http://www.all4naturalhealth.com/red-clover-uses.html

Atkinson, C., Compston, J.E., Day, N.E., Dowsett, M., and Bingham, S.A. (2004.) The effects of phytoestrogen isoflavones on bone density in women: a double-blind, randomized, placebo-controlled trial. American Journal of Clinical Nutrition, 79: 326-333.

Chedraui, P., San Miguel, G., Hidalgo, L., Morocho, N., and Ross, S. (2008.) Effect of Trifolium pratense-derived isoflavones on the lipid profile of postmenopausal women with increased body mass index. Gynecological Endocrinology, 24(11): 620-624.

Herbs2000. (2010.) Red clover, Trifolium pratense. http://www.herbs2000.com/herbs/herbs_red_clover.htm

Herbs for Menopause. (2010.) Uses of Red clover. http://www.herbs-for-menopause.com/red-clover/uses-of-red-clover.html

MD idea. (2010.) What is Trifolium pratense, Red clover? http://www.mdidea.com/products/herbextract/clove/data10.html

National Cancer Institute. (2010.) Tamoxifen: Questions and Answers. http://www.cancer.gov/cancertopics/factsheet/Therapy/tamoxifen

National Center for Complementary and Alternative Medicine (NCCAM). (2010.) Red clover. http://nccam.nih.gov/health/redclover/

Terzic, M.M., Dotlic, J., Maricic, S., Mihailovic, T., and Tosic-Race, B. (2009.) Influence of red clover-derived isoflavones on serum lipid profile in postmenopausal women. The Journal of Obstetrics and Gynaecology Research, 35(6): 1091-1095.

TrueStar Health. (2010.) Encyclopedia of Health: Red clover. http://www.truestarhealth.com/Notes/2153008.html

University of Maryland Medical Center (UMMC). (2006.) Red clover. http://www.umm.edu/altmed/articles/red-clover-000270.htm