Red Clover

Red CloverAlso known as:Meadow Clover, Trifolium, Wild Clover. 

Scientific name:Trifolium pratense.

Family: Fabaceae/Leguminosae.

Parts used: Flowering tops.

Traditional use.

Red clover is used for for its alterative action. It is anti-spasmodic, expectorant, sedative and acts on skin disorders. It is used for menopausal symptoms and hot flashes, cyclic breast pain or tenderness, premenstrual syndrome and for promotion of lymph flow.

Red clover is used as a flavoring ingredient In drinks and foods. 

Safety.

No concerns regarding safety when used orally in food amounts. Red clover has Generally Recognized As Safe (GRAS) status for use in foods in the US.1.2.3

There are no concerns regarding safety when used in traditional medicinal amounts. There is no evidence for any concerns when Red clover extracts have been used for up to one year . 4,5,6,7,8,9 

Pregnancy: Refer to a medical herbalist.

Breastfeeding: Refer to a medical herbalist.

Constituents.

Isoflavones; afrormosan, biochanin A, daidzein, formononetin, genistein, pratensein, calyconin, pseudobaptigin, orobol.irilone, and trifoside, and their glycoside conjugates.

Other flavonoids, including pectolinarin and trifolin.

Coumarins;coumestrol,medicagol and coumarin.

Volatile oil;furfural.

Miscellaneous; clovamides, L-dopa-caffeic acid conjugates, minerals, vitamins and phytoalexins. 

Scientific evidence.

Breast Pain. Preliminary evidence suggests that red clover might relieve menstrual cycle breast pain. Red clover isoflavones 40-80 mg daily seem to reduce breast pain and tenderness in about 45% of patients.10 

Menopausal symptoms. There is conflicting evidence about the effects of red clover on menopausal symptoms. 6,9,11,12,13,14,15 

Mechanism of action.

The flowering tops contain more than 100 different chemicals. Red clover contains phytoestrogens (plant estrogens), which are structurally similar to estrogens. 4,16,17,18 The health effects of methylated isoflavones have not been evaluated.19

Similar to isoflavones from soy, red clover isoflavones might act as selective estrogen-receptor modulators.16,20 In premenopausal women with normal endogenous estrogen levels, isoflavones may have an anti-estrogen effect. In postmenopausal women with low endogenous estrogens, isoflavones are likely to act as weak estrogens. 21,22,23,24,25,26 It is suggested that red clover might have anti-anxiety effects due to its beta estrogen receptor agonist activity.9

Red clover is thought to be beneficial for preventing osteoporosis due to its weak estrogenic effects . 5,16,26. The isoflavones also appears to directly inhibit the breakdown of bone.19

Red clover isoflavones don't seem to lower cholesterol. 4,7,8 Some researchers still think that red clover might play a role in improving cardiovascular health by increasing bile acid excretion, up-regulating low-density lipoprotein (LDL) receptors, and lowering resistance in the systemic arterial blood vessels. 19,26,27,28,29. 

Adverse reactions.

Red clover is generally well tolerated. 6,7,8,9 It can rarely cause rash-like reactions, muscle pain, headache, nausea, and vaginal spotting.30 

There is some concern that red clover might increase the risk of endometrial hyperplasia due to its potential estrogenic effects. However, the ingestion of phytoestrogens in dietary amounts, 1-3 mg isoflavones per day, does not seem to increase the risk of endometrial cancer.3 Preliminary evidence also suggests that taking red clover isoflavones 50 mg daily does not have any significant effect on endometrial growth in women age 45-53 when taken for 3 months.18 

Interactions with herbs and supplements.

None reported. 

Interactions with drugs:

Tamoxifen (breast cancer treatment): Always consult an Herbal Medicine Physician.

Interactions with foods:

None known.

Interactions with laboratory tests:

None known.

Interactions with diseases or conditions:

Breast Cancer: Refer to an Herbal Medicine Physician.

None known. 

Dosage.

Recommended dose: 4-15mls per day 1:5 tincture 30% alcohol.

Insfusion: range from 2-6 tsps. per day.

Powder/capsule: 750mgs per day.

Raw herb: 4gms per day.

Liquid extract: 2-4mls/day.

Dr Clare’s Joint Cleansing Tea provides ½ tsp. per day of peppermint.

References.

1.  FDA. Center for Food Safety and Applied Nutrition, Office of Premarket Approval, EAFUS: A food additive database. Available at: vm.cfsan.fda.gov/~dms/eafus.html. [Accessed 22/6/2014]

2.  Nelsen J, Barrette E, Tsouronix C, et al. Red clover (Trifolium pratense) monograph: A clinical decision support tool. J Herb Pharmacother. 2002;2:49-72.

3.  Horn-Ross PL, John EM, Canchola AJ, et al. Phytoestrogen intake and endometrial cancer risk. J Natl Cancer Inst 2003;95:1158-64.

4.  Howes JB, Sullivan D, Lai N, et al. The effects of dietary supplementation with isoflavones from red clover on the lipoprotein profiles of postmenopausal women with mild to moderate hypercholesterolemia. Atherosclerosis 2000;152:143-7.

5.  Atkinson C, Compston JE, Day NE, et al. The effects of phytoestrogen isoflavones on bone density in women: a double-blind, randomized, placebo-controlled trial. Am J Clin Nutr 2004;79:326-33.

6.  van de Weijer P, Barentsen R. Isoflavones from red clover (Promensil) significantly reduce menopausal hot flush symptoms compared with placebo. Maturitas 2002;42:187-93.

7.  Schult TM, Ensrud KE, Blackwell T, et al. Effect of isoflavones on lipids and bone turnover markers in menopausal women. Maturitas 2004;48:209-18.

8.  Atkinson C, Oosthuizen W, Scollen S, et al. Modest protective effects of isoflavones from a red clover-derived dietary supplement on cardiovascular disease risk factors in perimenopausal women, and evidence of an interaction with ApoE genotype in 49-65 year-old women. J Nutr 2004;134:1759-64.

9.  Geller SE, Shulman LP, van Breemen RB, et al. Safety and efficacy of black cohosh and red clover for the management of vasomotor symptoms: a randomized controlled trial. Menopause 2009;16:1156-66.

10.  Ingram DM, Hickling C, West L, et al. A double-blind randomized controlled trial of isoflavones in the treatment of cyclical mastalgia. The Breast 2002;11:170-4.

11.  Baber RJ, Templeman C, Morton T, et al. Randomized placebo-controlled trial of an isoflavone supplement and menopausal symptoms in women. Climacteric 1999;2:85-92.

12.  Knight DC, Howes JB, Eden JA. The effect of Promensil, an isoflavone extract, on menopausal symptoms. Climacteric 1999;2:79-84.

13.  Nelson HD, Vesco KK, Haney E, et al. Nonhormonal therapies for menopausal hot flashes: systematic review and meta-analysis. JAMA 2006;295:2057-71.

14.  Krebs EE, Ensrud KE, MacDonald R, Wilt TJ. Phytoestrogens for treatment of menopausal symptoms: a systematic review. Obstet Gynecol 2004;104:824-36.

15.  Lipovac M, Chedraui P, Gruenhut C, et al. Improvement of postmenopausal depressive and anxiety symptoms after treatment with isoflavones derived from red clover extracts. Maturitas 2010;65:258-61.

16.  Umland EM, Cauffield JS, Kirk JK, et al. Phytoestrogens as therapeutic alternatives to traditional hormone replacement in postmenopausal women. Pharmacotherapy 2000;20:981-90.

17.  Roberts DW, Doerge DR, Churchwell MI, et al. Inhibition of extrahepatic human cytochromes P450 1A1 and 1B1 by metabolism of isoflavones found in Trifolium pratense (red clover). J Agric Food Chem 2004;52:6623-32.

18.  Hale GE, Hughes CL, Robboy SJ, et al. A doubleblind randomized study on the effects of red clover isoflavones on the endometrium. Menopause 2001;8:338-46.

19.  Anon. The role of isoflavones in menopausal health: consensus opinion of the North American Menopause Society. Menopause 2000;7:215-29.

20.  This P, De La Rochefordiere A, Clough K, et al. Phytoestrogens after breast cancer. Endocr Relat Cancer 2001;8:129-34.

21.  Zand RS, Jenkins DJ, Diamandis EP. Steroid hormone activity of flavonoids and related compounds. Breast Cancer Res Treat 2000;62:35-49.

22.  Baird DD, Umbach DM, Lansdell L, et al. Dietary intervention study to assess estrogenicity of dietary soy among postmenopausal women. J Clin Endocrinol Metab 1995;80:1685-90.

23.  Duncan AM, Underhill KE, Xu X, et al. Modest hormonal effects of soy isoflavones in postmenopausal women. J Clin Endocrinol Metab 1999;84:3479-84.

24.  Ginsburg J, Prelevic GM. Lack of significant hormonal effects and controlled trials of phyto-oestrogens. Lancet 2000;355:163-4.

25.  Hargreaves DF, Potten CS, Harding C, et al. Two-week dietary soy supplementation has an estrogenic effect on normal premenopausal breast. J Clin Endocrinol Metab 1999;84:4017-24.

26.  Setchell KD, Cassidy A. Dietary isoflavones: biological effects and relevance to human health. J Nutr 1999;129:758S-67S.

27.  Nestel PJ, Pomeroy S, Kay S, et al. Isoflavones from red clover improve systemic arterial compliance but not plasma lipids in menopausal women. J Clin Endocrinol Metab 1999;84:895-8.

28.  Lissin LW, Cooke JP. Phytoestrogens and cardiovascular health. J Am Coll Cardiol 2000;35:1403-10.

29.  Hodgson JM, Puddey IB, Beilin LJ, et al. Supplementation with isoflavonoid phytoestrogens does not alter serum lipid concentrations: a randomized controlled trial in humans. J Nutr 1998;128:728-32.

30.  Tice J, Cummings SR, Ettinger B, et al. Few adverse effects of two red clover extracts rich in phytoestrogens: a multicenter, placebo-controlled trial. Alt Ther 2001;7:S33.

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