- The official EU monograph (EMA/HMPC/159075/2014, adopted 5 April 2016) recognises hawthorn leaf with flower only as a traditional remedy for temporary nervous heart complaints and mild stress, with a tea dose of 1–2 g in 150 ml boiling water up to four times daily, never above 6 g a day.
- Almost every heart study used standardised extracts, not tea: the 2,681-patient SPICE trial found no significant effect on its main outcome after 24 months, and the HERB CHF trial found no functional benefit.
- A 2025 meta-analysis of six placebo-controlled trials (428 people), mostly using powdered leaf and flower, found an average systolic drop of 6.65 mmHg, with uneven study quality.
- Anyone on heart or blood-pressure medication, or with chest pain, swollen ankles or breathlessness, needs a doctor before a teacup; the EU monograph also advises against hawthorn in pregnancy and breastfeeding.
- Avoid supplements sold as tejocote (Mexican hawthorn) root: the US FDA found products substituted with toxic yellow oleander and has updated its warning through September 2026.
What Hawthorn Tea Actually Is
Hawthorn is a thorny shrub or small tree of the rose family, genus Crataegus, that grows in temperate regions worldwide. In Britain it is the may tree of hedgerows; in northern China its fruit is shanzha, the tart red haw sold candied on sticks. Three different products are sold as hawthorn tea.
Leaf-and-flower tea is the herbalist’s hawthorn: young leaves and creamy-white blossom of Crataegus monogyna, C. laevigata and related species, dried and cut. This is the part the European Medicines Agency reviewed, and it brews a pale straw-to-gold infusion.
Berry tea uses the dried red haws, often in slices. It brews redder and sharper, closer to a fruit tisane, and sits outside the EU leaf-and-flower monograph discussed here.
Chinese shanzha drinks use the larger fruit of Crataegus pinnatifida, a culinary tradition of its own.
All three are naturally caffeine-free, which is one reason hawthorn shows up in evening blends; our guide to caffeine in tea explains why true teas from Camellia sinensis behave so differently. For how hawthorn fits among the rest of the herbal family, start with our guide to herbal tea that isn’t really tea.
What the EU Monograph Says
Most articles ranking for hawthorn tea benefits never say who has assessed the heart claims. The clearest official answer comes from the European Medicines Agency’s Committee on Herbal Medicinal Products. Its monograph on Crataegus spp., folium cum flore (reference EMA/HMPC/159075/2014, adopted 5 April 2016) grants hawthorn leaf with flower traditional use status only. That means long use is documented, not that trials prove it works.
The monograph recognises two traditional indications:
- relief of symptoms of temporary nervous cardiac complaints, such as palpitations or a perceived extra heartbeat linked to mild anxiety, after serious conditions have been excluded by a doctor;
- relief of mild symptoms of mental stress and to aid sleep.
Only the first indication lists a herbal tea. The posology is 1–2 g of the cut herb in 150 ml of boiling water as an infusion, up to four times daily, with a ceiling of 6 g a day. The stress-and-sleep indication is covered only by powdered herb and a dry extract, so a teacup taken purely for sleep falls outside what the regulator assessed.
The warnings carry the real weight. Use for the cardiac indication is not recommended under 18 years, and use for stress and sleep has not been established under 12. Anyone whose symptoms last longer than two weeks or get worse should see a doctor, and the monograph tells users to seek medical help at once if ankles or legs swell, pain appears in the heart region, or breathing becomes difficult. Pregnancy and breastfeeding use is not recommended for lack of data. It lists no known interactions, side effects or overdoses, which reflects limited reporting rather than proof of safety. You can read the full EU hawthorn monograph on the EMA site.
Evidence Scorecard: Hawthorn Claims Graded
Hawthorn has more clinical research than most herbal teas, but nearly all of it tested two branded, standardised leaf-and-flower extracts, WS 1442 and LI 132, at doses no teacup can reliably match. The table grades each popular claim on what was actually tested.
| Claim | Best evidence | What was tested | Grade for the teacup |
|---|---|---|---|
| Helps chronic heart failure symptoms | Cochrane review, 2008: 14 randomised trials found better exercise tolerance and maximal workload than placebo | Standardised extracts WS 1442 and LI 132 added to treatment | Not applicable: extract data, medical setting only |
| Prevents heart events or death in heart failure | SPICE, 2008: 2,681 patients, 24 months, event rate 27.9% vs 28.9%, not significant | WS 1442 extract, 900 mg a day | Not supported |
| Improves walking distance in heart failure | HERB CHF, 2009: 120 patients, 6 months, no difference in 6-minute walk (P = 0.61) | Extract, 450 mg twice daily | Not supported |
| Lowers blood pressure | Szikora et al. 2025 meta-analysis: 6 trials, 428 people, systolic down 6.65 mmHg; diastolic change not significant | Mostly powdered leaf and flower, 250–1,200 mg a day, 10 weeks to 6 months | Weak to moderate; promising but small, mixed trials |
| Lowers blood pressure in diabetes | Walker et al. 2006: 79 patients on medication, 16 weeks, diastolic 2.6 mmHg lower than placebo; systolic no difference | LI 132 extract, 1,200 mg a day | Weak; one extract trial |
| Calms nerves and aids sleep | EU traditional-use indication; NCCIH says it is unclear whether hawthorn affects anxiety | Powder and dry extract only in the monograph | Traditional use only |
One detail from the Walker trial explains why the gap matters. Its 1,200 mg daily extract was described as equivalent to about 6 g of dried flowering tops, the same weight as the EU’s daily tea ceiling. Extraction concentrates selected compounds, though, while a home infusion pulls out whatever dissolves in a few minutes of hot water, so the two cannot be treated as the same dose.
Heart Health: What the Big Trials Found
The 2008 Cochrane review pooled 14 randomised trials of these extracts in people with chronic heart failure and found improvements in exercise tolerance and maximal workload, plus a lower pressure-heart rate product, compared with placebo.
Two larger, more rigorous trials then cooled that picture. SPICE randomised 2,681 patients with moderate heart failure and an ejection fraction of 35% or less to 900 mg a day of WS 1442 or placebo for 24 months. Time to first cardiac event was 620 days on hawthorn and 606 on placebo, with event rates of 27.9% and 28.9%, a difference that was not statistically significant. A trend toward fewer cardiac deaths also missed significance. In a subgroup with ejection fraction of at least 25%, sudden cardiac death was 39.7% lower, but subgroup findings like that generate hypotheses rather than settle them. Adverse events were similar in both arms. The SPICE abstract sets out the numbers in full.
HERB CHF, a US trial of 120 patients, gave 450 mg of extract twice daily for six months. Walking distance did not differ from placebo, and the authors concluded that hawthorn provides no symptomatic or functional benefit when added to standard therapy. Adverse events were more frequent in the hawthorn group, mostly non-cardiac.
The US National Center for Complementary and Integrative Health summarises the evidence on heart failure as conflicting, and finds too little research to judge hawthorn for angina, irregular heartbeat, arterial plaque or weight loss. See its hawthorn fact sheet, updated April 2025. None of these trials tested tea.
Blood Pressure: The Most Promising Claim
If any hawthorn claim reaches closer to the teacup, it is blood pressure. A 2025 meta-analysis in Pharmaceuticals by Szikora and colleagues pooled six randomised, placebo-controlled trials with 428 participants. Five of the six used powdered leaf and flower rather than a concentrated extract, at 250–1,200 mg a day for 10 weeks to six months. Systolic pressure fell by an average 6.65 mmHg more than placebo; the diastolic reduction of 7.19 mmHg was not statistically significant. The authors flagged mixed patient groups, varied treatment lengths and poorly described products, and asked for larger trials.
Together, the data suggest a modest effect from leaf-and-flower preparations taken for months, not proof of what home-brewed tea achieves, and anyone on blood-pressure drugs could see an added effect. If you are comparing tisanes for this reason, our hibiscus tea guide grades a better-studied blood-pressure tea the same way.
Side Effects, Interactions and Who Should Avoid It
At the doses studied, hawthorn appears well tolerated. NCCIH lists dizziness, nausea, vomiting, diarrhea and muscle pain among reported side effects and notes there is no safety information beyond 16 weeks of use. Information on pregnancy and breastfeeding is limited, and the EU monograph advises against use in both.
The bigger risk is the heart itself. A review in American Family Physician by Dahmer and Scott noted theoretical interactions with antiarrhythmics, blood-pressure medicines, digoxin and lipid-lowering drugs. The EU monograph reports no interactions, but its stance that serious conditions must be excluded first, and that swelling, heart-region pain or breathlessness need urgent care, says enough. Talk to the prescriber before adding hawthorn if you take any heart or blood-pressure medicine.
The tejocote warning
One hawthorn product carries a serious safety alert. Tejocote, Crataegus mexicana or Mexican hawthorn, is a relative whose root has been sold as a weight-loss supplement. The US Food and Drug Administration found that certain products labelled tejocote root were substituted with yellow oleander, a poisonous plant that can cause severe or fatal neurological, digestive and heart effects. The FDA first warned in September 2023 and has kept adding products, with updates in August and on 17 September 2026. Its yellow oleander warning page lists the affected brands. Leaf-and-flower tea from a reputable herb supplier is a different product, but avoid any root sold for weight loss.
How to Brew Hawthorn Tea
For leaf and flower, follow the EU posology: 1–2 g of dried, cut herb, roughly one to two level teaspoons depending on how finely it is cut, in 150 ml of freshly boiled water. Cover the cup so the steam stays in, steep for several minutes and strain; the monograph does not fix a steeping time. Up to four cups a day keeps you within the 6 g ceiling. Weigh it if you can: blossom-heavy blends are lighter per spoonful.
Dried berries are hard and need longer contact. Crush them lightly and simmer gently rather than steeping, then strain; no official dose exists for berry tea, so treat any ratio as a kitchen starting point. Our brewing guide covers water temperature and steeping time for every tea family.
| Form | Plant part | Method | Notes |
|---|---|---|---|
| Leaf-and-flower tea | Leaves with blossom, C. monogyna or C. laevigata | 1–2 g in 150 ml boiling water, covered, then strained | EU tea posology: up to 4 times daily, maximum 6 g |
| Hawthorn berry tea | Dried red haws | Crushed and gently simmered, then strained | No official tea dose; outside the EU leaf-and-flower monograph |
| Shanzha drink | Fruit of C. pinnatifida | Dried slices simmered, then strained | Culinary and traditional Chinese use |
| Capsules and extracts | Standardised leaf-and-flower extracts | Taken as directed on the label | The form used in heart trials; discuss with a doctor first |
Buying, Storing and Foraging
Buy leaf-and-flower hawthorn labelled with its Latin name, ideally Crataegus monogyna or C. laevigata, from a herb supplier that states origin and harvest year. Store it airtight, dark and away from heat.
Foragers in Europe gather leaves and flowers in spring and haws in autumn. Pick away from roads and sprayed fields, and be certain of identification. If you already make hedgerow teas, our rosehip tea guide covers the autumn sibling.
Where Hawthorn Meets Travel
Hawthorn is woven into the places it grows. In Glastonbury, Somerset, the Holy Thorn, Crataegus monogyna ‘Biflora’, flowers twice a year, once in winter and again in spring. The famous tree on Wearyall Hill, planted in 1951, was vandalised in December 2010 and removed by the landowner in 2019, but specimens still grow at Glastonbury Abbey and in the churchyard of St John the Baptist. Since 1929 a flowering sprig has been sent to the monarch every Christmas, and it now comes from one of those trees. Glastonbury Abbey states it is open seven days a week, 10am to 5pm; check before travelling.
In northern China, winter streets bring tanghulu, skewers of candied haws glazed in hardened sugar and long associated with Beijing, while haw flakes and shanzha drinks fill shop shelves year round. If hawthorn draws you east, our China tea travel guide maps the country’s tea regions.
Frequently Asked Questions
Is hawthorn tea good for your heart?
There is no direct evidence that hawthorn tea benefits the heart. Heart research used concentrated extracts, and the largest trial, SPICE, found no significant reduction in cardiac events over 24 months. The EU recognises leaf-and-flower tea only as a traditional remedy for temporary nervous heart complaints after a doctor has ruled out disease, never as treatment for heart conditions.
How much hawthorn tea can I drink a day?
The EU monograph sets hawthorn leaf-and-flower tea at 1–2 g in 150 ml of boiling water, up to four times a day, with a maximum of 6 g daily. It is not recommended under 18 for heart symptoms, and anyone whose symptoms last more than two weeks or worsen should see a doctor.
Can hawthorn tea lower blood pressure?
Hawthorn may lower blood pressure modestly, but tea itself is untested. A 2025 meta-analysis of six trials, mostly using powdered leaf and flower for 10 weeks to six months, found systolic pressure fell 6.65 mmHg more than placebo. Anyone already taking blood-pressure medicine should speak to their prescriber first, because effects could add up.
Who should not drink hawthorn tea?
Pregnant and breastfeeding women should avoid hawthorn tea, as the EU monograph advises against it for lack of safety data. People taking heart, blood-pressure or cholesterol medicines, including digoxin, should check with a doctor first. Anyone with chest pain, swollen ankles or breathlessness needs medical care immediately rather than an herbal remedy.
Does hawthorn tea contain caffeine?
No, hawthorn tea contains no caffeine. It is made from the leaves, flowers or berries of Crataegus species rather than the tea plant, Camellia sinensis. That makes it suitable for evening drinking, although the EU monograph lists the stress-and-sleep indication only for powdered herb and dry extract, not tea.