He Shou Wu (Polygonum multiflorum, Fo-Ti)
TCM longevity root with traditional reputation for hair pigmentation, significant hepatotoxicity case reports limit modern use.
Why
He Shou Wu (Polygonum multiflorum, also called Fo-Ti) is a TCM root with longstanding reputation for kidney/liver tonification, hair pigmentation, and longevity. The crucial modern caveat: a substantial cluster of hepatotoxicity case reports (including liver failure cases) has led to regulatory restrictions in several countries. Singapore and Australia have issued warnings; the UK MHRA flagged the herb for hepatic risk. Inclusion here is for honest reference including the safety signal.
How it works
TCM framework: tonifies Liver and Kidney essence, nourishes Blood. Stilbene glucosides (TSG) and anthraquinones have multiple preclinical effects. Hepatotoxicity mechanism is incompletely characterised, appears related to processing (raw vs prepared) and to chronic high doses.
Expected onset · Traditional indications assessed over months; safety considerations are the more immediate concern
How to take
Dosage
TCM traditional: 9–15 g/day of prepared (zhi) He Shou Wu, decocted. Raw (sheng) preparation is laxative and not for chronic use.
Timing
Divided 2–3 times daily
On the label
If used at all, only prepared (zhi shou wu) form from a quality-certified TCM dispensary with documented stilbene/anthraquinone content. Many practitioners now substitute alternatives given the safety profile.
Ideal for
Educational reference, including safety considerations. Modern use should be under close clinical supervision and with attention to liver function monitoring.
Safety
Evidence
Hepatotoxicity case reports cluster, including liver failure, leading to regulatory warnings in Singapore (HSA), Australia (TGA), UK (MHRA). Lei 2015 Front Pharmacol systematic review summarises the safety signal. Tradition-only, no Cochrane review, no EMA HMPC monograph, no EFSA-authorised claim, no major-journal RCT supports a specific therapeutic effect. Inclusion reflects documented historical use in the tradition; modern clinical evidence is limited. This is a case where 'honest framing' means leading with the safety signal.
Hepatotoxicity case reports are the dominant modern signal. No regulator anchor supports use; multiple national regulators have issued warnings. Documented use in TCM tradition remains, with increasing practitioner-side substitution.
Where to get it
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