He Shou Wu (Fo-Ti)
Commonly used for
Healthy Aging
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What is it? / Overview
He Shou Wu's stilbene and anthraquinone constituents have antioxidant and anti-hyperlipidemic activity in laboratory models, traditionally used for hair-graying and anti-aging claims that are not established in human trials -- but the same constituents are implicated in real, repeatedly documented idiosyncratic hepatotoxicity, including liver failure and death, which is the far more clinically relevant fact about this herb than any claimed benefit.
How is it used? / Administration
Form: Polygonum multiflorum root -- raw (Shengshouwu) or processed (Zhiheshouwu) forms exist; neither has a validated safe supplement dose
Typical dose studied: No validated safe supplement dose -- hepatotoxicity is idiosyncratic and can occur even at conventional doses
Timing: Not established
Ships trigger-empty and deliberately without a positive-use framing -- this entry exists chiefly for safety screening. Efficacy for any of its traditional claims is unproven; the hepatotoxicity risk is real and well documented.
How well does it work? / Evidence
? Emerging / limited evidence
Who should avoid it?
Avoid with: End-stage liver disease / Cirrhosis; NAFLD / MASLD — Fatty liver disease; Chronic Hepatitis B — active / on antiviral therapy; Chronic Hepatitis C — active / untreated; Chronic kidney disease (Stage 3, 4, or 5) — NOT on dialysis
Interacts with: Other hepatotoxic drugs/supplements -- avoid combining given He Shou Wu's own documented hepatotoxicity risk; Digoxin, diuretics -- anthraquinone constituents can act as a stimulant laxative with electrolyte effects, theoretical interaction
Already taking it? There are repeated worldwide reports of drug-induced liver injury -- including liver failure and death -- associated with this herb, occurring idiosyncratically and not predictably tied to dose. Anyone reporting current use with any liver condition, or any unexplained abnormal liver enzymes, should stop and see a doctor rather than continue.
Research & references
Teka T et al. (2021). Polygonum Multiflorum: Recent Updates on Newly Isolated Compounds, Potential Hepatotoxic Compounds and Their Mechanisms. Journal of Ethnopharmacology. Lin L et al. (2015). Traditional Usages, Botany, Phytochemistry, Pharmacology and Toxicology of Polygonum Multiflorum Thunb. Journal of Ethnopharmacology.
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