Ho Shou Wu (Polygonum multiflorum), is also known as Fo-ti, Fo-ti-teng, He Shou Wu, Chinese knotweed and Flowery knotweed. In North America and Europe, this herb may be known as Polygonium multiflorum or Radix poltgoni multiflori. Ho Shou Wu is a widely used Chinese herb and is a popular herbal remedy for gray hair and hair loss. Indeed the name SHOU-WU means “a head full of black hair” in Chinese.

According to Chinese traditional medical theory hair condition is an indication of the health of the body’s internal organs. Weaknesses in the kidney and liver tend to manifest as symptoms such as hair loss and premature gray hair. Such conditions can be corrected by replenishing the nutrients that are necessary to revitalize our kidneys and livers – at least that is what Chinese herbalists believe. Ho Shou Wu is usually taken orally as a dietary supplement. Long term used is recommended by most Chinese herbalists. More recently, topical lotions have been formulated containing extracts from the herb for treating hair loss.

Health benefits of Ho Shou Wu

In traditional Chinese medicine Ho Shou Wu has been used for thousands of years and is believed to:

• Treat premature graying of hair and hair loss
• Tonify the kidneys and liver
• Balance a fragile yin
• Treat weak bones
• Protect the skin against UVB damage

He Shou Wu is considered to be one of the most important of the Chinese herbal tonics. It is believed to restore vitality and virility by strengthening the liver, reproductive, urinary and circulatory systems.

The tuberous roots and the stems have antibacterial, anticholesterolemic, antispasmodic, astringent, cardiotonic, demulcent, depurative, hypoglycaemic, laxative, sedative and tonic properties.

The roots are taken internally in the treatment of menstrual and menopausal complaints, constipation in the elderly, swollen lymph glands and high cholesterol levels. They are very effective in reducing high cholesterol levels in the blood and increasing blood sugar levels. Applied topically the roots are used to treat ringworm, bleeding wounds and sores.

The leaves and roots tonify the liver and kidneys, fortify the blood, strengthen the muscles and prevent premature greying of the hair. The stem has deobstruent and sedative properties. It is taken internally in the treatment of insomnia and neurasthenia. Extracts of the plant have shown antipyretic, antitumour, hypoglycaemic and sedative activity.

Ho Shou Wu dosage

One of the most commonly found brands of Ho Shou Wu is Shou Wu Pian. It is manufactured by Shanghai Chinese Medicine Works in China. The dosage is 5 tablets three times daily. This is a very common dosage for Chinese herbs. Chinese herbs are usually very mild in nature. The herb has been taken by the Chinese for thousands of years and few side effects have been reported.

Each 4-bottle package can last 1-2 months. It is not necessary to take the supplement every day. If sore throat or light headache is experienced, the suggested dosage can be reduced by half.

Side effects of Ho Shou Wu

Excessive doses of Ho Shou Wu can cause sore throat, headache, skin rash and numbness of the extremities.

Although there is no specific mention of Ho Shou Wu, there have been reports that some members of this genus can cause photosensitivity in susceptible people. Many species also contain oxalic acid. Whilst not toxic, this substance can bind to minerals making them unavailable to the body and leading to mineral deficiency. Having said that, a number of common foods such as sorrel and rhubarb contain oxalic acid and the leaves of most members of this genus are nutritious and beneficial to eat in moderate quantities. Cooking the leaves will reduce their content of oxalic acid. People with a tendency to rheumatism, arthritis, gout, kidney stones or hyperacidity should take especial caution if including Ho Shou Wu in their diet since it can aggravate their condition.

Ho Shou Wu is considered a dietary supplement similar to vitamins and, as such, it is not regulated by the FDA.

Constituents of Ho Shou Wu

Ho Shou Wu contains stilbene glycosides similar to resveratrol but with superior antioxidant activity. Resveratrol has been suggested to extend lifespan by a variety of mechanisms. Anthraquinones, polydatin, 2, 3, 5, 4′-tetrahydroxy stilbene-2-O-beta-D-glucopyranoside, arbutin, and resveratrol are found in Ho Shou Wu. Anthraquinones in Ho Shou Wu include physcion, emodin, and questin. Other substances in the herb include chrysophanol, rhein, polygonimitin B and gallic acid.

Ho Shou Wu contains several derivatives of tetrahydroxystilbene that are antioxidant and anti-inflammatory compounds investigated for their effects on neurons. Ho Shou Wu also contains the laxative compound emodin and a number of derivatives of emodin; this accounts for a potential adverse effect of the herb in causing loose stools when consumed in quantity.

Scientific studies on Ho Shou Wu

Several published human clinical studies have supported the traditional uses of Ho Shou Wu. While results vary among studies and individuals, over 60% of people who had hair loss (alopecia) experienced hair regrowth within 3 months after taking He Shou Wu. In animal studies using an aging mouse model, He Shou Wu was demonstrated to lower total cholesterol and triglyceride, to reduce brain pathological changes and promote learning and memory (1,2,3, 4).

Potential rare liver reactions to Ho Shou Wu

Ho Shou Wu is known for being a safe herb with little toxicity, and one that is used for a prolonged time in some anti-aging formulas. However, the Medicines and Health Care Products Regulatory Agency (MHRA) in the UK have issued an alert about potential adverse liver reactions to Ho Shou Wu. Reports on these adverse effects have been published (3,4,5,6).

There are many signs and symptoms of liver disease. These include jaundice (yellowing of the skin or whites of the eyes), dark urine, nausea, vomiting, unusual tiredness, weakness, stomach or abdominal pain, and /or loss of appetite. If a liver disorder is diagnosed it is recommended that Ho Shou Wu should be discontinued.

Individuals who have previously experienced liver complaints or other serious health complaints are advised not to take Ho Shou Wu without speaking to a doctor first.

Ho Shou Wu cultivation details

Ho Shou Wu is a quickly spreading vine that will spread rapidly. There are delicate flowers that appear in the fall. The roots are harvested in the fall, preferably from plants 3 – 4 years old, and are dried for later use. The stems are harvested in late summer or early autumn and are also dried before use.

Ho Shou Wu can grow in ordinary garden soil but prefers a moisture retentive not too fertile soil in sun or part shade. This species can withstand temperatures to at least -15 0C. Seed should be sown in spring in a cold frame. When they are large enough to handle, prick the seedlings out into individual pots and plant them out in the summer if they have reached sufficient size. If not, over winter them in a cold frame and plant them out the following spring after the last expected frosts.

References

1. Chan YC et al. Polygonum multiflorum extracts improve cognitive performance in senescence accelerated mice. Am J Chin Med. 2003; 31:171-179.

2. Chan YC et al. Beneficial effects of different Polygonum multiflorum Thunb. extracts on memory and hippocampus morphology. J Nutr Sci Vitaminol. 2002; 48: 491-7.

3. Battinelli et al. New case of acute hepatitis following the consumption of Shou Wu Pian, a Chinese Herbal product derived from Polygonum multiflorum. Annals of Internal Medicine. 2004; 140: E589

4. But et al (1996) Hepatitis related to the Chinese medicine Shou Wu Pian manufactured from Polygonum multiflorum. Veterinary and Human Toxicology. 1996; 38: 208-282

5. Park et al. Acute hepatitis induced by Shou Wu Pian, a herbal product derived from Polygonum multiflorum. Journal of Gastroenterology and Hepatology. 2001; 16: 115-117

6. Panis et al. Recurrent toxic hepatitis in a Caucasian girl related to the use of Shou-Wu-Pian, a Chinese herbal preparation. Journal of Pediatric Gastroenterology and Nutrition. 2005; 41: 256-258.

Dong Quai (Angelica sinensis), also known as Dang gui, is used to stop hair loss and is claimed to be able to stimulate hair re-growth. Dong Quai contains phytoestrogens which inhibit the formation of DHT, a major cause of hair loss.

Dong quai is a perennial herb. The root of Dong quai has been used for thousands of years in the treatment of female health problems in Japan, China and Korea. The name Dong quai translates as “return to order” due to its apparent health restorative properties.

Health benefits of Dong quai

The root of Dong quai has analgesic, anticholesterolemic, anti-inflammatory, antispasmodic, emmenagogue, emollient, hepatic, laxative, sedative and peripheral vasodilator properties. It is commonly used as an alternative medicine to regulate the menstrual cycle, relieve period pain and also to ensure a healthy pregnancy and easy delivery.

Dong quai contains vitamin B12, vitamin E, biotin, ferulic acid, nicotinic acid, butylidenephalide, ligustilide, folinic acid, succinic acid, carotene, beta-sitosterol, sequiterpenes, and carvacrol. Dong quai’s pharmacologically active ingredients can be divided into two groups, the water-soluble, non-volatile group and the alcohol-soluble group containing essential oil. While the non-volatile ingredients are believed to stimulate the uterus, the alcohol-soluble group is believed to relax the uterus.

Dong quai is believed to: lower blood pressure; slow heart rate; reduce respiratory rate; dilate coronary vessels and increases coronary blood flow; reduce inflammation and headache; and treat infections and neuropathic (nerve) pain. Dong quai is primarily used to treat women’s ailments, such as pre-menstrual discomfort, menstrual problems, anemia, and symptoms related to menopause.

Although Dong quai has many historical and theoretical uses based on animal studies, there is little clinical evidence supporting the effects of Dong quai for any condition. Few clinical trials have been carried out, most of which have been either poorly designed or reported insignificant results.

Side effects of Dong quai

All members of Genus Angelica contain furocoumarins, which increase skin sensitivity to sunlight and may cause dermatitis. Although Dong quai is accepted as being safe as a food additive in the United States and Europe, its safety when administered at medicinal dose levels is unknown. There are no reliable long-term studies on the side effects of this herb. Most precautions are based on theory, laboratory research, tradition, or isolated case reports.

Components of Dong quai may increase the risk of bleeding due to anticoagulant and anti-platelet effects, although there are no reliable reports of clinically significant bleeding in humans. Caution is advised in patients with bleeding disorders or taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary. It is recommended that use of Dong quai be discontinued prior to surgical or major dental procedures.

It remains unclear if Dong quai has the same effects on the body as estrogens, blocks the activity of estrogens, or has no significant hormonal effects. It remains unclear if Dong quai is safe in individuals with hormone-sensitive conditions such as breast cancer, uterine cancer, ovarian cancer, or endometriosis. It is not known if Dong quai possesses the beneficial effects that estrogen is believed to have on bone mass, or the potential harmful effects such as increased risk of stroke or hormone-sensitive cancers.

Increased sun sensitivity with a risk of severe skin reactions (photosensitivity) may occur due to chemicals in Dong quai. Prolonged exposure to sunlight or ultraviolet light should be avoided while taking Dong quai.

Safrole, a volatile oil in Dong quai, may be carcinogenic (cancer-causing). Long-term use should therefore be avoided.

Dong quai has traditionally been associated with gastrointestinal symptoms (particularly with prolonged use), including laxative effects/diarrhea, upset stomach, nausea, vomiting, loss of appetite, burping, or bloating. Published literature is limited in this area.

Dong quai preparations may contain high levels of sucrose, and should be used cautiously by patients with diabetes or glucose intolerance.
Other side effects can include: headache, lightheadedness/dizziness, sedation/drowsiness, insomnia, irritability, fever, sweating, weakness, abnormal heart rhythms, blood pressure abnormalities, wheezing/asthma, hot flashes, worsening premenstrual symptoms, reduced menstrual flow, increased male breast size (gynecomastia), kidney problems (nephrosis), or skin rash.

The safety of Dong quai injected into the skin, muscles, or veins is not known and should be avoided.

People with known allergy/hypersensitivity to Angelica radix or members of the Aplaceae/Umbelliferae family (anise, caraway, carrot, celery, dill, parsley) should avoid Dong quai. Skin rash has been reported with the use of Dong quai, although it is not clear if this was an allergic response. An asthma response has occurred after breathing in Dong quai powder.

If you have a hemorrhagic disease or other bleeding disorder, excessive menses or severe flu do not take Dong quai. If you have gastrointestinal distress or low blood pressure, talk to your doctor before taking Dong quai .

Scientific studies have reported that certain ingredients contained in Dong quai act in a similar manner to the body’s natural hormone estrogen. If you have or are susceptible to hormonally related cancers, such as breast, ovarian and prostate, talk to your doctor before taking this Dong quai.

Dong quai dosage

Adults (18 years and older)

Dong quai is a component of numerous herbal combinations, and various doses have been used traditionally. Powdered/dried root/root slices, fluid extracts, tinctures, decoctions, dried leaf preparations are available to be taken by mouth. Topical preparations are available to be applied to the skin. Safety of intravenous use is not established, although it has been reported in research.

Decoctions: A daily intake of decoction from 3-15 grams of dried root is suggested.

Standardized extract: Take 200mg 2-3 times a day (standardization of Dong quai: the most current available medical and scientific literature indicates that this dietary supplement should be standardized to 0.8-1.1% of ligustilide per dose).

Dong quai dosage for children (younger than 18 years)

There is not enough scientific data to recommend Dong quai for use in children, and it is not recommended due to potential side effects.

Interactions of Dong quai with other medicines

Dong quai has been found to interact with the following medications:

• Anticoagulant medications
• Antiplatelet medications
• Antihypertensive medications
• Estrogen and estrogen-like medications
• Oral contraceptives

Dong quai may increase the risk of bleeding due to anticoagulant and anti-platelet effects, and may heighten the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants such as warfarin (Coumadin) or heparin, anti-platelet drugs such as clopidogrel (Plavix), and non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin, Advil) or naproxen (Naprosyn, Aleve).

Laboratory studies suggest that Dong quai may increase the effects of drugs that affect heart rhythms, such as digoxin, beta-blockers (e.g. Lopressor, Toprol), calcium channel blockers such as nifedipine (Procardia) or other anti-arrhythmic drugs.

It remains unclear if Dong quai has the same effects on the body as estrogens, blocks the activity of estrogens, or has no significant hormonal effects. It is not known if taking Dong quai increases or decreases the effects of oral contraceptives or hormone replacement therapy such as Premarin which contain estrogen, or on the anti-tumor effects of selective estrogen receptor modulators (SERMs) such as tamoxifen.

Dong quai should not be taken in combination with other drugs that cause photosensitivity, such as tretinoin (Retin-A, Renova), and some types of anti-depressants, cancer drugs, antibiotics, or anti-psychotic medications. Patients taking medications should consult their doctor or pharmacist before starting Dong quai.

Interactions with herbs and dietary supplements

In theory, due to its anticoagulant properties, Dong quai may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Dong quai should not be taken with products containing Hypericum perforatum (St. John’s wort) or capsaicin, which are also reported to cause photosensitivity.

Dong quai and pregnancy and breastfeeding

Taking Dong quai during pregnancy is not recommended due to possible hormonal and anticoagulant/anti-platelet effects of the herb. Animal research has reported effects on the uterus that include both stimulation and relaxation. There is a published report of miscarriage in a woman taking Dong quai, although it is not clear that Dong quai was the cause. Dong quai is traditionally viewed as increasing the risk of abortion. There is insufficient evidence regarding the safety of Dong quai during breastfeeding.

With its ability to regulate estrogen hormone levels, black cohosh has been found to be helpful in the treatment of hair loss in women. Black cohosh is a common ingredient in many hair loss remedies.

Black Cohosh (Cimicifuga racemosa), also known as Black Snakeroot, Bugbane, Bugwort, and Squawroot, is a perennial plant native to woodlands in the United States and Canada. Black cohosh can reach up to 8 feet in height, its feathery spikes of white Astilbe-like flowers blooming from June through July. Its root is almost black in color and thick and knotted. The root was used by Native Americans as a natural medicine for the treatment of many ailments that included rattlesnake bites, menopause and gynecological disorders, rheumatism, inflammation of painful joints, improving circulation and relieving pain.

What is black cohosh?

Black cohosh is considered as a food and not a drug by the Food and Drug Adminstration (FDA). The roots and rhizomes of the black cohosh plant are used in herbal remedies. Black cohosh supplements are available over the counter in pill, capsule, and tincture forms. Black cohosh contains vitamins A and B5, calcium, iron, phosphorus, potassium, lipids and resin.

How does black cohosh work?

Black cohosh comes from a family of plants well known for their ability to deaden pain, and it has analgesic properties. The root contains steroid-like compounds that are thought to play a key role in its anti-inflammatory action. These compounds are believed to act both locally (when applied topically) and systemically (when taken internally) to reduce inflammation.

Black cohosh has been found to contain chemicals that can affect the female reproductive tract, notably formononetin and cimicifugoside. Formononetin, an isoflavonoid, has been shown to stimulate the production of estrogen and to have anti-cancer activity. Formononetin has also been demonstrated to be a fungicide, improving or prevent symptoms associated with Candid albicans (thrush) infection.

Black Cohosh also has weak estrogenic effects which help reduce the number, severity and frequency of hot flushes and night sweats as well as inhibiting other symptoms such as insomnia, mood swings, nervousness, irritability, heart palpitations and headaches.

Another compound found in black cohosh, cimicifugin, has been found to reduce blood pressure. Cimicifugin has also been shown to boost the circulation.

Side effects of black cohosh

There are no reported side effects from black cohosh when taken at recommended doses. However, in large doses black cohosh can cause stomach pain, diarrhea, dizziness, nausea, tremors, joint pain and headaches. The side effects of taking black cohosh extract over an extended period of time have not yet been determined.

Additionally the safety of black cohosh in relation to breast cancer, due to its estrogenic properties, has not yet been fully established. It is advisable that women with a family history of breast cancer consult a health practitioner prior to taking the herb. Pregnant and lactating women should avoid black cohosh since it has been associated with the stimulation of contractions and the induction of premature labor in some users.

Black cohosh dosage

Decoction: Boil 2 teaspoons of ground root in 1 pint of water. Take 2 to 3 tablespoons 6 times a day.
Fluid extract: Take from 5-30 drops in liquid daily.
Tincture: Doses range from 1-30 drops in a teaspoon of water.
Capsule: The recommended dosage is 1 capsule, taken 3 times daily.

Caution – excessive intake of black cohosh can cause nausea, vomiting and vertigo.

Remifemin

Most studies involving black cohosh have used an extract called Remifemin, which is standardized to contain 1 mg of terpene glycosides per 20 mg tablet. The most commonly used dosage of Remifemin is two 20 mg tablets taken twice daily.