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Fo-ti (Polygonum multiflorum)

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Also listed as: Polygonum multiflorum
Related terms
Background
Evidencetable
Tradition
Dosing
Safety
Interactions
Attribution
Bibliography

Related Terms
  • 2,3,5,4'-Tetrahydroxystilbene-2-beta-D-glucoside, 2,3,5,4'-tetrahydtoxystilbene-2-O-beta-D-glucopyranoside, 2,3,5,4'-tetrahydroxystilbene-2-O-beta-D-glucoside, 2-acetylemodin, 2-methoxy-6-acetyl-7-methyjuglone, 6-OH-emodin, Achyranthes, anthraquinone, anthrone, chein, Chinese climbing knotweed, Chinese cornbind, Chinese flowery knotweed, Chinese knotweed, chrysophanol, cis-E-3-butylidene-4,5,6,7-tetrahydro-6,7-dihydroxy-1(3H)-isobenzofuranone, citrus, Cuscuta, Danggui Yin Zi, E-2,3,5,4'-tetrahydroxystilbene-2-O-beta-D-glucopyranoside, E-2,4,6,4'-tetrahydroxystilbene-2-O-beta-D-glucopyranoside, emodin, emodin-1-6-dimethylether, emodin-8-beta-D-glucoside, emodin-8-O-beta-D-glucopyranoside, emodin-citrosein, fleeceflower, flowery knotweed, fo ti, foti, fo-ti root, fo-ti-teng, fo-ti-tient, gallic acid, He Ren Yin, he shou wu, heshouwu, ho shou wu, hoelen, hoshouwu, ho-shou-wu, lecithin, Lycium fruit, Multiflora preparata, multiflori, N-transferuloyl-3-methyldopamine, N-transferuloyltyramine, physcion, physcion-8-O-beta-D-glucopyranoside, polygonimitin B, Polygonum, Polygonum multiflorum, Polygonum multiflorum Thunb., Psoralea, Qibao Meiran Dan, questin, questinol, radix Polygoni, radix Polygoni multiflori, radix Polygoni Shen Min, "red" fo-ti, rhapontin, rhein, Shen Min, Shenwu, Shou Wu, shou wu pian, shou xing bu zhi, Shou-Wu, Shouwu, shou-wu-pian, show-wu-pian, starch, stilbene glucoside, stilbene glycoside, tang-kuei, tannin, tetrahydroxystilbene-glucoside, trans-E-3-butylidene-4,5,6,7-tetrahydro-6,7-dihydroxy-1(3H)-isobenzofuranone, tricin, "white" fo-ti, Yangxue Dingfeng Tang, ye jiaoteng (Chinese), zhihe shou wu, Zhihe Shou Wu, Zhihe-Shou-Wu, zhiheshouwu, zi shou wu, Zi-Shou-Wu, zishouwu.
  • Note: Fo-ti is not contained in the product Fo-ti-Tieng®.

Background
  • Fo-ti is a plant native to China that is used in Chinese herbal medicine. It also grows in Japan and Taiwan. The vine of the herb was called ye jiaoteng, referring to its form, an evening intertwining vine (ye = evening, jiao = intersecting, teng = vine). It is also known by its Latin name, Polygonum multiflorum. The Chinese-sounding names fo-ti-teng and fo-ti were made up by U.S. businesspersons.
  • The roots and rhizomes (underground stem of plant) of fo-ti are harvested from 3-4 year-old plants, dried, and then used in an unprocessed or processed form (processing involves steaming the dried roots in black soybean juice). The vine of fo-ti is also used in Chinese medicine. Unprocessed fo-ti (also known as "white" fo-ti) is taken by mouth as a laxative. Unprocessed fo-ti is also applied to the skin to treat conditions such as acne, athlete's foot, skin inflammation, razor burn, and scrapes. Processed fo-ti, also known as "red" fo-ti, is used to prevent or delay heart disease.
  • Currently, high-quality human studies supporting the use of fo-ti for any condition are lacking.

Evidence Table

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. GRADE *


Combination fo-ti has been shown to stop cognitive decline and improve memory and daily functioning in people with mild cognitive decline or Alzheimer's disease. Although this is promising, available evidence is limited by the use of fo-ti combination therapies. A firm conclusion about the effect of fo-ti in this area is unable to be determined, and further research is needed.

C


Early research suggests that a combination decoction (extract from boiling in water) with fo-ti, is superior to Jinshuibao capsule for the treatment of hepatitis B-associated liver fibrosis (excess connective tissue). Although this is promising, further research is needed.

C


Early research has suggested that the mixed-herb decoction (extract from boiling in water) Yangxue Dingfeng Tang, partly made up of fo-ti, has short- and long-term treatment effects when given with localized plumb-blossom needle tapping. Due to the small amount of available research, a firm conclusion about the effect of fo-ti for hepatitis B is unable to be determined. Further research in this area is needed.

C
* Key to grades

A: Strong scientific evidence for this use
B: Good scientific evidence for this use
C: Unclear scientific evidence for this use
D: Fair scientific evidence for this use (it may not work)
F: Strong scientific evidence against this use (it likley does not work)


Tradition / Theory

The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.

  • Abscesses (pus), acne, aging, anemia, antibacterial, anti-inflammatory, antioxidant, antiviral,, athlete's foot, autoimmune diseases, back pain (lower), blood purification, bone (weak), cancer, carbuncles (a skin infection involving hair follicles), cerebral ischemia (insufficient blood and oxygen to the brain), chest pain, clogged arteries, constipation, cosmetic uses (gray hair), dementia (vascular), dermatitis (skin inflammation), diabetes, dizziness (vertigo), energy, enhanced immune function, erectile dysfunction (inability to achieve an erection), expectorant (loosen mucus in lungs), fatigue, fever reducer, fluid retention "damp wind", heart disease, high blood pressure, high cholesterol, hormone replacement therapy (HRT) infections, infertility, insomnia, itchiness, kidney dysfunction, laxative, liver enlargement or disease, malaria, memory (learning), menopausal symptoms, muscle soreness, muscle strength, pain relief, Parkinson's disease, scrapes, skin eruptions, skin ulcers, sore throat, stomach disorders, swelling (lymph glands), tonic (liver, kidney), transplant rejection prevention, tuberculosis, vaginal discharge, vertigo (dizziness), yeast infection.

Dosing

Adults (over 18 years old):

  • Slices, powders, capsules, extracts, syrups, teas, and skin creams or ointments are commercially available. Fo-ti is used individually, or in combination formulas such as the traditional Chinese 13-herb mixture Shou Xing Bu Zhi.
  • Doses of 560 milligrams (capsules) 2-3 times daily, three grams of raw herb three times daily, and 9-15 grams of the dried herb daily have been taken by mouth. One teaspoon or five grams of the root boiled in one cup of water for 15 minutes has also been taken by mouth.
  • Creams or ointments have been applied to the affected skin 3-4 times daily.

Children (under 18 years old):

  • There is no proven safe or effective dose for fo-ti in children.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

  • Avoid in people with a known allergy or sensitivity to unprocessed or processed forms of fo-ti, which may cause a skin rash. Mild eosinophilia (high white blood cell count) has also been reported.

Side Effects and Warnings

  • Fo-ti may cause hallucinations, hepatitis (inflammation of the liver), hypokalemia (low potassium levels), and muscle weakness and numbness.
  • Fo-ti may lower blood sugar levels. Caution is advised in people with diabetes or low blood sugar, and in those taking drugs, herbs, or supplements that affect blood sugar. Blood sugar levels may need to be monitored by a qualified healthcare professional, including a pharmacist, and medication adjustments may be necessary.
  • Fo-ti may cause low blood pressure. Caution is advised in people taking drugs or herbs and supplements that lower blood pressure.
  • Fo-ti may interfere with the way the body processes certain drugs using the liver's "cytochrome P450" enzyme system.
  • Use cautiously in people with liver dysfunction or abnormal liver function tests, due to a possible risk of liver toxicity or elevation of liver enzymes.
  • Use cautiously in people with heart disease, as fo-ti may cause low blood potassium, potentially decreasing heart function.
  • Use cautiously in people with estrogen-related cancers of the breast, ovary, uterus, and prostate, due to reports of the estrogen-like effects of fo-ti.
  • Use cautiously in people using agents that affect immune function, agents that affect the width of blood vessels, or nonsteroidal anti-inflammatory agents.
  • Use cautiously in constipation, due to possible laxative dependency.
  • Use cautiously in people with low potassium levels.
  • Because fo-ti contains estrogen-like chemicals, the effects of other agents believed to have estrogen-like properties may be altered.
  • Avoid unprocessed fo-ti in people with diarrhea, blockage of intestines, inflammation of the intestines (Crohn's disease, ulcerative colitis, appendicitis), ulcer, stomach pain of unknown cause, nausea, or vomiting, due to the possibility of irritating the lining of the stomach and intestines, which may worsen inflammatory bowel conditions.
  • Avoid in people with a known allergy or sensitivity to unprocessed or processed forms of fo-ti.
  • Avoid use in children or during pregnancy, due to a lack of sufficient data.
  • Avoid in breastfeeding women, as it is known to enter breast milk. Taking it while breastfeeding may cause diarrhea in infants.

Pregnancy and Breastfeeding

  • Avoid use in children or during pregnancy, due to a lack of sufficient data.
  • Avoid in breastfeeding women, as it is known to enter breast milk. Taking it while breastfeeding may cause diarrhea in infants.

Interactions

Interactions with Drugs

  • Fo-ti may lower blood sugar levels. Caution is advised when using agents that may also lower blood sugar. Patients taking insulin or drugs for diabetes by mouth should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.
  • Fo-ti may interfere with the way the body processes certain agents using the liver's cytochrome P450 enzyme system. As a result, the levels of these drugs may be increased or decreased in the blood, and may cause increased or decreased effects or potentially serious adverse reactions. Patients using any medications should check the package insert and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.
  • Fo-ti may cause low blood pressure. Caution is advised in patients taking drugs that lower blood pressure.
  • Because fo-ti contains estrogen-like chemicals, the effects of other agents believed to have estrogen-like properties may be altered.
  • Fo-ti may also interact with agents for itchiness, agents for skin disorders, agents for the heart, agents that decrease fibrosis (excess connective tissue), agents that affect the stomach and intestines, agents that affect the blood, agents that affect the width of blood vessels, agents that are toxic to the liver, agents that decrease immune function, agents that increase urination, antibiotics, anticancer agents, anti-inflammatories, cardiac glycosides, calcium channel blockers, digoxin, hormonal agents, laxatives, and lipid-lowering agents.

Interactions with Herbs & Dietary Supplements

  • Fo-ti may lower blood sugar levels. Caution is advised when using agents that may also lower blood sugar. Patients taking insulin or drugs for diabetes by mouth should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.
  • Fo-ti may interfere with the way the body processes certain agents using the liver's cytochrome P450 enzyme system. As a result, the levels of these drugs may be increased or decreased in the blood, and may cause increased or decreased effects or potentially serious adverse reactions. Patients using any medications should check the package insert and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.
  • Fo-ti may cause low blood pressure. Caution is advised in patients taking drugs that lower blood pressure.
  • Because fo-ti contains estrogen-like chemicals, the effects of other agents believed to have estrogen-like properties may be altered.
  • Fo-ti may also interact with antibacterials, anticancer herbs and supplements, anti-inflammatories, antioxidants, cardiac glycosides, foxglove, herbs and supplements for itchiness, that affect the blood, that affect the stomach and intestines, that affect the width of blood vessels, that are toxic to the liver, that decrease fibrosis (excess connective tissue), that decrease immune function, that have an effect on the heart, that have an effect on hormones, that increase urination, laxatives, licorice, lipid-lowering herbs and supplements, and oleander.

Attribution
  • This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

Bibliography
  1. Avula B, Joshi VC, Wang YH, et al. Simultaneous identification and quantification of anthraquinones, polydatin, and resveratrol in , various species, and dietary supplements by liquid chromatography and microscopic study of species. J AOAC Int 2007;90(6):1532-1538.
  2. Chen L, Huang J, and Xue L. [Effect of compound Polygonum multiflorum extract on Alzheimer's disease]. Zhong.Nan.Da.Xue.Xue.Bao.Yi.Xue.Ban. 2010;35(6):612-615.
  3. Choi SG, Kim J, Sung ND, et al. Anthraquinones, Cdc25B phosphatase inhibitors, isolated from the roots of Thunb. Nat Prod Res 2007;21(6):487-493.
  4. Furukawa M, Kasajima S, Nakamura Y, et al. Toxic hepatitis induced by show-wu-pian, a Chinese herbal preparation. Intern.Med. 2010;49(15):1537-1540.
  5. Huang WY, Cai YZ, Xing J, et al. Comparative analysis of bioactivities of four species. Planta Med 2008;74(1):43-49.
  6. Jung KA, Min HJ, Yoo SS, et al. Drug-Induced Liver Injury: Twenty Five Cases of Acute Hepatitis Following Ingestion of Polygonum multiflorum Thunb. Gut Liver 2011;5(4):493-499.
  7. Kang SC, Lee CM, Choi H, et al. Evaluation of oriental medicinal herbs for estrogenic and antiproliferative activities. Phytother Res 2006;20(11):1017-1019.
  8. Ling S, Nheu L, Dai A, et al. Effects of four medicinal herbs on human vascular endothelial cells in culture. Int J Cardiol. 8-29-2008;128(3):350-358.
  9. Mazzanti G, Battinelli L, Daniele C, et al. New case of acute hepatitis following the consumption of Shou Wu Pian, a Chinese herbal product derived from . Ann Intern Med 2004;140(7):W30.
  10. Oerter Klein K, Janfaza M, Wong JA, et al. Estrogen bioactivity in fo-ti and other herbs used for their estrogen-like effects as determined by a recombinant cell bioassay. J Clin Endocrinol Metab 2003;88(9):4077-4079.
  11. Wang X, Zhao L, Han T, et al. Protective effects of 2,3,5,4'-tetrahydroxystilbene-2-O-beta-d-glucoside, an active component of Polygonum multiflorum Thunb, on experimental colitis in mice. Eur.J Pharmacol. 1-14-2008;578(2-3):339-348.
  12. Xu ML, Zheng MS, Lee YK, et al. A new stilbene glucoside from the roots of Thunb. Arch Pharm Res 2006;29(11):946-951.
  13. Yao S, Li Y, Kong L. Preparative isolation and purification of chemical constituents from the root of by high-speed counter-current chromatography. J Chromatogr A 2006;1115(1-2):64-71.
  14. Zhang L, Yang X, Sun Z, et al. [Retrospective study of adverse events of Polygonum multiflorum and risk control]. Zhongguo Zhong.Yao Za Zhi. 2009;34(13):1724-1729.
  15. Zuo GY, Wang GC, Zhao YB, et al. Screening of Chinese medicinal plants for inhibition against clinical isolates of methicillin-resistant (MRSA). J Ethnopharmacol 2008 Nov 20;120(2):287-90.

Copyright © 2011 Natural Standard (www.naturalstandard.com)


The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.

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