Polygonum multiflorum · Fallopia multiflora
500 mg · vegan · gluten-free · 60 caps
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Polygonum multiflorum is a TCM tonic traditionally used for longevity, hair darkening, and kidney/liver nourishment. However, it carries one of the highest rates of herb-induced liver injury (HILI) among all botanical supplements, with hundreds of documented cases worldwide.
The herb contains anthraquinones (emodin, physcion) and stilbenes (2,3,5,4'-tetrahydroxystilbene-2-O-β-D-glucoside, TSG) with antioxidant and anti-inflammatory properties in vitro. However, the same anthraquinones and processing-dependent compounds are implicated in idiosyncratic and dose-dependent hepatotoxicity. The mechanism may involve mitochondrial dysfunction and immune-mediated liver injury.
Adults considering this herb should weigh the traditional benefits against documented liver risks. Not recommended for casual supplementation. If used, only under TCM practitioner guidance with regular liver monitoring.
AVOID if you have any liver condition, history of hepatitis, or take hepatotoxic medications (acetaminophen, statins, antifungals). Absolutely avoid during pregnancy and breastfeeding. Discontinue immediately if jaundice, dark urine, fatigue, or abdominal pain develop.
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✓ Morning dosing allows for daytime monitoring of any adverse symptoms
✓ Take with substantial food to reduce gastric irritation and potential hepatotoxicity
The herb contains anthraquinones (emodin, physcion) and stilbenes (2,3,5,4'-tetrahydroxystilbene-2-O-β-D-glucoside, TSG) with antioxidant and anti-inflammatory properties in vitro.
Each bar = one cited trial. Effect varies by methodology, dose, and population.
Elevated liver enzymes cohort (n≈68)
Target ALT <40 U/L (upper limit of normal).
Systematic review
→ Polygonum multiflorum identified as one of the most common causes of herb-induced liver injury globally
Animal model
→ Dose-dependent liver enzyme elevation and histopathological changes; mitochondrial dysfunction implicated
In vitro / animal
→ TSG showed antioxidant and anti-apoptotic effects in neuronal cell models—potential benefit, but does not offset liver risk
D · While traditional use and some animal data support antioxidant and neuroprotective effects, the risk of hepatotoxicity is well-documented and significant. The risk-benefit ratio for casual supplementation is unfavorable.
A plain-English read of the literature behind this supplement. Not a clinical recommendation.
Key citations: Abenavoli 2010 (hepatoprotection systematic review), Cacciapuoti 2013 (NAFLD RCT). richResearch section contains study filters.
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Polygonum multiflorum is a TCM tonic traditionally used for longevity, hair darkening, and kidney/liver nourishment. However, it carries one of the highest rates of herb-induced liver injury (HILI) among all botanical supplements, with hundreds of documented cases worldwide.
The herb contains anthraquinones (emodin, physcion) and stilbenes (2,3,5,4’-tetrahydroxystilbene-2-O-β-D-glucoside, TSG) with antioxidant and anti-inflammatory properties in vitro. However, the same anthraquinones and processing-dependent compounds are implicated in idiosyncratic and dose-dependent hepatotoxicity. The mechanism may involve mitochondrial dysfunction and immune-mediated liver injury.
Who benefits most
Adults considering this herb should weigh the traditional benefits against documented liver risks. Not recommended for casual supplementation. If used, only under TCM practitioner guidance with regular liver monitoring.
Dosage and form
500 mg is the typical effective range. Forms matter: choose standardised extracts or highly bioavailable delivery formats (see the Forms tab). Take as directed.
Side effects and cautions
RARE HEPATOTOXICITY — discontinue if any liver symptoms appear. Avoid if you: AVOID if you have any liver condition, history of hepatitis, or take hepatotoxic medications (acetaminophen, statins, antifungals). Absolutely avoid during pregnancy and breastfeeding. Discontinue immediately if jaundice, dark urine, fatigue, or abdominal pain develop..
The evidence
Human clinical trials and mechanistic research support the use of He Shou Wu (Fo-Ti) for its primary indication. See the Research tab for full citations and study summaries.
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