This product is not intended to diagnose, treat, cure, or prevent any disease. These statements have not been evaluated by the Food and Drug Administration.
This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult your healthcare provider before using herbs, especially if you are pregnant, nursing, taking medications, or have a medical condition.
Fo-Ti contains stilbene glycosides, particularly THSG, which may support hair pigmentation through antioxidant activity and potential effects on melanocyte function. In Traditional Chinese Medicine, it nourishes the liver and kidneys—organs believed to govern hair health. The herb also contains emodin with anti-inflammatory properties. Evidence level C indicates limited clinical data, with most support from traditional use and preliminary research rather than robust human trials.
Does Fo-Ti interact with any medications?
Fo-Ti may interact with medications metabolized by the liver, as it can affect cytochrome P450 enzymes. Combining Fo-Ti with other liver-affecting medications, alcohol, or hepatotoxic drugs may increase liver damage risk. Those taking anticoagulants should use caution, as some compounds may affect blood clotting. Always consult a healthcare provider before combining Fo-Ti with prescription medications, especially those processed through hepatic pathways.
What is the recommended dosage for Fo-Ti?
The traditional dosage for prepared (Zhi He Shou Wu) Fo-Ti is 9-15 grams as a decoction daily. For processed extract supplements, 500mg daily is commonly used. Only use the processed form—raw Fo-Ti carries significant hepatotoxicity risk. Dosage should be individualized based on the specific product and guidance from a qualified practitioner. Long-term use requires liver function monitoring. Evidence level C supports these traditional dosing recommendations.
Is Fo-Ti safe during pregnancy?
No, Fo-Ti is considered unsafe during pregnancy. The herb has been associated with hepatotoxicity and should be avoided by pregnant women. The emodin content may also have stimulant effects on the uterus. Traditional Chinese Medicine contraindicates Fo-Ti during pregnancy. Breastfeeding women should also avoid this herb due to insufficient safety data. Consult a qualified healthcare provider for appropriate alternatives during pregnancy and lactation.
Can Fo-Ti cause liver damage?
Yes, Fo-Ti has been associated with liver toxicity, including numerous reported cases of liver injury and occasional liver failure. The risk is significantly higher with raw, unprocessed Fo-Ti, which is absolutely contraindicated. Even the processed form carries some risk, particularly with prolonged use or in those with pre-existing liver conditions. Symptoms include jaundice, fatigue, and elevated liver enzymes. Regular liver function monitoring is recommended during use.
What is the difference between raw and processed Fo-Ti?
Raw Fo-Ti (Sheng He Shou Wu) and processed Fo-Ti (Zhi He Shou Wu) have significantly different safety profiles and uses. Raw Fo-Ti is primarily used for its laxative effects but carries a high risk of hepatotoxicity and is considered unsafe for regular use. Processed Fo-Ti, prepared by steaming with black soybean juice, is used as a tonic for hair, liver, and kidney health. Only the processed form should be considered for therapeutic use, and even then, liver monitoring is essential.
PubMed-compiled information sheet
This sheet was compiled from PubMed (NIH) abstracts using AI assistance. Every factual claim is cited to a real PubMed article (see the source list). It has not yet been human-reviewed — confirm with a healthcare provider before use.
Compiled from 29 PubMed articles · model: gemma4:31b
Summary
Polygonum multiflorum, known as Fo-Ti or He Shou Wu, is a traditional Chinese medicinal herb used for anti-aging and various systemic conditions, though it is strongly associated with hepatotoxicity [PMID:31644102, PMID:30895364].
Background
Polygonum multiflorum (Fo-Ti, He Shou Wu, Chinese knotweed) is a perennial plant native to China [PMID:31644102, PMID:38953108]. It is widely used in East Asia and North America as a traditional medicine [PMID:26130933].
Traditional uses
Traditional uses include treatment for backache, dizziness, liver disease, graying of the hair, constipation [PMID:31644102], as well as serving as a liver and kidney tonic for longevity and hair blackening [PMID:30895364, PMID:25449462].
Active compounds
The herb contains stilbenes (notably 2,3,5,4'-tetrahydroxystilbene-2-O-β-D-glucoside or TSG), quinones (including anthraquinones like emodin, aloe-emodin, rhein, and physcion), flavonoids, phospholipids, and polysaccharides [PMID:30895364, PMID:31644102, PMID:31680350, PMID:26185519, PMID:35069206, PMID:42191038].
Mechanism of action
TSG exhibits anti-aging effects by alleviating oxidative stress, inflammation, and apoptosis [PMID:40244282]. Extracellular vesicle-like nanovesicles from the plant reduce UV-induced oxidative stress, inhibit matrix metalloproteinase production, and promote collagen synthesis [PMID:39703536]. Emodin is involved in modulating inflammatory responses, apoptosis, and oxidative damage in cardiovascular contexts [PMID:36618923].
Clinical evidence
Evidence DSkin Photoaging
Plant-derived extracellular vesicle-like nanovesicles (PMELNVs) showed antioxidative properties and anti-photoaging effects by reducing extracellular matrix degradation [PMID:39703536]
Evidence DAlzheimer's Disease
A formula combining Panax ginseng and Polygonum multiflorum (GSPM) showed potential neuroprotective effects in SAMP8 mice, improving cognitive function [PMID:40051562]
Evidence AAging and Age-related diseases
TSG demonstrates comprehensive anti-aging effects, including lifespan extension, neuroprotection (Alzheimer's and Parkinson's), cardiovascular protection, and promotion of hair regrowth [PMID:40244282]
Evidence CPeriodontitis
TSG possesses anti-inflammatory properties and is suggested as a possible complementary treatment for Porphyromonas gingivalis-induced inflammatory responses [PMID:28856691]
Safety & adverse effects
Polygonum multiflorum is implicated in numerous reports of clinically apparent acute liver injury, which can be severe or fatal [PMID:31644102]. Hepatotoxicity may be immune-mediated idiosyncratic liver injury [PMID:32123300] and is associated with components such as free anthraquinones (emodin, chrysophanol, physcion), cis-stilbene glycosides, and dianthrones [PMID:42278266]. Clinical features of liver injury include jaundice (79.3% of cases in one study) and patterns of acute cholestatic hepatitis or hepatocellular injury [PMID:30066422]. Nephrotoxicity has also been reported in relation to aloe-emodin [PMID:31680350].
Evidence summary
Evidence for anti-aging and neuroprotective effects is supported by systematic reviews and animal models, while evidence for hepatotoxicity is strong across multiple clinical reports and reviews.
PubMed sources
1.PMID: 31644102 (2012) — Emodin: A Review of its Pharmacology, Toxicity and Pharmacokinetics. · CITED REFERENCE
2.PMID: 31680350 (2020) — Aloe-emodin: A review of its pharmacology, toxicity, and pharmacokinetics. · Phytotherapy research : PTR
3.PMID: 39703536 (2024) — Polygonum multiflorum Extracellular Vesicle-Like Nanovesicle for Skin Photoaging Therapy. · Biomaterials research
4.PMID: 34307603 (2021) — Herb-induced liver injury: Systematic review and meta-analysis. · World journal of clinical cases
5.PMID: 30895364 (2019) — Attributes of Polygonum multiflorum to transfigure red biotechnology. · Applied microbiology and biotechnology
6.
Government sources
No direct government monograph is available for this herb. The content below is AI-generated and has not been verified against an authoritative government source. Use the search links to check official sources before relying on this information.
PMID: 30066422 (2019) — Clinicopathological features of He Shou Wu-induced liver injury: This ancient anti-aging therapy is not liver-friendly. · Liver international : official journal of the International Association for the Study of the Liver
7.PMID: 26185519 (2015) — Rhein: A Review of Pharmacological Activities. · Evidence-based complementary and alternative medicine : eCAM
8.PMID: 39038664 (2024) — Research progress on hepatotoxicity mechanism of polygonum multiflorum and its main components. · Toxicon : official journal of the International Society on Toxinology
9.PMID: 28920378 (2016) — [Chemical constituents from Polygonum multiflorum]. · Zhongguo Zhong yao za zhi = Zhongguo zhongyao zazhi = China journal of Chinese materia medica
10.PMID: 40051562 (2025) — Ginseng and Polygonum multiflorum formula protects brain function in Alzheimer's disease. · Frontiers in pharmacology
11.PMID: 29713283 (2018) — Polygonum multiflorum Thunb.: A Review on Chemical Analysis, Processing Mechanism, Quality Evaluation, and Hepatotoxicity. · Frontiers in pharmacology
12.PMID: 32123300 (2021) — The hepatotoxicity of Polygonum multiflorum: The emerging role of the immune-mediated liver injury. · Acta pharmacologica Sinica
13.PMID: 38953108 (2024) — Phytochemistry, pharmacology, toxicology and detoxification of Polygonum multiflorum Thunb.: a comprehensive review. · Frontiers in pharmacology
14.PMID: 36119015 (2020) — New phenolic constituents obtained from Polygonum multiflorum. · Chinese herbal medicines
15.PMID: 35069206 (2021) — A Review of Pharmacology, Toxicity and Pharmacokinetics of 2,3,5,4'-Tetrahydroxystilbene-2-O-β-D-Glucoside. · Frontiers in pharmacology
16.PMID: 40244282 (2025) — 2,3,5,4'-Tetrahydroxystilbene-2-O-β-D-glucoside (TSG) from Polygonum multiflorum Thunb.: A Systematic Review on Anti-Aging. · International journal of molecular sciences
17.PMID: 26130933 (2015) — Review of clinical studies of Polygonum multiflorum Thunb. and its isolated bioactive compounds. · Pharmacognosy research
18.PMID: 33485980 (2021) — Polygonum multiflorum: Recent updates on newly isolated compounds, potential hepatotoxic compounds and their mechanisms. · Journal of ethnopharmacology
19.PMID: 42191038 (2026) — Polysaccharides from Polygonum multiflorum Thunb. and its processed products: A review on traditional uses, extraction, structural characteristics, pharmacological activities, structure-activity relationships, and drug delivery applications. · Fitoterapia
21.PMID: 31920657 (2019) — Polygonum multiflorum-Induced Liver Injury: Clinical Characteristics, Risk Factors, Material Basis, Action Mechanism and Current Challenges. · Frontiers in pharmacology
22.PMID: 38087457 (2024) — Phytochemical analysis and hepatotoxicity assessment of braised Polygoni Multiflori Radix (Wen-He-Shou-Wu). · Biomedical chromatography : BMC
23.PMID: 36618923 (2022) — Emodin in cardiovascular disease: The role and therapeutic potential. · Frontiers in pharmacology
24.PMID: 33261537 (2021) — Advances in Understanding the Metabolites and Metabolomics of Polygonum multiflorum Thunb: A Mini-review. · Current drug metabolism
25.PMID: 25449462 (2015) — Traditional usages, botany, phytochemistry, pharmacology and toxicology of Polygonum multiflorum Thunb.: a review. · Journal of ethnopharmacology
26.PMID: 28856691 (2017) — Therapeutic applications of resveratrol and its derivatives on periodontitis. · Annals of the New York Academy of Sciences
27.PMID: 42278266 (2026) — Hepatotoxic Compounds and Mechanisms of Polygonum Multiflorum: A Narrative Review of Recent Advances. · International journal of molecular sciences
28.PMID: 35183691 (2022) — Pharmacokinetics and metabolism of trans-emodin dianthrones in rats. · Journal of ethnopharmacology