Related Terms

• 2,3,5,4'-Tetrahydroxystilbene-2-beta-D-glucoside, 2-acetylemodin, 2-methoxy-6-acetyl-7-methyjuglone, 6-OH-emodin, Achyranthes, anthraquinone, Chinese climbing knotweed, Chinese cornbind, Chinese flowery knotweed, Chinese knotweed, chrysophanol, chrysophanol anthrone, cis- and trans-E-3-butylidene-4,5,6,7-tetrahydro-6,7-dihydroxy-1(3H)-isobenzofuranone chein, 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, 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, ginger, ginseng, He Ren Yin, he shou wu, heshouwu, ho shou wu, hoelen, hoshouwu, 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 stilbene glycoside, Psoralea, Qibao Meiran Dan, questin, questinol, radix Polygoni, radix Polygoni multiflori, radix Polygoni Shen Min, "red" fo-ti, rhapontin, rhein, Shen Min, Shou Wu, shou wu pian, shou xing bu zhi, Shou-Wu, Shouwu, shou-wu-pian, stilbene glucoside, stilbene glycoside, tang-kuei, tricin, "white" fo-ti, ye jiaoteng (Chinese), zhihe shou wu, Zhihe Shou Wu, Zhihe-Shou-Wu, zhiheshouwu, zi shou wu, Zi-Shou-Wu, zishouwu.

• Note: No fo-ti is 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 extensively 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 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, there are no high-quality human trials available supporting the use of fo-ti for any condition.

Scientific Evidence

Tradition/Theory

The below uses are based on tradition or scientific theories. 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 health care professional.

• Abscesses (pus), acne, aging, Alzheimer's disease, anemia, angina (chest pain), antibacterial, anti-inflammatory, antioxidant, antiviral, atherosclerosis (hardening of the arteries), athlete's foot, autoimmune diseases, back pain (lower), blood purification, bone (weak), cancer, candidal infection, carbuncles (a skin infection involving hair follicles), cerebral ischemia (insufficient blood and oxygen to the brain), constipation, cosmetic uses (gray hair), dermatitis (skin inflammation), diabetes, dizziness (vertigo), energy, enhanced immune function, erectile dysfunction, fatigue, fever reducer, fluid retention (damp wind), heart disease, high blood pressure, high cholesterol, hormone replacement therapy (HRT), immune function, impotence (inability to achieve an erection), 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, phlegm (mucus), pruritus, scrapes, skin eruptions, skin ulcers, sore throat, stomach disorders, swelling of lymph glands, tonic (liver, kidney), transplant rejection prevention, tuberculosis, vaginal discharge, weakness.

Dosing

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Adults (over 18 years old):

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

• 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 area 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 with known allergy or hypersensitivity to unprocessed or processed forms of fo-ti, which usually manifests as a skin rash. Mild eosinophilia (high white blood cell count) has also been reported.

Side Effects and Warnings

• Use cautiously in constipation, due to possible laxative dependency.

• Use cautiously in patients with low iron levels.

• Use cautiously in patients with liver dysfunction or abnormal liver function tests, due to a possible risk of liver toxicity or elevation of liver enzymes.

• Use cautiously when taken by mouth by pregnant women.

• Use cautiously in patients with estrogen-related cancers of the breast, ovary, uterus, and prostate, due to reports of the estrogen-like effects of fo-ti.

• Because fo-ti contains estrogen-like chemicals, the effects of other agents believed to have estrogen-like properties may be altered.

• Use cautiously in individuals using immunomodulators or nonsteroidal anti-inflammatory agents.

• Fo-ti may cause low blood pressure. Caution is advised in patients taking drugs, herbs, or supplements that lower blood pressure, including vasodilators.

• Fo-ti may lower blood sugar levels. Caution is advised in patients with diabetes or hypoglycemia, and in those taking drugs, herbs, or supplements that affect blood sugar. Blood glucose levels may need to be monitored by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.

• Use cautiously in patients with heart disease, as fo-ti may cause low blood potassium, potentially decreasing heart function.

• Use cautiously in patients taking lipid-lowering agents.

• Use high, chronic doses of unprocessed fo-ti cautiously, as they may lead to low blood potassium, which may cause muscle weakness and potentially dangerous changes in heart rhythm.

• Use cautiously when taken by mouth by pregnant women. Fo-ti is not recommended in pregnancy, due to a lack of sufficient data. Fo-ti may cause laxative effects.

• Avoid in breastfeeding women, as it is known to enter breast milk. Taking it while breastfeeding may cause diarrhea in infants.

• Avoid unprocessed fo-ti in patients with diarrhea, intestinal obstruction, acute intestinal inflammation (Crohn's disease, ulcerative colitis, appendicitis), ulcer, abdominal pain of unknown origin, nausea, or vomiting, due to the possibility of irritating the lining of the gastrointestinal tract, which may worsen inflammatory bowel conditions.

• Avoid in individuals with a known allergy or hypersensitivity to unprocessed or processed forms of fo-ti, which usually manifests as a skin rash. Mild eosinophilia (high white blood cell count) has also been reported.

• Fo-ti may cause abdominal cramping or pain, diarrhea, increased risk of digoxin cardiotoxicity, nausea, vomiting, acute or recurrent hepatitis, chronic hepatitis B with liver dysfunction, muscle weakness and numbness, or hallucinations.

Pregnancy and Breastfeeding

• Use cautiously when taken by mouth by pregnant women. Fo-ti is not recommended in pregnancy, due to a lack of sufficient data. Fo-ti may cause laxative effects.

• Avoid in breastfeeding women, as it is known to enter breast milk. Taking it while breastfeeding may cause diarrhea in infants.

Interactions

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. 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.

Interactions with Drugs

• Fo-ti may lower blood sugar levels. Caution is advised when using medications 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 drugs 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.

• Because fo-ti contains estrogen-like chemicals, the effects of other agents believed to have estrogen-like properties may be altered.

• Fo-ti may cause low blood pressure. Caution is advised in patients taking drugs that lower blood pressure, such as vasodilators.

• Fo-ti may also interact with antibiotics, anticancer agents, anti-inflammatories, calcium channel blockers, digoxin, drugs that increase urination, immunosuppressants, laxatives, and lipid-lowering agents.

Interactions with Herbs & Dietary Supplements

• Fo-ti may lower blood sugar levels. Caution is advised when using herbs or supplements that may also lower blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.

• Fo-ti may interfere with the way the body processes certain herbs or supplements using the liver's cytochrome P450 enzyme system. As a result, the levels of other herbs or supplements may become too high or too low in the blood. It may also alter the effects that other herbs or supplements possibly have on the P450 system.

• Because fo-ti contains estrogen-like chemicals, the effects of other agents believed to have estrogen-like properties may be altered.

• Fo-ti may cause low blood pressure. Caution is advised in patients taking herbs or supplements that lower blood pressure, including vasodilators.

• Fo-ti may also interact with antibacterials; anticancer agents; anti-inflammatories; antioxidants; calcium channel blockers; cardiac glycosides; foxglove; immunosuppressants; laxatives; licorice; and lipid-lowering agents, herbs, supplements, or foods (such as alder buckthorn, aloe, asparagus, cascara, celery, parsley, rhubarb, senna, yellowdock, and watermelon) that increase urination.

Author Information

• 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).

References

Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

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2. Chan YC, Wang MF, Chang HC. Polygonum multiflorum extracts improve cognitive performance in senescence accelerated mice. Am J Chin Med 2003;31(2):171-179. View Abstract

3. Cho HC, Min HJ, Ha CY, et al. Reactivation of Pulmonary Tuberculosis in a Patient with Polygonum multiflorum Thunb-Induced Hepatitis. Gut Liver 2009;3(1):52-6. View Abstract

4. Choi SG, Kim J, Sung ND, et al. Anthraquinones, Cdc25B phosphatase inhibitors, isolated from the roots of Polygonum multiflorum Thunb. Nat Prod Res 2007;21(6):487-493. View Abstract

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