DRUGS AND SUPPLEMENTS

Schisandra (Schisandra chinensis, Schisandra spenanthera)

March 22, 2017

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Schisandra (Schisandra chinensis, Schisandra spenanthera)

Natural Standard Bottom Line Monograph, Copyright © 2013 (www.naturalstandard.com). Commercial distribution prohibited. This monograph is intended for informational purposes only, and should not be interpreted as specific medical advice. You should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.

While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy.

Related Terms

  • Acetylursolic acid, andrographolide, anti-HBeAg lignan, bac ngu vi tu (Vietnamese), BDD, bei wu wei zi (Chinese), bei wu zi, beiwuweizi, benzoylisogomisin O, beta-sitosterol, C(18) dibenzocyclooctadiene lignan derivatives, C19 homolignans, catechin, chicanine, chindranda berry, Chinese magnolia vine, Chinesischer limonenbaum (German), chosen-gomischi (Japanese), cycloartane skeleton, daucosterol, deoxyschisandrin, deoxyschizandrin, dibenzocyclooctene lignans, dihytroxyursolic acid eklikit, eklikit gomisi, Equiguard™, ESP-102, five-flavor-fruit, five-flavor-seed, fructus schisandrae sphenantherae, fructus schizandrae, gamma-schisandrin, gamma-schizandrin, ganwuweizic acid, geranylgeranoic acid, gomishi (Japanese), gomisi, gomisin, hoku-gomishi, ImmunoGuard®, interiotherin A, Japanese-manchurian endemite, kadsumarin A, kita-gomishi, lancifodilactone G, lancifodilactones B-E, lanostane triterpenoids, lignan-enriched extract of schisandra fruit, lignans, limonnik kitajskij (Russian), m mei gee (Cantonese), magnolia vine, matsbouza (Japanese), micrandilactone, micranoic acid, monoterpenes, nanwuweizi, ngu mei gee, nigranoic acid, nitrophenolic glycosides, norcycloartane skeleton, norschiartane, north wuweizi, northern schisandra, northern schizandra, nortriterpenoids, octanortriterpenoids, omicha (Korean), pregomisin, S-113m, SC-Ex, schiarisanrin, schiartane, schisanartane, schisandra fruit, schisandra berry, Schisandra chinensis Bail., Schisandra chinensis Baill., Schisandra chinensis baillon, Schisandra chinensis (Turcz.) Bail., Schisandra chinensis (Turcz.) Baill., Schisandra glaucescens, Schisandra henryi, Schisandra incarnata, Schisandra incarnate, Schisandra lancifolia, Schisandra micrantha, Schisandra propinqua, Schisandra rubriflora, Schisandra rubrifolia, Schisandra rubriflora Rhed et Wils, Schisandra sphenanthera Rehd. et Wils, Schisandra viridis, Schisandraceae (family), schisandrae, Schisandrae fructus, schisandrin, schisandrol, schisandronic acid, schisanhenol, schisanlactone, schizandra, Schizandra arisanensis, Schizandra arisanensis Hayata, Schizandra chinensis Bail., Schizandra chinensis Baill., Schizandra chinensis baillon, Schizandra chinensis (Turcz.) Bail., Schizandra chinensis (Turcz.) Baill., Schizandra nigra Max., schizandrae, Schizandrae fructus, schizandrin, sesquiterpenes, sheng mai san, sheng-mai-san, shengmai san, shengmaisan, shengmaiye, sheng mai yin, sheng-mai-yin, shengmai yin, shengmaiyin, shisandra, slyceryl 26-hydroxyhexacosanoate, slyceryl hexacosanoate, southern schisandra, TJN-101, triterpenoid acids, triterpenoids, ursolic acid, vitamin A, vitamin C, vitamin E, wei zi (Chinese), western schisandra, wurenchun, wu wei zi (Chinese), wu-wei-zi (Chinese), wu xiwuweizi (Chinese), wuweizi (Chinese), wuweizisu (Chinese), xiwuweizi (Chinese).

Background

  • Schisandra (Schisandra chinensis), also spelled schizandra, is a vining shrub native to northern and northeast China, as well as areas of Korea and Russia.

  • Schisandra berries are called wu wei zi in Chinese, translated as "five-flavor fruit," based on their salty, sweet, sour, pungent, and bitter flavors. The dried fruit is formed into powder, tinctures, and wine, and used in capsules and teas either as a single ingredient or in a combination herbal product.

  • The berries of schisandra have been used in traditional Chinese medicine (TCM) to increase the body's resistance to stress, for liver protection, immune system effects, and as a "harmonizing agent" in herbal formulas. In Russia it has been used for increasing attention, concentration, coordination, endurance, and strength.

Scientific Evidence

Uses

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*

Adaptogen

Schisandra is believed to strengthen nonspecific resistance of the body to various stressors. At this time however, only limited, poorly designed study has been conducted to study these effects. High quality study is needed to make a conclusion.

C

Eczema

Results from limited study using schisandra in combination with other herbs for eczema, suggested a potential benefit. Further study using schisandra alone is required before conclusions can be drawn.

C

Familial Mediterranean Fever (FMF)

There is currently a lack of sufficient evidence to determine if schisandra is an effective treatment for familial Mediterranean fever (FMF). Results from limited study using schisandra in combination with other herbs for this condition suggested a potential benefit. Further study is required before conclusions can be drawn.

C

Liver disease

Although not well studied in humans, schisandra has been suggested as a liver protective agent. Several components of schisandra have strong antioxidant activity, which may enhance liver enzyme systems and regenerate liver tissue. Many studies, however, have evaluated purified constituents, such as schisandrin C. Additional research is needed in this area.

C

Vision

In limited available study, visual acuity was improved following use of schisandra. Additional research is needed in this area.

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 against this use (it may not work); F: Strong scientific evidence against this use (it likely does not work).

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.

  • Adrenal tonic, aging, allergies, Alzheimer's disease, antibacterial, anti-inflammatory, antioxidant, anti-parasitic, asthma, astringent, blood circulation, blood vessel dilation, burn treatment, cancer, chemotherapy support, childbirth (labor induction), common cold, concentration enhancement, cough, depression, diabetes, diarrhea, dysentery, ear infection, enhancing recovery from surgery or illness, exercise capacity improvement, fatigue, frostbite, gastrointestinal disorders, hearing loss, heart disease, heavy metal/lead toxicity, HIV, high blood pressure, high cholesterol, kidney disorders, learning disabilities, liver protection, low blood pressure (during pregnancy), immune stimulation, impotence, infection, insomnia, irritability, leukemia, lung conditions, memory loss, menopause, motion sickness, muscle wasting, nervous system disorders, night sweats, palpitations, pneumonia, premenstrual syndrome, radiation protection, sedation, seizure, sexual dysfunction, shortness of breath, sinus infection, skin conditions, sleep difficulties, sore throat, sperm production, stress, stroke, sweating (excessive), thirst, tranquilizer, ulcers, urinary disorders, uterine tonic.

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 (18 years and older)

  • Schisandra has been taken by mouth as a juice, tea, wine, liquid herbal extract, capsule, or syrup.

  • For use as an adaptogen, a dose of 91.1 milligrams of standardized schisandra has been taken twice daily.

  • For liver disease, a dose of 7.5mg of HpPro (a natural version of schisandin C, a component of schisandra) has been taken three times daily for up to four weeks.

  • For vision improvement, a 5% solution of schisandra has been applied to the eye for 20-25 days.

Children (under 18 years old)

  • There is no proven safe or effective dose for schisandra 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 schisandra or any of its constituents. Skin rashes and hives have been reported.

Side Effects and Warnings

  • Schisandra may lower blood sugar levels. Conversely, some schisandra preparations may contain sugar, which may increase blood sugar. 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, and medication adjustments may be necessary.

  • Schisandra may have effects on bleeding. Caution is advised in patients with bleeding disorders or taking drugs that affect bleeding. Dosing adjustments may be necessary.

  • Schisandra may cause heartburn, increased stomach activity, decreased appetite, and stomach pain. Use cautiously in patients with gastrointestinal disorders.

  • Schisandra may cause drowsiness, nervous system depression, or nervous system stimulation. Use cautiously in patients with nervous system disorders, seizures, or in patients engaging in activities requiring alertness.

  • Schisandra may cause the skin to be sensitive to sunlight. Use cautiously in patients with skin diseases.

  • Use cautiously in patients with high intracranial (within the skull) pressure or high blood pressure.

Pregnancy and Breastfeeding

  • Schisandra is not recommended in pregnant or breastfeeding women due to a lack of available scientific evidence.

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

  • Schisandra may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar. Patients taking drugs for diabetes by mouth or insulin should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.

  • Schisandra may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants ("blood thinners") 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®).

  • Schisandra 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 altered 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.

  • Schisandra may increase the amount of drowsiness caused by some drugs. Examples include benzodiazepines such as lorazepam (Ativan®) or diazepam (Valium®), barbiturates such as phenobarbital, narcotics such as codeine, some antidepressants, and alcohol. Caution is advised while driving or operating machinery.

  • Schisandra may also interact with antiparasitics, antibiotics, anti-inflammatory drugs, lipid lowering drugs, anti-cancer agents, antiviral drugs, anti-ulcer drugs, reserpine, doxorubicin, estrogens, halothane, seldane, neurological agents, tacrine, tacrolimus, blood vessel dilators, cardiovascular agents, morphine, immune altering agents, cholinergic agents, and photosensitizing agents.

Interactions with Herbs and Dietary Supplements

  • Schisandra 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.

  • Schisandra may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.

  • Schisandra 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 these drugs may be altered 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.

  • Schisandra may increase the amount of drowsiness caused by some herbs or supplements.

  • Schisandra may also interact with adaptogens, antiparasitics, antibiotics, antioxidants, anti-inflammatory herbs and supplements, lipid lowering herbs and supplements, anti-cancer herbs and supplements, antiviral herbs and supplements, anti-ulcer herbs and supplements, estrogens, halothane, neurological herbs and supplements, blood vessel dilators, cardiovascular herbs and supplements, immune altering herbs and supplements, cholinergic herbs and supplements, athletic performance enhancer herbs and supplements, and photosensitizing herbs and supplements.

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.

  1. Bol'shakova, IV, Lozovskaia, EL, and Sapezhinskii, II. [Antioxidant properties of a series of extracts from medicinal plants]. Biofizika 1997;42(2):480-483. View Abstract

  2. Chang, J and Xie, J. [Total synthesis of schizandrin, the main active ingredient isolated from the Chinese herbal medicine fructus schizandrae]. Yao Xue Xue Bao. 1998;33(6):424-428. View Abstract

  3. Chen, J and Tian, G. [Ecological investigation on Schisandra chinensis (Turcz.) Baill. of the Changbai Mountain]. Zhongguo Zhong Yao Za Zhi. 1992;17(4):204-5, 255. View Abstract

  4. Cyong, JC, Ki, SM, Iijima, K, et al. Clinical and pharmacological studies on liver diseases treated with Kampo herbal medicine. Am J Chin Med 2000;28(3-4):351-360. View Abstract

  5. Greenlee, H, Atkinson, C, Stanczyk, FZ, et al. A pilot and feasibility study on the effects of naturopathic botanical and dietary interventions on sex steroid hormone metabolism in premenopausal women. Cancer Epidemiol Biomarkers Prev. 2007;16(8):1601-1609. View Abstract

  6. Iwata, H, Tezuka, Y, Kadota, S, et al. Identification and characterization of potent CYP3A4 inhibitors in Schisandra fruit extract. Drug Metab Dispos. 2004;32(12):1351-1358. View Abstract

  7. Kassler, WJ, Blanc, P, and Greenblatt, R. The use of medicinal herbs by human immunodeficiency virus-infected patients. Arch Intern Med 1991;151(11):2281-2288. View Abstract

  8. Kim, BH, Lee, YS, and Kang, KS. The mechanism of retinol-induced irritation and its application to anti-irritant development. Toxicol Lett. 12-15-2003;146(1):65-73. View Abstract

  9. Li, Y, Xu, C, Zhang, Q, et al. In vitro anti-Helicobacter pylori action of 30 Chinese herbal medicines used to treat ulcer diseases. J Ethnopharmacol. 4-26-2005;98(3):329-333. View Abstract

  10. Melhem, A, Stern, M, Shibolet, O, et al. Treatment of chronic hepatitis C virus infection via antioxidants: results of a phase I clinical trial. J Clin Gastroenterol. 2005;39(8):737-742. View Abstract

  11. Panossian, A and Wikman, G. Pharmacology of Schisandra chinensis Bail.: an overview of Russian research and uses in medicine. J Ethnopharmacol. 7-23-2008;118(2):183-212. View Abstract

  12. Ram, VJ. Herbal preparations as a source of hepatoprotective agents. Drug News Perspect. 2001;14(6):353-363. View Abstract

  13. Wang, K, Tong, YY, and Song, WZ. [Determination of the active ingredients in Chinese drug wuweizi (Schisandra chinensis) by TLC-densitometry]. Yao Xue Xue Bao. 1990;25(1):49-53. View Abstract

  14. Wang, YH, Gao, JP, and Chen, DF. [Determination of lignans of Schisandra medicinal plants by HPLC]. Zhongguo Zhong Yao Za Zhi. 2003;28(12):1155-1160. View Abstract

  15. Xin, HW, Wu, XC, Li, Q, et al. Effects of Schisandra sphenanthera extract on the pharmacokinetics of tacrolimus in healthy volunteers. Br J Clin Pharmacol. 2007;64(4):469-475. View Abstract

Copyright © 2013 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.

Updated:  

March 22, 2017