Rootwork

He Shou Wu

Reynoutria multiflora

PolygonaceaeCentral and southern China, Taiwan, Japan; naturalized across temperate Asia

Description

overall appearance

Twining perennial vine reaching 2–4 m in length, with a tuberous root that can grow very large with age (reputedly centuries old specimens reach several kilograms). Aboveground portions die back in winter; the plant emerges vigorously each spring from the persistent rootstock.

roots

Tuberous, irregularly shaped, brown-skinned root (tuber) with reddish-brown or orange-red interior; starchy and medicinal; roots of older plants may weigh 0.5–2 kg; also fibrous roots extending outward

stem

Twining, branched, reddish-brown to purplish, glabrous (hairless) stem; hollow internodes; tendril-like twining habit allows climbing

leaves

Broadly ovate-cordate (heart-shaped), 4–8 cm long and 3–5 cm wide; pointed apex; smooth surface; reddish petioles 1–3 cm long; alternate arrangement

flowers

Tiny white to greenish-white flowers 2–3 mm; clustered in large axillary and terminal panicles 10–20 cm long; appearing in late summer to autumn

fruits/seeds

Small trigonous (three-angled) achenes 2–3.5 mm long; enclosed in winged persistent tepals forming papery-winged fruits; black when ripe

Active Compounds

Stilbenes: trans-resveratrol, trans-ε-viniferin, piceid (resveratrol-3-O-glucoside)Anthraquinones: emodin, chrysophanol, rhein, physcionStilbene glycosides: 2,3,5,4′-tetrahydroxystilbene-2-O-β-D-glucoside (TSG, primary bioactive)Flavonoids: quercetin, kaempferol, catechinPhospholipids: lecithinTannins: catechins and proanthocyanidinsTocopherols (vitamin E)

Traditional Uses

  • Traditional Chinese Medicine (TCM): tonifies Liver and Kidney yin; used for premature graying of hair and hair loss
  • TCM: anti-aging tonic; associated with longevity in classical texts including Bencao Gangmu (Li Shizhen, 1578)
  • TCM: nourishes blood and essence (jing); used for weakness, dizziness, soreness of lower back and knees
  • TCM: constipation remedy (raw/unprocessed form); anthraquinones exert laxative effect
  • Traditional use for malaria, carbuncles, and scrofula (lymph node TB) in Chinese folk medicine
  • Stems (Yejiaoteng) used as sedative in insomnia and anxiety
  • TCM blood tonic for irregular menstruation, anemia, and postpartum weakness
  • Traditional cardiovascular tonic: reputed to lower cholesterol and strengthen heart in elderly

Modern Applications

  • Neuroprotection: TSG shown to reduce Aβ aggregation and neuroinflammation in Alzheimer's disease models via SIRT1 and NF-κB pathways
  • Lipid-lowering: TSG and emodin shown to reduce LDL and total cholesterol in clinical and animal studies
  • Antioxidant: resveratrol and TSG are potent radical scavengers; extend lifespan in model organisms (C. elegans) via sirtuin activation
  • Hair follicle stimulation: TSG promotes anagen phase in hair cycle; in vitro and in vivo evidence for hair growth promotion
  • Hepatoprotection vs. hepatotoxicity: paradox — prepared root has hepatoprotective effects in some models, yet raw/high-dose preparations are associated with liver toxicity (emodin-mediated)
  • Anti-inflammatory: emodin inhibits COX-2, NF-κB, and TNF-α in multiple inflammatory models
  • Antimicrobial: anthraquinones effective against Staphylococcus aureus, H. pylori, and various fungal pathogens
  • Immunomodulation: polysaccharides and stilbenes modulate macrophage and T-cell activity

⚠️ Safety Information

Contraindications

  • Liver disease or elevated liver enzymes: raw/high-dose preparations linked to drug-induced liver injury (DILI); absolutely contraindicated
  • Diarrhea or loose stools: anthraquinone laxative action; avoid unprocessed form
  • Pregnancy and lactation: insufficient safety data; anthraquinones may stimulate uterine contractions
  • Children under 18: no established safety; hepatotoxicity risk
  • Concurrent use with hepatotoxic drugs: additive liver toxicity risk

Side Effects

  • Drug-induced liver injury (DILI): well-documented; cases of fulminant hepatitis, cholestatic hepatitis; attributed to emodin and immune-mediated reactions
  • Diarrhea, abdominal cramping (especially with raw/unprocessed form due to anthraquinones)
  • Numbness of limbs, hypokalemia with chronic high-dose use
  • Allergic reactions: rash, nausea; immune-mediated hepatotoxicity pattern suggests allergic component

Drug Interactions

  • Hepatotoxic drugs (acetaminophen, statins, isoniazid, methotrexate): additive hepatotoxicity; avoid combination
  • Anticoagulants (warfarin): resveratrol inhibits CYP2C9 and CYP3A4; may increase anticoagulant effect
  • Antidiabetics (insulin, sulfonylureas): may enhance hypoglycemic effects
  • CYP450 substrates: anthraquinones and stilbenes inhibit CYP1A2, CYP2E1; monitor drugs with narrow therapeutic index

Parts Used

  • Tuberous root (processed/prepared — zhì hé shǒu wū)
  • Unprocessed raw root (shēng hé shǒu wū — different activity profile)
  • Stems and leaves (Yejiaoteng; used as sedative)

Preparation Methods

Prepared root powder (zhì hé shǒu wū): 6–15 g/day as decoction; black bean processing reduces anthraquinone toxicity

Standardized extract (TSG 50%): 300–600 mg twice daily

Decoction: 9–15 g processed root simmered 30–45 min in 500 mL water; taken in divided doses

Tincture (1:5, 50% ethanol): 2–4 mL three times daily; use prepared root only

TCM patent formulas (e.g., Shou Wu Pian): per product labeling (typically 3–6 tablets)

Resveratrol-standardized extract: 100–500 mg/day resveratrol equivalent

Related Plants

Yellow Dock

Rumex crispus

Polygonaceae
Constipation and digestive sluggishnessIron deficiency anemiaSkin conditions including eczema and psoriasis

Andrographis

Andrographis paniculata

Acanthaceae
Ayurveda: Kalmegh — liver tonic, bitter digestive, antimalarial, and anti-infective; used in Kalmegh asava and other classical formulasTCM: Chuan Xin Lian — clears heat and toxins; used for upper respiratory infections, sore throat, and dysenteryThai traditional medicine: Fah Talai Jon — treatment of fever, cold, flu, and infections; widely sold as OTC herbal supplement in Thailand

Bhringaraj

Eclipta prostrata

Asteraceae
Ayurveda: primary herb for all hair conditions; stimulates hair growth, prevents premature graying, and strengthens hair follicles; Bhringaraj taila (oil) is cornerstone of Ayurvedic hair careAyurveda: liver tonic and treatment for jaundice, hepatitis, and liver enlargement; classified as hepatoprotective rasayanaTCM: Mo Han Lian — used for liver and kidney yin deficiency causing dizziness, blurred vision, premature graying; hemostatic herb

Codonopsis

Codonopsis pilosula

Campanulaceae
TCM: primary 'poor man's ginseng' tonic for spleen and lung qi deficiency; part of countless classical formulasShen Nong Ben Cao Jing (Divine Farmer's Classic): listed as a superior herb for fatigue, shortness of breath, and loss of appetiteKorean traditional medicine (Hanbang): used interchangeably with Panax ginseng for qi tonification at lower cost

Cordyceps

Cordyceps militaris

Cordycipitaceae
Tibetan medicine (sowa rigpa): Yartsa gunbu (caterpillar fungus) — used for 1,000+ years as prime lung tonic and aphrodisiac; reserved for royalty and the wealthyTCM: Dong Chong Xia Cao — tonifies lung and kidney yang; used for fatigue, impotence, night sweats, chronic cough, and kidney deficiencyAyurvedic adoption (Krimi Kalpa): some Indian traditions adopted cordyceps into their pharmacopeia for respiratory and energy tonic purposes

Gotu Kola

Centella asiatica

Apiaceae
Ayurveda: classified as medhya rasayana; used for improving memory, concentration, and intelligence; central to Brahmi ghrita formula (note: also used interchangeably with Bacopa monnieri as 'Brahmi')Traditional Southeast Asian medicine: wound healing and skin regeneration; leaves applied topically to cuts, burns, and ulcersTCM: Chi Xue Cao — diuretic, anti-inflammatory, detoxifying; used for urinary tract infections and dysentery
Disclaimer: For educational purposes only. This is not medical advice. Always consult a qualified healthcare provider.