White Peony Root

Paeonia lactiflora

PaeoniaceaeNortheast China (Manchuria), Siberia, Mongolia, Korea, and Japan; primarily distributed in temperate grasslands and forest edges of the Asian continent

Description

overall appearance

A bushy herbaceous perennial 45–90 cm tall with large, showy flowers (white to deep pink to red) and compound leaves; the medicinal root (Bai Shao) is the peeled, parboiled root of the white-flowered garden peony, while Red Peony (Chi Shao) is the unprocessed root — both from the same species but used differently in TCM.

roots

Thick, fleshy, cylindrical tuberous roots 8–20 cm long, 1–4 cm thick; outer skin removed and roots boiled then dried for Bai Shao (white peony); pale, yellowish-white after processing; pungent and slightly bitter taste

stem

Erect, branched, glabrous or slightly hairy; 45–90 cm; green to reddish at base; dies back to ground each winter

leaves

Alternate, biternate or triternate compound; leaflets 3–9 cm; elliptic-lanceolate; dark glossy green above, pale and glabrous below; petiolate with stipules; form elegant foliage mound before flowering

flowers

Large, 8–14 cm diameter; single to double; white, pink, red, or varicolored; 5–10 petals in single forms, many more in double cultivars; numerous yellow stamens; fragrant; bloom in late spring to early summer

fruits/seeds

Star-shaped cluster of 2–5 leathery follicles, each 2–4 cm; containing 3–5 large, round, glossy black-blue seeds 8–12 mm

Active Compounds

Paeoniflorin — monoterpene glycoside; major active compound (3–6% of dried root); anti-inflammatory, antispasmodic, neuroprotective, analgesicAlbiflorin — paeoniflorin isomer with distinct pharmacology; sedative and analgesic propertiesOxypaeoniflorin, benzoylpaeoniflorin — paeoniflorin derivatives with biological activityPaeonol (from root bark; more concentrated in Cortex Moutan — tree peony bark)Gallic acid and pentagalloylglucose — hydrolyzable tannins with astringent and antioxidant activityBeta-sitosterol, daucosterol — phytosterolsBenzoic acid and parabens (methyl, ethyl esters in the root)Sucrose, glucose, and polysaccharides (arabino-galactans) contributing to tonic properties

Traditional Uses

Traditional Chinese medicine: 'Bai Shao' — one of the most widely used herbs; nourishes Liver blood, softens and soothes the Liver, relieves pain; used for dysmenorrhea, muscle cramping, and chronic fatigue from blood deficiency
Classical formula Gui Zhi Fu Ling Wan: Peony combined with cinnamon, poria, peach seed, and tree peony for gynecological blood stasis conditions
Si Wu Tang (Four Substance Decoction): Bai Shao + Rehmannia + Angelica + Ligusticum — foundational TCM blood tonic formula used for over 1,000 years
Shao Yao Gan Cao Tang: Bai Shao + Licorice for muscle spasm, abdominal cramping, and leg cramps — clinically validated formula
Japanese Kampo: Shakuyaku-kanzo-to formula for muscle cramps, dysmenorrhea, and spasticity — used in clinical medicine in Japan
Korean traditional medicine: used for headache, dizziness, and reproductive disorders in women
Traditional Chinese pediatric use: combined with other herbs for childhood convulsions and febrile seizures
Chinese post-partum care: standard blood-nourishing tonic for women after childbirth to replenish blood and prevent complications

Modern Applications

Muscle spasm and pain relief: paeoniflorin inhibits neuromuscular transmission and reduces intracellular calcium; clinically effective in dysmenorrhea and muscle cramps (Shakuyaku-kanzo-to RCTs)
Neurological: paeoniflorin shows neuroprotective effects and is studied for Parkinson's disease, epilepsy, and Alzheimer's in animal models
Autoimmune and inflammatory diseases: suppresses Th17 cells and promotes Tregs; clinical use in RA, SLE, and inflammatory bowel disease in China
Antidiabetic: paeoniflorin improves insulin sensitivity and reduces blood glucose via AMPK and other pathways
Hepatoprotective: galloylated paeoniflorin protects against liver fibrosis and drug-induced hepatotoxicity in animal studies
Antidepressant: paeoniflorin modulates serotonin and dopamine systems; synergistic with SSRIs in animal studies
Cardiovascular: paeoniflorin reduces platelet aggregation, improves microcirculation, and has cardioprotective effects
Menopausal symptoms: Bai Shao formulas studied for reducing hot flashes and improving bone density in post-menopausal women

⚠️ Safety Information

Contraindications

Diarrhea from cold-deficiency patterns (TCM): contraindicated in patients with loose stools from cold and weak digestion per TCM theory
Concurrent use with veratrum alkaloids (Veratrum species): classical TCM incompatibility ('18 incompatibilities' — Bai Shao incompatible with Li Lu)
Pregnancy at high doses: may promote uterine activity; traditional TCM formulas used carefully in pregnancy by qualified practitioners only
Hypotension: paeoniflorin may lower blood pressure additively
Hypersensitivity to Paeoniaceae family

Side Effects

Gastrointestinal: diarrhea, abdominal pain, and nausea at high doses (>15 g daily)
Hepatotoxicity: rare cases of drug-induced liver injury reported with Chinese herbal formulas containing Bai Shao
Hypotension and dizziness in sensitive individuals
Allergic skin reactions occasionally reported
Drug interactions via CYP enzyme modulation at high doses

Drug Interactions

Anticoagulants (warfarin, aspirin): antiplatelet effects of paeoniflorin may increase bleeding risk
CNS depressants (benzodiazepines, opioids): paeoniflorin may potentiate CNS depression
Antihypertensives: additive blood pressure lowering
Antidiabetics (insulin, metformin): additive hypoglycemic potential
Methotrexate and immunosuppressants: paeoniflorin has immunomodulatory effects; potential interaction in autoimmune patients

Parts Used

Processed root (Bai Shao — peeled, boiled): primary blood-nourishing and spasmolytic applications
Unprocessed root (Chi Shao — red peony, raw): blood-moving and anti-inflammatory applications
Root extract standardized to paeoniflorin

Preparation Methods

TCM decoction: 6–15 g dried Bai Shao in 500 ml water, decocted 30–40 minutes; strain and drink in 2–3 doses daily

Standardized extract: 200–400 mg paeoniflorin equivalent, 2–3× daily

Si Wu Tang granules: traditional four-herb blood formula; follow package directions (typically 3–6 g granules twice daily)

Shakuyaku-kanzo-to (Shao Yao Gan Cao Tang): 6 g peony root + 6 g licorice root, standard Japanese Kampo formula; commercially available in granule form

Bai Shao tincture (1:5 in 50% ethanol): 3–5 ml, 2–3× daily

Peony root powder capsules: 500 mg, 3–4 capsules daily as tonic