Eden Apothecary · Herb Profile
Polygonum multiflorum
Also known as He Shou Wu
Pronounced Fo-Ti: FOH-tee. He Shou Wu: huh-show-WOO. Latin: puh-LIG-oh-num mul-tih-FLOR-um.
A warm, moist, sweet-bitter-astringent tonic that rebuilds Liver Blood and Kidney essence and blackens the hair, restoring the depleted and aging body, yet cloying to damp constitutions and shadowed by a real risk of idiosyncratic liver injury.
Avoid. Safety in pregnancy has not been established and reliable human data are lacking; NCCIH and the Natural Medicines database rate Fo-Ti as likely unsafe or insufficiently studied in pregnancy. Concerns include documented idiosyncratic maternal hepatotoxicity, animal signals of embryotoxicity, and the stimulant-laxative anthraquinones of the raw root with theoretical reflex uterine and bowel stimulation. Do not use. Source: NCCIH; Natural Medicines Comprehensive Database; Brinker, Herb Contraindications and Drug Interactions (3rd ed.).
Avoid. There are no adequate data on the safety of Fo-Ti during lactation. Anthraquinone metabolites of the raw root can pass into breast milk and may cause loose stools in the nursing infant, and the risk of maternal liver injury argues against use. Prefer better-characterized alternatives. Source: NCCIH; Natural Medicines; general anthraquinone-laxative guidance in NIH LactMed.
Not recommended. Fo-Ti is not appropriate for infants or children outside professional supervision because of the risk of idiosyncratic liver injury and the laxative effect of the raw-root anthraquinones. Pediatric safety data are insufficient. Source: NCCIH; Natural Medicines; NIH LiverTox (2020).
The headline caution is idiosyncratic, immune-mediated hepatotoxicity. Polygonum multiflorum is one of the most frequently reported causes of herb-induced liver injury, presenting as acute hepatitis with fatigue, nausea, right upper quadrant pain, dark urine, and jaundice, usually within days to a few months of starting. Up to about 10 percent of clinically apparent cases have been fatal or required liver transplant, and the HLA-B*35:01 allele is a major genetic risk factor. The injury is not clearly dose-dependent and can occur idiosyncratically, though the raw (unprocessed) root carries a higher anthraquinone load and greater risk than the black-soybean-prepared root. This is not an herb for casual self-dosing: use only the correctly prepared form, keep courses time-limited, and monitor liver function. The raw root and higher doses also loosen the stool through anthraquinones such as emodin.
Pre-existing liver disease, hepatitis, or elevated liver enzymes; concurrent use of other hepatotoxic drugs or herbs; loose stools, diarrhea, or Spleen-damp digestive weakness; pregnancy and lactation (see safety fields); infants and young children except under professional supervision; a known prior reaction to Polygonum multiflorum (never rechallenge). Discontinue immediately at any sign of liver injury.
Commercial supply is overwhelmingly cultivated in China (Guizhou, Sichuan, Guangdong, Hubei, and neighboring provinces), so pressure on wild stands is limited, and it is not a United Plant Savers at-risk species (it is not native to North America). Prefer cultivated, properly black-soybean-prepared root from reputable suppliers who verify botanical identity and screen for the hepatotoxic raw-anthraquinone load.
Not in canonical biblical texts; native to central and southern China and cultivated across East Asia. Its use is rooted in Tang-dynasty China (the legend of Mr. He, traditionally dated to the 9th century) and codified in Li Shizhen's Ben Cao Gang Mu (1596).
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