He Shou Wu and Liver Toxicity: True or False?

February 1, 2016

A recent death of a college graduate from eastern China after the ingestion of a hair tonic containing He Shou Wu (Polygonum Multiflorum) has justly created headlines. Apparently two Chinese hospitals prescribed and dispensed herbal formulas containing the popular herb for the treatment of premature hair greying and hair loss.

He Shou Wu achieves its desired therapeutic effects by the following actions:

  • It replenishes Jing (Essence) and nourishes the blood of the liver and kidney
  • It eliminates toxins
  • It treats malarial disorders
  • It moistens the intestines and unblocks the bowels
  • It lowers cholesterol and treats cardiovascular disorders


In traditional decoctions the dosage is between 10 and 30g per day. He Shou Wu contains the laxative compound emodin, and a number of derivatives of emodin which can cause loose stools. On the other side, emodin also serves as a liver-protective agent.

However in recent years, some adverse effects on the liver were reported:

2006: Seven reports of suspected adverse reactions associated with He Shou Wu (Polygonum Multiflorum) have been reported to the MHRA through the Yellow Card Scheme. All seven reports are of liver reactions and comprise one report of abnormal liver function, 3 reports of jaundice, 2 reports hepatitis and one report of jaundice and hepatitis. The patients, 5 women and 2 men aged from 36 to 70 years old, were taking He Shou Wu (Polygonum Multiflorum) for hair loss (3 patients had taken the product Shen Min and 3 patients had taken the product Shou Wu Wan).  All patients had recovered or were recovering after stopping He Shou Wu (Polygonum Multiflorum).

Reports of hepatitis associated with He Shou Wu (Polygonum Multiflorum) have also been described in the published literature (1–4).

The UK Health Government issued a warning for He Shou Wu (Polygonum Multiflorum) not to be taken if affected by liver disease.

The next 4 references talk about liver toxicity in relation to a product called ‘Shou Wu Pian’ (which is a proprietary blend of several Chinese herbs with He Shou Wu (Polygonum Multiflorum) being the main ingredient):

  1. Battinelli et al (2004) New case of acute hepatitis following the consumption of Shou Wu Pian, a Chinese Herbal product derived from Polygonum multiflorum. Annals of Internal Medicine 140: E589
  2. But et al (1996) Hepatitis related to the Chinese medicine Shou Wu Pian manufactured from Polygonum multiflorum. Veterinary and Human Toxicology 38: 208-282
  3. Park et al (2001) Acute hepatitis induced by Shou Wu Pian, a herbal product derived from Polygonum multiflorum. Journal of Gastroenterology and Hepatology 16: 115-117.
  4. Panis et al (2005) Recurrent toxic hepatitis in a Caucasian girl related to the use of Shou-Wu-Pian, a Chinese herbal preparation. Journal of Pediatric Gastroenterology and Nutrition 41: 256-258.

Further research on rats concluded that high dosage of the herb had either an injuring effect on normal rats, or a therapeutic effect on the rats with chronic liver injury. Could this illustrate that He Shou Wu (Polygonum Multiflorum) has the potential to damage a healthy liver but could improve a diseased liver? At least in rats.

The news article reporting the death of the student did not reveal if he suffered from a known liver condition. Also, information is available on what the daily dosage was, for how long the formula was administered and what other herbs were part of the prescription.

It’s a tragic outcome for someone young seeking treatment for hair loss to have better chances in his professional endeavors. However, to put the blame on He Shou Wu (Polygonum Multiflorum) alone would be premature and unsolicited.

We still consider He Shou Wu (Polygonum Multiflorum) to be a safe herb to be administered for the desired therapeutic effects and within dosage requirements. Perhaps if there is any suspicion of a potential adverse effect in a small group of susceptible patients for adverse effects with He Shou Wu (Polygonum Multiflorum), it might indicated to monitor blood levels especially in prolonged therapy.




Chinese Medical Herbology and Pharmacology, John K. Chen, Tina T. Chen, Art of Medicine Press

Chinese Herbal Medicine Materia Medica, 3rd Edition, Bensky, Clavey, Stoeger Eastland Press

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