Goreisan (Five Ingredient Powder with Poria)

Goreisan (五苓散) is a traditional Kampo/TCM formula composed of five herbs, typically in the following standard ratio — Takusha (Alisma rhizome) 4-6g, Chorei (Polyporus sclerotium) 3-4.5g, Bukuryo (Poria/Hoelen) 3-4.5g, Byakujutsu (Atractylodes rhizome) 3-4.5g, and Keihi (Cinnamomum cassia bark) 1.5-2g per daily dose. As a medicinal decoction/granule formulation rather than a food, it has negligible macronutrient value (minimal calories, protein, fat, and carbohydrate per therapeutic dose). Key bioactive compounds include: Alisol A and Alisol B monoacetate (triterpenoids from Alisma, ~0.5-2% w/w of crude herb) which inhibit aquaporin-2 expression and exert diuretic and anti-edema effects; Ergosterol and polyporusterone A/B (from Polyporus, ergosterol ~0.3-0.8%) contributing to diuretic and immunomodulatory activity; Pachymic acid and poricoic acid A (triterpenoids from Poria, ~0.5-1.5%) providing diuretic, anti-inflammatory, and mild sedative effects; Atractylenolide I, II, and III (sesquiterpenoids from Atractylodes, ~0.05-0.3%) offering anti-inflammatory, gastroprotective, and aquaporin-regulating properties; Cinnamaldehyde and cinnamic acid (from Cinnamomum bark, cinnamaldehyde ~1-5% of bark) providing vasodilatory, anti-inflammatory, and warming circulatory effects. Mineral content is trace and variable depending on source soil (small amounts of potassium, calcium, magnesium, and zinc from herbal matrix). The formula contains water-soluble polysaccharides (beta-glucans from Poria and Polyporus, estimated 2-5% of those components) which have immunomodulatory bioactivity. No significant vitamins or dietary fiber are delivered at therapeutic doses. Bioavailability notes: Triterpenoids such as pachymic acid and alisol derivatives have moderate oral bioavailability (estimated 20-40%) and are enhanced by the warm decoction preparation method; cinnamaldehyde is rapidly absorbed but undergoes first-pass hepatic metabolism to cinnamic acid; beta-glucans are partially degraded by gut microbiota and exert both local intestinal and systemic immunological effects. The synergistic combination is clinically standardized for aquaporin (AQP) channel regulation, particularly AQP-2 and AQP-4, which underlies the formula's primary mechanism for fluid redistribution rather than simple diuresis.