# Ho Shou Wu (Polygonum multiflorum)

**Canonical URL:** https://ingredients.hermeticasuperfoods.com/ingredients/ho-shou-wu
**Data Source:** Hermetica Superfoods Ingredient Encyclopedia
**Updated:** 2026-04-01
**Evidence Score:** 2 / 10
**Category:** Traditional Chinese Medicine
**Also Known As:** Polygonum multiflorum, Fallopia multiflora, Chinese Knotweed, Fleeceflower Root, Climbing Knotweed, Zhi Shou Wu, Sheng Shou Wu, Chinese Cornbind, Tuber Fleeceflower, Reynoutria multiflora, Fo-Ti

## Overview

Ho Shou Wu (Polygonum multiflorum) is a Traditional Chinese Medicine root whose primary bioactive compound, stilbene glycoside (2,3,5,4'-tetrahydroxystilbene-2-O-β-D-glucoside, or THSG), drives its [antioxidant](/ingredients/condition/antioxidant) and [neuroprotective](/ingredients/condition/cognitive) properties. Emodin and other anthraquinones in the root modulate [inflammatory](/ingredients/condition/inflammation) signaling pathways, including NF-κB inhibition, and contribute to its historically claimed [anti-aging](/ingredients/condition/longevity) effects.

## Health Benefits

• May provide [antioxidant](/ingredients/condition/antioxidant) and [anti-inflammatory](/ingredients/condition/inflammation) effects (preclinical evidence) • Traditionally used for [anti-aging](/ingredients/condition/longevity) and improving hair health (historical use) • Potential [neuroprotective](/ingredients/condition/cognitive) actions (preclinical evidence) • Contains compounds known for [hepatoprotective](/ingredients/condition/detox) effects (preclinical evidence, contradictory due to hepatotoxicity) • Used to promote wound healing (traditional use)

## Mechanism of Action

The primary bioactive stilbene glycoside THSG activates the Nrf2/ARE pathway, upregulating endogenous antioxidant enzymes such as superoxide dismutase (SOD) and catalase to reduce [oxidative stress](/ingredients/condition/antioxidant). Emodin, an anthraquinone, inhibits NF-κB nuclear translocation, suppressing [pro-inflammatory cytokine](/ingredients/condition/inflammation)s including TNF-α and IL-6. Additionally, THSG has demonstrated inhibition of monoamine oxidase B (MAO-B) and acetylcholinesterase in preclinical models, which may underlie reported [neuroprotective](/ingredients/condition/cognitive) and cognitive effects.

## Clinical Summary

The majority of evidence supporting Ho Shou Wu is preclinical, derived from in vitro cell studies and rodent models rather than robust human clinical trials. A small number of human studies and case reports exist, primarily focused on liver toxicity rather than efficacy outcomes, limiting quantifiable benefit data. One small Chinese clinical study suggested improvements in lipid profiles (LDL reduction) with processed He Shou Wu extract at doses of 10–20 g/day, but sample sizes were under 100 participants and methodological rigor was limited. Overall, evidence strength is currently insufficient to make definitive efficacy claims in humans, and regulatory bodies including the WHO have flagged the need for controlled trials.

## Nutritional Profile

{"macronutrients": {"protein": "Approximately 1.5 grams per 100 grams", "fiber": "Approximately 2.0 grams per 100 grams"}, "micronutrients": {"iron": "Approximately 1.2 mg per 100 grams", "zinc": "Approximately 0.6 mg per 100 grams"}, "bioactive_compounds": {"emodin": "Approximately 1.1 mg per 100 grams", "chrysophanol": "Approximately 0.8 mg per 100 grams", "resveratrol": "Approximately 0.5 mg per 100 grams"}, "bioavailability_notes": "The bioavailability of these compounds can vary based on preparation methods and individual [digestive health](/ingredients/condition/gut-health). Emodin and chrysophanol are known for their laxative effects, which may influence absorption rates of other nutrients."}

## Dosage & Preparation

No clinically studied dosage ranges are available. Traditional uses include Shou Wu Pian at 2 tablets/day, which has been linked to liver injury. Consult a healthcare provider before starting any new supplement.

## Safety & Drug Interactions

Ho Shou Wu is associated with clinically documented hepatotoxicity, with over 400 case reports worldwide linking raw or processed root preparations to acute liver injury, including fulminant hepatic failure requiring transplant in rare cases. The processed form (Zhi He Shou Wu) is considered safer than the raw root, but neither is free of hepatotoxic risk, particularly with doses exceeding 15 g/day or prolonged use beyond 12 weeks. It may interact with hepatotoxic drugs (e.g., statins, acetaminophen), anticoagulants, and medications metabolized by CYP3A4 and CYP2C9 enzymes due to emodin's inhibitory effects on these pathways. Ho Shou Wu is contraindicated in pregnancy, active liver disease, and in individuals with a history of drug-induced liver injury.

## Scientific Research

There is a lack of specific human clinical trials or meta-analyses on Ho Shou Wu's efficacy. The referenced review (PMID: 27484243) discusses its [hepatoprotective](/ingredients/condition/detox) and hepatotoxic potential, but human trial specifics are missing.

## Historical & Cultural Context

In Traditional Chinese Medicine, Ho Shou Wu has been used for centuries to address hair loss, aging, and other age-related conditions. It is listed in the Chinese Pharmacopoeia and is a staple in TCM practices, with both raw and processed forms offering different benefits.

## Synergistic Combinations

Black soybeans, ginseng, gotu kola, licorice, reishi

## Frequently Asked Questions

### Can Ho Shou Wu reverse gray hair?

Traditional Chinese Medicine has used Ho Shou Wu for centuries to restore hair pigmentation, but modern clinical evidence is lacking. Preclinical studies suggest THSG may stimulate melanocyte proliferation and tyrosinase activity in hair follicles in rodent models, but no peer-reviewed randomized controlled trials in humans confirm this effect. It should be considered unproven for gray hair reversal based on current evidence.

### What is the recommended dosage of Ho Shou Wu supplement?

Traditional Chinese Medicine typically uses 9–15 g/day of the dried, processed root (Zhi He Shou Wu) in decoction form. Standardized extracts used in modern supplements often range from 500–1,000 mg/day, though no universally agreed therapeutic dose exists for specific health outcomes. Given hepatotoxicity risk, many practitioners recommend limiting use to no more than 12 consecutive weeks and consulting a healthcare provider before use.

### Is Ho Shou Wu safe for the liver?

Ho Shou Wu carries a well-documented risk of hepatotoxicity, with over 400 published case reports of liver injury attributed to its use, ranging from mild transaminase elevation to acute liver failure. The toxic mechanism is thought to involve reactive oxygen species generation by emodin and stilbene glycosides in susceptible individuals, possibly via idiosyncratic immune-mediated reactions. Individuals with pre-existing liver conditions, those taking other hepatotoxic medications, or those with CYP enzyme polymorphisms appear to be at highest risk.

### What is the difference between raw and processed Ho Shou Wu?

Raw He Shou Wu (Sheng He Shou Wu) contains higher concentrations of free anthraquinones, including emodin and physcion, which are associated with laxative effects and greater hepatotoxicity risk. Processed He Shou Wu (Zhi He Shou Wu) is prepared by steaming the root with black soybean juice, which reduces free anthraquinone content and is considered less toxic while retaining more of the tonic THSG stilbene glycosides. Despite reduced risk, processed forms are still linked to liver injury cases and are not considered fully safe for unmonitored long-term use.

### Does Ho Shou Wu interact with any medications?

Ho Shou Wu can inhibit cytochrome P450 enzymes CYP3A4 and CYP2C9, potentially increasing plasma concentrations of drugs metabolized by these pathways, including warfarin, statins, and certain antiepileptics. Its emodin content may potentiate the effects of anticoagulants and anti-platelet drugs, raising bleeding risk. Co-administration with other hepatotoxic drugs such as acetaminophen, methotrexate, or isoniazid should be strictly avoided due to compounded liver injury risk.

### Who should avoid taking Ho Shou Wu supplements?

People with existing liver disease or elevated liver enzymes should avoid Ho Shou Wu due to reported cases of hepatotoxicity, particularly with unprocessed forms. Pregnant and breastfeeding women should consult healthcare providers before use, as safety data in these populations is limited. Those with diarrhea or weak digestive systems may experience gastrointestinal upset, as Ho Shou Wu can have mild laxative properties.

### What does current research show about Ho Shou Wu's anti-aging effects?

While Ho Shou Wu has been used in traditional Chinese medicine for centuries to support longevity, most clinical evidence is preclinical or observational rather than from rigorous human trials. Available research suggests potential antioxidant and anti-inflammatory properties that may support cellular health, but these effects have not been definitively proven in humans. More robust clinical studies are needed to validate traditional claims about hair pigmentation reversal and overall anti-aging benefits.

### How does Ho Shou Wu support skin and wound healing?

Traditional use suggests Ho Shou Wu promotes wound healing through its antioxidant and anti-inflammatory compounds, though clinical evidence in humans remains limited. The herb's potential to support collagen integrity and reduce oxidative stress theoretically benefits skin regeneration and healing processes. Most evidence for these benefits comes from laboratory studies and traditional applications rather than controlled human clinical trials.

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