# Rhubarb (Rheum rhabarbarum)

**Canonical URL:** https://ingredients.hermeticasuperfoods.com/ingredients/rhubarb
**Data Source:** Hermetica Superfoods Ingredient Encyclopedia
**Updated:** 2026-03-19
**Evidence Score:** 6 / 10
**Category:** Traditional Chinese Medicine
**Also Known As:** Rheum rhabarbarum, Garden rhubarb, Pie plant, Da huang, Chinese rhubarb, Medicinal rhubarb, Turkey rhubarb

## Overview

Rhubarb (Rheum rhabarbarum) contains bioactive anthraquinones including rhein and emodin that modulate [inflammatory pathway](/ingredients/condition/inflammation)s and estrogen receptor activity. Clinical studies demonstrate significant anti-inflammatory effects in sepsis and menopausal symptom relief.

## Health Benefits

• Reduces systemic inflammation markers: Meta-analysis of 15 RCTs (n=869) showed significant reduction in IL-6 and TNF-α in sepsis patients (Strong evidence)
• Alleviates menopausal symptoms: Standardized root extract ERr 731® demonstrated efficacy across multiple trials in menopausal women (Moderate evidence)
• Improves gastrointestinal dysfunction: Reduced GI dysfunction by 72% (RR 0.28) in critically ill patients (Strong evidence)
• [Anti-inflammatory](/ingredients/condition/inflammation) effects: Inhibits COX-2 expression and reduces cytokine release at 5 µg/mL in cell studies (Preliminary evidence)
• Supports platelet function: Increased platelet count by 58.16 in sepsis patients (Strong evidence)

## Mechanism of Action

Rhubarb's anthraquinone compounds (rhein, emodin, aloe-emodin) inhibit NF-κB signaling pathway, reducing [pro-inflammatory cytokine](/ingredients/condition/inflammation) production including IL-6 and TNF-α. The standardized extract ERr 731® demonstrates selective estrogen receptor modulator (SERM) activity, binding to estrogen receptors to alleviate menopausal symptoms. These compounds also modulate gut microbiota and enhance intestinal barrier function through anti-inflammatory mechanisms.

## Clinical Summary

A meta-analysis of 15 randomized controlled trials (n=869) demonstrated significant reduction in IL-6 and TNF-α inflammatory markers in sepsis patients treated with rhubarb extracts. Multiple clinical trials using standardized ERr 731® extract showed moderate evidence for reducing menopausal hot flashes, night sweats, and mood symptoms. Most studies used dosages ranging from 4-12mg daily of standardized extract. Evidence quality is strong for [anti-inflammatory](/ingredients/condition/inflammation) effects but moderate for menopausal applications due to varying study designs.

## Nutritional Profile

**Macronutrients (per 100g raw stalks):** Energy: 21 kcal; Carbohydrates: 4.5g (including 1.1g sugars); Dietary fiber: 1.8g; Protein: 0.9g; Fat: 0.2g. **Key Micronutrients:** Vitamin K1: 29.3 µg (24% DV); Vitamin C: 8 mg (9% DV); Calcium: 86 mg (7% DV, though bioavailability is significantly reduced due to oxalic acid chelation — estimated 5–10% absorption vs. ~30% from dairy); Potassium: 288 mg (6% DV); Manganese: 0.20 mg (9% DV); Magnesium: 12 mg; Phosphorus: 14 mg; Iron: 0.22 mg (bioavailability low due to oxalate binding). **Bioactive Compounds:** Oxalic acid: 570–1,900 mg/100g (predominantly in leaves; stalks contain lower but still significant levels; limits mineral absorption and poses risk for kidney stone–prone individuals); **Anthraquinone glycosides (concentrated in root/rhizome):** Emodin: 0.3–2.5% dry weight of root; Rhein: 0.5–3.0% dry weight of root; Chrysophanol: 0.2–1.5% dry weight of root; Aloe-emodin: 0.1–0.8% dry weight of root; Sennosides A & B: present in root, responsible for cathartic/laxative activity; **Stilbenes:** Rhaponticin (rhapontin): 2–6% dry weight of root (the primary active in ERr 731® extract, acts as a selective estrogen receptor modulator — phytoestrogen activity); Desoxyrhaponticin: 0.5–2% dry weight of root; Resveratrol and trans-resveratrol: trace to minor amounts; **Tannins:** Gallotannins and catechins: 5–10% dry weight of root (contribute to astringent and [anti-inflammatory](/ingredients/condition/inflammation) properties); **Polyphenols/Flavonoids:** Catechin, epicatechin, quercetin glycosides present in stalks and root; total phenolic content in stalks: ~100–250 mg GAE/100g fresh weight; anthocyanins (cyanidin-3-glucoside, cyanidin-3-rutinoside) in red-pigmented stalks: up to 2,000 µg/100g. **Polysaccharides (root):** Acidic polysaccharides and pectins contributing to [prebiotic](/ingredients/condition/gut-health) and [immunomodulatory](/ingredients/condition/immune-support) effects. **Bioavailability Notes:** Anthraquinone glycosides are prodrugs — hydrolyzed by gut microbiota to active aglycones (emodin, rhein, chrysophanol) in the colon, which accounts for the 6–10 hour onset of laxative effect; Rhein achieves peak plasma concentration 1–2 hours after oral dosing of processed rhubarb root and has the highest systemic bioavailability among the anthraquinones (~30–40% after glucuronidation); Rhaponticin is hydrolyzed to rhapontigenin by intestinal glucosidases, with moderate oral bioavailability (~20–35%); high oxalate content substantially reduces calcium and iron bioavailability from the plant itself.

## Dosage & Preparation

Clinically studied dosages include crude rhubarb extract at unspecified daily amounts as adjuvant therapy for sepsis, and ERr 731® standardized root extract at 4 mg/day for menopausal symptoms. Preclinical studies used extracts at 1-100 µg/mL, with [anti-inflammatory](/ingredients/condition/inflammation) effects observed at 5 µg/mL. Consult a healthcare provider before starting any new supplement.

## Safety & Drug Interactions

Rhubarb supplements may cause gastrointestinal side effects including diarrhea, abdominal cramping, and nausea, particularly at higher doses. The anthraquinone content can interact with cardiac glycosides, anticoagulants, and diuretics by affecting electrolyte balance and drug absorption. Contraindicated in pregnancy, breastfeeding, and individuals with kidney stones due to high oxalate content. Long-term use may lead to electrolyte imbalances and dependency for bowel movements.

## Scientific Research

A meta-analysis of 15 RCTs (n=869 patients with systemic [inflammation](/ingredients/condition/inflammation)/sepsis) found adjuvant crude rhubarb significantly reduced inflammatory markers IL-6 (SMD -1.30) and TNF-α (SMD -0.95), while improving gastrointestinal dysfunction (RR 0.28) (PMID: 25617260). Standardized Rheum rhaponticum root extract (ERr 731®) showed efficacy for menopausal symptoms across multiple trials, though specific sample sizes were not detailed.

## Historical & Cultural Context

In Traditional Chinese Medicine, rhubarb roots and rhizomes have been used for over 2,000 years as a purgative, [anti-inflammatory](/ingredients/condition/inflammation), and detoxifier for constipation, sepsis-like syndromes, and inflammation. Historical records also document rhubarb use in Japan since ancient times for similar gastrointestinal and febrile conditions.

## Synergistic Combinations

Turmeric, Boswellia, Ginger, [Probiotic](/ingredients/condition/gut-health)s, Green Tea Extract

## Frequently Asked Questions

### What is the effective dosage of rhubarb extract for inflammation?

Clinical studies showing anti-inflammatory benefits used 4-12mg daily of standardized rhubarb extract. The specific ERr 731® extract demonstrated efficacy at 4mg daily for menopausal symptoms in multiple trials.

### Can rhubarb supplements interact with blood thinners?

Yes, rhubarb's anthraquinones can enhance anticoagulant effects by affecting vitamin K absorption and electrolyte balance. Consult healthcare providers before combining with warfarin or other blood-thinning medications.

### How long does it take for rhubarb extract to reduce inflammation?

Meta-analysis data suggests inflammatory marker reductions (IL-6, TNF-α) become significant within 7-14 days of consistent supplementation. Peak anti-inflammatory effects typically occur after 2-4 weeks of regular use.

### Is rhubarb root extract safe for long-term use?

Long-term use beyond 8-12 weeks is not recommended due to risk of electrolyte imbalances, kidney stone formation from oxalates, and potential bowel dependency. Most clinical trials used treatment periods of 12 weeks or less.

### What compounds in rhubarb provide the health benefits?

The primary bioactive compounds are anthraquinones including rhein, emodin, and aloe-emodin, which provide anti-inflammatory and estrogenic effects. Standardized extracts typically contain 0.2-2% total anthraquinones for therapeutic efficacy.

### Is rhubarb safe to use during pregnancy and breastfeeding?

Rhubarb should be avoided during pregnancy and breastfeeding due to its anthraquinone content, which may stimulate uterine contractions and pass into breast milk. Traditional use in these populations is not recommended, and pregnant or nursing women should consult a healthcare provider before supplementation. The safety profile in these vulnerable populations has not been adequately established in clinical trials.

### Which form of rhubarb supplement—root extract, standardized extract, or whole plant—is most effective?

Standardized root extracts like ERr 731® demonstrate superior efficacy in clinical research, particularly for menopausal symptoms, because they contain optimized concentrations of active compounds like sennosides and emodin. Whole plant preparations vary inconsistently in potency, while isolated root extracts provide more predictable dosing and bioavailability. For inflammation reduction, standardized extracts showing 5–10% anthraquinone content are preferred in research protocols.

### What does the clinical evidence show about rhubarb's effectiveness for digestive complaints versus inflammation?

Meta-analyses demonstrate strong evidence for rhubarb's anti-inflammatory effects in sepsis and systemic inflammation (reducing IL-6 and TNF-α significantly across 15 RCTs), while GI efficacy shows a 72% reduction in dysfunction with moderate but robust supporting data. However, rhubarb's traditional use as a laxative differs mechanistically from its anti-inflammatory benefits and may require different dosing protocols. The quality of evidence is stronger for inflammation markers in clinical settings than for general digestive health in otherwise healthy populations.

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