What is Fo-Ti?
Fo-Ti, scientifically known as Polygonum multiflorum or Fallopia multiflora, is a traditional Chinese medicinal herb derived from a climbing vine native to China, Japan, and Taiwan. In Traditional Chinese Medicine (TCM), it's called "He Shou Wu," which translates to "black haired Mr. He," named after a legendary figure who allegedly restored his youth, virility, and black hair by taking this herb.
The herb exists in two primary forms:
Raw Fo-Ti (White Fo-Ti/Sheng He Shou Wu): Unprocessed dried root with laxative properties and different medicinal applications.
Processed Fo-Ti (Red Fo-Ti/Zhi He Shou Wu): Root traditionally prepared by steaming or boiling in black soybean juice, which changes its chemical composition and reduces toxicity while enhancing tonic properties.
Primary Functions & Traditional Uses
Traditional Functions in TCM:
Nourishes Blood: Supports blood quality and circulation
Tonifies Liver and Kidneys: Strengthens these organ systems
Promotes Longevity: Used as an anti-aging tonic
Nourishes Jing (Essence): Supports vitality and reproductive health
Calms the Spirit: Promotes mental clarity and restful sleep
Health Claims & Potential Benefits:
Prevents premature graying and promotes hair growth
Supports hair pigmentation and melanin synthesis
Improves skin health and treats skin conditions
Relieves constipation (raw form)
May support cardiovascular health
May enhance immune function
May improve cognitive function and memory
May help manage blood sugar levels
May support liver and kidney function
IMPORTANT NOTE: Most benefits are based on traditional use, animal studies, or limited human research. High quality clinical trials in humans are lacking for most claimed benefits.
Recommended Dosages
Traditional Dosages:
Raw Herb: 9 to 15 grams daily
Chinese Pharmacopoeia Standard: 3 to 12 grams per day
Processed (Cured) Form: 3 grams three times daily
Capsule/Extract Form: Follow manufacturer instructions
Important Dosage Considerations:
No standardized safe dosage has been clinically established
Higher doses (>12 grams daily) may increase liver injury risk
Duration matters: Long term use at high doses increases risk
Processed form is generally considered safer than raw
Always start with lower doses and increase gradually
Food Sources
Fo-Ti is not a food source in the traditional sense. It is exclusively used as a medicinal herb and is not consumed as part of a regular diet. The root must be harvested from 3- to 4-year-old plants and properly prepared before use.
Supplement Forms & Preparations
Available Forms:
Raw Dried Root: Used for laxative effects or external applications
Processed/Cured Root: Prepared with black soybean juice
Capsules/Tablets: Standardized extracts
Powder: Can be added to water, tea, or smoothies
Tea: Dried root steeped in hot water
Tincture/Liquid Extract: Alcohol or glycerin-based extracts
Wine Preparations: Traditional preparation method
Topical Products: Hair and skin care formulations
Processing Methods:
The traditional processing involves steaming or boiling the raw root in black soybean juice for several hours (sometimes up to 3 days) and then drying. This process:
Reduces harsh laxative compounds
Decreases potential liver toxicity
Enhances tonic properties
Changes the chemical composition
Makes it more suitable for long term use
Timing & Administration
Best Time to Take:
Morning or Evening: No specific time advantage
With Meals: Recommended to reduce digestive upset
Consistency: Regular daily use traditionally recommended for tonic effects
How to Take:
With food to minimize stomach discomfort
With water or warm liquid
Can be divided into 2 to 3 doses throughout the day
For laxative effects (raw form): Short term use only (2 to 3 days)
Synergistic Herbs & Supplements
Traditional Combinations in TCM Formulas:
Rehmannia (Shu Di Huang): Blood nourishing combination
Angelica/Tang Kuei (Dang Gui): Enhanced blood tonic effects
Ginseng: Improved cognitive and energy effects
Lycium/Goji Berry (Gou Qi Zi): Kidney and liver support
Ligustrum (Nu Zhen Zi): Complementary kidney tonic
Salvia (Dan Shen): Blood circulation support
Compatible Supplements:
Antioxidants (Vitamin C, Vitamin E)
B Complex vitamins
Minerals (Zinc, Iron for blood support)
What NOT to Take With Fo-Ti
Medications With Serious Interactions:
Hepatotoxic Drugs (Avoid Completely): Any medication that can harm the liver increases risk of liver damage when combined with Fo-Ti.
Warfarin (Coumadin): Fo-Ti may increase bleeding risk and enhance warfarin's effects. Avoid combination.
Diabetes Medications: Fo-Ti may lower blood sugar, potentially causing hypoglycemia when combined with:
Glimepiride (Amaryl)
Glyburide (DiaBeta, Micronase)
Insulin
Pioglitazone (Actos)
Other antidiabetic drugs
Diuretics/Water Pills: May cause excessive potassium loss when combined with:
Furosemide (Lasix)
Hydrochlorothiazide (HCTZ)
Chlorothiazide
Other diuretics
Stimulant Laxatives: Additive laxative effects may cause severe diarrhea and electrolyte imbalances.
Cytochrome P450 3A4 Substrates: Fo-Ti may slow liver breakdown of medications including:
Statins (lovastatin, atorvastatin)
Ketoconazole
Itraconazole
Triazolam
Fexofenadine
Many others
Other Medications to Use With Caution:
Digoxin
Elavil (Amitriptyline)
Haldol (Haloperidol)
Inderal (Propranolol)
Theophylline
Prilosec (Omeprazole)
Prevacid (Lansoprazole)
Valium (Diazepam)
Immunosuppressants
Antiretrovirals
Some antidepressants
Who Should Take Fo-Ti
Ideal Candidates (Under Medical Supervision):
Individuals experiencing premature graying
Those with thinning hair or hair loss
People seeking traditional anti-aging support
Individuals with constipation (raw form, short term only)
Those with skin conditions (topical use)
People interested in traditional longevity practices
Individuals with adequate liver function
Those under care of a TCM practitioner
Important Caveat:
Due to lack of clinical evidence and safety concerns, Fo-Ti should only be used under professional guidance, particularly from practitioners trained in Traditional Chinese Medicine.
Who Should AVOID Fo-Ti
Absolute Contraindications:
Liver Disease: Anyone with existing liver problems, liver damage, or liver dysfunction must avoid Fo-Ti completely.
Pregnancy: Possibly unsafe due to embryonic toxicity in animal studies. Laxative effects could stimulate uterine contractions.
Breastfeeding: Laxative compounds pass into breast milk and may cause infant diarrhea.
Children Under 5: Safety not established in young children.
Scheduled Surgery: Discontinue at least 2 weeks before surgery due to blood sugar and bleeding concerns.
Use With Extreme Caution:
Heavy alcohol users (increased liver toxicity risk)
People taking multiple medications
Those with kidney disease
Individuals with blood clotting disorders
People with diabetes (monitor blood sugar closely)
Anyone with history of liver sensitivity
Those planning to use long term or at high doses
Deficiency This Herb Addresses (TCM Perspective)
In Traditional Chinese Medicine, Fo-Ti is used for specific deficiency patterns:
Primary Deficiencies Treated:
Liver and Kidney Yin Deficiency: Symptoms include premature graying, dizziness, blurred vision, weak knees and lower back
Blood Deficiency: Manifests as pale complexion, fatigue, insomnia, palpitations
Jing (Essence) Deficiency: Shows as premature aging, weak bones, reproductive issues, decreased vitality
Signs That May Indicate These Deficiencies:
Premature graying of hair
Hair loss or thinning
Dizziness or vertigo
Lower back weakness or pain
Knee weakness
Insomnia or restless sleep
Poor memory
Premature aging signs
Decreased sexual vitality
Chronic constipation
Dry, lackluster skin
Note: These are TCM diagnostic concepts that differ from Western medical diagnoses. Consult a qualified TCM practitioner for proper assessment.
Side Effects & Toxicity
Common Side Effects:
Diarrhea (especially with raw form)
Nausea
Abdominal pain and cramping
Stomach discomfort
Vomiting
Dehydration (from diarrhea)
Skin rash (in sensitive individuals)
Numbness in arms or legs (>15 grams processed form)
Serious Adverse Effects:
Liver Toxicity (Hepatotoxicity): The most serious concern with Fo-Ti
Symptoms of Liver Damage:
Jaundice (yellowing of skin and eyes)
Dark urine
Severe fatigue
Abdominal pain in upper right quadrant
Loss of appetite
Elevated liver enzymes (ALT, AST)
Risk Factors for Liver Injury:
Higher doses (>12 grams daily)
Longer duration of use (>30 to 60 days)
Using raw vs. processed form
Preexisting liver conditions
Concurrent use of hepatotoxic medications
Individual genetic susceptibility
Documented Cases: Over 25 cases of hepatitis reported, including severe cases requiring hospitalization and rare cases resulting in chronic liver disease or death.
Other Potential Toxicities:
Kidney toxicity (nephrotoxicity)
Nerve toxicity (neurotoxicity)
Embryo toxicity (in animal studies)
Mutagenicity (damage to genetic material)
Agranulocytosis (severe drop in white blood cells, very rare)
Recovery:
Most people recover from liver injury with treatment after discontinuing Fo-Ti, but some cases have resulted in permanent liver damage. Rechallenge (retaking after recovery) commonly causes recurrence and should be avoided.
Special Considerations
Quality & Safety Concerns:
Contamination Issues: Asian herbal products have been found to contain:
Unlisted toxic ingredients
Heavy metals
Pesticides
Adulteration with pharmaceutical drugs
Product Selection:
Choose processed (red) Fo-Ti over raw for general use
Look for third party tested products
Verify proper botanical name (Polygonum multiflorum)
Purchase from reputable suppliers
Ensure traditional processing methods were used
Monitoring Recommendations:
If using Fo-Ti (under medical supervision):
Baseline liver function tests before starting
Regular liver enzyme monitoring during use
Discontinue immediately if symptoms of liver injury appear
Monitor blood sugar if diabetic
Watch for signs of bleeding if on anticoagulants
Duration of Use:
Raw Form: 2 to 3 days maximum for laxative effects
Processed Form: Traditional use suggests long term is acceptable, but modern safety data recommends:
Avoid prolonged use without medical supervision
Take periodic breaks
Use minimum effective dose
Regular monitoring if using >30 days
Processing Matters:
Processed Fo-Ti is generally considered safer because:
Lower levels of toxic anthraquinones (emodin, physcion)
Higher levels of beneficial compounds
Reduced laxative effects
Better suited for tonic use
Less harsh on digestive system
However, even processed Fo-Ti carries liver toxicity risk.
Research Limitations
Current Evidence Status:
Animal and Lab Studies: Show promise for:
Hair growth and pigmentation
Neuroprotection
Antioxidant effects
Anti-inflammatory effects
Cardiovascular protection
Immune modulation
Human Clinical Trials: Severely lacking or of poor quality
Very few well designed studies
Small sample sizes
Short duration
Limited replication of findings
Safety Studies: Inadequate
No comprehensive human safety trials
Unknown safe dosage range
Individual variation not well studied
Long term effects unclear
Cultural & Historical Context
Fo-Ti has been used in Traditional Chinese Medicine since at least 713 AD. The legendary story tells of Mr. He, who at age 58 was unable to father children. After a monk advised him to consume the herb, he allegedly:
Fathered several children (some versions say 7 or more)
Lived to 130 or 160 years old
Had his gray hair turn black
Regained his youthful appearance and vitality
While these stories are folklore rather than documented fact, they illustrate the herb's traditional reputation as a powerful rejuvenating tonic.
Summary & Key Takeaways
Fo-Ti is a traditional Chinese medicinal herb with centuries of use for promoting longevity, preventing premature aging, and supporting hair health. While animal and laboratory research shows promise, human clinical evidence is lacking, and there are serious safety concerns, particularly regarding liver toxicity.
Critical Safety Points:
Liver damage is a documented risk, even at traditional doses
Processed form is safer than raw, but still carries risks
Avoid if you have liver disease or take hepatotoxic medications
Not safe during pregnancy or breastfeeding
Requires medical supervision, ideally from a TCM practitioner
Quality control is essential due to contamination concerns
Bottom Line: Fo-Ti shows promise based on traditional use and preliminary research, but the lack of clinical evidence and documented cases of serious liver injury mean it should only be used with extreme caution under qualified medical supervision. The risks may outweigh the benefits for most people, especially given the availability of safer alternatives for many of its purported uses. Always purchase high quality, properly processed products from reputable sources, and never use without informing your healthcare provider.