FO-TI

OTHER NAME(S):

Chinese Cornbind, Chinese Knotweed, Climbing Knotweed, Flowery Knotweed, Fo Ti, Fo Ti Tieng, Fo-Ti-Tient, He Shou Wu, Heshouwu, Ho Shou Wu, Ho-Shou-Wu, Multiflora Preparata, Poligonum, Poligonum Multiflorum, Polygonum, Polygonum multiflorum, Polygonum Multiflorum Thunberg, Racine de Renouée Multiflore, Radix Polygoni Multiflori, Radix Polygoni Shen Min, Shen-Min, Renouée, Renouée à Fleurs Nombreuses, Renouée de Chine, Renouée Multiflore, Rhizoma Polygonata, Shen Min, Shou Wu, Shou Wu Pian, Shou-Wu-Wan, Tuber Fleeceflower, Zhihe Shou Wu, Zi Shou Wu.<br/><br/>

Overview

Overview Information

Fo-ti is an herb. The processed (cured) root of the plant is used to make medicine.

Fo-ti is commonly used by mouth to help treat or prevent conditions related to aging, including cancer, heart disease, and memory problems. Fo-ti is also applied directly to the skin for sores, carbuncles, skin eruptions, and itching. But there is limited scientific evidence to support these uses.

In manufacturing, fo-ti extract is used as an ingredient in hair and skin care products.

Don’t confuse fo-ti with the commercial product Fo-ti-Teng that contains no fo-ti.

How does it work?

Fo-ti cured root might affect the levels of various chemicals in the body which have been suggested to have anti-aging effects.

Uses

Uses & Effectiveness?

Insufficient Evidence for

  • Age-related memory problems. Early research suggests taking fo-ti root along with Panax ginseng might improve memory in older people.
  • Liver and kidney problems.
  • High cholesterol.
  • Insomnia.
  • Lower back and knee soreness.
  • Premature graying.
  • Dizziness.
  • Other conditions.
More evidence is needed to rate the effectiveness of fo-ti for these uses.

Side Effects

Side Effects & Safety

Fo-ti is POSSIBLY UNSAFE to take by mouth due to concerns that it might cause liver damage in both adults and children. Fo-ti has been linked to liver damage in several reports, including one case in a 5-year-old child.

There isn't enough information available to know if fo-ti is safe when applied directly the skin.

Special Precautions & Warnings:

Children: Fo-ti is POSSIBLY UNSAFE when taken by mouth by children due to concerns that it might cause liver damage. At least one case of liver damage linked with fo-ti use in a 5-year-old child has been reported.

Pregnancy and breast-feeding: Fo-ti is POSSIBLY UNSAFE to take by mouth during pregnancy. Fo-ti contains chemicals that can act like a strong laxative. The chemicals work by stimulating the intestine. Bulk-forming laxatives are a safer choice in pregnancy.

It is also POSSIBLY UNSAFE to use fo-ti if you are breast-feeding. The chemicals that have a laxative effect can pass into breast milk and cause diarrhea in some breast-fed infants.

Not enough is known about the safety of applying fo-ti to the skin during pregnancy or breast-feeding. It’s best to avoid using it.

Diabetes: Fo-ti might affect blood sugar levels in people with diabetes. Watch for signs of low blood sugar (hypoglycemia) and monitor your blood sugar closely if you have diabetes and take fo-ti.

Hormone-sensitive conditions such as breast cancer, uterine cancer, ovarian cancer, endometriosis, or uterine fibroids: Fo-ti extract might act like estrogen. If you have any condition that might be made worse by exposure to estrogen, don’t use fo-ti.

Liver disease: Fo-ti has been linked to multiple cases of liver problems including hepatitis. There is a concern that fo-ti might make existing liver disease worse and may also increase the risk of bleeding in patients with liver disease.

Surgery: Fo-ti might affect blood sugar levels and the ability of blood to clot, so there is concern that it might interfere with blood sugar control and blood clotting during and after surgery. Stop using fo-ti at least 2 weeks before a scheduled surgery.

Interactions

Interactions?

Moderate Interaction

Be cautious with this combination

!
  • Digoxin (Lanoxin) interacts with FO-TI

    Fo-ti is a type of laxative called a stimulant laxative. Stimulant laxatives can decrease potassium levels in the body. Low potassium levels can increase the risk of side effects of digoxin (Lanoxin).

  • Medications changed by the liver (Cytochrome P450 1A2 (CYP1A2) substrates) interacts with FO-TI

    Some medications are changed and broken down by the liver.<br/><br/> Fo-ti might decrease how quickly the liver breaks down some medications. Taking fo-ti along with some medications that are broken down by the liver can increase the effects and side effects of some medications. Before taking fo-ti, talk to your healthcare provider if you take any medications that are changed by the liver.<br/><br/> Some medications that are changed by the liver include amitriptyline (Elavil), haloperidol (Haldol), ondansetron (Zofran), propranolol (Inderal), theophylline (Theo-Dur, others), verapamil (Calan, Isoptin, others), and others.

  • Medications changed by the liver (Cytochrome P450 2C19 (CYP2C19) substrates) interacts with FO-TI

    Some medications are changed and broken down by the liver.<br/><br/> Fo-ti might decrease how quickly the liver breaks down some medications. Taking fo-ti along with some medications that are broken down by the liver can increase the effects and side effects of some medications. Before taking fo-ti, talk to your healthcare provider if you take any medications that are changed by the liver.<br/><br/> Some medications that are changed by the liver include omeprazole (Prilosec), lansoprazole (Prevacid), and pantoprazole (Protonix); diazepam (Valium); carisoprodol (Soma); nelfinavir (Viracept); and others.

  • Medications changed by the liver (Cytochrome P450 2C9 (CYP2C9) substrates) interacts with FO-TI

    Some medications are changed and broken down by the liver.<br/><br/> Fo-ti might decrease how quickly the liver breaks down some medications. Taking fo-ti along with some medications that are broken down by the liver can increase the effects and side effects of some medications. Before taking fo-ti, talk to your healthcare provider if you take any medications that are changed by the liver.<br/><br/> Some medications that are changed by the liver include diclofenac (Cataflam, Voltaren), ibuprofen (Motrin), meloxicam (Mobic), and piroxicam (Feldene); celecoxib (Celebrex); amitriptyline (Elavil); warfarin (Coumadin); glipizide (Glucotrol); losartan (Cozaar); and others.

  • Medications changed by the liver (Cytochrome P450 3A4 (CYP3A4) substrates) interacts with FO-TI

    Some medications are changed and broken down by the liver.<br/><br/> Fo-ti might decrease how quickly the liver breaks down some medications. Taking fo-ti along with some medications that are broken down by the liver can increase the effects and side effects of some medications. Before taking fo-ti, talk to your healthcare provider if you are taking any medications that are changed by the liver.<br/><br/> Some medications changed by the liver include lovastatin (Mevacor), ketoconazole (Nizoral), itraconazole (Sporanox), fexofenadine (Allegra), triazolam (Halcion), and many others.

  • Medications for diabetes (Antidiabetes drugs) interacts with FO-TI

    Fo-ti might decrease blood sugar. Diabetes medications are also used to lower blood sugar. Taking fo-ti along with diabetes medications might cause your blood sugar to go too low. Monitor your blood sugar closely. The dose of your diabetes medication might need to be changed.<br/><br/> Some medications used for diabetes include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), chlorpropamide (Diabinese), glipizide (Glucotrol), tolbutamide (Orinase), and others.

  • Medications that can harm the liver (Hepatotoxic drugs) interacts with FO-TI

    Fo-ti might harm the liver. Taking fo-ti along with medication that might also harm the liver can increase the risk of liver damage. Do not take fo-ti if you are taking a medication that can harm the liver.<br/><br/> Some medications that can harm the liver include acetaminophen (Tylenol and others), amiodarone (Cordarone), carbamazepine (Tegretol), isoniazid (INH), methotrexate (Rheumatrex), methyldopa (Aldomet), fluconazole (Diflucan), itraconazole (Sporanox), erythromycin (Erythrocin, Ilosone, others), phenytoin (Dilantin) , lovastatin (Mevacor), pravastatin (Pravachol), simvastatin (Zocor), and many others.

  • Stimulant laxatives interacts with FO-TI

    Fo-ti is a type of laxative called a stimulant laxative. Stimulant laxatives speed up the bowels. Taking fo-ti along with other stimulant laxatives could speed up the bowels too much and cause dehydration and low minerals in the body.<br/><br/> Some stimulant laxatives include bisacodyl (Correctol, Dulcolax), cascara, castor oil (Purge), senna (Senokot), and others.

  • Warfarin (Coumadin) interacts with FO-TI

    Fo-ti can work as a laxative. In some people fo-ti can cause diarrhea. Diarrhea can increase the effects of warfarin and increase the risk of bleeding. If you take warfarin do not to take excessive amounts of fo-ti.

  • Water pills (Diuretic drugs) interacts with FO-TI

    Fo-ti is a laxative. Some laxatives can decrease potassium in the body. "Water pills" can also decrease potassium in the body. Taking fo-ti along with "water pills" might decrease potassium in the body too much.<br/><br/> Some "water pills" that can decrease potassium include chlorothiazide (Diuril), chlorthalidone (Thalitone), furosemide (Lasix), hydrochlorothiazide (HCTZ, HydroDIURIL, Microzide), and others.

Dosing

Dosing

The appropriate dose of fo-ti depends on several factors such as the user’s age, health, and several other conditions. At this time there is not enough scientific information to determine an appropriate range of doses for fo-ti. Keep in mind that natural products are not always necessarily safe and dosages can be important. Be sure to follow relevant directions on product labels and consult your pharmacist or physician or other healthcare professional before using.

View References

REFERENCES:

  • Avula, B., Joshi, V. C., Wang, Y. H., and Khan, I. A. Simultaneous identification and quantification of anthraquinones, polydatin, and resveratrol in Polygonum multiflorum, various Polygonum species, and dietary supplements by liquid chromatography and microscopic study of Polygonum species. J AOAC Int 2007;90(6):1532-1538. View abstract.
  • Bae, S. H., Kim, D. H., Bae, Y. S., Lee, K. J., Kim, D. W., Yoon, J. B., Hong, J. H., and Kim, S. H. [Toxic hepatitis associated with Polygoni multiflori]. Korean J.Hepatol. 2010;16(2):182-186. View abstract.
  • Chen, H. and Weng, L. [Comparison on efficacy in treating liver fibrosis of chronic hepatitis B between Astragalus Polygonum anti-fibrosis decoction and jinshuibao capsule]. Zhongguo Zhong.Xi.Yi.Jie.He.Za Zhi. 2000;20(4):255-257. View abstract.
  • Chen, J. [An experimental study on the anti-senility effects of shou xing bu zhi]. Zhong.Xi.Yi.Jie.He.Za Zhi. 1989;9(4):226-7, 198. View abstract.
  • Chen, L. W., Wang, Y. Q., Wei, L. C., Shi, M., and Chan, Y. S. Chinese herbs and herbal extracts for neuroprotection of dopaminergic neurons and potential therapeutic treatment of Parkinson's disease. CNS.Neurol.Disord.Drug Targets. 2007;6(4):273-281. View abstract.
  • Chen, L., Huang, J., and Xue, L. [Effect of compound Polygonum multiflorum extract on Alzheimer's disease]. Zhong.Nan.Da.Xue.Xue.Bao.Yi.Xue.Ban. 2010;35(6):612-615. View abstract.
  • Choi, S. G., Kim, J., Sung, N. D., Son, K. H., Cheon, H. G., Kim, K. R., and Kwon, B. M. Anthraquinones, Cdc25B phosphatase inhibitors, isolated from the roots of Polygonum multiflorum Thunb. Nat.Prod.Res 5-20-2007;21(6):487-493. View abstract.
  • Foster, S. and Tyler, V. E. Tyler's Honest Herbal: A Sensible Guide to the Use of Herbs and Related Remedies. Binghamton, NY: Haworth Herbal Press;1993.
  • Furukawa, M., Kasajima, S., Nakamura, Y., Shouzushima, M., Nagatani, N., Takinishi, A., Taguchi, A., Fujita, M., Niimi, A., Misaka, R., and Nagahara, H. Toxic hepatitis induced by show-wu-pian, a Chinese herbal preparation. Intern.Med. 2010;49(15):1537-1540. View abstract.
  • Grech, J. N., Li, Q., Roufogalis, B. D., and Duck, C. C. Novel Ca(2+)-ATPase inhibitors from the dried root tubers of Polygonum Multiflorum. J.Nat.Prod. 1994;57(12):1682-1687. View abstract.
  • Horikawa, K., Mohri, T., Tanaka, Y., and Tokiwa, H. Moderate inhibition of mutagenicity and carcinogenicity of benzo[a]pyrene, 1,6-dinitropyrene and 3,9-dinitrofluoranthene by Chinese medicinal herbs. Mutagenesis 1994;9(6):523-526. View abstract.
  • Huang, H. C., Chu, S. H., and Chao, P. D. Vasorelaxants from Chinese herbs, emodin and scoparone, possess immunosuppressive properties. Eur.J.Pharmacol. 6-6-1991;198(2-3):211-213. View abstract.
  • Huang, W. Y., Cai, Y. Z., Xing, J., Corke, H., and Sun, M. Comparative analysis of bioactivities of four Polygonum species. Planta Med 2008;74(1):43-49. View abstract.
  • Kang, S. C., Lee, C. M., Choi, H., Lee, J. H., Oh, J. S., Kwak, J. H., and Zee, O. P. Evaluation of oriental medicinal herbs for estrogenic and antiproliferative activities. Phytother Res 2006;20(11):1017-1019. View abstract.
  • Ling, S., Nheu, L., Dai, A., Guo, Z., and Komesaroff, P. Effects of four medicinal herbs on human vascular endothelial cells in culture. Int J Cardiol. 8-29-2008;128(3):350-358. View abstract.
  • Liu, C., Zhang, Q., and Lin, J. [Effect of the root of Polygonum multiflorum Thunb. and its processed products on fat accumulation in the liver of mice]. Zhongguo Zhong.Yao Za Zhi. 1992;17(10):595-6, 639. View abstract.
  • Liu, Q. L., Xiao, J. H., Ma, R., Ban, Y., and Wang, J. L. Effect of 2,3,5,4'-tetrahydroxystilbene-2-O-beta-D-glucoside on lipoprotein oxidation and proliferation of coronary arterial smooth cells. J Asian Nat.Prod.Res 2007;9(6-8):689-697. View abstract.
  • McGuffin, M., Hobbs, C., Upton, R., and Goldberg, A. American Herbal Products Association's Botanical Safety Handbook. Boca Raton, FL: CRC Press, LLC;1997.
  • Ryu, G., Ju, J. H., Park, Y. J., Ryu, S. Y., Choi, B. W., and Lee, B. H. The radical scavenging effects of stilbene glucosides from Polygonum multiflorum. Arch.Pharm.Res. 2002;25(5):636-639. View abstract.
  • Wang, X., Zhao, L., Han, T., Chen, S., and Wang, J. Protective effects of 2,3,5,4'-tetrahydroxystilbene-2-O-beta-d-glucoside, an active component of Polygonum multiflorum Thunb, on experimental colitis in mice. Eur.J Pharmacol. 1-14-2008;578(2-3):339-348. View abstract.
  • Weiying, L., Yuanjiang, D., and Baolian, L. Treatment of the localized neurodermatitis by plum-blossom needle tapping and with the modified yangxue dingfeng tang--a clinical observation of 47 cases. J.Tradit.Chin Med. 2006;26(3):181-183. View abstract.
  • Xu, M. L., Zheng, M. S., Lee, Y. K., Moon, D. C., Lee, C. S., Woo, M. H., Jeong, B. S., Lee, E. S., Jahng, Y., Chang, H. W., Lee, S. H., and Son, J. K. A new stilbene glucoside from the roots of Polygonum multiflorum Thunb. Arch Pharm Res 2006;29(11):946-951. View abstract.
  • Yan, Y., Su, X., Liang, Y., Zhang, J., Shi, C., Lu, Y., Gu, L., and Fu, L. Emodin azide methyl anthraquinone derivative triggers mitochondrial-dependent cell apoptosis involving in caspase-8-mediated Bid cleavage. Mol Cancer Ther 2008;7(6):1688-1697. View abstract.
  • Yang, P. Y., Almofti, M. R., Lu, L., Kang, H., Zhang, J., Li, T. J., Rui, Y. C., Sun, L. N., and Chen, W. S. Reduction of atherosclerosis in cholesterol-fed rabbits and decrease of expressions of intracellular adhesion molecule-1 and vascular endothelial growth factor in foam cells by a water-soluble fraction of Polygonum multiflorum. J Pharmacol.Sci 2005;99(3):294-300. View abstract.
  • Yao, S., Li, Y., and Kong, L. Preparative isolation and purification of chemical constituents from the root of Polygonum multiflorum by high-speed counter-current chromatography. J Chromatogr.A 5-19-2006;1115(1-2):64-71. View abstract.
  • Yuen, M. F., Tam, S., Fung, J., Wong, D. K., Wong, B. C., and Lai, C. L. Traditional Chinese medicine causing hepatotoxicity in patients with chronic hepatitis B infection: a 1-year prospective study. Aliment.Pharmacol.Ther 10-15-2006;24(8):1179-1186. View abstract.
  • Zhang, L., Yang, X., Sun, Z., and Qu, Y. [Retrospective study of adverse events of Polygonum multiflorum and risk control]. Zhongguo Zhong.Yao Za Zhi. 2009;34(13):1724-1729. View abstract.
  • Zhang, Z. G., Lu, T. S., and Yao, Q. Q. [Effect of preparation on the major chemical constituents of Polygonum multiflorum]. Zhong.Yao Cai. 2006;29(10):1017-1019. View abstract.
  • Zhong, J., Tian, J. Z., Zhu, A. H., and Yang, C. Z. [Clinical study on a randomized, double-blind control of Shenwu gelatin capsule in treatment of mild cognitive impairment]. Zhongguo Zhong.Yao Za Zhi. 2007;32(17):1800-1803. View abstract.
  • Zuo, G. Y., Wang, G. C., Zhao, Y. B., Xu, G. L., Hao, X. Y., Han, J., and Zhao, Q. Screening of Chinese medicinal plants for inhibition against clinical isolates of methicillin-resistant Staphylococcus aureus (MRSA). J Ethnopharmacol. 11-20-2008;120(2):287-290. View abstract.
  • Bounda GA, Feng YU. Review of clinical studies of Polygonum multiflorum Thunb. and its isolated bioactive compounds. Pharmacognosy Res 2015;7(3):225-236. View abstract.
  • But PP, Tomlinson B, Lee KL. Hepatitis related to the Chinese medicine Shou-wu-pian manufactured from Polygonum multiflorum. Vet Hum Toxicol 1996;38:280-2. View abstract.
  • Cardenas A, Restrepo JC, Sierra F, Correa G. Acute hepatitis due to shen-min: a herbal product derived from Polygonum multiflorum. J Clin Gastroenterol 2006;40:629-32. View abstract.
  • Covington TR, et al. Handbook of Nonprescription Drugs. 11th ed. Washington, DC: American Pharmaceutical Association, 1996.
  • Dharmananda, S. Ho-Shou-Wu. What's in an herb name? June 1998. Accessed February 5th, 2017. Available at: http://www.itmonline.org/arts/hoshouwu.htm.
  • Dong H, Slain D, Cheng J, Ma W, Liang W. Eighteen cases of liver injury following ingestion of Polygonum multiflorum. Complement Ther Med 2014;22(1):70-4. View abstract.
  • Hwang YH, Kang KY, Kim JJ, et al. Effects of hot water extracts from Polygonum multiflorum on ovariectomy induced osteopenia in mice. Evid Based Complement Alternat Med 2016;2016:8970585. View abstract.
  • Jung KA, Min HJ, Yoo SS, et al. Drug-Induced Liver Injury: Twenty Five Cases of Acute Hepatitis Following Ingestion of Polygonum multiflorum Thunb. Gut Liver 2011;5(4):493-9. View abstract.
  • Laird AR, Ramchandani N, deGoma EM, et al. Acute hepatitis associated with the use of an herbal supplement (Polygonum multiflorum) mimicking iron-overload syndrome. J Clin Gastroenterol 2008;42:861-2. View abstract.
  • Lei X, Chen J, Ren J, et al. Liver damage associated with Polygonum multiflorum Thunb.: a systematic review of case reports and case series. Evid Based Complement Alternat Med 2015;2015:459749. View abstract.
  • Li RW, David Lin G, Myers SP, Leach DN. Anti-inflammatory activity of Chinese medicinal vine plants. J Ethnopharmacol 2003;85:61-7. View abstract.
  • Ma KF, Zhang XG, Jia HY. CYP1A2 polymorphism in Chinese patients with acute liver injury induced by Polygonum multiflorum. Genet Mol Res 2014;13(3):5637-43. View abstract.
  • Mazzanti G, Battinelli L, Daniele C, et al. New case of acute hepatitis following the consumption of Shou Wu Pian, a Chinese herbal product derived from Polygonum multiflorum. Ann Intern Med 2004;140:E589-90. View abstract.
  • Oerter Klein KO, Janfaza M, Wong JA, Chang RJ. Estrogen bioactivity in Fo-Ti and other herbs used for their estrogen-like effects as determined by a recombinant cell bioassay. J Clin Endocrinol Metab 2003;88:4077-9.. View abstract.
  • Panis B, Wong DR, Hooymans PM, De Smet PA, Rosias PP. Recurrent toxic hepatitis in a Caucasian girl related to the use of Shou-Wu-Pian, a Chinese herbal preparation. J Pediatr Gastroenterol Nutr 2005;41:256-8. View abstract.
  • Park GJ, Mann SP, Ngu MC. Acute hepatitis induced by Shou-Wu-Pian, a herbal product derived from Polygonum multiflorum. J Gastroenterol Hepatol 2001;16:115-7. View abstract.
  • Sklar S, et al. Drug therapy screening system. Indianapolis, IN: First Data Bank 99.1-99. 2 eds.
  • UK Medicines and Healthcare Products Regulatory Agency. Polygonum multiflorum and liver reactions. April 2006. Available at: www.mhra.gov.uk/home/idcplg?IdcService= SS_GET_PAGE&useSecondary=true&ssDocName= CON2023590&ssTargetNodeId= 833 (Accessed 10 May 2006).
  • Unger M, Frank A. Simultaneous determination of the inhibitory potency of herbal extracts on the activity of six major cytochrome P450 enzymes using liquid chromatography/mass spectrometry and automated online extraction. Rapid Commun Mass Spectrom 2004;18:2273-81. View abstract.
  • Wu X, Chen X, Huang Q, Fang D, Li G, Zhang G. Toxicity of raw and processed roots of Polygonum multiflorum. Fitoterapia 2012;83(3):469-75. View abstract.
  • Young DS. Effects of Drugs on Clinical Laboratory Tests 4th ed. Washington: AACC Press, 1995.
  • Zhang CZ, Wang SX, Zhang Y, et al. In vitro estrogenic activities of Chinese medicinal plants traditionally used for the management of menopausal symptoms. J Ethnopharmacol 2005;98:295-300. View abstract.
  • Zhang Y, Ding T, Diao T, Deng M, Chen S. Effects of Polygonum multiflorum on the activity of cytochrome P450 isoforms in rats. Pharmazie 2015;70(1):47-54. View abstract.

More Resources for FO-TI

CONDITIONS OF USE AND IMPORTANT INFORMATION: This information is meant to supplement, not replace advice from your doctor or healthcare provider and is not meant to cover all possible uses, precautions, interactions or adverse effects. This information may not fit your specific health circumstances. Never delay or disregard seeking professional medical advice from your doctor or other qualified health care provider because of something you have read on WebMD. You should always speak with your doctor or health care professional before you start, stop, or change any prescribed part of your health care plan or treatment and to determine what course of therapy is right for you.

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