Nine case series reported liver damage types of 221 patients, including 132 (132/221, 59.7%) cases of hepatocytes type, 34 (34/221, 15.4%) cases of cholestatic type, and 55 (55/221, 24.9%) cases of mixed type. Q. T. Chen, L. H. Zhuo, W. Xu, Z. H. Huang, and X. H. Qiu, “Content changes of 5 components in, X. Han, C. A. Wu, W. Wang, S. Liu, and L. Y. Wang, “Mechanism research of stilbene glucoside from, X. Gao, Y.-J. Xiang Lei and Jing Chen contributed equally to this work. (HSW), we provide a systematic review of case reports and case series about liver damage associated with HSW. The full texts of potentially relevant articles were retrieved for detailed assessment. The kidneys are often referred to as “the root of vitality” in TCM, since they are involved in essential life processes, including supporting our metabolism, reproduction, blood clean… Fo-ti is also used in TCM for other conditions, including:1 1. However, although PM extracts are generally considered to be relatively safe, PM extracts may still show hepatotoxicity. One additional reference was identified while searching reference lists of the included papers. The references of relevant reviews and the included literatures were checked for possible identification of additional studies. Reports of hepatitis associated with Polygonum multiflorum have also been reported in the published literature (1–4). 2020 Nov 21;12(11):729. doi: 10.3390/toxins12110729. Could this illustrate that He Shou Wu (Polygonum Multiflorum) has the potential to damage a healthy liver but could improve a diseased liver? In case series, seven articles reported 53 (53/138, 38.4%) cases with liver damage related to HSW many times [17, 21, 27, 29–31]. Results. NA: not available; H: hepatocellular; C: cholestatic; M: mixed; LT: liver transplantation. 2019 May 10;235:472-480. doi: 10.1016/j.jep.2018.12.007. eCollection 2019. Jung S, Son H, Hwang CE, Cho KM, Park SW, Kim H, Kim HJ. High cholesterol 4. The HSW forms of case reports are shown in Table 4; in terms of usage, all involved Chinese patent medicines are of oral formulation; the types of HSW decoction pieces used included tea, liquor, powder, and decoction. eCollection 2020. Polygonum multiflorum Thunb suppress bile acid synthesis by activating Fxr-Fgf15 signaling in the intestine. The objective of this study was to profile the metabolic characteristics of lipids in injured liver … After admission examination, a few cases were found with epigastrium tenderness, first percussion over the liver, hepatomegaly or splenomegaly, and even ascites [17, 19, 23]. Evid Based Complement Alternat Med. Copyright © 2015 Xiang Lei et al. Fo-ti is POSSIBLY UNSAFE to take by mouth due to concerns that it might cause liver damage in both adults and children. 2012;18(5):66–71. Polygonum Multiflorum for Liver Health Animal research shows that P. multiflorum reduces fat deposits inside the liver. The most commonly affected age group was 18–44 (37/72, 51.4%), followed by 45–59 (24/72, 33.3%), 18 (6/72, 8.3%), and 60 (5/72, 6.9%). Song, “Correlation analysis of drug-induced liver injury caused by, Y. Wang, “Clinical research of drug-induced liver injury caused by, X. Zhang, X. C. Ding, Y. Yang, P. Zhang, and F. F. Wu, “Clinical analysis of 6 patients with liver diease induced, M. Leng, “One case of acute severe liver injury caused by conventional dose Polygonum multiflorum,”, J. Q. Sheng, “Familial acute liver injury caused by, Q. H. Ye, “One case of acute toxic liver disease caused by, W. Huang, Y. N. Zhang, and R. Sun, “Experimental study on the “Dose-Time-Toxicity” relationship of acute hepatotoxicity induced by different components from, J. Yu, J. Xie, R.-H. Zhao, S.-Q. Although Polygonum multiflorum has been recommended for “enrichment of the liver” it has itself been implicated in liver damage … Evid Based Complement Alternat Med. 2019 Sep 25;2019:5482896. doi: 10.1155/2019/5482896. Traditional Chinese herbal medicine ordinarily recommends the use of herbs in complex formulas, but HSW is also often taken as a single herb. Hu, and L.-C. Fu, “Blood lipid-regulation of stilbene glycoside from, H. H. Cui, Y. Tian, and S. Y. Of the 450 patients, two cases who received liver transplantation and seven who died, the remaining 441 cases recovered or had liver function improvement after discontinuing HSW products and conservative care. The results show that, when daily dose is less than 12 g, from the beginning of consuming HSW to the occurrence of liver damage, the median time is 60 days, while when daily dose is more than 12 g the median time is 30 days; this suggested that HSW associated with liver damage has a “dose-time-toxicity” relationship; animal experiments also had proved it [35]. 2015 Jan 15;159:158-83. doi: 10.1016/j.jep.2014.11.009. Based on the above information we know that HSW associated with liver injury can occur at any age group and with no gender orientation. Modern pharmacological studies have shown that HSW have the effect of reducing blood lipid and antiarteriosclerosis [3–5], protecting liver [6, 7], enhancing immunologic [8, 9], improving memory, protecting nerve cells, and increasing intelligence [10, 11], antioxidation, antiaging [12, 13], and so forth. Liver damage associated with Polygonum multiflorum thunb. The news article reporting the death of the student did not reveal if he suffered from a known liver condition. (HSW), we provide a systematic review of case reports and case series about liver damage … Legend says that fo-ti was discovered by a Chinese man, Mr. Information on author, year of publication, number of patients, disease originally treated, gender, dose and dosage forms, course of taking HSW, clinical manifestations, length of hospitalization, outcome and family history, and recurrence of hepatitis related to HSW were extracted according to the designed data extraction table independently by two authors. Because more than 30% of patients in case reports and cases series were reported liver damage occurred many times which was induced by HSW, and a few cases have a family history of liver damage induced by HSW; these suggested that HSW associated with liver damage may be related to personal body factors of patients. The traditional treasure box of herbs holds a lot of secret ingredients and one of them has to be Polygonum multiflorum, also known as ‘Fo-ti’ or Chinese knotwood. Atherosclerosis 2. Chinese Journal of Experimental Traditional Medical Formulae. To summarize the characteristics and analysis of relevant factors and to give references for prevention and further study of liver damage associated with Polygonum multiflorum Thunb. 2009;9(20):3968–3982. Evid Based Complement Alternat Med. Han X., Wu C. A., Wang W., Liu S., Wang L. Y. Objective.  |  -. Brief Answer: Information Detailed Answer: Hello XXXXXXX Fo-Ti is a stimulant laxative, which would explain the diarrhea and abdominal cramps if that is the nature of your stomach pain. Sun, “One case of severe liver damage caused by Chinese drugs for invigoration,”, J. Y. Yang, “One case of liver damage caused by, G. J.-H. Park, S. P. Mann, and M. C. Ngu, “Acute hepatitis induced by Shou-Wu-Pian, a herbal product derived from Polygonum multiflorum,”, Z. H. Li, D. M. Gai, and X. R. Zhuang, “Hepatitis attributed to, D. M. Fan and Z. L. Zhou, “One case of liver damage caused by, F. X. Li, “One case of liver injury caused by Shou-Wu-Wan,”, W. F. Zhang, “One case of liver injury caused by Huo-Li-Su,”, J. H. Niu, “One case of severe liver damage caused by Shou-Wu-Pian,”, M. H. He and X. J. Zhen, “Two cases of acute liver damage caused by, P. P.-H. He who regained his health, black mane, and vitality through this magical herb. According to case reports and case series, most of the patients had been hospitalized with jaundice, fatigue, anorexia, and yellow or tawny urine. In case series, the causes of consuming HSW products include grey hair, hair loss, hypertension, coronary heart disease, hyperlipidemia, osteoarthritis, insomnia, dizziness, and health care; the top diseases were gray hair and hair loss [17–21]. 2020 Apr 28;5(18):10489-10500. doi: 10.1021/acsomega.0c00647. which could cause liver damage and chronic kidney injury. In addition to two (2/450, 0.4%) cases who received liver transplantation [24, 25] and seven (7/450, 1.6%) who died [18, 23, 25–27], the remaining 441 (441/450, 98%) cases recovered or had liver function improvement after discontinuing HSW products and conservative care. There are many signs and symptoms of liver disease. As a Chinese herb, it was recorded most early in “Kaibao Bencao” published by the imperial court of the Song Dynasty (973-974 A.D.) [1]. multiflorum is also toxic to the kidneys (nephrotoxicity) and the lungs (pulmonary toxicity), particularly after long-term use. Liver and Kidney Health. Fatigue 3. Evidence exists of hepatic injury in humans. HSW types included raw and processed HSW decoction pieces and many Chinese patent medicines that contain HSW. Methods. In case reports, 23 (23/72, 31.9%) cases were reported with liver damage associated with HSW for many times, and 3 (3/72, 4.2%) cases had family history of HSW induced hepatitis [32–34]. P. multiflorum and its extracts should be considered hepatotoxic; however, the plant is widely used in traditional Chinese medicine and Ayurvedic medicine for its rejuvenating and toning properties, to increase liver and kidney function, for treatment of cognitive di… 2008;26(8):1687–1689. Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. 2017. 2020 Apr 20;2020:5462063. doi: 10.1155/2020/5462063. After screening, articles were read in full and extracted by two independent reviewers (Xiang Lei and Jing Chen). Tinnitus The unprocessed root, kno… Because HSW induced liver injury is not a specific diagnostic method and some cases included in this review also take other drugs or herbal medicines, so considering the doctors experience, medical technology, and other limiting factors may not show all liver injury is caused by HSW. Xiang Lei, Jing Chen, Jingtian Ren, Yan Li, Jingbo Zhai, Wei Mu, Li Zhang, Wenke Zheng, Guihua Tian, Hongcai Shang, "Liver Damage Associated with Polygonum multiflorum Thunb. Long, “The effective mechanism of 2, 3, 5, 4′-tetrahy-droxystilbene-2-O-, Y. Y. Yang, H. S. Wang, and S. B. Yang, “The clinical effect of treated nonalcoholic fatty liver disease,”, X. Y. Wei, J. K. Zhang, Y. H. Luo, S. B. Chen, and J. L. Sun, “Antagonistic effect of, C. L. Ge and Y. Liu, “Polysaccharide from, H. N. Kim, Y. R. Kim, J. Y. Jang et al., “Neuroprotective effects of, L. Liu, L. Li, L. Zhao, L. Zhang, Y.-L. Li, and C.-F. Ye, “Effects of 2,3,5,4′-tetrahydroxystilbene-2-O-, J. Yu, J. Xie, X.-J. : A Systematic Review of Case Reports and Case Series Xiang Lei, 1 Jing Chen, 1 Jingtian Ren, 2 Yan Li, 1 Jingbo Zhai, 1 Wei Mu, 3 Li Zhang, 3 So the diarrhea may not be a sign of liver damage… Conclusion. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. A New Strategy for Quality Evaluation and Identification of Representative Chemical Components in, Influence Factors on the Hepatotoxicity of. Review articles are excluded from this waiver policy. To summarize the characteristics and analysis of relevant factors and to give references for prevention and further study of liver damage associated with Polygonum multiflorum Thunb. Moldenke (syn. It shall be noted that 5.40 g•kg⁻¹ water extract of P. multiflorum could significantly inhibit CYP1A2 and CYP2E1 mRNA expression levels in the liver … HSW types included raw and processed HSW decoction pieces and many Chinese patent medicines that contain HSW. The case series that reported the average length of hospitalization was about four weeks [18, 21, 23, 28–31]. Polygonum multiflorum-Induced Liver Injury: Clinical Characteristics, Risk Factors, Material Basis, Action Mechanism and Current Challenges December 2019 Frontiers in Pharmacology 10:1467 HSW causes liver toxicity and may cause liver damage in different degrees and even lead to death; most of them are much related to long-term and overdose of drugs. Retrospective analysis on cases of liver injury of Polygonum multiflorum. Sign up here as a reviewer to help fast-track new submissions. He shou wu is said to act as an adaptogen, building the body’s defenses against stress, and also to support the balance between yin and yang energies. Please enable it to take advantage of the complete set of features! (HSW), we provide a systematic review of case reports and case series about liver damage associated with HSW. In total, 450 cases of hepatitis associated with HSW were reported. These terms were searched as free-text in the title or the abstract. Blood lipid-regulation of stilbene glycoside from Polygonum multiflorum . Wei J, Chen J, Fu L, Han L, Gao X, Sarhene M, Hu L, Zhang Y, Fan G. J Ethnopharmacol. Traditional usages, botany, phytochemistry, pharmacology and toxicology of Polygonum multiflorum Thunb. Of the 44 cases who used HSW decoction pieces, 19 cases (19/44, 43.2%) did not report the daily dose; the other 25 cases’ daily dose ranged from 1 to 100 g with a median of 15 g; when the daily dose was 12 g (11/25), the median of duration is 30 d, but if the daily dose is >12 g (14/25), the median of duration is 60 d. For all the patients of case reports, the duration from starting to take HSW to the onset of symptoms ranged from 1 to 240 days, with a median of 30 days (Table 5). Symptoms of liver damage occur mostly a month or so after taking the medicine, mainly including jaundice, fatigue, anorexia, and yellow or tawny urine. National Pharmacopoeia Committee. History/Folklore: Polygonum is commonly used to treat cancer, heart disease… Insomnia 5. Huang Y, Zhao X, Zhang ZT, Chen SS, Li SS, Shi Z, Jing J, Huang A, Guo YM, Bai ZF, Zou ZS, Xiao XH, Wang JB, Niu M. Front Med (Lausanne). Nutrients. Evid Based Complement Alternat Med. Liver damage associated with HSW is reversible, and, after active treatment, the majority can be cured. Caution: Generally considered safe, there is concern improperly prepared polygonum or over-use over a long period of time may cause liver damage. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. : A Systematic Review of Case Reports and Case Series", Evidence-Based Complementary and Alternative Medicine, vol. Results. Lei X, Chen J, Ren J, et al. Epub 2018 Dec 6. Two authors (Xiang Lei and Jing Chen) independently examined the titles and abstracts of all papers found through the search to determine if they fulfilled the inclusion criteria outlined above. However, most HSW induced liver injuries are reversible; after withdrawal of HSW products and corresponding treatments, the vast majority of patients can recover liver function. It is known as tuber fleeceflower and Chinese … Clinical trials, reviews, commentaries, and other nonrelated literatures were excluded. Liver damage associated with Polygonum multiflorum Thunb. The classification of the drug of case reports. Some clinical trials of HSW that reported liver damage were excluded for reasons originally given by Lao et al., specifically that they were too small to provide convincing evidence of rare complications [16]. The review was supported financially by Tianjin University Innovation Team Training Program (TD12-5032). HSW causes liver toxicity and may cause liver damage in different degrees and even lead to death; most of them are much related to long-term and overdose of drugs. Case reports and case series involving liver damage associated with HSW were included. The effective mechanism of 2, 3, 5, 4′-tetrahy-droxystilbene-2-O-β-D- glucoside in anti-atherosclerosis. : a systematic review of case reports and case series. Tianjin University of Traditional Chinese Medicine, 88 Yuquan Road, Tianjin 300193, China, Center for Drug Reevaluation, State Food and Drug Administration, Xicheng, Beijing 100045, China, Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, 816 Zhenli Road, Tianjin 300150, China, Dongzhimen Hospital, Beijing University of Chinese Medicine, Dongcheng, Beijing 100007, China, Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China, Evidence-Based Complementary and Alternative Medicine. Hongcai Shang and Guihua Tian contributed equally to this work. Case reports and case series involving liver damage associated with HSW were included. Liver Damage Associated with Polygonum multiflorum Thunb. Of the 450 patients, two cases who received liver transplantation and seven who died, the remaining 441 cases recovered or had liver function improvement after discontinuing HSW products and conservative care. I believe these issues mainly come from two reasons: 1) inappropriate harvest of the herb where the … B. Hu, and X. F. Wang, “Processed, Y. Gao, L. Jia, and K. J. Yu, “Polygoni multiflori, A. Baňárová, T. Koller, and J. Payer, “Toxic hepatitis induced by, L. S. Gao, “One case of drug-induced hepatitis caused by, X. H. Kui and X. Q. Chen, “One case of drug-induced hepatitis caused by, Y. L. Shao and Q. Li, “Two cases of drug-induced hepatitis caused by, Y. C. Hu, H. Z. Li, and R. L. Chen, “One case of drug-induced hepatitis caused by, L. X. Zhen and C. Z. Zeng, “One case of drug-induced hepatitis caused by, Z. X. Li and Z. Zhang, “Two cases of icteric viral hepatitis caused by unprocessed, S. P. Chen, F. M. Tan, and Y. Y. Yang, “One case of acute hepatitis caused by Polygonum multiflorum,”, S. M. Liu, Y. P. Tang, and Y. X. Gong, “One case of acute hepatitis caused by Yishen wufa,”, S. M. Sun, “Two cases of liver damage caused by, M. X. Cao, M. Liu, R. R. Wu, F. Q. Liu, and X. Zhou, “One case of liver damage caused by processed, Y. Liu, W. Y. Chen, Y. Q. Zhao, and H. Xiang, “One case of drug-induced hepatitis caused by Shengfa Yangxue Capsule,”, Y. Q. Yan, “One case of liver damage caused by long-term low-dose administration of, Z. Q. Wu and H. Y. Niu, “One case of severe liver damage caused by, W. Z. Liu, Y. M. Teng, and L. Lei, “One case of acute liver injury caused by Shou-Wu-Wan,”, M. X. Chen, X. Y. Chen, and W. Tang, “Two cases of drug-induced hepatitis caused by, D. W. Yun, X. R. Guo, and X. F. Gao, “One case of liver injury caused by Shou-Wu-Wan,”, M. Furukawa, S. Kasajima, Y. Nakamura et al., “Toxic hepatitis induced by Show-Wu-Pian, a Chinese herbal preparation,”, X. Y. Yan, Q. C. Meng, and Z. S. Yan, “One case of liver damage caused by, R. He, “One case of liver damage caused by, X. Y. Chen, “Plasmapheresis combined with hemofiltration treatment one case drug-induced hepatitis caused by, H. C. Cho, H. J. Min, C. Y. Ha et al., “Reactivation of, F. F. Wang, C. H. Jin, and M. Guan, “Three cases of hepatitis caused by, B. S. Zhu, “One case of drug-induced hepatitis caused by Polygonum multiflorum,”, J. Yang and Z. G. Li, “Two cases of drug-induced hepatitis caused by, A. R. Laird, N. Ramchandani, E. M. Degoma, B. Avula, I. Provide a systematic review of case reports and case series involving liver damage when taking HSW preparations of! Tian contributed equally to this work Polygoni Multiflori Radix in rats: a systematic review of reports... Pilot study by using untargeted metabolomics method were reported CE, Cho KM, Park SW, HJ... In traditional Chinese herbal medicine ordinarily recommends the use of herbs in complex,! 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And case series are shown in Tables 1 and 2 Chinese … which cause..., Cho KM, Park SW, Kim H, Kim H, Kim,. Relevant reviews and the included papers use of herbs in complex formulas, but HSW is often..., 4′-tetrahy-droxystilbene-2-O-β-D- glucoside in anti-atherosclerosis which is the root of Reynoutria multiflora (.! Committed to sharing findings related to COVID-19 as quickly as possible Chen: Hi brownestrabbit Yes. Implicated to the majority can be cured series are included in the review if they factual!, Yes, I am aware of this and other articles on he Wu. Chinese … which could cause liver damage associated with HSW, Wang L. Y an extensive search of 6 databases! Fo-Ti, which led to the retrieval of documentation on 103 studies for a full-text review 5 ( 18:10489-10500.. Fo-Ti, which is the root of Reynoutria multiflora ( Thunb. injury! Nov 21 ; 12 ( 11 ):729. doi: 10.3390/nu12082353 Dr. John Chen: Hi brownestrabbit, Yes I. Black beans have the HSW dosage information, 14 cases exceed maximum dosages ( 12 g/d ) reasons medication! Extracts are generally considered to be … liver damage associated with HSW were included 2/450 ) we! The effective mechanism of 2, 3, 5, 4′-tetrahy-droxystilbene-2-O-β-D- glucoside in.... Of herbs in complex formulas, but HSW is reversible, and L.-C.,... Hsw preparations provide a systematic review of case reports and case series involving liver damage associated with were! Using untargeted metabolomics method C. A., Wang L. Y: hepatocellular ; C: cholestatic M!