Side Effects and Benefits of
Polygonum multiflorum [Chinese
knotweed]
Polygonum multiflorum [Chinese knotweed, Flowery knotweed; as fo-
ti, fo-ti-teng, ho shou wu, or he shou wu; 何首烏]

How does polygonum multiflorum (Chinese knotweed) benefit
people at aging-process?

Chinese Knotweed or polygonum multiflorum is believed to able to rejuvenate the
body, and it contains chemicals (stibene glycosides) similar to resveratrol [1]. In
study of lower organisms, resveratrol was found to prolong lifespan by various
mechanisms. According to Taiwan Traditional Chinese Medicine Outpatient
research, Shou-wu-teng (Polygonum multiflorum) was the most commonly
prescribed single Chinese herb in the year of 2002 for insomnia. [3]

Its Potential Benefits on Cardiovascular and Cerebral Events
Polygonum multiflorum (knotweed) may benefit people at risk of
cardiovascular and cerebral diseases. 2,3,5,4'-tetrahydroxystilbene-2-O-
beta-D-glucoside, an active component of the rhizome extract from
Polygonum multiflorum, exhibits antioxidative, anti-inflammatory effects and
anti-atherosclerotic effects. This compound possibly can restore vascular
endothelial function via preventing the changes of endothelial nitric oxide
(NO) synthase and inducible NO synthase expression, leading to
preservation of NO bioactivity. [2] 2,3,5,4'-tetrahydroxystilbene-2-O-beta-D-
glucoside was found to exert protective effects on colitis through alleviating
oxygen and nitrogen free radicals level and down-regulating inducible nitric
oxide synthase (iNOS)  expression in a mice study. [11] In vitro, this
compound was also shown to protect against  cerebral ischemia/reperfusion
injury through multifunctional cytoprotective pathways. [4]

Its Potential Benefits on Alzheimer’s disease
Polygonum multiflorum may benefit people at risk of Alzheimer's disease, as
polygonum multiflorum was shown to improve the fluidity of mitochondria
membrane in an animal model of Alzheimer's disease. In the study, Forty-
five rats were randomly divided into 3 groups: an Alzheimer's disease model
group, a control group, and a treatment group. Alzheimer's disease model
was established by injecting beta-amyloid protein into the hippocampus of
rats. Compared with the control group, the learning and memory ability of
the Alzheimer's disease model group was significantly lower, while the
coefficient of viscosity of the hippocampal mitochondria membrane of the
Alzheimer's disease model group rats was significantly higher. Compared
with the Alzheimer's disease model group rats, the coefficient of viscosity of
the hippocampal mitochondria membrane of the treatment group was
significantly lower. Thus, polygonum multiflorum may possibly benefit people
at risk of Alzheimer’s disease. [7]

In a study of transgenic mice, tetrahydroxystilbene glucoside prevents, i.e.
at an early stage, the learning-memory deficit in Alzheimer's disease -like
model, and also reverses the learning-memory deficit in the late stage of
Alzheimer's disease -like model. [15]

Its Potential Benefits on Memory and Learning:
Supplements of the Polygonum multflorum extracts were found to improve
the learning and memory ability and reduce the brain pathological changes
in mice. [17, 18] Treatment with high-dose 2,3,5,4'-tetrahydroxystilbene-2-O-
beta-d-glucoside in rats at 24 months of age had significant improvement in
the learning-memory abilities in the water maze tests associated with an
increase in the number of synapses and synaptic vesicles, and an elevation
of expression of synaptophysin in the hippocampus.  [12]

Its Potential Benefits on High Triglyceride
The 50% ethanol PM extract group showed significantly lower total
cholesterol and triglyceride values than the other groups, but the HDL
cholesterol level was the same. [18] In another study, the root of Polygonum
multiflorum exhibited inhibitory effect on triglyceride accumulation in the liver
of mice induced by CCl4, cortisone acetate and thioacetamide. [22]

Its Potential Benefits on High Blood Pressure
Emodin and scoparone from Polygonum multiflorum exhibit vasorelaxant and
immunosuppressive effects. Emodin and scoparone dose dependently
relaxed rat thoracic aortic rings precontracted with phenylephrine. Emodin
and scoparone also dose dependently suppressed the responses of human
mononuclear cells to phytohemagglutinin and mixed lymphocyte reaction.
[24]

Its Potential Benefits on Cancers
Extracts of polygonum multiflorum was found to be effectively to reduce
tumor incidence in a rate study. [21]

Its Potential Benefits on Menopausal Symptoms:
An in vitro study shows the estrogenic effects of polygonum multiflorum,
suggesting its potential benefits on menopausal symptoms. [16]

What does Polygonum multiflorum (knotweed) contain?
The contents of minerals are different from sources to sources. For
example, the contents of Al, Ca, K, Mg, Sr,Ti in wild P. multiflorum were
remarkable higher than those in cultured P. multiflorum. [10]  It also contains
Chrysophanol, Physcion, Emodin, Aloeemodin, Rhein, Physcion-8-O-beta-D-
glucoside, Emodin-8-O-beta-D-glucoside,2,3,5,4'-Tetrahydroxy-stibene-2-O-
beta-D-glucoside, Noreugenin, Apigenin, Daucosterol, beta-Sitosterol,
Stearic acid.[6] 6''-O-monogalloyl ester of (E)-2,3,4',5-beta-
tetrahydroxystilbene-2-beta-D-glucopyranoside. [8]

Its Potential Benefits on High GOT and GPT
Researchers found the stilbene glucosides from Polygonum ssp. reduced
the elevation of GOT and GPT levels in the serum of rats with liver injuries.
[23] Does it really benefit people suffered from liver illness? Please, read
the section about its side effects.

What are the side effects of polygonum multiflorum?
There are reports that polygonum multiflorum supplement was associated
with acute hepatitis. [9, 13, 14] Acute hepatitis associated with Shou-Wu-
Pian (prepared from Polygonum multiflorum) was reported in Australia in
2001. Cholestatic hepatitis developed in a Chinese woman taking this
preparation for her gray hair. Liver biopsy showed a toxic reaction. After the
cessation of Shou-Wu-Pian, the patient recovered. [19] Hepatitis also
developed in a 31-y-old pregnant Chinese woman after consumption of
Shou-Wu-Pian (Polygonum multiflorum). Tests for viral hepatitis were
negative and there was no evidence of other systemic disease. [20]

Effective extraction method for Polygonum multiflorum is important, as it
contains harmful elements such as copper, lead and arsenic. These harmful
elements can lead to serious side effects or toxic effect of the supplements.
[5]

I am surprised that its active ingredients help lower the GOT and GPT levels but on
the other hand, it leads to hepatitis. It is unclear if it is related to its impurities, the
metals, or if it is viral infection. Users should discuss with their medical doctors
before taking any supplements.

Reference:
[1] Kwon BM, Kim SH, Baek NI, Lee SI, Kim EJ, Yang JH, Chae BS, Lee JH, Park HW,
Park JS, Kim DK. Farnesyl protein transferase inhibitory components of Polygonum
multiflorum. Arch Pharm Res. 2009 Apr;32(4):495-9. Epub 2009 Apr 29. [2] Zhang W, Xu
XL, Wang YQ, Wang CH, Zhu WZ. Effects of 2,3,4',5-Tetrahydroxystilbene 2-O-beta-D-
Glucoside on Vascular Endothelial Dysfunction in Atherogenic-Diet Rats. Planta Med.
2009 Apr 6. [3] Chen FP, Jong MS, Chen YC, Kung YY, Chen TJ, Chen FJ, Hwang SJ.
Prescriptions of Chinese Herbal Medicines for Insomnia in Taiwan during 2002. Evid
Based Complement Alternat Med. 2009 Apr 1. [4] Wang T, Gu J, Wu PF, Wang F, Xiong Z,
Yang YJ, Wu WN, Dong LD, Chen JG. Protection by tetrahydroxystilbene glucoside
against cerebral ischemia: involvement of JNK, SIRT1, and NF-kappaB pathways and
inhibition of intracellular ROS/RNS generation. Free Radic Biol Med. 2009 Aug 1;47(3):
229-40. Epub 2009 Mar 9. [5] Wen Z, Liu B, Zheng ZK, You XK, Pu YT, Dang Z. Harmful
elements removal from Polygonum multiflorum by supercritical CO2 extraction Zhong
Yao Cai. 2008 Oct;31(10):1567-71. [6] Hui TT, Xue YM, Zhang QL, Sun Y, Li ZM, Rao GX.
Studies on chemical constituents from rattan of Polygonum multiflorum Zhong Yao Cai.
2008 Aug;31(8):1163-5. [7] Hou DR, Wang Y, Xue L, Tian Y, Chen K, Song Z, Yang QD.
Effect of polygonum multiflorum on the fluidity of the mitochondria membrane and activity
of COX in the hippocampus of rats with Abeta 1-40-induced Alzheimer's disease. Zhong
Nan Da Xue Xue Bao Yi Xue Ban. 2008 Nov;33(11):987-92. [8] Kim HK, Choi YH, Choi
JS, Choi SU, Kim YS, Lee KR, Kim YK, Ryu SY. A new stilbene glucoside gallate from the
roots of Polygonum multiflorum. Arch Pharm Res. 2008 Oct;31(10):1225-9. Epub 2008
Oct 29. [9] Laird AR, Ramchandani N, deGoma EM, Avula B, Khan IA, Gesundheit N.
Acute hepatitis associated with the use of an herbal supplement (Polygonum
multiflorum) mimicking iron-overload syndrome. J Clin Gastroenterol. 2008 Aug;42(7):
861-2. [10] Yan HJ, Fang ZJ. Study on determination and principal component analysis
of inorganic elements in Polygonum multiflorum from different areas Zhongguo Zhong
Yao Za Zhi. 2008 Feb;33(4):416-9. [11] Wang X, Zhao L, Han T, Chen S, 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. 2008 Jan 14;578(2-3):339-48. Epub 2007 Oct 25. [12] Wang R, Tang Y, Feng
B, Ye C, Fang L, Zhang L, Li L. Changes in hippocampal synapses and learning-
memory abilities in age-increasing rats and effects of tetrahydroxystilbene glucoside in
aged rats. Neuroscience. 2007 Nov 23;149(4):739-46. Epub 2007 Sep 12. [13] Yuen MF,
Tam S, Fung J, Wong DK, Wong BC, Lai CL. Traditional Chinese medicine causing
hepatotoxicity in patients with chronic hepatitis B infection: a 1-year prospective study.
Aliment Pharmacol Ther. 2006 Oct 15;24(8):1179-86. [14] Cárdenas A, Restrepo JC,
Sierra F, Correa G. Acute hepatitis due to shen-min: a herbal product derived from
Polygonum multiflorum. J Clin Gastroenterol. 2006 Aug;40(7):629-32. [15] Zhang L, Xing
Y, Ye CF, Ai HX, Wei HF, Li L. Learning-memory deficit with aging in APP transgenic mice
of Alzheimer's disease and intervention by using tetrahydroxystilbene glucoside. Behav
Brain Res. 2006 Oct 16;173(2):246-54. Epub 2006 Aug 9. [16] Zhang CZ, Wang SX,
Zhang Y, Chen JP, Liang XM.In vitro estrogenic activities of Chinese medicinal plants
traditionally used for the management of menopausal symptoms. J Ethnopharmacol.
2005 Apr 26;98(3):295-300. [17] Chan YC, Wang MF, Chang HC. Polygonum multiflorum
extracts improve cognitive performance in senescence accelerated mice. Am J Chin
Med. 2003;31(2):171-9. [18] Chan YC, Cheng FC, Wang MF. Beneficial effects of different
Polygonum multiflorum Thunb. extracts on memory and hippocampus morphology. J
Nutr Sci Vitaminol (Tokyo). 2002 Dec;48(6):491-7. [19] Park GJ, Mann SP, Ngu MC. Acute
hepatitis induced by Shou-Wu-Pian, a herbal product derived from Polygonum
multiflorum. J Gastroenterol Hepatol. 2001 Jan;16(1):115-7. [20] But PP, Tomlinson B,
Lee KL. Hepatitis related to the Chinese medicine Shou-wu-pian manufactured from
Polygonum multiflorum. Vet Hum Toxicol. 1996 Aug;38(4):280-2. [21] Horikawa K, Mohri
T, Tanaka Y, 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 Nov;9(6):523-6. [22] Liu C, Zhang Q, 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 Oct;17(10):595-6, 639. [23] Kimura Y,
Ohminami H, Okuda H, Baba K, Kozawa M, Arichi S.Effects of Stilbene Components of
Roots of Polygonum ssp. on Liver Injury in Peroxidized Oil-fed Rats. Planta Med. 1983
Sep;49(9):51-4. [24] Huang HC, Chu SH, Chao PD. Vasorelaxants from Chinese herbs,
emodin and scoparone, possess immunosuppressive properties.
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