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
Chinese 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
Chinese Knotweed may benefit people at risk of Alzheimer's disease, as Chinese Knotweed 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, Chinese Knotweed 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]

Chinese Knotweed Benefits on Memory and Learning:
Supplements of the Chinese Knotweed 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]

Chinese Knotweed 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 Chinese Knotweed
exhibited inhibitory effect on triglyceride accumulation in the liver of mice induced by CCl4, cortisone acetate
and thioacetamide. [22]

Chinese Knotweed Potential Benefits on High Blood Pressure
Emodin and scoparone from Chinese Knotweed 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]

Chinese Knotweed Benefits on Cancers
Extracts of Chinese Knotweed 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 Chinese Knotweed, suggesting its potential benefits on
menopausal symptoms. [16]

What does Chinese 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 Chinese Knotweed?
There are reports that Chinese Knotweed supplement was associated with acute hepatitis. [9, 13, 14] Acute
hepatitis associated with Shou-Wu-Pian (prepared from Chinese Knotweed) 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 (Chinese Knotweed).
Tests for viral hepatitis were negative and there was no evidence of other systemic disease. [20]

Effective extraction method for Chinese Knotweed 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,
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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.
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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.
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