Should Cancer Patients Use Heshouwu (Fo-Ti)? How to Use It Safely
Heshouwu (Fallopia multiflora / Fo-ti) is a household-name Chinese herb. As the name suggests, many believe it turns white hair black, to the point that shampoos advertise Heshouwu extract as restoring dark hair.
Most people know Heshouwu as a tonic, but not that it also has toxic side effects. The anthraquinone derivatives in Heshouwu have a purgative effect. Its active anthraquinones are mainly chrysophanic acid (chrysophanol) and emodin, with lesser amounts of rhein and trace physcion and chrysophanic acid anthrone—the same constituents as rhubarb (Dahuang). So its purgative side effect is no surprise.
Anthraquinone derivatives are also hepatotoxic. Common toxic reactions to Heshouwu include jaundice (yellowing of skin and sclera), nausea, vomiting, diarrhea, fatigue, weakness, dark urine, poor appetite, stomachache, and abdominal pain. Clinical reports exist of elevated transaminases and liver damage from taking Heshouwu, and of repeated jaundice and hepatic injury from Heshouwu tablets. Some patients develop allergic or familial allergic reactions after Heshouwu, with fever, nausea, scattered skin rash, drug fever, ocular pigmentation, psychiatric symptoms, dry mouth and dizziness, trance-like states, limb convulsions, and even upper gastrointestinal bleeding.
The toxic dose of Heshouwu is generally above 60 g, but special patients have been poisoned at under 10 g. Some years ago a woman reportedly died after taking an herbal paste prescribed by an old TCM doctor; the paste contained only a few grams of Heshouwu, and the fatality was mainly due to her underlying diseases.
Heshouwu's side effects have long been overlooked, yet some ancient materia medica works recorded them. Bencao Huiyan notes that Heshouwu "has slight toxicity, enters and communicates with the liver, externally joins with wind; it is ascending and yang." Successive materia medica also caution that those with loose stools or damp-phlegm should use it cautiously.
Moreover, since ancient times Heshouwu has mostly been used processed: raw Heshouwu is nine-steamed and nine-sunned into processed (Shouwu), sometimes steamed and sunned together with black beans and yellow rice wine. Modern pharmacology confirms processed Heshouwu is over fifty times less toxic than the raw. The free anthraquinones produced by steaming not only lack purgative action but increase liver glycogen in starving adrenalectomized mice and enhance immunity. Processing for 32 hours gives the best color and strongest tonic effect. Many patients wild-harvest Heshouwu without knowing how to process it and eat the raw root directly, achieving no tonic effect but instead unexpected side effects—a pity.
Yet for some conditions raw Heshouwu is preferred, because its purgative action can relieve constipation from certain diseases, and raw Heshouwu treats scabies and sores well—effects that decline after processing.
Heshouwu's toxicity warrants vigilance, but one should not throw out the baby with the bathwater. I write about its toxicity mainly to correct current misuse. Properly processed Heshouwu is indeed a fine tonic.
Modern medicine confirms Heshouwu enhances immunity, delays aging, protects the liver, lowers lipids, and is antibacterial. Lecithin from Heshouwu, diluted 1:100,000 to 1:200,000, strengthens myocardial contraction in isolated frog hearts—especially in fatigued hearts. Heshouwu injection slows heart rate and increases coronary flow. Oral decoction of processed Heshouwu also protects against acute myocardial ischemia induced by posterior pituitary extract in rabbits. Animal experiments in toads and rabbits confirm it markedly dilates peripheral vessels.
Traditional medicine holds that Heshouwu nourishes blood and yin, moistens the intestines, stops malaria, expels wind, and resolves toxins. It is used for dizziness and vertigo from blood deficiency, palpitations, insomnia, soreness and weakness of the lower back and knees from liver-kidney yin deficiency, premature graying, tinnitus, seminal emission, dry constipation, debility from prolonged malaria, rubella and itching, sores, and scrofula. It suits frail long-ill patients and cancer patients alike; the optimal dose for the chronically ill in decoction is 30 g of Zhi Shouwu (processed Fo-ti). If using raw Heshouwu, best obtain a doctor's prescription rather than self-medicate.