Polygonum multiflorum
Common name
Fo Ti
ID
HD0051
Scientific name of the plant
Polygonum multiflorum Thunb.
Anatomical part for use
root
Human use
Miscellaneous
Summary
Reynoutria multiflora (syn. Fallopia multiflora and Polygonum multiflorum) is a species of flowering plant in the buckwheat family Polygonaceae native to central and southern China. It is known by the English common names tuber fleeceflower and Chinese (climbing) knotweed. It is known as he shou wu in China and East Asia. Another name for the species is fo-ti, which is a misnomer. The name he shou wu means 'the black-haired Mr. He'.It can be difficult to prevent the spread of this vining plant and to remove it once established. The leaves are thin and fragile but the stems, although narrow in diameter, can be very strong. (Source: Wiki)
Evidence Level
Level 4 (Individual reports repeated observed over 5 years among different countries)
Hepatotoxicity reports in literature
- Acute hepatitis induced by Shou-Wu-Pian, a herbal product derived from Polygonum multiflorum : (Source)
- Acute hepatitis due to shen-min: a herbal product derived from Polygonum multiflorum : (Source)
- [Toxic hepatitis associated with Polygoni multiflori] : (Source)
- Drug-Induced Liver Injury: Twenty Five Cases of Acute Hepatitis Following Ingestion of Polygonum multiflorum Thunb : (Source)
- Eighteen cases of liver injury following ingestion of Polygonum multiflorum : (Source)
- Idiosyncratic drug-induced liver injury linked to Polygonum multiflorum: A case study by pharmacognosy : (Source)
- Toxic hepatitis induced by show-wu-pian, a Chinese herbal preparation : (Source)
Hepatotoxicity Description
Several published cases and a large case series from China, Korea and Japan of clinically apparent acute liver injury have been attributed to use of Polygonum multiflorum. Indeed, in China Polygonum multiflorum is reported to be the most common cause of herbal product related liver injury. The latency to onset is usually short, but ranges from a few days to as long as 6 months. The pattern of serum enzyme elevations is typically hepatocellular or mixed and the clinical presentation resembles acute viral hepatitis with onset of fatigue, nausea and right upper quadrant pain followed by dark urine and jaundice. Immunoallergic features are uncommon as are autoantibodies. Liver biopsy shows changes typical of acute hepatitis. The course is usually self-limited, resolving rapidly once the herbal is discontinued, but up to 10% of clinically apparent cases have been fatal or led to urgent liver transplantation. Recurrence upon re-exposure with a more rapid time to onset has been reported. Recent case series have identified the HLA allele B*35:01 as a risk factor, being found in 70% to 88% of cases compared to 5% of controls in Chinese populations. A similar HLA-association has been found for green tea in the United States. (Source: LiverTox)
Traditional medicine
Reynoutria multiflora is listed in the Chinese Pharmacopoeia and is one of the most popular perennial traditional Chinese medicines. Caution must be taken, however, as overconsumption can lead to toxicity-induced hepatitis. (Source: Wiki)
Common name
Fo Ti
ID
HD0051
Scientific name of the plant
Polygonum multiflorum Thunb.
Anatomical part for use
root
Human use
Miscellaneous
Summary
Reynoutria multiflora (syn. Fallopia multiflora and Polygonum multiflorum) is a species of flowering plant in the buckwheat family Polygonaceae native to central and southern China. It is known by the English common names tuber fleeceflower and Chinese (climbing) knotweed. It is known as he shou wu in China and East Asia. Another name for the species is fo-ti, which is a misnomer. The name he shou wu means 'the black-haired Mr. He'.It can be difficult to prevent the spread of this vining plant and to remove it once established. The leaves are thin and fragile but the stems, although narrow in diameter, can be very strong. (Source: Wiki)
Evidence Level
Level 4 (Individual reports repeated observed over 5 years among different countries)
Hepatotoxicity reports in literature
- Acute hepatitis induced by Shou-Wu-Pian, a herbal product derived from Polygonum multiflorum : (Source)
- Acute hepatitis due to shen-min: a herbal product derived from Polygonum multiflorum : (Source)
- [Toxic hepatitis associated with Polygoni multiflori] : (Source)
- Drug-Induced Liver Injury: Twenty Five Cases of Acute Hepatitis Following Ingestion of Polygonum multiflorum Thunb : (Source)
- Eighteen cases of liver injury following ingestion of Polygonum multiflorum : (Source)
- Idiosyncratic drug-induced liver injury linked to Polygonum multiflorum: A case study by pharmacognosy : (Source)
- Toxic hepatitis induced by show-wu-pian, a Chinese herbal preparation : (Source)
Hepatotoxicity Description
Several published cases and a large case series from China, Korea and Japan of clinically apparent acute liver injury have been attributed to use of Polygonum multiflorum. Indeed, in China Polygonum multiflorum is reported to be the most common cause of herbal product related liver injury. The latency to onset is usually short, but ranges from a few days to as long as 6 months. The pattern of serum enzyme elevations is typically hepatocellular or mixed and the clinical presentation resembles acute viral hepatitis with onset of fatigue, nausea and right upper quadrant pain followed by dark urine and jaundice. Immunoallergic features are uncommon as are autoantibodies. Liver biopsy shows changes typical of acute hepatitis. The course is usually self-limited, resolving rapidly once the herbal is discontinued, but up to 10% of clinically apparent cases have been fatal or led to urgent liver transplantation. Recurrence upon re-exposure with a more rapid time to onset has been reported. Recent case series have identified the HLA allele B*35:01 as a risk factor, being found in 70% to 88% of cases compared to 5% of controls in Chinese populations. A similar HLA-association has been found for green tea in the United States. (Source: LiverTox)
Traditional medicine
Reynoutria multiflora is listed in the Chinese Pharmacopoeia and is one of the most popular perennial traditional Chinese medicines. Caution must be taken, however, as overconsumption can lead to toxicity-induced hepatitis. (Source: Wiki)