Fo-Ti / He Shou Wu (Polygonum multiflorum)

Fo-ti - better known by its Chinese name He Shou Wu (and sold as Shou Wu Pian) - is the root of Polygonum multiflorum, a climbing knotweed used for centuries in traditional Chinese herbalism and marketed today mainly for reversing grey hair, slowing ageing, treating hair loss and relieving constipation. ORIA grades it caution, and it sits toward the more serious end of that grade, for a stark reason: the benefits are essentially unproven in rigorous human studies, while the liver harm is well documented. The US National Institutes of Health LiverTox database - the authoritative reference on herb- and supplement-induced liver injury - records that Polygonum multiflorum has been implicated in numerous reports of clinically apparent acute liver injury, presenting with jaundice and sharply raised liver enzymes. While many cases are self-limited and resolve after stopping the herb, the injury can be prolonged, and it is occasionally fatal. Two features make it especially worth respecting: the reaction is idiosyncratic, meaning it can strike unpredictably rather than only at very high doses, and recurrence is common and dangerous if someone stops and later restarts the herb, so rechallenge must be avoided. The documented cases include a five-year-old child who developed jaundice after months of use. The constituents thought to be responsible include anthraquinones and stilbene glycosides, and toxicity appears to depend partly on how the root is processed. ORIA's honest risk-benefit read is the whole point of the verdict: when a product offers shaky, largely cosmetic benefits and carries a real, documented, occasionally fatal risk of liver injury, the sensible conclusion is that it isn't worth taking. Anyone who has used He Shou Wu and notices yellowing of the skin or eyes, dark urine, pale stools, abdominal pain or unusual fatigue should stop immediately and seek medical attention. Verdict: weak evidence for the promised benefits, a serious and well-characterised liver-safety signal - caution, and ORIA's plain advice is to give it a miss.