Fo-Ti (He Shou Wu) for Liver Health

Research suggests that Fo-Ti (He Shou Wu, Polygonum multiflorum) presents a significant and well-documented hepatotoxicity risk, with multiple reviews and systematic analyses consistently identifying it as one of the most common herbs associated with herb-induced liver injury, including severe and fatal cases. The available evidence base consists primarily of reviews, case series, and mechanistic studies rather than controlled trials, and collectively these sources point toward immune-mediated and idiosyncratic mechanisms of liver injury, with one 2025 study specifically implicating a key active constituent, THSG, in T-cell-driven immune responses. Some reviews note that certain isolated compounds from the plant, including TSG, have shown hepatoprotective properties in laboratory settings, and a 2019 review acknowledged the plant's traditional use for liver and kidney support alongside its documented bioactive compounds, representing a genuinely mixed picture at the mechanistic level. However, the clinical and epidemiological evidence is not balanced in the same way — the weight of published research consistently positions Fo-Ti as a meaningful cause of liver harm in real-world use, a concern that regulatory agencies in multiple countries have also formally recognized.