Fo-Ti known as Polygonum multiflorum is one of the more popular herbs used in traditional Chinese medicine.
It is known more commonly as He shou wu in China and Fo-ti in North America, with research showing how this herb is beneficial for the treatment of hair loss, cancer, diabetes, neurogenerative diseases, and hardening of arteries.
Table of Contents
What Is Fo-Ti?
Fallopia maltiflora or P. multiflorum (Polygonum multiflorum Thunb, is listed officially in the Chinese Pharmacopoeia and is known as a highly popular herb used in both North America and Chinese medicines and is known as Fo-ti.
This herb is cultivated widely across China along with various other countries like Japan, where it grows rapidly in hillside forests, valley shrubs, gutter-rock crevices along with other locations.
These plants grow to 2 to 4m in height and made up of a woody-tuber, with leaves of 3 to 7cm in length with an arrowhead-shape, the flowers are greenish-white or white with a 6 to 7mm in diameter along with achene fruit that grows to 2.5 to 3mm in length.
Parts of the Fo-ti plant have been used for many years for various medicinal purposes.
The rhizomes, root tuber, and leaves are commonly used in anti-aging formulas and tonics, and the stems are widely used for treating diabetes and alleviating insomnia.
The Chemical Make-Up of Fo-Ti:
Over 100 chemical-compounds are isolated from Fo-ti, with the more biologically components that relevant have gone onto to be determined as part of the families associated with phospholipids, flavonoids, stilbenes, and quinones.
The process of processing Fo-ti in comparison to using the herb in raw form will influence the type and amount of chemical- constituents found in these plants.
Toxicity levels associated with processes Fo-ti is less in comparison to a crude-herb, that is believed to be linked with lower levels of a few components after the process of processing.
In addition, processing Fo-ti has also resulted in forming 5 new chemicals which were not present in the raw herb. For the list of full-names along with the new chemicals go to the technical section. For the comprehensive list of chemical constituents found in Fo-ti, visit the article by Lin et al. (2015).
Two of the better-studied constituents associated with Fo-ti are inclusive of emodin and TSG (2,3,5,4'-tetrahydroxystilbene-2-O-beta-D-glucoside).
The Pharmacokinetics Of Fo-Ti:
To date, there is limited data available in association with specific constituents of Fo-ti.
It has been discovered that rats will quickly absorb TSG into their bodily fluids, which is quickly eliminated, which distributes through the ling and liver, but minimally through the blood-testicle and blood-brain barriers.
Emodin is mainly found in the area of the brain and the liver.
Health Benefits Associated with Fo-Ti:
Fo-ti is associated with a wide-spectrum when it comes to pharmacological effects that include anti-inflammatory, anticancer, anti-aging, neuroprotective, and immunologic effects.
However, there are only minimal clinical studies which were conducted to evaluate traditional based therapeutic claims. Or to understand the therapeutic potentials of the bioactive compounds.
The Immune Supporting Effects Linked with Fo-Ti:
1) Anti-inflammatory effects:
Emodin and TSG found in Fo-ti can lower inflammation and assist with colitis present in mice models in the way increasing the PPAR-gamma along with decreasing the NF-kB (R, R1, R3).
In studies conducted on mice, methanol-extracts of Fo-ti showed anti-inflammatory effects on the macrophage cells which is stimulated by what is known as lipopolysaccharide which is one of the bacterial toxins from a harmful bacterium.
In this Fo-ti extract, it inhibited NF-kB activation and therefore lowered COX-2 enzyme, nitric oxide along with the inflammatory cytokines such as IL-6 and TNF-alpha. Emodin performs the role of protecting microglia cells from inflammation inside the brain due to the lipopolysaccharides via AMPK/Nrf2 activation.
2) Promotes better immune function:
Sugars such as glucose, rhamnose, xylose, and arabinose along with anthraquinone glycosides in Fo-ti can improve the immune responses as well as overall immune-system functions.
Fo-ti can boost immune-systems in the way of increasing production of the B and T cells, and improving activities in the immune cells, along with increasing secretions of inflammatory tumor necrosis factor.
In addition, Fo-ti increases the activities of the NK (natural killer) cells.
3) Might be effective against MRSA:
Fo-ti features anti-bacterial activities against MRSA (methicillin-resistant Staphylococcus aureus) in cell-based studies.
4) Antiviral activities:
Fo-ti has exhibited anti-HIV properties in the way of stopping this virus from entering into the lymphocytes according to cell-based studies.
While emodin blocks the binding of the SARS coronavirus in the human cells, discovered in one of the cell-based studies.
5) May assist with asthma:
In studies conducted on mice for asthma, Fo-ti lowered the airway allergic symptoms.
The Antioxidant Activities of Fo-Ti:
1) Protects the liver:
The polysaccharides and anthraquinones located in Fo-ti can protect the liver in the way of lowering inflammation, stopping fat oxidation as well as maximizing antioxidant effects.
A study that involved pre-treating rats with a 200mg/kg water-extract of Fo-ti protected the rats from chloroform-induced liver toxicity along with dramatically reducing plasma ALT the liver enzyme which indicates damages to the liver along with improving glutathione levels and other types of oxidative-stress markers.
In further studies, an increase in the dose to 400mg/kg failed to protect the rat's livers from chloroform toxicity. In a study that increased the dose to 4000mg/kg, the Fo-ti caused damages to the liver.
2) May protect the bones from oxidative stress:
TSG from Fo-ti extracts can protect bone-making cells known as osteoblasts from oxidative damages according to cell-based studies and suggests that TSG might protect against conditions such as osteoporosis caused by oxidative stress.
The hot water extracts of Fo-ti stops osteopenia (bone loss) in mice that have lost their bone mass after they have had their ovaries taken out.
3) Protects tissue oxidation in diabetes:
2,3,5,4'-tetrahydroxystilbene-2-O-beta-D-glucoside can protect against damages t the kidneys caused by high blood sugar levels in mice with diabetes through TGF-beta1 and SIRT1 pathways.
Stilbene glucoside found in Fo-ti prevents tissue aging caused by high blood sugar.
The Neuroprotective Effects of Fo-Ti:
1) Might assist with Alzheimer's disease:
In mice studies conducted on Alzheimer's the tetrahydroxystilbene glucoside associated with Fo-ti assists with memory deficits. In a Chinese clinical trial, it was discovered that Fo-ti extracts were an effective treatment for Alzheimer's disease.
It was found that tetrahydroxystilbene glucoside was able to slow down the age-associated memory-loss in studies conducted on rats. In cell-based studies, treatment using a Fo-ti root-extract was found to reduce amyloid plaques which are one of the causes of Alzheimer's disease.
The chemical known as emodin found in Fo-ti stops the enzyme which is responsible for breaking down acetylcholine that may be the explanation for how it assists with cognitive functions like Huperzine A and some of the Alzheimer's medications.
2) May assist with Parkinson disease:
In mice studies conducted on Parkinson Disease, ethanol and a TSG extract of Fo-ti protected the dopaminergic-neurons from chemically-induced damages.
3) Protects the brain from strokes:
The hexane extracts in Fo-ti can protect against damages to the tissues after a stroke in studies conducted on mice and might result in chemical applications when it comes to a type of protective-agent against the neurological injuries.
4) Protects against glutamate-induced toxicity:
According to one the recent cell-based studies, Fo-ti protected the hippocampus from glutamate toxicity, which suggests it can assist with the cognitive disorders, particularly the types which are associated with memory loss.
Fo-Ti and Cardiovascular Risks:
1) Helps to reduce cholesterol:
Fo-ti has the abilities to decrease triglycerides and cholesterol in individuals who have high cholesterol.
Yet, additional research is needed to gain an understanding of how Fo-ti can decrease cholesterol.
2) Prevents the hardening of arteries:
TSG can stop the arteries from hardening by decreasing lipid-levels inside the blood, decrease inflammation as well as normalize structures in blood vessels through a decrease in MMP-2 as well as MMP-9 genes expressions.
3) Protective effects associated with blood-clotting disorders:
Blood clotting (thromboembolic) disorders which result from lose blood-clots which form inside the blood vessels and are then transported in the bloodstream into other vessels which then become blocked.
This occurs more frequently in the area of the lungs which causes pulmonary embolisms, the brain which causes strokes, in the legs, kidneys and gastrointestinal tract. This is a phenomenon which is called thromboembolism.
2,3,5,4'-tetrahydroxystilbene-2-O-beta-D-glucoside a chemical isolated from Fo-ti is able to prevent this abnormal blood-clotting.
4) Protects the heart:
In studies conducted in rats, TSG protected the hearts from the squeezing pressure caused around the area of the abdomen.
In the heart-attack models, stilbene glycoside in Fo-ti protects against the cell injuries caused from a lack of blood flow or oxygen in the way of increasing cellular antioxidant levels like nitric oxide, superoxide dismutase, peroxidase and glutathione pathways.
5) Assists with fructose-induced metabolic syndrome:
Fo-ti combined with red-ginseng can assist with what is known as fructose-induced metabolic-syndrome in the way of decreasing high blood-pressure, high-blood lipids, obesity, insulin sensitivity and inflammation inside the blood vessels.
1) Fo-Ti can help to prevent cancer:
Cell death, known as anthraquinones induce-apoptosis in the cancer cells, is able to activate PI3K/AKT/mTOR pathways that are abnormal when it comes to many of the human cancers.
Aloe-emodin and emodin can stop cell growth in cervical cancer cells, melanoma cells, neuroblastoma cells, and tongue cancer cells.
It was found that emodin dramatically decreased colon tumor weight and volumes in mice. Also, enhanced cell-death in the gallbladder cancer-cells which were injected into mice.
2) Helps with sleep disorders and insomnia:
The Fo-ti extracts have been prescribed commonly in Taiwan for treating insomnia.
In addition, even though the evidence is still insufficient, P. multiflorum might ease insomnia and anxiety experienced by people who have bipolar disorder.
3) Assists with hair growth:
Traditionally Fo-ti has been used for treating people with hair loss and baldness all over East Asia.
Traditional use of this herb has gone onto be substantiated in studies which have been performed in mice studies, that have shown that P. multiflorum extracts where able to encourage hair growth in the way of inducing anagen phases in the resting hair-follicles.
Another compound known as Torachrysone-8-O-beta-D-glucoside in P. multiflorum may increase the amount of the dermal papilla-cells that are associated with hair-fiber length and hair growth.
The Potential Toxicity and Side Effects of Fo-Ti:
1) Liver toxicity:
One of the better-known toxicities associated with P. multiflorum has to do with induction of what is known as Hepatotoxicity induced from P. multiflorum which can be severe or cause death.
Some cases associated with hepatotoxicity from P. mulitiflorum were reported in the patients in Slovakia, Australia, Netherlands, Japan, Italy, and China, who took this product for the purpose of chronic prostatitis, hair loss or for boosting the immune system.
The primary chemicals held responsible for hepatotoxicity caused by P. multiflorum where free from the anthraquinones like physcion and emodin. Toxicity associated with emodin is detailed within the U.S. National Toxicology Program.
Hepatotoxicity of water extract is higher compared to acetone and ethanol extracts of P. multiflorum. The processing of P. multiflorum decreases hepatotoxicity.
2) Lung and kidney toxicity:
P. multiflorum is toxic for the kidneys known as nephrotoxicity and for the lungs known as pulmonary toxicity, especially for long-term use.
P. multiflorum was discovered to cause embryonic toxicity when it comes to mice and can affect embryonic developments, which is a suggestion that it is not safe for use in women that are pregnant.
In addition, a drug such as Warfarin which is often prescribed for preventing blood clot formation can negatively interact with P. multiflorum that results in suppression of bone marrow.
Underlying mechanisms associated with P. multiflorum can be linked to antioxidant effects linked to TSG, which lower angiotensin II levels, suppressing transforming growth-factor expression as well as inhibiting extracellular signal-regulated kinase and the p38 mitogen-activated kinase activation.
The term cardiac remodeling is a reference to changes in structure, shape, function, and the size of a heart and usually results pathologically from injuries to a heart muscle.
A number of studies demonstrate that anti-inflammatory effects linked with P. multiflorum occur by inhibiting expressions of the pro-inflammatory signal factors like cytokines, chemokines, cyclooxygenase-2, inducible nitric oxide synthase, tumor necrosis factor, and nuclear factor.
Also, the other markers associated with diabetes, including expressions of SIRT1 genes and TGF-beta1, COX-2, was discovered to improve in the TSG-treated rats with diabetes dramatically.
The full-chemical names associated with compounds that are present in P. multiflorum after the process of processing are 5-dihydroxy-6-methyl-4(H)-pyran-4-one, butanedioic acid, 5-hydroxymethylfurfural, 5-hydroxymethyl, and 2,3-di-hydro-3,5-dihydroxy-6-methyl-4(H)-pyran-4-one.
P. multiflorum can boost immune systems in the way of speeding up production of B and T lymphocytes which initiates mixed lymphocyte reactions, increasing secretion of TNF (tumor necrosis factor) and improving the macrophage-phagocytosis.
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