Overview

Fo-ti is a plant called Polygonum multiflorum. Fo-ti is available as an over-the-counter dietary supplement in various forms that are taken by mouth and forms that are applied to the skin or scalp. People take Fo-ti for many reasons, such as constipation, hair loss, graying hair, and trouble sleeping, although its benefits are not well defined. Common side effects include diarrhea, stomach pain, nausea, or vomiting. Fo-ti has been linked to reports of serious side effects, including liver damage. Check with your health care provider before using Fo-ti, especially if you have any health conditions or take any medicines.

Uses

What is Fo-ti used for?

Fo-ti (P. multiflorum) is used for various reasons, although its benefits are not well defined. Some common reasons people may take Fo-ti include the following.

• Constipation
• Graying hair
• Hair loss
• Aging
• Trouble sleeping

Note: The FDA has not reviewed Fo-ti for safety and effectiveness. Learn more about dietary supplements here.

How does Fo-ti work (mechanism of action)?

Fo-ti is a plant called Polygonum multiflorum. It is also sometimes called Chinese knotwood, Shou Wu Pian, or other names. Fo-ti supplements are usually made using the roots of the plant.

Fo-ti contains natural plant compounds called anthraquinones, which are thought to be the main active ingredients. The most common anthraquinones in Fo-ti include chrysophanol, emodin, and rhein. These compounds can affect the body in several ways. For example, they can stimulate the intestines, which may help move stool through the bowel. This is why Fo-ti is sometimes used for constipation.

Fo-ti is thought to act as an adaptogen, which is a substance that helps the body respond to stressful changes in its environment. But the benefits of taking Fo-ti as an adaptogen are not well defined.

Fo-ti may also have anti-inflammatory and antioxidant effects, meaning it may help reduce inflammation and protect cells from damage. Fo-ti extract may support hair growth by helping hair follicles stay in the active growth phase longer. To help with insomnia, Fo-ti may support sleep by affecting the energy balance in the body. However, the actual effects of Fo-ti are not well understood.

Herbal products like Fo-ti naturally contain many different chemicals. The amount of each chemical in a specific product may vary from product to product. Some, none, or all of these chemicals may have effects on the body. These effects may change depending on how much of each chemical is found in the product you are using.

How should I store Fo-ti?

You should store Fo-ti according to the product label. Most dietary supplements should be kept in a cool, dry location that is out of the reach of children and pets and not in direct sunlight.

Side Effects

What are the most common side effects of Fo-ti?

The most common side effects of Fo-ti are listed below. These side effects may vary depending on the dose you are using or the specific product you are using. Tell your health care provider if you have any of these side effects that bother you.

• Diarrhea
• Stomach pain
• Nausea and vomiting
• Numbness, tingling, or burning in your arms, feet, or face (with higher doses)

There may be other side effects of Fo-ti that are not listed here. Contact your health care provider if you think you are having a side effect of a supplement. In the U.S., you can report side effects to the FDA at www.safetyreporting.hhs.gov or by calling 888-SAFEFOOD (888-723-3366). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of Fo-ti?

While less common, the most serious side effects of Fo-ti are described below, along with what to do if they happen.

Severe Allergic Reactions. Fo-ti may cause allergic reactions, which can be serious. Stop using Fo-ti and get help right away if you have any of the following symptoms of a serious allergic reaction.

• Breathing problems or wheezing
• Racing heart
• Fever or general ill feeling
• Swollen lymph nodes
• Swelling of the face, lips, mouth, tongue, or throat
• Trouble swallowing or throat tightness
• Itching or skin rash
• Bumps on the skin called hives that can be red, pink, white, or brown depending on your skin tone
• Nausea or vomiting
• Dizziness, feeling lightheaded, or fainting
• Stomach cramps
• Joint pain

Liver Damage. Liver damage, also called hepatotoxicity, can happen when using Fo-ti. Call your health care provider right away if you have any of the following symptoms of liver damage.

• Nausea or vomiting
• Stomach or belly pain
• Fever
• Weakness or unusual tiredness
• Itching
• Loss of appetite
• Light-colored poop
• Dark-colored urine (pee)
• Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Precautions

Who should not use Fo-ti?

Allergies to Ingredients. People who are allergic to any of the following should not use Fo-ti.

• Chinese knotweed
• Fo-ti
• He Shou Pian
• He Shou Wu
• Polygonum multiflorum
• Shou Wu Pian
• Any of the ingredients in the specific product

Your pharmacist can tell you all of the ingredients in the specific Fo-ti products they stock.

What should I know about Fo-ti before using it?

Fo-ti is a dietary supplement. It cannot be marketed to treat or cure a disease.

Read and follow the directions on the specific product you are using, or use it as recommended by your health care provider.

Keep Fo-ti out of the reach of children.

Fo-ti is available in many different forms, including extracts, dried ground powder, teas, and more. It is also available in forms that can be applied to the skin or scalp. Each of these forms may contain different amounts of the chemicals naturally found in the plant.

Herbal products, such as Fo-ti, naturally contain many different chemicals. The amount of each chemical in a specific Fo-ti product can change for many reasons, including the area where the plant was grown, the weather during growth, the time of year when it was harvested, and the way the plant was processed after being harvested. If you switch to a new bottle or a different brand, you may not have the same effects or side effects because of this variability. Talk to your health care provider if you have questions or concerns.

Some traditional Chinese medicine herbal products have been linked to safety concerns, including contamination, ingredients not listed on the product label, and harmful substances that may cause serious side effects or drug interactions.

The FDA has not tested Fo-ti products to confirm that they contain the ingredients stated on their labels. Some dietary supplements have been tested by third-party organizations to confirm that they contain the ingredients listed on their labels and do not contain any harmful chemicals. Learn more about how to choose a safe dietary supplement product here.

What should I tell my health care provider before using Fo-ti?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if Fo-ti is right for you.

In particular, make sure that you discuss any of the following.

Other Medicines and Supplements. Fo-ti may interact with other medicines and supplements. Before using Fo-ti, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Current and Past Health Conditions.Tell your health care provider if you have any of the following.

• Liver problems
• Kidney problems

Pregnancy. It is not known if or how Fo-ti could affect pregnancy or harm a fetus. Tell your health care provider if you are pregnant or plan to become pregnant.

Breastfeeding. It is not known if Fo-ti passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed.

Interactions

Does Fo-ti interact with foods or drinks?

There are no known interactions between Fo-ti and foods or drinks.

It is unknown if drinking alcohol will affect Fo-ti.

Does Fo-ti interact with medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

The interactions between Fo-ti and medicines are not fully understood. As with most dietary supplements, the research on drug interactions with Fo-ti is limited. Always check with your health care provider before using Fo-ti with any medicines.

Dosing

What should I do if I accidentally use too much Fo-ti?

If you or someone else has used too much Fo-ti, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

Fo-ti comes in a range of doses and forms. Most Fo-ti products contain the root of the plant, but some products may contain other parts of the plant. Read the product label closely and speak to a health care provider about how to use Fo-ti safely. Do not take double or extra doses, even if you miss a dose.