He Shou Wu (Fo-Ti)

Updated June 29, 2026

He Shou Wu (何首乌) is the root of Polygonum multiflorum (also called Reynoutria multiflora or Fallopia multiflora), a climbing vine native to central and southern China. The name translates loosely as “the black-haired Mr. He” — a reference to a Tang Dynasty folk story about a man who restored his black hair and youthful vitality with the root. In Traditional Chinese Medicine it is one of the most prized longevity and tonic herbs, used for millennia for hair health, premature greying, kidney and liver strengthening, and anti-aging. Western interest has grown substantially in the nootropic and biohacking communities, primarily for its purported effects on hair, sexual vitality, and longevity pathways.

The primary bioactive compounds are stilbene glycosides (particularly 2,3,5,4′-tetrahydroxystilbene-2-O-β-d-glucoside, or THSG), anthraquinones including emodin and physcion, and various flavonoids. THSG has demonstrated antioxidant, neuroprotective, and anti-inflammatory activity in preclinical studies. Emodin activates SIRT1 in some models, providing a theoretical mechanism for the longevity association. Animal studies show improvements in memory, reduced oxidative stress in brain tissue, and mild androgen support. Human evidence for most traditional claims is limited to observational data and small trials.

The hair and anti-greying claim is the most culturally prominent. Mechanistically, THSG has been shown in cell culture to stimulate melanocyte activity and reduce oxidative damage to hair follicle cells — the kind of damage associated with premature greying. Whether this translates to measurable hair colour restoration in humans at realistic doses is not established by controlled trial data. Some users report subjective improvements, but the evidence base is primarily traditional and anecdotal at the human level.

The hepatotoxicity concern is real and must be clearly stated. He Shou Wu is one of the most frequently implicated herbal supplements in drug-induced liver injury (DILI) case reports globally. The WHO, the UK’s MHRA, and Australia’s TGA have all issued safety warnings. Over 450 published case reports describe liver injury ranging from mild transaminase elevation to acute liver failure requiring transplantation. The injury is idiosyncratic — it does not occur in most users but is unpredictable, dose-independent in some cases, and can appear after weeks or months of use. Raw (unprocessed) He Shou Wu carries higher risk than the traditionally prepared form (processed with black bean soup, called zhì shǒu wū), but processed forms have also been implicated in liver injury cases.

For anyone who chooses to use it, the minimally cautious approach involves using only the traditionally processed form from a verified source, starting at the lowest dose (typically 500 mg to 1 g daily), avoiding concurrent use of other hepatotoxic substances including alcohol, and monitoring liver enzymes (ALT, AST) before starting and after 4 to 6 weeks. Stop immediately and seek medical attention if symptoms of liver stress appear: unusual fatigue, nausea, abdominal discomfort, yellowing of the skin or eyes, or dark urine. This is general information, not medical advice — given the liver injury risk, clinician oversight is strongly recommended before use.