Opinions on the liver damage caused by Polygonum multiflorum

Some time ago, I wrote a prescription for treating gray hair for a female patient in the outpatient clinic. This careful patient checked the side effects of all the drugs in the prescription on the Internet. Among the drugs in the prescription, there was 15 grams of processed Polygonum multiflorum. When she came back for the second time, she screamed, "The Polygonum multiflorum you prescribed for me can cause liver damage. If I am found to have liver damage after taking your medicine, you will be fully responsible." I patiently explained:

1. Side effects of Polygonum multiflorum

Polygonum multiflorum has certain toxic side effects, which are mainly because it contains toxic anthraquinones, such as chrysophanol, rhamnolide, methyl ether, etc. If taken in excessive doses, it will irritate the gastrointestinal tract and cause symptoms such as intestinal rumbling, nausea, abdominal pain, diarrhea, and vomiting. In severe cases, paroxysmal tonic spasms, restlessness, convulsions, and even respiratory paralysis may occur. Raw Polygonum multiflorum cannot be used in large doses for a long time. Long-term and large-dose use can easily cause liver damage in the human body, resulting in increased transaminase or bilirubin, and clinical symptoms such as abdominal distension, diarrhea, nausea, and anorexia. If such conditions are found, the medication must be stopped as soon as possible.

2. What are the contraindications of using Polygonum multiflorum?

In clinical use, Polygonum multiflorum can be used raw or processed. Raw use refers to the use of unprocessed Polygonum multiflorum, while processed use refers to the use of Polygonum multiflorum after processing it according to a certain processing method. Unprocessed Polygonum multiflorum is raw Polygonum multiflorum, which has the effects of detoxification and moistening the intestines and promoting bowel movements; processed Polygonum multiflorum is processed Polygonum multiflorum, which has the effects of nourishing the liver and kidneys, replenishing the essence and blood, blackening the hair, strengthening the bones and tendons, resolving turbidity and lowering lipids. It is mainly used for anemia and chlorosis, dizziness and tinnitus, premature graying of hair, soreness of the waist and knees, numbness of limbs, metrorrhagia, leukorrhea, and hyperlipidemia. Whether to use raw or processed Polygonum multiflorum should be determined based on different signs and symptoms.

3. Don’t kill Polygonum multiflorum with one blow!

Polygonum multiflorum has been used in clinical practice as a traditional Chinese medicine for a long time. Since it is a traditional Chinese medicine, its specific application should follow the theory of traditional Chinese medicine and its application rules. Traditional Chinese medicine also believes that all medicines are poisonous to some extent, and it all depends on how you control the "poison". If used correctly, it can cure diseases, but if used incorrectly, it can be fatal. This involves many aspects such as drug collection, preparation, compatibility, dosage, timing of treatment, and syndrome differentiation and treatment. This cannot be explained clearly by simple pharmacological analysis. It is obviously not rigorous to rely solely on pharmacological analysis to determine whether Polygonum multiflorum is right or wrong.

4. Does eating too much Polygonum multiflorum really damage the liver?

I remember that the China Academy of Chinese Medical Sciences once published a report that the Institute of Chinese Materia Medica also believed that it cannot be arbitrarily said that Polygonum multiflorum is harmful to the liver. Adverse drug reactions are related to dosage and duration of administration. Chinese medicine may cause adverse effects if taken in excess or for too long. People often think that it is okay to take more tonic medicine or take it for a longer period of time. Because of this, Polygonum multiflorum is often taken in excessive amounts and for long periods of time, resulting in some abnormal liver test indicators.

5. Follow the traditional Chinese medicine's syndrome differentiation and treatment and take it with confidence!

Judging from the adverse reactions that have been reported so far, the vast majority of those involving the use of compound preparations containing Polygonum multiflorum or the use of Polygonum multiflorum alone are related to excessive medication, prolonged use of medication, or some are not used in accordance with the principles of traditional Chinese medicine for syndrome differentiation and treatment. However, there are a very small number of people who may experience some degree of abnormal liver indicators within normal medication dosage and time range. These people are often hypersensitive people, and some may have adverse reactions to multiple drugs or foods.

Therefore, if you take Polygonum multiflorum alone, you should take it according to clinical symptoms and syndrome differentiation or according to the doctor's advice. In my experience, when you prescribe Polygonum multiflorum, whether it is raw or processed, for the sake of caution, remember to first ask the patient whether there are any abnormalities in the liver test before, and make records in preparation for any unexpected events.