Bupleurum      Common names: Thorowax, Saiko, Hare’s ear, Chai hu Botanical names: Bupleurum chinense, Bupleurum falcatum Skip to: Botany Helpful for Traditional use How it works Amount to take Side effects & interactions References Parts used and where grown These Asian plants are part of the Apiaceae (Umbelliferae) family, and resemble dill or fennel. However, bupleurum has long thin leaves rather than the lacy appearance of fennel and dill leaves. The Chinese name for bupleurum, chai hu, means “kindling of the barbarians.” The origin of this name is unclear. The roots of the plant are used in herbal medicine. Bupleurum has been used in connection with the following conditions (refer to the individual health concern for complete information): Health Concerns Epilepsy Hepatitis (viral) Irritable bowel syndrome (Chinese herbal combination formula containing wormwood, ginger, bupleurum, schisandra, dan shen, and other extracts) Liver cirrhosis HIV/AIDS Historical or traditional use (may or may not be supported by scientific studies) Bupleurum has been used in Traditional Chinese Medicine for thousands of years to help relieve numerous conditions. Most particularly, infections with fever, liver problems, indigestion, hemorrhoids, and uterine prolapse.1 Bupleurum is a key ingredient in the formula known as sho-saiko-to. This is a Japanese kampo or traditional herbal medicine formula based on the traditional Chinese formula xiao-chai-hu-tang. In English, it has been called minor bupleurum formula. Bupleurum makes up 16% of the formula for sho-saiko-to (see below for the complete contents of the formula). Results reported for sho-saiko-to cannot be attributed solely to bupleurum because the other herbs in the formula also contribute.2 Sho-saiko-to (xao-chai-hu-tang or minor bupleurum formula) contains the following: Bupleurum falcatum (thorowax) root, 16% Paeonia lactiflora (peony) root, 16% Pinellia ternata (ban xia) rhizome, 14% Cinnamomum cassia (cassia) bark, 11% Zingiber officinale (ginger) rhizome, 11% Zizyphus jujuba (jujube) fruit, 11% Panax ginseng (Asian ginseng) root, 8% Scutellaria baicalensis (Chinese scullcap) root, 8% Glycyrrhiza uralensis (licorice, gan cao) rhizome, 5% Active constituents Bupleurum contains constituents known as saikosaponins that appear to account for much of the medicinal activity of the plant. Test tube studies have shown that the sho-saiko-to combination can increase production of various chemicals (known as cytokines) that immune cells use to signal one another. Test tube studies have also found that saikosaponins can inhibit growth of liver cancer cells, and are anti-inflammatory. Human trials, only one double-blind, have shown that the bupleurum-containing formula sho-saiko-to may help reduce symptoms and blood liver enzyme levels in children and adults with chronic active viral hepatitis. Most of these studies were in people with hepatitis B infection, though one preliminary human trial has also shown a benefit in people with hepatitis C. Sho-saiko-to was also found, in a large, preliminary (but not double-blind), study to decrease the risk of people with chronic viral hepatitis developing liver cancer. Sho-saiko-to has also been used to reduce symptoms of and possibly decrease the severity of liver cirrhosis, though clinical studies on this condition are generally lacking. One randomized trial (it was unclear if this trial was double-blind) found that sho-saiko-to could reduce the rate of liver cancer in people with liver cirrhosis. Several uncontrolled trials in Japan have shown that sho-saiko-to or very similar traditional Japanese and Chinese herbal formulas (all containing bupleurum) can reduce seizure frequency and/or severity in people with epilepsy that does not respond to anti-seizure medications. However, double-blind trials are still needed to determine the importance of these findings. Sho-saiko-to has been found to inhibit human immunodeficiency virus (HIV) in the test tube.18 Yet, it is unclear to what degree bupleurum or saikosaponins contributed to this effect. Sho-saiko-to also increased the efficacy of the standard anti-HIV drug lamivudine in the test tube.19 Human data are lacking on the benefit of sho-saiko-to or bupleurum in people with HIV infection or acquired immunodeficiency syndrome (AIDS). How much is usually taken? Generally 500–2,000 mg bupleurum dry root are taken three times daily in capsules. Traditionally, and in some clinical studies, bupleurum was prepared as a tea in which the root is decocted or cooked for hours before use. Some people take 1–4 grams per cup of water, three times daily. Sho-saiko-to formula is typically given in capsules (1.8–2.5 grams) three times per day. The amount given to children should be proportionally reduced based on individual weight and height as compared to adults. Are there any side effects or interactions? Bupleurum and sho-saiko-to taken as a tea can upset the stomach, an effect that tends to be lessened by taking them with food or in capsules. Bupleurum and sho-saiko-to are not recommended during pregnancy and breast-feeding. Sho-saiko-to has been used alone and with interferon to treat hepatitis. Eighty or more cases of drug-induced pneumonitis (inflammation of the lungs) have been associated with the use of sho-saiko-to alone or with interferon.Until more is known, sho-saiko-to should not be combined with interferon.