He Shou Wu (何首乌): The Legendary Hair-Blackening Herb of Traditional Chinese Medicine

Introduction to He Shou Wu

He Shou Wu (何首乌, Hé Shǒu Wū), also known as Fo-Ti in Western herbal circles, is one of the most revered tonic herbs in Traditional Chinese Medicine. Its Chinese name literally means “Mr. He’s [hair] first turned black” — a name derived from a legendary folk tale about an old man named He who, after taking the herb, restored his black hair, vitality, and even fathered children in his old age.

Used for over 1,500 years, He Shou Wu is classified as a superior tonic herb (上品药) in classical texts, prized for its ability to nourish the Liver and Kidneys, enrich the Blood, and arrest aging processes — particularly premature graying and hair loss. It holds a revered place alongside Ginseng and Astragalus in the TCM materia medica.

Properties and Channel Entry

Property	Description
Taste	Bitter, sweet, astringent (苦、甘、涩)
Temperature	Slightly warm (微温)
Channels Entered	Liver (肝), Kidney (肾)

Its bitter and astringent qualities help to drain and consolidate, while the sweet flavor provides nourishment. Its affinity for the Liver and Kidney channels is central to its therapeutic actions — the Liver governs Blood and the tendons, while the Kidneys govern Essence (Jing) and govern the bones.

Raw vs. Prepared He Shou Wu

One of the most important distinctions in clinical practice is between raw (Sheng) and prepared (Zhi) He Shou Wu. The preparation process — traditionally involving repeated cooking with black soybean juice — fundamentally alters the herb’s properties and indications.

Feature	Raw He Shou Wu (生何首乌)	Prepared He Shou Wu (制何首乌)
Primary Actions	Unblocks the bowels, relieves constipation; clears heat; detoxifies	Tonifies Liver and Kidneys; nourishes Blood; blackens hair; strengthens tendons
Indications	Constipation from intestinal dryness; carbuncles and sores	Blood deficiency; premature graying; hair loss; dizziness; tinnitus; weakness in lower back and knees
Nature Change	Slightly toxic (微毒)	Detoxified through preparation; safe for long-term use

The Preparation Process

Traditional preparation involves steaming and cooking fresh He Shou Wu root slices repeatedly with black soybean (Hei Dou) juice. This process:

• Reduces the herb’s potential liver toxicity
• Deepens its tonifying properties
• Converts it from a purgative to a tonic
• Enhances its ability to nourish Blood and Essence

Modern pharmacological research has identified that the preparation process significantly increases the content of certain compounds, particularly 2,3,5,4’-tetrahydroxystilbene-2-O-β-D-glucoside (TSG), which is believed to be one of the key active constituents responsible for the herb’s anti-aging and hair-health effects.

Key Functions and Clinical Applications

1. Tonifies Liver and Kidney Yin (补肝肾阴)

He Shou Wu is one of the most important herbs for nourishing Liver and Kidney Yin. This action underpins many of its most celebrated uses:

• Premature graying and hair loss: The Liver stores Blood and opens into the Hair (hair is considered a manifestation of Blood quality). By nourishing Liver Blood and Kidney Essence, He Shou Wu addresses the root causes of premature graying and thinning hair.
• Dizziness and tinnitus: Often caused by Liver Blood deficiency or Liver-Yin deficiency with rising Liver-Yang, He Shou Wu nourishes the root.
• Insomnia and dream-disturbed sleep: Related to Blood deficiency or Yin deficiency that fails to anchor the Shen (Spirit).

2. Nourishes Blood (养血)

As a Blood-nourishing herb, Prepared He Shou Wu is used for:

• Blood deficiency patterns: Pale complexion, pale lips and tongue, dizziness, palpitations
• Irregular menstruation: Used alongside other Blood-tonifying herbs such as Dang Gui and Shu Di Huang for Blood deficiency causing scanty periods or amenorrhea
• Postpartum recovery: Supports Blood replenishment after childbirth

3. Blackens Hair (乌须发)

This is perhaps the most famous application of He Shou Wu in folk medicine. While the herb is rarely used alone for this purpose in clinical TCM (it is typically combined with other Blood and Yin-tonifying herbs), its role in promoting hair health is well recognized. Modern research suggests that the stilbene compounds in He Shou Wu may help:

• Protect melanocytes (pigment-producing cells) in hair follicles
• Support blood circulation to the scalp
• Reduce oxidative stress that contributes to graying

4. Strengthens Tendons and Bones (强筋骨)

The Kidney network governs the bones and produces Marrow, which in turn nourishes the brain and spinal cord. By tonifying Kidney Essence, He Shou Wu helps:

• Relieve lower back pain and knee weakness
• Support recovery from bone injuries
• Address weakness and soreness in the lower body

5. Unblocks the Bowels (润肠通便) — Raw Form Only

Raw He Shou Wu has a moistening and slightly purgative quality that makes it useful for:

• Constipation in the elderly from intestinal dryness
• Blood deficiency causing dry stools

This action is entirely absent in the prepared form, which is constipating in large doses.

6. Detoxifies and Resolves Toxins (解毒)

In folk medicine, raw He Shou Wu has been used for:

• Swollen, painful sores and carbuncles
• Skin conditions such as eczema and dermatitis
• Lymph node tuberculosis (scrofula)

Modern Research Highlights

Modern pharmacological studies have identified several key bioactive compounds in He Shou Wu:

Compound	Pharmacological Action
Stilbene glycosides (TSG)	Antioxidant, neuroprotective, anti-aging, hair growth promotion
Anthraquinones	Laxative effect (raw form), antibacterial
Phenylpropanoids	Immunomodulatory effects
Polysaccharides	Immune enhancement, antioxidant activity

Research areas receiving significant attention include:

• Neuroprotection: Studies suggest He Shou Wu extracts may protect against neurodegenerative processes, supporting its traditional use for cognitive health
• Hair growth: Topical and oral formulations are being studied for androgenetic alopecia and premature graying
• Liver protection: Hepatoprotective effects have been observed in various experimental models
• Anti-oxidant activity: The stilbene compounds demonstrate potent free radical-scavenging properties

Common TCM Formulas Featuring He Shou Wu

Formula	Composition	Indications
Qi Bao Mei Ran Dan (Seven Treasure Beauty Hair Pill)	He Shou Wu, He Huan Pi, Gou Qi Zi, etc.	Premature graying, hair loss
Zhi Shen Ming Mu Dan	He Shou Wu, Gou Qi Zi, Ju Hua, etc.	Dizziness, blurred vision
Tian Wang Bu Xin Dan (Celestial Emperor Heart-Supplementing Pill)	He Shou Wu as a supporting herb	Insomnia, palpitations from Heart and Kidney imbalance
He Shou Wu and Da Zao	He Shou Wu, Da Zo decoction	Blood deficiency with constipation

He Shou Wu vs. Other Blood-Tonifying Herbs

Feature	He Shou Wu (何首乌)	Dang Gui (当归)	Shu Di Huang (熟地黄)
Primary Focus	Liver & Kidney Yin, Blood, hair	Blood, blood circulation	Blood, Yin, Essence
Key Action	Tonify and blacken	Nourish and move Blood	Deep tonification
Specialty	Hair health, anti-aging	Menstrual disorders	Chronic deficiency
Nature	Slightly warm	Warm	Slightly cold
Form	Both raw and prepared	Always used as whole herb	Always prepared

Dosage and Preparation

Form	Typical Dose	Preparation
Prepared He Shou Wu (powder)	6–12 g	Cooked with other herbs in decoction
Prepared He Shou Wu (whole root)	10–30 g	Decoction, often pre-cooked
Raw He Shou Wu	6–12 g	Decoction for constipation; external use for skin conditions
He Shou Wu wine	30–50 ml daily	Soaked in rice wine for 2–4 weeks

He Shou Wu is almost always decocted together with other herbs as part of a formula. As a single herb, it is most commonly taken as a prepared powder or in tonic soup (炖汤) preparations.

Cautions and Contraindications

• Pregnancy: Not recommended during pregnancy due to its Blood-nourishing and slightly laxative properties
• Spleen deficiency with loose stools: Prepared He Shou Wu may aggravate diarrhea
• ** Damp-Heat patterns**: He Shou Wu’s warm nature may worsen Damp-Heat
• Raw He Shou Wu: The raw form should not be used long-term; prolonged or excessive use of raw He Shou Wu has been associated with rare cases of liver toxicity in modern medical literature
• Medication interactions: May interact with anticoagulant medications due to its Blood-moving properties

Conclusion

He Shou Wu stands as one of the most fascinating herbs in the TCM pharmacopeia — a remedy whose legendary reputation for restoring youth and blackening hair has been supported by centuries of clinical use and, increasingly, by modern scientific investigation. Whether addressing premature graying, Blood deficiency, or the degenerative processes of aging, its role in nourishing Liver and Kidney Yin makes it a versatile and valuable tonic.

Prepared He Shou Wu, in particular, exemplifies the TCM principle that proper processing transforms a potentially toxic substance into a nourishing, long-term tonic — a testament to the sophistication of traditional pharmaceutical methods. When used appropriately, as part of a balanced formula and under the guidance of a qualified practitioner, He Shou Wu remains a powerful ally in the pursuit of vitality and graceful aging.

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References

1. Chen, J.K. & Chen, T.T. (2004). Chinese Herbal Medicine: Materia Medica. Seattle: Eastland Press.
2. World Health Organization. (2004). WHO Monographs on Selected Medicinal Plants, Vol. 2. Geneva: WHO.
3. Li, N. et al. (2019). “Bioactive compounds and pharmacological functions of Polygonum multiflorum Thunb.: A review.” Journal of Ethnopharmacology, 241, 111918.