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Traditional Chinese medicine

Aucklandia (costus root)Aucklandia costus (syn. Aucklandia lappa, Saussurea costus)

Costus root, named in 145 pharmacopoeia preparations; no human trial of it alone, and a 23-study review of one formula that contains it (RR 1.27).

Botanical name
Aucklandia costus (syn. Aucklandia lappa, Saussurea costus)
Part used
dried root
Also called
pinyin Mu xiang (also Guang mu xiang) (木香); Costus root, Aucklandiae radix
Used in
Traditional Chinese medicine
Taken for
Bloating, Cramping and pain, Indigestion
Sold as
dried root slices, powder, pills in formulas, granules, decoction

What is meant by aucklandia (costus root)

Aucklandia is the dried root of a daisy-family plant (Asteraceae), Aucklandia costus, a name that is a synonym of both Aucklandia lappa Decne. and Saussurea costus (Falc.) Lipsch. In Chinese the drug is mu xiang, written Aucklandiae Radix in pharmacopoeia texts. A Himalayan wild population of the plant is the subject of a review calling it an endangered medicinal plant, and the root used in Chinese medicine is largely cultivated in China.

In Chinese practice the root is decocted with other herbs or made into pills and granules, and its main constituents are sesquiterpene lactones, notably costunolide and dehydrocostus lactone. A systematic review counts 145 prescription preparations in the 2020 edition of the Chinese Pharmacopoeia that contain it, among them Xianglian Wan, Muxiang Shunqi Wan and Liuwei Muxiang San, and notes that in the plateau areas of Sichuan a related root, Vladimiriae Radix, has long been used as a local substitute. Aucklandia is also one of the eight ingredients of Xiang Sha Liu Jun Zi Tang, the formula in which the “Xiang” of its name refers to this root.

In the traditions

Traditional Chinese medicine (about TCM)

A systematic review describes Aucklandiae Radix, in the tradition’s terms, as warm, pungent and bitter, entering the spleen, stomach, large intestine and gallbladder channels, with the action of promoting the circulation of qi to relieve pain. It is used for what the texts describe as chest and flank fullness, abdominal fullness and pain, tenesmus (the urgent, incomplete feeling in dysentery), indigestion, and for warming the middle to harmonize the stomach. It is a standard herb for moving stuck qi in the digestive tract in the formulas listed above. These are the tradition’s own classifications and not findings about the body.

What the plant contains

The two main sesquiterpene lactones, costunolide and dehydrocostus lactone, are the compounds most studied in modern work. A systematic review reports 237 chemical components isolated from Aucklandiae Radix, and credits these two with anti-inflammatory activity in laboratory studies. In one rodent study, a methanol extract of the root and its two lactones relaxed contractions of isolated rat jejunum and shifted calcium dose-response curves in a way the authors compare to verapamil, a calcium channel blocker. Those are laboratory and animal findings, and no human trial of the root alone tests whether the effect occurs in people.

What has been tested in people

We found no randomized trial of aucklandia alone for any gut symptom. The strongest animal data are the study above: in normal mice a root extract at 100 to 400 mg per kg increased gastric emptying and slowed small-intestinal transit, and in mice given a drug that speeds the gut it slowed both, which the authors read as a spasm-relieving action. These are mouse and rat findings.

Human data are for the formula Xiang Sha Liu Jun Zi Tang (ginseng, atractylodes, poria, costus root, amomum, pinellia, tangerine peel and licorice), where costus root is one of eight herbs. A multicenter, double-blind, placebo-controlled trial in 216 adults with functional dyspepsia (Rome III criteria, spleen deficiency with qi stagnation in the tradition’s terms) gave granules or placebo for 4 weeks in a 2:1 ratio; the formula group improved more on the postprandial discomfort severity scale, the clinical global impression and anxiety and depression scores, and gastric emptying of the proximal and distal stomach was faster (P below 0.05 or 0.01). A meta-analysis of 23 trials with 2,101 participants found a higher clinical effectiveness rate than the control group (risk ratio 1.27, 95% CI 1.21 to 1.33), with no significant difference in adverse events, but the authors rated the included studies as low quality.

What has not been tested: costus root alone, its separation from the other seven herbs, and any comparison with the substitute Vladimiriae Radix.

StudyDoseWhat it found
Multicenter double-blind placebo-controlled trial, 216 adults with functional dyspepsia (formula: Xiang Sha Liu Jun Zi granules) PMID 28852318Granules in 300 mL water, 130 mL three times a day, 4 weeksBetter postprandial discomfort, global impression, anxiety and depression scores and faster gastric emptying than placebo (P below 0.05 or 0.01)
Meta-analysis of 23 trials, 2,101 participants, Xiang Sha Liu Jun Zi decoction in functional dyspepsia PMID 38933675Formula decoction; doses not reported in the paperHigher clinical effectiveness rate, RR 1.27 (95% CI 1.21 to 1.33); no significant difference in adverse events; low-quality studies
Mouse and rat study of Radix Aucklandiae methanol extract PMID 24649908100 to 400 mg per kg in mice; 0.1 to 0.4 mg per mL on rat jejunumGastric emptying increased and small-bowel transit decreased in normal mice; relaxed isolated rat jejunum

Doses used in trials and traditional preparations

No human trial of the root alone gives a dose. In the 216-adult formula trial, Xiang Sha Liu Jun Zi granules were dissolved in 300 mL of water and 130 mL was taken three times a day for 4 weeks. A modified Zhi Shi Xiao Pi formula in a 51-patient dyspepsia trial added 10 g of costus root to the decoction when bloating was severe. Both of these are formula doses, and the other herbs in them may account for any effect. In the tradition the root is decocted with other herbs, ground into powder, or made into pills, and we found no single-herb gram dose that we could tie to a primary source.

Treat these figures as a record of what was studied. Whether any amount of aucklandia (costus root) suits a particular person is a question for a clinician or pharmacist who knows their history.

Safety

A review notes that multiple studies indicate extracts of Aucklandia may cause adverse reactions, without naming a specific harm in its abstract, and says the mechanisms of its action in several diseases are not fully understood. The formula meta-analysis found no significant difference in adverse events, but its studies were low quality. We found no pregnancy or breastfeeding data in the sources read. Because a related root, Vladimiriae Radix, has been used as a local substitute for the pharmacopoeia drug, a label that says only mu xiang or costus does not by itself tell the reader which root is inside. Reviews of Asian herbal medicines have reported toxic heavy metals and undeclared prescription drugs in some products, mostly as anecdotal reports that the authors say cannot define prevalence; that is a finding about the products reviewed and not about every aucklandia product.

Drug interactions

We found no documented drug interaction for aucklandia in the sources read. In isolated rat jejunum the extract and its two lactones blocked contractions driven by acetylcholine, serotonin and potassium and reduced calcium influx, so an additive effect with medicines that also slow the gut is the pharmacological possibility a prescriber would consider; this is a laboratory observation and no human interaction has been reported in what we read.

Products in the catalog with aucklandia (costus root)

These catalog entries list aucklandia (costus root) or one of its preparations among their active ingredients. Each page shows the amount on the label, the trials behind it and what buyers report.

Health Concerns Six Gentlemen 4.4 out of 5 from 41 ratings from Amazon · $1.99 per day at two capsules three times a day ($29.90 for 90 on the brand site, $29.99 on Amazon, a 15-day bottle)

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Common questions

What is mu xiang?

Mu xiang is the Chinese name for the dried root of Aucklandia costus, also called costus root. It is a pharmacopoeia drug named in 145 preparations in the 2020 edition of the Chinese Pharmacopoeia, according to a systematic review.

What does TCM use it for?

TCM classes it as warm, pungent and bitter, entering the spleen, stomach, large intestine and gallbladder channels, and uses it for abdominal fullness and pain, tenesmus and indigestion. That is the tradition’s framework.

Is there a trial of costus root itself?

We found none. The human trials we read test the eight-herb formula Xiang Sha Liu Jun Zi, such as a 216-adult placebo-controlled trial in functional dyspepsia, and cannot separate out the root.

Is costus root the same in every product?

Not necessarily. A related root, Vladimiriae Radix, has long been used as a local substitute for it in Sichuan, so the label may need checking for the exact species.

Sources