Traditional Chinese medicine

SchisandraSchisandra chinensis (bei wu wei zi); Schisandra sphenanthera (nan wu wei zi)

Schisandra (wu wei zi) is a TCM astringent listed for chronic diarrhea at 2 to 6 g; its human data are on liver enzymes, and we found no gut trial of the herb alone.

Botanical name

Schisandra chinensis (bei wu wei zi); Schisandra sphenanthera (nan wu wei zi)

Part used

dried ripe fruit (berry)

Also called

pinyin Wu wei zi (五味子); Magnolia vine fruit, Omija (Korean)

Used in

Traditional Chinese medicine

Taken for

Loose stools and diarrhea, Liver and bile, Stress and the gut

Sold as

decoction, capsules, extract, tincture, powder

What schisandra is

Schisandra is the berry of a woody vine of the magnolia family (Magnoliaceae). Two species are sold. Schisandra chinensis is the northern species, called bei wu wei zi in Chinese, and Schisandra sphenanthera is the southern species, nan wu wei zi. Their dried ripe fruits are used in traditional Chinese medicine, and S. chinensis is also used as a tonic in Russia, Japan and Korea. The fruit is sold as whole dried berries, as powder, in capsules, as teas and decoctions, and as standardized extracts.

The Chinese Pharmacopoeia counts 100 prescriptions that contain S. chinensis and 11 that contain S. sphenanthera, so most of the herb’s use is inside formulas, not alone. One such formula, the Sishen Pill, is a patented medicine for abdominal pain and diarrhea that contains Psoraleae Fructus, Myristicae Semen, Euodiae Fructus and Schisandra. The two species have similar chemistry, but the extract sold in China as Wuzhi capsule is made from the southern species and is used for hepatitis.

What the traditions use it for

Traditional Chinese medicine (about TCM)

TCM classes wu wei zi as warm, sour and sweet, entering the lung, heart and kidney channels. The Chinese Pharmacopoeia entry for the southern species gives its functions as astringing and consolidating, tonifying qi and promoting body fluids, and nourishing the kidney and calming the mind. Its indications include chronic cough with wheezing, nocturnal emission, frequent urination, chronic diarrhea, spontaneous and night sweating, thirst from fluid loss, and palpitations with insomnia. The dose is 2 to 6 g. For the gut the idea is astringency, holding in the loose stool of chronic diarrhea, and wu wei zi appears alongside warming herbs in the Sishen Pill, a formula for abdominal pain and diarrhea. These are the tradition’s statements, not trial findings.

The constituents

Hundreds of compounds have been isolated from the two species (306 and 238 in one review), with lignans such as schisandrin among the most familiar; polysaccharides are also studied. In mice, a S. chinensis extract depolarized the pacemaker cells of the small intestine and speeded intestinal transit at 0.1 to 1 g/kg, including in mice with induced motility problems. In a review of 54 animal studies, Schisandra compounds lowered ALT and AST in models of liver injury. A polysaccharide fraction was tested in rats with antibiotic-associated diarrhea. These are animal results.

The human evidence

We could find no controlled trial in people of Schisandra alone for diarrhea or any other gut outcome. The nearest gut trial tested a formula: in a randomized, double-blind multicenter trial, 240 people with diarrhea-predominant irritable bowel syndrome took modified Sishen Wan or a placebo (roasted barley sprout) for 4 weeks. The effective rate was 92.24 percent against 49.07 percent, and recurrence over the next 6 months was 15.79 percent against 56.86 percent. The abstract does not list the herbs in the modified formula, and Schisandra is one component of the classic Sishen Pill, so the result cannot be credited to Schisandra.

The liver is where human data exist. In a randomized, placebo-controlled study of 40 people with borderline-high ALT or AST (40 to 60 U/L), a mixture of Schisandra fruit extract and sesamin (four tablets a day for 5 months) lowered ALT and AST compared with placebo and left bilirubin unchanged; the abstract gives no figures, and the product was a mixture. Natural Medicines rates Schisandra possibly effective for hepatitis (extract standardized to 20 mg of lignans a day) and for mental performance. The southern-species Wuzhi capsule has been used for viral and drug-induced hepatitis in China, and it has been studied together with tacrolimus (see interactions).

What has not been tested: Schisandra alone against placebo for chronic diarrhea, loose stools or irritable bowel syndrome, and the liver-enzyme findings are not gut results.

Doses, in trials and in practice

The Chinese Pharmacopoeia entry for the southern species gives 2 to 6 g of dried fruit. Natural Medicines lists the doses used in other conditions: an extract standardized to 20 mg of lignans (about 1.5 g of crude fruit) a day for hepatitis, and 500 mg to 2 g of extract or 1.5 to 6 g of crude fruit a day for mental performance, with a boiled tea made from 5 to 15 g of crude fruit also used. The transplant study used one Wuzhi capsule twice a day. No trial gives a dose for the gut, and the mouse study used 0.1 to 1 g/kg, an animal dose.

What is known about safety

Natural Medicines rates Schisandra possibly safe by mouth and lists heartburn, upset stomach, decreased appetite, stomach pain, rash and itching as possible side effects. It rates use in pregnancy possibly unsafe, since it may cause uterine contractions, and advises avoiding it while breastfeeding because reliable information is lacking. It says one expert warns against use in epilepsy, that it might worsen GERD or peptic ulcers by increasing stomach acid, and that it might worsen raised intracranial pressure. In the renal transplant study, kidney and liver function were not different between groups after 3 weeks. The Pharmacopoeia entry lists no cautions.

Where it meets prescription medicines

Schisandra changes how the liver and gut handle drugs. Natural Medicines rates as moderate its interactions with drugs cleared by CYP2C9 (such as warfarin, ibuprofen and losartan) and CYP3A4 (such as lovastatin, cyclosporine and diltiazem), with midazolam and phenobarbital, with talinolol and with tacrolimus. The tacrolimus interaction is the most thoroughly documented: in healthy volunteers Wuzhi capsule slowed tacrolimus clearance, and in 60 transplant recipients it allowed a lower tacrolimus dose. The same database says Schisandra may increase the breakdown of warfarin, so blood tests may be needed.

Catalog entries that list schisandra

If you want schisandra in a product rather than as a loose herb, these are the entries that carry it, with the label amounts and the reviews read.

Herbs that sit beside it

What people want to know

Sources

• Chinese Pharmacopoeia (2020 edition, Volume I), Schisandra sphenanthera fruit (nan wu wei zi) entry, as presented by the ShennongAlpha database shennongalpha.westlake.edu.cn/knowledge/nmm-01fi
• Yang K et al., "A comprehensive review of ethnopharmacology, phytochemistry, pharmacology, and pharmacokinetics of Schisandra chinensis and Schisandra sphenanthera", J Ethnopharmacol 2022;284:114759 pubmed.ncbi.nlm.nih.gov/34678416
• Su X et al., "Curative effect of warming kidney and fortifying spleen recipe on diarrhea-predominant irritable bowel syndrome", J Tradit Chin Med 2013;33:615-619 pubmed.ncbi.nlm.nih.gov/24660584
• Zhang B et al., "Sishen Pill and its active phytochemicals in treating inflammatory bowel disease and colon cancer: an overview", Front Pharmacol 2024;15:1375585 pubmed.ncbi.nlm.nih.gov/38650627
• Chiu HF et al., "Improvement of liver function in humans using a mixture of schisandra fruit extract and sesamin", Phytother Res 2013;27:368-373 pubmed.ncbi.nlm.nih.gov/22610748
• Wang K et al., "Effects of Wuzhi capsule on blood concentration of tacrolimus after renal transplantation", J Biol Regul Homeost Agents 2016;30:155-159 pubmed.ncbi.nlm.nih.gov/27049086
• Teng F et al., "Effect of hepar-protecting Wuzhi capsule on pharmacokinetics and dose-effect character of tacrolimus in healthy volunteers", Biopharm Drug Dispos 2022;43:119-129 pubmed.ncbi.nlm.nih.gov/35180322
• Ahn TS et al., "Effects of Schisandra chinensis extract on gastrointestinal motility in mice", J Ethnopharmacol 2015;169:163-169 pubmed.ncbi.nlm.nih.gov/25862968
• Huang BH et al., "Efficacy of Schisandra chinensis in liver injury: a systematic review and preclinical meta-analysis", Front Pharmacol 2025;16:1627081 pubmed.ncbi.nlm.nih.gov/40832608
• RxList / Natural Medicines, Schisandra monograph www.rxlist.com/supplements/schisandra.htm