CLINICAL APPLICATIONS

* Hair disorders: alopecia (hair loss, baldness), premature gray hair, and brittle, unhealthy hair with split ends

* Scalp, skin and nails: dryness with unhealthy complexion

* Other deficiency conditions: anemia and osteoporosis

 

WESTERN THERAPEUTIC ACTIONS

* Increases blood circulation to the scalp

* Provides essential nutrients for hair growth

* Osteogenic effect to promote generation of bones

* Hematopoietic effect to stimulate the production of blood

 

CHINESE THERAPEUTIC ACTIONS

* Replenishes the jing (essence) and promotes the growth and maintains the health of hair, skin, nails, and bones

* Nourishes blood and promotes circulation to the scalp

 

DOSAGE

Take 4 capsules three times daily on an empty stomach with warm water. Polygonum 14 should be taken continuously for two months prior to making an evaluation. Most patients report changes in hair texture within two months, and changes in hair color in four to six months.

 

INGREDIENTS

Bai Shao (Radix Paeoniae Alba)

Chuan Xiong (Rhizoma Chuanxiong)

Da Zao (Fructus Jujubae)

Dang Gui (Radix Angelicae Sinensis)

Gan Cao (Radix et Rhizoma Glycyrrhizae)

Ge Gen (Radix Puerariae Lobatae)

Gui Zhi (Ramulus Cinnamomi)

Hei Zhi Ma (Semen Sesami Nigrum)

Huang Qi (Radix Astragali)

Mo Han Lian (Herba Ecliptae)

Nu Zhen Zi (Fructus Ligustri Lucidi)

Sang Shen (Fructus Mori)

Shu Di Huang (Radix Rehmanniae Praeparata)

Zhi He Shou Wu (Radix Polygoni Multiflori Praeparata)

 

BACKGROUND

Hair disorders, such as alopecia (hair loss, baldness), premature gray hair and unhealthy hair, are common disorders affecting both men and women. Common causes of hair disorders include heredity, infection, endocrine disorder (i.e., hypothyroidism, hyperthyroidism, menopause), postpartum weakness, nutritional deficiencies, stress, and drugs (i.e., chemotherapy, radiation, anticoagulants, oral contraceptives, ACE inhibitors, beta blockers, anticonvulsants, lithium and others).

 

FORMULA EXPLANATION

Polygonum 14 is designed primarily to treat hair loss, premature gray hair, and brittleness with split ends, which are all signs of Kidney yin with Liver blood deficiency. Polygonum 14 is formulated to nourish Kidney yin and Kidney jing (essence), tonify Liver blood, and increase blood circulation to the scalp.

        Zhi He Shou Wu (Radix Polygoni Multiflori Praeparata) is an indispensable herb for treating any hair disorder. It replenishes the vital essence of the Liver and Kidney and tonifies the blood. Mo Han Lian (Herba Ecliptae), Sang Shen (Fructus Mori), and Nu Zhen Zi (Fructus Ligustri Lucidi) tonify the Liver and the Kidney yin to benefit the hair. Shu Di Huang (Radix Rehmanniae Praeparata), Hei Zhi Ma (Semen Sesami Nigrum) and Bai Shao (Radix Paeoniae Alba) are selected to tonify Liver blood and nourish the hair. Proper blood circulation to the scalp is also an important factor for healthy hair. Huang Qi (Radix Astragali), Ge Gen (Radix Puerariae Lobatae) and Gui Zhi (Ramulus Cinnamomi) have ascending properties that carry the therapeutic functions of this formula to the scalp. Chuan Xiong (Rhizoma Chuanxiong) and Dang Gui (Radix Angelicae Sinensis) improve microcirculation and nourish the blood. Da Zao (Fructus Jujubae) and Gan Cao (Radix et Rhizoma Glycyrrhizae) are used to harmonize the formula.

        In short, Polygonum 14 nourishes Kidney yin and Kidney jing (essence) to treat various disorders associated with aging and deterioration.

 

CAUTIONS & CONTRAINDICATIONS

* Because Polygonum 14 is a rich and cloying formula, some patients may experience loose stools after taking it. This can be alleviated by lowering the dosage, or taking it with food.

* Polygonum 14 is contraindicated in individuals with exterior or excess conditions.

* This herbal formula contains herbs that invigorate blood circulation, such as Dang Gui (Radix Angelicae Sinensis). Therefore, patients who are on anticoagulant or antiplatelet therapies, such as Coumadin (warfarin), should use this formula with caution, or not at all, as there may be a higher risk of bleeding and bruising.[1]^,[2],[3]

* According to most textbooks and contemporary references, the classic entry of "He Shou Wu" is now separated into two entries: the unprepared Sheng Shou Wu (Radix Polygoni Multiflori) and the prepared Zhi He Shou Wu (Radix Polygoni Multiflori Praeparata), as they have significantly different therapeutic effects and side effects. Sheng Shou Wu (Radix Polygoni Multiflori) is a stimulant laxative that treats constipation, but may cause nausea, vomiting, abdominal pain, diarrhea, and in rare cases, liver disorder (dose- and time-dependent, and reversible upon discontinuation).[4] On the other hand, Zhi He Shou Wu (Radix Polygoni Multiflori Praeparata) is a tonic herb that is safe and well-tolerated. The dramatic changes in the therapeutic effect and safety profile are attributed to the long and complicated processing of the root with Hei Dou (Semen Sojae) through repeated blending, cooking, and drying procedures. When properly processed, the chemical composition of the root changes significantly. Many new compounds are generated from the Maillard reaction (four furanones, two furans, two nitrogen compounds, one pyran, one alcohol and one sulfur compound). Furthermore, the preparation process causes changes in the composition of sugars and 16 kinds of amino acids; it also reduces the pH of the herb from 6.28 to 5.61.[5],[6] In summary, these changes give rise to the tonic effects of the prepared roots, and eliminate the adverse reactions associated with the unprepared roots. Note: Due to medical risks and legal liabilities, it is prudent to exercise caution and not use this herb in either prepared or unprepared forms in patients with pre-existing or risk factors of liver diseases.

 

CLINICAL NOTES

* Zhi He Shou Wu (Radix Polygoni Multiflori Praeparata) has been known as a popular antiaging herb since the Ming dynasty (14^th Century) in China. It is often used by the sages and Taoist monks to enhance longevity.

* Polygonum 14 is an herbal formula originally developed for Empress Chi-Xi, the last empress in the history of China. It was developed in the 19^th century by a private doctor in the Forbidden City who used a relatively large amount of Zhi He Shou Wu (Radix Polygoni Multiflori Praeparata) to enhance hair color and texture. Empress Chi-Xi took this formula throughout her life and it became the secret to her shiny, black hair even when she was in her eighties.

* Polygonum 14 is a constitutional tonic that changes the fundamental color and texture of hair. Change in hair texture requires approximately one to two months, and change in hair color requires four to six months of continuous herbal treatment. Therefore, individuals who take Polygonum 14 must be patient, as changes will not occur immediately.

 

SUPPLEMENTARY FORMULAS

* For hair loss due to chemotherapy and radiation, combine with C/R Support to minimize side effects.

* For hair loss due to stress, add Calm.

* For post-partum hair loss, add Schisandra ZZZ or Imperial Tonic.

* For low libido, add Vitality.

* For vaginal dryness, add Balance Spring.

* For prevention of osteoporosis, add Osteo 8.

* For forgetfulness, add Enhance Memory.

* To control appetite for weight loss, add Herbalite.

* To improve the shape and increase the size of the breasts, add Venus.

* To clear acne, add Dermatrol (Clear).

* To tonify blood, combine with Schisandra ZZZ.

* For depression, use Shine or Shine (DS).

* For constipation, use Gentle Lax (Deficient).

* For blurry vision or tinnitus, combine with Nourish.

* To tonify Kidney yang, add Kidney Tonic (Yang).

* To tonify Kidney yin, add Kidney Tonic (Yin).

* With blood stagnation, add Circulation (SJ).

 

ACUPUNCTURE TREATMENT

Traditional Points:

* Shangxing (GV 23), Baihui (GV 20), Yinlingquan (SP 9), Sanyinjiao (SP 6), Taixi (KI 3)

* Baihui (GV 20). Apply moxa to Zusanli (ST 36) and Sanyinjiao (SP 6).

 

Classic Master Tung's Points:

* Qianhui (T 1010.05), Zhenghui (T 1010.01), Houhui (T 1010.06), Tianhuangfu [Shenguan] (T 77.18), Minghuang (T 88.12), Tianhuang (T 88.13), Qihuang (T 88.14), Simashang (T 88.18), Simaxia (T 88.19), Simazhong (T 88.17). Bleed the LU and HT areas on the back, dark veins nearby Weizhong (BL 40), lateral side of the lower limb. Bleed before needling for best result.

* Dry skin/wrinkles: Needle along the lines of the wrinkle, Shuijin (T 1010.20), Shuitong (T 1010.19), Yuhuo (T 1010.21), Zhenjing (T 1010.08), Muzhi (T 1010.18), Sifuyi (T 1010.11), Sifuer (T 1010.10), Makuaishui (T 1010.14), Liukuai (T 1010.16), Qikuai (T 1010.17), Tianhuang (T 88.13), Minghuang (T 88.12), Qihuang (T 88.14), Simashang (T 88.18), Simaxia (T 88.19), Simazhong (T 88.17). Bleed the LR area T5 ¡V T9 and KI area T9 ¡V T12 on the back with cupping. Bleed before needling for best result.

Master Tung¡¦s Points by Dr. Chuan-Min Wang:

* Hair loss, premature gray, dry nails: Bleed Qixing (T DT.03). Needle Minghuang (T 88.12), Tianhuang (T 88.13), Qihuang (T 88.14), Shuixiang (T 66.14), Shuixian (T 66.15).

 

Auricular Medicine by Dr. Li-Chun Huang:

* Alopecia: Sympathetic, Kidney, Liver, Gallbladder, Spleen, Lung, Endocrine, Pituitary, Coronary Vascular Subcortex, corresponding points

 

NUTRITION

* Biotin, found in green peas, oats, soybeans, sunflower seeds and walnuts, is essential for healthy hair and skin. Kelp and seaweed are also excellent choices to include in the daily diet.

* Protein is the essential make-up of hair. Therefore, the intake of food high in protein such as milk, fish, egg, and beans is recommended.

* Foods that are high in collagen will improve the elasticity and shine of hair, such as wild yam, taro, lotus root, and tendons.

* Intake of vitamins A and B are also recommended, as they can improve circulation to the scalp and promote hair growth.

* Increase intake of water, vegetables, fruits, seeds and nuts for patients with dry skin.

* Those with dandruff can increase the intake of vitamin B₆ and B₁₂.

* Consume adequate amounts of vegetables for vitamins, as they improve circulation to the scalp and promote hair growth.

 

LIFESTYLE INSTRUCTIONS

* Avoid cigarette smoking and second-hand smoke, sugar, alcohol, caffeine, and junk food.

* Stay out of the sun as it can dry and damage skin and hair.

* Stress can impair the delivery of nutrients to the scalp as it causes stagnation. Patient should be advised to stay away from stressful situations.

* Natural bristle brushes are recommended. Brushes with sharp tips should not be used as they might scrape the scalp. To invigorate circulation to the scalp, brush hair 100 times from the back of the head towards the front with the head down at least twice a day.

* Untangle hair with a brush before shampooing. Mild shampoo should also be selected to avoid overstimulation to the scalp. Water temperature should not be too hot to avoid further hair loss. The scalp can be massaged while shampooing. Be sure to rinse completely, leaving no shampoo or conditioning residues to clog up the hair pores. Hair should be dried by gently padding on the towel instead of rubbing back and forth.

* Blow-drying and use of hair products such as gel, mousse, and hairspray are not recommended. Chemical treatments, perms, and color should also be avoided.

* Avoid swimming as much as possible as chlorine will do much damage to the hair. If one cannot avoid swimming, it is recommended that the patient wear a cap or rub some baby oil into the hair.

* Get regular exercise and establish a normal pattern of sleep.

 

CASE STUDIES

* D.K, a 65-year-old female, complained of both dry skin and thinning hair. She would wake up to a pillow covered with hair. The TCM diagnosis was Kidney yang and Liver blood deficiency. She was treated with Polygonum 14, instructed to take 2 capsules three times daily for the first week, gradually increasing the dosage to 4 capsules as the patient had a very sensitive digestive system. The patient noted no digestive upset from taking the herbs in this manner. After two months of taking Polygonum 14, the patient noted that her hair was no longer falling out all over her pillow nor was the ¡¥root¡¦ attached to the hairs that came out. The patient noticed her hair was beginning to thicken and soften in addition to having more moist skin. Additional treatment received included acupuncture for the Kidney yang deficiency. Submitted by C.V., Concord, North Carolina.

* A.T., a 35-year-old male, complained of gray hair that had been present since the previous year. He had a forceful pulse, yet it was weak in the Kidney areas. This condition was diagnosed as Kidney yin deficiency. The patient was treated with Polygonum 14 at four capsules three times a day. Since he had been taking the formula he noticed less gray hair coming in. Patient is continuing to take the formula and his hair has been less gray ever since. Submitted by A.I., Hilo, Hawaii.

* T.W., a 47-year-old female, who had a habit of frequently coloring her own hair, presented with thinning of hair which was breaking off easily. The practitioner prescribed Polygonum 14 at four capsules three times daily. After taking the herbs for many months, the patient reported she was very pleased with the results. She had also noticed new growth that had grown in more red than her normal color. Submitted by L.W., Arroyo Grande, California.

* Two females, ages 54- and 55-years-old, presented with hair loss. The practitioner attributed their hair loss to blood deficiency with some underlying Liver yin and Spleen qi deficiencies. They were both treated with the Polygonum 14 formula. The patients reported new hair growth as well as normalization of bowel movements. The practitioner concluded Polygonum 14 to be quite effective in treating hair loss due to aging. Submitted by D.N., Pacific Palisades, California.

* C.W., a 40-year-old male, presented with tiredness, poor sleep, constipation, gray hair, over-work, and high cholesterol. His blood pressure was 130/80 mmHg and his heart rate was 80 beats per minute. There was no Western diagnosis and the TCM diagnosis was found to be Liver blood deficiency. Polygonum 14 was prescribed at 2 grams three times daily. This patient also received acupuncture as the overall treatment regime. The patient reported the quality of sleep improved after taking the herbs. Energy level increased and the constipation was relieved. Additionally, his cholesterol level dropped from 223 to 190 mg/dL. Submitted by W.F., Bloomfield, New Jersey.

* A 22-year-old male college student presented with dry skin and hair loss on the scalp, as noted by a patch near the vertex. He admitted to drug use and smoking, along with depression. His pulse was rapid and full while his tongue was crimson. The patient appeared restless. The practitioner diagnosed the condition as yin deficiency and fluid consumption, possibly from an overuse of stimulants. After taking Polygonum 14 for less than one month, the patient observed that his hair felt less brittle and that he had not seen any hair strands on his pillow unlike in the past. The patch of lost hair was less noticeable and he detected new hair growth after 1½ months. The patient also reported an increased energy level, as well as a more cheerful disposition. He also appeared less restless. Additionally, he had refrained from drugs and smoking, from which he fortunately did not develop any withdrawal signs or cravings. Interestingly, with the use of Polygonum 14, the patient¡¦s hair not only felt healthier but also became darker, although his hair was naturally dark blonde. Submitted by F.V., Orlando, Florida.

* A 35-year-old female singer presented with hair loss, fatigue and low energy. She had a pale tongue, soft pulse and cold feet. The practitioner diagnosed her condition as Kidney yang deficiency. The patient was instructed to take Polygonum 14. The patient reported excellent results. The practitioner concluded that Polygonum 14 had been quite effective in treatment of a variety of conditions, including Kidney yin deficiency and Spleen qi deficiency, but especially with hair loss symptoms. Submitted by L.T., Chicago, Illinois.

 

PHARMACOLOGICAL AND CLINICAL RESEARCH

Polygonum 14 is designed mainly to treat hair disorders, including hair loss, premature gray, and brittleness with split ends. As the herbs nourish the body, other associated benefits include increased production of blood, skin, nails, and bones.

        The main ingredient of Polygonum 14 is Zhi He Shou Wu (Radix Polygoni Multiflori Praeparata), an herb commonly used to tonify the Liver and Kidney jing (essence), nourish the blood, and treat various hair disorders. Pharmacologically, use of Zhi He Shou Wu (Radix Polygoni Multiflori Praeparata) via oral ingestion or topical application has been shown to promote hair growth and stimulate an increase in the number and the size of hair follicles. The mechanism of this action is attributed to the induction of the anagen phase in resting hair follicles.[7] Clinically, use of Zhi He Shou Wu (Radix Polygoni Multiflori Praeparata) has been shown to effectively treat both hair loss (alopecia) and poor hair quality (premature gray). According to one clinical trial, 24 patients with alopecia were treated with oral and topical applications of herbs with good results. For oral ingestion, all patients received an herbal formula that uses Zhi He Shou Wu (Radix Polygoni Multiflori Praeparata) as the main ingredient, with other additions and modifications as needed. For topical application, the patients were instructed to wash their hair with an herbal solution made from Sang Ye (Folium Mori) 60g and Ma Ye (Folium Cannabis) 60g.[8] According to another study, 36 patients with gray hair were treated to evaluate the effectiveness of herbs. Out of 36 patients, 20 had partial white discoloration of hair and 16 had complete white discoloration of hair. The herbs selected include Zhi He Shou Wu (Radix Polygoni Multiflori Praeparata), Dang Gui (Radix Angelicae Sinensis) and Shu Di Huang (Radix Rehmanniae Praeparata). The patients were advised to take the herbs once to twice daily continuously until there were significant changes, which could vary from one year to ten years. After ten years of clinical trial, it was concluded that the use of these herbs were 88.89% effective, with 24 out of 36 patients showing significant improvement, and 8 patients showing moderate improvement.[9]

        Polygonum 14 also contains many herbs to promote generation of bones and prevent osteoporosis. Pharmacologically, Di Huang (Radix Rehmanniae) has an antiosteoporotic effect to stimulate the proliferation and activities of osteoblasts, while inhibiting the generation and resorptive activities of osteoclasts. It also shows preventive effects on osteoporotic bone loss induced by ovariectomy. In addition, the water extract of Dang Gui (Radix Angelicae Sinensis) has been found to contribute to the formation of bones and treatment of bone injuries. It directly stimulates the proliferation, alkaline phosphatase activity, protein secretion and particularly type I collagen synthesis of human osteoprecursor cells in a dose-dependent manner.[10] In another study, Dang Gui (Radix Angelicae Sinensis) shows a marked effect on osteoblast proliferation and differentiation systems, as well as in a fibroblast-secreted hyaluronic acid assay. It enhances the deposition of hyaluronic acid and proliferation of osteoblasts in vitro, as well as bone regeneration.[11]^,[12] Clinically, an herbal formula that contains Zhi He Shou Wu (Radix Polygoni Multiflori Praeparata) as the main ingredient showed 90.8% effectiveness to treat osteoporosis. Out of 76 cases, the study reported significant improvement in 12 cases, moderate improvement in 57 cases, and no benefit in 7 cases.[13]

        In addition to its function of nourishing hair, many herbs in Polygonum 14 have remarkable effects to stimulate the production of blood and improve blood circulation. Dang Gui (Radix Angelicae Sinensis), Nu Zhen Zi (Fructus Ligustri Lucidi) and Shu Di Huang (Radix Rehmanniae Praeparata) have hematopoietic effects to stimulate the production of blood through expediting the multiplication and differentiation of bone marrow hematopoietic cells (CFU-S and CFU-E).[14]^,[15] Chuan Xiong (Rhizoma Chuanxiong) increases peripheral blood circulation by reducing the agglutination and the peripheral activities of platelets.[16]

        Lastly, Polygonum 14 contains many herbs with antioxidant effects to prevent damage or death to cells. The extract of Zhi He Shou Wu (Radix Polygoni Multiflori Praeparata) has an antioxidant effect to treat skin damage induced by ultraviolet B irradiation (UVB). Zhi He Shou Wu (Radix Polygoni Multiflori Praeparata) strongly inhibits the destruction of superoxide dismutase by UVB and probably contains agents to slow down photo-aging of the skin.[17] Shu Di Huang (Radix Rehmanniae Praeparata) has been shown to scavenge reactive oxygen species and suppresses many adverse effects of ultraviolet radiation, such as DNA fragmentation, damage to mitochondrial function, modulation of apoptotic marker proteins, and UV-induced apoptosis of cells.[18] Hei Zhi Ma (Semen Sesami Nigrum) has antioxidant activity with a potency comparable to that of a standard antioxidant (ascorbic acid), according to in vitro assays.[19] Dang Gui (Radix Angelicae Sinensis) and Chuan Xiong (Rhizoma Chuanxiong) protect against endothelial cells damage induced by hydrogen peroxide by enhancing the antioxidative ability, activating ERK and eNOS signaling pathways.[20]

        Overall, Polygonum 14 is a great tonic formula to improve the quality and quantity of hair, bone, and blood.

 

COMPARATIVE ANALYSIS

One striking difference between Western and traditional Chinese medicine is that Western medicine focuses and excels in crisis management, while traditional Chinese medicine emphasizes and shines in holistic and preventative treatments. Therefore, in emergencies, such as gunshot wounds or surgery, Western medicine is generally the treatment of choice. However, for treatment of chronic idiopathic illness of unknown origins, where all lab tests are normal and a clear diagnosis cannot be made, traditional Chinese medicine is distinctly superior.

        In regards to premature aging of the hair characterized by hair loss, premature gray hair, and unhealthy hair, there is very few drug treatments available in Western medicine. Rogaine (minoxidil) and Propecia (finasteride) are two of very limited options available, and their effects are often disappointing and side effects staggering. Limited hair growth may occur only after continuous use for several months. Furthermore, hair loss occurs after drug use is discontinued. Lastly, sexual dysfunction is common with the use of these medications. In short, drug treatment is only marginally beneficial and is only effective for a short period of time.

        On the other hand, traditional Chinese medicine is significantly superior to Western medicine to restore normal appearance and texture of hair. Furthermore, when used continuously for four to six months, it also helps to promote lasting hair growth. In addition to improving texture and volume of hair, this formula also has an antiaging effect to improve overall well-being. Lastly, it is very safe and can be used for a prolonged period of time.