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Limited evidenceStress & mood

Bupleurum (Chai Hu)

A root used as the chief herb in classical Chinese formulas for stress and low mood. Almost all clinical evidence is for multi-herb formulas containing it, not for bupleurum on its own.

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What the science says

  • Depressive symptoms as part of a formula Limited evidence

    A systematic review and meta-analysis of Chaihu-Shugan-San, a formula in which bupleurum is the principal herb, reported reductions in depression scores versus control. The trials were mostly small, conducted in China, and rated at high risk of bias, and the contribution of bupleurum itself cannot be separated out.

  • Anxiety and insomnia as part of Xiao Yao San Limited evidence

    A meta-analysis of Xiao Yao San, another bupleurum-containing formula, found improvement in insomnia combined with anxiety compared with conventional care. Trial quality was low and blinding was frequently absent.

  • Bupleurum alone Limited evidence

    A comprehensive review of bupleurum in depression found that the antidepressant work is almost entirely animal and mechanistic; no placebo-controlled human trial of the isolated herb was identified.

Dosage & safety

Studied doseNo dose is established for the single herb. Traditional decoctions use roughly 3–9 g of dried root per day as one component of a multi-herb formula.
SafetyBupleurum-containing formulas have been linked to case reports of drug-induced liver injury and, in Japan, to interstitial pneumonitis when Sho-saiko-to was combined with interferon. Avoid in pregnancy and in existing liver disease, and do not combine with interferon therapy. Saponins can cause nausea and abdominal discomfort.

How to take it

TimingTiming does not matter for the single herb - it has no established solo dose and is traditionally used inside a formula.
With food?With food; the saponins cause nausea and abdominal discomfort on an empty stomach.
Worth knowingStop immediately and get liver enzymes checked if you develop jaundice, dark urine, pale stools or unexplained fatigue - the liver signal here is the reason to be careful.

Interactions

With medications

  • interferon therapy

    Sho-saiko-to, the bupleurum-containing formula, was linked in Japan to interstitial pneumonitis when combined with interferon in chronic hepatitis patients, some cases fatal. do not combine under any circumstances

  • methotrexate, isoniazid, amiodarone and other drugs that stress the liver

    Bupleurum-containing formulas have their own case reports of drug-induced liver injury. do not combine, and avoid bupleurum entirely with existing liver disease

Well-established interactions only — this is not a complete list. Always tell your doctor and pharmacist what you take.

Frequently asked questions

Does bupleurum help depression or anxiety?

The evidence is limited: trials of Chinese formulas in which bupleurum is the main herb, such as Chaihu-Shugan-San and Xiao Yao San, reported benefits but were small, often unblinded and at high risk of bias. No placebo-controlled trial of bupleurum alone exists.

Is bupleurum safe for the liver?

Bupleurum-containing formulas have case reports of drug-induced liver injury, so avoid bupleurum with existing liver disease and stop it and get liver enzymes checked if you develop jaundice, dark urine, pale stools or unexplained fatigue.

Can bupleurum be taken with interferon?

No. The bupleurum formula Sho-saiko-to was linked in Japan to interstitial pneumonitis, some cases fatal, when combined with interferon, so do not combine them under any circumstances.

Scientific references

Related in Stress & mood

Herbal medicines: what the evidence says (335)