Supplement analysis backed by scientific evidence · PT

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Moderate evidenceJoints & skin

White Peony

White peony root (Paeonia lactiflora) is unusual among herbs: its standardized extract, total glucosides of paeony (TGP), is an approved prescription immunomodulator in China with a real trial base in rheumatoid arthritis and other autoimmune conditions. Ordinary Western "white peony" capsules are not TGP and do not carry that evidence.

What the science says

  • TGP as add-on therapy in rheumatoid arthritis has meta-analytic support, mainly for tolerability Moderate evidence

    A systematic review and meta-analysis of TGP as adjuvant therapy in rheumatoid arthritis pooled randomized trials and found that adding TGP to conventional DMARDs did not increase adverse events and was associated with fewer liver-enzyme elevations and gastrointestinal complaints than DMARDs alone. Efficacy signals (DAS28, ESR, CRP) favor TGP add-on, but the trials are almost entirely Chinese, often unblinded, and at moderate-to-high risk of bias.

  • Add-on benefit reported in psoriasis and other autoimmune conditions Limited evidence

    A 2025 systematic review and meta-analysis of TGP added to conventional psoriasis therapy found improved PASI response rates versus conventional therapy alone. Similar add-on reviews exist for lupus, Sjögren's syndrome and recurrent aphthous ulcers. All share the same limitations: small, single-country, mostly open-label trials, and none tests TGP as monotherapy.

  • Standard white peony supplements are not the studied product Limited evidence

    Trials use TGP standardized to roughly 40% or more paeoniflorin and dosed at 1,200-1,800 mg/day. A typical Western capsule is 500 mg of peony root powder or a low-ratio extract with unstated paeoniflorin content, delivering a small fraction of the studied active. Claims about hormone balance, PCOS and testosterone lowering in women rest on cell studies and a few small trials of the Japanese formula shakuyaku-kanzo-to (peony plus licorice), not on peony alone.

Dosage & safety

Studied doseClinical trials of TGP use 1,200-1,800 mg/day in 2-3 divided doses, standardized to about 40% paeoniflorin, for 12-24 weeks. Traditional decoction uses 6-15 g/day of dried root in formula. Western capsules commonly supply 500 mg of root or extract per capsule — check for a paeoniflorin percentage; if there isn't one, you are not taking the studied preparation.
SafetyTGP is generally well tolerated; the main side effect across trials is loose stools or diarrhea, reported in roughly 5-15% of users and usually dose-related and transient. It has immunomodulatory activity, so discuss with your rheumatologist before adding it to DMARDs or biologics — the trial data are all add-on, not replacement. In China TGP is a regulated prescription medicine, which is worth knowing if you are buying an unregulated "white peony" supplement abroad. The peony-licorice combination carries licorice's mineralocorticoid risks (see our licorice entry). Avoid in pregnancy; peony has traditional uterine effects and no safety data.

Scientific references

Where to buy

Life Extension, Peony Immune, 60 Vegetarian Capsules (600 mg per Capsule)

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