IngredientsAnemarrhena asphodeloides Bunge is a perennial herbaceous plant and the only species in the genus Anemarrhena in the Liliaceae (or Asparagaceae) family. It is an erect herbaceous plant with horizontal, thickened rhizomes 0.5–1.5 cm wide, covered by retained leaf sheaths. The leaves are grasslike and all basal, up to 60 cm long and 2 cm wide, gradually narrowing into a filiform tip distally.
The plant's medicinal part is the rhizome. Authentic Anemarrhena asphodeloides is distinguished by its characteristic horizontal rhizome densely covered in golden-yellow fibrous hairs, basal grass-like leaves, and a distinctive long spike-like raceme; the cross-section should show a yellowish-white color with sticky mucilage.
The plant is mainly distributed in China, Mongolia, and other eastern Asian countries. The rhizome of Anemarrhena asphodeloides, known pharmacologically as Anemarrhenae Rhizoma, is called Zhimu (also spelled Zhi Mu) in Chinese, Yanghuzi in Chinese vernacular, Chimo in Japanese Sino-medicine, and Jimo in Korean medicine.
It is cultivated in the Anhui and Hebei provinces of China, and also widely cultivated in Mongolia, Korea, and other eastern countries. Studies show that it mainly grows in sunny, dry hillsides, hilly grasses, or plains, and prefers loose, fertile, and well-drained humus loam.
In traditional preparation, the rhizomes are gathered in spring and autumn, cleaned of sand, mud, and fibrous roots, dried in the sun, cut into slices, and used directly or stir-fried with saltwater to make the Chinese herbal medicine. Preparations include decoctions, medicated liquors, and lotions. Zhi mu is available commercially; the most common dosage forms are the whole herb, capsules, and teas.
Zhi Mu, commonly known as Rhizoma Anemarrhenae, is the rhizome of Anemarrhena asphodeloides. It is a relatively practical and common Chinese herbal medicine that first appeared in the Shennong Ben Cao Jing in the late Western Han Dynasty (around 100 BCE). In the Shen Nong Ben Cao Jing, it was classified as a middle-grade (中品) herb. Zhi Mu has accumulated over two thousand years of documented medical use.
The rhizomes of Anemarrhena asphodeloides have been widely used in traditional Chinese medicine (TCM) for more than 2,000 years with remarkably therapeutic effects for the treatment of febrile diseases with high fever and thirst, heat in the lung with dry cough, consumptive fever, as well as diabetes due to internal heat and constipation. It exerted curative functions by clearing evil-heat and purging body-fire, generating body-fluids, and moistening dryness in TCM.
Anemarrhena asphodeloides has been commonly used in traditional medicine in China, Japan, and Korea for thousands of years. The traditional curative functions include treating febrile diseases, fever, cough, and diabetes. Traditional medicine systems in China, Japan, Korea, and Mongolia have mainly employed it to treat allergic diseases, diabetes, fever, thirst, and respiratory tract inflammation. It has been used in TCM for thousands of years for antipyretic, anti-inflammatory, sedative, diuretic, antitussive, antidiabetic, and antidepressant purposes. It significantly affects treating arthralgia, hematochezia, tidal fever, night sweats, cough, dry mouth and tongue, and hemoptysis.
Traditional Chinese medicine classifies this herb as cold (or yin) and bitter. Anemarrhena is used to treat heat disorders caused by excessive yang or insufficient yin functions. TCM uses bitter and cold herbs such as anemarrhena to clear the internal heat and provide moisture to the lungs and kidneys.
The herb is described as bitter, sweet, and cold, entering the lung, stomach, and kidney meridians, and is known in TCM for its actions of clearing heat and purging fire, nourishing yin, and moistening dryness.
Anemarrhena has historically been used as an ingredient in major classical formulas. It has a long history of use to treat various ailments, including cold-induced febrile disease with arthralgia, hematochezia, tidal fever and night sweats by yin deficiency, bone-steaming, cough, and hemoptysis. It is also used as an ingredient of healthy food, wine, tea, and biological toothpaste.
In the famous "Bai Hu Tang" formula, it works in synergy with Gypsum Fibrosum (Shi Gao), Licorice (Gan Cao), and Rice (Geng Mi) to treat high fever and intense thirst. In another classic blend, Zhi Mu is paired with Phellodendron (Huang Bai) in the "Zhi Bai Di Huang Wan" formula to address menopausal symptoms and nourish kidney yin.
Depression is considered to be an "emotional disease" in ancient books of TCM, and its clinical features are similar to those of "Lily disease" in the ancient Chinese medicine book Synopsis of the Golden Chamber, written by Zhang Zhongjing in the Han Dynasty. Baihe Zhimu decoction (Lilium lancifolium bulb and Anemarrhena asphodeloides rhizome) is the first prescription for "Lily Disease" in this book and is a special remedy after sweating. The classic recipe consists of fresh lily bulbs and dried Rhizoma Anemarrhena slices, and has the effect of supplementing nutrition, clearing heat, nourishing yin, and moistening. After more than two thousand years of clinical practice, it has been widely used in clinical treatment of depression.
Up to 108 compounds have been isolated from Anemarrhena asphodeloides, including steroidal saponins, flavonoids, phenylpropanoids, alkaloids, steroids, organic acids, anthraquinones, and others. The chemical constituents of Rhizoma Anemarrhenae are complex and diverse, mainly including steroidal saponins, flavonoids, phenylpropanoids, benzophenones, and alkaloids.
Steroidal saponins are considered the primary bioactive class. The most pharmacologically investigated include:
Anemarrhena asphodeloides is predominantly composed of steroidal saponins including sarsasapogenin.
Anemarrhena asphodeloides primarily contains xanthones, such as mangiferin, and steroidal saponins, such as timosaponin AIII and sarsasapogenin. Mangiferin is a C-glucosyl xanthone and a prominent compound isolated from the rhizome. The glucosidase inhibitory effect of flavones, including mangiferin and isomangiferin, was more effective than steroidal saponins including timosaponin AIII and timosaponin BII, revealing more potent anti-diabetic effects of flavones than saponins isolated from A. asphodeloides.
Polysaccharides (anemarans) are components in Rhizome Anemarrhena and comprise up to 20% of the rhizome. Neutral anemarans A, B, C, and D have shown hypoglycemic effects in vivo. These polysaccharides exhibit diverse biological activities such as antioxidant and immunomodulatory effects.
Additional identified compounds from the rhizome include 2,6,4'-trihydroxy-4-methoxybenzophenone, zimoside A, iriflophene, multiple anemarrhenasaponin types, timosaponin variants (B-III, C, D), isovitexin, vitexin, trans-hinokiresinol, tryptophan, and adenosine, among others.
Oral administration of timosaponin AIII (TAIII) and sarsasapogenin inhibited 2,3,4-trinitrobenzene sulfonic acid (TNBS)-induced colon shortening and myeloperoxidase activity in mice, along with reducing NF-κB activation and interleukin (IL)-1β, tumor necrosis factor (TNF)-α, and IL-6 levels, while simultaneously increasing IL-10. Both compounds inhibited Th17 cell differentiation in colonic lamina propria but induced Treg cell differentiation. Further, TAIII and sarsasapogenin inhibited the differentiation of splenic CD4+ T cells into Th17 cells in vitro.
These results suggest that orally administered TAIII may be metabolized to sarsasapogenin by gut microbiota, which may ameliorate inflammatory diseases such as colitis by inhibiting TLR4-NF-κB/MAPK signaling pathway and restoring Th17/Treg cell balance.
The total phenolic fraction of A. asphodeloides regulated serine/tyrosine phosphorylation of insulin receptor substrate-1 and subsequently restored Akt phosphorylation in response to insulin, thereby improving insulin-mediated glucose uptake. It also enhanced AMP-activated protein kinase (AMPK) phosphorylation, contributing to the inhibition of inflammation implicated in insulin resistance.
Following oral administration, timosaponin AIII and BII undergo rapid microbial biotransformation into sarsasapogenin, whose plasma concentration shows significant time-dependent accumulation. Both in vitro and in vivo studies indicate that sarsasapogenin exhibits superior anti-inflammatory activity compared to its parent compounds. Sarsasapogenin reduces high-fat diet-induced insulin resistance and adipose tissue inflammation by inhibiting IKK/NF-κB and c-Jun N-terminal kinase (JNK) pathways. As a key inflammatory mediator, activated PPARγ inhibits NF-κB transcriptional activity, which suppresses pro-inflammatory cytokines release.
In scopolamine-treated mice, timosaponin AIII (TA3) significantly reversed scopolamine-induced deficits in a passive avoidance test and in the Morris water maze test. TA3 also increased hippocampal acetylcholine levels in scopolamine-treated mice and dose-dependently inhibited acetylcholinesterase (AChE) activity (IC₅₀ value: 35.4 μM).
A bioactivity-oriented screening platform based on a modified Ellman's method and HPLC-QTOF MS technique was developed to rapidly screen active agents of Anemarrhena asphodeloides. The 60% ethanol fraction from an ethyl acetate extract exhibited the most potential anticholinesterase activity. Fifteen steroid saponins were identified, and twenty-five compounds were isolated from the active fraction. Compounds with the C₆–C₃–C₆ skeleton probably had both AChE and BuChE inhibitory activities. Xanthone and benzene derivatives exhibited no or little activity, lignans showed weak BuChE inhibitory activity, and steroidal saponins demonstrated moderate or weak AChE inhibitory activity.
Timosaponin A-III (TA-III) was screened and identified as a potentially active component for anti-Alzheimer's disease activity, and BACE1 was proven to be a potential high-affinity target.
TAIII from Anemarrhena asphodeloides induced autophagy preceding mitochondria-mediated apoptosis in HeLa cancer cells with IC₅₀ values ranging from 8.5–10.1 μmol/L after 48 hours of incubation. TAIII could potentially inhibit the growth of several human colorectal cancer cells (HCT-15: 6.1 μM; HCT-116: 5.5 μM; HT-29: 10.3 μM; SW-480: 13.1 μM; SW-620: 11.1 μM) with IC₅₀ values less than 15 μM, through inhibition of mTOR and induction of ER stress.
Although TAIII and TBII are mainly metabolized to sarsasapogenin in vivo, the sugar chain plays important roles in their pharmacological activities. The sugar chain in TAIII is indispensable to its pharmacological activities, and conversion of TBII to TAIII enhanced its cytotoxicity. TAIII presents the most potential anti-cancer activity due to its specific sugar chain binding site. However, the hydrophobicity and low bioavailability of TAIII have limited its efficacy in vivo, and many studies have focused on derivatization or drug delivery system design based on TAIII.
Six steroidal saponins isolated from the rhizome of A. asphodeloides inhibited platelet aggregation in human blood and activated partial thromboplastin times. Timosaponin A-III exhibited the strongest effect on hemolysis, anemarrhenasaponin IA had a slight effect, and the other saponins had no effect. Timosaponin B-II inhibited blood coagulation and formation of a thrombus in rabbits but had no thrombolytic effect in a rabbit arteriovenous shunt model. Timosaponin B-II may enhance fibrinolytic activity and accelerate thrombolysis at higher doses.
Evidence level: Predominantly preclinical (animal and in vitro); no robust human clinical trials identified.
Mangiferin and mangiferin-7-O-β-glucoside from Anemarrhena asphodeloides were studied for potential utility in treating type 2 diabetes at 90 mg/kg (oral administration) in KK-Ay diabetic mice; blood glucose levels were markedly reduced from 5.21±0.17 mg/mL to 2.90±0.36 mg/mL and from 5.65±0.19 mg/mL to 3.12±0.44 mg/mL respectively (P<0.001). The antidiabetic mechanism may involve a decrease in insulin resistance and an increase in insulin sensitivity.
Intraperitoneal injection of pseudoprototimosaponin AIII at 64 mg/kg isolated from Anemarrhena asphodeloides decreased the blood sugar level of diabetic mice by 68.2%.
A study investigating the effects of the total phenolic fraction of Anemarrhena asphodeloides on regulation of insulin sensitivity in adipocytes found that through treatment with macrophage-derived conditioned medium, insulin resistance was induced in adipocytes; this plant is widely used for treatment of metabolic disorders in TCM. Insulin resistance was induced in adipocytes with IKKβ activation and dysregulation of adipokine production. These changes were reversed by treatment with the total phenolic fraction of A. asphodeloides at concentrations of 1, 10, and 50 μg/mL.
Anemarrhena asphodeloides Bunge total saponins (RATS) are the main bioactive components of the plant; modern pharmacological effects of RATS are anti-inflammatory, hypoglycemic, and cardioprotective. A study using streptozotocin and a high-fat diet to induce diabetic cardiomyopathy (DCM) in rats found that Anemarrhena asphodeloides total saponins could improve diabetic cardiomyopathy; the study discussed the chemical composition, pharmacological action, and mechanism of these saponins, and found that they could improve diabetic cardiomyopathy by regulating glycolytic metabolism.
All evidence in this area is currently based on animal models and cell culture studies. No peer-reviewed human clinical trials evaluating Anemarrhena asphodeloides preparations as a primary antidiabetic intervention were identified.
Evidence level: Preclinical animal studies and in vitro; no human clinical trials identified.
Anemarrhenae Rhizoma, derived from the rhizome of Anemarrhena asphodeloides, is frequently used as a traditional Chinese medicine to treat Alzheimer's disease (AD) and other memory deficits associated with aging. The herb and its components have been demonstrated to have multiple pharmacological activities to prevent and treat Alzheimer's disease.
One study aimed to evaluate the therapeutic effect and mechanism of Anemarrhenae Rhizoma on AD model rats induced by D-galactose and AlCl₃, combining behavior studies, histopathological observations, and biochemical analyses in an AD model assessment. Gas chromatography-mass spectrometry (GC-MS) and liquid chromatography-mass spectrometry (LC-QTOF/MS) were combined with multivariate statistical analysis to identify potential biomarkers. A total of 49 biomarkers associated with the AD model were identified by metabolomics, and pathway analysis was performed to obtain the closely related metabolic pathways.
Sarsasapogenin, extracted from Anemarrhena asphodeloides, has been reported to protect neurons from H₂O₂-induced damage in cell culture models. Sarsasapogenin, isolated from rhizomes of Anemarrhena asphodeloides, was found to be able to enhance memory in preclinical research.
The rhizome of Anemarrhena asphodeloides, used in Traditional Chinese Medicine as a brain function-improving herb, is a promising source of neuroprotective substances. One study evaluated the protective action of xanthones from A. asphodeloides rhizomes on the PC12 cell line exposed to the neurotoxic agent 3-nitropropionic acid (3-NP). The xanthone-enriched fraction of the ethanolic extract, rich in polyphenolic xanthone glycosides, was examined at concentrations from 5 to 100 μg/mL. The results showed a significant increase in the number of cells surviving after treatment with the xanthone fraction following exposure to neurotoxic 3-NP, with decreased morphological changes in PC12 cells in a dose- and time-dependent manner. The most effective protective action was observed when PC12 cells were pre-incubated with the fraction, an effect that may contribute to the traditional indications of this herb for neurological and cognitive complaints.
Based on phytochemical and pharmacological studies since the 1930s, Anemarrhena asphodeloides has been investigated for potential to treat Alzheimer's disease, Parkinson's disease, and schizophrenia. These remain areas of active preclinical research. Clinical translation in human populations has not yet been established.
Evidence level: Preclinical (animal and in vitro); no human clinical trials identified.
Rhizoma Anemarrhenae is a famous traditional Chinese medicine that is the dried rhizome of Anemarrhena asphodeloides. The medicine presents anti-inflammatory, antipyretic, sedative, and diuretic effects.
The anti-inflammatory mechanisms of timosaponin AIII and sarsasapogenin have been characterized in animal models of colitis (see Section 4 above). Both in vitro and in vivo studies indicate that sarsasapogenin exhibits superior anti-inflammatory activity compared to its parent saponin compounds.
Evidence level: Preclinical (animal and in silico network pharmacology); early-stage research only.
Osteoporosis is a systemic bone disease characterized by reduced bone density and quality. Anemarrhena asphodeloides shows therapeutic potential in this condition, but its mechanisms remain under investigation.
A combined bioinformatics and experimental study found that Anemarrhena asphodeloides contains multiple active ingredients that may exert therapeutic effects on osteoporosis by regulating targets such as AKR1C1, AKR1C2, ABCC1, SMO, and AKT1, and key signaling pathways like PI3K-Akt and VEGF, thereby providing theoretical support for the clinical use of Anemarrhena asphodeloides in the treatment of osteoporosis.
Anemarrhena asphodeloides Bunge paired with Phellodendron chinense (AA/PC) is the core herb pair in traditional Chinese medicine formulae for postmenopausal osteoporosis treatment, though the synergistic effects and mechanisms of AA/PC on alleviating ferroptosis and postmenopausal osteoporosis remain under study. Micron-scale computed tomography analysis showed that the AA/PC combination increased bone mineral density in ovariectomized mice.
Increasing studies show that several components of AA/PC—including berberine, timosaponin AIII, and timosaponin BII—have protective effects on osteoblasts.
Evidence level: In vitro / preclinical only.
The decoction of Anemarrhena asphodeloides can inhibit Shigella, typhoid, paratyphi, Vibrio cholerae, Escherichia coli, Proteus, diphtheria, Staphylococcus, Pneumococcus, β-hemolytic streptococcus, and Candida albicans in laboratory studies. No human clinical trials on antimicrobial applications were identified.
Evidence level: In vitro and limited animal studies; no human clinical trials identified.
Timosaponin A-III, a saponin isolated from the rhizome of A. asphodeloides, is an autophagy- and apoptosis-inducing agent toward cancer cells in laboratory models. The mechanism involves mitochondria-mediated apoptosis, induction of ER stress, mTOR inhibition, and anti-angiogenesis effects as characterized in cell line studies (see Section 4 above). All existing evidence comes from in vitro cancer cell lines and animal models.
Evidence level: Preclinical (animal models) and some clinical evidence within the context of combination formulas.
After more than two thousand years of clinical practice, the Baihe Zhimu decoction has been widely used in clinical treatment of depression. Depression is considered an "emotional disease" in ancient books of TCM, and its clinical features are similar to those of "Lily disease" in the ancient Chinese medicine book Synopsis of the Golden Chamber. Baihe Zhimu decoction is the first prescription for "Lily Disease" in this book.
Notably, the available clinical evidence pertains to the combination formula (Baihe Zhimu / LBRAD), not to isolated Anemarrhena asphodeloides preparations. Modern pharmacological research has confirmed that the crude extracts and pure compounds of Anemarrhena asphodeloides possess beneficial effects on the central nervous system and can regulate mood.
Modern research has proven that A. asphodeloides possesses various pharmacological effects, including nervous system activity, antitumour, anti-inflammatory, antidiabetic, antiosteoporotic, antiallergic, antiplatelet aggregation, antimicrobial, antiviral, anti-ageing, promoting hair growth, and preventing cell damage.
The dosage of Zhi Mu in TCM practice should be controlled at 6–12 g. Other traditional TCM sources specify a somewhat broader range: decoct 5–15 g and take it orally.
The most common dosage forms are the whole herb, capsules, and teas for treating "cold and bitter" conditions. Manufacturers suggest using three to six 500 mg capsules two to three times daily as a tea.
No peer-reviewed human clinical trial specifying a validated therapeutic dose for any indication has been identified in the published literature. All preclinical doses listed above were established in cell culture or animal models and cannot be directly extrapolated to human use.
Evaluating the quality and toxicity of Anemarrhena asphodeloides is essential to confirm its safe use in humans. Few preliminary studies have reported the toxic properties of A. asphodeloides, and detailed research should be carried out to confirm its safe use in humans.
Although Anemarrhena asphodeloides possesses therapeutic effect in the treatment of diabetes, Alzheimer's disease, Parkinson's disease, and other diseases, there is a pressing need to investigate current therapeutic agent information and the evidence of clinical studies on toxicity and adverse effects.
A significant cytotoxicity was observed at higher xanthone fraction (XF) concentrations (over 10 μg/mL) and longer incubation time (48 hours), requiring caution in future research and thorough investigation into potential adverse effects.
Overdose may cause diarrhea. The herb is not suitable for deficiency cold syndrome. TCM practice traditionally contraindicates the herb in patients presenting with signs of spleen-stomach cold-deficiency, diarrhea, or loose stools — conditions framed in TCM as "middle jiao cold" — because the cold energetic quality of the herb is considered likely to exacerbate these states.
Six steroidal saponins isolated from the rhizome of A. asphodeloides inhibited platelet aggregation in human blood and activated partial thromboplastin times. Timosaponin B-II inhibited blood coagulation and formation of a thrombus in rabbits. Timosaponin B-II may enhance fibrinolytic activity and accelerate thrombolysis at higher doses. These findings suggest a potential pharmacodynamic interaction with anticoagulant or antiplatelet medications, though this has not been evaluated in human clinical studies.
Timosaponin A-III exhibited the strongest effect on hemolysis among the steroidal saponins tested. This hemolytic potential of timosaponin AIII is a relevant safety consideration noted in laboratory studies.
Avoid use in patients with known allergy or hypersensitivity reactions to A. asphodeloides or its constituents.
Following oral administration, timosaponin AIII and BII undergo rapid microbial biotransformation into sarsasapogenin, whose plasma concentration shows significant time-dependent accumulation. Studies have implied that saponin fractions could increase the absorption and improve the bioavailability of the four steroidal saponins from Anemarrhena asphodeloides. Chinese traditional medicine extracts are an effective aggregation of multiple components, and the pharmacokinetics of a single ingredient cannot represent the pharmacokinetics of the whole herbal medicine.
Timosaponin BII and mangiferin are biomarkers used to determine the quality of A. asphodeloides. It has been suggested that a few more biomarkers should be identified and used to determine quality.
In light of long traditional use and modern phytochemical and pharmacological studies, Anemarrhena asphodeloides has demonstrated strong potential for therapeutic and health-maintaining purposes. Both the extracts and chemical components isolated from the plant showed a wide range of biological activities.
More pharmacological mechanisms on main active compounds (TBII, TAIII, mangiferin, and other ingredients) are necessary to be explored. In addition, clinical studies of main therapeutic aspects such as diabetes, Alzheimer's disease, and Parkinson's disease, as well as toxicity and adverse effects of Anemarrhena asphodeloides, will undoubtedly be a focus of future investigation.
Current studies on the chemical constituents and pharmacological mechanisms of Anemarrhena asphodeloides lack depth, and more studies on phytochemistry and the mechanisms of the main active ingredients (TBII, TAIII, and mangiferin) in displaying certain biological activities (neuroprotective activity, lowering blood sugar, and others) should be encouraged to fully understand the compounds responsible for the pharmacological effects.
In summary, the overwhelming body of evidence for Anemarrhena asphodeloides is preclinical — derived from in vitro cell studies and animal model experiments. The existing data provide a mechanistic rationale for many of the traditional uses, particularly the antidiabetic, anti-inflammatory, neuroprotective, and antiosteoporotic indications. However, robust human clinical trials — randomized controlled trials establishing efficacy, optimal dosing, and safety in human populations — are largely absent from the peer-reviewed literature as of the current date. Anemarrhena asphodeloides is widely used in traditional medicine and has diverse chemical constituents with obvious biological activities; nevertheless, more studies should be carried out in animals and humans to evaluate the cellular and molecular mechanisms involved in its biological activity and confirm its safe use.
Health conditions that Anemarrhena may help support.
Body systems that Anemarrhena may help support.
Go back