Cuspidatum root

Other Names

American bambooAsian knotweedBillyweedCot khi cuDonkey rhubarbElephant-ear bambooFallopia cuspidataFallopia japonicaFalse bambooFleeceflowerHimalayan fleece vineHojang-geunHu ZhangHuzhangItadoriItadori-konJapanese bambooJapanese knotweedKojo-konMexican bambooMonkeyweedPea shootersPleuropterus cuspidatusPleuropterus zuccariniiPolygoni Cuspidati RhizomaPolygoni Cuspidati Rhizoma et RadixPolygonum cuspidatumPolygonum cuspidatum var. compactumPolygonum japonicumPolygonum reynoutriaPolygonum zuccariniiReynoutria japonicaReynoutriae RhizomaRhizoma Polygoni CuspidatiTiger caneTiger staff

Synopsis

Cuspidatum Root (Polygonum cuspidatum / Reynoutria japonica): A Comprehensive Reference

1. Identity, Taxonomy, and Nomenclature

Cuspidatum root is the dried root and rhizome of the herbaceous perennial plant known botanically as Polygonum cuspidatum Sieb. et Zucc. The current accepted species name is Reynoutria japonica Houtt., with Fallopia japonica and Polygonum cuspidatum serving as widely used synonyms. It is a member of the family Polygonaceae. In pharmacopeial and traditional medicine contexts, the drug material is designated as Polygoni Cuspidati Rhizoma et Radix. The dried root of Polygonum cuspidatum Sieb. et Zucc. is one of the medicinal herbs listed in the Pharmacopoeia of the People's Republic of China.

Common names vary by region and context. In traditional Chinese medicine the plant is known as Hu Zhang; it is also called Japanese knotweed and Mexican bamboo in English. In Japan, the plant and its edible young shoots are known by numerous regional folk names. Regional Japanese names include tonkiba (Yamagata), gonpachi (Shizuoka), and sukanpo (many areas), among others. In Korea the plant is similarly used as a folk medicine. The plant spread naturally across Japan, Korea, Taiwan, and parts of China, where it is known as Itadori and used in traditional medicine.

Botanical characteristics: Polygonum cuspidatum is a perennial shrubby herb of the genus Polygonum, used in dried form with stems and roots. It grows in southwest, central, and southern China, and is more common on slopes of hills and ditches at an altitude of 500–2500 meters. Japanese knotweed has hollow stems with distinct raised nodes that give it the appearance of bamboo, though it is not related. In Chinese medicine, slices of the dried rhizome are mostly short, cylindrical or irregular and thick, with a length of 1–7 cm and a diameter of 0.5–2.5 cm. The plant is native to East Asia in Japan, China, and Korea. In North America and Europe the species has successfully established itself in numerous habitats, and is classified as a pest and invasive species in several countries.

Commercial preparations include standardized dry root extracts, typically characterized and standardized to their trans-resveratrol or polydatin content. In the 2020 edition of the Chinese Pharmacopoeia, emodin and polydatin are used as the official markers to monitor the quality of the stems and roots. The roots of Polygonum cuspidatum are a commercial source of the botanical dietary supplement trans-resveratrol; 50% ethanol is used as a food-grade solvent for extraction. Extracts are sold as powders, capsules, tablets, liquid tinctures, and topical cosmetic preparations.

2. Traditional and Historical Use

Traditional Chinese Medicine (TCM)

Japanese knotweed has a long history of human use in China and Japan. In traditional Eastern medicine it has been a herbal ally since at least 500 CE, where it was first recorded in the Ming Yi Za Zhu (Miscellaneous Records of Famous Physicians). In this text it is included in more than 77 classic formulas and was used frequently by physicians of the time. The herb first appeared in the Mingyi Bie Lu around 420–589 AD.

From the perspective of TCM theory, Hu Zhang is used to remove jaundice and clear heat-toxin, so as to promote blood circulation, dispel stasis, expel wind and dampness, dissipate phlegm, and suppress cough. Therefore, Hu Zhang is commonly prescribed by TCM practitioners for the treatment of cough, hepatitis, jaundice, amenorrhea, leucorrhoea, arthralgia, hyperlipidemia, scald and bruises, snake bites, and carbuncles. The roots are officially listed in the Chinese Pharmacopoeia for the treatment of various inflammatory diseases, tumors, and diarrhea.

Hu Zhang is frequently used as a hepatoprotective and cholagogic drug in TCM. Its effects on hypertension, hyperlipidemia, and cardiovascular and neurodegenerative diseases have also been intensively investigated, both experimentally and clinically. In China, Hu Zhang is usually used in combination with other TCM herbs. Statistically, 140 Chinese patent medicines containing Hu Zhang have been developed on the basis of data from the National Medical Products Administration.

Japanese and Korean Traditional Use

Hu Zhang is widely distributed in the world and can be found in Asia and North America; it is used as folk medicine in countries such as Japan and Korea. Polygonum cuspidatum is a medicinal plant used in traditional Chinese medicine, with alleged effects on the liver, gallbladder, and lungs. It grows widely throughout Japan and is foraged as a wild edible vegetable (sansai). As a widely used ethnomedicine in Asia including China, Japan, and Korea, Hu Zhang can invigorate the blood, cool heat, and resolve toxicity, and is commonly used in the treatment of favus, jaundice, scald, and constipation.

Traditional Preparations

In spring and autumn, the roots and rhizomes are gathered, fibrous roots and impurities removed, washed with water, cut into sections or thick slices, dried in the sun, and made into Chinese herbal medicines. Traditional preparations include a tincture (1:3 in 35%) taken in doses up to 5 ml in a little water up to three times a day; a decoction is prepared by placing one teaspoon of dried root in one cup of boiling water, simmered for 15–20 minutes, and drunk hot three times a day. The traditional treatment dose in herbal medicine contexts is typically 6 to 40 g per day of the raw herb. The plant is used in traditional Chinese medicine, with alleged effects on the liver, gallbladder, and lungs.

3. Key Constituents and Active Compounds

Over 67 compounds from the root of this plant have been isolated and identified; they include quinones, stilbenes, flavonoids, coumarins, lignans, and others. More recent investigations have expanded that inventory: more than 100 compounds have been isolated and identified from Hu Zhang, including quinones, aromatic hydrocarbons, flavonoids, and other less abundant ingredients such as phenylpropanoids and organic acids; among them, anthraquinones and stilbenes have been the most extensively studied and possess the most notable bioactivity.

Stilbenes

Stilbene compounds, such as resveratrol and polydatin, are the main active components in Polygonum cuspidatum. Trans-resveratrol (3,5,4′-trihydroxy-trans-stilbene) is the principal stilbene and the compound most extensively investigated. Resveratrol exists in cis- and trans-configurations, of which trans-resveratrol is the principal biologically active form. Polydatin (resveratrol-3-O-β-D-glucoside, also called piceid) is the glycoside precursor of resveratrol. Polydatin, the glycoside form of resveratrol, has a more significant pharmacological effect on the cardiovascular system than resveratrol. While polydatin and resveratrol convert to each other in the body, polydatin is absorbed better orally. Polydatin is more resistant to enzymatic oxidation than resveratrol and possesses much better solubility in water.

Anthraquinones

Anthraquinone compounds mainly include emodin and its derivatives. Emodin (1,3,8-trihydroxy-6-methylanthraquinone) is a prominent active compound. Emodin is a naturally occurring anthraquinone derivative and an active ingredient of Polygonum cuspidatum, among other Chinese herbs that have been widely used as traditional medicines in eastern Asia. Other anthraquinones present include physcion, chrysophanol, rhein, emodin 8-O-β-D-glucopyranoside, aloe-emodin, and citreorosein. Anthraquinones are considered the biologically active component in the rhizome and root; anthraquinone is also considered the most toxic component of P. cuspidatum.

Flavonoids and Other Polyphenols

Stilbenes including resveratrol, polydatin, and anthraquinones such as emodin and its glycoside are the major compounds in Hu Zhang. Hu Zhang also contains flavonoids such as quercetin and (+)-catechin. Flavonoids are mainly found in the leaves and stems. Additional flavonoids identified include kaempferol, rutin, luteolin, apigenin, hyperoside, isoquercitrin, reynoutrin, epicatechin, genistein, and hesperetin. Tannins and polysaccharides are also present.

Phytochemical Distribution Within the Plant

Stilbene and anthraquinone compounds are more concentrated in the rhizomes than in other tissues, which may explain why the root is used in traditional Chinese medicine. Extracts of resveratrol from R. japonica roots are higher in content than those from stems or leaves, and have highest levels at the end of the growing season.

4. Mechanisms of Action

Anti-Inflammatory Mechanisms

Hu Zhang extract standardized to contain 20% trans-resveratrol demonstrated comprehensive suppressive effects on inflammatory and oxidative stress, achieved through decreasing levels of TNF-α, interleukin, intranuclear NFκB binding, JNK1, PTP-1B, and reactive oxygen species generation in mononuclear cells. Resveratrol and polydatin in P. cuspidatum can inhibit the releasing of IL-6 and nitric oxide (NO) in the murine macrophage cell inflammatory model; this effect is related to the suppression of NF-κB and Janus kinase/STAT signaling pathway. Emodin was shown to inhibit the expression of inflammatory-associated genes including iNOS, TNF-α, interleukin-10, IKK-alpha, and IKK-gamma and to inhibit the nuclear translocation of NFκB on LPS-induced inflammatory responses in RAW 264.7 macrophages.

Citreorosein, an anthraquinone derivative isolated from Hu Zhang, inhibited COX-2-dependent prostaglandin D2 generation and COX-2 expression in mouse bone marrow-derived mast cells.

Antioxidant Mechanisms

The molecular structure of resveratrol (3,4′,5-trihydroxystilbene) enables it to act as a potent antioxidant, anti-inflammatory agent, and modulator of cellular signaling pathways. Resveratrol neutralizes reactive oxygen species (ROS) directly and upregulates endogenous antioxidant defense systems. Resveratrol functions in plant disease resistance by activating constitutive and inducible defense responses.

Lipid and Cardiovascular Mechanisms

The mechanism of antihyperlipidemic action of P. cuspidatum extract is related to the activation of the PI3K/AKT signaling pathway and its downstream FOXO3/ERα factors, with polydatin and resveratrol as the main active ingredients exerting antihyperlipidemic effects. Resveratrol stimulates HDL production by the liver, decreases LDL production, and avoids circulating LDL oxidation, and therefore plays a role in lowering the risk of cardiovascular disorders.

Sirtuin Activation and Metabolic Modulation

Trans-resveratrol is one of the most studied activators of SIRT1, a NAD+-dependent deacetylase linked to caloric-restriction-like metabolic effects. This mechanism has been implicated in observed metabolic, anti-aging, and anti-inflammatory outcomes in preclinical models, though the degree to which this translates to clinical relevance in humans remains under active investigation.

Neuroprotective Mechanisms

There is growing interest in neuroprotective agents from natural products. Several studies have reported the neuroprotective effects of Hu Zhang extract or its major compounds such as polydatin, emodin 8-O-β-D-glucopyranoside, and resveratrol. Resveratrol, especially in the form of trans-resveratrol, has pharmacological uses in treating inflammation and cardiovascular-related diseases.

Anticancer Mechanisms

Resveratrol can down-regulate Bcl-2 protein and up-regulate the expression of Bax protein, inducing human liver carcinoma cells into phase S and promoting apoptosis. Resveratrol can also inhibit the growth of human gastric adenocarcinoma cells and arrest them at the G0/G1 stage. Emodin (20 μmol/L) inhibited the expression of TGF-β2 and reduced cell viability and colony formation of human ovarian cancer cells; this effect was mediated by activating FoxD3 and miR-199a. These mechanisms have been demonstrated primarily in cell-based (in vitro) models.

Pharmacokinetics

After oral administration, resveratrol is swiftly metabolized in the liver and intestine, mostly into sulfate conjugates and glucuronides, and excreted through the urine. It has also been reported that these metabolites can be converted back to resveratrol by intestinal microbes. Polydatin is mainly metabolized to resveratrol in the small intestine and liver, then metabolized to glucuronidation forms, but polydatin can still be detected in plasma and urine. The sulfates/glucuronides of resveratrol and emodin are the major forms in circulation and most assayed organs after oral intake of P. cuspidatum; however, the free form of emodin is predominant in liver. Pharmacokinetic studies have demonstrated that emodin has poor oral bioavailability in rats because of its extensive glucuronidation.

5. Scientific Evidence by Area of Use

5.1 Anti-inflammatory Effects

Human clinical evidence: A clinical study investigated the effect of a Polygonum cuspidatum extract (PCE) containing resveratrol on oxidative and inflammatory stress in normal subjects. Two groups of 10 normal-weight healthy subjects each were randomized to placebo or PCE containing 40 mg resveratrol daily for 6 weeks, with fasting blood samples obtained at 1, 3, and 6 weeks. The intake of an extract of Polygonum cuspidatum containing resveratrol suppressed oxidative stress and inflammation in normal subjects. Ghanim et al. in 2010 found that intake of PCE containing resveratrol suppressed plasma concentration of TNF-α, IL-6, and C-reactive protein after 6 weeks in healthy humans, while no changes were observed in the control group.

A separate randomized double-blind placebo-controlled trial in male professional basketball players evaluated the anti-inflammatory effect of P. cuspidatum extract (PCE) containing resveratrol for 6 weeks: intake of PCE containing resveratrol for 6 weeks was demonstrated to reduce the plasma concentration of TNF-α and IL-6 significantly (P < 0.05).

Limitations: These human trials were small (n = 20 per study), short in duration (6 weeks), and did not always separate the contributions of resveratrol from other polyphenols in the extract. The evidence is preliminary; larger, longer-term trials are needed.

5.2 Cardiovascular Risk Factors and Lipid Metabolism

Human clinical evidence: A 6-week supplementation with 200 mg of P. cuspidatum extract containing 40 mg of resveratrol did not alter fasting plasma concentrations of cholesterol (total, LDL, and HDL), triglycerides, or leptin compared with placebo in 20 subjects. This null result contrasts with other data: resveratrol has gained particular attention due to its potential antioxidant and anti-inflammatory action, but the results in humans are conflicting, possibly due to inter-individual different responses.

Resveratrol is a pharmacologically active compound that interacts with multiple targets in a variety of cardiovascular disease models to exert protective effects or induce a reduction in cardiovascular risk parameters. A clinical trial (NCT01842399) in overweight and obese people over age 50 investigated resveratrol at two doses. The 12-month Phase 1–2 double-blind randomized study assigned 120 participants to one of two doses (75 mg twice daily or 150 mg twice daily) or placebo, self-administered for 52 weeks, with the primary endpoint of vascular stiffness measured by Pulse Wave Velocity.

Limitations: Human clinical trials have shown conflicting results, which may be due to differences in dosage and duration of supplementation, the bioavailability of resveratrol, the role of food matrix to improve resveratrol bioactivity, and the characteristics of the patients studied. Much of the cardiovascular evidence remains preclinical or from small human studies.

5.3 Glycemic Control and Type 2 Diabetes

Resveratrol has been widely studied because of its antioxidant and anti-inflammatory activities as well as potential protective effects against cancer, cardiovascular, metabolic, and neurodegenerative diseases. Although extensively studied in both in vitro and in vivo models, the evidence on its potential effects in humans is not univocal. A clinical investigation specifically using PCE at 500 mg/day and 40 mg/day of resveratrol for 6 months aimed to determine whether resveratrol reduced concentrations of C-reactive protein and ameliorated the metabolic pattern in type 2 diabetes mellitus patients. One randomized trial found that resveratrol, a polyphenolic compound found in the root of Polygonum cuspidatum, has been identified for the following beneficial properties: antioxidant, anti-inflammatory, anti-carcinogenic, anti-platelet aggregation, cardio-protective, neuroprotective, insulin sensitizer, and anti-aging activities; yet the same trial concluded that results in T2D patients were not consistently significant.

Limitations: Trials are heterogeneous in population, dose, extract type, and duration. No large multicenter RCT has definitively established resveratrol from cuspidatum root as an effective agent for glycemic control. Evidence for diabetes remains preliminary.

5.4 Neuroprotection

Several studies have reported the neuroprotective effects of Hu Zhang extract or its major compounds such as polydatin. It has been found that polydatin could reduce the volume of cerebral infarction and improve rat neurological deficits in animal models of stroke. These findings are exclusively preclinical. No human clinical trials focused specifically on cuspidatum root preparations and neurological outcomes were identified in the current literature.

5.5 Antimicrobial Activity

Extracts of the herbal medicine have exhibited antibacterial and antiviral effects in vitro. The root and rhizome of Polygonum cuspidatum have been described as an antiherpesviral, antipolioviral, anti-varicella-zoster virus, and anti-CMV agent. Resveratrol has also been reported as an antifungal and antibacterial component in the root of Polygonum cuspidatum. Evidence remains primarily in vitro or in animal models; no robust human clinical trials for infectious disease indications were identified.

5.6 Cancer — Preclinical Evidence

The first published human study dealing with resveratrol and cancer was a 4-arm pilot trial to evaluate the effects of different plant preparations on colon cancer patients. Some patients ingested 20 mg P. cuspidatum extract (containing 3.9 mg resveratrol) plus 120 mg quercetin, or 80 mg P. cuspidatum extract (containing 15.5 mg resveratrol) plus 480 mg quercetin; preparations were ingested daily from cancer diagnosis until surgery, for approximately 14 days. Normal colonic mucosa and colon cancer tissues were evaluated by Wnt pathway-specific microarrays. The most significant effects were obtained after ingesting 80 g of grape powder in normal colonic mucosa, not the cuspidatum extract arm. Animal and cell studies indicate proapoptotic and cell-cycle-arresting activities of resveratrol and emodin across several cancer cell types; however, these findings remain firmly preclinical.

5.7 Hepatoprotective Effects

Polygonum cuspidatum is a medicinal plant with alleged effects on the liver, gallbladder, and lungs. Polydatin may help people cope with oxidative stress and inflammation-related liver damage. The rhizome of Polygonum cuspidatum is prescribed for the treatments of amenorrhea, arthralgia, jaundice, abscess, scald, and bruises. Hepatoprotective activity is well-documented in preclinical models, but dedicated human clinical trials are limited.

6. Body Systems and Health Areas

Cardiovascular system: Polygonum cuspidatum and its extracts have demonstrated anti-inflammatory, antioxidant, anticancer, and heart protection pharmacological effects. Polydatin and resveratrol have been studied for lipid regulation and vascular function.
Hepatobiliary system: Hu Zhang is frequently used as a hepatoprotective and cholagogic drug in TCM.
Metabolic/endocrine system: Polygonum cuspidatum has been used for treatment of inflammation, favus, jaundice, scald, and hyperlipemia.
Nervous system: Oxidative stress is implicated as a causative factor in neuronal death in neurodegenerative disorders. There is growing interest in neuroprotective agents from natural products since they contain compounds with high antioxidant power.
Immune and inflammatory system: Resveratrol, polydatin, and emodin modulate multiple proinflammatory pathways including NF-κB, COX-2, and cytokine production.
Musculoskeletal system: Hu Zhang-containing TCM prescriptions have been used for treating arthralgia.
Integument: The root of Polygonum cuspidatum has been used in the treatment of inflammation, female disorders, infection, jaundice, skin burns, and hyperlipemia diseases.
Gastrointestinal system: Excessive use of the herbal medicine may cause a slight diarrhea; emodin has laxative properties via anthraquinone-mediated stimulation of the large intestine.

7. Dosage Forms and Reported Dosages

Cuspidatum root and its extracts are available in multiple forms. In traditional use, the treatment dose is typically 6 to 40 g per day of the raw herb. Standardized dietary supplement extracts are considerably more concentrated. The following dosages are those reported in published clinical research:

Ghanim et al. (2010), anti-inflammatory study in healthy subjects: Two groups of 10 normal-weight healthy subjects each received placebo or PCE containing 40 mg resveratrol daily for 6 weeks.
Smoliga et al. review (2011), lipid endpoints in 20 subjects: 6 weeks of supplementation with 200 mg of P. cuspidatum extract containing 40 mg of resveratrol did not alter fasting plasma concentrations of cholesterol (total, LDL, and HDL), triglycerides, or leptin compared with placebo.
Clinical trial resveratrol doses (cardiovascular study, NCT01842399): One of two doses (75 mg twice daily or 150 mg twice daily) or placebo were self-administered twice a day for 52 weeks to participants aged 50 years or older.
T2DM protocol dosages: Resveratrol supplementation at two dosages (500 mg/day and 40 mg/day) for 6 months was investigated for effects on C-reactive protein and metabolic parameters in type 2 diabetes mellitus patients.
Extraction yield data: Under ultrasonic extraction conditions (50 °C; 150 W), yields of 3.5 mg/g for trans-resveratrol, 9.2 mg/g for trans-piceid, and 7.8 mg/g for emodin were obtained from dried root.

Commercially available standardized extracts range widely in potency, from 10% to 98% resveratrol content. Dosage recommendations vary across products and studied populations; the clinical trial literature does not yet support a single universally established therapeutic dose for any indication.

8. Safety Considerations and Drug Interactions

General Tolerability

Hu Zhang has a variety of active ingredients and broad pharmacological activities. It is widely used in health products, cosmetics, and animal husbandry feed and has no obvious toxicity when used at traditional doses. However, systematic safety data in humans from long-duration, large-sample trials are limited.

Anthraquinone-Related Concerns

Anthraquinones are a biologically active component in the rhizome and root of P. cuspidatum, and anthraquinone is considered the most toxic component. Emodin, the principal anthraquinone, has a documented toxicological profile. Pharmacokinetic studies have demonstrated that emodin has poor oral bioavailability in rats because of its extensive glucuronidation. The sulfates/glucuronides of resveratrol and emodin are the major forms in circulation after oral intake of P. cuspidatum, but the free form of emodin is predominant in the liver, which has implications for potential hepatic accumulation.

Pregnancy

Japanese knotweed should not be used in pregnancy, as advised in TCM pharmacopeias, owing to the herb's abortifacient effects. There is insufficient safety data for resveratrol supplementation during pregnancy and breastfeeding; supplementation is not recommended.

Drug Interactions: CYP Enzyme Pathways

Resveratrol is metabolized by cytochrome P450 enzymes (particularly CYP3A4, CYP2C9, and CYP2D6) and may interact with medications processed by these same pathways, including certain statins, calcium channel blockers, and immunosuppressants.

A specific herb-drug interaction of clinical significance has been documented for the combination with carbamazepine (an antiepileptic drug): carbamazepine (CBZ), an antiepileptic with narrow therapeutic window, is a substrate of CYP3A, which metabolizes CBZ to carbamazepine-10,11-epoxide (CBZE), an active metabolite. A study investigated the acute and chronic effects of Polygonum cuspidatum, a resveratrol-rich nutraceutical, on the pharmacokinetics of CBZ in rats and the underlying mechanisms. The results showed that PC significantly increased the AUC(0-t) of CBZ and CBZE, whereas the formation rate of CBZE was decreased. Tissue analysis showed that the concentrations of CBZ and CBZE in brain, liver, and kidney were significantly increased by PC.

Resveratrol-rich vegetal products act not only on membrane transporters but also on metabolizing enzymes; Polygonum cuspidatum, an important source of resveratrol, inhibits the activities of CYP3A involved in the metabolism of carbamazepine, thus increasing systemic exposure to the drug.

Estrogenic Activity

Resveratrol may have weak oestrogenic activity; individuals with breast cancer, endometriosis, or uterine fibroids should exercise caution. Phytoestrogens from the roots, including certain hydroxyanthraquinones, have also been isolated and characterized.

Anticoagulant/Antiplatelet Effects

Due to potential effects on bleeding, resveratrol should ideally be discontinued at least two weeks before elective surgical procedures. Resveratrol's inhibition of platelet aggregation is documented in preclinical studies, and potential interaction with anticoagulants warrants attention.

Gastrointestinal Effects

Excessive use of the herbal medicine may cause a slight diarrhea. This is consistent with the known laxative properties of emodin and other anthraquinones, which act by stimulating intestinal motility.

Overall Evidence Characterization

It is used in traditional Chinese and Japanese medicine to treat various disorders through the actions of resveratrol, although there is no high-quality evidence from clinical research for any medical efficacy. Resveratrol has been widely studied for its antioxidant, anti-inflammatory, and potential protective effects against various diseases; although extensively studied in both in vitro and in vivo models, the evidence on its potential effects in humans is not univocal. The preclinical (animal and cell-based) evidence is extensive and mechanistically compelling, but most human clinical trials to date have been small, short-term, and heterogeneous, making firm evidence-based conclusions premature for most claimed indications.

References

Health Conditions

Health conditions that Cuspidatum root may help support.

Lyme DiseaseScientific
Japanese knotweed root (Polygonum cuspidatum) was one of the two most potent botanicals against B. burgdorferi in the 2020 Johns Hopkins in vitro study, with the lowest MIC values. Its active compounds resveratrol and emodin exhibit direct anti-borrelia, anti-inflammatory, neuroprotective, and blood-brain barrier-penetrating properties. It has been a central herb in the Buhner Lyme protocol. Evidence is primarily in vitro with no clinical trials completed.

Body Systems

Body systems that Cuspidatum root may help support.

No body systems available.