Bupleurum (Chai Hu)

Bupleurum chinense
Evidence Level
Preliminary
2 Clinical Trials
5 Documented Benefits
1/5 Evidence Score

Bupleurum (Chai Hu) is a foundational herb in traditional Chinese medicine, where it appears in classical formulas such as Xiao Chai Hu Tang for liver-channel support and emotional regulation. The root contains triterpene saponins called saikosaponins (notably saikosaponins A and D), along with polysaccharides, lignans, and essential oils. Laboratory and animal work has examined saikosaponins for effects on the liver, inflammation, and immune signaling, but there are no controlled human trials of bupleurum on its own. The single human study cited here tested a seven-herb formula (sho-sai-ko-to) in 24 people with chronic hepatitis C and had no control group. That same formula has been linked in Japan to reports of interstitial pneumonitis, a serious lung inflammation that has been fatal in some cases, and to cases of liver injury. In traditional practice bupleurum is used inside multi-herb formulas rather than alone, and those traditional uses have not been tested in controlled human trials.

Studied Dose No dose of bupleurum alone has been tested in a controlled human trial. Traditional decoctions use 3-9 g/day of dried root and commercial extracts commonly list 200-500 mg/day, but those figures come from traditional practice and product labels, not from studies.
Active Compound Triterpene saponins (saikosaponins A, C, D, F), polysaccharides, flavonoids, lignans, essential oils; some extracts standardized to total saikosaponins.

Benefits

Traditional liver-channel use, with an important safety caution

This use comes from traditional Chinese medicine and from animal experiments, not from human trials. No controlled study has shown that bupleurum improves liver function in people. Bupleurum-containing formulas have themselves been linked to cases of liver injury, so this should not be read as a liver benefit.

Immune effects seen only in laboratory studies

Bupleurum polysaccharides and saikosaponins change immune-cell signaling in cell and animal experiments. Nothing about immune function has been measured in people taking bupleurum, so no immune benefit can be claimed.

Traditional use during periods of stress and tension

Bupleurum appears in classical multi-herb formulas given during periods of stress and irritability. This is traditional use only. No human trial has tested bupleurum for mood, stress, or anxiety.

Traditional use for stress-related digestive complaints

Classical formulas containing bupleurum were used for bloating and discomfort linked to stress. No human trial has tested bupleurum for digestive symptoms, and the gut-brain-liver mechanism language is theory rather than a measured effect.

Antioxidant activity seen in the laboratory only

Saikosaponins show antioxidant and anti-inflammatory activity in test-tube and animal models. These effects have not been demonstrated in people taking bupleurum.

Mechanism of action

1

Saikosaponin hepatoprotection

Saikosaponin A and D help protect hepatocytes from chemical injury in animal models by supporting glutathione status, modulating Kupffer-cell activation, and reducing lipid peroxidation.

2

Immunomodulation via polysaccharides

In cell and animal studies, bupleurum polysaccharides engage pattern-recognition receptors and change macrophage activity. Whether any of this happens in people taking bupleurum has not been tested.

3

HPA-axis modulation

Preclinical studies suggest saikosaponins modulate HPA-axis signaling and corticosterone responses, contributing to traditional stress-related uses.

4

Anti-inflammatory NF-κB inhibition

Saikosaponins inhibit NF-κB activation and downstream production of pro-inflammatory cytokines such as TNF-α and IL-6 in laboratory models.

Clinical trials

1
Sho-saiko-to (Xiao Chai Hu Tang) in hepatitis C

Single-arm phase II study with no control group, testing sho-sai-ko-to, a compound of seven botanical extracts of which bupleurum is only one

n=24 adults with chronic hepatitis C ineligible for interferon

AST improved in 16 of the 24 participants (67%) and ALT in 18 of 24 (75%). Everyone received the formula and there was no placebo or control group, so these numbers do not show an effect: liver enzymes rise and fall on their own in chronic hepatitis C. The product also contained seven herbs, so nothing here can be credited to bupleurum. This was a study in people already diagnosed with a liver disease, not a test of what bupleurum does for a healthy person.

2
Review article on the Bupleurum genus (not a clinical trial)

Comprehensive pharmacology review of approximately 50 Bupleurum species and ~250 isolated compounds

Mixed in vitro, animal, and limited human evidence

This is a review article, not a study in people. It summarizes mostly test-tube and animal findings on saikosaponins, notes that extracts are poorly standardized, and points out that what little human evidence exists comes from multi-herb formulas rather than bupleurum on its own.

Side effects and drug interactions

Common Potential side effects

Mild gastrointestinal upset, nausea, or loose stools can occur at higher doses.
Liver injury: bupleurum-containing herbal formulas have case reports of drug-induced liver injury in people, and high-dose or prolonged use of isolated saikosaponins damages the liver in animal studies. Stop use and see a doctor for dark urine, yellowing of the eyes or skin, or unexplained fatigue.
Possible drowsiness or sedation in sensitive individuals.
Rare allergic reactions including skin rash. Far more seriously, the bupleurum formula sho-saiko-to has been linked in Japan to interstitial pneumonitis, an inflammation of the lung tissue that has been fatal in some reported cases and that led to formal warnings from the Japanese health authority. New or worsening cough, breathlessness, or fever needs immediate medical attention.
Headache occasionally reported during early use.

Important Drug interactions

Interferon-based therapies: do not combine. Sho-saiko-to, the exact bupleurum formula behind the only human study cited on this page, has been associated with interstitial pneumonitis including deaths, and the risk was particularly linked to use alongside interferon in hepatitis patients.
CYP450 substrates: saikosaponins may modulate select CYP enzymes and influence drug clearance.
Immunosuppressants: theoretical interaction via immunomodulatory polysaccharides.
Anticoagulants: bupleurum may have additive effects on bleeding risk in high doses.

Frequently asked questions about Bupleurum (Chai Hu)

What is bupleurum used for?

Bupleurum (chai hu) is a traditional Chinese herb that appears in many classic multi-herb formulas used for liver-related patterns, stress and mood, and digestion. Those are traditional uses only; there are no controlled human trials of bupleurum by itself. It is rarely used alone, almost always within a formula.

What is bupleurum good for?

In traditional Chinese medicine it is described as smoothing the flow of qi, and it appears in well-known formulas for stress, tension, and digestion. These are traditional descriptions, not tested benefits: no controlled human trial has tested bupleurum alone for any of them, and its saikosaponins have been studied mainly in the laboratory.

How much bupleurum should I take?

It is almost always used within traditional formulas under practitioner guidance rather than alone; follow product or practitioner direction.

Is bupleurum safe?

It carries risks worth knowing about. The bupleurum formula sho-saiko-to has been linked to interstitial pneumonitis, a serious lung inflammation that has been fatal in some Japanese case reports, with the highest risk in hepatitis patients also receiving interferon; this led to formal safety warnings in Japan. Bupleurum-containing formulas have also been linked to liver injury. Anyone with a liver or lung condition, anyone taking medication, and anyone on interferon should not use it without a doctor's supervision.

What is Bupleurum?

Bupleurum (Chai Hu) is a foundational herb in traditional Chinese medicine, where it appears in classical formulas such as Xiao Chai Hu Tang for liver-channel support and emotional regulation.

What is the recommended dosage of Bupleurum?

The clinically studied dose is No dose of bupleurum alone has been tested in a controlled human trial. Traditional decoctions use 3-9 g/day of dried root and commercial extracts commonly list 200-500 mg/day, but those figures come from traditional practice and product labels, not from studi… Always follow the product label and check with a healthcare provider for personal advice.

Is Bupleurum safe, and does it have side effects?

For most healthy adults, Bupleurum is well tolerated at studied doses. Reported effects can include: Mild gastrointestinal upset, nausea, or loose stools can occur at higher doses. Liver injury: bupleurum-containing herbal formulas have case reports of drug-induced liver injury in people, and high-dose or prolonged use of isolated saikosaponins damages the liver in animal studie… It may also interact with some medications. Bupleurum is not right for everyone, so check with a healthcare provider first if you are pregnant or breastfeeding, have a medical condition, or take prescription medication.

Does Bupleurum interact with any medications?

Possible interactions include: Interferon-based therapies: do not combine. Sho-saiko-to, the exact bupleurum formula behind the only human study cited on this page, has been associated with interstitial pneumonitis including deaths, and the risk was particularly linked to use alongside interferon in hepatitis… If you take prescription medication, check with a pharmacist or doctor before using it.

How strong is the scientific evidence for Bupleurum?

NutraSmarts rates the evidence for Bupleurum as Preliminary (1 out of 5). It is backed by 2 clinical trials and 2 cited references summarized on this page. A higher rating reflects more, larger, and better-designed human studies.

References(2 citations)

Evidence ratings on NutraSmarts are based on the totality of human clinical research, with emphasis on randomized controlled trials, meta-analyses, and systematic reviews. The references below directly support claims made throughout this page.

  1. Deng G, Kurtz RC, Vickers A, Lau N, Yeung KS, Shia J, Cassileth B. A single arm phase II study of a Far-Eastern traditional herbal formulation (sho-sai-ko-to or xiao-chai-hu-tang) in chronic hepatitis C patients. J Ethnopharmacol. 2011;136(1):83-7. doi: 10.1016/j.jep.2011.04.008.PubMedUsed to support: Single-arm phase II study with no control group, testing sho-sai-ko-to, a seven-herb formula containing bupleurum, in 24 patients with chronic hepatitis C. AST improved in 67% and ALT in 75% of participants, but with no control group and six other herbs in the product this does not demonstrate any effect of bupleurum.
  2. Ashour ML, Wink M. Genus Bupleurum: a review of its phytochemistry, pharmacology and modes of action. J Pharm Pharmacol. 2011;63(3):305-321. doi: 10.1111/j.2042-7158.2010.01170.x.PubMedUsed to support: Review article containing no new human data, covering about 50 Bupleurum species and saikosaponin chemistry, with hepatoprotective, anti-inflammatory, and immunomodulatory activity reported mainly in laboratory and animal models; emphasizes the need for standardization.