Chai Hu Shu Gan San
Quick Facts
- What it is: A seven-herb Chinese formula, treated as a single drug, traditionally used for stress-linked digestive upset and tension under the ribs.
- Main uses: Stress-linked indigestion and bloating, Irritable bowel syndrome (IBS) symptoms, Mild low mood and tension, Period-related irritability
- Best for: Short courses for indigestion that flares with stress, Use under a qualified practitioner rather than self-prescribed
- Active ingredients: Chai Hu (bupleurum root), Chen Pi (dried tangerine peel), Chuan Xiong (Ligusticum root), Xiang Fu (nutgrass rhizome), Zhi Ke (bitter orange fruit), Bai Shao / Shao Yao (white peony root), Zhi Gan Cao (honey-fried licorice root)
- Forms: Dried herb mix for decoction (simmering in water), Granules dissolved in hot water, Powder, Tablets and pills
- Time to effect: One to two weeks for digestive symptoms; two to four weeks for mood and tension, if at all.
- Side effects: Usually mild stomach upset; rarely liver injury, lung inflammation, high blood pressure or low potassium.
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What is Chai Hu Shu Gan San?
Chai Hu Shu Gan San is a traditional Chinese herbal formula. It blends seven herbs in fixed amounts. It is also known as Bupleurum Powder to Dredge the Liver.
You take the whole mixture together. It is handled as one drug (a TCM formula), not as seven separate supplements.
Chinese medicine gives it for a pattern called "liver qi stagnation". That is the old name for tightness under the ribs, sighing and a short temper. It also covers bloating, belching and stomach trouble that flare with stress.
Today most practitioners reach for it in indigestion, irritable bowel symptoms, low mood, and tension before a period.
Where does the evidence stand? This formula is a long-standing staple of Chinese medicine. But good human trials are few, and most are small and low in quality, so its benefits are not proven.
Long tradition and proof of effect are two different things. This page reports them separately. That point is made here once, and not repeated in every section below.
One thing to know up front: the formula contains licorice root and bupleurum root. Both carry real safety issues. That is why this page is rated at the caution level rather than routine.
How does Chai Hu Shu Gan San work?
In Chinese medicine, the formula is said to move stuck liver qi. Qi is the traditional name for the body's flow of energy. Freeing it is meant to ease tightness under the ribs, bloating and irritability.
The seven herbs are taken as one blend in fixed proportions. They are not used as single parts.
Modern science has not shown how the formula works in the body. The human trials are few, small and mostly low in quality. So the way it acts stays unproven.
Some effects of single herbs are known from safety reports. Chuan xiong (Ligusticum) and white peony are thought to slow blood clotting. Licorice lowers potassium, raises blood pressure, and holds salt and water in the body.
Licorice also slows the breakdown of steroid hormones. Bupleurum has been linked to liver injury in case reports. Drowsiness has been reported with the formula too.
These are the same effects that drive the drug interactions listed further down this page.
Who should avoid Chai Hu Shu Gan San?
- Do not use if you are pregnant or trying to become pregnant: several herbs in this formula, including chuan xiong and xiang fu, are traditionally avoided in pregnancy.
- Do not use if you are breastfeeding.
- Never take this formula together with interferon (a medicine used for hepatitis) — the combination has been linked to serious lung injury and deaths.
- Do not use if you have any liver disease, including hepatitis or cirrhosis (permanent scarring of the liver).
- Do not use if you take warfarin, apixaban, clopidogrel, daily aspirin or any other blood thinner, unless your doctor has checked it.
- Do not use if you have high blood pressure, heart failure, or an irregular heartbeat.
- Do not use if you have kidney disease.
- Do not use if you take digoxin (a heart medicine) or water pills (diuretics), because the licorice in the formula can drop your potassium too low.
- Do not use if you have hypokalaemia (low potassium) or have been told your potassium runs low.
- Do not give it to children unless a qualified practitioner has prescribed it for that child.
- Do not use in the two weeks before planned surgery, because of the bleeding risk.
- Do not use if you have ever had an allergic reaction to any herb in the formula.
When should you see a doctor?
Stop taking it and see a doctor straight away if your skin or the whites of your eyes turn yellow, your urine goes dark, or you feel unusually tired or sick — these can be signs of liver trouble. Get urgent help if you develop a new cough with breathlessness or fever, or if your heart feels like it is racing, fluttering or skipping.
See a doctor within a few days if your ankles swell, your blood pressure readings rise, or you get muscle weakness or cramps, as these can point to the licorice affecting your potassium and fluid balance.
Book a normal appointment if your indigestion, bowel symptoms or low mood have not improved after four weeks, or if they are getting worse. Also see a doctor before starting this formula for any rib-side or upper-abdominal pain, weight loss you did not plan, blood in your stools, or difficulty swallowing — those need a diagnosis, not a herbal remedy.
Evidence grades and traditional-use labels are explained in our methodology. Nothing here is medical advice.
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