Gan Cao Gan Jiang Fu Ling Bai Zhu Tang
Quick Facts
- What it is: A classical four-herb Chinese decoction, treated as a single drug, used traditionally for a cold, heavy, aching lower back.
- Main uses: Cold, heavy, aching lower back, Cold sensation in the waist and hips, Heaviness in the lower body, Cold-type weak digestion with loose stools
- Best for: Short courses for a lower back that feels cold and weighed down rather than hot or swollen
- Active ingredients: Glycyrrhizin and glycyrrhetinic acid (licorice), Gingerols and shogaols (dried ginger), Pachymic acid and polysaccharides (poria), Atractylenolides and volatile oil (white atractylodes)
- Forms: Water decoction from bulk dried herbs, Concentrated granules or powder, Pills or capsules
- Time to effect: Tradition suggests a few days; no trial has measured this.
- Side effects: Mostly mild stomach warmth, but the licorice can raise blood pressure, cause swelling and lower potassium.
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What is Gan Cao Gan Jiang Fu Ling Bai Zhu Tang?
Gan Cao Gan Jiang Fu Ling Bai Zhu Tang is a Chinese herb tea. You make it by boiling four herbs in water. Chinese medicine uses it for a cold, heavy, aching low back.
It is treated as one drug. The mix is fixed: licorice root, dried ginger, poria mushroom and white atractylodes root.
It has other names too. One is Licorice, Ginger, Poria, and Atractylodes Macrocephala Decoction. The old name is Shen Zhuo Tang, or Kidney Fixity Decoction.
The old texts paint a vivid picture. The waist feels cold, heavy and damp, "as if you were sitting in water". Appetite, thirst and urine stay normal.
Evidence verdict: this tea is a long-standing staple of one tradition, with a clear old record. But we found no human trials of the finished mix.
So its effects in people are not proven. Long use shows what healers have done. It is not proof that the mix works.
How does Gan Cao Gan Jiang Fu Ling Bai Zhu Tang work?
In traditional terms, the tea is said to warm the middle. It dries "cold-damp" that has settled in the low back.
Each herb has a job in that story. Dried ginger warms, and white atractylodes dries damp. Poria drains fluid, and licorice brings the other three into balance.
That is a traditional idea, not a tested one. No one has shown that the tea changes any measured process in the back or kidneys of people.
Lab and animal work on the single herbs gives some clues. All of them are indirect.
Glycyrrhizin from licorice calms swelling in cells. It also makes the body hold salt and water.
Poria holds compounds studied as a mild diuretic (a substance that makes you pass more urine). Ginger compounds have been studied for pain and nausea signals.
None of this has been carried through to a trial of the whole tea. So treat the idea as a guess, not a finding.
What forms does Gan Cao Gan Jiang Fu Ling Bai Zhu Tang come in?
A water decoction (herbs boiled in water) is the old and most common form. The dried herbs are simmered together. You strain the liquid and drink it warm, usually split across the day.
Other forms you may meet:
Strong granules or powder that melt in hot water. They are sold by weight, and a practitioner sets the dose.
Ready-made pills or capsules of the same four herbs.
Loose bulk herbs, weighed out by a Chinese medicine pharmacy from a written script.
Strength varies a lot between products. So the amount of licorice you take can differ several-fold between brands.
Where it comes from:
The formula comes from the Jin Gui Yao Lue (Essentials from the Golden Cabinet). The book is credited to Zhang Zhongjing, around 200 CE in Han dynasty China.
Chinese medicine has used it ever since. It still appears in standard modern TCM (Chinese medicine) formula textbooks.
Its classic use has barely changed in eighteen hundred years. The target is a cold, heavy, wet-feeling low back and hips, with no thirst and no urine trouble.
It belongs to one tradition only. It is not shared across several systems of medicine.
Who should avoid Gan Cao Gan Jiang Fu Ling Bai Zhu Tang?
- Do not use if you have high blood pressure, whether or not it is treated
- Do not use if you have heart failure, an irregular heartbeat, or any other heart condition
- Do not use if you take digoxin
- Do not use if you take water tablets (diuretics), such as furosemide or bendroflumethiazide
- Do not use if you have low potassium (hypokalaemia) or have been told your potassium runs low
- Do not use if you have kidney disease or reduced kidney function
- Do not use if you have liver disease, especially cirrhosis (severe liver scarring) with fluid build-up
- Do not use if you are pregnant or trying to become pregnant, because licorice intake in pregnancy has been linked to harm to the baby
- Do not use if you are breastfeeding
- Do not use if you are giving it to a child, unless a qualified practitioner and your doctor have both agreed
- Do not use if you take corticosteroids such as prednisolone
- Do not use if you have swelling (oedema) anywhere in your body from fluid build-up
- Do not use if you have back pain with fever, unexplained weight loss, loss of bladder or bowel control, or numbness in your groin or legs — get urgent medical care instead
When should you see a doctor?
See a doctor before you start if you have back pain that is new, severe, or lasting more than a few weeks, or if you take any regular medicine.
Stop taking it and see a doctor promptly if you notice swollen ankles or face, headaches, unusual thirst, muscle weakness or cramps, or if a blood pressure reading is higher than usual.
Get emergency help straight away if you have chest pain, a fast or irregular heartbeat, severe muscle pain with dark urine, or sudden severe weakness. These can be signs of dangerously low potassium.
Also get urgent care for back pain with fever, numbness between your legs, or trouble controlling your bladder or bowels.
Evidence grades and traditional-use labels are explained in our methodology. Nothing here is medical advice.
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