What is Kakkontokasenkyushin?

Kakkontokasenkyushin is a herbal mix used in Kampo, the herbal medicine of Japan. People take it for a stuffy, blocked nose. It is used most for long-term sinus trouble, for nose allergy, and for a head cold.

It is sold and listed as one fixed Kampo item, not as loose herbs. The base is kudzu root (Latin name: Pueraria), with two herbs added: senkyu and shin'i. It also holds ephedra (ma-huang) and licorice root, and those two drive most of its risks.

Kampo doctors have used this mix for many years, and that record is real. But long use is not proof that a remedy works. Good human trials of this mix are few, so the evidence in people stays weak.

How does Kakkontokasenkyushin work?

The most likely reason it helps a blocked nose is the ephedra in it. Ephedra holds ephedrine (a stimulant that narrows small blood vessels). Narrowed vessels in the nose lining may cut swelling, so air moves more freely.

The other herbs are thought to add to this in small ways. Senkyu and shin'i are the classic Kampo pair for nose and sinus complaints. Lab work hints that some of their oils calm swelling, but that work is in dishes and animals, not people.

In Kampo thinking, the mix is said to warm the body, open the surface, and move what is stuck in the head. That is a traditional way of speaking, not a tested body process. No one has shown step by step what this formula does inside a person.

What forms does Kakkontokasenkyushin come in?

In Japan it is sold mainly as a dried extract granule or fine powder. You stir the granules into warm water and drink them. Some brands press the same extract into tablets or capsules.

A few pharmacies still make it the old way, as a decoction. That means the raw sliced herbs are simmered in water and the liquid is drunk warm.

Strength is not the same from brand to brand. Follow the label on the pack you hold, not a dose you read elsewhere.

Where it comes from:

The base of this mix, Kakkonto, comes from the Shang Han Lun, a Chinese text from about the third century. Kampo doctors in Japan took it up and used it widely.

The two extra herbs, senkyu and shin'i, were added in Japan to aim the formula at the nose and sinuses. It became a standard Kampo item and is still covered by Japanese health insurance today.

What does Kakkontokasenkyushin help with?

• Long-term sinus trouble (sinusitis): This is the main use in Kampo practice, and Japanese doctors have prescribed it for this for decades. Good trials in people are lacking, so we cannot say how well it works or who it suits best. If your sinus symptoms last more than ten days, or come with fever or face pain, see a doctor rather than treating it yourself.
• Stuffy or blocked nose: A short-term easing of a blocked nose is the most believable effect, because ephedra works much like a decongestant drug (a medicine that shrinks swollen nose lining). The trade-off is that it can also speed your heart and raise your blood pressure. It is not a good choice if you have heart or blood pressure problems.
• Nose allergy (allergic rhinitis): Kampo doctors use it for a blocked, dripping nose in hay fever season. Human trial evidence for this formula in allergy is thin. Standard allergy medicines have far stronger proof behind them.
• Early head cold: The Kakkonto base is a classic Kampo choice in the first day or two of a cold, when you feel chilled and your neck is stiff. Trial evidence is limited and mixed. It does not shorten or cure a cold, and it will not treat an infection.
• Stiff neck and shoulders: Tradition links the kudzu base to tight neck and shoulder muscles during a cold. This use rests on long practice, not on trials. There is no human study we can point to for it.

Which foods are rich in Kakkontokasenkyushin?

1. Kuzu starch: the same kudzu root, used as a thickener in Japanese cooking; it is a food, not a dose of this formula
2. Licorice sweets and licorice tea: a source of the same glycyrrhizin, which adds to the risk of low potassium

Practical Tips:

Cut back on licorice sweets and licorice tea while you take this mix, and go easy on coffee and energy drinks.

What are the side effects of Kakkontokasenkyushin?

• Upset stomach, nausea or loss of appetite
• A fast or pounding heartbeat
• Trouble getting to sleep, or feeling jittery
• Sweating more than usual
• Headache
• Higher blood pressure
• Rash or itching
• Swollen ankles, muscle weakness or cramps (possible signs of low potassium, a salt your muscles need)
• Rare: liver injury, seen as yellow skin or eyes, dark urine, or pain under the right ribs
• Rare: lung inflammation, seen as a dry cough, fever and breathlessness
• Rare: muscle breakdown, seen as severe muscle pain with weakness and brown urine

Good to know:

Mild effects are the common ones: stomach upset, sweating, a racing heart and poor sleep. Most settle once you stop.

The serious effects are rare, but they are real and they are the reason this mix is not a casual daily supplement. Licorice can cause pseudoaldosteronism (a licorice-driven salt problem that raises blood pressure and lowers potassium). Low potassium can weaken muscles and upset the heart's rhythm.

Rare cases of liver injury and of lung inflammation have been reported with Kampo extract formulas. Stop the product and get medical help if any of the rare signs above appear.

How much Kakkontokasenkyushin should you take?

• Recommended daily: A common adult dose of the Japanese extract granules is 7.5 g a day, split into two or three doses. Brands differ, so always follow your own pack. There is no dose set by research outside Japan. Children, older people and frail people need a smaller dose, set by a doctor. Do not stack it with other herbal products that hold licorice or ephedra. The amounts add up and so does the risk.
• Best time of day: It is usually taken two or three times a day, spaced through the day. Take the last dose well before bed. The ephedra in it can keep you awake.
• With or without food: In Japan it is taken before meals or between meals, with warm water. If it upsets your stomach, take it with a little food.
• Time to effect: A blocked nose may ease within a few hours to a day or two. For long-term sinus trouble, Kampo doctors usually look for change over two to four weeks.
• How long to take it: For a cold or a short flare of a blocked nose, use it for a few days only. If nothing changes in about a week, stop and get advice. For long-term sinus trouble, a Kampo doctor may plan two to four weeks and then review. Long use raises the risk from licorice, so your doctor should check your blood pressure and your blood potassium.