What is Keishi-ka-ryukotsu-borei-to?

Keishi-ka-ryukotsu-borei-to (KRB) is a classical eight-herb Japanese Kampo formula with roots in the ancient Chinese medical text Shang Han Lun (c. 200 CE). The formula centers on cinnamon twig for warming circulation, paired with two mineral ingredients — dragon bone (a fossilized calcium carbonate mineral) and oyster shell — which together are said to anchor restless or scattered energy. It is one of the most researched Kampo formulas in modern Japanese clinical medicine.

How does Keishi-ka-ryukotsu-borei-to work?

The mineral components (dragon bone and oyster shell) are rich in calcium and are thought to calm overactive nerve signaling, supporting a quieter nervous system response to stress. Cinnamon twig improves peripheral circulation and body warmth, while white peony root and licorice work together to relax smooth muscle and ease tension. Ginger and jujube round out the formula to support digestion and buffer the formula's tolerability.

What forms does Keishi-ka-ryukotsu-borei-to come in?

In Japan, KRB is most commonly prescribed as a standardized granule powder (notably Tsumura TJ-26) dispensed by licensed physicians under Japan's national health insurance system. Granules are dissolved in warm water and taken as a drink. In Chinese herbal practice, the formula is typically prepared as a decocted tea from raw herbs. Capsule and tablet forms are available in some Western markets but are less standardized.

Where it comes from:

The formula originates from Zhang Zhongjing's Shang Han Lun (Treatise on Cold Damage Disorders), written around 200 CE, making it nearly 1,800 years old. It was adopted into Japanese Kampo medicine during the Edo period and today is one of roughly 148 formulas covered by Japan's national health insurance, reflecting its mainstream clinical role in modern Japanese medicine.

What does Keishi-ka-ryukotsu-borei-to help with?

• Anxiety and nervous tension: KRB has a long Kampo tradition for people who feel chronically anxious, mentally scattered, or on edge. The mineral components — dragon bone and oyster shell — are thought to calm an overactivated stress response, and modern clinical use in Japan continues to reflect this for anxiety-type presentations.
• Sleep problems and insomnia: This formula is specifically indicated for the type of poor sleep that comes with mental restlessness, vivid dreaming, and waking easily — common in people who run anxious or overthink. The calming mineral and adaptogenic herb combination is used to help the mind settle at night.
• Erectile dysfunction (stress-related): KRB is one of the more studied Kampo formulas for psychogenic erectile dysfunction — the kind linked to anxiety, stress, and nervous system overactivation rather than vascular disease. Clinical studies from Japan have shown improvements in erectile function scores in men using this formula.
• ADHD and hyperactivity in children: Japanese pediatric studies have explored KRB for children with hyperactivity, emotional dysregulation, and sleep difficulties associated with ADHD-type presentations. It is viewed as a gentler calming option for children who present with heat, agitation, and physical restlessness.
• Night sweats and palpitations: The formula directly addresses what Kampo calls 'excess above and deficiency below' — symptoms like heart palpitations, flushing, and night sweats that come from nervous system instability. The anchoring mineral herbs are specifically chosen for this pattern.
• Stress and burnout: For people caught in a cycle of exhaustion, irritability, and poor recovery from stress, KRB offers a calming formula that also supports circulation and digestive function. It is best matched to those who feel cold, depleted, and emotionally frayed rather than fiery or overtly anxious.
• Male sexual health: Beyond erectile dysfunction, KRB has been used in Kampo for premature ejaculation and general male reproductive vitality, particularly in men whose sexual difficulties appear linked to nervous tension and fatigue rather than hormonal deficiency.
• Menopause symptoms: Some Japanese practitioners use KRB for perimenopausal women experiencing palpitations, hot-flash-related sleep disruption, and emotional instability — symptoms that overlap with the nervous system agitation this formula is designed to address.
• Irritability and emotional restlessness: KRB is a classic choice for irritability, emotional volatility, and a hair-trigger stress response — particularly when these accompany fatigue or cold sensitivity. The formula is intended to calm without sedating.
• Premature ejaculation: Clinical use in Japan includes premature ejaculation in men where nervous system over-sensitivity is the underlying issue. The calming and circulation-supporting herbs together address the autonomic imbalance thought to contribute to this condition.

What can Keishi-ka-ryukotsu-borei-to help prevent?

• Relapse of stress-induced insomnia during high-demand periods (supported by clinical use patterns in Japanese integrative medicine)

Which foods are rich in Keishi-ka-ryukotsu-borei-to?

Keishi-ka-ryukotsu-borei-to is a multi-herb formula and not found in any food source. To support the same calming, nervous-system-stabilizing goals, focus on foods that nourish the nervous system and reduce excess cortisol activity: magnesium-rich foods like dark leafy greens, pumpkin seeds, and dark chocolate help calm nervous tension; calcium-rich foods like sesame seeds, tofu, and dairy echo the mineral-anchoring role of dragon bone and oyster shell in the formula; warming spices like cinnamon and ginger in your diet reinforce the circulation-supporting core of this formula; and complex carbohydrates from oats and sweet potatoes support steady serotonin production. Avoid excess caffeine, alcohol, and highly processed foods, all of which worsen the nervous system agitation this formula targets. Foods to limit: Caffeine (coffee, energy drinks) — Worsens the nervous system overactivation and sleep disruption this formula is intended to calm, Alcohol — Disrupts sleep quality and increases anxiety rebound — counteracts the formula's calming intent, High-sodium foods — The licorice root component of KRB can raise blood pressure in some people; a high-sodium diet compounds this risk.

What are the side effects of Keishi-ka-ryukotsu-borei-to?

• Stomach upset or nausea (mild, usually resolves with food)
• Elevated blood pressure with prolonged use (licorice root effect)
• Low potassium levels with extended use, especially combined with diuretics
• Fluid retention or mild edema with long-term use
• Skin rash (rare allergic reaction)
• Not recommended in pregnancy without supervision

Good to know:

KRB has a strong safety record in Japanese clinical use, where it is prescribed by physicians under the national health system. Most side effects are mild and related to the licorice root content with long-term use. It is generally not recommended during pregnancy without professional guidance.

How much Keishi-ka-ryukotsu-borei-to should you take?

• Recommended daily: Standard Japanese pharmaceutical dosing: 7.5 g/day of granule extract (Tsumura TJ-26 or equivalent), divided into 2–3 doses. This corresponds to roughly 3.75 g of crude herb equivalent per dose. Raw herb decoction: approximately 8–12 g of formula blend per day, simmered and drunk as tea.
• Best time of day: Traditionally taken before meals (30 minutes before eating) for better absorption. For sleep support, a dose before bed is appropriate. For two-dose regimens: morning and evening.
• With or without food: Traditionally taken on an empty stomach before meals for best absorption. If stomach upset occurs, taking with a small amount of warm food is acceptable.
• Time to effect: Calming and sleep effects: some people notice improvement within days to 2 weeks. Erectile function and deeper nervous system changes: typically 4–8 weeks of consistent use.
• How long to take it: Short-term use (4–12 weeks) is typical for acute anxiety or sleep issues. For chronic conditions, Japanese clinical practice often continues for 3–6 months under physician supervision. Given the licorice root content, extended use beyond 3 months should be monitored for blood pressure and potassium levels. Periodic breaks are advisable for long-term users.