What is Keishikakkonto?

Keishikakkonto is a Japanese Kampo herbal formula. People take it at the first sign of a cold, with chills, a stiff neck and tight shoulders. It is a ministry-approved Kampo medicine in Japan, made by firms such as Tsumura.

The name means Cinnamon Twig Decoction plus Pueraria. It is the older keishito recipe with kakkon (kudzu root) added. Unlike the better-known kakkonto, this version contains no ephedra (ma huang).

Here is the evidence in one line. The traditional standing is strong, but human trial data on this exact formula is very thin. Long use by many people is not the same as proof that a medicine works.

One safety point is not in doubt. The formula contains licorice root, about 2 g a day, and licorice can upset your salt and potassium balance.

How does Keishikakkonto work?

The honest answer is that its effects in people have not been well studied.

In Kampo theory, the formula warms the body surface and loosens a tight neck. It is matched to a person who sweats a little and feels chilled.

In laboratory studies, kudzu root and cinnamon bark show anti-inflammatory activity in cells. Whether that helps a person with a cold is not established.

One effect is well shown in people, and it is a risk, not a benefit. Glycyrrhizin from licorice blocks 11beta-HSD2 (an enzyme that shields the kidney from cortisol). This can cause pseudoaldosteronism (a salt and water imbalance caused by licorice), with low potassium, swelling and higher blood pressure.

What forms does Keishikakkonto come in?

Most people take it as extract granules in single-dose sachets. Tablets and capsules are also sold.

Traditional practice uses a decoction, where the raw herbs are simmered in water. Granules are the common form in Japanese pharmacies today.

Check the label for the licorice (kanzo) amount. You need that number if you take any other Kampo formula.

Where it comes from:

The recipe comes from the Shang Han Lun, a Chinese medical text from about 200 CE. It was carried into Japan and became part of Kampo practice.

Kampo doctors have used it for centuries for early colds with neck and shoulder stiffness. It is now an approved prescription medicine under Japanese rules.

What does Keishikakkonto help with?

• Early stage of a common cold with chills: This is the classic Kampo use, and it is the main reason the formula exists. Kampo practice reserves it for the first day or two of a cold. The person is chilled, sweats a little and has a weak pulse. We found no controlled human trials of Keishikakkonto for colds. Treat the benefit as traditional, not proven.
• Stiff, aching neck and shoulders: Kudzu root was added to the base formula for exactly this complaint. Kampo doctors also use it for neck stiffness without a cold. Human trial evidence for this use is lacking. If neck stiffness comes with high fever or confusion, seek care the same day.
• Headache felt at the base of the skull: Traditional use covers a dull headache tied to a tight neck. This sits inside the same pattern as the stiff shoulders. No human trials support it. A sudden, severe headache is not a job for a herbal formula.
• Mild fever with light sweating: Kampo separates two cold patterns. Kakkonto suits a person with no sweat, and Keishikakkonto suits one who sweats a little. This split is a traditional rule, not a trial result. A fever above 39C, or one lasting past three days, needs a doctor.

Which foods are rich in Keishikakkonto?

1. Licorice sweets and licorice tea: they add more glycyrrhizin, the compound behind the salt and potassium risk
2. Kuzu (kudzu) starch, used in Japanese sauces and desserts: the same root as kakkon, though the food amount is small
3. Cinnamon as a kitchen spice: the same bark, at a much lower dose

Practical Tips:

While you take this formula, skip licorice sweets and licorice tea.

What are the side effects of Keishikakkonto?

• Nausea or loss of appetite
• Stomach discomfort
• Rash or itching
• Swelling in the ankles, face or hands (edema)
• Low potassium (hypokalaemia), which can cause muscle weakness and cramps
• A rise in blood pressure
• Headache or a heavy feeling in the head
• Rarely, liver problems, with yellow skin or dark urine
• Rarely, an irregular heartbeat linked to low potassium

Good to know:

Most people who take it for a few days have no trouble. Mild stomach upset and rash are the usual complaints.

The serious risk comes from licorice. It can cause pseudoaldosteronism (a salt and water imbalance caused by licorice), which shows up as swelling, weakness, cramps and higher blood pressure.

This is more likely with long use, higher doses, older age or other licorice products. Very low potassium can affect heart rhythm, so do not ignore new weakness or swelling.

How much Keishikakkonto should you take?

• Recommended daily: A common adult dose of extract granules is about 7.5 g a day. It is split into two or three doses. Follow the label or your practitioner. Products differ in strength, so the gram figure is not fixed. Do not double up with another licorice-containing Kampo formula. The licorice adds up, and so does the risk.
• Best time of day: Take the doses spread through the day, morning, midday and evening. For a cold, many people start at the first chill.
• With or without food: Kampo practice is to take it before meals or between meals, with warm water. If it upsets your stomach, take it with a little food.
• Time to effect: Traditional use expects a change within a day or two for a cold. Neck stiffness may ease over a few days. If nothing changes in five days, stop and rethink.
• How long to take it: For a cold, use it for a few days only. Kampo practice expects a result within one to three days. Stop and reassess if you are no better after about five days. Long-term daily use raises the licorice risk. If you use it for weeks, your doctor should check your blood pressure and potassium level.