What is Keishikaogito?

Keishikaogito is a herb mix used in Kampo, the herbal medicine of Japan. People take it for heavy sweating, night sweats, and skin that stays damp, itchy or weepy. It is chosen most often for people who feel chilly, tire fast, and sweat with little effort.

The mix is the old cinnamon twig formula with one more herb added: astragalus root. In Japanese, that herb is called ogi, and it gives the formula its name.

It is one of the 148 Kampo formulas on the MHLW list, so a doctor in Japan can write it on a health plan script. Good human trial proof is thin. Long use in a tradition shows a formula has a place there; it does not show that it works.

How does Keishikaogito work?

No one has shown how this mix works in the body. What follows is the old Kampo idea, not proven fact.

In Kampo, cinnamon twig and peony root are used to settle the surface of the body when sweat leaks out too easily. Astragalus root is used to firm that surface up. Ginger, jujube date and licorice root are said to warm and soften the mix.

Lab work on single herbs is not the same as proof for the whole mix. We do not know if any of these steps happen in people.

What forms does Keishikaogito come in?

In Japan, the usual form is a dried extract granule in a sachet. You stir it into hot water or swallow it with water. Tablets and fine powders are also sold.

Kampo doctors also brew the raw herbs as a tea, called a decoction. This is less common now.

Outside Japan you may find it as loose herbs or capsules. Quality varies a lot, so buy from a seller who tests what they sell.

Where it comes from:

The recipe comes from the Jingui Yaolue, a Chinese medical text from around 200 CE. It was written as a small change to the cinnamon twig formula, for sweating and for damp, sore skin.

Japanese doctors took it up and kept it in daily use. It has stayed in Kampo practice for centuries and sits on Japan's list of 148 covered Kampo formulas.

What does Keishikaogito help with?

• Heavy sweating in the day: This is the classic reason a Kampo doctor picks this mix. The old texts use it for people who sweat with little effort and feel cold after. We could not find a human trial that tests it for sweating.
• Night sweats: Kampo texts use it for sweat that soaks the bed in a person who is pale and weak. There is no trial proof. Night sweats can also come from infection, thyroid trouble or cancer, so get new night sweats checked first.
• Feeling weak and tired with easy sweating: Astragalus root was added to this formula for exactly this picture. This is a tradition-based use only. Ongoing tiredness needs a doctor's look, since low iron, low thyroid and other causes are common and treatable.
• Damp, weepy skin sores: Kampo practice uses it for skin that oozes and heals slowly. Reports in Japan are mostly single case write-ups, not trials. Any sore that spreads, smells bad or brings a fever needs a doctor, not a herb.
• Itchy rashes such as eczema: Some Kampo doctors use it for mild, damp eczema in a weak, chilly person. The proof is tradition and case reports. It is not a stand-in for the creams and care your skin doctor gives you.
• Sores that are slow to heal: Old texts group slow healing with weak surface energy, which is what astragalus root is meant to address. No human trial supports this. Slow healing can be a sign of diabetes or poor blood flow, so have it checked.

Which foods are rich in Keishikaogito?

1. Licorice sweets: they add to the licorice already in the formula
2. Licorice root tea: same problem, and easy to miss
3. Some soft drinks and herbal blends flavoured with licorice

Practical Tips:

Cut back on licorice foods while you take this mix, since the doses stack up.

What are the side effects of Keishikaogito?

• Rash or itching
• Upset stomach or nausea
• Loss of appetite
• Swelling in the legs, hands or face
• Weight gain from held water
• Rising blood pressure
• Low potassium, a salt your blood needs
• Muscle weakness, cramps or aching
• Headache
• Rare liver upset, seen as yellow skin or eyes

Good to know:

Most people who take it briefly have no trouble. The main worry is the licorice root in the mix.

Licorice can cause pseudoaldosteronism (a licorice side effect that raises blood pressure, holds water and drops your potassium). Signs are puffy legs, weight gain, headache, weak muscles and cramps. It is more likely with higher doses, longer use, in older people, and in people already on water pills.

Low potassium can upset your heart rhythm, so it is not a small thing. Stop the mix and call a doctor if these signs show up.

How much Keishikaogito should you take?

• Recommended daily: In Japan, the usual adult dose of the extract granule is about 7.5 g a day. You split that into two or three doses. Raw herb teas are dosed by the person who brews them. No dose has been set by trials. Follow the pack or the person who gave it to you. Do not take two licorice mixes at once without asking a doctor.
• Best time of day: Split the day's amount over two or three times. Morning and evening is the common pattern in Japan.
• With or without food: Kampo granules are usually taken before meals or between them, with warm water. If it upsets your stomach, take it with food instead.
• Time to effect: Some people notice less sweating within a few days. Two to four weeks is a fairer test. Skin changes are slower still.
• How long to take it: Kampo doctors often review after two to four weeks. If nothing has changed by then, stop and rethink. Long runs raise the risk from licorice. If you take it for more than a few weeks, ask your doctor to check your blood pressure and your potassium (a salt your blood needs).