Keishininjinto
Quick Facts
- What it is: A five-herb Japanese Kampo formula — ginseng, dried ginger, licorice, atractylodes and cinnamon — used as a single prescription for cold-type stomach and bowel upset with headache and palpitations.
- Main uses: Cold-type gastroenteritis (stomach and bowel upset) with watery diarrhoea, Headache that comes with a stomach upset, Palpitations (a fluttering or pounding heartbeat) in people who feel the cold, Poor appetite and a weak, cold stomach
- Best for: Short-term watery diarrhoea with a cold belly, no high fever, plus headache, People already under Kampo care who fit the cold, weak pattern
- Active ingredients: Glycyrrhizin (from licorice root), Ginsenosides (from ginseng), Cinnamaldehyde and cinnamon oils, Gingerols and shogaols (from dried ginger), Atractylenolides (from atractylodes)
- Forms: Granule or powdered water extract, Tablets or capsules of the extract, Traditional decoction from raw herbs
- Time to effect: Traditionally one to three days for an acute upset; no trial evidence confirms this.
- Side effects: Usually well tolerated short-term, but licorice can raise blood pressure, cause swelling and lower blood potassium.
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What is Keishininjinto?
Keishininjinto is a traditional Japanese Kampo formula. It is made from five herbs. It is used for a "cold type" stomach and bowel upset.
The signs it targets are watery diarrhoea, a cold and weak stomach, and poor appetite. It is chosen when a headache and palpitations come with those signs. Palpitations means a fluttering or pounding heartbeat.
In Kampo it is given as a single drug. The whole five-herb formula counts as one medicine. It is not a mix you build or stack yourself.
Another name for it is "Ninjinto plus cinnamon". Ninjinto is the older warming stomach formula. The added cinnamon is the part aimed at the headache and the palpitations.
Here is the honest verdict. It has a long record in Kampo and in Chinese herbal practice. But we could not find published human trials that test it.
Long traditional use is not proof that something works. That applies to everything said in this document.
How does Keishininjinto work?
No one has shown how this formula works in people. What follows is the traditional idea. It also covers what is known about the single herbs.
In Kampo thinking, the formula warms a stomach and bowel seen as "cold and weak". That is the pattern behind watery diarrhoea with a cold belly and low appetite.
Ginseng and atractylodes are said to restore stomach strength. Dried ginger is said to warm. Cinnamon is said to settle the headache and the pounding heartbeat that go with that pattern.
In the lab, ginger and cinnamon compounds relax gut muscle. They also lower swelling in animal tissue. Ginseng compounds have many effects in cell studies.
None of this has been carried through to a human trial of the finished formula. So treat it as background, not as an explanation.
One mechanism is well established, and it is a harm rather than a benefit. Licorice root contains glycyrrhizin. This makes the body hold on to sodium and lose potassium.
Doctors call this pseudoaldosteronism (a state where the body keeps salt and loses potassium). That is why the safety section below is long. You may not expect that from a mild-sounding stomach remedy.
What forms does Keishininjinto come in?
Most people take it as granules or fine powder. These are made from a dried water extract. In Japan it is sold as a prescription or pharmacy Kampo product.
Tablets and capsules of the same extract also exist.
Some practitioners still use a traditional decoction. That means the raw herbs are simmered in water and strained. It tastes sweet, warm and a bit pungent.
Product strength varies a lot between makers. So the dose on the label matters more than a general rule.
Where it comes from:
The formula comes from the Shang Han Lun, a Chinese medical classic. The title means Treatise on Cold Damage. It was put together around the third century CE.
In that book it appears as Guizhi Renshen Tang.
Japanese Kampo doctors took it up centuries later. They have kept it in routine use. Today it is one of the standard extract formulas covered by Japanese health insurance.
Korean herbal practice uses the same formula under its own name. So the recipe has an unbroken written record of about 1,800 years. That says nothing about whether it works.
Who should avoid Keishininjinto?
- Do not use if you have low potassium in your blood (hypokalaemia), or have been told your potassium runs low.
- Do not use if you have aldosteronism or pseudoaldosteronism: hormone problems, or a licorice effect, that raise blood pressure and lower potassium.
- Do not use if you have myopathy (muscle damage causing weakness and pain) or have reacted badly to licorice before.
- Do not use if you are taking another licorice-containing Kampo formula, a licorice supplement or glycyrrhizin medicine, unless a Kampo-trained doctor has added up the total dose for you.
- Do not use if you take a potassium-losing water pill (a diuretic such as furosemide or a thiazide) unless your doctor is monitoring your potassium.
- Do not use if you take digoxin (a heart medicine) without your doctor's agreement.
- Do not use if you have heart failure, an irregular heartbeat, or high blood pressure that is not controlled, unless your doctor approves.
- Do not use if you have severe kidney or liver disease without medical advice.
- Do not use if you are pregnant or breastfeeding, unless a doctor who knows Kampo has told you to.
- Do not use if your illness comes with a high fever, blood or mucus in the stool, severe belly pain, or signs of dehydration (dry mouth, dizziness, very little urine) — that needs medical care.
- Do not give it to a child without a doctor's advice.
- Do not use it as a replacement for rehydration drinks in diarrhoea, or for any medicine your doctor has prescribed.
When should you see a doctor?
See a doctor now if your ankles, face or hands swell up, your blood pressure climbs, or your muscles feel weak, cramping or sore — those can be signs that licorice has pushed your potassium too low.
Get urgent help for a racing, thumping or irregular heartbeat, chest pain, fainting, or sudden severe weakness.
Stop and get checked if you develop a dry cough with fever and breathlessness, or if your skin or eyes turn yellow.
Also see a doctor if diarrhoea lasts more than a few days, if you cannot keep fluids down, or if there is blood in your stool.
Evidence grades and traditional-use labels are explained in our methodology. Nothing here is medical advice.
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