Kosharikkunshito
Quick Facts
- What it is: A Japanese Kampo herbal formula for weak digestion, poor appetite and bloating.
- Main uses: Ongoing indigestion with no ulcer found, Poor appetite, Bloating and fullness after meals, Mild nausea
- Best for: A tired, chilly person who feels full after a few bites, Long-running mild stomach upset already checked by a doctor
- Active ingredients: Ginseng, Atractylodes, Poria, Processed pinellia tuber, Citrus peel, Licorice (glycyrrhizin), Ginger, Jujube, Cyperus root, Amomum seed, Agastache herb
- Forms: Extract granules, Powder sachets, Tablets, Boiled herb tea (decoction)
- Time to effect: Often one week for small change; judge it at two to four weeks.
- Side effects: Usually mild stomach upset or rash; licorice can cause swelling, high blood pressure and low potassium.
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What is Kosharikkunshito?
Kosharikkunshito is a Japanese herbal formula for a weak, sluggish stomach. People take it for poor appetite, bloating and a heavy feeling after meals. It suits someone who feels tired, chilly and easily full.
It is an approved Kampo formula in Japan. It is sold as a standard extract granule by makers such as Tsumura. The name means Cyperus and Amomum Six-Gentlemen Decoction.
The formula builds on rikkunshito, the "Six Gentlemen" base. Three warm, aromatic herbs are added: Cyperus, Amomum and Agastache.
Here is the short verdict. Tradition behind it is deep and long. Human trial data for this exact mix is very thin, so long use is not proof that it works.
How does Kosharikkunshito work?
The honest answer is that no one has shown how this formula works in people.
Kampo describes it as warming a cold, damp stomach and moving stuck qi. That is a traditional model, not a measured effect.
Lab and animal work on the rikkunshito base gives some clues. In animals, it appears to raise ghrelin, a hormone that drives hunger. In small human studies of rikkunshito, stomach emptying and fullness seemed to improve.
Those findings belong to the simpler base formula. Whether the full Kosharikkunshito mix does the same has not been tested.
The three added herbs are warming and aromatic in tradition. Their effect in people has not been studied on its own.
What forms does Kosharikkunshito come in?
Most people take it as a dried extract granule or fine powder in a sachet. This is the form used in Japanese hospitals and pharmacies.
Tablets and capsules of the same extract are also sold. Some practitioners still boil the raw herbs into a tea, called a decoction.
Granules are usually stirred into warm water and drunk warm. Quality matters, since the herb mix and dose must match the approved recipe.
Where it comes from:
The formula comes from Chinese medicine, where it is called Xiangsha Liujunzi Tang. It grew out of the older Six Gentlemen formula during the Ming era.
It was taken up in Japan and became a Kampo standard. Korean medicine uses a close version too.
Today it sits on Japan's approved Kampo list. Doctors there can prescribe it for stomach complaints under national health cover.
Who should avoid Kosharikkunshito?
- Do not use if you are pregnant or think you may be; Kampo tradition warns against pinellia in pregnancy.
- Do not use if you are breastfeeding, unless a doctor who knows Kampo guides you.
- Do not use if blood tests have shown low potassium (hypokalaemia).
- Do not use if you have aldosteronism (a hormone disorder that raises blood pressure and lowers potassium).
- Do not use if you have myopathy (a disease that weakens and damages muscle).
- Do not use if you already take another licorice product, including other Kampo formulas or glycyrrhizin tablets or injections, unless a doctor has added up the total.
- Do not use if you have heart failure, poorly controlled high blood pressure or severe kidney disease, unless a doctor is watching you.
- Never take raw, unprocessed pinellia tuber; only the processed herb belongs in this formula, because the raw root can badly burn the mouth, throat and gut.
- Do not give it to a child without advice from a doctor or trained Kampo practitioner.
When should you see a doctor?
Stop the formula and see a doctor soon if your face, hands or ankles puff up. The same goes for fast weight gain over a few days, a jump in blood pressure, or muscle weakness, cramps and heavy legs.
Get urgent care if you cannot lift your arms or legs, or if your urine turns dark brown. Those can mean muscle damage from low potassium.
Get urgent care for yellow skin or eyes, dark urine and deep tiredness. Those can mean liver injury.
Get urgent care for a new dry cough, fever and breathlessness. That can mean a rare lung inflammation.
Also see a doctor before starting if you have lost weight without trying, vomited blood, passed black stools, or have trouble swallowing. Those need tests, not herbs.
Evidence grades and traditional-use labels are explained in our methodology. Nothing here is medical advice.
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