Mokuboito is a four-herb Kampo formula composed of Boi (Sinomenium acutum or Stephania tetrandra), Gypsum (calcium sulfate mineral), Keishi (Cinnamomum cassia bark), and Ogi (Astragalus membranaceus root). It has been used in traditional East Asian medicine for over a thousand years to treat patterns described as 'water retention with heat' — conditions we now recognize as congestive heart failure and pulmonary edema. It remains a licensed Kampo prescription in Japan and is actively researched for cardiovascular applications.

The formula works through several complementary actions: sinomenine from the Boi root helps relax blood vessels and reduce fluid buildup by supporting kidney filtration and mildly lowering vascular resistance. Astragalus strengthens heart muscle function and supports immune balance, while cinnamon bark supports circulation. Gypsum contributes cooling and anti-inflammatory effects within the traditional framework. Together, the formula reduces excess fluid load on the heart and lungs while gently supporting cardiac output.

In Japan, Mokuboito is most commonly dispensed as a standardized granule (Tsumura or Kotaro brand extract granules) taken dissolved in hot water, which mirrors the traditional decoction method. Decoctions made from raw herbs are used by traditional practitioners. Extract powders and tablets are available for patient convenience but may vary in standardization.

• Heart failure and reduced heart function
• Fluid retention and edema (swelling in legs, ankles)
• Shortness of breath from fluid buildup
• Pulmonary edema (fluid in lungs)
• Pleural effusion (fluid around lungs)
• High blood pressure with fluid congestion
• Fatigue associated with poor circulation
• Cardiac-related breathlessness at rest or exertion

• Worsening of heart failure symptoms when used as adjunct maintenance therapy
• Recurrence of pleural or pulmonary fluid accumulation in susceptible individuals

Mokuboito is a multi-herb Kampo formula and is not found in food. However, dietary choices can meaningfully support the same goals — reducing fluid congestion, supporting heart function, and easing inflammation. Prioritize foods that support healthy fluid balance and cardiac function: (1) Asparagus — a natural mild diuretic that helps reduce fluid retention; (2) Celery — contains phthalides that relax blood vessels and support fluid balance; (3) Beets — support nitric oxide production and healthy blood pressure; (4) Garlic — well-documented heart-protective and blood-pressure-lowering effects; (5) Oily fish (salmon, mackerel, sardines) — omega-3 fats reduce cardiac inflammation and support heart muscle. Reduce sodium intake, which is the single most impactful dietary change for managing fluid retention and heart failure symptoms. Avoid excessive alcohol and caffeine, which can stress the heart and worsen fluid dysregulation.

• Mild digestive upset (nausea, loose stools, stomach discomfort)
• Skin rash or itching (occasional allergic reaction)
• Low blood pressure or dizziness, especially when standing
• Fatigue or lightheadedness if electrolytes become imbalanced
• Rare: elevated liver enzymes with prolonged high-dose use

• Recommended daily: Standardized Tsumura Mokuboito extract granules (TJ-62): 7.5 g per day divided into 2–3 doses. Traditional decoction: 1 standard packet of raw herbs (approx. 15–20 g combined herbs) simmered in 600 mL water, reduced to 300 mL, taken in divided doses. Always follow the prescribing practitioner's guidance.
• Best time of day: Typically taken 30 minutes before meals (standard Kampo practice) or as directed by your practitioner. Granules are dissolved in warm water.
• With or without food: Traditionally taken on an empty stomach or 30 minutes before meals to maximize absorption. If stomach sensitivity occurs, taking with a small amount of food is acceptable.
• Time to effect: Most clinical studies report measurable improvement in fluid retention and breathing within 4–8 weeks of consistent daily use. Symptom relief may begin within 1–2 weeks.
• How long to take it: Used as a longer-term supportive therapy in heart failure patients — often months to years under medical supervision. Not typically cycled like adaptogens. Reassess with your practitioner every 3 months.