Shichimotsukokato
Quick Facts
- What it is: A seven-herb Japanese Kampo formula given for headache, stiff shoulders, dizziness and ringing ears in people with mild high blood pressure.
- Main uses: Symptoms alongside mild high blood pressure, Headache, Stiff neck and shoulders, Ringing in the ears, Dizziness
- Best for: Adults under a doctor's care who tire easily and have mildly raised blood pressure with head and neck symptoms
- Active ingredients: Jio (rehmannia root), Toki (Japanese angelica root), Shakuyaku (peony root), Senkyu (cnidium rhizome), Chotoko (uncaria hook), Ogi (astragalus root), Ogon (skullcap root)
- Forms: Granule extract (ekisu) sachets, Powder, Tablets or capsules, Loose herbs boiled as a tea
- Time to effect: Not properly tested; Kampo doctors usually review after two to four weeks.
- Side effects: Usually mild stomach upset; rarely liver injury or lung inflammation, which need urgent care.
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What is Shichimotsukokato?
Shichimotsukokato is a seven-herb formula from Kampo, the Japanese school of herbal medicine. The name is the Japanese romanised name. Japanese doctors give it to people with mild high blood pressure who also feel unwell.
The usual complaints it is aimed at are headache, a stiff neck and shoulders, ringing in the ears, dizziness and a flushed face. It is meant for people who tire easily and look pale. It is not a stand-in for blood pressure medicine.
It is one of the 148 Kampo formulas on Japan's approved list, set by the Ministry of Health, Labour and Welfare (MHLW) for the national health insurance scheme. That approval rests on long use and expert review, not on large modern trials.
Evidence verdict: the formula has a real place in modern Kampo practice, but we could not find good human trial evidence that it lowers blood pressure. Long use in a tradition shows that people trusted a remedy. It does not prove the remedy works, and that gap applies to everything below.
How does Shichimotsukokato work?
No one has shown how this formula works in the body, and the honest answer is that it is not known.
Kampo doctors explain it in their own terms. They say the four base herbs feed and move the "blood", while the other three calm heat and rising energy in the head. These are traditional ideas, not measurements.
Lab and animal studies hint at a few things. Some herbs in the mix seem to relax blood vessel walls a little, and some act as antioxidants (they mop up damaging molecules in cells). Those findings come from dishes and animals, not from people taking the finished formula.
So treat any talk of how it works as an idea being tested, not a settled fact.
What forms does Shichimotsukokato come in?
Most people take it as a dried water extract, called ekisu in Japan. It comes as fine granules or powder in single-dose sachets.
Other forms you may meet: - Loose dried herbs, boiled at home into a tea (the old method) - Tablets or capsules made from the same extract - Liquid extracts, less common outside Japan
In Japan the granules are a prescription product. Outside Japan the same blend may be sold as a supplement, where checks on strength and purity are weaker. Buy only from a seller that publishes testing for heavy metals and for other plants mixed in by mistake.
Where it comes from:
The formula is modern by Kampo standards. Otsuka Keisetsu, one of the doctors who revived Kampo in 20th-century Japan, put it together around the 1950s. He is said to have made it for his own high blood pressure.
He built it on Shimotsuto, a four-herb blood-building formula from Song dynasty China. He added three herbs: chotoko, ogi and ogon. Seven herbs in total, hence "shichimotsu" (seven things).
Because it is only about 70 years old, it has no classical pedigree. What it does have is steady use in Japanese practice and a place on the MHLW approved list.
If this is an emergency
Some reactions to Shichimotsukokato need urgent care. Call your local emergency number or go to an emergency department straight away — do not wait to see whether it passes.
Who should avoid Shichimotsukokato?
- Do not use if you are taking interferon injections (a drug for hepatitis or some cancers) — this combination has been linked to serious lung inflammation.
- Do not use if you have interstitial pneumonia (swelling and scarring deep in the lungs) or another long-term lung disease.
- Do not use if you have liver disease, hepatitis (an inflamed liver), or have ever had liver injury caused by a herb or a drug.
- Do not use if you are pregnant, trying to become pregnant, or breastfeeding — safety has not been shown.
- Do not give it to a child.
- Do not use if you take warfarin or another blood thinner, unless the doctor who manages that medicine has agreed and will check you.
- Do not use if you are allergic to any of the seven herbs in the blend.
- Never stop or cut down your prescribed blood pressure medicine in order to take this instead.
- Do not use it as your only treatment for high blood pressure.
When should you see a doctor?
Stop taking it and get medical help the same day if you notice yellow skin or eyes, dark urine, pale stools, pain under your right ribs or deep unexplained tiredness. These can mean liver injury.
Get emergency help if you develop a dry cough with fever and trouble breathing, or if your face, lips or throat swell. Breathing problems after starting a Kampo formula need to be seen at once.
See your doctor within a few days if you get a rash, ongoing stomach pain, unusual bruising or bleeding, or if you feel faint when you stand up.
Book a normal appointment if your blood pressure readings stay high, or if headache, dizziness or ear ringing has not improved after about eight weeks.
Evidence grades and traditional-use labels are explained in our methodology. Nothing here is medical advice.
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