What is Untanto?

Untanto is a Kampo herbal formula used in Japan. The name means "decoction to warm the gallbladder". It is a ministry-approved Kampo formula, sold mostly as a granule extract.

It is given to people who feel jumpy, uneasy and sleep badly. Kampo doctors also use it for nausea, a heavy stomach and dizziness. In Kampo thinking, these signs point to "phlegm-damp" sitting in the chest and stomach.

The formula contains kanzo (licorice), which can raise blood pressure and lower potassium. It also contains hange (Pinellia ternata), which must be processed before use. Both facts are covered in the safety section below.

Tradition here is long and well documented. Tradition is not proof that a medicine works, and that applies to everything on this page. We could not find good human trials of Untanto itself.

How does Untanto work?

The honest answer is that nobody has shown how Untanto works in people.

In Kampo terms, the formula is said to clear "phlegm-damp", settle the stomach and calm the mind. This is a traditional model of the body. It is not a test-tube finding and it is not a proven mechanism.

Some parts have been studied in the laboratory. In animal studies, extracts of Poria and sour jujube seed appear to have mild calming effects. Whether this happens in people taking the whole formula is not known.

One effect is well established in people, and it is a harm, not a benefit. Glycyrrhizin from licorice blocks an enzyme called 11-beta-HSD2. This makes the body hold on to salt and water and lose potassium.

What forms does Untanto come in?

Most people take Untanto as a dried granule extract. This is the standard form made by Japanese Kampo companies.

Other forms include: - Fine powder or tablets of the same extract - Loose raw herbs, boiled at home into a tea (a decoction) - Liquid extracts, less common outside Japan

Quality varies a lot between brands. Buy from a maker that tests its herbs and lists every ingredient. Ask a pharmacist or Kampo doctor if the label does not name the herbs.

Where it comes from:

Untanto is the Japanese name for a very old Chinese formula, Wen Dan Tang. Early versions appear in Tang era writings, and the better known recipe dates from the Song era.

The formula travelled to Japan with Chinese medical texts. Edo period Kampo doctors kept it and adjusted the herb amounts. It is still listed as an approved Kampo medicine in Japan today.

It is also used in Chinese and Korean practice, which gives it a wide traditional footing.

What does Untanto help with?

• Trouble sleeping with a restless, busy mind: This is the classic use. Kampo texts describe a person who lies awake, feels edgy and wakes often. Human trial evidence is weak. Small studies of the Chinese form of this formula exist, but they are poorly reported. We cannot say it helps sleep better than a dummy treatment.
• Anxiety and feeling easily startled: Traditional use is strong and goes back many centuries. The formula is picked for people who feel fearful and jumpy after illness or stress. No good trial shows an effect on anxiety in people. If anxiety is severe or lasting, see a doctor rather than self-treating.
• Nausea and a heavy, full stomach: Hange and ginger are long-standing Kampo choices for nausea. Ginger itself has some human evidence for nausea in other settings. That does not prove the whole formula works for your stomach. Lasting nausea needs a medical check, not a herbal trial.
• Dizziness and a muzzy head: In Kampo, dizziness with phlegm-damp signs is a match for this formula. It is often chosen alongside a heavy chest and poor sleep. There is no reliable human trial evidence here. New or sudden dizziness should be checked by a doctor first.
• Palpitations with worry: Traditional texts describe a fluttering heartbeat that comes with fear and poor sleep. This is a traditional picture, not a diagnosis. Note the risk runs the other way too. The licorice in this formula can lower potassium, and low potassium can itself upset heart rhythm.

Which foods are rich in Untanto?

1. Licorice sweets and black liquorice - the same glycyrrhizin as in kanzo
2. Licorice root tea - can push the licorice dose higher without you noticing
3. Ginger - one of the herbs in the formula, used fresh or dried
4. Dried citrus peel - close to the chinpi used here
5. Jujube dates - the taiso in the formula, eaten as a dried fruit

Practical Tips:

Cut out licorice sweets and licorice tea while you take this formula.

What are the side effects of Untanto?

• Stomach upset, nausea or loss of appetite
• Loose stools or belly ache
• Rash, itching or flushing
• Swollen ankles, puffy face or quick weight gain
• Rising blood pressure
• Low potassium in the blood, which can cause muscle weakness and cramps
• Numbness or tingling
• Uneven or thumping heartbeat, linked to low potassium
• Rare liver injury, with yellow skin or eyes and dark urine
• Rare muscle breakdown, with severe muscle pain, weakness and cola-coloured urine
• Mouth and throat burning if raw, unprocessed hange is used

Good to know:

Most people who take a short course have no trouble, or mild stomach upset only.

The serious problem to know about is pseudoaldosteronism (a salt and water imbalance caused by licorice). It builds up slowly over weeks. Swelling, weight gain, rising blood pressure and muscle weakness are the warning signs.

Risk goes up with higher doses, longer use, older age, and other licorice products. Stop and call your doctor if these signs appear.

How much Untanto should you take?

• Recommended daily: There is no dose proven by trials. The amounts below are the usual Kampo practice. Adults typically take 5 to 7.5 g of the granule extract a day. This is split into two or three doses. Follow the label and your doctor's advice, since makers differ. Older adults, small adults and children are usually given less. Do not take other licorice products on top of it. If you boil the raw herbs, have a trained practitioner set the amounts. Never use raw, unprocessed hange.
• Best time of day: Doses are usually spread through the day, morning, midday and evening. If sleep is the main problem, the last dose is often taken in the evening.
• With or without food: Kampo granules are usually taken before meals or between meals, on a fairly empty stomach. Take them with warm water. If they upset your stomach, take them with food instead.
• Time to effect: Sleep and stomach symptoms may shift within one to two weeks. Some people notice nothing at all. Judge it by four weeks.
• How long to take it: Short courses are safer. Many Kampo doctors review after two to four weeks. If nothing has changed by four weeks, stop and rethink the plan. Longer use raises the risk from licorice. If you must take it for months, ask your doctor to check your blood potassium and blood pressure.