What is Yokukansankachimpihange?

Yokukansankachimpihange is a Japanese Kampo herb mix. Kampo is Japan's own form of old Chinese herbal medicine. Doctors there give this mix for anger, a short temper, restless nerves and poor sleep.

It is the older mix yokukansan with two herbs added. The extras are chinpi (dried citrus peel) and hange (pinellia tuber). They were added for people whose stomach is weak or easily upset.

It sits on Japan's MHLW list of 148 Kampo formulas that health insurance will pay for. That means it is a normal part of care there, not a fringe product.

The short verdict on evidence: use in Japan is long and real, but human trials are few and small, and most tested plain yokukansan instead. Long traditional use is not proof that a remedy works.

How does Yokukansankachimpihange work?

No one knows just how it works. Most of what we have comes from lab dishes and animal tests, not people.

Uncaria hook (chotoko) holds a compound that acts on serotonin, a brain chemical linked to mood. Poria and angelica root may calm nerve signals in animals. Some animal work also points to glutamate, another brain chemical.

The two added herbs, chinpi and hange, are aimed at the stomach. In Kampo they are used to settle nausea and phlegm, not to change mood.

Lab results do not prove the same thing happens in a person.

What forms does Yokukansankachimpihange come in?

Most people take it as dried extract granules. These come in small paper packets and mix into hot water.

Tablets and capsules are also sold. Some Kampo doctors still make it the old way, as a tea boiled from raw sliced herbs.

In Japan the granules are a prescription item. Outside Japan you may find it sold as a supplement, where the strength and the herb mix can differ between brands.

Where it comes from:

Yokukansan comes from a Chinese child health text of 1556, written by Xue Kai. It was first given to children who cried at night and to their mothers.

Japanese doctors later used it for adults with anger and tremor. In the Edo period they added chinpi and hange for patients with a weak stomach, and that version became this formula.

It has been used in Japan for centuries and is still prescribed today.

What does Yokukansankachimpihange help with?

• Irritability, anger and short temper: This is the classic Kampo use, and the reason the formula has its name. Kampo doctors pick it for a person who snaps easily, feels wound up, and also has a weak or queasy stomach. Human trial proof for this exact mix is thin.
• Trouble falling or staying asleep: It is often given when poor sleep comes with a racing, irritable mind. Small Japanese studies of yokukansan report better sleep in older adults. Those studies were small, and most did not test this version of the mix.
• Restlessness and agitation in dementia: Dementia is a disease that slowly harms memory and thinking. Most published trials here used plain yokukansan, not this formula, and they were short and small. It is not a treatment for dementia itself and does not slow the disease.
• Night crying and restlessness in children: This is the oldest recorded use, going back to the 1556 source text. The record is traditional only. Give it to a child only if a doctor has checked the child first.
• Nervous tension in people with a weak stomach: The two added herbs are the whole point of this version. Kampo doctors choose it over yokukansan when the patient also feels sick, bloated or brings up phlegm. This choice rests on tradition, not on trial data.

Which foods are rich in Yokukansankachimpihange?

1. Licorice sweets and licorice tea: they add to the licorice already in the formula
2. Salty foods: extra salt adds to the swelling and blood pressure risk

What are the side effects of Yokukansankachimpihange?

• Low potassium in the blood, which can cause weakness and cramps
• A rise in blood pressure
• Swelling in the legs, hands or face
• Muscle weakness, aching or cramping
• Nausea, loose stools or belly discomfort
• Loss of appetite
• Skin rash or itching
• Rare: liver injury, seen as yellow skin or eyes and dark urine
• Rare: lung inflammation, seen as a dry cough, fever and shortness of breath
• Rare: severe muscle breakdown, with strong muscle pain and brown urine

Good to know:

Most people who take it have no trouble. The side effects that matter most come from the licorice root in the mix.

Too much licorice can cause pseudoaldosteronism (a licorice reaction that raises blood pressure, drops potassium and causes swelling). It is more likely at high doses, over long periods, in older people, and in anyone taking other licorice products.

Liver injury and lung inflammation are rare, but they are serious. Stop the formula and get medical help if the signs above appear.

How much Yokukansankachimpihange should you take?

• Recommended daily: In Japan the usual adult dose of extract granules is 7.5 g a day, split into two or three doses. Follow the dose on your product or from your doctor, since brands differ in strength. Children need a smaller dose worked out by a doctor.
• Best time of day: Split the day's amount between morning, midday and evening. If you take it for sleep, the evening dose can come about an hour before bed.
• With or without food: Kampo granules are usually taken before meals or between meals, with warm water. If it upsets your stomach, take it with a little food instead.
• Time to effect: Some people feel calmer within one to two weeks. Sleep and mood changes may take three to four weeks. It is not a fast-acting sedative.
• How long to take it: Check how you feel after two to four weeks. If nothing has changed, stop and talk to your doctor. If you take it for more than a few weeks, ask for blood tests to check your potassium, because of the licorice in it.