What is Zhu Ye Shi Gao Tang?

Zhu Ye Shi Gao Tang is a classic Chinese herbal formula. In English it is called Lophatherum and Gypsum Decoction. We treat it as a single drug (TCM formula), even though it blends seven herbs and foods.

It is used at the tail end of a fever or illness. The traditional picture is a person who feels hot, dry and worn out. They may be thirsty, restless, off their food, and prone to dry retching.

Human trial evidence for this formula is thin, so we cannot say it works. Long use in a tradition is not proof of effect, and we say that once here rather than in every section.

How does Zhu Ye Shi Gao Tang work?

In Chinese medicine terms, the formula is said to clear leftover heat and rebuild lost fluids. That is a traditional idea, not a proven body process.

Shi Gao (gypsum) is mostly calcium sulfate, a chalk-like mineral salt. Ren Shen (ginseng) and Mai Men Dong are used to build back strength and moisture. Gan Cao (licorice) is said to tie the other herbs together.

Lab and animal work has looked at some of these single herbs. It hints at effects on fever, on inflammation (swelling and heat in tissue) and on blood sugar. None of that tells us what the whole formula does in people.

What forms does Zhu Ye Shi Gao Tang come in?

Most people take it as a hot tea brewed from raw herbs, which a herbalist weighs out for them.

It also comes as granules that you stir into hot water. Pills, tablets and capsules are sold as well.

Strength varies a lot between brands. Check the label for how much Gan Cao (licorice) each dose holds, since that is the part that limits how long you can take it.

Where it comes from:

The recipe comes from the Shang Han Lun, a Chinese medical text from about 200 CE. Its author is named as Zhang Zhongjing.

Since then it has been used for the weak, dry, hot stage after a fever breaks. It is a long-standing staple of Chinese herbal medicine and is also used in Japanese Kampo.

What does Zhu Ye Shi Gao Tang help with?

• Lingering low fever after an illness: This is the classic reason the formula is prescribed. Chinese texts describe a person whose fever has broken but who still feels hot, dry and drained. We found no published human trial that tests the formula for this, so the support is traditional only.
• Thirst and a dry mouth during recovery: Tradition holds that Shi Gao (gypsum) and Mai Men Dong ease heat and dryness together. There is no trial evidence in people that it helps thirst or dry mouth. If your mouth stays dry for weeks, ask a doctor, since diabetes and some medicines cause this.
• Restlessness and feeling hot and edgy: Herbalists use it when a person feels irritable, flushed and unable to settle after being ill. This is a pattern-based use from Chinese medicine, not a tested treatment for anxiety or insomnia.
• Poor appetite and nausea while getting over a fever: Ban Xia and Jing Mi (rice) are included to settle the stomach in the traditional reading. Human evidence for this formula and nausea is lacking. Ongoing vomiting needs medical care, not herbs.
• Dry cough with little sticky phlegm: Traditional use only. A cough that lasts more than three weeks, or that brings up blood, should be checked by a doctor.
• Heat exhaustion in summer: Some Chinese texts describe using it for summer heat with sweating, thirst and weakness. Real heat exhaustion needs cooling, fluids and medical help. Do not rely on a herbal tea for it.

Which foods are rich in Zhu Ye Shi Gao Tang?

1. White rice - Jing Mi in the formula is ordinary white rice, used as a stomach-settling ingredient
2. Licorice sweets and licorice tea - these add to the licorice load and the same blood pressure and potassium risks
3. Salty processed food - high salt alongside licorice can worsen swelling and raise blood pressure

Practical Tips:

Cut back on licorice sweets and salty food while you are taking this formula.

What are the side effects of Zhu Ye Shi Gao Tang?

• Upset stomach, nausea or loose stools
• Bloating or a heavy feeling after meals
• Puffy ankles, hands or face (from licorice)
• Rising blood pressure (from licorice)
• Low potassium, a blood salt, causing weakness, muscle cramps or an irregular heartbeat
• Headache or feeling flushed
• Trouble sleeping or a jittery feeling (from ginseng)
• Tingling or burning in the mouth and throat if the Ban Xia was poorly treated
• Skin rash or itching from an allergy to one of the herbs

Good to know:

Most people who take this formula for a short course have no trouble. The common problems are mild, such as an upset stomach, loose stools or bloating.

The real risk comes from Gan Cao (licorice) when the course runs long. It can raise blood pressure, cause swelling, and lower your potassium, a blood salt your heart and muscles need. Low potassium can bring weakness, cramps and an irregular heartbeat.

Stop taking it and get medical advice if you notice swelling, a pounding or uneven heartbeat, or sudden weakness.

How much Zhu Ye Shi Gao Tang should you take?

• Recommended daily: No dose has been set by modern research. What follows is the traditional range a practitioner works from, not a self-treatment plan. A one-day decoction commonly uses Zhu Ye 6 to 15 g, Shi Gao 15 to 30 g, Mai Men Dong 10 to 20 g, Ren Shen 3 to 6 g, treated Ban Xia 6 to 9 g, Gan Cao 3 to 6 g and Jing Mi 10 to 15 g. The herbs are boiled, strained, and the liquid is split into two or three warm drinks across the day. For granules, follow the label, which is often 3 to 6 g twice a day. Doses for children must come from a qualified practitioner.
• Best time of day: Spread the day's liquid over two or three warm drinks, morning, afternoon and early evening. If the Ren Shen (ginseng) keeps you awake, take the last drink before 6 pm.
• With or without food: Traditionally taken warm between meals. If it upsets your stomach, take it just after food instead.
• Time to effect: Traditionally people expect some change within two to four days. There is no trial data to confirm any timeline. If you feel worse at any point, stop.
• How long to take it: Short courses only. Tradition uses it for a few days up to about two weeks, while the recovery stage lasts. Reassess after one week. If nothing has changed, stop and get a proper diagnosis. Do not take it for weeks on end without supervision. The Gan Cao (licorice) in it builds up and can raise blood pressure and drop your potassium, a blood salt your heart and muscles need.