- Wu wei zi
- Five flavor berry
- Fructus schisandra
- Ngu mie gee
- Chinese magnolia vine fruit
For Patients & Caregivers
Schisandra is a fruit extract used in traditional Chinese medicine.
Scientists do not know how Schisandra works, but laboratory experiments have begun to identify some of its biological activities. Schisandra has antioxidant activity, which means that it neutralizes free radicals that can cause cellular and genetic damage. When tested in animals, schisandra had the following effects: 1) protection of the liver and nervous system, 2) improved mental and physical functioning, 3) antidiabetic effects, and 4) reversal of resistance to chemotherapy drugs by tumor cells. The small number of studies in humans is too limited to draw any conclusions.
- To treat lung problems
Although schisandra is used to treat some pulmonary symptoms in traditional Chinese medicine, there are no clinical trials to support this use.
- To treat coughs
Schisandra is used in traditional medicine to treat coughs. No scientific studies to support this use have been conducted.
- To treat gastrointestinal problems
The traditional use of schisandra to treat diarrhea and indigestion is not yet supported in clinical trials. A small study in liver transplant patients suggests schisandra may help with the side effect of diarrhea associated with immune suppressant medication.
- To treat liver disease
Animal studies do show that schisandra can protect the liver from chemically-induced damage. In humans, one small study in liver transplant patients suggests schisandra can improve liver function. Another small study indicates it may be helpful in combination with other treatments for chronic hepatitis. However, these are uncontrolled trials that are inconclusive. Larger, more rigorous studies are needed to confirm these results.
- To increase strength and stamina
There are no human studies that validate this claim.
- To reduce sweating
The traditional use of schisandra to treat excessive sweating is not supported in clinical trials.
For Healthcare Professionals
Schisandra is derived from the fruit of the plant and is used in traditional Chinese medicine for coughs and wheezing (1), various liver diseases (2), stomach disorders (3), spontaneous sweating (4), and as an adaptogen (5). In vitro studies have shown that schisandra has anti-inflammatory (1) (6) and anticancer (7) (8) properties, and protects against adriamycin-induced cardiotoxicity (9). In animal models, schisandra protects the liver against various toxins (10) (11), has beneficial effects after myocardial infarction (12), enhances endurance and metabolism (13), improves cognitive functioning (14), and exhibits antimicrobial (15), antioxidant, neuroprotective (16), and anti-hyperglycemic activity (17) (18) (19). Active lignans isolated from schisandra, particularly schisandrin A, were found to reverse P-glycoprotein (Pgp)-mediated multidrug resistance of various cancer cell lines to doxorubicin, vincristine, and paclitaxel (20).
Very few human trials have been performed with this supplement. Two small clinical trials suggest improvements in subjects with fatty liver disease using a mixture of schisandra fruit extract and sesamin, a lignan marketed as a fat-reduction supplement (21), and possible benefit for those with chronic hepatitis C virus when used in combination with other oral antioxidants (22). Another small trial of a proprietary herbal combination that included schisandra suggests improved performance of cognitive tasks (23). Schisandra was also found to reduce tacrolimus-associated side-effects of diarrhea and agitation and to improve liver function in liver transplant patients (24). Additional research is necessary to determine actual efficacy attributable to schisandra and to uncover possible interactions or side effects associated with this supplement.
Lignans in schisandra have been linked to various effects including hepatoprotective (10), antiproliferative, and estrogenic activities (27). In vitro, schisantherins downregulated pro-inflammatory cytokines and mediators by blocking NF-κB and MAPK signaling (1). In animal toxicity models, pretreatment with schisandra lignans increased DT-diaphorase activity associated with enhanced menadione elimination (10), and provided hepatoprotection and improved Phase I metabolism 24 h after carbon tetrachloride exposure (28) (29). Other animal studies suggest that schisandra increases hepatic glutathione levels and glucose-6-phosphate and glutathione reductase activities (17). It also inhibits α-glucosidase activity, thereby lowering postprandial blood glucose levels (19), and can improve cardiac function after ischemic injury by downregulating inflammatory cytokines, activating the eNOS pathway, inhibiting apoptosis, and enhancing cell proliferation (12). In amyloid-beta-induced memory impairment, schisandra increased superoxide dismutase and glutathione peroxidase activities and glutathione levels in the cerebral cortex and hippocampus of mice while decreasing malondialdehyde and oxidized glutathione (14). It also enhanced endurance and metabolism in the skeletal muscle of exercised rats by upregulating PGC-1α expression (13).
α-iso-cubebenol in schisandra inhibited iNOS and COX-2 expression in lipopolysaccharide-stimulated macrophages (6) and reversed septic shock by triggering protective downstream signaling pathways in a mouse sepsis model (15).The anthocyanin cyanidin-3-O-xylosylrutinoside (Cya-3-O-xylrut) has been identified as responsible for its antioxidant activity (18).
In human renal cell carcinoma cells, a schisandra polysaccharide identified as SCP induced apoptosis via caspase-3 and -9 activation, increased PARP cleavage, and inactivation of the ERK pathway (8). Another polysaccharide known as SCPP11 exhibited antitumor effects in hepatic cancer models via increased thymus index as well as serum IL-2 and TNF-alpha levels, and enhanced phagocytosis and NO production (26). Pgp-mediated chemotherapy drug-resistance in various cancer cell lines was reversed by schisandrins through the inhibition of Pgp and total protein kinase C function/expression (20).
Schisandra coadministration increases oral bioavailability of tacrolimus via inhibition of Pgp-mediated efflux and cytochrome P450 3A-mediated metabolism, and reduction of intestinal first-pass effect (30).
No serious side effects have been reported, although schisandra is not well studied in humans. A few minor adverse events, such as sleepiness and cold extremities, were observed in both treatment and placebo groups in one small trial (23).
- Cytochrome P450 3A4 and 1A2 substrates: Schisandra inhibits CYP3A4 and CYP1A2 and can affect the intracellular concentration of drugs metabolized by these enzymes. Long-term use can also induce CYP3A4 activity (33) (34).
- P-glycoprotein substrates: Schisandra can inhibit Pgp activity and interfere with the metabolism of certain drugs (35) (36).
- Tacrolimus: Schisandra can increase blood levels of tacrolimus, an immunosuppressant, in liver transplant patients (24).