- Tian-Xian Liquid
- Tien Hsien
- Tien-Hsien Liquid
For Patients & Caregivers
How It Works
The claims of anticancer effects of Tian Xian are based on anecdotal reports. Scientific evidence is lacking.
Tian Xian is an herbal extract used in traditional medicine and consists of the following herbs: Cordyceps sinensis (Dong Chong Xia Cao), Astragulus membranaceus (Huang Qi), Ganoderma lucidum (Ling Zhi), Panax ginseng (Ren Shen), Atractylodes macrocephalae (Bai Zhu), Dioscorea batatas (Shan Yao), Codnopsis pilosula (Dang Shen), Pogostemon cablin (Huo Xiang), Lycium barbarum (Gou Qi Zi), Pteria margaritifera (Pearl Powder), Ligustrum lucidum Ait (Nu Zhen Zi), and Radix glycyrrhizae (Licorice). Ingredients may vary depending on manufacturers.
Promoters of Tian Xian claim that it has immunomodulating and anticancer effects. Laboratory studies show that it can increase the number of immune cells upon stimulation with antigens, and also has anticancer effects. Only one small study in humans suggests it may improve quality of life and alleviate chemotherapy side effects. Larger controlled trials are needed to confirm these effects and determine safety.
A laboratory study showed that Tian Xian increased the number of immune cells when stimulated with specific antigens.
- Cancer Treatment
Lab studies show that Tian Xian has anticancer properties. A small study in breast cancer patients suggests it may improve quality of life and alleviate chemotherapy side effects, but larger studies are needed to confirm effects and ensure safety.
Do Not Take If
- You have hypersensitivity to any of the constituents. In addition, please see individual monographs for drug interactions with the following individual botanicals: Cordyceps, Astragulus, Reishi mushroom, Asian ginseng, Lycium, Ligustrum lucidum, and Licorice.
- You are taking cytochrome P450 substrate drugs: Tian Xian may affect how these drugs are metabolized.
- You are receiving chemotherapy: Tian Xian may alter the effects of conventional therapies.
For Healthcare Professionals
Tian Xian is an extract of Chinese medicinal herbs that is used for cancer treatment in traditional medicine. Ingredients may vary depending on manufacturers but usually include ginseng and astragalus as the main components. Proponents claim that the anticancer effects are due to the immunomodulating properties of the constituents.
In vitro and animal studies demonstrate that Tian Xian has immunomodulating (1) (3) and anticancer (4) (5) (6) (7) (8) effects. In a small randomized controlled trial, Tian Xian liquid significantly improved QOL, decreased chemotherapy side effects, and demonstrated immunomodulating effects on lymphocytes in patients with refractory metastatic breast cancer. Larger studies are needed to confirm safety and efficacy (9).
No serious adverse effects have been reported from the use of Tian Xian liquid. However, patients should use caution because some of the herbs in Tian Xian may interact with prescription drugs due to cytochrome P450 3A4 induction (10). Future studies are needed to determine the extent to which this herbal remedy may either positively or negatively alter conventional anticancer therapy.
Mechanism of Action
A number of ingredients in Tian Xian, including Cordyceps sinensis (Dong Chong Xia Cao), Astragulus membranaceus (Huang Qi), Ganoderma lucidum (Ling Zhi, reishi mushroom), Panax ginseng (Ren Shen), Atractylodes macrocephalae (Bai Zhu), Dioscorea batatas (Shan Yao), Codnopsis pilosula (Dang Shen), Pogostemon cablin (Huo Xiang), Lycium barbarum (Gou Qi Zi), Pteria margaritifera (Pearl Powder), Ligustrum lucidum (Nu Zhen Zi), and Radix glycyrrhizae (Licorice) (2) have various characteristics and activities.
Tian Xian liquid increased proliferation of antigen-stimulated peripheral blood mononuclear cells and T cells isolated from patients with recurrent aphthous ulcers, perhaps via increased cytotoxic activity of NK cells, increased phagocytic activity of macrophages, anti-inflammatory effects, and immunopotentiation by the active constituents (1).
In vitro and in vivo studies indicate that Tian Xian activates human pregnane X receptor (PXR), which is involved in the hepatic uptake, metabolism, and elimination of toxic compounds, and alters the strength of PXR protein / transcriptional cofactor protein interactions (10). In humanized PXR mice, Tian Xian increased hepatic CYP3A11 expression and induced CYP3A4 expression, indicating its coadministration with conventional chemotherapeutic agents may be contraindicated (10). In models of human colorectal cancer, Tian Xian inhibits proliferation via the mitochondrial apoptotic pathway (8), downregulates matrix metalloproteinase-2 (MMP2) and MMP7 mRNA expression, and increases vascular endothelial growth factor (VEGF) mRNA expression, but not protein levels in vivo (11). It also upregulates p21 protein levels and downregulates MMP1 and multidrug resistance-1 (MDR1) protein levels (12). Suppression of gene expression and tumorigenicity of cancer stem-like hepatoma side population cells as well as synergy with doxorubicin also occur through inhibition of multiple oncogenic signaling pathways (7).
- Cytochrome P450 substrates: Tian Xian induces CYP3A4 and increases CYP3A11 expression, and may therefore affect the intracellular concentration of drugs metabolized by these enzymes, including certain chemotherapy drugs (10).
- In addition, please see individual monographs for drug interactions with the following individual botanicals: Cordyceps, Astragulus, Reishi mushroom, Asian ginseng, Lycium, Ligustrum lucidum, and Licorice (2) .