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Chinese White Peony

Also known as: Chinese White Peony, Bai Shao, Paeonia lactiflora

Overview

Chinese White Peony, scientifically known as Paeonia lactiflora, is a traditional Chinese medicinal herb primarily derived from its root. It is rich in bioactive compounds, notably paeoniflorin and total glucosides of paeony (TGP), which are believed to be responsible for its therapeutic effects. This herb is widely recognized for its anti-inflammatory, immunomodulatory, and hormone-regulating properties. Research on Chinese White Peony, particularly TGP, is moderately mature, with several clinical trials and systematic reviews supporting its use in autoimmune diseases and gynecological disorders. While some well-conducted randomized controlled trials (RCTs) and meta-analyses exist, especially concerning rheumatoid arthritis (RA) and polycystic ovary syndrome (PCOS), more high-quality research is needed to solidify its efficacy across all potential indications. It is commonly used as an herbal supplement in various forms.

Benefits

Chinese White Peony offers several evidence-based benefits, primarily due to its anti-inflammatory and immunomodulatory properties: - **Rheumatoid Arthritis (RA):** Total glucosides of paeony (TGP) have shown significant efficacy in reducing disease activity and inflammatory markers in RA patients. A systematic review and meta-analysis protocol aims to confirm that TGP improves clinical effective rates and reduces serum rheumatoid factor, C-reactive protein, and erythrocyte sedimentation rate, with a favorable safety profile. This indicates strong potential for managing RA symptoms. - **Polycystic Ovary Syndrome (PCOS):** A meta-analysis of multiple RCTs demonstrated that a compound containing Yulinzhu (which includes white peony) significantly improved clinical outcomes and pregnancy rates when combined with regular treatment, compared to regular treatment alone. This suggests a notable benefit for women with PCOS. - **Primary Sjögren's Syndrome (pSS):** Network pharmacology and molecular docking studies indicate that active compounds in white peony, such as paeoniflorin, kaempferol, and beta-sitosterol, target inflammatory and immune pathways (e.g., IL-6, TNF, AKT1) relevant to pSS. While promising, clinical trials are currently limited, meaning this benefit is still largely theoretical. - **Menopausal Symptoms:** White peony contains phytoestrogens that may help alleviate menopausal symptoms like hot flashes and vaginal dryness. Some traditional Chinese herbal formulations containing white peony have shown effects comparable to hormone therapy, though more direct research on white peony alone is needed. - **Mental Health:** Preclinical studies suggest paeoniflorin may reduce anxiety and depression by inhibiting serotonin transporter expression, thereby increasing serotonin availability. However, human data supporting these neuropsychological effects are currently lacking.

How it works

Chinese White Peony exerts its therapeutic effects through multiple mechanisms. Its primary actions involve anti-inflammatory and immunomodulatory pathways, achieved by inhibiting pro-inflammatory cytokines like TNF-α and IL-6, modulating immune cell activity, and regulating signaling pathways such as AGE-RAGE, TNF, IL-17, and Toll-like receptor pathways. In conditions like PCOS, it is thought to contribute to hormonal regulation by balancing sex hormone levels and improving ovarian function, though the precise molecular targets require further investigation. Paeoniflorin, a key active compound, also modulates neurotransmitter systems, specifically by inhibiting serotonin transporter expression, which increases serotonin availability and may contribute to its potential neuropsychological effects. It may also influence gut microbiota, further impacting systemic health.

Side effects

Chinese White Peony and its active component, total glucosides of paeony (TGP), are generally considered safe with a low incidence of adverse effects in clinical studies. Common side effects are not extensively documented but may include mild gastrointestinal discomfort, such as nausea or diarrhea. Uncommon side effects (occurring in 1-5% of users) are rare but could include allergic reactions or mild, transient elevations in liver enzymes. While not well-studied, there is a theoretical potential for interactions with certain medications. Caution is advised when co-administering with immunosuppressants due to its immunomodulatory effects, or with anticoagulants due to potential, though unconfirmed, effects on blood clotting. Chinese White Peony is contraindicated during pregnancy and breastfeeding due to insufficient safety data; its use in these populations is not well established and should be avoided. Data on its safety and efficacy in children and the elderly are also limited, as most research has focused on adult populations. Users should consult a healthcare professional before starting supplementation, especially if they have pre-existing medical conditions or are taking other medications.

Dosage

Dosage recommendations for Chinese White Peony vary depending on the specific condition and formulation. For rheumatoid arthritis, clinical trials commonly use total glucosides of paeony (TGP) at doses ranging from 600 mg to 1200 mg daily, typically divided into two or three doses. For conditions like PCOS and other indications, dosages depend on the specific herbal formulation, and standardized extracts containing defined amounts of paeoniflorin are generally preferred for consistency. It is usually recommended to administer Chinese White Peony orally with meals to enhance absorption and minimize potential gastrointestinal discomfort. The maximum safe dose has not been definitively established, but clinical studies have not reported serious toxicity at commonly used therapeutic doses. There are no specific cofactors required for its efficacy, but it is frequently combined with other herbs in traditional Chinese medicine formulations to achieve synergistic effects.

FAQs

Is Chinese White Peony effective for autoimmune diseases?

Evidence supports its benefit in rheumatoid arthritis and potentially Sjögren's syndrome, particularly its active component TGP. However, more high-quality randomized controlled trials are needed for broader confirmation across all autoimmune conditions.

Can it be used for menopausal symptoms?

Some evidence suggests its phytoestrogenic effects may help alleviate menopausal symptoms. However, it should not replace conventional hormone therapy without medical advice and supervision.

Are there risks of side effects?

Generally, the risk of side effects is low. Mild gastrointestinal discomfort and rare allergic reactions or liver enzyme elevations can occur. It's considered safe for most adults at recommended doses.

How long before effects appear?

Clinical improvements in conditions like rheumatoid arthritis and PCOS are typically observed after several weeks to months of consistent and regular use, rather than immediate effects.

Research Sources

https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2024.1458621/full – This meta-analysis of randomized controlled trials (RCTs) investigated the efficacy of Yulinzhu (containing white peony) for Polycystic Ovary Syndrome (PCOS). It found significant improvements in clinical effectiveness (RR 1.19) and pregnancy rates (RR 2.80) with low heterogeneity, suggesting Yulinzhu is a high-quality, effective treatment for PCOS.
https://pmc.ncbi.nlm.nih.gov/articles/PMC7523790/ – This systematic review and meta-analysis protocol outlines a plan to consolidate clinical evidence on Total Glucosides of Paeony (TGP) for Rheumatoid Arthritis (RA). The study aims to provide high-level evidence on TGP's efficacy in improving clinical effective rates and reducing inflammatory markers in RA patients, with a focus on safety.
https://pmc.ncbi.nlm.nih.gov/articles/PMC9391099/ – This network pharmacology study explored the potential mechanisms of white peony in treating primary Sjögren's syndrome (pSS). It identified key active compounds and molecular targets, suggesting multi-target immunomodulatory effects, but noted the need for clinical trials to validate these findings.
https://www.healthline.com/health/white-peony-root – This source provides a general overview of white peony root, including its traditional uses and potential health benefits. It mentions its use for menopausal symptoms and mental health, citing preclinical studies on paeoniflorin's effects on serotonin, though it emphasizes the lack of human data for these specific applications.
https://onlinelibrary.wiley.com/doi/10.1155/2022/6887988 – This article discusses the mechanisms of action of paeoniflorin, a major active compound in white peony. It highlights its anti-inflammatory and immunomodulatory effects through various signaling pathways and its potential role in modulating neurotransmitter systems and gut microbiota, contributing to its diverse therapeutic properties.