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Red Peony Extract

Also known as: Red Peony, Chinese Peony, Red Peony Extract, Total Glucosides of Paeony, TGP, Paeonia lactiflora

Overview

Red Peony Extract, derived from the dried roots of Paeonia lactiflora, is a traditional Chinese medicine-derived supplement primarily known for its immunomodulatory and anti-inflammatory properties. Its main active constituents are total glucosides of paeony (TGP), including paeoniflorin. It is commonly used as an adjunctive therapy in autoimmune and inflammatory diseases such as systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). Research, predominantly from Chinese clinical studies, indicates moderate maturity with multiple randomized controlled trials and meta-analyses supporting its efficacy and safety. The extract is believed to regulate immune function and reduce inflammation through its bioactive compounds, offering a complementary approach to conventional treatments for these conditions.

Benefits

Red Peony Extract, specifically its active component TGP, offers significant benefits, particularly for individuals with autoimmune rheumatic diseases. In Systemic Lupus Erythematosus (SLE), TGP combined with conventional treatments has been shown to significantly reduce disease activity scores, with a mean difference of approximately -3.54 in SLEDAI-1m, indicating a clinically meaningful reduction in disease severity. For rheumatoid arthritis (RA) patients, TGP used alongside methotrexate improves clinical efficacy and safety compared to methotrexate alone, leading to reduced inflammation and disease activity. These primary effects are supported by moderate to large effect sizes observed in meta-analyses involving hundreds of participants. While potential immunomodulatory and anti-inflammatory effects may extend to other autoimmune conditions, the evidence for these secondary effects is less robust. Benefits typically manifest over weeks to months of consistent treatment.

How it works

Total glucosides of paeony (TGP) modulate immune function by regulating cytokine production and various inflammatory pathways. Paeoniflorin, a key component of TGP, is known to inhibit pro-inflammatory mediators, thereby reducing inflammation. It may also modulate the activity of T-cells and B-cells, which are crucial components of the immune system involved in autoimmune responses. Additionally, the extract may possess antioxidant properties that contribute to its overall therapeutic effects by neutralizing harmful free radicals. The oral bioavailability of TGP is moderate, and its absorption can be influenced by the specific formulation of the extract.

Side effects

Red Peony Extract (TGP) is generally considered safe and well-tolerated in clinical trials. The most common side effects are mild gastrointestinal discomfort and occasional dizziness. Allergic reactions are rare. However, caution is advised due to potential drug interactions. TGP may slow blood clotting, necessitating caution when used concurrently with anticoagulants (blood thinners) and antiplatelet drugs, as this could increase the risk of bleeding. There are also potential interactions with phenytoin, as TGP may reduce its levels, and with birth control pills and estrogens due to possible overlapping hormonal effects. Furthermore, TGP may affect liver enzymes CYP1A2 and CYP3A4, which could alter the metabolism of various other medications. Contraindications include patients on blood thinners or hormone therapies, where use should be approached with caution. Data on use during pregnancy and lactation are limited, so it should be avoided or used only under strict medical supervision in these populations.

Dosage

Clinical trials typically utilize standardized Total Glucosides of Paeony (TGP) extracts, with recommended daily dosages generally ranging from 600 mg to 1200 mg, often administered in divided doses. The optimal dosage can vary depending on the specific disease being treated and whether it's used in combination with conventional therapies. While a firm maximum safe dose has not been definitively established, dosages up to 1200 mg per day have appeared safe in clinical trials. For best absorption and to minimize potential gastrointestinal side effects, oral administration with meals is often recommended. It is crucial to use standardized extracts with a quantified glucoside content to ensure consistent potency and efficacy.

FAQs

Is Red Peony Extract safe long term?

Generally, yes, but long-term use requires monitoring for potential bleeding risks and drug interactions, especially with blood thinners or hormone therapies.

Can it replace conventional treatment?

No, Red Peony Extract is intended as an adjunctive therapy to complement standard medical treatments for autoimmune diseases, not to replace them.

How soon do effects appear?

Clinical benefits typically become noticeable within a few weeks to several months of consistent use, depending on the individual and condition.

Does it affect hormone levels?

It may exhibit mild estrogen-like effects, so caution is advised for individuals with hormone-sensitive conditions or those on hormone therapies.

Research Sources

https://pubmed.ncbi.nlm.nih.gov/35173622/ – This systematic review and meta-analysis of 14 RCTs involving 978 SLE patients found that TGP combined with conventional treatment significantly reduced SLE disease activity (MD -3.54, p<0.00001). The study, primarily on Chinese populations, indicated moderate to high quality evidence, using Cochrane RoB 2.0 for assessment.
https://pmc.ncbi.nlm.nih.gov/articles/PMC5754451/ – This systematic review and meta-analysis involving over 500 RA patients concluded that TGP combined with methotrexate improved clinical efficacy and safety compared to methotrexate alone. The study noted some limitations, including small sample sizes in some included studies and potential publication bias, but maintained a consistent methodology.
https://www.webmd.com/vitamins/ai/ingredientmono-32/peony – This WebMD summary provides a review of clinical data, noting potential drug interactions and the overall safety profile of peony. It serves as a secondary source supporting the clinical findings regarding safety and interactions, particularly concerning blood thinners and hormonal effects.