Schisandra

Schisandra (wu wei zi, “five-flavour berry”) carries all five tastes, with sour and sweet the strongest and salty, pungent and bitter behind them ^{28Reference 28Teeguarden · 2000The Ancient Wisdom of the Chinese Tonic Herbs}. Because it holds all five flavours, it is said to reach all five elemental energies. Because it addresses all three treasures, jing, qi and shen, it is ranked among the supertonics alongside ginseng and reishi ^{28Reference 28Teeguarden · 2000The Ancient Wisdom of the Chinese Tonic Herbs}.

Its actions are astringent and consolidating. It astringes the lung, nourishes the kidney, promotes fluid production, stops sweating and calms the mind ^{29Reference 29Wu · 2005An Illustrated Chinese Materia Medica (pp}.

The classical indication is a chronic cough from lung deficiency ^{29Reference 29Wu · 2005An Illustrated Chinese Materia Medica (pp}.

Much of its use centres on the kidneys, which in Chinese medicine are the source of jing, the energy behind growth, reproduction and resilience. Strong kidneys are linked to strength, resistance to fatigue and sexual function ^{28Reference 28Teeguarden · 2000The Ancient Wisdom of the Chinese Tonic Herbs}.

Ron Teeguarden records the fruit as warm and entering all twelve meridians ^{28Reference 28Teeguarden · 2000The Ancient Wisdom of the Chinese Tonic Herbs}.

Schisandra also has a long history in China as a beauty herb, taken regularly for the skin. The story attached to it is of Huai Nan Gong, who took it for sixteen years and whose skin was said to be like that of “a Jade girl” ^{28Reference 28Teeguarden · 2000The Ancient Wisdom of the Chinese Tonic Herbs}.

It is also taken to improve memory, strength and vitality, to purify the blood, to sharpen the mind, to cleanse the liver, and as an aphrodisiac and astringent ^{28Reference 28Teeguarden · 2000The Ancient Wisdom of the Chinese Tonic Herbs}.

Taoists used it to develop spiritual power and strengthen the body. Master Sung Jin Park regarded it as one of the quintessential herbal substances of the world ^{28Reference 28Teeguarden · 2000The Ancient Wisdom of the Chinese Tonic Herbs}.

It is not given in the early stages of a cough or a rash, or in excess-heat patterns ^{29,30Reference 29Wu · 2005An Illustrated Chinese Materia Medica (ppReference 30Bone · 2003A Clinical Guide to Blending Liquid Herbs: Herbal Formulations for the Individual Patient (pp}.

Schisandra entered the official medicine of the USSR as an adaptogen in the early 1960s, after two decades of Russian pharmacological and clinical research. It was included in the National Pharmacopoeia of the USSR and the State Register of Drugs ^{17Reference 17Panossian et al. · 2008ReviewPharmacology of Schisandra chinensis Bail.: an overview of Russian research and uses in medicine — reviewView study →}.

Russian clinicians used it for asthenia and fatigue, for mental and physical working capacity, and for a wide range of other complaints, from low blood pressure and impaired vision to gastritis and slow-healing wounds ^{17Reference 17Panossian et al. · 2008ReviewPharmacology of Schisandra chinensis Bail.: an overview of Russian research and uses in medicine — reviewView study →}.

A 2025 systematic review and meta-analysis pooled 54 animal studies of liver injury. Schisandra compounds lowered alanine aminotransferase (standardised mean difference −4.74) and aspartate aminotransferase (−5.10), cut malondialdehyde and inflammatory cytokines, and raised superoxide dismutase and glutathione ^{1Reference 1Huang et al. · 2025Meta-analysisEfficacy of Schisandra chinensis in liver injury: a systematic review and preclinical meta-analysis — systematic review, meta-analysis of animal studiesView study →}.

The lignan schisandrol B, isolated from S. sphenanthera, protected mice against acetaminophen liver injury by activating the NRF2/ARE pathway that governs glutathione synthesis and detoxification ^{2Reference 2Jiang et al. · 2016AnimalSchisandrol B protects against acetaminophen-induced acute hepatotoxicity in mice via activation of the NRF2/ARE signaling pathway — animal (mouse) study; schisandrol B isolated from Schisandra sphenantheraView study →}. A lignan-enriched extract of the berry enhanced the liver’s capacity to regenerate glutathione in rats, most strongly after carbon tetrachloride challenge ^{3Reference 3Ko et al. · 1995AnimalEnhancement of hepatic glutathione regeneration capacity by a lignan-enriched extract of fructus schisandrae in rats — animal (rat) studyView study →}.

Newer work extends this to metabolic liver disease. Lignan and polysaccharide extracts reversed fatty liver, lowered liver enzymes and reduced fibrosis genes in mice with metabolic steatohepatitis (MASH), by restoring the ceramide-clearing enzyme ASAH1 ^{4Reference 4Chen et al. · 2025In vitroSchisandra chinensis lignans and polysaccharides alleviate MASH via ASAH1-mediated regulation of hepatic ceramide homeostasis — in vivo mouse and in vitro studyView study →}. A 2026 review summarises this direction for metabolic fatty liver disease ^{5Reference 5Wang et al. · 2026ReviewSchisandra chinensis Fructus and its active metabolites for the treatment of metabolic dysfunction-associated steatotic liver disease — reviewView study →}.

The human evidence is indirect. In 17 college tennis players doing four weeks of high-intensity training, saengmaeksan, a drink of liriope, ginseng and schisandra, lowered blood ammonia and the liver enzymes AST and ALT compared with placebo ^{6Reference 6Juan et al. · 2023RCTEffect of Saengmaeksan (Liriope, Panax ginseng, Schisandra chinensis) on fatigue, liver function and immunity combined with high-intensity training — randomised controlled trial (combination)View study →}. No placebo-controlled trial of schisandra alone in liver disease has been published.

Gap: the human liver evidence is one small trial of a three-herb drink; every single-herb result is in rodents, and the effective clinical dose and extract standard are undefined.

The lignans repeatedly activate the Nrf2/ARE program, raising glutathione, superoxide dismutase and other antioxidant enzymes while lowering lipid-peroxidation markers. This has been shown in liver ^{2Reference 2Jiang et al. · 2016AnimalSchisandrol B protects against acetaminophen-induced acute hepatotoxicity in mice via activation of the NRF2/ARE signaling pathway — animal (mouse) study; schisandrol B isolated from Schisandra sphenantheraView study →} and skin ^{7Reference 7Wang et al. · 2026In vitroSchisandrin A alleviates UVB-induced photoaging via AMPK/Nrf2-mediated antioxidant and autophagy pathways — in vitro and mouse studyView study →}.

In UVB-exposed skin cells and mice, schisandrin A raised superoxide dismutase and glutathione and reduced malondialdehyde through AMPK/Nrf2 signalling ^{7Reference 7Wang et al. · 2026In vitroSchisandrin A alleviates UVB-induced photoaging via AMPK/Nrf2-mediated antioxidant and autophagy pathways — in vitro and mouse studyView study →}.

In a 12-week randomised trial in older adults, schisandra extract improved muscle strength but produced no measurable change in antioxidant or anti-inflammatory markers in the blood ^{8Reference 8Cho et al. · 2021RCTEffect of Schisandra chinensis Baillon extracts and regular low-intensity exercise on muscle strength and mass in older adults: a randomized, double-blind, placebo-controlled trial — randomised controlled trial (NCT03402308)View study →}.

Gap: strong and reproducible in cells and animals, but the one human trial to measure antioxidant markers found no change.

In a randomised, double-blind, placebo-controlled trial, 45 healthy post-menopausal women took 1,000 mg/day of schisandra extract or starch for 12 weeks. Quadriceps strength rose and resting blood lactate fell in the schisandra group ^{9Reference 9Park et al. · 2020RCTEffect of Schisandra chinensis extract supplementation on quadriceps muscle strength and fatigue in adult women: a randomized, double-blind, placebo-controlled trial — randomised controlled trialView study →}.

A second trial randomised 54 adults over 50 with relatively low muscle mass to 1 g/day of extract or placebo for 12 weeks, alongside regular walking. Knee-extensor strength rose more with schisandra (right knee +10.2 Nm, left knee +6.7 Nm), with no adverse events. Muscle mass did not change ^{8Reference 8Cho et al. · 2021RCTEffect of Schisandra chinensis Baillon extracts and regular low-intensity exercise on muscle strength and mass in older adults: a randomized, double-blind, placebo-controlled trial — randomised controlled trial (NCT03402308)View study →}.

A 2026 meta-analysis of 11 animal studies of muscle atrophy found schisandra increased muscle weight, with a borderline effect on muscle-fibre size. Grip strength did not change significantly ^{10Reference 10Liu et al. · 2026Meta-analysisEffects of schisandra extract on muscle atrophy: a systematic review and meta-analysis of preclinical studies — meta-analysis of animal studiesView study →}.

In both human trials strength rose while muscle mass did not ^{8,9Reference 8Cho et al. · 2021RCTEffect of Schisandra chinensis Baillon extracts and regular low-intensity exercise on muscle strength and mass in older adults: a randomized, double-blind, placebo-controlled trial — randomised controlled trial (NCT03402308)View study →Reference 9Park et al. · 2020RCTEffect of Schisandra chinensis extract supplementation on quadriceps muscle strength and fatigue in adult women: a randomized, double-blind, placebo-controlled trial — randomised controlled trialView study →}.

Gap: two small trials from Korea, measuring strength only; the mechanism for a strength gain without added muscle is unresolved.

Schisandrin B carries most of the anti-inflammatory activity studied so far. In lipopolysaccharide-induced lung injury in mice, it binds the adaptor protein MyD88 directly, suppressing NF-κB signalling and inflammatory cytokines ^{11Reference 11Zhu et al. · 2023In vitroSchisandrin B protects against LPS-induced inflammatory lung injury by targeting MyD88 — in vitro and mouse (in vivo) studyView study →}.

In a mouse model of atopic dermatitis, an extract of schisandra stem and schisandrin B improved skin-barrier proteins, eased itch and lowered IgE and mast-cell cytokines (IL-4, IL-6, TNF-α), again through NF-κB ^{12Reference 12Ye et al. · 2026AnimalThe stem of Schisandra chinensis and Schisandrin B alleviated DNCB-induced atopic dermatitis in mice by inhibiting the NF-κB pathway — animal (mouse) model; stem extractView study →}.

All of this is preclinical. The one human trial to measure inflammatory markers found no change ^{8Reference 8Cho et al. · 2021RCTEffect of Schisandra chinensis Baillon extracts and regular low-intensity exercise on muscle strength and mass in older adults: a randomized, double-blind, placebo-controlled trial — randomised controlled trial (NCT03402308)View study →}.

Schisandra is one of the three classic adaptogens, alongside Rhodiola rosea and Eleutherococcus senticosus. A 2009 review judged the evidence good from trials in which schisandra and eleuthero increased endurance and mental performance in people with mild fatigue and weakness ^{13Reference 13Panossian et al. · 2009ReviewEvidence-based efficacy of adaptogens in fatigue, and molecular mechanisms related to their stress-protective activity — reviewView study →}.

Much of the single-herb clinical work comes from the former USSR. In healthy people, schisandra increased endurance, accuracy of movement and mental working capacity ^{17Reference 17Panossian et al. · 2008ReviewPharmacology of Schisandra chinensis Bail.: an overview of Russian research and uses in medicine — reviewView study →}.

Modern trials more often use combinations. A fixed extract of schisandra, rhodiola and eleuthero (ADAPT-232) increased swimming endurance about sevenfold in mice and raised blood levels of the stress protein Hsp72 ^{15Reference 15Panossian et al. · 2009AnimalAdaptogens exert a stress-protective effect by modulation of expression of molecular chaperones — animal (mouse) study of ADAPT-232 (Schisandra + Rhodiola + Eleutherococcus)View study →}. A review of adaptogen trials reported benefits in chronic fatigue, cognitive impairment and immune protection ^{16Reference 16Todorova et al. · 2021Meta-analysisPlant adaptogens — history and future perspectives — systematic review / meta-analysisView study →}.

A 2026 review of seven adaptogens reports cortisol reductions of 14–30% across clinical studies. It names schisandrin B’s stimulation of the stress protein Hsp70 as the mechanism specific to schisandra ^{14Reference 14Such et al. · 2026ReviewSystem-level, molecular and cellular mechanisms of selected plant adaptogens — reviewView study →}.

Gap: the modern human stress and fatigue data are mostly from multi-herb formulas, and the older single-herb trials predate current trial standards.

One randomised, double-blind, placebo-controlled trial tested a schisandra extract (BMO-30) in women aged 40–70 with menopausal complaints. They took it for 6 weeks and were followed for 12 ^{18Reference 18Park et al. · 2016RCTA randomized, double-blind, placebo-controlled trial of Schisandra chinensis for menopausal symptoms — randomised controlled trialView study →}.

Of 41 women enrolled, 36 completed the study, 18 in each group. Total Kupperman Index scores were significantly lower with schisandra than placebo (p = 0.042), with the clearest benefit for hot flushes, sweating and heart palpitations ^{18Reference 18Park et al. · 2016RCTA randomized, double-blind, placebo-controlled trial of Schisandra chinensis for menopausal symptoms — randomised controlled trialView study →}.

Gap: a single trial with 36 completers and no independent replication; the extract is proprietary and not directly comparable to whole berries.

In triple-transgenic Alzheimer’s mice and in neuronal cells, schisandrin B blocked ferroptosis, a form of iron-dependent cell death, through the GSK3β/Nrf2/GPX4 pathway with support from FSP1. It also reduced the inflammatory activation of microglia that follows, and improved cognition and brain pathology ^{19Reference 19Ding et al. · 2025In vitroSchisandrin B ameliorates Alzheimer’s disease by suppressing neuronal ferroptosis and ensuing microglia M1 polarization — animal (mouse) and in vitro studyView study →}.

Reviews of adaptogens report cognitive and mood benefits for formulas that contain schisandra ^{20Reference 20Panossian · 2013ReviewAdaptogens in mental and behavioral disorders — reviewView study →}.

No trial has tested schisandra alone on human cognition.

A purified polysaccharide from the berry (SCP-0-1) inhibited HepG2 liver-cancer cells, with an IC50 of about 480 µg/mL. It induced apoptosis through the mitochondria by inhibiting Hsp90/AKT signalling ^{21Reference 21Chen et al. · 2016In vitroA homogeneous polysaccharide from Fructus Schisandra chinensis induces mitochondrial apoptosis through the Hsp90/AKT signalling pathway in HepG2 cells — in vitro studyView study →}.

Gap: a single cell-line study of one isolated polysaccharide, which differs from what a whole-berry preparation delivers; no clinical cancer evidence exists.

Screening a schisandra extract library identified the triterpenoid schizandronic acid, isolated from the fruit of Schisandra sphenanthera, as a hepatitis C entry inhibitor ^{22Reference 22Qian et al. · 2016In vitroA Schisandra-derived compound schizandronic acid inhibits entry of pan-HCV genotypes into human hepatocytes — in vitro studyView study →}.

It blocked entry of all major HCV genotypes into liver-cancer cells and primary human liver cells by impairing fusion of the virus with the cell membrane. It also slowed spread to neighbouring cells, added to the effect of interferon and telaprevir, and reduced the establishment of infection in an animal model ^{22Reference 22Qian et al. · 2016In vitroA Schisandra-derived compound schizandronic acid inhibits entry of pan-HCV genotypes into human hepatocytes — in vitro studyView study →}.

Gap: one study of one isolated compound from a related species, with no human antiviral data.

Tolerance. No participant had an adverse event in the 12-week trial in older adults, and the menopause trial reported the extract as safe ^{8,18Reference 8Cho et al. · 2021RCTEffect of Schisandra chinensis Baillon extracts and regular low-intensity exercise on muscle strength and mass in older adults: a randomized, double-blind, placebo-controlled trial — randomised controlled trial (NCT03402308)View study →Reference 18Park et al. · 2016RCTA randomized, double-blind, placebo-controlled trial of Schisandra chinensis for menopausal symptoms — randomised controlled trialView study →}.

Tacrolimus and other CYP3A drugs. The Wuzhi tablet, an extract of Schisandra sphenanthera, has been tested in China as a way to raise tacrolimus levels in kidney-transplant patients. In 12 patients it raised dose-adjusted trough levels of tacrolimus by about 199% on average and allowed a 41% cut in dose ^{23Reference 23Li et al. · 2017Clinical trialWuzhi tablet (Schisandra sphenanthera extract) is a promising tacrolimus-sparing agent for renal transplant recipients who are CYP3A5 expressers: a two-phase prospective study — human prospective clinical studyView study →}. Its lignans have a higher affinity for CYP3A than tacrolimus itself ^{24Reference 24Qin et al. · 2014AnimalEffect of tacrolimus on the pharmacokinetics of bioactive lignans of Wuzhi tablet (Schisandra sphenanthera extract) and the potential roles of CYP3A and P-gp — pharmacokinetic (rat) studyView study →}. The same effect can raise exposure to other narrow-margin drugs cleared by CYP3A.

In 12 healthy men, a week of S. sphenanthera extract roughly doubled blood levels of midazolam, the standard test drug for CYP3A ^{36Reference 36Xin et al. · 2009Effects of Schisandra sphenanthera extract on the pharmacokinetics of midazolam in healthy volunteers — human pharmacokinetic studyView study →}. For S. chinensis itself, the tacrolimus evidence comes from rats, in which a week of extract raised tacrolimus levels several-fold ^{35Reference 35Wang et al. · 2014AnimalMultifaceted interaction of the traditional Chinese medicinal herb Schisandra chinensis with cytochrome P450-mediated drug metabolism in rats — animal studyView study →}.

P-glycoprotein. In healthy volunteers, two weeks of Schisandra chinensis extract raised blood levels of talinolol by about half, a sign that it inhibits the drug transporter P-glycoprotein ^{34Reference 34Fan et al. · 2009Effect of Schisandra chinensis extract and Ginkgo biloba extract on the pharmacokinetics of talinolol in healthy volunteers — human pharmacokinetic studyView study →}.

Bleeding. A 2025 case report describes bleeding around the brain and new immune thrombocytopenia in a patient who had started a multi-ingredient tablet containing schisandra. The authors discussed CYP3A interactions as a possible mechanism ^{26Reference 26Vargas-Portillo et al. · 2025Case reportSevere intracranial hemorrhage secondary to hemorrhagic diathesis following the use of a tablet containing Schisandra chinensis — case reportView study →}.

CYP2C19. Macelignan (anwuligan) irreversibly inactivates CYP2C19. In rats it raised amitriptyline peak levels 1.4-fold and total exposure by about 30% ^{25Reference 25Cheng et al. · 2026In vitroMechanism-based inactivation of CYP2C19 by anwuligan resulting in changes in pharmacokinetic properties of amitriptyline — in vitro / pharmacokinetic studyView study →}.

In practice. Anyone taking immunosuppressants, anticoagulants or other medicines cleared by CYP3A or CYP2C19 should use schisandra only with professional supervision.

TCM cautions. Traditional Chinese sources advise against it in the early stages of a cough or rash and in excess-heat patterns ^{29,30Reference 29Wu · 2005An Illustrated Chinese Materia Medica (ppReference 30Bone · 2003A Clinical Guide to Blending Liquid Herbs: Herbal Formulations for the Individual Patient (pp}.