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How does it feel?
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What can I use it for?
Atractylodes root in a bowl (Atractylodes macrocephala) White atractylodes is a Spleen qi tonic. In TCM, a primary role of the Spleen is to convert the food and drink we consume into energy (qi) and fluids and to transport these around the body. When this organ system is weak, qi becomes depleted and fluid metabolism impeded. This commonly results in fatigue, weakness (particularly in the limbs as these are governed by the Spleen in TCM), diarrhoea, bloating, poor appetite, vomiting and fluid accumulation in the body â âdampnessâ â often manifesting as oedema and urinary dysfunction. Â
White atractylodes has the ability to strengthen the Spleen, thereby boosting qi production, support digestion, facilitate the proper dissemination of fluids in the body and dry dampness, often via diuresis (increased urine excretion).
It has a long history of treating diarrhoea specific to Spleen qi deficiency, bearing in mind that in TCM one symptom or pathology can have a variety of underlying causes. Spleen qi deficiency-diarrhoea may be differentiated by its nature and accompanying symptoms; frequent loose stools, worse when tired, after exertion and after specific foods (e.g. raw foods that require a robust digestive system to digest them), abdominal distension that is better for pressure and warmth, fatigue, weak limbs and poor appetite. This specific pattern of digestive pathology often presents as inflammatory bowel disease (IBD) and diarrhoea-predominant irritable bowel syndrome, as well as food allergies and sensitivities, candida, coeliac disease, malabsorption syndrome, childhood nutritional impairment and eating disorders. White atractylodes will invariably be used in TCM herbal formulae to address such conditions where Spleen qi xu (deficiency) is at the root.
In TCM, there is a clear and established link between the gut and brain and white atractylodes is a commonly used herb in formulae addressing forgetfulness, poor concentration, anxiety and insomnia with a compromised digestive system at its essence; an ability reflected in modern research findings of its modulating effect on gut microbiota.
It is also used to strengthen the immune system (wei qi) and âstabilise the exteriorâ, for cases where qi deficiency has compromised the immune system and the correct functioning of the pores of the skin leading to spontaneous sweating.
These are the obvious applications of white atractylodes, however, in clinical practice it is utilised for any condition with spleen qi deficiency at its root which are many and varied; from bloody noses, rheumatism, painful urination, threatened miscarriage and dermatological conditions.Â
Modern day applications include cancer support, osteoporosis and obesity with emerging research also suggesting possible benefits for diabetes management and neuroprotection as well as a focus on its anti-inflammatory, anti-tumour and antioxidant potential. (1,2)
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Into the heart of atractylodes
White atractylodes is an integral herb in TCM, one that no practitioner would be without. Bitter, sweet and warm in nature, it supports the Earth element; the digestive organs of the Spleen and Stomach which, in TCM, are responsible for the transformation and transportation of food and fluids and are a primary source of qi (energy) production. In traditional Chinese herbal medicine, the bitter flavour has a draining and drying effect, while the sweet flavour, especially when paired with an energetic warmth, is tonifying and harmonising. Such energetic qualities make white atractylodes a wonderful, nourishing support for those with weak digestions and an excess of fluids in the body. Its primary actions of tonifying the Spleen and drying dampness make this herb a great example of a medicine which addresses both the root (Spleen qi deficiency) and branch (dampness) of a pathology. Â
The various methods of preparation for this herb can enhance specific properties and actions as needed; raw atractylodes (sheng bai zhu) is best for âdrying dampnessâ and promoting urination, stir-frying (chao bai zhu) enhances its energetic warmth making it better for tonifying the Spleen and qi and frying until blackened (bai zhu tan) enhances its astringent effect making it preferable for stopping diarrhoea.
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Traditional uses
Atractylodes root was first recorded in the Shen Nong Ben Cao Jing (Classic of the Materia Medica), TCMâs earliest text detailing individual herbs, in the 2nd century CE where A. macrocephala (bai zhu) was not differentiated from other, now distinct, herbs from the same species. It was recorded for use in the treatment of âwind–cold–dampnessâ arthralgia, muscle necrosis, spasm, deep-rooted ulcer, excessive internal heat and indigestion. It was also suggested that frying it into cakes and consuming it long-term could âprolong life and satisfy hungerâ.(3)Â
It was not until the Song Dynasty (circa 1100CE) that bai zhu received an entry in its own right in the classical herbal text, Ben Cao Yan Yi (Extended Ideas on Materia Medica). Â
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Traditional actions
Herbal actions describe therapeutic changes that occur in the body in response to taking a herb. These actions are used to express how a herb physiologically influences cells, tissues, organs or systems. Clinical observations are traditionally what have defined these actions: an increase in urine output, diuretic; improved wound healing, vulnerary; or a reduction in fever, antipyretic. These descriptors too have become a means to group herbs by their effects on the body â herbs with a nervine action have become the nervines, herbs with a bitter action are the bitters. Recognising herbs as members of these groups provides a preliminary familiarity with their mechanisms from which to then develop an understanding of their affinities and nuance and discern their clinical significance.
Chinese actions
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Traditional energetic actions
Herbal energetics are the descriptions Herbalists have given to plants, mushrooms, lichens, foods, and some minerals based on the direct experience of how they taste, feel, and work in the body. All traditional health systems use these principles to explain how the environment we live in and absorb, impacts our health. Find out more about traditional energetic actions in our article “An introduction to herbal energetics“.
Chinese energetics
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What practitioners say
Atractylodes (Atractylodes macrocephala) As with all TCM herbs, white atractylodes is typically prescribed within a synergistic herbal formula. It is present in countless formulae and perhaps one of the most commonly used herbs in TCM.
Its primary action, to tonify Spleen qi, is an invaluable one for modern times. Overwork, over-thinking, poor eating habits, overconsumption of âdampâ (eg. high-sugar, fried or fatty foods) or difficult to digest foods can all lead to a depleted Spleen. This in turn results in qi deficiency and the generation of dampness in the body, leaving us in the all-too-common state of suffering from lowered vitality, foggy-headedness, digestive difficulties, lowered immunity and so on.   Â
Si Jun Zi Tang (four gentlemen decoction)â comprised of ginseng (ren shen), white atractylodes (bai zhu), poria (fu ling) and licorice (gan cao) â is the classic TCM formula for tonifying Spleen qi and is used widely in clinical practice on its own and combined with other formulas as a tonifying adjunct for a wide variety of conditions with qi deficiency and dampness at their heart. In this formula, as in many, white atractylodes is a deputy herb â meaning that it supports and compliments the actions of the chief herb, in this case ginseng â reinforcing the tonic properties of the chief medicinal while addressing the root and branch of the symptoms by drying dampness.        Â
Research into the bioactive constituents of white atractylodes in recent decades has revealed pharmacological functions congruent with the traditional uses for this herb, notably its ability to support gastrointestinal and immune function. Sesquiterpenoids â compounds found in A. macrocephala â in particular, have displayed, amongst other effects, anti-inflammatory, immunomodulatory, antiemetic and antioxidant activities. (1,2,4,5) Recent research has also shown ethanol extracts, polysaccharides and volatile oils from this herb help to modulate gut bacteria. (6â9)Â
The combination of gut flora balancing, inflammation reduction and immune system modulation may go some way to explain the beneficial effects White atractylodes has for sufferers of inflammatory bowel diseases (IBDs) such as ulcerative colitis. Shen Ling Bai Zhu San (ginseng, poria and atractylodes powder), a popular 10-herb TCM formula named after three of its chief herbs, is the primary formula for Spleen qi deficiency with dampness in the form of diarrhoea and one of the most common prescriptions for chronic diarrhoea, including IBD. While sample sizes have been small, a number of clinical trials have shown that Shen Ling Bai Zhu San can enhance the efficacy of treatment and reduce the recurrency rate of ulcerative colitis, though larger, more rigorous studies are required. (10) This formula is also used in east Asia for post-surgery recovery from colon cancer.
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Research
Atractylodes flowers (Atractylodes macrocephala) Gastrointestinal
A recent review of 11 pre-clinical studies found that A. macrocephala polysaccharides boost gastrointestinal function, regulate the intestinal microbiota and help to repair gastrointestinal mucosal damage. (11â13)Â
Studies suggest the gastroprotective function of these polysaccharides is achieved via the regulation of intestinal flora and related signalling pathways as well as from the production of gastrointestinal hormones and neurotransmitters and inhibition of the oxidative stress response. (8,9)
A 2023 in vivo study of the effect of volatile oil from A. macrocephala found that it alleviated symptoms of colitis and colon damage and positively altered the gut microbiome by increasing beneficial bacteria and decreased potentially harmful bacteria. The authors posited that A. macrocephala volatile oil could serve as a prebiotic for ulcerative colitis sufferers. (7)Â
Earlier in vivo studies found that extract of A. macrocephala was more effective than sulfasalazine (a common medicine for IBD in preventing a relapse of colitis and the suppression of inflammation was achieved via the inhibition of macrophage and T-lymphocyte expression (14) and that an ethanolic extract of fried A. macrocephala significantly inhibited weight loss, diarrhoea, pathological changes in colon tissue and, again, significantly inhibited the levels of potentially pathogenic bacteria and increased those of beneficial bacteria. (6)
Pre-clinical studies have also shown that A. macrocephala extracts and preparations benefit IBD and irritable bowel syndrome (IBS) by improving gut motility, improving intestinal hypersensitivity and having a protective effect on intestinal epithelial cells. (14â16) Â
In a small-scale randomised control trial pilot, Shen Ling Bai Zhu San â one of the most common TCM formulas for ulcerative colitis, irritable bowel syndrome and other digestive complaints, containing A. macrocephala as a lead herb â improved symptoms of diarrhoea-predominant IBS (abdominal pain and frequency and stool form) when given alongside the antispasmodic drug, otilonium bromide, as compared to taking the drug alone and with fewer adverse events. (17)Â Â Â
Immune
Polysaccharides from A. macrocephala have been studied at length in pre-clinical studies for their immunomodulatory effects and the potential mechanisms for these. A 2022 review of 12 such studies concluded that A. macrocephala polysaccharides can activate the immune system by binding with macrophage-specific cell receptors, stimulating lymphocyte, cytokine and antibody production, influencing the related messenger signalling pathways, increasing the weight of the spleen and thymus and inhibiting damage to immune organs. (9)
Anti-tumour
A 2019 in vitro study found that essential oils from crude A. macrocephala and atractylone (a sesquiterpenoid compound from the essential oil) exhibited significant anti-tumor activity with human gastric, liver and colon cancer cells (16). An earlier study investigating the cytoxic potential of sesquiterpenoids (atractylon and atractylenolides I, II, and III) from A. macrocephala, found that atractylone displayed significant cytotoxic abilities with human and mouse leukemia cells in a dose-dependent manner and with no impact on healthy cell lines. Atractylenolides I also induced apoptosis (cell death) on these cell lines at a higher dosage and longer duration. (18)
Anti-inflammatory
In an early in vitro study, sesquiterpenoids found in A. macrocephala (atractylenolides I and III) decreased tumour necrosis factor alpha (TNF-α â an inflammatory chemical messenger (cytokine)) levels in activated macrophages (immune cells involved in the activation and sustainment of inflammation) in a dose-dependent manner by inhibiting TNF-α mRNA (a molecule involved in protein synthesis) expression. (19)
A later study also found that three compounds from A. macrocephala (one quinone compound and two polyacetylenes) inhibited the production of nitrous oxide (NO; an inflammatory mediator) and prostaglandin E2Â (PE2; another inflammation mediator associated with pain) in a concentration-dependent manner in activated macrophages. (20)
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Did you know?
Black atractylodes (A. lancea), or cang zhu in Mandarin, is another common TCM herb from the Atractylodes genus. Once used interchangeably and somewhat similar in function, it is distinct in its properties and applications; it is warm, acrid, bitter, aromatic and has a stronger ability than white atractylodes to âdry dampnessâ and induce perspiration to alleviate external pathogens.
Additional information
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Botanical description
A. macrocephala is a herbaceous perennial plant belonging to the Asteraceae family. It has a thick rhizome from which a cluster of stems emerge, growing up to 60 cm tall. It has ovate, entire leaves and yellow flowers.
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Common names
- White atractylodes rhizome
- Large-headed atractylodes
- Bai zhu (China)
- Byakujutsu (Japan)
- Paekâchul (Korea)
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Safety
There is currently no evidence supporting the safe use of white atractylodes in pregnancy or breastfeeding, however, white atractylodes has a long history of use in pregnancy at the appropriate dosage under the guidance of qualified and experienced TCM practitioners. Indeed, one of this herbâs functions in TCM is to support pregnancy in cases of qi deficiency.
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Interactions
Atractylenolides have an inhibitory effect on metabolic enzymes, hence, be mindful of potential side effects when combining with other drugs. (4) Potential interactions with omeprazole, anticoagulant or antiplatelet drugs and diuretics. (21)
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Contraindications
yin deficiency with heat signs or injured fluids, qi stagnation with sensations of oppression or distension.
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Preparation
- Decoction
- Tincture
- Powder
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Dosage
4.5â15g dried crude herb for decoction
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Plant parts used
Root
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Constituents
Sesquiterpenoids (atractylodin, atractylon), sesquiterpene lactones (atractylenolide -I,-II,-III), triterpenoids, polysaccharides, flavonoids, steroids, coumarins, phenylpropanoids, polyacetylenes, volatile oils. (1)
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Habitat
Grows widely in China (especially Zhejiang, Anhui, Hubei, Hunan, Jiangxi and Fujian provinces) Korea, Japan and Vietnam in pastures, wastelands, forests and grasslands at altitudes of 600 to 2800 m.
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Sustainability
The atractylodes species is not listed on the International Union for Conservation of Nature (IUCN) Red List of Threatened Species.
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Quality control
Atractylodes sesquiterpene lactones (atractylenolides) -I, -II and -III and atractylon, a sesquiterpene compound, are some of the primary biomarkers of quality for A. macrocephala.
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How to grow
- Sow seeds in spring and cover lightly with soil.
- Transplant seedlings the following spring/ early summer to well-drained soil with partial sun.
- Grows best at around 20 degrees but can also grow well at temperatures as low as five degrees and may tolerates sub-zero temperatures.Â
- Water regularly, particularly in the early stages of growth.
- Bud removal directs nutrition to the roots.
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Recipe
Atractylodes is typically prepared as a decoction. Learn how to make a decoction.
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References
- Zhu B et al. The traditional uses, phytochemistry, and pharmacology of Atractylodes macrocephala Koidz.: A review. Journal of Ethnopharmacology. 2018;226:143-167. doi.org/10.1016/j.jep.2018.08.023.
- Singh K et al. A comprehensive pharmacological review of Atractylodes Macrocephala: Traditional uses, phytochemistry, pharmacokinetics, and therapeutic potential. Pharmacological Research – Modern Chinese Medicine. 2024;10:100394. doi.org/10.1016/j.prmcm.2024.100394.
- Zhang WJ et al. Atractylodis Rhizoma: A review of its traditional uses, phytochemistry, pharmacology, toxicology and quality control. J Ethnopharmacol. 2021 Feb 10;266:113415. doi: 10.1016/j.jep.2020.113415. Epub 2020 Sep 28. PMID: 32987126; PMCID: PMC7521906.
- Deng M et al. Atractylenolides (I, II, and III): a review of their pharmacology and pharmacokinetics. Arch Pharm Res. 2021 Jul;44(7):633-654. doi: 10.1007/s12272-021-01342-6. Epub 2021 Jul 16. PMID: 34269984.
- Bailly C. Atractylenolides, essential components of Atractylodes-based traditional herbal medicines: Antioxidant, anti-inflammatory and anticancer properties. Eur J Pharmacol. 2021 Jan 15;891:173735. doi: 10.1016/j.ejphar.2020.173735. Epub 2020 Nov 18. PMID: 33220271.
- Shi K, Qu L, Lin X, Xie Y, Tu J, Liu X, Zhou Z, Cao G, Li S, Liu Y. Deep-Fried Atractylodis Rhizoma Protects against Spleen Deficiency-Induced Diarrhea through Regulating Intestinal Inflammatory Response and Gut Microbiota. International Journal of Molecular Sciences. 2020; 21(1):124. doi.org/10.3390/ijms21010124.
- Cheng H et al. Atractylodes macrocephala Koidz. volatile oil relieves acute ulcerative colitis via regulating gut microbiota and gut microbiota metabolism. Front. Immunol. 2023;14:1127785. doi: 10.3389/fimmu.2023.1127785.
- Zhang N et al. Two new compounds from Atractylodes macrocephala with neuroprotective activity. Journal of Asian Natural Products Research. 2017; 19(1):35-41. doi.org/10.1080/10286020.2016.1247351
- Liu C et al. The chemistry and efficacy benefits of polysaccharides from Atractylodes macrocephala Koidz. Front Pharmacol. 2022 Aug 25;13:952061. doi: 10.3389/fphar.2022.952061. PMID: 36091757; PMCID: PMC9452894.
- Yang L et al. Shen-Ling-Bai-Zhu-San for ulcerative colitis: Protocol for a systematic review and meta-analysis. Medicine (Baltimore). 2018 Sep;97(38):e12337. doi: 10.1097/MD.0000000000012337. PMID: 30235688; PMCID: PMC6160248.
- Wang J et al. Gut microbial modulation in the treatment of chemotherapy-induced diarrhea with Shenzhu Capsule. BMC Complement. Altern. Med. 2019; 19, 126. 10.1186/s12906-019-2548-yÂ
- Yang S et al. Network pharmacology-based strategy to investigate the pharmacologic mechanisms of Atractylodes macrocephala koidz. For the treatment of chronic gastritis. Front. Pharmacol. 2020;10, 1629. 10.3389/fphar.2019.01629
- Wen W et al. Research Progress of action mechanism of Baizhu powder based on intestinal microecology. Microbiol. China. 2021;7, 1â11. 10.4103/wjtcm.wjtcm_51_21
- Han KH et al. Heme Oxygenase-1 Induction and Anti-inflammatory Actions of Atractylodes macrocephala and Taraxacum herba Extracts Prevented Colitis and Was More Effective than Sulfasalazine in Preventing Relapse. Gut Liver. 2017 Sep 15;11(5):655-666. doi: 10.5009/gnl16496. PMID: 28651306; PMCID: PMC5593328.
- Gilani, AH et al. Evaluation of In Vitro Anti-Inflammatory Activities and Protective Effect of Fermented Preparations of Rhizoma Atractylodis Macrocephalae on Intestinal Barrier Function against Lipopolysaccharide Insult. Evidence Based Complementary and Alternative Medicine. 2023;2013. ID 363076. doi.org/10.1155/2013/363076
- Gu S et al. Antitumor, Antiviral, and Anti-Inflammatory Efficacy of Essential Oils from Atractylodes macrocephala Koidz. Produced with Different Processing Methods. Molecules. 2019 Aug 15;24(16):2956. doi: 10.3390/molecules24162956. PMID: 31443182; PMCID: PMC6719198.
- Lee JH et al. Effect of Samryungbaekchul-san Combined with Otilonium Bromide on Diarrhea-Predominant Irritable Bowel Syndrome: A Pilot Randomized Controlled Trial. J Clin Med. 2019 Sep 27;8(10):1558. doi: 10.3390/jcm8101558. PMID: 31569833; PMCID: PMC6832362.
- Wang CC et al. Cytotoxic Activity of Sesquiterpenoids from Atractylodes ovata on Leukemia Cell Lines. Planta Medica. 2002;68(03):204-408. doi: 10.1055/s-2002-23144
- Li CQ et al. Atractylenolide I and atractylenolide III inhibit Lipopolysaccharide-induced TNF-alpha and NO production in macrophages. Phytother Res. 2007 Apr;21(4):347-53. doi: 10.1002/ptr.2040. PMID: 17221938.
- Jeong D et al. Anti-Inflammatory Compounds from Atractylodes macrocephala. Molecules. 2019; 24(10):1859. doi.org/10.3390/molecules24101859
- Chen J, Chen T. Chinese Medical Herbology and Pharmacology. Art of Medicine Press; 2004.