Schisandra

Schisandra chinensis (Turcz.) Baill. belongs to the family Schisandraceae in the order Austrobaileyales. Kew’s Plants of the World Online records that it was first described by Turczaninow in 1837 as Kadsura chinensis and moved to Schisandra by Baillon in his Histoire des Plantes of 1868, and that older names such as Maximowiczia amurensis and Sphaerostema japonicum are now synonyms. Kew gives its native range as the Russian Far East (Amur, Khabarovsk, Primorye, and Sakhalin), northern China (Manchuria, Inner Mongolia, and North-Central China), Korea, and Japan, and describes it as a climber of the temperate biome. The Flora of China places it in ravines, on slopes, and along rivers at 1,200–1,700 m in Hebei, Heilongjiang, Jilin, Liaoning, Inner Mongolia, and Shanxi, and WHO adds the Kuril Islands. Sources differ on the size of the genus: Szopa and colleagues (Phytochemistry Reviews 2017) count 20 to 30 species, all in East and Southeast Asia except Schisandra glabra of the southeastern United States, while a 2015 HerbalGram profile counts 19, of which 12 are found only in China.

This is a deciduous woody vine that WHO describes as climbing up to 8 m long, twining up trees and shrubs at forest edges. The Flora of China describes its leaves as elliptic to obovate, usually 4.5–8 cm long, thin, and finely toothed, on stalks up to 4 cm. In May to July, single flowers hang from the leaf axils at the base of new shoots, each with five to nine waxy tepals that are white to yellow or, in WHO’s description, yellowish-white to pinkish. Flowers are either male, with about five stamens, or female, with 14 to 40 carpels; WHO and Szopa describe the species as dioecious, with the sexes on separate plants, whereas HerbalGram calls it monoecious, so sources disagree. After flowering, the receptacle at the center of the female flower lengthens into a spike 1.5–9.5 cm long carrying small pinkish-red to red berries 5–7.5 mm across, which ripen from July to September, and Szopa likens the clusters to bunches of grapes. Each berry holds one or two smooth, kidney-shaped seeds. WHO notes that the pulp tastes sour and the seeds pungent and slightly bitter, with an aromatic smell when crushed. The Flora of China adds that the fruit is edible and the stems were used to make rope.

Northern schisandra has a southern relative. Schisandra sphenanthera, nan wu wei zi or southern schisandra, grows in broad-leaved forests of central and southern China at 700–2,000 m, and HerbalGram explains that traditional Chinese medicine uses the two interchangeably, calling the northern fruit bei wu wei zi. The Chinese Pharmacopoeia nonetheless carries separate quality standards for each, while the European, Japanese, Korean, and US pharmacopoeial standards and WHO’s monograph cover only S. chinensis (HerbalGram). The dried fruits look alike; Szopa notes that southern fruits can be told apart under the microscope by oil cells and crystals in the fruit wall, and that the two species differ in chemistry. The European Pharmacopoeia defines schisandra fruit as the whole dried, or steamed and dried, ripe fruit of S. chinensis with at least 0.40% schisandrin (as summarized by the European Food Safety Authority in 2024). The signature compounds are dibenzocyclooctadiene lignans, about 30 in all according to WHO, chiefly schisandrin (also called schisandrol A; PubChem CID 3001664, C24H32O7), gomisin A, deoxyschisandrin (schisandrin A), and γ-schisandrin (schisandrin B). Southern schisandra is richer in schisantherins, and Wuzhi tablets are standardized to schisantherin A.

Schisandra’s Chinese history is long. HerbalGram reports that its first recorded use is in the Shen Nong Ben Cao Jing, the Divine Husbandman’s Classic of Materia Medica, which counted it among the superior medicines thought to “prolong life without aging,” and credited it with raising energy, treating cough and fatigue, and serving as a male tonic. Szopa and colleagues add that Li Shizhen described the plant in his great herbal of 1596, the Bencao Gangmu. The name wu wei zi is a description of taste: HerbalGram explains that the skin and pulp are sweet and sour, the seed pungent and bitter, and the fruit as a whole salty, so that the berry was regarded as perfectly balanced. Traditional Chinese practice classed it as a warming herb acting on the heart, lungs, and kidneys, and used it for chronic cough and asthma, night sweats and spontaneous sweating, chronic diarrhea, frequent urination, insomnia, and palpitations. In Japan the fruit is known as gomishi and appears in Kampo formulas, which Iwata and colleagues (Drug Metabolism and Disposition 2004) note use it as a sedative, cough remedy, and general tonic.

Its reputation as a stamina herb came from the far north. HerbalGram, drawing on Panossian and Wikman’s 2008 review of Russian research, reports that Nanai hunters in the Russian Far East used the berries to improve stamina and night vision and to reduce hunger and thirst, and that Soviet research between 1940 and 1960 followed up these uses. Panossian and Wikman (Journal of Ethnopharmacology 2008) write that schisandra first gained recognition as an adaptogen in the official medicine of the USSR in the early 1960s and was included in the national pharmacopoeia. WHO’s monograph summarizes some of that work: an extract improved the accuracy of telegraph operators by 22%, a single 3 g dose of the fruit improved vision in dim light in 134 healthy people, and athletes reported less fatigue on 1.5–6 g a day, although WHO notes that many such studies were uncontrolled. The word adaptogen itself was coined by the Soviet scientist N. V. Lazarev in 1947 (EMA), and EMA’s herbal committee concluded in 2008 that the concept still needed clarification and that the clinical studies had a number of shortcomings.

Elsewhere the berry is food as much as medicine. In Korea, omija is consumed as a tea and a wine whose pinkish-red color comes mainly from a single anthocyanin pigment, a cyanidin glycoside (Kim and colleagues, Journal of Food Science 2009). Western standards arrived late: the American Herbal Pharmacopoeia published a monograph in 1999 (HerbalGram), WHO followed in 2007, and the European Pharmacopoeia added the fruit in 2008 (Szopa). HerbalGram reports that the berries count as an established food in the European Union, that Sweden granted traditional herbal registrations in 2013 to two Swedish Herbal Institute products combining schisandra, eleuthero, and rhodiola, labeled as “traditionally used as an adaptogen in case of reduced performance ability such as tiredness and fatigue,” and that schisandra is sold as a dietary supplement in the United States. The wild harvest has a conservation side: in the Russian Far East, berries collected from tiger habitat have been marketed under a “Tiger Friendly” certification, and in China a project in giant panda country set up a village cooperative selling certified wild southern schisandra.

Most mechanistic research centers on the liver, and almost all of it is in animals or cells. WHO summarizes studies in which lignan-rich schisandra extracts given by mouth protected rats from liver damage caused by carbon tetrachloride, a classic liver poison, while preserving glutathione, one of the liver’s main antioxidant defenses. Gomisin A sped liver regrowth after partial removal in rats, and schisandrin B raised glutathione inside liver mitochondria in mice and protected them against several toxins. A 2025 meta-analysis by Huang and colleagues (Frontiers in Pharmacology) pooled 54 animal studies of schisandra in liver injury and found large falls in the liver enzymes ALT and AST, less oxidative damage, and lower inflammatory messengers such as TNF-α and IL-6, but the results varied widely between studies, and the authors called for further research to confirm efficacy and safety. Mu and colleagues (Journal of Pharmacology and Experimental Therapeutics 2006) showed that schisandra lignans switch on the pregnane X receptor (PXR), a sensor that turns up the liver’s detoxifying enzymes, which they proposed as one explanation for its protective effects.

Enzyme-lowering is the property that drew Chinese chemists. WHO cites Chinese studies from the 1970s that searched the fruit for the compounds responsible for lowering raised SGPT (ALT) levels in animals poisoned with liver toxins. Szopa and colleagues report that the most successful product of this work was a synthetic analogue of schisandrin C known as DDB, or bifendate (PubChem CID 108213), which they describe as a potent liver-protective drug used for chronic viral hepatitis and chemical or drug-induced liver damage and sold in South Korea, Vietnam, and Myanmar. Bifendate is a drug, not schisandra, and taking the berry is not the same as taking it. MSKCC notes that schisandra itself can reduce ALT and AST on laboratory tests without changing bilirubin. Liver enzymes are an indirect measure, and a falling number does not by itself show that the liver is less inflamed or less scarred. In WHO’s account of a Chinese hepatitis B trial, enzyme levels rose again within weeks of stopping schisandra.

The same lignans act on the body’s drug-handling machinery, which explains the interactions. In human liver tissue, gomisin C blocked CYP3A4, one of the main enzymes that break down medicines, even more potently than the antifungal ketoconazole, and inactivated it irreversibly (Iwata and colleagues 2004). Short- and long-term exposure behave differently: in rats, a single dose of schisandra lignans inhibited CYP3A, but several weeks of treatment raised CYP3A protein 2.5-fold in the liver and 4-fold in the gut and sped midazolam clearance, a net inducing effect (Lai and colleagues, Drug Metabolism and Disposition 2009). In people, schisandra extract also inhibited P-glycoprotein, a pump that pushes drugs back out of gut cells (Fan and colleagues, Xenobiotica 2009). Supporters of the adaptogen idea propose broader actions: Panossian and Wikman describe effects on nitric oxide and the stress hormone cortisol, and WHO reports an eight-day trial in which a standardized extract raised resting nitric oxide in athletes’ saliva without changing other measures. These are hypotheses rather than explanations of a proven effect in people.

No major agency recognizes a medical use for schisandra. WHO’s 2007 monograph lists no uses supported by clinical data, noting that some clinical evidence for psychosis, gastritis, hepatitis, and fatigue comes without controlled trials, while it records pharmacopoeial uses for chronic cough and asthma, diabetes, and urinary complaints, and as a general tonic for fatigue after illness. MSKCC (2022) describes the human studies as few and too limited to draw conclusions, and lists traditional uses for cough, diarrhea, indigestion, liver disease, strength and stamina, and sweating. EMA has no monograph on the herb. RxList, which draws on the Natural Medicines database, is slightly more generous, rating schisandra possibly effective for mental performance and for lowering liver enzymes in hepatitis, and finding insufficient evidence for exercise performance and many other uses. The common thread is that the published trials are small and short, usually test a single branded extract, and frequently mix schisandra with other ingredients, so most claims rest on tradition, animal research, and Soviet-era studies that would not meet modern standards.

For strength and stamina, the newest trials are Korean and small. Cho and colleagues (American Journal of Clinical Nutrition 2021) randomized 54 adults over 50 with relatively low muscle mass, all asked to walk 30–60 minutes at least three days a week, to 1 g of schisandra extract a day or placebo for 12 weeks. Knee-extension strength rose more with schisandra, by 10.2 newton-meters on the right and 6.7 on the left, but muscle mass, inflammatory and antioxidant markers, and quality-of-life scores did not differ, and no one reported adverse events. Park and colleagues (International Journal of Environmental Research and Public Health 2020) gave 45 postmenopausal women 1,000 mg of extract or starch for 12 weeks and reported better quadriceps strength and lower resting lactate with schisandra, with no differences in other measures. These are encouraging but modest signals, and both trials were small and short and measured strength rather than everyday tiredness. The Soviet studies of athletes, soldiers, and airline crews that WHO summarizes were mostly uncontrolled.

Several trials tested ADAPT-232, a Swedish Herbal Institute blend of rhodiola, schisandra, and eleuthero extracts in which schisandra makes up about half (HerbalGram). Aslanyan and colleagues (Phytomedicine 2010) gave 40 women who had felt stressed for a long time a single 270 mg tablet or placebo; two hours later the ADAPT-232 group scored better for attention, speed, and accuracy on a standard concentration test, with minor sleepiness and cold hands or feet reported in both groups. In 60 adults with pneumonia receiving antibiotics, adding the liquid version, Chisan, for 10–15 days shortened antibiotic treatment by about two days and improved quality-of-life scores (Narimanian and colleagues, Phytomedicine 2005). Both were small pilot studies with overlapping authors, and as HerbalGram notes, results from combinations cannot be credited to schisandra alone. They are better read as evidence for one specific product than for schisandra berries or capsules in general.

Menopause has one dedicated trial. Park and Kim (Climacteric 2016) randomized Korean women aged 40 to 70 with menopausal symptoms to a schisandra extract called BMO-30 or placebo for six weeks, then followed them to week 12. Of 41 eligible women, 36 completed the study, 18 in each group. Scores on the Kupperman Index, a standard menopausal symptom scale, fell more with schisandra over time (p = 0.042), and the authors highlighted hot flushes, sweating, and palpitations. MSKCC cites the study as suggesting help for menopausal symptoms. It is a single small trial of one product, run for a short time, with no comparison against hormone therapy or other established treatments. In a separate 12-week trial in 28 Korean women with obesity, schisandra fruit shifted gut bacteria but did not change weight, fat mass, blood sugar, or blood fats significantly compared with placebo (Song and colleagues, Nutrition Research 2015).

Liver results are older or mixed with other ingredients. WHO describes Chinese reports of more than 5,000 hepatitis patients whose liver enzymes fell on schisandra preparations, but stresses that these were uncontrolled observations of questionable method. In a controlled trial of 189 people with chronic hepatitis B, an extract containing 20 mg of lignans, about 1.5 g of fruit, normalized SGPT in 68% after four weeks, versus 44% of those given liver extracts and vitamins, but levels rose again 6–12 weeks after treatment stopped. More recently, Chiu and colleagues (Phytotherapy Research 2013) gave 40 adults with borderline-high ALT or AST (40–60 U/L) a tablet combining schisandra extract with sesamin from sesame seeds, or placebo, for five months; ALT and AST fell and fatty liver improved, but sesamin makes it impossible to isolate schisandra’s part. MSKCC notes improvements in fatty liver disease and hepatitis C only when schisandra was combined with other substances, and in liver transplant patients liver function improved alongside Wuzhi, which also raised tacrolimus levels (Jiang and colleagues 2010). Schisandra is not a treatment for hepatitis, fatty liver disease, or cirrhosis.

Schisandra is sold as whole or crushed dried berries, powders, tinctures, teas, and capsules or tablets of extracts. WHO gives an average daily dose of 1.5–6 g of the dried fruit, taken from the Chinese Pharmacopoeia. RxList lists doses used in research of 500 mg to 2 g of extract or 1.5–6 g of crude fruit a day, or 5–15 g of fruit boiled as a tea. Trials used defined products: 1 g of extract a day for 12 weeks in the two Korean strength studies, a single 270 mg tablet of ADAPT-232 in the attention study, and in the hepatitis B trial an ethanol extract containing 20 mg of lignans, equivalent to about 1.5 g of fruit. Lignan content varies a great deal with ripeness, harvest time, and growing site, and Szopa and colleagues give a range of roughly 4% to 19% of the dried fruit. The European Pharmacopoeia sets a minimum of 0.40% schisandrin for the fruit, so a product that names Schisandra chinensis fruit and states a lignan or schisandrin content is easier to compare with the research.

Northern and southern schisandra are not the same product, even when both are sold as schisandra. HerbalGram notes that both are traded under the same common name, and that traditional Chinese medicine treats them as interchangeable. Wuzhi, sold in China as tablets or capsules, is a prescription medicine made from an ethanol extract of southern schisandra, which HerbalGram describes as containing 7.5 mg of schisantherin A per tablet. Zhang and colleagues (Therapeutic Drug Monitoring 2024) describe Wuzhi capsules as widely used in China for drug-induced hepatitis and liver dysfunction, and as usually prescribed there to raise tacrolimus levels. Wuzhi is not a supplement, and its interaction data should be taken seriously for any schisandra product. Combination products add their own herbs: ADAPT-232, sold in Sweden as Chisan and Chisandra, also contains rhodiola and eleuthero, each with its own cautions, and the liver studies described above paired schisandra with sesamin or with silymarin from milk thistle and other antioxidants.

Practical points: if you want to try schisandra, the gentlest way is as a food, such as Korean omija tea made from the dried berries, rather than as a concentrated extract. Choose a product that names Schisandra chinensis fruit, and be aware that a product labeled southern schisandra or S. sphenanthera may act more strongly on drug-clearing enzymes. Stop if heartburn, stomach pain, or a rash appears. Before starting, ask a pharmacist to check every prescription medicine you take, and do not use it at all alongside tacrolimus, cyclosporine, or other transplant drugs unless your transplant team is directing it. Because schisandra raised blood levels of the sedative midazolam in healthy volunteers, tell your surgical or endoscopy team about it before any procedure. Avoid it in pregnancy and while breastfeeding, as WHO advises. If you have liver disease, talk to your specialist first, and keep in mind that schisandra can lower liver enzyme results without that meaning your liver is healthier.