Educational information, not medical advice — ask your doctor or midwife.
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Kihito is a Japanese Kampo herbal formula. It is sold in Japan as an approved medicine, Tsumura 65. Its old name in English is Spleen-Restoring Decoction.
It is chosen for people who are worn out, worried and sleeping badly. Kampo doctors also use it for poor appetite, pale skin and anemia (low red blood cells). The classic picture is weak digestion plus an overworked mind.
Here is the evidence in one line. The formula has centuries of traditional use behind it. Good human trials are scarce, and traditional use is not proof that a remedy works.
One safety point belongs up front. Kihito contains licorice root (kanzo), and it contains Polygala root (onji). Both carry known risks, and the safety section below explains them.
The honest answer is that no one has shown how Kihito works in the body.
Kampo explains it in its own language. The formula is said to build "qi" (vital energy) and "blood", and to settle the mind. These are traditional ideas, not measured body functions.
Modern research is mostly in cells and animals. In animal work, ginseng and Polygala (onji) extracts appear to act on stress and memory pathways. Whether that happens in people who take Kihito is not established.
One effect is well proven in people, and it is a side effect. Licorice blocks an enzyme in the kidney (a protein that drives a body reaction). That can push potassium down and blood pressure up over time.
In Japan the usual form is a dried extract granule in single-dose sachets. Tablets and capsules of the same extract are also made. Both are taken with warm water.
Traditional practice boils the raw herbs into a decoction (a strong tea). This is less common today outside specialist clinics.
Products sold outside Japan vary a lot in strength and in how much licorice they hold. Check the label for the licorice (kanzo or Glycyrrhiza) amount before you buy.
Kihito comes from a Chinese text, Jisheng Fang, written by Yan Yonghe in 1253. The original name is Guipi Tang. It was built for tiredness, poor appetite and a restless mind.
Later Chinese doctors added Bupleurum and Gardenia to make a related formula. In Japan that version is called Kamikihito.
Japanese Kampo took up the base formula as Kihito. It is now a ministry-approved prescription formula in Japan, numbered Tsumura 65. The same recipe is still used in Chinese and Korean practice.
Stop taking it and see a doctor the same day if you notice muscle weakness, cramps, or a heavy, tired feeling in your legs. These can be signs that your potassium has fallen.
Get urgent help for a fast, slow or irregular heartbeat, or for sudden swelling and weight gain.
Stop and get checked if you have lasting nausea, pain under your right ribs, dark urine, or yellow skin or eyes. These can point to a liver problem.
See a doctor if your blood pressure readings climb, or if your symptoms have not changed after about four weeks. Also see a doctor for new anemia (low red blood cells), rather than treating it yourself.
Evidence grades and traditional-use labels are explained in our methodology. Nothing here is medical advice.
Reviewed by the HealisticMD editorial team How we grade evidence →
The published evidence for Kihito is weak or absent. That usually means no controlled trial has tested it, not that a trial found it ineffective — the two are different, and we grade only what has been published.
What it is typically used for, usual dose, cautions, and the study behind it where real trial data exists.
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