Zhen Gan Xi Feng Tang
Do not self-treat with Zhen Gan Xi Feng Tang
If this is an emergency
Some reactions to Zhen Gan Xi Feng Tang need urgent care. Call your local emergency number or go to an emergency department straight away — do not wait to see whether it passes.
Who should avoid Zhen Gan Xi Feng Tang?
- Do not use if you are pregnant, trying to become pregnant, or breastfeeding.
- Do not use if you have any liver disease, hepatitis (swelling of the liver), or have ever had liver injury from a drug or herb.
- Do not use if you have kidney disease.
- Do not use if you have heart failure, an odd or fast heartbeat, or low potassium (a salt your heart and muscles need).
- Do not use if you take digoxin, a water pill (diuretic), warfarin or any other blood thinner.
- Do not use if you take blood pressure tablets, steroid tablets or thyroid tablets, unless your doctor has approved it and is checking you.
- Do not use if you take a medicine that can stress the liver, such as methotrexate or isoniazid.
- Do not use if you have high blood pressure that is not under control, or swelling in your legs.
- Do not use if you are allergic to shellfish, as the formula contains oyster shell.
- Do not give it to a child.
- Never use it to treat a suspected stroke, a sudden severe headache or sudden weakness. Call emergency services instead.
- Do not use a product unless the seller can show lab tests for lead, arsenic and mercury, because the formula contains mineral ores.
When should you see a doctor?
Call emergency services at once if you have sudden weakness on one side, a drooping face, slurred speech, sudden loss of vision, or the worst headache of your life. These are signs of a stroke and every minute counts.
Stop the formula and see a doctor the same day if your skin or the whites of your eyes turn yellow, your urine goes dark, you have pain under your right ribs, or you feel very tired for no reason. These can be signs of liver injury.
See a doctor soon if your ankles or face swell, your blood pressure climbs, you feel weak or crampy, or your heartbeat feels odd. Also see a doctor if dizziness, headache or ringing in the ears is new, getting worse, or only on one side.
- What it is: A classic Chinese herb and mineral formula, treated as a single drug, used for dizziness, headache and ringing in the ears.
- Active ingredients: Hematite (iron ore), Dragon bone, Oyster shell, Achyranthes root, Turtle shell, Scrophularia root, Asparagus root, White peony root, Yin chen hao, Chuan lian zi, Barley sprout, Licorice root
- Side effects: Gut upset is common; swelling, high blood pressure, low potassium and liver injury are the serious risks.
- Pregnancy & breastfeeding: Avoid in pregnancy and while breastfeeding.
Educational information, not medical advice — ask your doctor or midwife.
What is Zhen Gan Xi Feng Tang?
Zhen Gan Xi Feng Tang is an old Chinese herb formula. The name is often given in English as Sedate the Liver and Extinguish Wind Decoction. It is used for dizziness, throbbing headache, ringing in the ears and a hot, red face.
It is handled as a single drug, though it holds about twelve herbs and minerals. Chinese medicine gives it for a pattern it calls rising liver yang. That is an idea from within that system, not a Western test result.
The honest verdict: we could not find sound published trials in people. Two of its parts, licorice and chuan lian zi, can cause real harm. Long use in a tradition is not proof that a remedy works.
How does Zhen Gan Xi Feng Tang work?
No one has shown how this formula acts in the body. The idea within Chinese medicine is that heavy minerals pull rising energy back down, while cooling, moist herbs settle the heat behind it.
A few parts do have known drug-like effects. Licorice can make the body hold salt and water, which raises blood pressure and drops potassium (a salt your heart and muscles need). Hematite, dragon bone and oyster shell are minerals that can bind other drugs in the gut and block them.
Lab and animal work on single herbs cannot tell us what the whole boiled mix does in a person. Treat any story about the mechanism as an idea, not a finding.
What forms does Zhen Gan Xi Feng Tang come in?
You will meet it in four main forms.
The first is loose raw herbs, boiled at home into a decoction (a strong boiled tea). The second is granules or powder that you stir into hot water. The third is ready-made pills or tablets.
Some shops sell liquid extracts too. Quality varies a lot between brands. Because the mix holds mineral ores, ask the seller for lab tests showing low lead, arsenic and mercury.
Where it comes from:
A Chinese doctor named Zhang Xichun wrote this formula in the early 1900s. It appeared in his book Yi Xue Zhong Zhong Can Xi Lu, printed between 1918 and 1934. He was trying to blend Chinese herb practice with the Western medical ideas of his day.
He aimed it at people with pounding headache, dizziness and a flushed face, and at some people after a stroke. Schools took it up fast.
It is now a set piece in Chinese medicine teaching and the model formula for calming what that system calls liver wind. That gives it a firm place in one tradition.
What does Zhen Gan Xi Feng Tang help with?
- Dizziness and spinning feelings (vertigo): This is the classic use. Herbalists pick it when dizziness comes with a red face, a tight head and a pounding pulse. We could not find a trial in people that we are confident enough to cite, so this rests on tradition alone.
- Throbbing headache: Used for headache felt at the top or sides of the head, often with tension in the neck. Tradition is strong here. Published human evidence that we can verify is absent.
- Ringing in the ears (tinnitus): Given when ringing is loud, sudden and comes with dizziness. There is no trial evidence we can point to. New or one-sided ringing needs a doctor, not a herb.
- High blood pressure, in a Chinese medicine pattern: Often used in China alongside blood pressure drugs. Be careful: the formula contains licorice, which can push blood pressure up and drop potassium. Never swap it for your prescribed tablets, and do not use it to manage blood pressure without your doctor watching your readings.
- Flushed, hot face and red eyes: Seen as a sign of the pattern the formula targets rather than a problem on its own. Traditional use only. No human trial evidence.
- Irritability and poor sleep: The mineral parts are said to settle the mind. Dragon bone and oyster shell are used this way across many Chinese formulas. No trial in people supports this for this mix.
- Numbness, shaking or stiffness of the limbs: These signs are read as liver wind in Chinese medicine. They can also be signs of serious nerve or brain illness. Get them checked by a doctor first.
- After-effects of a stroke: Zhang Xichun described using it after a stroke, and it is still used that way in some Chinese hospitals as an add-on. We found no trial we can cite with confidence. A stroke is a medical emergency and self-treatment is not safe.
What are the side effects of Zhen Gan Xi Feng Tang?
- Loose stools or diarrhoea
- Stomach ache or nausea
- Poor appetite
- Swollen ankles, hands or face
- Rising blood pressure
- Low potassium (a salt your heart and muscles need), causing weakness, cramps or an odd heartbeat
- Headache or dizziness that gets worse
- Liver injury, with yellow skin or eyes, dark urine, pain under the right ribs or deep tiredness
- Allergic rash, itching or swelling
- Build-up of lead, arsenic or mercury from poorly tested mineral products
Good to know:
Mild gut upset is the most common complaint. It usually settles when the dose is lowered.
The serious risks are not common but they are real. Licorice can cause swelling, high blood pressure and low potassium. Chuan lian zi has been linked to liver injury.
Mineral ores can carry heavy metals if the maker does not test them. Buy only from a supplier who shows test results.
Options to discuss with a clinician
For every one of the problems this formula is reached for, there are routes with far better safety data behind them — and each one belongs in a conversation with a doctor, pharmacist or qualified herbalist rather than being swapped in on your own.
- **Raised blood pressure:** readings this high need a clinician's eye first, because the cause changes what helps. Things worth asking about include the DASH Diet (an eating pattern studied for blood pressure), Hibiscus Tea, Beetroot extract, Aged Garlic Extract, Potassium and Magnesium — alongside, not in place of, any prescribed treatment. - **After-effects of a stroke:** this is firmly specialist territory. Ask your stroke team where supervised rehabilitation fits, and whether gentle movement work such as Tai Chi or Pilates suits your stage of recovery. - **Dizziness, spinning feelings or unsteadiness:** vertigo has many causes, some needing urgent assessment. Raise Ginger for the nausea side of it, and ask whether Ginkgo biloba or Gastrodin have been studied for your particular pattern. - **Irritability, poor sleep, tension headache:** Cognitive Behavioral Therapy, CBT-based Mindfulness (MBSR/MBCT), Music Therapy, 4-7-8 Breathing, Magnesium or Melatonin are all reasonable things to put to your GP.
Any new headache pattern, or ringing in one ear only, should be checked promptly.
Graded pages for the options named above:
- CBT-based Mindfulness (MBSR/MBCT) — evidence grade A, traditional tier T0
- Cognitive Behavioral Therapy — evidence grade A, traditional tier T0
- Aged Garlic Extract — evidence grade A, traditional tier T0
- Beetroot extract — evidence grade A, traditional tier T1
- 4-7-8 Breathing — evidence grade C, traditional tier T0
- Ginkgo biloba — evidence grade B, traditional tier T2
- Music Therapy — evidence grade A, traditional tier T1
- Hibiscus Tea — evidence grade A, traditional tier T2
- DASH Diet — evidence grade A, traditional tier T0
- Gastrodin — evidence grade C, traditional tier T0
- Magnesium — evidence grade A, traditional tier T0
- Melatonin — evidence grade A, traditional tier T0
- Potassium — evidence grade A, traditional tier T0
- Pilates — evidence grade A, traditional tier T0
- Tai Chi — evidence grade A, traditional tier T2
- Ginger — evidence grade A, traditional tier T3
Review status
This page has not been signed off by a pharmacist and is not published. It is shown here for a policy decision only.