Gui Pi Tang
Specifically for Alzheimer's
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Why it works for Alzheimer's:
TCM rationale. Gui Pi Tang (GPT) “tonifies Spleen-Qi and Heart-Blood” and “calms the Shen,” traditionally used for poor memory, insomnia, anxiety, fatigue and palpitations—symptom clusters common in dementia care. ajtcvm.org
Modern hypotheses (by components & related formulas).
Research on GPT/Kihito/Kamikihito points to several plausible—but not yet definitive—mechanisms relevant to dementia care:
- Cholinergic support & neuroprotection (preclinical): Kamiguibi-tang has been reported to increase choline acetyltransferase and reduce hippocampal Aβ-related injury in animal models. Home
- Network effects from multi-herb synergy: analytical chemistry shows GPT is a 12-herb mix with diverse phytochemicals affecting inflammation, stress and neurotransmission. ScienceDirect
- Symptom focus (BPSD): In AD care, managing anxiety, agitation and sleep disruption is critical; an observer-blind randomized study found Jia-Wei-Gui-Pi-Tang (the augmented version) improved BPSD and positive emotions versus control, aligning with its approved indication for anxiety in Japan. Europe PMC
- Broader TCM-in-AD context: recent reviews summarize multiple TCM approaches for AD/memory impairment, but emphasize the need for larger, higher-quality trials. ScienceDirect
How to use for Alzheimer's:
Which product?
- Gui Pi Tang (Kihito, 帰脾湯) – the classical base formula.
- Jia-Wei-Gui-Pi-Tang / Kamikihito (加味帰脾湯) – “augmented” version commonly studied in dementia settings.
Typical Kampo dosing (Japan; standardized extracts):
- Kihito (Gui Pi Tang): Usual adult dose 7.5 g/day extract granules in 2–3 divided doses before or between meals; adjust per age/weight/symptoms. Package-insert standard. tsumura.co.jp
- Kamikihito (Jia-Wei-Gui-Pi-Tang): same 7.5 g/day in 2–3 divided doses (e.g., Tsumura TJ-137). tsumura.co.jp
Who seems most likely to benefit (based on trials):
- Patients with BPSD (anxiety, agitation, insomnia) in AD or mixed dementia → consider Jia-Wei-Gui-Pi-Tang / Kamikihito alongside standard care. Europe PMC
- Predementia / aMCI → small RCTs and protocols evaluate KGT (Kamikihito); signals are stronger in MCI than established AD. BioMed Central
Monitoring & coordination:
- Start with low end of dosing; review blood pressure, potassium, INR if on anticoagulants; track sleep, agitation, caregiver burden and cognitive batteries at baseline and every 8–12 weeks. Package inserts and clinical protocols stress tailoring to patient status. tsumura.co.jp
Scientific Evidence for Alzheimer's:
Behavioural symptoms in dementia (BPSD):
- Observer-blind multicentre randomized controlled study (Japan): Jia-Wei-Gui-Pi-Tang improved BPSD and positive emotions vs. usual care in AD/mixed dementia (n≈63 reported in registry). Peer-reviewed in Psychogeriatrics (2023) with trial registration UMIN000045650. Europe PMC
Cognition:
- Mild AD—add-on pilot RCT (2018–2020; Korea): KGT (Kamikihito) + AChEI vs placebo + AChEI for 24 weeks (n=14 completers). Primary cognitive outcome not improved vs placebo; no KGT-related adverse events reported. Evidence-Based Complementary and Alternative Medicine (2023). Home
- aMCI (predementia) pilot RCT (Korea): KGT showed memory and global cognitive improvements vs placebo; led to a registered phase III double-blind trial protocol. BMC Complementary Medicine and Therapies (2021, 2022). BioMed Central
- Open-label / crossover (Japan): Kihito (Gui Pi Tang) improved certain cognitive tests in AD; non-blinded designs limit certainty. Evid-Based Complement Altern Med (2019). Wiley Online Library
Specific Warnings for Alzheimer's:
Because Gui Pi Tang–type formulas are polyherbal, screen for condition- and drug-specific risks tied to their constituents:
- Licorice (Glycyrrhiza / Zhi Gan Cao) in GPT can raise blood pressure, cause hypokalemia and fluid retention, and counteract antihypertensives—use caution in cardiovascular/renal disease. Memorial Sloan Kettering Cancer Center
- Angelica sinensis (Dang Gui) may potentiate warfarin (case reports/PK data); bleeding risk—avoid or monitor INR closely. SAGE Journals
- Ginseng (Ren Shen) has many drug interactions and may affect warfarin; monitor if combined with anticoagulants/antiplatelets or stimulants. Memorial Sloan Kettering Cancer Center
- Polygala (Yuan Zhi): limited human data; watch for GI irritation and sedative/psychoactive interactions (caution with antidepressants, antipsychotics, sedatives). SelfDecode Supplements
- General Kampo precautions (official inserts): dose-related GI upset; tailor to patient “pattern;” take before or between meals; adjust for age/weight; clinician supervision recommended. tsumura.co.jp
Elderly/complex polypharmacy: Review full medication list (especially anticoagulants, anti-hypertensives, diuretics, psychotropics), electrolytes, BP, and renal function periodically. Consider using standardized Kampo extracts (e.g., Tsumura) for dose consistency. tsumura.co.jp
General Information (All Ailments)
What It Is
Gui Pi Tang, which translates as Restore the Spleen Decoction, is a classical herbal formula from traditional Chinese medicine. It was first recorded in the Ji Sheng Fang (Formulas to Aid the Living) during the Song Dynasty. The formula combines herbs that tonify both Qi (vital energy) and Blood, strengthen the Spleen and Heart, and calm the Shen (spirit).
The standard composition typically includes herbs such as:
- Ren Shen (Ginseng) or Dang Shen (Codonopsis) – tonifies Qi
- Huang Qi (Astragalus) – strengthens Spleen and raises Yang
- Bai Zhu (Atractylodes) – supports digestion and Spleen function
- Fu Ling (Poria) – drains dampness and supports the Spleen
- Suan Zao Ren (Ziziphus seed) and Long Yan Rou (Longan fruit) – nourish Heart Blood and calm the spirit
- Dang Gui (Angelica sinensis) – nourishes Blood
- Mu Xiang (Aucklandia) – promotes Qi movement to prevent stagnation from tonics
- Zhi Gan Cao (Honey-fried Licorice) – harmonizes the formula
- Sometimes Yuan Zhi (Polygala) is added to enhance calming of the mind
It is commonly prescribed for people experiencing fatigue, poor memory, insomnia, palpitations, anxiety, or menstrual irregularities — symptoms that arise from Spleen Qi deficiency and Heart Blood deficiency.
How It Works
In the TCM framework, the Spleen governs transformation of food into Qi and Blood, while the Heart governs Blood circulation and mental activity. When the Spleen is weak, it cannot generate sufficient Blood; when the Heart is under-nourished, emotional and cognitive symptoms arise.
Gui Pi Tang works through multiple synergistic actions:
- Tonifying Spleen Qi: Ginseng, Astragalus, and Atractylodes enhance digestive function and energy production, helping to rebuild Qi and support nutrient assimilation.
- Nourishing Heart Blood: Angelica sinensis, Longan fruit, and Ziziphus seed replenish Blood and moisten dryness that may disturb the Heart.
- Calming the Shen: The combined action of nourishing Blood and using tranquilizing herbs like Suan Zao Ren settles the mind, reducing anxiety and improving sleep.
- Harmonizing and Circulating Qi: Mu Xiang ensures that the rich tonic herbs do not cause stagnation or digestive heaviness, maintaining smooth Qi flow.
- Supporting overall vitality: The interaction of Qi and Blood tonics restores balance, leading to improved focus, emotional stability, and resilience to stress.
From a modern biomedical view, research suggests Gui Pi Tang may influence the nervous system, endocrine regulation, and immune modulation, possibly explaining its calming, adaptogenic, and restorative effects.
Why It’s Important
Gui Pi Tang is important because it addresses a common TCM pattern known as Spleen-Heart deficiency, which manifests in physical exhaustion and emotional fragility. It has been widely used for:
- Chronic fatigue and weakness from overwork or stress
- Insomnia, poor memory, and anxiety due to mental strain
- Palpitations or irregular menstruation from Blood deficiency
- Recovery support after illness, childbirth, or prolonged mental exertion
By strengthening both Qi and Blood, the formula nourishes the foundation of vitality and supports the integration of body and mind. It remains a cornerstone prescription for individuals who feel “drained,” “forgetful,” or “on edge” from both physical and emotional overuse.
Considerations
While Gui Pi Tang is gentle and restorative, several considerations apply:
- Pattern Differentiation: It should be used only when signs clearly indicate Spleen Qi and Heart Blood deficiency (e.g., fatigue, pale complexion, poor appetite, weak pulse). It is not suitable for conditions involving excess heat, dampness accumulation, or acute infections.
- Individualization: Dosage and specific herb substitutions (e.g., Ginseng vs. Codonopsis) should be tailored by a licensed practitioner to the person’s constitution and current symptoms.
- Duration of Use: The formula is designed for gradual, tonic support, not rapid symptom relief. It may be used for several weeks or months under supervision.
- Possible Side Effects: Rarely, if taken in excess or in individuals with sluggish digestion, it may cause bloating or fullness due to its tonifying nature.
- Modern Interactions: As it may affect energy metabolism and stress response, it should be used cautiously alongside stimulants, antidepressants, or immune-modulating drugs; consultation with a qualified healthcare provider is advised.
- Lifestyle Integration: For best results, users are encouraged to combine it with rest, proper diet (warm, easily digestible foods), and balanced emotional habits — all of which reinforce the Spleen’s role in TCM physiology.
Helps with these conditions
Gui Pi Tang is most effective for general wellness support with emerging research . The effectiveness varies by condition based on clinical evidence and user experiences.
Detailed Information by Condition
Alzheimer's
TCM rationale. Gui Pi Tang (GPT) “tonifies Spleen-Qi and Heart-Blood” and “calms the Shen,” traditionally used for poor memory, insomnia, anxiety, fat...
Anemia (Iron-Deficiency)
TCM rationale: Gui Pi Tang “augments Qi, nourishes Blood, strengthens the Spleen, and nourishes the Heart,” patterns that often co-present with fatigu...
Brain Fog
TCM pattern logic. Brain fog often overlaps with poor concentration, forgetfulness, fatigue, insomnia, and anxiety. In TCM this commonly maps to Splee...
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