Jia Wei Xiao Yao San
Specifically for Fibroids
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Why it works for Fibroids:
Pattern-based fit in TCM: The formula “harmonizes Liver and Spleen,” nourishes Blood, moves Qi, and clears heat (due to the “jia wei/dan-zhi” additions Mu Dan Pi and Zhi Zi). These actions are considered helpful in fibroid patients who present with the typical TCM pattern of Liver-Qi stagnation with heat and Blood disharmony (e.g., irritability, breast distension, clots, dysmenorrhea). Ingredient list and actions are summarized in Tsumura’s official label for the equivalent Kampo formula (TJ-24) and classical descriptions. tsumura.co.jp
Observed clinical usage for heavy or irregular bleeding: Population-level studies of Chinese herbal medicine (CHM) for dysfunctional/abnormal uterine bleeding (AUB/DUB) found JWXYS is among the most commonly prescribed formulas, which aligns with its symptom-targeting role (not proof of efficacy on fibroid size). BioMed Central
Modern evidence in adjacent gynecologic indications: A multicentre, double-blind RCT showed JWXYS improved PMS symptoms versus placebo; this supports its effect on mood, irritability, and menstrual-related discomfort, i.e., symptoms that often co-occur in fibroid patients. Europe PMC
How to use for Fibroids:
Standard dose (Kampo extract, TJ-24): 7.5 g/day of extract granules, divided 2–3 times daily before or between meals. The official Japanese package insert also lists the exact crude-herb composition and titrated extract content. (Practitioners may adjust dose based on body weight, age, and response.) tsumura.co.jp
Form factors: In practice you’ll see granules/extracts (as above) or patent “pills/wan”; brands vary in strength and quality. Use quality-controlled products that disclose extract ratios and testing. General product monographs and classical formulas database entries explain naming (JWXYS ≈ Dan-Zhi Xiao-Yao-San ≈ “Free & Easy Wanderer Plus”). Yin Yang House
Treatment role for fibroids: As an adjunct aimed at symptoms (pelvic pain, PMS-like mood symptoms, dysmenorrhea, heavy/irregular bleeding), often combined with other measures (e.g., iron for anemia, conventional options). Real-world DUB data suggest CHM users (with JWXYS commonly prescribed) underwent fewer surgeries, but this is associational and not specific to fibroid shrinkage. Dove Medical Press
Scientific Evidence for Fibroids:
Symptom trials (adjacent indications):
- PMS RCT: Multicentre, randomized, double-blind, placebo-controlled trial of JWXYS (Jiawei Xiaoyao pill) showed symptom improvement and acceptable safety. Useful for mood/menstrual symptoms that often accompany fibroids. Europe PMC
Observational/real-world data relevant to bleeding:
- Taiwan NHIRD cohort (AUB/DUB): CHM users had a lower rate of surgery than non-users; JWXYS was the most commonly prescribed formula. This supports its clinical popularity for bleeding-related gynecologic complaints, not causal effectiveness on fibroids. BioMed Central
- A similar real-world analysis of DUB patients reported the same pattern (JWXYS most used; surgery reduction association). Dove Medical Press
Case-level evidence (very low certainty): A case report of leiomyoma with adenomyosis used relugolix plus kamishoyosan (JWXYS) to improve side effects during therapy; the main driver of uterine shrinkage was the GnRH antagonist, not the herb. BioMed Central
Specific Warnings for Fibroids:
Authoritative labelling for Kamishoyosan (TJ-24)—the standardized Japanese version of JWXYS—lists the following precautions and adverse effects:
Pregnancy & lactation: Not recommended in pregnancy; Moutan bark “may cause premature birth or abortion.” Safety in lactation and pediatric use is not established. tsumura.co.jp
Electrolytes & blood pressure (licorice content): Because it contains Glycyrrhiza (licorice), pseudoaldosteronism can occur (hypokalemia, hypertension, edema, weight gain, myopathy). Monitor serum potassium and blood pressure; avoid combining with other licorice-containing products. tsumura.co.jp
Liver injury: Labeling warns of hepatic dysfunction and jaundice; discontinue if liver enzymes rise. Independent pharmacovigilance reviews also describe rare liver injury reports with Kamishoyosan/JWXYS (Kampo synonym TJ-24). tsumura.co.jp
Very long-term use & gardenia-related colon risk: Prolonged use of gardenia-containing formulas (often ≥ 5 years) has been linked to mesenteric phlebosclerosis (a rare colonic vascular disorder). Periodic CT/colonoscopy is suggested if long-term therapy is contemplated. tsumura.co.jp
GI intolerance: Nausea, epigastric distress, abdominal pain, diarrhea can occur; avoid in those with very weak GI function. tsumura.co.jp
Drug interactions:
- Avoid stacking licorice-containing products (↑ risk of pseudoaldosteronism). tsumura.co.jp
- For anticoagulants (e.g., warfarin) and other narrow-therapeutic-index drugs, use caution and monitor closely—multiple reviews document herb–drug interaction risks with CHM and warfarin (variable directions of effect). Check INR more frequently if co-administered. Frontiers
General Information (All Ailments)
What It Is
Jia Wei Xiao Yao San, also known as Augmented Free and Easy Wanderer Powder, is a classical Chinese herbal formula derived from the traditional Xiao Yao San (Free and Easy Wanderer Powder). It was first recorded in the “Imperial Grace Formulary of the Tai Ping Era” (太平惠民和剂局方) during the Song Dynasty.
The original formula (Xiao Yao San) was designed to soothe the liver, strengthen the spleen, and nourish the blood. The “Jia Wei” (加味) version — meaning “modified” or “augmented” — adds two additional herbs: Mu Dan Pi (Moutan Cortex) and Zhi Zi (Gardeniae Fructus). These additions enhance its ability to clear heat and reduce irritability, making the formula more suitable for cases where emotional tension leads to internal heat symptoms.
It’s widely used in both traditional Chinese medicine and modern integrative medicine for conditions linked to stress, hormonal imbalance, and emotional dysregulation — particularly in women’s health and mental well-being.
How It Works
From a TCM perspective, Jia Wei Xiao Yao San works by regulating the liver qi, harmonizing the spleen, nourishing the blood, and clearing internal heat.
Here’s how the herbs function together:
- Chai Hu (Bupleurum root): Soothes and spreads liver qi to relieve stagnation and emotional constraint.
- Dang Gui (Angelica sinensis) & Bai Shao (White peony root): Nourish and harmonize the blood, alleviating menstrual and emotional symptoms.
- Fu Ling (Poria) & Bai Zhu (Atractylodes): Strengthen the spleen and improve digestion, counteracting fatigue or digestive upset caused by stress.
- Gan Cao (Licorice): Harmonizes the formula and supports overall qi balance.
- Mu Dan Pi (Moutan bark) & Zhi Zi (Gardenia fruit): Clear heat and reduce irritability, addressing symptoms such as restlessness, hot flashes, or insomnia.
From a biomedical perspective, studies suggest Jia Wei Xiao Yao San may help modulate the hypothalamic–pituitary–adrenal (HPA) axis, reduce cortisol levels, and balance neurotransmitters like serotonin and dopamine. These effects contribute to stress reduction, mood regulation, and hormonal balance.
Why It’s Important
Jia Wei Xiao Yao San holds a significant place in both traditional and modern health practice for its wide-ranging benefits:
- Emotional Health: Commonly used to manage symptoms of stress, anxiety, depression, and irritability associated with liver qi stagnation.
- Women’s Health: Often prescribed for premenstrual syndrome (PMS), menstrual irregularities, menopausal symptoms, and postpartum mood disturbances.
- Digestive Harmony: Helps individuals whose emotional stress leads to bloating, poor appetite, or digestive discomfort.
- Stress-Related Disorders: Beneficial for individuals whose physical symptoms (e.g., headaches, fatigue, muscle tension) stem from chronic emotional stress.
- Integrative Use: Increasingly used alongside conventional treatments for mood disorders, hormonal imbalances, and chronic fatigue, providing a holistic approach to mind–body health.
Considerations
While Jia Wei Xiao Yao San is generally considered safe when used appropriately, several important points should be noted:
Individualized Prescription
- TCM formulas are best prescribed after consultation with a qualified practitioner, who tailors the dosage and composition based on one’s specific constitution and pattern diagnosis.
Possible Side Effects
- Mild digestive upset or loose stools may occur in sensitive individuals.
- Allergic reactions are rare but possible.
Contraindications and Precautions
- Not suitable for people with cold-type or deficient constitutions without heat signs.
- Should be used with caution during pregnancy.
- Individuals taking antidepressants, hormonal therapy, or sedatives should consult a healthcare professional before combining therapies.
Quality and Source
- Use products from reputable sources to avoid contamination or adulteration, as herbal quality can vary widely.
Monitoring and Duration
- Typically used for several weeks to months under supervision, with periodic evaluation of symptoms and progress.
Helps with these conditions
Jia Wei Xiao Yao San 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
Acne
TCM pattern: JWXYS is a modification of Xiao Yao San that adds Mu Dan Pi (moutan bark) and Zhi Zi (gardenia) to “clear heat.” It’s traditionally chose...
PMS
Targets core PMS mood symptoms. PMS and PMDD involve dysregulation of serotonergic and GABAergic signalling and stress-axis reactivity. Animal and tra...
Endometriosis
TCM rationale (pattern-based):Jia Wei Xiao Yao San is a classic modification of Xiao Yao San that adds Moutan cortex (牡丹皮) and Gardenia fruit (梔子...
Fibroids
Pattern-based fit in TCM: The formula “harmonizes Liver and Spleen,” nourishes Blood, moves Qi, and clears heat (due to the “jia wei/dan-zhi” addition...
Ovarian Cysts
Stress–HPA axis & mood regulation. JWXYS/Xiao Yao–family formulas show anxiolytic effects and HPA-axis modulation, which can indirectly normalize...
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