Jia Wei Xiao Yao San
Specifically for PMS
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Why it works for PMS:
Targets core PMS mood symptoms. PMS and PMDD involve dysregulation of serotonergic and GABAergic signalling and stress-axis reactivity. Animal and translational studies with Kamishoyosan show anxiolytic effects linked to 5-HT1A and GABA-A mechanisms, which map to PMS mood symptoms (irritability, anxiety). Kampo
Neuroendocrine modulation. Reviews of JWXYS/Xiao Yao–based formulas suggest normalization of the HPA (stress) axis, neurotransmitter balance, neuroinflammation and synaptic plasticity—mechanisms relevant to cyclic mood symptoms. ScienceDirect
TCM pattern fit. In TCM terms, JWXYS “soothes Liver qi,” nourishes Blood, and adds gardenia + moutan to clear “heat,” a pattern frequently assigned in PMS consultations; large prescribing datasets show JWXYS is the single most commonly prescribed Chinese herbal formula for PMS in Taiwanese claims data. Me and Qi
How to use for PMS:
Form & dose (granules; Japanese TJ-24 package insert):
- Adult dose: 7.5 g/day of extract granules, divided 2–3 times daily, before or between meals. Dose may be adjusted by age, body weight and symptoms. Tsumura
Course/duration:
- In a multicentre placebo-controlled PMS trial with a Chinese patent pill equivalent, participants took 12 g/day (6 g twice daily) for 3 menstrual cycles; effects were assessed with DRSP scores in the luteal phase. Your clinician may mirror this 2–3-cycle trial period before judging benefit. Journal TCM
What to track:
- Track symptoms daily for at least 2 cycles with the DRSP (gold-standard PMS/PMDD diary) to see whether JWXYS is helping. iapmd.org
Who it’s for (Kampo insert “SHO” guidance):
- Kamishoyosan is used when the pattern includes irritability/anxiety, fatigue, menstrual irregularity/dysmenorrhea and autonomic imbalance; continue only if there’s clear improvement. Tsumura
Scientific Evidence for PMS:
Multicentre randomized, placebo-controlled PMS trial (China). Regularly menstruating women with PMS were randomized to Jiawei Xiaoyao pill 12 g/day vs placebo for 3 cycles. The primary outcome was luteal-phase DRSP reduction; the study reports superior symptom improvement and acceptable safety in the JWXYS arm. (Full English abstract available; details in article.) Europe PMC
Observational/open studies & older trials (Japan). Small studies in PMS/PMDD report improvement with Kamishoyosan (TJ-24); e.g., an open PMDD series (n=30; ~63% responders by HAM-D) and a 2007 PMS study showing symptom improvements alongside autonomic indices. These are supportive but lower quality than modern RCTs. Kyushu University
Ongoing/registered RCT (Japan). A government-registered RCT specifically for PMS with Kamishoyosan has completed enrolment; registry details are public. rctportal.mhlw.go.jp
Utilization evidence. In a national Taiwanese PMS cohort (14,312 CHM prescriptions), JWXYS was most commonly prescribed (37.5%), underscoring real-world clinician preference for this formula in PMS. (Prevalence ≠ efficacy, but it shows clinical uptake.) BioMed Central
Specific Warnings for PMS:
From the official TJ-24 (Kamishoyosan) package insert—please read carefully:
Licorice-related risks (present in JWXYS): may cause pseudoaldosteronism—hypertension, edema, weight gain, hypokalaemia, muscle weakness—especially with other licorice-containing medicines or long use. Monitor blood pressure and potassium; stop and seek care if symptoms occur. Tsumura
- Mechanism and risk factors are well-characterized in modern reviews and pharmacology papers. Frontiers
Gardenia-related long-term risk: chronic use of gardenia-containing formulas (typically ≥5 years) has been associated with mesenteric phlebosclerosis (a serious colonic vascular disorder); long-term therapy should be periodically reviewed. Tsumura
Pregnancy & lactation: Not recommended in pregnancy (insert specifically warns because Moutan bark may cause premature birth or abortion). Safety in breastfeeding and children is not established. Tsumura
GI sensitivity: use cautiously in people with weak gastrointestinal function (nausea, diarrhea, epigastric distress can worsen). Tsumura
Herb–drug interactions (important examples):
- Warfarin/anticoagulants: Angelica sinensis and possibly peony may increase bleeding risk; monitor INR closely or avoid without medical supervision. Frontiers
- Other licorice products/diuretics/corticosteroids: raise hypokalaemia risk—avoid combinations or monitor potassium. Tsumura
Stop and seek medical care for: rising blood pressure, leg swelling, unexplained fatigue/weakness, severe GI pain/bleeding, jaundice or marked liver enzyme elevations. Tsumura
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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Helps With These Conditions
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