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Fo Ti – a Herb to Support The Kidneys & Klotho Production

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Traditional Chinese medicine (TCM) has given us a number of amazing herbs to use in the treatment of kidney disease and Fo-ti is no different. Let’s have a look at this unique herb.

Polygynum multiflorum (also known as Fo-ti or He shou wu) is one of the most popular herbs in TCM and is used to treat high blood pressure, diabetes, cancer, insomnia, headaches, support the kidneys and to prevent premature ageing. 

The name He Shou Wu which means ‘black-haired Mr He’, refers to the legend of an older villager named Mr He who took the herb and restored his black hair, youthful appearance and vitality.

Fo Ti Klotho CKD

https://www.phcogres.com/temp/PhcogRes73225-3737302_102253.pdf

 Actions of Fo-ti:

  • Protects the kidneys
  • Antioxidant
  • Anti-inflammatory
  • Lowers cholesterol
  • Anti-diabetic
  • Protects against atherosclerosis (hardening of the arteries)
  • Modulates the immune system
  • Protects the liver
  • Protects against neurodegenerative diseases and cardiovascular disease
  • Anti-tumour
  • Antibacterial 

Fo-ti is an excellent herb for people with kidney disease from any cause, but it is particularly well indicated for treating and preventing cardiovascular disease associated with kidney disease. 

Let’s take a closer look at some of the actions of Fo-ti.

Fo-ti has a protective effect on the kidneys. Many of the benefits of Fo-ti come from its strong antioxidant and anti-inflammatory actions. Oxidative stress is defined as tissue damage from an imbalance between excessive reactive oxygen species and insufficient antioxidant capacity. Oxidative stress and inflammation are considered to be key factors in the development of CKD and if not dealt with usually lead to end stage renal disease.

It makes sense then that reducing oxidative stress and inflammation will help to prevent the progression of CKD. 

How does Fo-ti do this?

Well, it increases levels of superoxide dismutase (SOD) and glutathione peroxidase (GPx) which are two of the most important antioxidant enzymes in the body whose main role is to protect the body from oxidative damage. It also reduces inflammation in the body by down regulating major pro-inflammatory pathways in the body that are upregulated in CKD.

Fo-ti increases klotho levels

One of the other really important actions of Fo-ti is that it up regulates the klotho gene so increases klotho levels in the body. Initially, klotho was identified as an anti-aging gene, but further research has shown that it’s much more than that. 

In humans, klotho deficiency has been associated with ageing, hardening of the arteries, high blood pressure, chronic kidney disease, osteoporosis, anaemia and various cancers.

There is plenty of evidence showing that CKD is related to klotho deficiency. What this means is that low levels of klotho contribute to the progression of kidney disease not only by directly affecting the kidneys themselves but also by contributing to the development of cardiovascular disease, high blood pressure and diabetes. 

Most of the klotho in the body is produced in the kidneys which means that the more kidney damage you have, the less klotho you make which then results in further kidney damage. 

Klotho production and Fo Ti

 https://www.sciencedirect.com/science/article/abs/pii/S8756328217300170

The actions of klotho in the kidneys include:  

  • Protection of the cells in the kidneys
  • Reduction in oxidative stress
  • Anti-fibrosis- renal fibrosis is like scarring in the kidneys which results in progressive loss of kidney function and can ultimately lead to end-stage renal failure
  • Reduces inflammation
  • Protection against vascular calcification and mineral bone disease (a consequence of later stages of kidney disease)
  • Inhibits phosphate absorption and promotes excretion of phosphate in urine

Researchers at the University of Texas found that injecting klotho into mice that had kidney failure reduced the damage to the kidneys, promoted healing of the kidneys, prevented the progression of the disease to a chronic disease and prevented the formation of heart failure which is the leading cause of death amongst patients with CKD.

Companies are currently trying to develop klotho that can be used as a drug or find ways to stimulate endogenous klotho in humans and Fo-ti appears to do just that.

A study in aged mice found that administration of TSG (tetrahydroxystilbene glucose) a constituent of Fo-ti for 8 weeks reversed age related decreases in klotho, increased the levels of klotho in the bloodstream and increased the expression of klotho in the brain, heart, kidney, testis and epididymis in a dose-dependent manner. Examination of the organs also showed that TSG improved disease related changes in the organs. 

If you’re interested in learning more about klotho and its benefits in CKD, check out one of my previous articles that discusses all things klotho.

Heart disease

Heart disease and kidney disease are strongly linked. Heart disease can cause kidney disease and vice versa. It is also the most common cause of death in people with CKD so controlling heart disease should be a high priority.

Atherosclerotic coronary artery disease is particularly common in people with CKD and is a risk factor for developing ischaemic heart disease (angina), heart attack, stroke, peripheral vascular disease and heart failure. 

Atherosclerosis is a disease in which plaque builds up inside your arteries. These deposits are made up of cholesterol, fatty substances, cellular waste products, calcium and fibrin. As plaque builds up, the wall of the blood vessel thickens causing narrowing of the arteries, reducing the amount of oxygen and nutrients travelling to the heart, brain, legs, arms or kidneys.

Elevated levels of cholesterol and triglycerides are one of the causes of atherosclerosis so maintaining healthy cholesterol levels is one of the ways to reduce the risk of atherosclerosis occurring. 

Fo-ti has been shown to have a positive effect on cholesterol levels by decreasing total cholesterol, triglycerides and LDL cholesterol while also increasing HDL cholesterol, the ‘protective’ cholesterol.

One of the other benefits of Fo-ti when it comes to cholesterol and atherosclerosis is that it reduces inflammation and lipid peroxidation which both play a really big role in the development of atherosclerotic plaque. 

A study on laboratory animals found that Fo-ti inhibited arterial plaque formation and its use resulted in up to 60% less atherosclerosis. Researchers concluded that Fo-ti shows potential as a powerful natural substance for prevention of cardiovascular disease. 

Diabetic kidney disease

TSG, one of the primary constituents in Fo-ti has a protective effect on diabetic nephropathy which is kidney disease caused by diabetes which as we know, is the number one cause of kidney disease world-wide.

The therapeutic effects of TSG on diabetic nephropathy come from its ability to reduce inflammation and oxidative stress and the expression of transforming growth factor beta (TGF-B) which plays a key role in renal fibrosis or scarring. 

Treatment with Fo-ti has also shown a significant reduction in blood glucose levels and a significant improvement in glucose tolerance and insulin sensitivity in diabetic mice which will further protect the kidneys from damage. 

Angiotensin

One of the other key benefits of Fo-ti when it comes to kidney disease is its ability to reduce angiotensin II levels. To understand the benefits of this let’s have a quick little biology lesson.

Angiotensin II CKD

Angiotensin II is a protein hormone that:

  1. Causes blood vessels to become narrower which increases blood pressure
  2. Stimulates production of the hormone aldosterone which results in the body retaining sodium and losing potassium from the kidneys and 
  3. Increases sodium retention in the kidneys and alters the way the kidneys filter blood.

So basically, it increases blood pressure, fluid retention and sodium levels in the body.

Elevated angiotensin II causes kidney injury by increasing blood pressure and pressure within the kidneys and by constricting blood vessels within the kidneys, reducing blood flow and oxygen to the kidneys. 

Angiotensin II also induces proteinuria (protein in urine) which causes further injury to the kidney tubules and promotes the production of TGF-B that triggers fibrosis or scarring of the kidneys. 

Ok, biology lesson over!

Now that you understand the negative effects that angiotensin II can have on the kidneys, I’m sure you can see how reducing angiotensin II levels through the use of Fo-ti can protect the kidneys and prevent the progression of CKD. 

Animal studies with TSG (found in Fo-ti) have shown that it can prevent and reduce the loss of protein in urine, improve kidney fibrosis or scarring, reduce the severity of glomerular injury and play a protective role in preventing the progression of focal segmental glomerulosclerosis (FSGS), a disease in which scar tissue develops in the kidneys filtering units (glomeruli). 

Therapeutic dose

The therapeutic dose of Fo-ti is 500mg-1500mg a day. Quality is very important when purchasing this herb so make sure you purchase it from a reputable herbal company.

Safety first!

As always, make sure you consult your doctor or naturopath before starting any new supplement regime to make sure this herb is appropriate for your use. Fo-ti may interact with warfarin and has oestrogenic activity so may not be appropriate for people who have a health condition linked to oestrogen such as oestrogen related breast cancer. 

Because of its blood glucose lowering ability, Fo-ti may potentiate the actions of insulin and hypoglycemic medication so closer monitoring of blood sugar levels is necessary when starting on Fo-ti. 

So, there you have it, a detailed look at the healing properties of Fo-ti including its klotho promoting activities and its benefits in kidney disease and heart disease. As I mentioned in the beginning, Fo-ti may be beneficial in kidney disease regardless of the cause but particularly for treating and preventing cardiovascular disease associated with kidney disease.

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