Tibetan rhubarb (chu rtsa / da huang)
Rheum palmatum
Photo credit: Alexander Klink
Safety information
Safety information
Toxicity: Moderate. As a stimulant (anthraquinone) laxative, overuse causes cramping, electrolyte loss and dependence; chronic high-dose concern (melanosis coli; theoretical genotoxicity of free emodin). High tannin content can irritate the gut.
Contraindications: Pregnancy and lactation (purgative; avoid), intestinal obstruction/ileus, inflammatory bowel disease, appendicitis-type acute abdomen, children, dehydration.
Interactions: Potassium loss can potentiate cardiac glycosides (digoxin) and interact with diuretics/corticosteroids; may speed gut transit and reduce absorption of co-administered oral drugs.
Pregnancy & breastfeeding: Avoid in pregnancy and lactation (purgative).
Evidence level
Supported by laboratory or animal studies; not yet confirmed in humans.
Preparations
powder · root and rhizome
Part used: root and rhizome
pill · root and rhizome
Part used: root and rhizome
decoction · root and rhizome
Part used: root and rhizome
Traditional use: constipation, hot blood, liver/bile disorders, abdominal fullness, downward-draining; inflammatory/febrile patterns
Proposed mechanism: hydroxyanthraquinones and glycosides (emodin, aloe-emodin, rhein, chrysophanol, physcion), sennosides, stilbenes, tannins — stimulant-laxative (colonic motility), anti-inflammatory, hepatoprotective
Dosage note (descriptive only): usually a minor/structured component of compound formulas
Associated conditions
Nutritional notes
Not a nutritional source; bioactives are anthraquinones, stilbenes, tannins.
Healing traditions
Sources (3)
- Yang et al. 2024, Phytomedicine (PMID 38852474)
- Zou et al. 2024, Front Pharmacol (PMID 39399469)
- Wang et al. 2022, BMC Complement Med Ther (PMID 35505340)