Eucommia
EucommiaceaeEucommia ulmoides
Also known as: Du Zhong, Tochu, Gutta-percha tree
clinical_notes Clinical Summary
Eucommia ulmoides (Du Zhong) is a cornerstone TCM Liver-Kidney tonic valued for over two millennia for lumbago, weak knees, and threatened miscarriage.
Modern RCTs demonstrate meaningful antihypertensive activity mediated by pinoresinol diglucoside and iridoids, with additional osteogenic and neuroprotective effects.
It is now a China FDA-approved adjunctive treatment for mild-to-moderate hypertension.
Pregnancy Safety
Traditionally used to stabilize pregnancy within formulas; modern controlled safety data in pregnancy are limited. Use only under qualified TCM supervision.
Lactation Safety
Information regarding safety and efficacy in lactation is lacking.
warning Contraindications
- Yin deficiency with heat (caution)Theoretical
- Estrogen-dependent cancers (caution)Theoretical
- Hypotension / concurrent antihypertensives (caution)Clinically Proven
vital_signs Clinical Profile
Primary Indications
- check_circle Low back pain
- check_circle Weak knees
- check_circle Hypertension
- check_circle Osteoporosis
- check_circle Threatened miscarriage
- check_circle Fatigue
- check_circle Impotence
- check_circle Frequent urination
Therapeutic Actions
System Affinities
- check_circle Musculoskeletal
- check_circle Cardiovascular
- check_circle Renal
- check_circle Hepatic
- check_circle Reproductive
labs Active Constituents
Pinoresinol diglucoside
Aucubin
Geniposide
Geniposidic acid
Chlorogenic acid
Ulmoprenol
Gutta-percha
Lignans
history_edu Traditional Use
Traditional Chinese Medicine (TCM)
杜仲 (Du Zhong)
Nature: warm
- Kidney Yang deficiency
- Liver-Kidney deficiency
- Weak lower back and knees
- Restless fetus
- Hypertension
Primary herb for lumbago and weak knees associated with Liver-Kidney deficiency. History of use dating back over 2000 years.
Traditional Uses Across Healing Systems
While many herbs lack controlled clinical trials, centuries of traditional practice across cultures provide valuable insight into their therapeutic applications.
Tonifies Liver and Kidney, strengthens sinews and bones, calms the fetus, lowers blood pressure.
Considered 'top grade' herb.
Tochu — used as tonic for lumbago and hypertension; Tochu leaf tea is a common functional beverage in Japan.
Leaf extracts approved as functional food in Japan.
spa Parts Used
bark
- Hypertension
- Low back pain
- Osteoporosis
Cork removed; often salt-processed (yan du zhong) to enhance Kidney-tonifying action.
leaf
- Hypertension
- Obesity
- Metabolic syndrome
Popular as Tochu tea in Japan; more sustainable than bark harvest.
shield Safety
Contraindications — Evidence Basis
Yin deficiency with heat
Eucommia is warm and may aggravate heat signs in true Yin deficiency patterns.
Estrogen-dependent cancers
Potential phytoestrogenic lignan activity; theoretical concern for hormone-sensitive tumors.
Hypotension / concurrent antihypertensives
Additive BP-lowering effect demonstrated in clinical and preclinical trials; monitor blood pressure.
Monitoring Parameters
Monitor during use, especially with prolonged or high-dose therapy.
Blood pressure
Baseline and every 2-4 weeksEucommia has demonstrated dose-dependent antihypertensive activity; monitor for symptomatic hypotension especially in patients on antihypertensive medication.
flagThreshold: Hold if SBP <100 mmHg or symptomatic hypotension
Toxicity
No toxicity at 1,200 mg/kg/day in rats for 28 days; no acute toxicity at 6.68 g/kg in mice (~334x human clinical dose).
Mild headache, dizziness, edema, or cold-like symptoms reported in one clinical study.
Discontinue; supportive care.
Adverse Effects
CYP Metabolism
Limited CYP interaction data. Theoretical potential for interaction with antihypertensive and ACE-modulating drugs.
swap_horiz Interactions
Antihypertensives (ACE inhibitors, ARBs, beta-blockers, diuretics, CCBs)
Class: Antihypertensive
Eucommia ulmoides lignans (especially pinoresinol diglucoside) and chlorogenic acid have demonstrated antihypertensive effects via multiple mechanisms: nitric oxide-mediated endothelium-dependent vasorelaxation, activation of the ACE2-Ang-(1-7)-Mas axis, and beta-adrenergic blockade (shown in a controlled human trial where Eucommia extract reduced BP by 7.5/3.9 mmHg vs placebo).
Patients on antihypertensive medication who use Eucommia (Du Zhong) tea or supplements should monitor home blood pressure and watch for symptomatic hypotension. Antihypertensive dose reduction may be required; communicate changes to prescribing physician.
Beta-blockers (metoprolol, atenolol, propranolol)
Class: Beta-Adrenergic Antagonist
Eucommia ulmoides exhibits intrinsic beta-adrenergic blocking activity, as demonstrated by its reduction of isoproterenol-stimulated lipolysis in human fat cell assays. Combined with pharmaceutical beta-blockers, this can produce additive bradycardia, hypotension, and blunted exercise heart rate response.
Patients on beta-blockers should use Eucommia cautiously. Monitor heart rate (especially resting HR) and blood pressure. Watch for symptomatic bradycardia, fatigue, cold extremities, or exercise intolerance. Avoid in patients with baseline bradycardia or heart block.
Oral Hypoglycemics (metformin, sulfonylureas, insulin)
Class: Antidiabetic
Eucommia ulmoides leaf extracts have documented hypoglycemic effects through aldose reductase inhibition and insulin-sensitizing activity. When combined with antidiabetic medications, additive glucose-lowering may produce hypoglycemia.
Diabetic patients starting Eucommia should monitor blood glucose more frequently (fasting and postprandial) for the first 2-4 weeks. Counsel on hypoglycemia symptoms (sweating, tremor, confusion). Insulin or sulfonylurea dose adjustment may be required.
Warfarin / Anticoagulants
Class: Anticoagulant / Antiplatelet
Eucommia has theoretical anticoagulant and antiplatelet effects through chlorogenic acid and iridoid constituents (geniposide-related compounds have shown antithrombotic effects in mouse models). Clinical evidence of INR impact is limited, but caution is prudent.
Monitor INR within 1-2 weeks of initiating Eucommia in patients on warfarin. Watch for signs of increased bleeding in patients on antiplatelets. Discontinue Eucommia 1-2 weeks before elective surgery.
Hepatically metabolized drugs (CYP substrates)
Class: CYP450 substrates (general)
Eucommia ulmoides active ingredients (lignans, iridoids) have theoretical potential to modulate hepatic CYP enzyme activity. A pharmacokinetic study of Eucommia combined with Psoralea corylifolia showed altered plasma concentrations of multiple bioactive components, suggesting enzyme or transporter modulation.
For patients on narrow-therapeutic-index CYP substrates (e.g., cyclosporine, tacrolimus, theophylline, phenytoin), monitor drug levels when initiating Eucommia. Document baseline and periodic follow-up levels. Avoid concentrated Eucommia extracts in complex polypharmacy regimens.
hub Combinations
Synergistic pairings can enhance therapeutic outcomes, while knowing suitable substitutes helps when specific herbs are unavailable or contraindicated.
Classical Formulas
1Rehmannia
Traditional UseCombined in You Gui Wan for Kidney Yang deficiency with lumbago.
Classical TCM formula; long traditional use.
Synergistic Combinations
2Dan Shen
Moderate EvidenceComplementary cardiovascular support; eucommia lowers BP while dan shen improves microcirculation.
Used together in modern Chinese patent cardiovascular formulas.
Teasel Root
Traditional UseBoth tonify Liver and Kidney, strengthen sinews and bones; pair used for chronic back pain, weak knees, and threatened miscarriage.
Long-standing traditional combination in TCM formulas.
Traditional Pairings
1He Shou Wu
Traditional UseBoth Liver-Kidney tonics; paired in anti-aging formulas.
Traditional use; limited modern clinical data.
science Studies
A clinical trial testing the safety and efficacy of a standardized Eucommia ulmoides Oliver bark extract to treat hypertension
RCTThis controlled trial evaluated standardized Eucommia ulmoides bark extract (standardized to 8% pinoresinol diglucoside) in adult subjects with blood pressure of 120-160/80-100 mmHg across multiple sub-studies. In the primary human study, 30 subjects received 1 g extract three times daily for two weeks and were monitored with 24-hour ambulatory blood pressure monitoring. Eucommia extract significantly reduced systolic and diastolic blood pressure by an average of 7.5/3.9 mmHg (p<0.008). The extract was well-tolerated with no significant adverse effects. A concurrent in vitro assay demonstrated that the extract has beta-adrenergic blocking activity, suggesting a mechanism for its antihypertensive effect.
medication Dosing
decoction
6-15 g bark
1x/day
Salt-fried for Kidney-tonic action; decoct 30 min.
capsule
500 mg standardized extract
3x/day
Used for 8 weeks in clinical hypertension trial.
tea
2-4 g leaf
1-3x/day
Leaf tea (Tochu) as functional beverage.
Disclaimer: This information is largely AI-generated and reviewed by human experts at Evara Health. It is intended for educational and clinical reference purposes only and should not replace professional medical advice.
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