Liu Wei Di Huang Wan

Purported Benefits, Side Effects & More
Liu Wei Di Huang Wan

Common Names

  • Six-flavor rehmannia pills
  • Six-ingredient pill with rehmannia
  • Yukiji hwang-hwan
  • Liu Wei Di Huang Pian
  • Longevity Blend

Jump to:

For Patients & Caregivers

Tell your healthcare providers about any dietary supplements you’re taking, such as herbs, vitamins, minerals, and natural or home remedies. This will help them manage your care and keep you safe.

Liu Wei Di Huang Wan (LWDHW) is a traditional Chinese medicine (TCM) formula. It’s made up of six different herbs.

Liu Wei Di Huang Wan is used to:

  • Treat hot flashes
  • Lower high blood pressure
  • Treat diabetes

Talk with your healthcare provider before taking herbal formulas. They can interact with some medications and affect how they work. For more information, read the “What else do I need to know?” section below.

Side effects of LWDHW may include:

  • Dizziness
  • Headache
  • Rash
  • Palpitations (feeling of the heart beating too hard or fast)

For Healthcare Professionals

Liu Wei Di Huang Wan (LWDHW) is a traditional Chinese medicine (TCM) formula, first documented in  “Xiao Er Yao Zheng Zhi Jue,“  a 12th century Treatise on Key to Therapeutics of Children’s Diseases. Composed of six herbs – Shu Di Huang (Rehmannia glutinosa), Shan Zhu Yu (Cornus officinalis), Shan Yao (Dioscorea japonica), Fu Ling (Wolfiporia extensa), Mu Dan Pi (Paeonia suffruticosa) and Ze Xie (Alisma orientale) – LWDHW is commonly used to treat hot flashes, hypertension, diabetes, and fatigue (33).

Clinical studies indicate effectiveness of LWDHW against diabetes and diabetic nephropathy (2) (12) (14) (15) (16), and its use was found to be safe in elderly (3) as well as pediatric (1) patients with diabetes. Whether it benefits those with gestational diabetes remains to be evaluated (17). Findings also suggest LWDHW to be beneficial in treating hypertension (26).

In cancer settings, LWDHW has been associated with reductions in the risk of colon cancer (5) (6), hepatocellular carcinoma (7) and breast cancer (8) in patients with diabetes, as well as with improvements in xerostomia and quality of life in those with head and neck cancer (9). 

Additionally, modified versions of LWDHW are also used to manage various disorders/symptoms.

Zhi Bai Di Huang Wan consists of LWDHW, Zhi Mu (Anemarrhena asphodeloides) and Huang Bai (Phellodendron amurense). It is associated with reduced risk of indwelling catheterization in patients with dementia  (18) and may also benefit patients with systemic lupus erythematosus (19) and breast cancer patients with endocrine therapy-induced hot flashes (25).

Qi Ju Di Huang Wan, composed of LWDHW plus two herbs including Gou Qi Zi (Lycium barbarum) and Ju Hua (Flos chrysanthemi), is used to treat ocular diseases including dry eyes (28) (29) as well as hypertension  (30).

Ba Wei Di Huang Wan, comprising LWDHW, Gui Zhi or Rou Gui (Cinamomum cassia) and Zhi Fu Zi (Rx. Lateralis Aconiti Preparata), may help improve quality of life in patients with peripheral artery disease (21), alleviate symptoms of frequent urination and urgency in those with overactive bladder (22), along with improving survival in patients with metastatic prostate cancer (27). 

Large, well-designed studies are needed to expand the evidence.

  • Hot flashes
  • Hypertension
  • Diabetes

LWDHW extract demonstrated anti-diabetic effects in a murine model by inhibiting the activity of α-amylase and α-glucosidase. It also had a protective effect in beta cells in mice with type-2 diabetes through inhibition of NF-κB expression in pancreatic islets, and improved insulin resistance by modulating the PI3K/Akt signaling pathway or by increasing IRS-2 expression (16).

Suggested mechanisms underlying the preventive effects of this formula against breast cancer include inactivation of the insulin pathway or insulin-like-growth-factor pathway, and not regulation of endogenous sex hormones (32).

Dizziness, headache, rash, and palpitations have been reported in clinical studies (1) (14).

  • CYP450 substrates: In healthy adults, LWDHW induced CYP 1A2 and suppressed CYP 2A6, and may affect the metabolism of drugs induced by these enzymes (23).
  • N-acetyltransferase 2 substrates: In healthy adults, LWDHW suppressed NAT2, and may affect the metabolism of drugs induced by this enzyme (23).
  1. Hou X, Xu M, Li J, Li R, Zhang J, Ju J. Study of the Therapeutic Effects of Chinese Herbal Decoction Combined with Glucocorticoid in Treating Primary Nephrotic Syndrome in Children. Evid Based Complement Alternat Med. 2021 Nov 19;2021:4434504.
  2. Liao T, Zhao K, Huang Q, Tang S, Chen K, Xie C, Zhang C, Gan W. A randomized controlled clinical trial study protocol of Liuwei Dihuang pills in the adjuvant treatment of diabetic kidney disease. Medicine (Baltimore). 2020 Jul 31;99(31):e21137.
  3. Li N, Yao Y, An E. Clinical Efficacy of Bolus of Six Drugs Including Rehmannia as an Adjunct to Metformin in the Treatment of Senile Type-2 Diabetes Mellitus and its Influence on Insulin Resistance, Inflammatory Factors and Blood Glucose-related Indicators. Pak J Med Sci. 2023 Sep-Oct;39(5):1429-1433.
  4. Huang CY, Tsai YT, Lai JN, Hsu FL. Prescription pattern of chinese herbal products for diabetes mellitus in taiwan: a population-based study. Evid Based Complement Alternat Med. 2013;2013:201329.
  5. Jhang JS, Livneh H, Yang SY, Huang HJ, Chan MWY, Lu MC, Yeh CC, Tsai TY. Decreased risk of colorectal cancer among patients with type 2 diabetes receiving Chinese herbal medicine: a population-based cohort study. BMJ Open Diabetes Res Care. 2020 Mar;8(1):e000732.
  6. Tang M, Zhang W, Qin W, Zou C, Yan Y, He B, Xu Y, Zhang Y, Liu J, Sun H, Yang Y. Association between Oral Chinese Herbal Medicine and Recurrence and Metastasis in Patients with Stages II and III Colorectal Cancer: A Cohort Study in China. Evid Based Complement Alternat Med. 2022 Nov 8;2022:8529395.
  7. Lu HL, Su YC, Lin MC, Sun MF, Huang ST. Integrating Chinese and Western medicines reduced the incidence of hepatocellular carcinoma in patients with diabetes mellitus: A Taiwanese population-based cohort study. Complement Ther Med. 2020 Mar;49:102332.
  8. Wu CT, Tsai YT, Lin JG, Fu SL, Lai JN. Chinese herbal products and the reduction of risk of breast cancer among females with type 2 diabetes in Taiwan: A case-control study. Medicine (Baltimore). 2018 Aug;97(31):e11600.
  9. Lim RJ, Nik Nabil WN, Chan SY, Wong YF, Han LX, Gong JY, Ho KL, Shew YS, Xu L. Effects of herbal medicine for xerostomia in head and neck cancer patients: an observational study in a tertiary cancer hospital. Support Care Cancer. 2019 Sep;27(9):3491-3498.
  10. Zhao BB, Long QH, Wang CY, Chen LL, Xie GJ, Bo WJ, Xu B, Li ZF, Li HM, Wang P. Protective Effects of Liu Wei Di Huang Wan on the Liver, Orbitofrontal Cortex Nissl Bodies, and Neurites in MSG+PH-Induced Liver Regeneration Rat Model. Evid Based Complement Alternat Med. 2018 Aug 27;2018:9090128.
  11. Zhan X, Li H, Jin J, Ju X, Gao J, Chen X, Yuan F, Gu J, Xu D, Ju G. Network pharmacology and experimental validation to explore the role and potential mechanism of Liuwei Dihuang Decoction in prostate cancer. BMC Complement Med Ther. 2024 Jul 26;24(1):284.
  12. Lien AS, Jiang YD, Mou CH, Sun MF, Gau BS, Yen HR. Integrative traditional Chinese medicine therapy reduces the risk of diabetic ketoacidosis in patients with type 1 diabetes mellitus. J Ethnopharmacol. 2016 Sep 15;191:324-330.
  13. Chan KW, Yu KY, Yiu WH, Xue R, Lok SW, Li H, Zou Y, Ma J, Lai KN, Tang SC. Potential Therapeutic Targets of Rehmannia Formulations on Diabetic Nephropathy: A Comparative Network Pharmacology Analysis. Front Pharmacol. 2022 Mar 21;13:794139.
  14. Lin M, Zhang H, Liu S, Li A, Nan Z. Efficacy of “Dihuang pill prescriptions” combined with conventional treatment for diabetic kidney disease: A network meta-analysis and systematic review. Medicine (Baltimore). 2023 Sep 29;102(39):e35290.
  15. Chen HH, Wu CT, Tsai YT, Ho CW, Hsieh MC, Lai JN. Liu Wei Di Huang Wan and the Delay of Insulin Use in Patients with Type 2 Diabetes in Taiwan: A Nationwide Study. Evid Based Complement Alternat Med. 2021 Aug 19;2021:1298487.
  16. Baek J, Kim J, Shin S, Cho C. The efficacy and safety of yukmijihwang-hwan (Liuweidihuang-wan) for type 2 diabetes mellitus without complications: A protocol for systematic review and meta-analysis. Medicine (Baltimore). 2022 Mar 18;101(11):e29087.
  17. Xiong Y, Li Q, Chen X, Zhu T, Lu Q, Jiang G. Identification of the Active Compound of Liu Wei Di Huang Wan for Treatment of Gestational Diabetes Mellitus via Network Pharmacology and Molecular Docking. J Diabetes Res. 2022 May 28;2022:4808303.
  18. Lin SK, Lin PH, Hsu RJ, Chuang HC, Liu JM. Traditional Chinese medicine therapy reduces the catheter indwelling risk in dementia patients with difficult voiding symptoms. J Ethnopharmacol. 2017 May 5;203:120-126.
  19. Yang Z, Xie RF, Zhong MH, Xie GQ, Fan YS, Zhao T. Potential Molecular Mechanisms of Zhibai Dihuang Wan in Systemic Lupus Erythematosus Based on Network Biology. Evid Based Complement Alternat Med. 2020 Apr 13;2020:7842179.
  20. Hsu YH, Chen TH, Wu MY, Lin YF, Chen WL, Cheng TH, Chen CH. Protective effects of Zhibai Dihuang Wan on renal tubular cells affected with gentamicin-induced apoptosis. J Ethnopharmacol. 2014;151(1):635-42.
  21. Kawago K, Shindo S, Inoue H, Akasaka J, Motohashi S, Urabe G, Sato M, Uchiyama H, Ogino H. The Effect of Hachimi-Jio-Gan (Ba-Wei-Di-Huang-Wan) on the Quality of Life in Patients with Peripheral Arterial Disease - A Prospective Study Using Kampo Medicine. Ann Vasc Dis. 2016;9(4):289-294.
  22. Kim D, Choi C, Ahn I, Ryu I, Choi M, Lee Y, Lee MS. Efficacy and safety of Baweidihuang-wan in women with overactive bladder: a randomized, double blind, placebo controlled trial. Int J Clin Exp Med. 2014 Sep 15;7(9):2744-53.
  23. Chen Y, Kang Z, Yan J, Yang GP, Tan ZR, Zhou G, Ouyang DS. Liu wei di huang wan, a well-known traditional Chinese medicine, induces CYP1A2 while suppressing CYP2A6 and N-acetyltransferase 2 activities in man. J Ethnopharmacol. 2010 Oct 28;132(1):213-8.
  24. Sham TT, Chan CO, Wang YH, Yang JM, Mok DK, Chan SW. A review on the traditional Chinese medicinal herbs and formulae with hypolipidemic effect. Biomed Res Int. 2014;2014:925302.
  25. Li Y, Zhu X, Bensussan A, Li P, Moylan E, Delaney G, McPherson L. Herbal Medicine for Hot Flushes Induced by Endocrine Therapy in Women with Breast Cancer: A Systematic Review and Meta-Analysis. Evid Based Complement Alternat Med. 2016;2016:1327251.
  26. Limopasmanee W, Chansakaow S, Rojanasthien N, Manorot M, Sangdee C, Teekachunhatean S. Effects of the Chinese Herbal Formulation (Liu Wei Di Huang Wan) on the Pharmacokinetics of Isoflavones in Postmenopausal Women. Biomed Res Int. 2015;2015:902702.
  27. Liu JM, Lin PH, Hsu RJ, Chang YH, Cheng KC, Pang ST, Lin SK. Complementary traditional Chinese medicine therapy improves survival in patients with metastatic prostate cancer. Medicine (Baltimore). 2016 Aug;95(31):e4475.
  28. Chang YH, Lin HJ, Li WC. Clinical evaluation of the traditional chinese prescription Chi-Ju-Di-Huang-Wan for dry eye. Phytother Res. 2005 Apr;19(4):349-54.
  29. Liu F, Tian M. Study on the mechanism of Qiju Dihuang pill in the treatment of ophthalmic diseases based on systems pharmacology. Medicine (Baltimore). 2022 Aug 5;101(31):e30033.
  30. Wang J, Xiong X, Yang G, Zhang Y, Liu Y, Zhang Y, Zhang Z, Li J, Yang X. Chinese herbal medicine qi ju di huang wan for the treatment of essential hypertension: a systematic review of randomized controlled trials. Evid Based Complement Alternat Med. 2013;2013:262685.
  31. Hu Z, Liu X, Yang M. Evidence and Potential Mechanisms of Jin-Gui Shen-Qi Wan as a Treatment for Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis. Front Pharmacol. 2021 Sep 6;12:699932.
  32. Lai JN, Wu CT, Chen PC, et al. Increased risk for invasive breast cancer associated with hormonal therapy: a nation-wide random sample of 65,723 women followed from 1997 to 2008. PLoS One. 2011;6:e25183.
  33. Chen R, Moriya J, Yamakawa J, Takahashi T, Kanda T. Traditional chinese medicine for chronic fatigue syndrome. Evid Based Complement Alternat Med. 2010 Mar;7(1):3-10. doi: 10.1093/ecam/nen017.
Email your questions and comments to aboutherbs@mskcc.org.

Last Updated