Kudzu
Generic name: Pueraria Lobata (Willd) Ohwi., Pueraria Montana (Lour.) Merr., Pueraria Thunbergiana (Siebold & Zucc.) Benth., Pueraria Tuberosa (Indian Kudzu)
Brand names: Ge, Ge Gen, Japanese Arrowroot, Kakka, Kakkon, Kudzu, Kudzu Vine, XJL (NPI-028)
Usage of Kudzu
Alcohol use disorder
The isoflavones daidzin, daidzein, and puerarin may help to suppress ethanol intake. Although the mechanism of action is not certain, inhibition of alcohol dehydrogenase is thought to be a major factor in kudzu's potential antidipsotropic activity.(Keung 1993a, Keung 1993c, Keung 1998, Keung 2003, Lin 1998, Xie 1994)
Animal data
Available animal studies of the effects of kudzu on alcohol dependence have been reviewed, with plant constituents (daidzin, daidzein, puerarin) showing alcohol-suppressing effects in rats.(Keung 2003, Rezvani 2003, Xu 2005)
Clinical data
Clinical trials evaluating the effects of kudzu on alcohol consumption provide conflicting results.(Ulbricht 2015) In a study of 38 military veterans, 1.2 g of kudzu root extract administered twice daily for 1 month had no effect on alcohol consumption patterns or cravings.(Shebek 2000) Another small study (N=14) conducted over a period of several weeks demonstrated a reduction in the number of beers and total volume consumed by heavy drinkers.(Herbal treatment 2005, Lukas 2005) The amount of isoflavone present in the extracts used in these 2 trials likely differed, which may account for the inconsistent results.(Lukas 2005)
Several clinical studies available in the literature and conducted by the same pool of researchers demonstrate favorable effects of kudzu on moderate to heavy alcohol consumption.(Bracken 2011, Lukas 2005, Lukas 2013, Penetar 2011, Penetar 2012, Penetar 2015)
Anti-inflammatory effects
Animal and in vitro data
Animal and in vitro studies have demonstrated anti-inflammatory effects of kudzu leaf and root extracts, as well as its active constituents puerarin and robinin. In a colitis mouse model, oral administration of puerarin reversed colonic shortening and spleen weight in a dose-dependent manner (P<0.01 for each) and significantly improved disease severity (P<0.05 at 10 mg/kg and 50 mg/kg doses; P<0.01 at a 50 mg/kg dose). Improvements were noted in antioxidant processes (ie, cyclooxygenase-2 [COX-2], prostaglandin E2) via inhibition of nuclear factor kappa B and activation of necrosis factor erythroid 2–related factor 2 pathways, as well as via reductions in the activity and levels of anti-inflammatory cytokines (ie, tumor necrosis factor alpha [TNF-alpha], interleukin [IL]-1beta, IL-6).(Jeon 2020) In mouse peritoneal macrophages, kudzu leaf extract was a more potent inhibitor of the inflammatory proteins inducible nitric oxide synthase (iNOS), COX-2, TNF-alpha, and IL-6. Robinin, found predominantly in kudzu leaves and not the roots, was found to inhibit interferon-gamma and iNOS production but not TNF-alpha, COX-2, or IL-6.(Eom 2018)
Antiviral activity
Animal and in vitro data
Puerarin administered to mice infected with influenza virus strain H1N1 significantly reduced lung inflammatory pathology and pulmonary enterovirus titer compared with untreated controls (P<0.01 each). Inflammatory lesions in the GI tract (ie, ileum, colon) were reduced, as were inflammatory cytokines (ie, TNF-alpha, IL-6, IL-7) in the lungs and intestines (P<0.05).(Zeng 2021) Anti-HIV activity of kudzu root extract was also demonstrated in vitro.(Mediouni 2018)
Ataxia
In vitro data
Spinocerebellar ataxia 3 (SCA3), the most common subtype among the autosomal dominant cerebellar ataxias, results in cellular polyglutamine aggregates, which contribute to cellular dysfunction and death. In an SCA3 in vitro model, the constituents puerarin and daidzein derived from P. lobata suppressed this aggregation and the proapoptotic marker BCL-2-associated X protein, as well as restored ubiquitin-proteasome system function and enhanced cellular proteasome activity.(Phang 2021)
Cancer
In vitro data
A kudzu ethanolic extract has been evaluated for antiproliferative activity against breast, ovarian, and cervical cancer cell lines, with some components demonstrating cytotoxic activity.(Jeon 2005)
Cardiovascular effects
Animal and in vitro data
Kudzu has been examined for its effects on vascular smooth muscle tissue.(Wang 1994) The main constituent, puerarin, has been found to inhibit endothelium-dependent contractions in mouse carotid arteries in a dose-dependent manner.(Chen 2020) Kudzu has also been studied for potential effects in arrhythmia, ischemia, and angina pectoris,(Lai 1989, Qicheng 1980, Zhou 1995) and for antioxidant activity.(Sato 1992, Zhang 2013)
Clinical data
A meta-analysis examined patients with unstable angina pectoris who received puerarin injection as an adjunct to conventional therapy. Most of the 41 included studies (N=2,953) were conducted among Chinese populations, with small sample sizes. The meta-analysis reported improvements in angina pectoris incidence, electrocardiogram findings, nitroglycerin consumption, and plasma endothelin levels.(Gao 2015)
A small 12-week study (N=15) reported decreased blood pressure and enhanced plasma fibrinolytic activity with consumption of 1.5 g of P. tuberosa (each capsule contained 0.75 g of powder) twice a day for 12 weeks.(Verma 2012)
Cervical spondylosis
Clinical data
In a 15-day observational study enrolling 200 patients with cervical spondylosis, oral administration of a nanoparticle P. lobata targeted preparation (3 g added to 250 mL physiological saline once daily) for 15 days was associated with a significantly better cure rate (41%) and total effective rate (97%), as well as a lower incidence of adverse events (3%) compared with controls (12%, 78%, and 12%, respectively) (P<0.001 for efficacy; P<0.05 for adverse events). Effects were attributed partially to a beneficial shift in the composition and distribution of gut microbiota (P<0.05).(Qin 2022)
CNS effects
Animal data
In an Alzheimer rat model, puerarin alleviated beta-amyloid–induced cognitive dysfunction by maintaining neuroplasticity.(Liu 2021) Puerarin has also demonstrated antidepressant effects in mice subjected to mild unpredictable stress; effects appeared to be due to improved gut microbiota diversity and composition.(Song 2021)
Diabetes
Animal and in vitro data
Isoflavones in P. lobata have demonstrated alpha-glucosidase–inhibitory effects in vitro. Other constituents (eg, puerarin) have resulted in increased glucose utilization in rat models.(Hsu 2003, Wang 2017)
In a study of mice with streptozotocin-induced diabetes, improvements in memory and cognitive function, as well as changes in acetylcholinesterase activity, were observed.(Liu 2015)
Estrogenic activity
In vitro data
The high isoflavone content of kudzu has prompted investigation of the potential estrogenic activity of kudzu extracts. In vitro experiments suggest that daidzein exhibits more potent estrogenic activity than daidzin or puerarin.(Park 2006) In studies comparing estrogenic effects of legume extracts containing phytoestrogens, kudzu was more potent than red clover, soybean, mung, and alfalfa sprouts.(Boué 2003) In another study, P. lobata was less effective than Pueraria mirifica or Mucana collettii, with no proliferation and a mild antiproliferation effect on the growth of MCF-7 cells observed.(Cherdshewasart 2004)
Clinical data
In one trial of 25 menopausal females, a decrease in the number of hot flushes per day occurred when a multiple-ingredient preparation containing kudzu extract was used.(Lukaczer 2005) However, in a larger trial (N=127), a P. lobata extract given daily for 3 months did not demonstrate positive effects on symptoms of menopause.(Woo 2003) In another study in postmenopausal females with pelvic floor dysfunction (N=60), P. lobata root administration (one 0.33 g tablet [including 0.425 mg of isoflavones] per day) for 60 days prior to hysterectomy resulted in increased collagen and elastin content and less blood loss during surgery compared to controls.(Yan 2016)
Hepatoprotective effects
In vitro data
In experimental studies in mouse and human cells investigating the hepatoprotective effects of puerarin and saponins, some antihepatotoxic activity was demonstrated.(Arao 1997b, Arao 1998, Hayashino 2005)
Obesity
In vitro data
In an in vitro experiment, biochanin A demonstrated potential hypolipidemic activity via activation of peroxisome proliferator–activated receptors.(Shen 2006)
Clinical data
The effects of kudzu flower (as Pueraria thomsonii extract) on obesity have been evaluated in a 12-week clinical trial (N=81). Reductions in body mass index and visceral (but not subcutaneous) fat were demonstrated.(Kamiya 2012)
Osteogenic activity
In vitro data
In an in vitro study of a Radix puerariae (kudzu root) extract, an increase in the synthesis of alkaline phosphatase in human osteoblast cells was observed.(Huh 2006)
Ototoxicity
Animal data
Puerarin protected against gentamicin-induced ototoxicity in mice, as demonstrated by significant improvements in the auditory brainstem response thresholds as well as surviving outer and inner cochlear hair cells compared with untreated controls (P<0.01 for each). In vitro experiments indicated the effects were related to improved antioxidant activity, protective effects on the mitochondrial membrane, and reduction in apoptosis.(Niu 2021)
Kudzu side effects
Kudzu has historically been used for medicinal purposes, with few reported adverse reactions.(Keung 1993a) There are a few case reports of hypersensitivity reactions (ie, maculopapular drug eruption, Stevens-Johnson syndrome–type reaction) to the kudzu-containing Kakkonto decoction.(Akita 2003)
Before taking Kudzu
Avoid use. Information regarding safety and efficacy in pregnancy and lactation is lacking.
How to use Kudzu
In one pharmacokinetic profile study, the isoflavone puerarin was rapidly absorbed after oral administration, reaching peak levels in 2 hours.(Penetar 2006) Isoflavone content varies widely among commercial kudzu preparations, with most containing less than 1%.(Lukas 2005)
Cervical spondylosis
In a 15-day observational study of patients with cervical spondylosis, oral administration of a nanoparticle P. lobata targeted preparation (3 g added to 250 mL physiological saline once daily) for 15 days was evaluated for effects on clinical symptoms.(Qin 2022)
Estrogenic activity
In a small study in postmenopausal females with pelvic floor dysfunction, P. lobata root (one 0.33 g tablet [including 0.425 mg isoflavones] per day) was administered for 60 days prior to hysterectomy to evaluate effects on collagen and elastin content.(Yan 2016)
Warnings
Although data regarding use in traditional Chinese medicine indicate a lack of toxicity, the safety profile of kudzu and its extracts has not been determined by systematic pharmacologic screens.(Qicheng 1980) Acute toxicity of 4 Pueraria species has been studied comparatively.(Zhou 1995)
What other drugs will affect Kudzu
None well documented. Several in vitro and animal studies indicate glucose-lowering effects; therefore, additive effects are possible with use of antihyperglycemic agents.(Hsu 2003, Wang 2017) Puerarin and other compounds from Radix puerariae (kudzu root) affect CYP-450 isoenzymes; study results demonstrate contradictory effects (ie, a complex pattern of CYP modulation was observed, including both induction and inactivation).(Guerra 2000)
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