Herb

Chi Shao

Red peony root | 赤芍

Also known as:

Chi Shao Yao , Red Peony Root

Chi Shao

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Properties

Heat-clearing herbs · Slightly Cool

Traditionally supports*

Menstrual Health Circulation Support Inflammation Support Liver Health Skin Health

Parts Used

Root (根 gēn)

*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

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About This Herb

Traditional Chinese Medicine background and properties

Herb Description

Red peony root is a cooling herb that clears excess heat from the blood and promotes healthy circulation. It is widely used in Chinese medicine for conditions involving blood stagnation, such as painful periods, traumatic injuries, and inflammatory skin conditions. It also helps calm redness and inflammation related to Liver heat, including red, swollen eyes and flank pain.

Herb Category

Heat-clearing herbs Herbs that clear Heat and cool the Blood (清热凉血药) Blood-invigorating and stasis-dispelling herbs (活血化瘀药)

Main Actions

  • Clears Heat and Cools the Blood
  • Invigorates Blood and Dispels Stasis
  • Clears Liver Fire
  • Alleviates Pain
  • Disperses Swelling and Dissipates Abscesses

How These Actions Work

'Clears Heat and cools the Blood' means Chi Shao can remove excess Heat that has entered the Blood level. In TCM, when pathogenic Heat invades deeply into the Blood, it can force Blood out of the vessels, causing bleeding (nosebleeds, vomiting blood, bloody stool) or skin rashes and blotches. Chi Shao's bitter, slightly cool nature allows it to descend into the Blood level through the Liver channel, cooling the Blood and stopping this reckless movement. This is its most important action in febrile diseases.

'Invigorates Blood and dispels stasis' means Chi Shao actively promotes blood circulation and breaks up stuck, stagnant Blood. When Blood stops flowing properly, it can cause sharp, fixed pain, dark menstrual clots, missed periods, or masses in the abdomen. Chi Shao's bitter taste gives it a strong dispersing quality that pushes through these blockages. This is why it appears in so many formulas for painful periods, traumatic injuries, and abdominal masses.

'Clears Liver Fire' means Chi Shao specifically targets excess Heat rising from the Liver. Since the Liver channel connects to the eyes, Liver Fire often manifests as red, swollen, painful eyes. The Liver also governs the free flow of Qi throughout the body, so when Liver Fire flares, it can cause pain in the flanks and ribs, irritability, and headaches. Chi Shao enters the Liver channel directly, draining this Fire and relieving the associated pain.

'Relieves pain' is closely tied to Chi Shao's Blood-moving ability. In TCM, the principle is: where there is stagnation, there is pain. By clearing Blood stasis, Chi Shao addresses pain at its root. This applies to menstrual pain, chest and rib pain from Liver Qi stagnation, abdominal pain from Blood stasis, and pain from traumatic injuries.

Patterns Addressed

In TCM, symptoms cluster into recognizable patterns of disharmony that reveal what's out of balance in the body. Chi Shao is traditionally associated with these specific patterns.

The following describes this herb's classification within Traditional Chinese Medicine theory and is provided for educational purposes only.

Why Chi Shao addresses this pattern

Chi Shao is bitter and slightly cool, entering the Liver channel directly. The Liver stores Blood, and when pathogenic Heat invades the Blood level, it can force Blood out of the vessels and cause skin blotches. Chi Shao's bitter, cool nature descends into the Blood level to clear this Heat, calming reckless Blood movement. It is one of the key herbs in the classical approach of 'cooling the Blood and dispersing Blood stasis' (凉血散血) for Blood Heat patterns, where it works alongside herbs like Shēng Dì Huáng and Mǔ Dān Pí.

A practitioner would look for one or more of these signs

Nosebleeds

From Blood Heat forcing blood upward

Skin Rashes

Purple or dark-coloured macules and blotches

Vomiting Blood

Heat driving Blood out of vessels

High Fever

Fever with restlessness at the nutritive or Blood level

TCM Properties

Temperature

Slightly Cool

Taste

Bitter (苦 kǔ), Sour (酸 suān)

Channels Entered
Liver
Parts Used

Root (根 gēn)

This is partial information on the herb's TCM properties. More detailed information is available on the herb's dedicated page

Product Details

Manufacturing, supplier, and product specifications

Product Type

Granules

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Botanical & Sourcing

Quality Indicators

The best quality Chi Shao root (particularly Duolun Chi Shao from Inner Mongolia) is characterized by the traditional description "rough bark, powdery cross-section" (糟皮粉碴). Good roots are thick, long (10-40cm), cylindrical, and slightly curved. The outer surface is brown to dark brown with rough longitudinal wrinkles and horizontal lenticel-like bumps. The bark peels off easily. When broken, the cross-section should be pinkish-white or powdery white, with a narrow cortex and clearly visible radial striations in the wood (sometimes described as having a "chrysanthemum heart" pattern). The herb should have a faint aromatic smell and a slightly bitter, sour, and astringent taste. Avoid roots that are thin, dark-colored throughout, hollow, soft, or showing signs of mold. The Chinese Pharmacopoeia requires a minimum paeoniflorin content of 2.0%.

Primary Growing Regions

The primary producing regions are Inner Mongolia, Liaoning, Hebei, and Sichuan. The most prized dao di (道地) source is Duolun County (多伦) in the Xilingol League of Inner Mongolia, where wild Chi Shao has long been regarded as the finest quality and is known as "Duolun Chi Shao" (多伦赤芍). Other notable production areas in Inner Mongolia include Yakeshi, Hulunbuir, and Xing'an League. Heilongjiang and Jilin provinces also produce significant quantities. Chuan Chi Shao (川赤芍, from Paeonia veitchii) is produced in western Sichuan, eastern Tibet, southern Gansu, eastern Qinghai, and southern Shaanxi, but is less common in commerce and generally considered of secondary quality.

Harvesting Season

Spring and autumn. The roots are dug from wild plants, cleaned of rhizomes, fibrous rootlets, and soil, then dried directly in the sun without peeling.

Supplier Information

Treasure of the East

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Miscellaneous Info

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Usage & Safety

How to use this herb and important safety information

Important Medical Disclaimer

The information provided here is for educational purposes only and is not intended as medical advice or to replace consultation with a qualified healthcare professional. This herb is a dietary supplement and has not been evaluated by the FDA. It is not intended to diagnose, treat, cure, or prevent any disease.

Always consult with a qualified healthcare provider, particularly if you are pregnant, nursing, have a medical condition, or are taking other medications. Discontinue use and consult your healthcare provider if you experience any adverse reactions.

Recommended Dosage

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Instructions for safe storage and consumption

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Traditional Dosage Reference

Standard

6–12g

Maximum

Up to 30–60g under practitioner supervision for specific conditions such as severe jaundice, cholestatic hepatitis, or acute Blood-Heat patterns. High-dose use has been clinically documented for hepatobiliary conditions but requires careful monitoring.

Notes

At the standard dosage range of 6–12g, Chi Shao is used for clearing Heat from the Blood level, cooling Blood in febrile disease, and mild Blood-stasis conditions. Higher doses of 15–30g are often used when the primary goal is to invigorate Blood and resolve stasis, such as in fixed abdominal masses, stubborn menstrual pain, or traumatic injury. Very high doses of 30–60g have been used clinically by specialists for severe jaundice and cholestatic hepatitis (based on Professor Wang Chengbo's protocol), but this requires practitioner supervision. At these high doses, the herb's anticoagulant and Blood-moving effects are significantly amplified. Wine-processed Chi Shao (酒赤芍) reduces the cold nature and enhances its Blood-moving action. Dry-fried Chi Shao (炒赤芍) moderates both the cold and dispersing properties.

Processing Methods

Processing method

Chi Shao slices are dry-fried over gentle heat until the colour deepens and occasional scorch marks appear, then removed and cooled.

How it changes properties

Stir-frying moderates Chi Shao's cold nature slightly, making it gentler on the Spleen and Stomach. It somewhat reduces the Blood-cooling action while preserving the Blood-invigorating and pain-relieving effects.

When to use this form

Preferred when the patient has underlying Spleen-Stomach weakness or cold digestion but still needs Chi Shao's Blood-moving action. The gentler thermal nature reduces the risk of digestive upset from the raw herb's coolness.

Toxicity Classification

Non-toxic

Chi Shao is classified as non-toxic in the Chinese Pharmacopoeia. No significant toxic components have been identified at standard dosages. At very high doses (above 30g), it may occasionally cause mild gastrointestinal discomfort or loose stools due to its bitter, cold properties. Injectable preparations of Chi Shao extract have been associated with rare allergic reactions including itching, redness, palpitations, and shortness of breath, but these are related to the injection route rather than the herb itself in decoction form.

Contraindications

Caution

Blood deficiency without Heat or stasis. Chi Shao is bitter, cooling, and dispersing in nature. It can further deplete Blood and Yin in those who are already Blood-deficient without any concurrent Heat or stasis pathology.

Caution

Amenorrhea or menstrual disorders due to Blood-Cold (blood congealing from Cold). Chi Shao's cool nature may worsen Cold-stagnation patterns. Warming Blood-moving herbs are indicated instead.

Caution

Excessive menstrual bleeding (menorrhagia) without underlying Blood stasis. Chi Shao invigorates Blood circulation and may increase bleeding volume.

Caution

Ulcerated, already-ruptured abscesses and sores. Chi Shao is appropriate for the early inflammatory stage of abscesses, but once the sore has ulcerated and is draining, its Blood-moving action is no longer indicated and may impair healing.

Caution

Spleen deficiency with chronic loose stools or diarrhea. Chi Shao's bitter, cold properties can further damage Spleen Yang and worsen diarrhea.

Avoid

Concurrent use with Li Lu (Veratrum, 藜芦). Chi Shao (as a form of Shao Yao) is listed in the Eighteen Incompatibilities as incompatible with Li Lu. Combined use may produce toxic or adverse effects.

Classical Incompatibilities

Chi Shao (as a form of Shao Yao / 芍药) is listed in the Eighteen Incompatibilities (十八反) as incompatible with Li Lu (藜芦, Veratrum). The relevant line of the classical verse is: "诸参辛芍叛藜芦" — all types of Shen (Ren Shen, Dan Shen, Sha Shen, Xuan Shen), Xi Xin (Asarum), and Shao Yao (both Chi Shao and Bai Shao) are incompatible with Li Lu. This is recorded in the Chinese Pharmacopoeia under Chi Shao's cautions section.

Special Populations

Pregnancy

Use with caution during pregnancy. Chi Shao actively moves Blood and disperses stasis, and its blood-invigorating properties may theoretically stimulate uterine contractions or increase the risk of bleeding. It is not considered an absolute contraindication in the way that strongly abortifacient herbs are, and it does appear in some classical gynecological formulas used during pregnancy (such as Gui Zhi Fu Ling Wan for treating pregnancy-related stasis conditions). However, it should only be used during pregnancy under the guidance of a qualified practitioner when there is a clear clinical indication, and should be avoided in early pregnancy or in cases of threatened miscarriage.

Breastfeeding

No specific safety data exists for Chi Shao during breastfeeding. Its bitter, cold properties could theoretically be transmitted through breast milk and may cause mild digestive upset in nursing infants. Standard dosages used short-term as part of a balanced formula are generally considered acceptable, but prolonged use of high doses should be avoided. Consult a qualified practitioner before use during breastfeeding.

Pediatric Use

Chi Shao may be used in pediatric prescriptions at appropriately reduced dosages based on the child's age and body weight. A common guideline is approximately one-third to one-half the adult dose for children over 3 years old. Its bitter, cold nature means it should be used cautiously in young children with weak digestion. It appears in some classical pediatric formulas for childhood fever with rashes or abdominal pain.

Drug Interactions

Anticoagulants and antiplatelet drugs (warfarin, heparin, aspirin, clopidogrel): Chi Shao has demonstrated anticoagulant and antiplatelet properties through its active compound paeoniflorin and its tannin content. Due to its Blood-invigorating nature, concurrent use with pharmaceutical anticoagulants may have additive effects, potentially increasing bleeding risk. Patients taking warfarin should have their INR monitored more closely if Chi Shao-containing formulas are used concurrently.

Tetracycline antibiotics and rifampicin: Some Chinese clinical sources note that the tannins in Chi Shao may form insoluble complexes with tetracycline-class antibiotics, reducing the absorption and efficacy of both substances. It is advisable to separate administration by at least 2 hours.

Dietary Advice

While taking Chi Shao, especially in formulas for Blood-Heat conditions, it is advisable to avoid excessively spicy, greasy, or deep-fried foods, as these can generate internal Heat and counteract the herb's cooling effect. Cold and raw foods should be consumed in moderation if the formula also contains warming herbs for Blood stasis. Avoid excessive alcohol consumption, as alcohol is warming and Blood-moving, which may amplify Chi Shao's effects beyond the intended therapeutic range.

Cautions & Warnings

Although this formula is typically safe for most individuals, it may cause side effects in some people. Pregnant women, nursing mothers, postpartum women, and those with liver disease should use the formula with caution.

As with any Chinese herbal remedy, it is advisable to seek guidance from a qualified TCM practitioner before beginning treatment.