Benefits and Uses of Xiao Yao San

This traditional Chinese medicine formulation may help with stress, depression and more
Person drinking Xiao Yao San tea and reading.

The Chinese herbal medicine blend Xiao Yao San may be an ancient antidote for a modern-day problem. “In our industrial society, everybody is busy and stressed,” says licensed Chinese herbalist Song Luo, MPH, LAc. “Xiao Yao San helps soothe and relax you by improving the movement of your liver qi (pronounced ‘chi’).”

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In order to understand how Xiao Yao San works, you need to first understand that biomedicine and traditional Chinese medicine (TCM) use completely different systems of explaining, diagnosing and treating disease. In traditional Chinese medicine, qi is the energy that circulates through your body. And freely flowing qi is believed to be important for good health.

While organs like the liver, stomach and spleen exist in both TCM and Western medicine, they’re conceptualized very differently. In TCM:

  • The liver governs endocrine and mental health, in addition to detoxifying blood.
  • The stomach receives food and water, but isn’t responsible for digestion.
  • The spleen is responsible for digestion.

Taken together, these organs — along with your small and large intestines — function like the gastrointestinal (GI) tract in biomedicine. 

TCM sees depression and anxiety as a kind of traffic jam in your liver, preventing your qi from moving where it needs to go. Luo explains how Xiao Yao San may help, its uses and its potential side effects.

What is Xiao Yao San?

Xiao Yao San in English means “free and easy wanderer,” and Luo says that’s exactly how this formulation should make you feel. “In TCM, the liver, spleen and gastrointestinal (GI) system are all closely related to each other and are impacted by stress, anxiety and depression. This herbal formula primarily targets your liver, spleen and stomach to help with these problems.”

Xiao Yao San has been around for about 700 years and is a mixture of eight herbs:

  • Bupleurum (Chai Hu) and white peony root (Bai Shao), which target your liver.
  • Chinese angelica root (Dang Gui), which helps keep your blood healthy and improves circulation.
  • White atractylodes (Bai Zhu) and poria mushroom (Fu Ling), which support your GI system and help treat digestive issues. “Fu Ling can also help invigorate the spleen, promote urination and calm down your shen (‘spirit’), which may help you lose weight and relax mentally,” adds Luo.
  • Peppermint (Bo He), whose aromatic properties may help ease brain fog.
  • Ginger root (Sheng Jiang), which helps circulate qi.
  • Licorice root (Gan Cao), which harmonizes the combined effects of all these herbs.

What is Xiao Yao San used for?

In TCM, Chinese herbs have primary and secondary uses. Primary uses are the main benefits of an herb that have shown the strongest results. Secondary uses are additional benefits you may experience. Luo highlights three uses for Xiao Yan San:

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1. Stress, anxiety and depression

“One of Xiao Yao San’s primary uses is soothing congested qi from your liver,” Luo explains. “It moves and disperses your liver qi throughout your body, which helps alleviate stress, anxiety and depression.”

Several studies back up these benefits. A 2019 lab experiment suggested that Xiao Yao San may reduce depression symptoms by regulating intestinal flora. A 2021 study yielded similar findings.

2. Indigestion and other digestive issues

In TCM, prevention is just as important as treatment. “A diseased liver is going to negatively affect your spleen and stomach. Another primary use of Xiao Yao San is to protect these organs in advance,” says Luo.

In Chinese herbology, white atractylodes, poria mushroom and ginger root strengthen the spleen and stomach, shielding your digestive system from future problems.

“The spleen and stomach are the most important organs for digestion. Poria mushrooms and white atractylodes go straight to your spleen,” says Luo. “Ginger goes directly to your stomach. When nausea, cramping and vomiting occur, there is a rise in your stomach qi, which ginger can quickly cool off.”

A 2022 review of studies in Biomedicine and Pharmacotherapy concluded that Xiao Yao San may reduce symptoms and recurrence rates in people with gastrointestinal (GI) disorders such as irritable bowel syndrome, constipation, and indigestion (dyspepsia). The studies themselves had flaws, though. More research is needed to fully understand Xiao Yao San’s impact on GI health.

3. Premenstrual syndrome (PMS)

A secondary use of Xiao Yao San is helping ease mood changes during pre-menstrual syndrome (PMS). In TCM, PMS indicates a problem with the liver qi. The thinking, then, is that the positive effects that Xiao Yao San has on liver qi can also help improve period-related mood symptoms. But Luo says there are more powerful Chinese medicine formulations to treat PMS, and the research on Xiao Yao San and PMS isn’t very robust.

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Xiao Yao San side effects

Luo says Xiao Yao San is a gentle blend — clinical trials suggest most people will have no problems when they take it. But some could experience side effects from specific herbs in the blend, including:

  • Uterine contractions from Chinese angelica root. The blend shouldn’t be taken during pregnancy.
  • Increased blood pressure from the licorice root. “If you have uncontrolled high blood pressure — for example, more than 160/90 — avoid taking Xiao Yao San,” warns Luo.
  • Mild headache and dizziness.
  • Stomach discomfort and gas from Chinese angelica root.

“And if you’re allergic to one of the herbs in this formulation, you could also experience itchy skin or diarrhea. But that’s extremely rare,” notes Luo.

How to take Xiao Yao San

Luo advises consulting a licensed Chinese herbalist before starting any herbal therapy regimen. “This is the safest way to do it. Even though Xia Yao San is available online, I don’t recommend ordering it on your own. They can’t guarantee the quality,” he says. In the United States, you can find practitioners through the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM).

“Most licensed herbalists will perform blood tests for liver and kidney function and take a detailed health history to make sure it’s safe for you to take an herbal blend,” explains Luo. “They should also recheck your blood work a few weeks later to ensure everything is still OK. Your herbalist can also connect you with a reputable herbal company with quality herbs.”

While Luo most often prescribes taking one small 2-gram bag of powdered Xiao Yao San three times daily, dosages should be tailored to your health. If you have a sensitive stomach, for example, he recommends taking it 30 minutes after a meal. To take 2 grams of powdered Xiao Yao San, completely dissolve the herbal blend in 3 to 4 ounces of hot water and drink it while it’s warm.

Chinese herbal medicine is all about the big picture. You’re not just treating symptoms and diseases, but the whole person. “That’s why it’s important to incorporate other healthy habits into your routine,” notes Luo.

“The liver relates to stress, hormones, menstruation — even your tendons and your eyes. Try yoga, walking, jogging and stretching. So many different things can help relieve your liver and get your qi moving. Combine them with Xiao Yao San, and you’ll have a better quality of life.”

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