{"ok":true,"entry":{"slug":"pueraria-mirifica","kind":"supplement","name":"pueraria mirifica","aliases":["white kwao krua","Pueraria candollei"],"brands_sg":[],"class":"botanical","tags":["womens-health"],"use_for":"menopausal vasomotor and urogenital symptoms, small trials","use_after":"daily","use_duration":"the phase iii trial ran 24 weeks at 50 mg a day","take_with":null,"pros":["50 mg/day matched equine estrogen over 24 weeks, n=60","20–50 mg/day cut bap without endometrial thickening","reviewed as a high-potency phytoestrogen for menopause"],"cons":["review: long-term safety margin may be fairly narrow","animal data: hyperplasia, irreversible amenorrhea","root powders vary; no standardised therapeutic window"],"dose_note":"published human studies used 20–50 mg a day: a phase iii randomised trial (n=60) compared 50 mg a day against conjugated equine estrogen over 24 weeks, and a randomised double-blind placebo-controlled trial (n=71) used 20–50 mg a day; historical texts specify a range of 30–500 mg a day; the 2026 review says the discrepancy in dosages across studies and the variable phytochemical fingerprint of the root powders prevent a standardised therapeutic window","dosage":{"ul":null,"unit":"mg","fda_dv":null,"rda_ai":null,"ul_status":"none_established","population":"general adult","hsa_max_daily":null},"ul_status":"none_established","sg_class":null,"cautions":["hormone-sensitive conditions — chronic high doses stimulated endometrial hyperplasia in animals","long-term use — the review calls toxicity dose-dependent and time-cumulative","much of the safety data is rodent, which may not predict human risk","not listed in hsa annex a or b (oct 2025) — not a clearance"],"clashes":[{"src":["pm_future"],"note":"the 2026 review lists potential herb–drug interactions among the things pharmacokinetic studies still need to clarify — i.e. unstudied, not absent","with":"medicines generally"}],"sources":[{"id":"pm_abstract","url":"https://europepmc.org/article/PMC/PMC13279689","label":"Pueraria mirifica: a critical review of the ethnobotany, phytochemistry, pharmacology and challenges in standardisation (Front Pharmacol / Europe PMC 2026) — results and conclusion","quote":"Clinical data suggest that its high concentration of potent phytoestrogens effectively mitigates vasomotor symptoms and urogenital syndromes in menopausal women … the translation from traditional use to clinical standardization is hindered by a lack of rigorous pharmacokinetic data","accessed":"2026-08-27"},{"id":"pm_clinical","url":"https://europepmc.org/article/PMC/PMC13279689","label":"Europe PMC 2026 P. mirifica review — the phase III trial against conjugated equine estrogen","quote":"A subsequent Phase III randomized controlled trial (n = 60) compared a daily dose of 50 mg of P. mirifica against standard conjugated equine estrogen (CEE) therapy, finding no significant difference in efficacy for reducing MGCS scores over 24 weeks","accessed":"2026-08-27"},{"id":"pm_bone","url":"https://europepmc.org/article/PMC/PMC13279689","label":"Europe PMC 2026 P. mirifica review — bone marker trial","quote":"A randomized, double-blind, placebo-controlled trial (n = 71) indicated that doses of 20–50 mg/day significantly suppressed Bone-specific Alkaline Phosphatase (BAP) levels without stimulating endometrial thickening","accessed":"2026-08-27"},{"id":"pm_traditional","url":"https://europepmc.org/article/PMC/PMC13279689","label":"Europe PMC 2026 P. mirifica review — traditional dosage range","quote":"Historical texts specify a dosage range of 30–500 mg/day, recommending a gradual escalation from low to high doses.","accessed":"2026-08-27"},{"id":"pm_toxicity","url":"https://europepmc.org/article/PMC/PMC13279689","label":"Europe PMC 2026 P. mirifica review — toxicological profile and safety margin","quote":"Current research indicates that its toxicity is clearly dose-dependent and time-cumulative, suggesting that the safety margin for long-term use may be relatively narrow","accessed":"2026-08-27"},{"id":"pm_toxic_manifest","url":"https://europepmc.org/article/PMC/PMC13279689","label":"Europe PMC 2026 P. mirifica review — animal toxicity findings","quote":"In female rodent models, high-dose exposure (≥100 mg/kg/day) results in significant endocrine-disrupting effects, including endometrial hyperplasia and hydrometra. Critically, in non-human primates, these dosages can induce irreversible amenorrhea","accessed":"2026-08-27"},{"id":"pm_endometrial","url":"https://europepmc.org/article/PMC/PMC13279689","label":"Europe PMC 2026 P. mirifica review — dual regulatory nature of its estrogenic activity","quote":"while short-term or low-dose application can alleviate postmenopausal vaginal atrophy, chronic high-dose administration carries the risk of stimulating endometrial hyperplasia and potential oncogenesis","accessed":"2026-08-27"},{"id":"pm_heterogeneity","url":"https://europepmc.org/article/PMC/PMC13279689","label":"Europe PMC 2026 P. mirifica review — methodological heterogeneity","quote":"The discrepancy in dosages across studies (20 mg vs. 100 mg) and the lack of long-term fracture-reduction data or cardiovascular endpoint studies … prevent a definitive recommendation.","accessed":"2026-08-27"},{"id":"pm_future","url":"https://europepmc.org/article/PMC/PMC13279689","label":"Europe PMC 2026 P. mirifica review — what is still unknown","quote":"pharmacokinetic and metabolic studies should be expanded to clarify oral bioavailability, metabolite transformation, microbiota-related variability, tissue distribution, and potential herb–drug interactions","accessed":"2026-08-27"},{"id":"hsa_prohibited_2025","url":"https://file.go.gov.sg/hsa-chp-prohibited-restricted-ing-guidelines.pdf","label":"HSA — Guidelines on Prohibited and Restricted Ingredients in Health Supplements and Traditional Medicines, GL-CHPB-1-012 Rev. No. 001 (Oct 2025)","quote":"The objective of this guideline is to highlight the substances of concern when used in HS and TM and is not meant to be an exhaustive list","accessed":"2026-08-27"}],"brand_certs":null,"updated_at":"2026-08-29T16:16:29.426925+08:00"},"disclaimer":"kozen-x is not a medical device and does not give medical advice. it lists what published sources have written down. absence of a record is not the same as safe."}