kudzu

Kudzu (Pueraria lobata): A Comprehensive Reference

1. Identity, Nomenclature, and Botanical Description

Accepted Botanical Names and Taxonomy

Kudzu root (Gegen in Chinese) is the dried root of Pueraria lobata (Willd.) Ohwi, a semi-woody, perennial, and leguminous vine native to Southeast Asia. The plant's current accepted taxonomic name in many authoritative references is Pueraria montana var. lobata (Willd.) Sanjappa & Pradeep, though Pueraria lobata remains widely used in the scientific and medical literature. It is often used interchangeably in traditional Chinese medicine with thomson kudzu root (Fengen in Chinese), the dried root of P. thomsonii, although the Chinese Pharmacopoeia has separated them into two monographs since the 2005 edition.

Other common names include kudzu vine, Japanese arrowroot, ge gen (ge hua) in Chinese, and bidari kand in Sanskrit. It is also known as Gegen, Yegen, or Kudzuvine root. In Japan the root is called kuzu, and the starch derived from it is used in cuisine.

Kudzu (Pueraria species) is a perennial plant within the Fabaceae family, native to China, Japan, and India. Kudzu is a coarse, high-climbing, twining, trailing, perennial vine. The huge root, which can grow to the size of a human, is the source of medicinal preparations used in Traditional Chinese Medicine and modern herbal products. Kudzu grows in most shaded areas in mountains, fields, along roadsides, thickets, and thin forests throughout most of China and the southeastern United States.

Plant Parts Used

Kudzu is used in traditional medicine to treat alcoholism, cardiovascular disease, menopausal symptoms, diabetes, fever, the common cold, and neck or eye pain. There are several species of kudzu and both the flowers and root extract are used for their medicinal properties. Both the roots and flowers of kudzu — Radix and Flos Puerariae, respectively — have been used to treat alcohol abuse in China for more than a millennium.

Introduction to North America

Kudzu was first introduced to the USA in the 1870s and was widely planted in the southeastern states up to 1933 as protection against erosion and as a source of food and fiber. It was deliberately planted in the early twentieth century for use as animal fodder and to control soil erosion. The plant was incredibly prolific and soon spread throughout the southern United States. Kudzu can grow one foot per day during the summer months and as much as sixty feet annually, giving it the folk name "mile-a-minute vine."

Common Forms and Preparations

The most popular ways to use kudzu root today are as an herbal supplement or a root tea. However, kudzu root can also be consumed as a food. People often eat different parts of the plant raw, sautéed, deep-fried, baked, or jellied. The root can be eaten as one would other root vegetables. Kudzu roots can be dried and ground into a powder, which some people use as breading for fried foods or as a thickener for soups and sauces. The standard dosage of kudzu in herbal practice ranges from 9 to 15 grams daily, consumed in tea or taken as tablets.

2. Traditional and Historical Use

Ancient Chinese Medicine

The oldest Chinese written reference to the use of kudzu is described in the Classic of Poetry (Shih Ching), dated between 1000 BC and 500 BC. Kudzu root has been known for centuries in Traditional Chinese Medicine as ge-gen. The first written mention of the plant as a medicine is in the ancient herbal text of Shen Nong (circa A.D. 100). In Traditional Chinese Medicine, kudzu root is used in prescriptions for the treatment of wei (superficial) syndrome — a disease that manifests just under the surface, with fever — thirst, headache, and stiff neck with pain due to high blood pressure. It is also recommended for allergies, migraine headaches, and diarrhea.

As early as 1000 years ago, Radix Puerariae was used to treat alcohol-related problems, such as alcohol intoxication (Sun Simiao, circa 600 AD) and alcohol abuse (Li Dongyuan, circa 1200 AD). Its medicinal use was documented in the Chinese text Ben Cao Gang Mu from the 16th century, one of the most significant works of traditional Chinese medicine, where kudzu is described as a remedy for fever, diarrhea, and stomach problems.

Radix Puerariae has been used in traditional Chinese medicine for the treatment of fevers, gastrointestinal disorders, muscle aches, allergies, skin problems, high blood pressure, and chronic alcoholism. It is also used in modern Chinese medicine as a treatment for angina pectoris.

Japanese and Korean Traditions

Kudzu, a fast-growing legume-family plant, has been a popular food in Japan and China for thousands of years. In China, kudzu root was used in traditional Chinese medicine for treating fevers, diarrhea, diabetes, and heart disease. In Japan, the root starch (kuzu-ko) has long been used as a food thickener and is a core ingredient in traditional confectionery and cuisine. Kudzu root, also called Japanese arrowroot, is native to China, Japan, and Korea, and these cultures have used it widely for centuries.

Ayurvedic Tradition

Kudzu is utilized in several Ayurvedic formulations as a demulcent, purgative, nutritive, galactagogue, spermatogenic, antiaging, vital energy booster, and restorative tonic. Ayurvedic doctors frequently administer it to treat menstrual abnormalities, general weakness, dysmenorrhea, uterine hemorrhage, and menopausal syndrome symptoms.

3. Key Constituents and Active Compounds

Isoflavones: Primary Bioactive Class

Over seventy phytochemicals have been identified in kudzu root, with isoflavonoids and triterpenoids as the major constituents. Common isoflavones of kudzu root extracts include puerarin (daidzein 8-C-glucoside), daidzin (daidzein 7-O-glucoside), daidzein, genistein, and formononetin. Depending on growing conditions, the total isoflavone content varies from 1.77–12.0%, with puerarin in the highest concentration, followed by daidzin and daidzein.

Kudzu roots are rich in isoflavone C- and O-glycosides, of which puerarin (daidzein 8-C-glucoside) is the most abundant isoflavone. Puerarin is a unique isoflavone in that it is resistant to intestinal hydrolysis and has a wide range of effects on metabolic disease prevention. The major isoflavone in kudzu is puerarin, which is the C8-glucoside of daidzein. Puerarin is metabolized to daidzein by intestinal bacteria.

The structural formula of puerarin is 8-β-D-glucopyranose-4,7-dihydroxy isoflavone; it is a white needle crystal that is slightly soluble in water, and its aqueous solution is colorless or light yellow.

Additional Phytochemicals

Among the flavonoid compounds identified in kudzu are puerarin, puerarin-3′-methoxy-4′-O-glucoside, puerarin-4′-O-glucoside, 3′-methoxypuerarin, daidzein, daidzein-4′,7-O-glucoside, daidzin, genistein, genistin, mirificin, sophoraside A, and ononin. Kudzu also contains glycosides (kudzusaponins A1, A2, Ar, SA4, SB1) and sterols.

Kudzu root harvesting time can influence the concentration of bioactive components. The average concentration of the major isoflavone puerarin in kudzu root cultures has been measured at 33.6 mg/g extract.

Phytoestrogenic Character

Kudzu root contains isoflavones, mainly puerarin and, to a lesser extent, daidzein and daidzin. It has been suggested that isoflavones, belonging to the phytoestrogen group of compounds, act similarly to selective estrogen receptor modulators (SERMs). Due to their antioxidant and phytoestrogen qualities, isoflavonoids contained in kudzu have anti-inflammatory, antithrombotic, antihypertensive, antiarrhythmic, spasmolytic, and cancer chemopreventive activities.

4. Mechanisms of Action

Alcohol-Related Mechanisms

It is well established that inherited human aldehyde dehydrogenase 2 (ALDH-2) deficiency reduces the risk for alcoholism. Kudzu plants and extracts have been used for 1,000 years in traditional Chinese medicine to treat alcoholism. Kudzu contains daidzin, which inhibits ALDH-2 and suppresses heavy drinking in rodents. Decreased drinking due to ALDH-2 inhibition is attributed to aversive properties of acetaldehyde accumulated during alcohol consumption. However, not all of the anti-alcohol properties of daidzin are due to inhibition of ALDH-2.

Daidzin also affects the breakdown of serotonin and dopamine into the primary metabolites 5-hydroxyindole acetic acid (5-HIAA) and 3,4-dihydroxyphenyl acetic acid (DOPAC), respectively. Moreover, it has been suggested that selective ALDH-2 inhibitors reduce craving for alcohol by increasing dopamine in the nucleus accumbens (NAc).

The precise mechanism of action of kudzu on alcohol consumption is unknown, but one possible explanation is that the isoflavones in kudzu might increase the intensity or duration of alcohol's effects and thus delay the desire for subsequent drinks. Data suggest that individuals who drink alcohol while being treated with kudzu extract experience no adverse consequences and that reported reductions in alcohol intake after kudzu extract treatment are not related to an alteration in alcohol's subjective or psychomotor effects.

Cardiovascular Mechanisms

Puerarin has the following pharmacological effects on the cardiovascular system: (1) dilating coronary arteries to relieve vasospasm and increase coronary blood flow, thus improving blood supply to ischemic myocardium; (2) reducing blood pressure, heart rate, and myocardial oxygen consumption; and (3) inhibiting platelet aggregation, reducing blood viscosity. Puerarin also protects the myocardium against ischemia and reperfusion injury via opening the calcium-activated potassium channel and activating protein kinase C.

Puerarin is a natural antioxidant with high health value and has a series of biological activities such as antioxidation, anti-inflammation, anti-tumor effects, immunity improvement, and cardio-cerebrovascular and nerve cell protection.

Anti-Diabetic and Metabolic Mechanisms

Puerarin, an isoflavonoid extracted from kudzu roots, has been reported to possess antioxidant, anti-inflammatory, anti-apoptotic, and anti-diabetic properties which are useful in the treatment of various diseases. Puerarin regulates NLRP3 inflammation through autophagy and has protective effects on chronic vascular diseases induced by hyperglycemia.

5. Scientific Evidence by Area of Use

5.1 Alcohol Use Reduction

This is the area for which kudzu has the most human clinical evidence, though the evidence remains mixed and the studies are predominantly small.

Animal/preclinical foundation: Both the roots and flowers of kudzu have been used to treat alcohol abuse in China for more than a millennium. A crude extract of Radix Puerariae was shown to suppress free-choice ethanol intake in ethanol-preferring golden Syrian hamsters, with two of its isoflavones, daidzin and daidzein, identified as responsible for this effect. These findings have since been confirmed in rats that were either trained or genetically bred to prefer and consume large amounts of ethanol.

Positive human clinical evidence: In a naturalistic laboratory setting (Lukas et al., 2005), kudzu treatment resulted in a significant reduction in the number of beers consumed, paralleled by an increase in the number of sips and time to consume each beer, and a decrease in the volume of each sip. These changes occurred in the absence of a significant effect on the urge to drink alcohol. No side effects of kudzu treatment were reported, suggesting it may be a useful adjunct in reducing alcohol intake.

A later double-blind, placebo-controlled, between-subjects study (n=10/group) tested the effects of kudzu extract (Alkontrol-Herbal™) on alcohol consumption in 20 men. A single dose of kudzu extract (2 g total with an active isoflavone content of 520 mg) or placebo was administered 2.5 hours before the onset of a 90-minute afternoon drinking session during which participants could drink up to 6 beers ad libitum. This was the first demonstration that a single dose of kudzu extract quickly reduces alcohol consumption in a binge drinking paradigm, and the data were said to add to the clinical evidence that kudzu extract may be a safe and effective adjunctive pharmacotherapy for alcohol abuse.

A standardized formulation of kudzu extract produced minimal side effects, was well-tolerated, and resulted in a modest reduction in alcohol consumption in young non-treatment-seeking heavy drinkers. Additional studies using treatment-seeking alcohol-dependent persons were identified as necessary to determine the usefulness of this preparation in other populations.

In one double-blind, placebo-controlled crossover study, 12 healthy adult men and women (mean age 27.5 years) who consumed moderate amounts of alcohol participated; they were treated with either kudzu extract (total isoflavone dose of 750 mg/day) or matched placebo for nine days. On days 8 and 9, participants received an acute ethanol challenge.

The dose of the kudzu root extract used in studies by Lukas et al., given three times a day, provides 750 mg of three isoflavones: 570 mg puerarin, 120 mg daidzin, and 60 mg daidzein. This dose produced a steady-state plasma puerarin level of approximately 41 ng/mL, with a speculated therapeutic range of 25 to 60 ng/mL.

Negative/null clinical evidence: A prospective, randomized, double-blind, controlled clinical trial was conducted at a Veterans Affairs Medical Center to assess whether kudzu root extract influences the drinking habits of veterans in a substance abuse treatment program. Patients were randomly assigned to receive either kudzu root extract 1.2 g twice daily or matching placebo. In this small patient population, kudzu root appeared to be no better than placebo in reducing the craving for alcohol or promoting sobriety.

Overall assessment: Therapeutically, kudzu is primarily investigated for its potential in treating alcoholism, with studies suggesting it may help reduce alcohol consumption and alter drinking behavior, although results in human trials have been mixed. Despite the strong animal literature and the lack of uniformly effective treatments, testing of these compounds in humans has been sparse. The available human studies are small, short-term, and conducted primarily in non-treatment-seeking populations; larger and more definitive trials are lacking.

5.2 Cardiovascular Disease

Kudzu root (Gegen in Chinese), the dried root of Pueraria lobata, is traditionally used as a TCM to promote blood circulation and increase blood flow. Clinically, Gegen is mostly used in the prevention and treatment of cardiovascular diseases (CVDs) and diabetes. Puerarin, an isoflavone glycoside, is the major bioactive ingredient of Gegen and has been shown to be responsible for the pharmacological effects of Gegen in the cardiovascular system.

Angina pectoris: A study involving 388 patients with angina pectoris found that the total efficacy of the puerarin injection group was 88.14% (171/194), compared with 61.86% (120/194) in the danshen injection group. No obvious adverse reactions were noticed in either group. In analyses comparing conventional Western medicines alone versus conventional medicines combined with puerarin injection, patients in the combination group exhibited significant improvements in incidence of angina pectoris, electrocardiogram findings, nitroglycerin consumption, and plasma endothelin levels. However, much of this clinical evidence comes from Chinese medical literature, and many studies are not randomized controlled trials by current international standards.

Carotid intima-media thickness: An open, controlled, randomized, parallel-group comparison trial (NCT02254655) on 119 subjects with active rheumatoid arthritis demonstrated that 24 weeks of intravenous treatment with puerarin reduced carotid intima-media thickness, and its action may be related to the amelioration of insulin resistance, indicating that puerarin might be a potential therapeutic candidate against cardio-metabolic comorbidities.

Blood pressure (preclinical): Puerarin, a major isoflavonoid compound from kudzu roots, has been widely used for the treatment of hypertensive and cardiovascular diseases in China. Evidence for antihypertensive effects is largely from animal models. There are numerous reports in Chinese medical literature describing the successful use of kudzu in the treatment of symptoms of high blood pressure such as headache and dizziness. Recent clinical uses of kudzu include treatments for hypertension and angina pectoris. Large-scale, well-designed randomized controlled trials in Western populations remain lacking.

5.3 Menopausal Symptoms and Bone Health

In humans, benefits from kudzu on hot flashes, night sweats, and cognitive function are attributed to isoflavones. The phytoestrogenic properties of kudzu isoflavones form the theoretical basis for this application.

A 2021 clinical trial (Frontiers in Pharmacology, NCT04552106) evaluated five dose regimens of kudzu root extract administered once, twice, or three times daily in postmenopausal women aged 45–60. The investigational product contained 13.4 g puerarin/100 g, corresponding to 37.5 mg of puerarin per capsule. The lowest total daily dose regimen corresponded to 0.84 g of kudzu extract (113 mg puerarin) and the maximum daily dose of nine capsules corresponded to 2.52 g (338 mg puerarin). The results demonstrated a consistent reduction in bone resorption as measured by urinary CTX-I in all but six trial participants, reduced cartilage degradation, as well as statistically significant climacteric symptom relief. The study concluded that kudzu extract may possess beneficial effects on bone and cartilage health and may be a promising natural alternative to existing treatments for menopausal symptoms. Kudzu root extract was well tolerated for short-term treatment of mild to severe menopausal symptoms in women in all tested doses and dose frequencies.

However, an earlier study found no evidence of beneficial effects of kudzu root powder on menopausal symptoms or urine deoxypyridinoline as a measure of bone resorption, with the investigators suggesting the difference may be related to dosing and formulation — specifically that raw powdered root may not deliver a physiologically relevant dose.

Clinical research in adults with type 2 diabetes has shown that taking oral puerarin 750 mg per day in addition to rosiglitazone 4 mg per day for 12 weeks significantly reduces blood glucose and glycated hemoglobin (HbA1c) compared with baseline.

5.4 Diabetes and Glycemic Control

For more than 2,000 years, kudzu root has been used as a herbal medicine for the treatment of fever, acute dysentery, diarrhoea, diabetes, and cardiovascular diseases. Numerous studies indicate that puerarin has beneficial effects on common health issues such as hypertension, diabetes, and hyperlipidemia.

The evidence base for anti-diabetic effects consists primarily of animal studies and small Chinese clinical trials. Animal and cellular studies have provided support for the traditional uses of kudzu root on cardiovascular, cerebrovascular, and endocrine systems, including diabetes and its complications. Further studies to define the active phytochemical compositions, quality standards, and clinical efficacy are warranted.

5.5 Neuroprotection and Cognitive Function

Several authors have reported beneficial effects of puerarin in cerebral ischemic disease, intracerebral hemorrhage, vascular dementia, Alzheimer's disease, Parkinson's disease, depression, anxiety, and traumatic brain injury, though the bulk of this evidence is from preclinical and animal studies. Puerarin has been reported to have effects on learning and memory performance in humans and animal models. However, there is as yet no detailed clinical evidence specifically on the effect of puerarin on diabetes-associated cognitive decline (DACD).

5.6 Anti-Inflammatory Activity

In vitro, kudzu has demonstrated antiproliferative, anti-inflammatory, and neuroprotective properties. Preliminary in vitro and human studies suggest that kudzu and its constituents, including puerarin, may inhibit inflammatory processes, possibly by inhibiting prostaglandin synthesis and the production of inflammatory cytokines. Evidence from human trials in this area is limited and largely preliminary.

6. Body Systems and Health Areas

• Central Nervous System / Addictions: Kudzu contains isoflavones that exhibit estrogen-like effects and possess anti-inflammatory and neuroprotective properties. Research centers on ALDH-2 inhibition and monoamine pathway modulation in the context of alcohol use disorders.
• Cardiovascular System: Cardiovascular diseases are the leading cause of death globally, and puerarin has been investigated in preclinical studies for conditions such as atherosclerosis, cardiac hypertrophy, heart failure, diabetic cardiovascular complications, myocardial infarction, stroke, and hypertension.
• Endocrine / Metabolic System: Kudzu plant has an extensive range of pharmacological benefits, including managing hypertension, hypolipidemia, hyperglycemia, and illnesses of the heart and brain.
• Reproductive / Hormonal System: The phytoestrogenic isoflavones in kudzu are studied for menopausal symptom management. A 12-week randomized controlled study of postmenopausal women significantly improved the vaginal maturation index, decreased adverse vaginal symptoms, and showed results comparable to conjugated equine estrogen cream.
• Musculoskeletal System: Kudzu may have beneficial effects on bone density. In human research, kudzu has been reported to improve markers of bone remodeling in menopausal women. In animal research, kudzu has been shown to increase bone mineral density. Puerarin appears to decrease bone resorption and promote bone formation.
• Gastrointestinal System: Traditionally used for diarrhea, dysentery, and fever. Radix Puerariae has been used in TCM for the treatment of fevers, gastrointestinal disorders, muscle aches, and allergies.

7. Dosage Forms and Reported Dosages

Kudzu is commercially available in multiple forms: dried root for decoction, standardized root extracts in capsule or tablet form, powdered root, and (in China and parts of Asia) as intravenous puerarin injection. The following dosages are those reported in specific studies, not recommendations:

• In a randomized controlled trial of alcoholism in veterans, the dose used was kudzu root extract 1.2 g twice daily (2.4 g/day total).
• In a binge-drinking paradigm study, a single dose of kudzu extract (2 g total with an active isoflavone content of 520 mg) was administered 2.5 hours before a drinking session.
• In studies by Lukas et al. on alcohol reduction, the kudzu root extract dose given three times a day provided 750 mg of three isoflavones: 570 mg puerarin, 120 mg daidzin, and 60 mg daidzein.
• In one double-blind, crossover study on intoxication effects, participants were treated with kudzu extract at a total isoflavone dose of 750 mg/day for nine days.
• In the menopausal symptoms and bone health trial (2021), the investigational capsule contained 37.5 mg of puerarin; the lowest daily dose regimen (three capsules/day) corresponded to 0.84 g of kudzu extract (113 mg puerarin), and the maximum (nine capsules/day) corresponded to 2.52 g of extract (338 mg puerarin).
• In a human trial for type 2 diabetes, the dosage studied was 750 mg oral puerarin per day in addition to rosiglitazone 4 mg per day for 12 weeks.
• Kudzu has been used safely in clinical settings for up to 4 months; puerarin, a constituent of kudzu, has been used safely for up to 20 days in intravenous formulations.

8. Safety Considerations and Drug Interactions

General Tolerability

A standardized formulation of kudzu extract produced minimal side effects and was well-tolerated in young non-treatment-seeking heavy drinkers. In clinical trials of puerarin injection for angina pectoris, adverse reactions observed included headache, fever, abdominal distension, pruritus, nausea, orthostatic hypotension, dizziness, and perspiration; however, none of these adverse reactions were serious.

Hepatotoxicity

Kudzu root has been used as food and medicine for centuries, but a small number of studies indicate that kudzu root may cause liver damage. Puerarin has hepatotoxicity, which may be caused by the up-regulation of Mt1 mRNA expression involved in the acute phase response and Bax, which is crucial for apoptosis. Kudzu might harm the liver. Some medications can also harm the liver. Taking kudzu along with a medication that can harm the liver might increase the risk of liver damage.

A case report described acute interstitial nephritis in a middle-aged woman who consumed kudzu root juice to promote health and well-being for 10 days, without evidence of any other causes.

Phytoestrogenic Effects

Human and animal studies suggest that kudzu has some estrogenic activity. In one small study of postmenopausal women, transient negative profiles including anemia and altered liver profiles were observed. Tamoxifen is used to help treat and prevent cancers that are affected by estrogen. Kudzu might act like estrogen in the body. By affecting estrogen in the body, kudzu might decrease the effects of tamoxifen. Clinical relevance of this interaction has not been definitively established in human trials.

Drug Interactions

• Methotrexate: In animal studies, taking kudzu at the same time reduced elimination of the drug methotrexate, causing increased drug levels. Clinical relevance has yet to be determined.
• Antidiabetic medications: Animal studies suggest a key component in kudzu may increase the activity of antidiabetic medications.
• Antihypertensive medications: Caution is warranted when administering kudzu to persons with hypertension or those taking hypotensive medications, as puerarin has been shown to lower heart rate and myocardial oxygen consumption in human studies.
• Neurological/Psychiatric medications: Caution is warranted when administering kudzu to persons who are also taking neurologic medications, as the daidzin compound in kudzu has the potential to impede the metabolism of serotonin and dopamine.
• Benzodiazepines: Caution is warranted when administering puerarin to persons who are also taking benzodiazepines, as it may induce anxiety.
• Caffeine: Kudzu might decrease how quickly the body breaks down caffeine, potentially increasing the risk of caffeine side effects such as jitteriness, headache, and rapid heartbeat.
• Anticoagulants/Antiplatelet agents: Puerarin inhibits platelet aggregation in several animal and cellular models, which may interact with anticoagulant or antiplatelet medications.

Special Populations

Due to phytoestrogenic activity, kudzu contains phytoestrogens, making it potentially unsafe for those with hormone-sensitive cancers or conditions like endometriosis. Safety data in pregnancy and lactation from human clinical trials are absent; the lack of evidence warrants caution in these populations. From the standpoint of labeling and standardization of kudzu supplements, the isoflavones are the constituents of interest regarding perceived health benefits. From a safety aspect, a concern for many botanical dietary supplements is the toxic element content, specifically arsenic, cadmium, lead, and mercury.

9. Regulatory and Classification Status

Kudzu is categorized as a food supplement by the European Commission Health and Food Safety Department. In the United States, kudzu root is sold as a dietary supplement and is not approved by the FDA as a drug for any condition. In China, puerarin injection has been an approved pharmaceutical for the treatment of cardiovascular conditions. Since 2002, the National Institute of Standards and Technology (NIST) has collaborated with the Office of Dietary Supplements at the National Institutes of Health to provide reference materials for use in the validation of analytical methods for the determination of chemical markers and toxic elements in botanical dietary supplement ingredients, including kudzu.

References

• Effects of Puerarin on the Prevention and Treatment of Cardiovascular Diseases — PMC (2021)
• Pharmacological Activity, Pharmacokinetics, and Clinical Research Progress of Puerarin — PMC (2022)
• Kudzu Extract Treatment Does Not Increase the Intoxicating Effects of Acute Alcohol in Human Volunteers — PMC (2011)
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