What is Sho-Saiko-To (SST)?

SST (Sho-Saiko-To), also known as Minor Bupleurum Formula and Xiao Chai Hu Tang in Chinese, is a supplement used to aid in liver function based upon Kampo, the Japanese adaptation of traditional Chinese medicine. It is comprised of 7 herbal ingredients (Bupleurum Root, Pinellia Tuber, Scutellaria Root, Ginseng, Jujube, Licorice, and Ginger) that work synergistically to aid in liver health. In Japan, SST is the predominant treatment prescribed for liver disease, specifically hepatitis. As interferon is the main treatment option for hepatitis C, interferon's low response rate with HCV genotype 1 and debilitating side effects have established SST as a popular alternative. SST is currently undergoing clinical trial at Memorial Sloan-Kettering Cancer Center in New York and the liver center at University of California San Diego.

What does SST do for the liver?

Over 200 clinical trials and scientific research have shown that SST cares for the liver through anti-inflammatory, anti-fibrotic, and chemopreventive effects.  Additionally, SST improves the immune system through increasing activity of interleukins, interferon, macrophages, and killer cells, and enhances overall digestive health.  In animal studies, SST has been shown to promote liver regeneration and prevent liver injury. Through human studies, SST has also been shown to reduce the onset of hepatocellular carcinoma.

It is important to note that these results have only been associated with SST as specified by the empirically derived Kampo formula under the Japanese specification for herbal medicine.

SST Ingredients:

• Bupleurum Root: Defends against tumor cells
• Pinellia Tuber: Increases interferon activity
• Scutellaria Root: Relaxes blood vessels and reduces blood pressure, exhibits antitumor activity and, scavenges free radicals
• Ginseng: Improves immune system and inhibits cancer cell growth
• Jujube: Increases killer cell activity, antiasthmatic
• Licorice: Increases interferon activity, protects gastric system, and has antiviral activity
• Ginger: Reduces spread of cancer cells

Although interferon is the common treatment option for hepatitis C, there are many herbal treatments that are just as viable. A common misconception is that herbal supplements, because they are natural and not synthesized, are safe to take under any circumstance and less potent and less useful than synthesized medication. However, herbal supplements can be just as powerful, if not more, than conventional Western medication, and as a result, should be taken with care and under physician supervision. Additionally, many of the Western medicines commonly used today are simply purified forms of herbs and plants, such as penicillin. As a result, the success of much of Western medicine only attests to the strength that lies in herbal treatments. Furthermore, because of the complexity of many herbal compounds, such as sho-saiko-to, the synergy in empirically documented combinations can lead to potential effects that conventional medicine cannot provide.

There are many herbal supplements on the market for hepatitis C. However, only two have undergone rigorous clinical trials in order to prove efficacy: sho-saiko-to and milkthistle. Given its long documented history and rapid advancement through clinical trial in top medicinal research clinics, sho-saiko-to has established itself as the premier natural option for hepatitis C.

Sho-saiko-to is currently manufactured in Japan where, unlike the US, all herbal medicines are regulated under stringent quality control by the Japanese government. For example, current specifications for sho-saiko-to by the Japanese Ministry of Health and Welfare include measurement of ingredient markers such as: Glycyrrhizin (24.7-46.0 mg/day),  Baicalin (110.6-205.6 mg/day), and Saikosaponin (6.5-19.7 mg/day). The current leading Kampo manufacturers in Japan include Tsumura, Kracie (formerly Kanebo) and Honso.

In 2002, sho-saiko-to was introduced to North America by Honso USA under Liver Kampo (low dosage in tablets) and H09 sho-saiko-to (full dosage in granules) in the exact Japanese formulation. Since then Honso USA and HepCare (full dosage SST in capsules) are the only companies in North America that provide the unadulterated Japanese sho-saiko-to product.

Any side effect or caution with SST?

One major implication with taking SST is that there have been reports (at about 1 in 20000) that taking SST alongside interferon therapy greatly increases the chances of developing interstitial pneumonitis. Thus, those currently using interferon or those with lung disease should not take SST.

Other side effects of SST include increased blood pressure, caused by the licorice and ginseng. Those with high blood pressure should consult with their doctors before taking SST. Care should also be taken if you are on any anticoagulants or antiplatelet medications.

There are no problems associated with long term use of SST.

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