What is Corydalis?

Corydalis yanhusuo is a perennial plant, and its roots have been used in medicine for centuries in traditional Chinese medicine (TCM). In TCM, Corydalis is referred to as Yan Hu Suo [i].

This plant contains alkaloids which are the active medicinal part of the plant. Alkaloids are naturally occurring compounds made by bacteria, fungi, plants, and animals. They have a bitter taste and act as a protective mechanism for plants [ii]. There are over a dozen different alkaloids in the Corydalis plant, and scientists are performing tests on the various alkaloids to better understand how they interact with the body to improve health [iii].  They may taste bitter, but these active compounds are used in treating pain, tumors, and blood vessel diseases [iv].

The plant is part of the Papaveraceae family. Opium also comes from a plant in the same family [v]. Corydalis is also used in pain relief, but don’t worry! Corydalis is being studied to help heroin addicts recover [vi].

History of Use in TCM

Yan Hu Suo has been used for thousands of years in TCM both on its own and in combination with other herbs. It is considered to be warm in energy and affects the heart, liver, lung, and stomach channels. The herb is thought to nourish the blood and circulate the qi [i].  It has been used to help with insomnia and inflammation and to alleviate acute and chronic pain [iii]. People with painful menstrual cycles, intestinal pain, chest pain, and traumatic injuries have also found Corydalis beneficial [i].

Although Corydalis has not been shown to cure disease, Corydalis is able to affect many parts of the body and may be used to promote health. Because of this, there is research being done on the medical applications of Corydalis’s derivatives.

 

Pain (Acute and Chronic)

Whenever you feel pain, it is because of a message sent to the brain. When nerves are activated anywhere in the body, nerve impulses are sent up through the body to the spinal cord and then to the brain [xv].

There are three types of pain. Pain can be because of an acute response to physical damage to tissue (like stubbing your toe). It can be direct damage to the nervous system, like spinal cord injury pain or diabetic neuropathy. Some symptoms might be numbness, hypersensitivity, or tingling. The third type of pain is inflammatory pain. After injury, inflammatory mediators are released at the site of injury. Some examples include rheumatoid arthritis and inflammatory bowel disease [xxii]. An increase in inflammation is correlated with higher feelings of pain [xv]. Pain management mostly depends on medicines that reduce inflammation or block the feeling of pain [v].

Various alkaloids in Corydalis help with pain management. They alleviate pain by blocking neurotransmitters to reduce the message being sent to the brain. Most drugs aren’t able to cross the blood-brain barrier, which is a membrane that helps keeps chemicals and toxins in the bloodstream away from the brain. One of the benefits of corydalis is that it is able to cross the blood-brain barrier. Instead of just working on your neurons spread along your skeleton, it can directly affect how the brain is receiving these neuronal messages. Additionally, corydalis can produce pain relief similar to morphine but is less sedative. Patients taking the herb for pain relief generally did not develop a tolerance to Corydalis [v]. It works for managing inflammatory and neuropathic pain, without inducing tolerance. This means it could potentially help many people dealing with chronic pain [viii].

Heart

Corydalis can be an aid for people with cardiovascular issues, because it can alleviate pain, protect heart tissue, promote a normal heartbeat, and minimize clots.

Because Corydalis works on the nervous system, the chest pain associated with heart disease is also alleviated. One component of Corydalis is dehydrocorydaline, and blocks the release of the neurotransmitter noradrenaline. The heart is made of smooth muscle, and this alkaloid relaxes smooth muscle in the heart and relieves pain [ix].

Research studies suggest the alkaloid, l-Tetrahyropalmatine, within Corydalis is cardioprotective. Heart attacks and the following loss of functional heart tissue can cause heart failure. When Corydalis was given to rats two to thirty minutes before a myocardial infarction, the rats had less heart failure. There was less heart cell death in these rats, so their cardiac function was able to improve over time [x].

After taking Corydalis, patients may also experience an improvement in their quality of life by minimizing palpitation, chest discomfort, and shortness of breath. The herb acts by regulating ion channels that control heart function, stopping harmful inflammatory factors, increasing antioxidant activity, and minimizing platelet clots. Corydalis can improve blood circulation and again relieve the pain associated with heart disease. Alkaloids found in the herb are anti-inflammatory, and they can also decrease platelet aggregation. There are fewer clots traveling around the bloodstream that can cause a blockage in an artery. Additionally, the herb helps with rhythm control [xi].

Gastrointestinal Pain

Inflammation in the gastrointestinal system can be painful. Corydalis can help alleviate occasional gastrointestinal pain. Research is being done on corydaline and tetrahydroberberine, which are derivatives of Corydalis. Studies suggest these maintain the gastrointestinal system dynamics. Gastric emptying is increased, so the overall gastric system movement is better [xii].

Addiction Treatment

Treating drug addiction is complicated and many strategies are currently being used. For cocaine addiction, the most common treatment is using cognitive and behavioral-based interventions, but this doesn’t always help patients. One struggle to overcome in treating addiction is craving drugs after getting clean. One component of Corydalis has been shown to be beneficial for cocaine addiction in mice.

Among heroin addicts, Corydalis may help with promoting the detoxification step. It can reduce drug craving, which helps prevent relapsing.  In animal models, one component of Corydalis reduced the rewarding feelings of cocaine and reduced the stimulation reward in the brain [xiii]. When combined with methadone in heroin-dependent populations, the patients used less methadone and completed their detoxification treatment several days faster [vi].

Ulcers

Gastric ulcers are a common disease throughout the world. Some of the factors that contribute to ulcers are Helicobacter pylori, stress, smoking, nutritional deficiencies, alcohol, infection, non-steroidal anti-inflammatory drug use (NSAIDs), and hydrochloric acid.

Corydalis has been used in TCM to alleviate inflammation and pain for centuries. It reduces inflammation in the gastrointestinal tract. Metabolomics research has been done on Corydalis to better understand how it interacts with our genes and proteins, including how it affects ulcer formation [xiv].

Cancer

As mentioned previously, Corydalis can be used to treat pain. This is especially important for cancer patients. The World Health Organization (WHO) created the “Three-Step Therapy” plan over thirty years ago for treating cancer pain. Patients with cancer often suffer from chronic pain, and managing this pain is necessary for improving their quality of life. In TCM, it is thought that cancer pain is caused from the accumulation of toxins, blood stasis, and slowed vital energy. Corydalis has been used in combination with other herbs for cancer pain in TCM. When Corydalis has been combined with morphine, patients experienced stronger pain relief and fewer adverse side effects (nausea, constipation, fatigue, and anorexia) that accompany cancer pain and morphine treatment. Corydalis can alleviate chronic cancer pain and help reduce the dose of other pain medicine given [xviii].

Several derivatives of Corydalis are being tested for medical applications targeting tumors. Studies suggest that the compound protopine in Corydalis may affect MDA-MB-231 breast cancer cells, so they may be less adhesive [xvii]. Several other derivatives’ effects on MDA-MB-231 cells are also being researched. Berberine, dehydrocorydaline, and dl-tetrahydropalmatine are being studied both separately and together. When combined, research suggests that these derivatives impact tumor cell proliferation [xvi].

Menstrual Pain

PMS is common among women who are reproductive ages. Some of the symptoms associated with PMS are headaches, abdominal discomfort, food cravings, pain, depression, irritability, and anxiety. These symptoms are caused by changes in neurotransmitter levels and hormonal changes. Current drugs used to relieve these symptoms often have adverse side effects like drowsiness, weight gain, and headache. [xix]. Chinese herbal medicine can be used to treat menstrual symptoms. Corydalis can help alleviate the abdominal pain and menstrual cramps associated with the menstrual cycle [xx]. As stated before, Corydalis is used to promote circulation of the blood, so it is thought to improve the symptoms associated with periods. Because it can be used to treat pain, it is helpful for the pain associated with menstrual cycles [xxi].

How to Use

Form

Corydalis is most commonly available as a concentrated extract powder. The medicinal compounds and isolates are still viable in the extract. This means 2 pounds of herbs are used to make 1 pound of a 2:1 extract. There are 1:1 extracts available (not concentrated), but these are less common. This powder can be consumed in a capsule or be added to hot water to make a tea. It can also be added to vinegar in a stir-fry [i].

Safety and Precautions

There have been few adverse side effects but some people may experience vertigo, fatigue, nausea, or an allergic reaction [iii]. Chronic intake may harm the liver and cause slowed neural function, breathing, and heart function [i].

The following groups of people are advised against using Corydalis:

• Pregnant and breast-feeding women
• People with hypothyroid disease
• Anyone who has had an adverse event with a plant product from the same family (Papaveraceae).

Currently, there are no known drug interactions with Corydalis, but you should always talk to your health care provider before beginning a new supplement regiment.

One component tetrahydropalmatine (THP) has seen an increase in popularity as a recreational drug. The FDA classifies concentrated and purified THP as a controlled substance and is banned [i].

References

[i] Schwartz, S. (2005). Psychoactive herbs in veterinary behavior medicine (1st ed.). Ames, Iowa: Blackwell Pub.

[ii] Wei, X., Shen, H., Wang, L., Meng, Q., & Liu, W. (2016). Analyses of Total Alkaloid Extract of Corydalis yanhusuo by Comprehensive RP × RP Liquid Chromatography with pH Difference. Journal of Analytical Methods in Chemistry, 2016, 9752735. http://doi.org/10.1155/2016/9752735

[iii] Fetrow, C., & Avila, J. (2004). Professional’s handbook of complementary & alternative medicines (3rd ed.). Philadelphia, Pennsylvania: Lippincott Williams & Wilkins.

[iv]Liao, D., Wang, P., Jia, C., Sun, P., Qi, J., Zhou, L., & Li, X. (2016). Identification and developmental expression profiling of putative alkaloid biosynthetic genes in Corydalis yanhusuo bulbs. Scientific Reports, 6, 19460. http://doi.org/10.1038/srep19460

[v] Zhang, Y., Wang, C., Wang, L., Parks, G. S., Zhang, X., Guo, Z., … Civelli, O. (2014). A novel analgesic Isolated from a Traditional Chinese Medicine. Current Biology : CB, 24(2), 117–123. http://doi.org/10.1016/j.cub.2013.11.039

[vi] Jia Bei, W., & John R., M. (2012). L-Tetrahydropalamatine: A Potential New Medication for the Treatment of Cocaine Addiction. Future Medicinal Chemistry, 4(2), 10.4155/fmc.11.166. http://doi.org/10.4155/fmc.11.166

[vii] Shorter, D., & Kosten, T. R. (2011). Novel pharmacotherapeutic treatments for cocaine addiction. BMC Medicine, 9, 119. http://doi.org/10.1186/1741-7015-9-119

[viii] Ingram, S. L. (2014). Pain: Identification of novel analgesics from traditional Chinese medicines. Current Biology : CB, 24(3), R114–R116. http://doi.org/10.1016/j.cub.2013.12.030

[ix] Li, B., Xu, X., Wang, X., Yu, H., Li, X., Tao, W., … Yang, L. (2012). A Systems Biology Approach to Understanding the Mechanisms of Action of Chinese Herbs for Treatment of Cardiovascular Disease. International Journal of Molecular Sciences, 13(10), 13501–13520. http://doi.org/10.3390/ijms131013501

[x] Han, Y., Zhang, W., Tang, Y., Bai, W., Yang, F., Xie, L., … Ji, Y. (2012). l-Tetrahydropalmatine, an Active Component of Corydalis yanhusuo W.T. Wang, Protects against Myocardial Ischaemia-Reperfusion Injury in Rats. PLoS ONE, 7(6), e38627. http://doi.org/10.1371/journal.pone.0038627

[xi] Dong, Y., Liao, J., Yao, K., Jiang, W., & Wang, J. (2017). Application of Traditional Chinese Medicine in Treatment of Atrial Fibrillation. Evidence-Based Complementary and Alternative Medicine : eCAM, 2017, 1381732. http://doi.org/10.1155/2017/1381732

[xii] Choi, M.-G., Rhee, P.-L., Park, H., Lee, O. Y., Lee, K. J., Choi, S. C., … Shin, Y. W. (2015). Randomized, Controlled, Multi-center Trial: Comparing the Safety and Efficacy of DA-9701 and Itopride Hydrochloride in Patients With Functional Dyspepsia. Journal of Neurogastroenterology and Motility, 21(3), 414–422. http://doi.org/10.5056/jnm14117

[xiii] Xu, W., Wang, Y., Ma, Z., Chiu, Y.-T., Huang, P., Rasakham, K., … Liu-Chen, L.-Y. (2013). l-Isocorypalmine reduces behavioral sensitization and rewarding effects of cocaine in mice by acting on dopamine receptors. Drug and Alcohol Dependence, 133(2), 693–703. http://doi.org/10.1016/j.drugalcdep.2013.08.021

[xiv] Tianjiao, L., Shuai, W., Xiansheng, M., Yongrui, B., Shanshan, G., Bo, L., … Xiaorong, R. (2014). Metabolomics Coupled with Multivariate Data and Pathway Analysis on Potential Biomarkers in Gastric Ulcer and Intervention Effects of Corydalis yanhusuo Alkaloid. PLoS ONE, 9(1), e82499. http://doi.org/10.1371/journal.pone.0082499

[xv] IRWIN, M., & WONG, G. (2010). Neurobiology and Mechanisms of Pain. In TSUI S., CHEN P., & NG K. (Eds.), Pain Medicine: A Multidisciplinary Approach (pp. 1-8). Hong Kong University Press. Retrieved from http://www.jstor.org.proxy.library.emory.edu/stable/j.ctt1xwd0n.6

[xvi] Zhao, Y., Gao, J.-L., Ji, J.-W., Gao, M., Yin, Q.-S., Qiu, Q.-L., … Wang, X.-F. (2014). Cytotoxicity enhancement in MDA-MB-231 cells by the combination treatment of tetrahydropalmatine and berberine derived from Corydalis yanhusuo W. T. Wang. Journal of Intercultural Ethnopharmacology, 3(2), 68–72. http://doi.org/10.5455/jice.20140123040224

[xvii] He, K., & Gao, J.-L. (2014). Protopine Inhibits Heterotypic Cell Adhesion in MDA-MB-231 Cells Through Down-Regulation of Multi-Adhesive Factors. African Journal of Traditional, Complementary, and Alternative Medicines, 11(2), 415–424.

[xviii] Cong, Y., Sun, K., He, X., Li, J., Dong, Y., Zheng, B., … Song, X.-J. (2015). A Traditional Chinese Medicine Xiao-Ai-Tong Suppresses Pain through Modulation of Cytokines and Prevents Adverse Reactions of Morphine Treatment in Bone Cancer Pain Patients. Mediators of Inflammation, 2015, 961635. http://doi.org/10.1155/2015/961635

[xix] Chen, H.-Y., Huang, B.-S., Lin, Y.-H., Su, I. H., Yang, S.-H., Chen, J.-L., … Chen, Y.-C. (2014). Identifying Chinese herbal medicine for premenstrual syndrome: implications from a nationwide database. BMC Complementary and Alternative Medicine, 14, 206. http://doi.org/10.1186/1472-6882-14-206

[xx] Lin, P.-Y., Tsai, Y.-T., Lai, J.-N., Yeh, C.-H., & Fang, R.-C. (2014). Bian Zheng Lun Zhi as a Complementary and Alternative Treatment for Menstrual Cramps in Women with Dysmenorrhea: A Prospective Clinical Observation. Evidence-Based Complementary and Alternative Medicine : eCAM, 2014, 460386. http://doi.org/10.1155/2014/460386

[xxi] Lin, Y.-R., Wu, M.-Y., Chiang, J.-H., Yen, H.-R., & Yang, S.-T. (2017). The utilization of traditional Chinese medicine in patients with dysfunctional uterine bleeding in Taiwan: a nationwide population-based study. BMC Complementary and Alternative Medicine, 17, 427. http://doi.org/10.1186/s12906-017-1939-1

[xxii] University of Wisconsin. (2010). Pain Management. Retrieved December 24, 2017, from http://projects.hsl.wisc.edu/GME/PainManagement/session2.4.html

References

1. Ji, H. Y., Liu, K. H., Jeong, J. H., Lee, D.-Y., Shim, H. J., Son, M., & Lee, H. S. (2012). Effect of a New Prokinetic Agent DA-9701 Formulated with Corydalis Tuber and Pharbitidis Semen on Cytochrome P450 and UDP-Glucuronosyltransferase Enzyme Activities in Human Liver Microsomes. Evidence-Based Complementary and Alternative Medicine : eCAM, 2012, 650718. http://doi.org/10.1155/2012/650718

2. Guo, Z., Cai, R., Su, H., & Li, Y. (2014). Alkaloids in Processed Rhizoma Corydalis and Crude Rhizoma Corydalis Analyzed by GC/MS. Journal of Analytical Methods in Chemistry, 2014, 281342. http://doi.org/10.1155/2014/281342

3. Liu, P., Shang, E.-X., Zhu, Y., Yu, J.-G., Qian, D.-W., & Duan, J.-A. (2017). Comparative Analysis of Compatibility Effects on Invigorating Blood Circulation for Cyperi Rhizoma Series of Herb Pairs Using Untargeted Metabolomics. Frontiers in Pharmacology, 8, 677. http://doi.org/10.3389/fphar.2017.00677

4. Abbas, Z., Khan, S. M., Alam, J., Khan, S. W., & Abbasi, A. M. (2017). Medicinal plants used by inhabitants of the Shigar Valley, Baltistan region of Karakorum range-Pakistan. Journal of Ethnobiology and Ethnomedicine, 13, 53. http://doi.org/10.1186/s13002-017-0172-9

5. Tang, H., He, S., Zhang, X., Luo, S., Zhang, B., Duan, X., … Sun, Y. (2016). A Network Pharmacology Approach to Uncover the Pharmacological Mechanism of XuanHuSuo Powder on Osteoarthritis. Evidence-Based Complementary and Alternative Medicine : eCAM, 2016, 3246946. http://doi.org/10.1155/2016/3246946

6. Li, R., Chan, W., Mat, W., Ho, Y., Yeung, R. K., Tsang, S., & Xue, H. (2017). Antiaging and Anxiolytic Effects of Combinatory Formulas Based on Four Medicinal Herbs. Evidence-Based Complementary and Alternative Medicine : eCAM, 2017, 4624069. http://doi.org/10.1155/2017/4624069

8. Zhang, Y., Mao, X., Su, J., Geng, Y., Guo, R., Tang, S., … Yang, H. (2017). A network pharmacology-based strategy deciphers the underlying molecular mechanisms of Qixuehe Capsule in the treatment of menstrual disorders. Chinese Medicine, 12, 23. http://doi.org/10.1186/s13020-017-0145-x

9. Shen Clinic. (n.d.). The Whole Truth About Corydalis (With Respect to Dr. Oz). Retrieved December 15, 2017, from https://shenclinic.com/pages/the-whole-truth-about-corydalis-with-respect-to-dr-oz

10. Teschke, R., Larrey, D., Melchart, D., & Danan, G. (2016). Traditional Chinese Medicine (TCM) and Herbal Hepatotoxicity: RUCAM and the Role of Novel Diagnostic Biomarkers Such as MicroRNAs. Medicines, 3(3), 18. http://doi.org/10.3390/medicines3030018

11. Teschke, R., & Eickhoff, A. (2015). Herbal hepatotoxicity in traditional and modern medicine: actual key issues and new encouraging steps. Frontiers in Pharmacology, 6, 72. http://doi.org/10.3389/fphar.2015.00072

12. Figueroa-Guzman, Y., Mueller, C., Vranjkovic, O., Wisniewski, S., Yang, Z., Li, S.-J., … Mantsch, J. R. (2011). Oral administration of levo-tetrahydropalmatine attenuates reinstatement of extinguished cocaine seeking by cocaine, stress or drug-associated cues in rats. Drug and Alcohol Dependence, 116(1-3), 72–79. http://doi.org/10.1016/j.drugalcdep.2010.11.023

13. Crofford, L. J. (2015). Chronic Pain: Where the Body Meets the Brain. Transactions of the American Clinical and Climatological Association, 126, 167–183.

14. Chen, J., Lu, X., Lu, C., Wang, C., Xu, H., Xu, X., … Du, W. (2016). 13-Methyl-palmatrubine induces apoptosis and cell cycle arrest in A549 cells in vitro and in vivo. Oncology Reports, 36(5), 2526–2534. http://doi.org/10.3892/or.2016.5093

15. Kang, H., Jang, S.-W., Pak, J. H., & Shim, S. (2015). Glaucine inhibits breast cancer cell migration and invasion by inhibiting MMP-9 gene expression through the suppression of NF-κB activation. Molecular and Cellular Biochemistry, 403(1-2), 85–94. http://doi.org/10.1007/s11010-015-2339-9