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Schisandra

Herb ·Moderate evidence ·Reviewed May 2026

Adaptogenic berry used in TCM for liver protection and stress resilience.

Evidence tier
Moderate
Indexed sources
19 2008–2026
Interactions
10
Cost / month
$5.40 budget
Read the sources → Compare profiles
What it's good for
  • Liver protection1,18
  • Stress adaptation11,15
  • Endurance17
  • Skin health
What to watch for
  • GI upset
  • Decreased appetite
  • Heartburn
  • Epilepsy
  • Peptic ulcers

The bottom line

Evidence rating moderate. Most-documented uses: liver protection, stress adaptation, endurance. 19 sources indexed (2008–2026), with 10 interaction records on file.

The science

How it works, mechanistically.

Core mechanism

Lignans such as schisandrin B influence oxidative stress, mitochondrial function, and hepatic glutathione. Schisandra lignans can also inhibit or modulate CYP450 enzymes and P-glycoprotein, creating clinically relevant drug-interaction potential.11,15

Class
Adaptogenic Berry
Found in food
Schisandra berries
Absorption
Water-soluble; take with food
Dosing

Dosing & protocol.

Common range
500-1,000 mg daily
Recommended form
Standardized extract (9% schisandrin)

Take with food4,16

Dosing protocol

Maintain · 500-2000 mg/day dried berry or extract

Inhibits CYP3A4; counsel on drug interactions. Best evidence for hepatic support.

No cycling requiredNo tolerance buildup
Forms

Forms & what to buy.

Ranked by evidence and value.

Lignan-Standardized Schisandra Extract Recommended
Rank 1: schisandrins-standardized concentrated form. Limited direct form-comparison evidence; ranking is based on review or mechanistic data (PMID: 40205412). Potential CYP interactions warrant caution.
Premium250-500 mg/day
Schisandra Berry Powder
Rank 2: whole berry form. Tart taste and larger doses.
Budget1-3 g/day
Schisandra Tincture
Rank 3: liquid extract form. Alcohol content varies.
MidUse label dose
Cost

What it actually costs.

Real-world pricing across three quality tiers. Assumes Standardized Schisandra Extract.

BudgetBest value
$5.40 /mo
$0.18 per dose
Mid
$11.40 /mo
$0.38 per dose
Premium
$22.50 /mo
$0.75 per dose

Assumes 500-1,000 mg/day. Vendor basis: NOW/iHerb, Vitacost, Amazon marketplace, and specialty herb brands; schisandrin-standardized extracts cost more. Updated 2026-05-28.

From food

The same dose, as food.

How much you'd eat to match a supplemental dose.

500-1,000 mg schisandra
About 1-2 teaspoons dried schisandra berries, schisandra tea, berry powder, tincture-style preparations, or schisandra in traditional soups can approximate low herb servings.

Extracts may standardize lignans more tightly than whole berries.

Lab work

Markers to track.

What to test, the optimal window inside the conventional range, and how long a response takes.

ALT

Schisandra chinensis lignans (schizandrin and gomisin) lower ALT and AST modestly in chronic hepatitis RCTs; mechanism includes induction of phase II detox enzymes.11,12

Optimal
10–25 U/L
Conventional
7–56 U/L
Responds in
ALT responds within 8 to 12 weeks.

Pair with AST and GGT. Schisandra inhibits CYP3A4; counsel on potential drug interactions.

ASTGGT

AST

Schisandra is expected to modestly lower AST in chronic liver conditions, with effects that are typically small, dose-dependent, and most apparent when AST is elevated at baseline.1,18

Optimal
8–25 U/L
Conventional
8–48 U/L
Responds in
8 to 12 weeks

Hold strenuous exercise and alcohol for 48 hours before the draw to avoid false elevations, and test at a consistent time. AST alone is nonspecific, so interpret alongside ALT. Retest at about 3 months.

ALTGGTALP
Protocols

Featured in protocols.

Evidence-based stacks that include it, with the exact dose and timing each one uses.

Liver Support Protocol

Liver HealthOptionalEmerging evidenceBeginner$25-50/mo
Dose here
500 to 1500 mg
Timing
Twice daily

Schisandra lignans support hepatocyte regeneration and reduce ALT in chronic hepatitis; inhibits CYP3A4 with drug interaction implications.11,12

Adaptogen Resilience Protocol

StressOptionalEmerging evidenceIntermediate$40-65/mo
Dose here
500-1000 mg standardized berry extract daily
Timing
With breakfast or a daytime meal

Schisandra (Schisandra chinensis) is a traditional adaptogen investigated for effects on stress mediators and physical and mental performance, often as part of combination formulas. Human evidence specific to stress resilience is still emerging and largely preliminary.12,13

Safety

Full safety detail.

Side effects

  • GI upset
  • Decreased appetite
  • Heartburn
  • Drug interaction risk via CYP3A4 and P-glycoprotein modulation

Contraindications

  • Epilepsy
  • Peptic ulcers
  • Pregnancy
  • Transplant medication use
  • Tacrolimus or cyclosporine therapy
  • CYP3A4 or P-glycoprotein substrate medications unless clinician-supervised10
Interactions

Interaction records.

DangerousContraindicated

Tacrolimus/Cyclosporine

Schisandra increased tacrolimus AUC by 164% and Cmax by 227%. Potentially fatal in transplant patients.

Recommendation: Do NOT combine. Schisandra dramatically increases immunosuppressant levels.

InfoSynergy

Milk Thistle

Schisandra lignans and milk thistle silymarin both support hepatocyte protection and antioxidant defense, giving complementary hepatoprotective effects.

Recommendation: Commonly used together for liver support. If on drugs with a narrow therapeutic window, monitor because both can influence hepatic enzyme activity.

InfoSynergy

NAC

Schisandra and NAC both raise hepatic glutathione and antioxidant capacity, providing complementary protection against oxidative liver stress.

Recommendation: Reasonable combination for antioxidant and liver support. No specific separation required.

InfoSynergy

Rhodiola Rosea

Schisandra and Rhodiola are both adaptogens that modulate the stress response and reduce fatigue, with traditional and clinical use of the combination for endurance and mental performance.

Recommendation: Commonly combined as adaptogens. Take earlier in the day since both can be mildly stimulating and may affect sleep if taken late.

InfoSynergy

Ashwagandha

Schisandra and ashwagandha are both adaptogens that help regulate the stress axis and lower perceived stress, with complementary calming and resilience effects.

Recommendation: Reasonable adaptogen combination for stress support. Monitor for excess sedation when stacking multiple adaptogens.

ModerateCaution

Methylprednisolone

Schisandra extract has human evidence of inhibiting CYP3A activity, and methylprednisolone exposure is highly sensitive to CYP3A inhibition. Combining them could raise steroid exposure and increase systemic adverse effects such as mood changes, high glucose, fluid retention, and adrenal suppression.

Recommendation: Avoid starting high-dose Schisandra during methylprednisolone therapy unless your prescriber knows. If the combination is used, monitor for stronger steroid effects and do not abruptly stop methylprednisolone after prolonged use.

ModerateCaution

Dexamethasone

Schisandra extract can inhibit CYP3A in humans, and dexamethasone exposure rises markedly when CYP3A4 is inhibited. Adding Schisandra could increase dexamethasone effects, including insomnia, mood changes, glucose elevation, and adrenal suppression.

Recommendation: Avoid adding Schisandra during dexamethasone therapy unless your prescriber is aware, especially with repeated or high-dose courses. Watch for stronger steroid side effects and ask about dose adjustment if Schisandra is continued.

ModerateCaution

Budesonide Inhaled

Schisandra extract inhibits CYP3A in human pharmacokinetic studies. Budesonide is normally cleared extensively by CYP3A, so inhibition can raise systemic steroid exposure even when budesonide is inhaled, especially at higher doses or with prolonged use.

Recommendation: Avoid adding high-dose Schisandra to inhaled budesonide without clinician review. Monitor for unusual steroid effects such as easy bruising, facial swelling, high glucose, or symptoms of adrenal suppression, but do not stop the inhaled steroid abruptly.

ModerateCaution

Fluticasone Inhaled

Schisandra has human evidence of CYP3A inhibition, and fluticasone is highly dependent on CYP3A metabolism. Strong CYP3A inhibition has caused adrenal suppression and Cushing syndrome with inhaled fluticasone, so Schisandra could increase systemic steroid exposure in high-risk use.

Recommendation: Do not add concentrated Schisandra extract to chronic or high-dose inhaled fluticasone without clinician review. Monitor for easy bruising, facial rounding, weight gain, high glucose, or fatigue that could suggest adrenal suppression.

ModerateCaution

Fluticasone Nasal

Nasal fluticasone usually has low systemic exposure, but CYP3A inhibition can still increase steroid exposure in susceptible patients. Schisandra extract inhibits CYP3A in humans, so concentrated products may increase the risk of systemic steroid effects during chronic nasal fluticasone use.

Recommendation: Use Schisandra cautiously if you use nasal fluticasone daily or at high doses. Watch for steroid excess symptoms such as easy bruising, facial swelling, weight gain, or unusual fatigue, and tell your clinician about the supplement.

Search all 10 interaction records for Schisandra →

Sources

Sources, by evidence tier.

Numbered references. Citations throughout the page link here.

Meta-analyses & systematic reviews

1

Randomized controlled trials

5

Reviews & position papers

8

Mechanistic & preclinical

3

Reference material

2
Keep exploring

Deep dives & adjacent profiles.

Goal hubStress & Anxiety
Holy Basil/TulsiHerbAshwagandhaAdaptogenTongkat AliHerbMilk ThistleHerbMaca RootHerbBacopa MonnieriHerb

This page is educational. Do not start, stop, or change a supplement or medication based on it without checking with a qualified healthcare professional.

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