A root with one narrow, well-supported job: short-term relief of occasional constipation, accepted by European medicines regulators for a few days' use. Wider claims in kidney failure and hospital care rest on weak trials from hospitals whose income depends on the answer. Harms scale with how long it is taken, not dose alone. (Full Review)
| Marker | Target | Why |
|---|---|---|
| Serum potassium | 4.0–4.5 mmol/L | Detects the depletion that drives arrhythmia risk |
| Red blood cell magnesium | 5.0–6.5 mg/dL | Falls alongside potassium; potassium repletion stalls while magnesium is low |
| Serum creatinine and eGFR | eGFR above 90 mL/min/1.73 m² in healthy adults; stable or rising in kidney disease | The endpoint the kidney claim rests on |
| Blood urea nitrogen | 10–16 mg/dL | The marker most consistently moved in the pooled trials |
| Alanine aminotransferase | Below 25 U/L in men, below 20 U/L in women | Earliest signal of herb-induced liver injury |
| 24-hour urinary oxalate | Below 25 mg per 24 hours | Quantifies calcium-oxalate stone risk before repeated dosing |
| LDL cholesterol | Below 100 mg/dL, or below 70 mg/dL with established plaque | Tracks the one cardiovascular endpoint tested in a trial |
| High-sensitivity C-reactive protein | Below 1.0 mg/L | Tracks the inflammatory claim made for the absorbed compounds |
| Colonic pigmentation at colonoscopy | No established target — record presence, absence and extent, and track change against the individual's own prior colonoscopy | Documents cumulative exposure, which no blood test captures |
| Stool frequency and Bristol Stool Form Scale | One to two stools daily at Bristol type 3–4 | The primary efficacy measure for the main indication |
Cadence: Baseline panel before starting. For occasional dosing within the one-week limit, no ongoing testing is warranted. For repeated intermittent use, potassium and magnesium at four weeks, then every three to six months. For any supervised course beyond a month, liver enzymes at four and twelve weeks, then every three months, with creatinine and urea at the same intervals if the goal is renal.