A southern African root extract used mainly to ease joint and back pain. The most consistent evidence supports short-term relief of ongoing low back pain, with a real but conflicting signal for osteoarthritis; broader uses are unproven. Generally well tolerated, mostly mild digestive effects. The science is suggestive rather than settled, and product quality varies widely. (Full Review)
| Marker | Target | Why |
|---|---|---|
| Pain score (e.g., VAS, 0–10) | Reduction of ≥2 points or ≥30% from baseline | Tracks the primary intended benefit |
| Function score (e.g., WOMAC) | Meaningful improvement from baseline | Captures stiffness and daily-activity impact, not just pain |
| INR (if on warfarin) | Within the individual's target range (often 2.0–3.0) | Detects added bleeding risk from herb–drug interaction |
| Fasting glucose | 70–90 mg/dL | Flags additive blood-sugar lowering in people on diabetes drugs |
| Blood pressure | <120/80 mmHg | Detects additive blood-pressure lowering |
| ALT / AST | <25 U/L (men), <20 U/L (women), functional target | Screens liver function given hepatic metabolism and rare hepatic concerns |
| eGFR | >90 mL/min/1.73m² | Gauges kidney reserve, relevant for older users on multiple drugs |
Cadence: Symptom and tolerability review at 4 weeks and again at 8–12 weeks, then periodically (every 6–12 months) for continued users; biomarker checks at baseline and as clinically indicated when interacting medications are involved.