A dried fern leaf used for two thousand years in East Asian medicine for painful urination, stones and cough, with almost no testing in people. The one human ingestion study found no change in stone-forming urine chemistry. Every benefit rests on animals or test tubes. Cheap and widely available, but sold under a name shared with two other ferns. (Full Review)
| Marker | Target | Why |
|---|---|---|
| Serum creatinine and eGFR | eGFR ≥ 90 mL/min/1.73 m² | Confirms the kidneys can absorb a diuretic action |
| Serum potassium | 4.0–4.5 mmol/L | Sustained diuresis drives potassium out |
| Serum sodium | 138–142 mmol/L | Catches dilutional drop from high fluid turnover |
| ALT | ≤ 25 U/L (men), ≤ 20 U/L (women) | Detects liver strain from an unstandardised botanical |
| 24-hour urine volume | > 2.5 L/day | The single strongest lever on stone risk, and the herb's claimed action |
| 24-hour urine oxalate | < 25 mg/day | The exact endpoint the rodent work claims to lower |
| 24-hour urine calcium | < 200 mg/day (men), < 150 mg/day (women) | Separates dietary and metabolic contributors to stone risk |
| 24-hour urine citrate | > 450 mg/day (men), > 550 mg/day (women) | Citrate blocks crystal growth and is the main treatable deficit |
| Whole-blood cadmium | < 0.5 µg/L | This fern concentrates cadmium, and wild-collected material can carry it |
Cadence: Baseline, then 4 weeks, 12 weeks and every 6 months. 24-hour urine repeated at 12 weeks; cadmium at 6 months.