Schisandra

The human evidence is thin. MSKCC summarizes it as "a small number of studies" that "are too limited to draw any conclusions" [15]. We graded three outcomes where placebo-controlled trials exist; each grade below links to its rationale and to how we grade evidence.

Does schisandra improve muscle strength?

Two small placebo-controlled trials point the same way, both in middle-aged or older adults [2][3]. In a randomized, double-blind trial in 54 adults over 50 with relatively low muscle mass, all of whom walked for 30-60 min a day on more than 3 days a week, 1 g a day of Schisandra chinensis extract for 12 weeks increased right knee extensor strength by 10.2 Nm (95% CI 3.7 to 16.8) and left knee extensor strength by 6.7 Nm (95% CI 0.3 to 13.1) more than placebo [2]. The trial was registered as NCT03402308, and its registry record names Pusan National University Yangsan Hospital as lead sponsor [2].

In a second double-blind trial, 52 postmenopausal women were randomized to 1000 mg of extract or 1000 mg of starch a day for 12 weeks; only the 45 who finished (24 and 21, average age 61.9 years) were analyzed [3]. Quadriceps muscle strength showed a significant group-by-time interaction (p = 0.001), and resting lactate fell in the schisandra group [3]. The full text states the work was supported by the Dong-A University research fund, while the PubMed record lists the Ministry of Education and the National Research Foundation of Korea, and the study product was provided by Bioport Korea Inc. [3].

These results are early. Both trials are small, lasted 12 weeks and were led from South Korea, from Pusan National University Yangsan Hospital and from Dong-A University in Busan (one author of the 2021 trial is also at Dong-A University), and neither tested younger adults or athletes [2][3]. The participants in the larger trial were also exercising, so the comparison is schisandra plus walking against placebo plus walking [2]. For other options studied for strength, see the physical performance goal hub.

Does schisandra increase muscle mass?

Neither trial found more muscle [2][3]. In the 12-week trial in 54 older adults, there were no differences in muscle mass, anti-inflammatory markers, antioxidative markers or quality-of-life scores between the schisandra and placebo groups [2]. The trial in postmenopausal women measured appendicular skeletal muscle mass by dual-energy X-ray absorptiometry and found no group-by-time interaction for any variable other than quadriceps strength and lactate [3]. The 2020 trial set out to study strength and lactate rather than muscle mass [3], and small trials can miss a modest effect, so this reads as limited, mixed evidence rather than proof of no effect.

Does schisandra, in a three-herb combination, improve focus after a single dose?

The only placebo-controlled trial we found on thinking skills tested a combination. ADAPT-232 is a fixed combination of Rhodiola rosea, Schisandra chinensis and Eleutherococcus senticosus extracts [4]. In a phase IIa pilot in 40 healthy women aged 20-68 who said they had felt stressed for a long time, a single 270 mg tablet improved attention, speed and accuracy on the d2 Test of Attention 2 hours later, given after a Stroop color-word task used to tire participants, compared with placebo (p < 0.05) [4]. Minor adverse events, such as sleepiness and cold extremities, occurred in both groups [4]. Two of the trial's six authors were affiliated with the Swedish Herbal Institute [4], which made the ADAPT-232 product used in a later trial [5].

Because three herbs were given together, the result cannot be credited to schisandra, and the grade applies only to the combination. As of November 11, 2026 we found no placebo-controlled trials of schisandra on its own for memory, attention or other cognitive tests in healthy adults (PubMed and Europe PMC searches, November 11, 2026). The focus goal hub compares better-studied options.

What the evidence does not show

Several popular claims rest on combinations, clinical groups or older research that we could not appraise.

• Stress and sleep. In a 60-day trial in 186 adults with high stress, a five-herb formula containing Rhodiola, holy basil, milky oat seed, Schisandra berry and ashwagandha root reduced Perceived Stress Scale scores compared with placebo, as did an ashwagandha-only product [6]. The trial was funded by Gaia Herbs, which supplied the products and employs two of the authors [6]. Schisandra's share of the effect cannot be separated. As of November 11, 2026 we found no placebo-controlled trials of schisandra on its own for sleep (PubMed and Europe PMC searches, November 11, 2026). See the mood and stress goal hub for graded options.
• Fatigue. In a trial in 100 people with ongoing symptoms after COVID-19, a clinical population, the authors report fewer people with fatigue in the ADAPT-232 group than in the placebo group on day 11 of two weeks of treatment, but for overall symptom severity the groups differed significantly only in daily walk time and cough, and symptoms improved in both groups [5]. The trial was funded by the Swedish Herbal Institute R&D AB, which also supplied the study product [5]. Results may not apply to healthy adults. The energy goal hub covers fatigue evidence for other compounds.
• Endurance. A 2008 review of research from the former USSR reports that schisandra increased endurance, mental performance and working capacity in healthy subjects [1]. It is a narrative review rather than a pooled analysis of placebo-controlled trials [1], and as of November 11, 2026 we found no placebo-controlled endurance trials of schisandra in PubMed or Europe PMC (searches November 11, 2026).
• Body weight. In 28 obese women, 12 weeks of schisandra fruit changed gut bacteria but was not sufficient to induce significant changes in obesity-related measures compared with placebo [8].
• Menopausal symptoms. In a placebo-controlled trial in women aged 40-70 with menopausal symptoms, 36 of whom completed the study, 6 weeks of a schisandra extract (BMO-30) lowered total Kupperman Index scores more than placebo (p = 0.042) [7]. Menopause symptom scores are not one of our graded outcomes [7].

Trials used daily dosing for 12 weeks to study strength [2][3], and the ADAPT-232 study measured attention 2 hours after a single tablet [4]. The 2020 trial's extract was made from fruit extracted in 20% ethanol and contained 4.92 mg/g of schizandrin [3]. Health Canada's monograph covers decoctions and water extracts, crude and ethanolic preparations, and extracts standardized to schisandrins, all as dried fruit taken by mouth [16]. Our evidence review did not include a human study of how long schisandra's lignans stay in the body, so this page gives no timing figures.

Short trials report few problems. In the 12-week trial in 54 adults over 50, none of the participants experienced adverse events [2]. In the 2020 trial, two people who dropped out reported abdominal pain, and both were in the placebo group [3]. In the ADAPT-232 study, minor events such as sleepiness and cold extremities occurred in both groups [4].

MSKCC reports that no serious side effects have been reported, but that schisandra is not well studied in humans [15]. It also notes that schisandra can reduce levels of the liver enzymes ALT and AST [15].

Health Canada's monograph requires products to state "Do not use if you are pregnant" and to advise consulting a health care practitioner before use when breastfeeding [16]. As of November 11, 2026 we found no human safety studies of schisandra in pregnancy, breastfeeding or children (PubMed and Europe PMC searches, November 11, 2026).

Interaction studies in healthy volunteers show that schisandra extracts can raise the amount of some medicines in the blood [9][10][11][12]. These findings are the basis for this page's safety flag. The glossary explains interaction and cytochrome P450 enzymes.

• Medicines moved by P-glycoprotein, such as talinolol. In 12 healthy men, 300 mg of Schisandra chinensis extract twice daily for 14 days raised talinolol exposure (AUC) by 47% and peak level by 51% [9]. The authors wrote that the results suggest the extract inhibited P-glycoprotein in humans [9].
• Immunosuppressants with a narrow safe range, such as tacrolimus and sirolimus (rapamycin). In 12 healthy men, 13 days of extract from the related species Schisandra sphenanthera raised tacrolimus exposure by an average of 164.2% [10]. In 18 healthy people, the same species almost doubled rapamycin exposure [12]. In 12 kidney transplant recipients who were CYP3A5 expressers and needed high tacrolimus doses, adding a Schisandra sphenanthera tablet (Wuzhi tablet) raised tacrolimus levels, and the daily tacrolimus dose needed fell by an average of 40.9% [13]. A review notes that tacrolimus has a narrow therapeutic index [14], and MSKCC reports that in liver transplant patients schisandra increased blood levels of tacrolimus [15].
• Medicines broken down by CYP3A, such as midazolam. In 12 healthy men, 7 days of Schisandra sphenanthera extract raised midazolam exposure by an average of 119.4%, and the authors describe the extract as a CYP3A inhibitor [11].
• Other enzyme pathways. MSKCC lists drugs processed by CYP1A2, CYP3A4 or CYP3A5 as a reason not to take schisandra, based on in vitro and animal studies, and says clinical relevance has yet to be determined [15].

If you take any of these medicines, talk to your doctor or pharmacist before combining them with schisandra.