Traditionally used for
- Dizziness
- Eye health
- Ears & hearing
- Bowel health
- Sleep
- Energy & fatigue
Cautions & contraindications
- Diabetes
☯ TCM Properties
Nourishes Yin and Blood; Generates Fluids; Moistens the Intestines and Unblocks the Bowels; Nourishes Liver and Kidney Yin
Traditional Chinese Uses
Sang Shen (mulberry fruit) is a cold, sweet-sour herb that tonifies Blood and Yin, moistens the Intestines, and addresses premature greying. It is used for patterns of Blood and Yin deficiency with symptoms including dizziness, tinnitus, insomnia, dry eyes, and premature greying. Its moistening quality also relieves dry constipation. As a pleasant-tasting food-grade tonic, it is commonly eaten fresh or processed into syrup for daily use.
Western Herbalism Properties
Traditional Uses
The Cherokee employed Morus alba as an antidiarrheal medicine and used various preparations of the plant as drug applications (Hamel & Chiltoskey, 1975). The fruits were also consumed as food.
Relationships
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Botanical Description
Morus alba, the white mulberry, is a fast-growing deciduous tree in the family Moraceae, native to north-central China and now cultivated and naturalized across much of the temperate world for its leaves, traditionally used to feed silkworms, and for its sweet edible fruit. Mature trees reach 10-20 m in height with a broad, dense, rounded crown and orange-brown, deeply fissured bark on older trunks. The alternate leaves are extremely variable, ovate to broadly ovate or palmately lobed, 5-15 cm long, with serrate margins, a glossy bright-green surface, and a heart-shaped to truncate base. The plant is usually dioecious, bearing small, pale green, wind-pollinated male and female flowers in separate axillary catkins in spring. The fruit, properly a syncarp of small drupelets fused on the persistent fleshy perianth, is cylindrical to ovoid, 1-2.5 cm long, and ripens from white through pink to dark purple-black or remains white depending on cultivar, with a sweet, mild flavor.
Active Constituents
Cyanidin-3-O-glucoside
Anthocyanin (anthocyanidin 3-O-glycoside)Concentration: 0.656-4.367 mg/g of fruit across 20 Chinese Morus alba varieties; the dominant anthocyanin of the ripe fruit
The principal pigment of the ripe mulberry and the compound that gives Sang Shen its deep purple-black colour. It is a strong radical scavenger in vitro, and total anthocyanin content tracks the antioxidant capacity of fruit from different varieties. Oral bioavailability of intact anthocyanins is low, so in-vitro potency should not be read as a systemic effect.
Cyanidin-3-O-rutinoside
Anthocyanin (anthocyanidin 3-O-rutinoside)Concentration: 0.226-1.649 mg/g of fruit across Chinese Morus alba varieties
The second major anthocyanin of Morus alba fruit; in some mulberry pigment preparations it is the more abundant of the two cyanidin glycosides. Contributes to the antioxidant activity of the fruit extract.
Pelargonidin-3-O-rutinoside
AnthocyaninConcentration: 0.319-0.432 mg/g in the varieties where it was detectable; absent from many samples
A minor anthocyanin, present in only some Morus alba varieties. Useful chiefly as a chemotaxonomic marker of fruit origin rather than as a bioactive of interest.
1-Deoxynojirimycin (DNJ)
Piperidine iminosugar (polyhydroxylated alkaloid)Concentration: roughly 0.4% w/w of the standardised Morus alba fruit extract used in the clinical trials (0.75 g extract supplied 2.90 mg DNJ); much lower in whole dried fruit, and far more concentrated in the leaf (Sang Ye) than in the fruit
A glucose analogue that competitively inhibits intestinal alpha-glucosidases (sucrase, maltase), slowing the release of glucose from starch and sucrose. In a randomised human bioequivalence trial, isolated DNJ reproduced about 90% of the postprandial glucose-lowering effect of the whole fruit extract, identifying it as the principal active. This is a genuine, dose-dependent pharmacological effect and the main reason Sang Shen preparations can interact with diabetic medication.
2-O-alpha-D-Galactopyranosyl-deoxynojirimycin
Iminosugar glycosideConcentration: not quantified in the dried fruit; reported as a minor iminosugar of the standardised fruit extract
A galactosylated DNJ derivative. Plasma DNJ was higher after the whole extract than after an equal dose of isolated DNJ, and this glycoside is the leading candidate for that difference, implying the extract contains additional alpha-glucosidase-inhibiting material beyond free DNJ.
Total phenolics (as gallic acid equivalents)
Mixed phenolics (phenolic acids, flavonols, anthocyanins)Concentration: 0.727-6.307 mg gallic acid equivalents per g of fruit, varying almost tenfold between varieties and growing regions
The bulk phenolic fraction of the fruit, correlating with measured DPPH and ABTS radical-scavenging capacity. The very wide range between varieties means a batch of Sang Shen cannot be assumed to carry any particular phenolic load.
Total flavonoids (as rutin equivalents)
Flavonoids (chiefly flavonols such as quercetin and its glycosides)Concentration: 0.199-3.662 mg rutin equivalents per g of fruit
Quercetin and isoquercitrin are the flavonols usually identified in mulberry fruit. They contribute to antioxidant activity in vitro; no fruit-specific human data attach a clinical effect to this fraction.
Ascorbic acid
Water-soluble vitaminConcentration: 3.310-45.712 mg per 100 g of fruit depending on variety and origin
Contributes to the nutritional value and to the measured antioxidant capacity of fresh fruit. Largely degraded in dried and decocted material, so it is not a meaningful component of the medicinal drug as dispensed.
Reducing sugars
Monosaccharides (glucose, fructose)Concentration: 0.515-16.961% of fruit by weight
The sugar load underlies the sweet taste on which the classical description of Sang Shen rests, and it is the reason a fruit drug is used to moisten the intestines. It also means the whole fruit itself delivers absorbable carbohydrate, partly offsetting the alpha-glucosidase inhibition of its own iminosugars.
⚠ Drug Interactions
Alpha-glucosidase inhibitors (acarbose, miglitol, voglibose)
Morus alba fruit contains 1-deoxynojirimycin, a competitive intestinal alpha-glucosidase inhibitor with the same target as acarbose. Three randomised human trials of a standardised Morus alba fruit extract (0.37-0.75 g, supplying about 1.4-2.9 mg DNJ) cut postprandial glucose by 11-27%, and a bioequivalence trial showed isolated DNJ accounts for about 90% of that effect. A dual-isotope study confirmed the mechanism is slowed glucose absorption rather than altered disposal or endogenous production. Adding an alpha-glucosidase inhibitor on top of a DNJ-containing mulberry preparation is pharmacodynamic duplication.
Clinical note: Ask specifically about mulberry supplements, which are usually leaf or fruit extracts standardised for DNJ rather than whole Sang Shen. Whole dried fruit in a decoction carries far less DNJ than these extracts and is much less likely to matter, but where a concentrated extract is used alongside acarbose, expect additive gastrointestinal effects and lower postprandial readings, and adjust the drug rather than the food.
Insulin and insulin secretagogues (sulfonylureas such as glibenclamide, glinides)
DNJ-containing Morus alba preparations reduce postprandial insulin as well as glucose (postprandial insulin fell 10-35% across the randomised trials), which is consistent with a smaller glucose load reaching the circulation rather than with any insulin-secretory action. Because these agents are dosed against the expected postprandial excursion, a mulberry preparation that flattens that excursion can leave the patient relatively over-medicated. No hypoglycaemia was reported in the healthy-volunteer trials, which did not include medicated diabetic subjects, so the risk is inferred from the mechanism rather than observed.
Clinical note: Do not start or stop a concentrated mulberry preparation in a patient on insulin or a sulfonylurea without arranging postprandial glucose monitoring for a week or two. The whole-fruit drug at customary decoction doses is a much smaller concern than a standardised extract.
Other Morus alba drugs dispensed as, or in place of, Sang Shen: Sang Ye (leaf, Folium Mori), Sang Bai Pi (root bark, Cortex Mori) and Sang Zhi (twig, Ramulus Mori)
One species, Morus alba, yields four separate Chinese drugs. This record is Sang Shen, the ripe fruit (Fructus Mori), used to nourish Yin and blood and moisten the intestines. The leaf (Sang Ye) is a wind-heat and eye drug and carries far higher 1-deoxynojirimycin than the fruit; the root bark (Sang Bai Pi) is a lung drug used to stop cough and promote urination; the twig (Sang Zhi) is a channel-opening drug for wind-damp painful obstruction. Commercial supplements labelled only "mulberry extract" are usually leaf, so a patient reporting that they already take mulberry may be taking the drug with the strongest metabolic activity, not the fruit. Substituting one for another changes both the intended action and the alpha-glucosidase inhibition the patient is exposed to.
Clinical note: Confirm the plant part on the label or invoice, not just the pinyin stem "Sang". When a patient reports a mulberry supplement, ask whether it is leaf or fruit and whether it is standardised to DNJ before assuming it is equivalent to dispensed Sang Shen.
Dosage
| Form | Amount | Frequency | Duration | Population | Notes |
|---|---|---|---|---|---|
| decoction | 9–15 g | Daily | — | — | 中国药典 2020 【用法与用量】9～15g。 【性味与归经】甘、酸，寒。归心、肝、肾经。 — Chinese Pharmacopoeia 2020, quoted verbatim; route and cautions preserved. Replaces a cleared category-filler value. |
Evidence Tier
Strong evidence · 5 studiesRecorded studies by study design, strongest design at the top. This is a study-design tier only, not a GRADE rating: it does not weigh risk of bias, consistency or precision.
Systematic review / meta-analysis
1
1 verified · 0 unverified
Randomized controlled trial
4
4 verified · 0 unverified
Show 4 studies
- Dose–response efficacy of mulberry fruit extract for reducing post-prandial blood glucose and insulin responses: randomised trial evidence in healthy adults
- Effect of mulberry fruit extract on post-prandial glycaemic and insulinemic responses to different rice types: a randomised trial in healthy adults
- Bioequivalence of Mulberry Fruit Extract and 1-Deoxynojirimycin for Postprandial Blood Glucose Lowering: A Randomized Trial in Humans
- Effect of mulberry fruit extract on glucose fluxes after a wheat porridge meal: a dual isotope study in healthy human subjects
Other clinical trial
0
Observational / case report
0
In vitro / animal
0
Other / unclassified
0
Verified: design read from PubMed for a DOI that resolves to the cited paper Unverified: taken from the study's recorded description
Clinical Studies
Dose–response efficacy of mulberry fruit extract for reducing post-prandial blood glucose and insulin responses: randomised trial evidence in healthy adults
Two randomised crossover trials in healthy adults (84 subjects each) tested a standardised Morus alba fruit extract added to a carbohydrate meal. In the first, all doses tested reduced postprandial glucose by 22.9-27.2% and postprandial insulin by 14.0-34.6%; in the second, the lowest effective dose was 0.37 g of extract, which reduced postprandial glucose by 20.4% and insulin by 17.0%. No adverse effects were reported. The subjects were healthy volunteers, not medicated diabetic patients, and the material was a concentrated fruit extract rather than whole dried Sang Shen.
Effect of mulberry fruit extract on post-prandial glycaemic and insulinemic responses to different rice types: a randomised trial in healthy adults
A randomised partial-factorial crossover trial in 120 healthy normal-weight Indian adults tested 0.37 g of Morus alba fruit extract against four rice varieties, each meal providing about 50 g of available carbohydrate. Averaged across rice types the extract reduced the postprandial glucose response by 11.4% and the postprandial insulin response by 10.1%, with the size of the effect varying by rice type (glucose -9.8 to -15.1%). The effect is therefore real but modest and food-matrix dependent.
Bioequivalence of Mulberry Fruit Extract and 1-Deoxynojirimycin for Postprandial Blood Glucose Lowering: A Randomized Trial in Humans
In 84 healthy adults, 0.75 g of Morus alba fruit extract (containing 2.90 mg DNJ), 2.90 mg of isolated 1-deoxynojirimycin, and placebo were compared on rice meals against FDA bioequivalence criteria. The two active treatments were bioequivalent, the ratio of DNJ to whole extract being 0.903 (90% CI 0.801-1.019), establishing DNJ as the principal active constituent. The whole extract was nonetheless somewhat more effective and produced higher plasma DNJ, which the authors attribute to additional iminosugars, notably 2-O-alpha-D-galactopyranosyl-deoxynojirimycin.
Effect of mulberry fruit extract on glucose fluxes after a wheat porridge meal: a dual isotope study in healthy human subjects
A dual stable-isotope study in healthy subjects given a wheat porridge meal with or without 0.75 g of Morus alba fruit extract. The extract delayed the time to 50% glucose absorption by 10.2 minutes, reduced the two-hour rate of glucose appearance by 8.4%, and lowered the postprandial glucose incremental AUC by 11%. It located the mechanism in slowed intestinal glucose absorption rather than in changed glucose disposal or endogenous production, which is what would be expected of an alpha-glucosidase inhibitor.
A meta-analysis of efficacy of Morus alba Linn. to improve blood glucose and lipid profile
A meta-analysis of thirteen randomised controlled trials of Morus alba products found significant reductions in postprandial glucose at 30, 60 and 90 minutes, but no significant effect on fasting glucose, HbA1c, HOMA-IR, total cholesterol, triglycerides, LDL or HDL. The pooled trials used mixed Morus alba preparations and were not restricted to the fruit, so the result should be read as evidence about Morus alba as a species, not specifically about Sang Shen; it does not support Sang Shen as a treatment for fasting hyperglycaemia or dyslipidaemia.
Historical Texts
Ben Cao Gang Mu
Ming dynasty, 1596References
- Chen T, Shuang FF, Fu QY, Ju YX, Zong CM, Zhao WG, Zhang DY, Yao XH, Cao FL. Evaluation of the Chemical Composition and Antioxidant Activity of Mulberry (Morus alba L.) Fruits from Different Varieties in China . Molecules (2022) [DOI]
- Batiha GE-S, Al-Snafi AE, Thuwaini MM, Teibo JO, Shaheen HM, Akomolafe AP, Teibo TKA, Al-kuraishy HM, Al-Garbeeb AI, Alexiou A, Papadakis M. Morus alba: a comprehensive phytochemical and pharmacological review . Naunyn-Schmiedeberg's Archives of Pharmacology (2023) [DOI]
This information is for educational purposes only and is not intended to replace professional medical advice. Always consult a qualified healthcare provider before using any herbal remedy, especially if you are pregnant, nursing, or taking medications.
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