Traditionally used for
- Headaches
- Dizziness
- Ears & hearing
- Cough & breathing
- Sleep
- Nerves & recovery
☯ TCM Properties
Extinguishes Wind and Stops Spasms; Calms the Liver and Subdues Yang; Dispels Wind-Dampness and Unblocks the Collaterals; Alleviates Pain
Traditional Chinese Uses
Tian Ma (gastrodia tuber) is one of the most important herbs in Chinese medicine for internally generated Wind. It calms Liver Yang, settles Wind, and relieves spasms — making it the primary herb for dizziness, vertigo, headache, and tinnitus from Liver Yang or Liver Wind rising. It also addresses convulsions, tremors, facial paralysis, and numbness of the limbs from Wind-Phlegm obstruction of the channels. Its balanced, gentle nature makes it suitable for both deficiency and excess Wind patterns and for both acute and chronic use.
Western Herbalism Properties
Used In Formulas (3)
Relationships
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Botanical Description
Gastrodia elata is a perennial, mycoheterotrophic orchid in the family Orchidaceae, distributed across East Asia, including China, Japan, Korea, and the Russian Far East. Lacking chlorophyll, it derives nutrients from a symbiotic association with Armillaria fungi in forest soils. The plant produces a stout, fleshy, ovoid to elongated underground tuber (rhizome) measuring 8-15 cm long, with prominent ring-like scars. A solitary, erect, leafless flowering stem 30-100 cm tall emerges in early summer, bearing a terminal raceme of small, urn-shaped, yellowish-brown to orange flowers. Following pollination, fruit capsules release dust-like seeds. The dried steamed tuber, known as Tian Ma, is the medicinal part used in East Asian herbalism.
Active Constituents
Gastrodin (4-hydroxybenzyl alcohol 4-O-β-D-glucoside)
Phenolic glucosideConcentration: the Chinese Pharmacopoeia assay marker; total gastrodin plus gastrodigenin measured after base hydrolysis ranged from 1.311 to 2.034 per cent across 47 batches from eight production areas
The compound on which the entire quality control of Tian Ma rests, and the one carried into almost all the clinical work. It is the marker assayed by HPLC under the Pharmacopoeia monograph, and because it is a small, water-soluble glucoside it is well represented in a decoction. Note that assaying free gastrodin alone understates the drug, since much of it is bound up in the parishins.
Parishins A, B, C and E
Citric acid esters of gastrodin (gastrodin conjugates)Concentration: each is one to three gastrodin units esterified to citric acid; Chinese Pharmacopoeia methods determine parishin, parishin B, C and E alongside gastrodin
These are gastrodin prodrugs. The ester bonds to citric acid are cleaved in the gastrointestinal tract to release gastrodin, and Tang and colleagues showed in rats that intragastric parishin at an equimolar gastrodin dose gives a gastrodin pharmacokinetic profile comparable to free gastrodin. Practically, they explain why a batch that assays low for free gastrodin may still deliver a full dose, and why base hydrolysis before assay gives a truer picture of potency than the free-gastrodin figure.
4-Hydroxybenzyl alcohol (gastrodigenin)
Phenolic aglyconeConcentration: co-marker with gastrodin in the Chinese Pharmacopoeia assay; total gastrodigenin after base-enzymatic hydrolysis was 0.748 to 1.120 per cent across eight production areas
The aglycone of gastrodin and the form generated when gastrodin is deglycosylated. It is the second compound in the official assay and carries much of the reported neuroprotective and blood-brain-barrier activity attributed to the drug.
4-Hydroxybenzaldehyde and vanillyl alcohol
Phenolic aldehydes and alcoholsConcentration: no quantitative content located for the crude drug
Minor phenolics of the same biosynthetic family as gastrodin. They are among the roughly 81 to 100 compounds isolated from the rhizome and are routinely included in fingerprint chromatograms used to distinguish genuine Tian Ma from starchy substitutes.
Gastrodia polysaccharides
PolysaccharidesConcentration: no standardised content specification; the polysaccharide fraction is not part of the official assay
Together with the phenolics, the polysaccharides are considered the characteristic active fraction of the rhizome. They are also the reason a starchy adulterant can pass a crude visual or gross-chemistry check: the genuine drug is itself largely polysaccharide, so bulk carbohydrate tells you nothing about identity.
β-Sitosterol
PhytosterolConcentration: no quantitative content located for the crude drug
A common plant sterol identified among the lipophilic constituents of the rhizome. It is not extracted to any extent by decoction and is not implicated in any of the drug's clinical effects.
⚠ Drug Interactions
Valproic acid
This is the best-characterised herb-drug interaction for Tian Ma and it is a transporter interaction, not a cytochrome one. Yang and Tsai used in vivo microdialysis in pilocarpine-induced epileptic rats and showed that co-treatment with Gastrodia elata extract raised valproic acid concentrations in the brain and produced a synergistic reduction in seizure severity, with hippocampal neuronal protection and altered DOPAC and 5-HT levels. The effect was partially blocked by the organic anion transporting polypeptide inhibitor cyclosporin A, identifying OATP-mediated transport at the blood-brain barrier as the route. The consequence is a brain concentration change that a serum valproate level would not necessarily reveal.
Clinical note: This is animal data, but it is directly on point for a herb commonly given for epilepsy and headache. Do not add Tian Ma to valproate without telling the prescriber, and watch for new drowsiness, tremor or unsteadiness rather than relying on a serum level.
Warfarin, direct oral anticoagulants and antiplatelet drugs
Jeon and colleagues showed that a mixed extract of Gastrodia elata and Zanthoxylum schinifolium inhibited collagen- and ADP-induced platelet aggregation dose-dependently in vitro and ex vivo and suppressed thrombosis in vivo. The important caveat is that this was a two-herb mixture, so the contribution of Gastrodia alone is not isolated; antiplatelet aggregation is however also listed among the established activities of Gastrodia elata in comprehensive reviews of the drug.
Clinical note: Ask about anticoagulants before prescribing, and stop Tian Ma at least a week before elective surgery or dental extraction. In warfarin patients, check the INR two weeks after starting or stopping the herb.
Sedatives, hypnotics and other CNS depressants
Sedation and hypnosis, anticonvulsant action, antidepressant action and neuroprotection are all among the documented activities of Gastrodia elata constituents in comprehensive reviews of the drug, and the herb is prescribed clinically for insomnia and vertigo on that basis. A herb with a reproducible sedative-hypnotic profile added to a prescribed hypnotic, sedating antihistamine or opioid is an additive pharmacodynamic combination even without a specific study of the pair.
Clinical note: Warn patients starting Tian Ma alongside a hypnotic or a sedating antihistamine about daytime drowsiness and driving, particularly older patients and those at fall risk.
Adulterants of Tian Ma: potato (Solanum tuberosum), Dahlia, Mirabilis jalapa, Cacalia, Thladiantha and Phytolacca acinosa (Shang Lu) tubers
Tian Ma is among the more heavily adulterated Chinese drugs because it is expensive and because a dried starchy tuber is easy to counterfeit with another dried starchy tuber. Tuberous substitutes reported for it include potato, Dahlia and Mirabilis jalapa roots, Cacalia and Thladiantha tubers and the root of Phytolacca acinosa. The last is the serious one: Phytolacca is the drug Shang Lu, a saponin-containing emetic and drastic purgative, and a patient given it in place of Tian Ma receives a toxic cathartic rather than an inert filler. Market-level DNA barcoding surveys of Chinese herbal medicines confirm that substitution of this kind is a routine feature of the trade rather than an exceptional event, and that morphological inspection alone does not detect it.
Clinical note: Buy Tian Ma with a gastrodin assay certificate rather than on appearance, since the Pharmacopoeia marker distinguishes it from every one of these substitutes. Separately, note the legal position: Gastrodia elata is an orchid and is therefore listed in CITES Appendix II under the family listing for Orchidaceae, and is a Class II nationally protected wild plant in China. The only orchid annotation exemption that mentions this species covers finished cosmetic and personal care products of artificially propagated material packaged for retail, not medicinal tubers, so international shipments of the crude drug require CITES documentation.
Dosage
| Form | Amount | Frequency | Duration | Population | Notes |
|---|---|---|---|---|---|
| decoction | 3–10 g | Daily | — | — | 中国药典 2020 【用法与用量】3～10g。 【性味与归经】甘，平。归肝经。 — Chinese Pharmacopoeia 2020, quoted verbatim; route and cautions preserved. Replaces a cleared category-filler value. |
Dui Yao — Herb Pairs
The classical two-herb combinations this herb appears in, each with an action neither herb has alone.
The pair transforms phlegm and extinguishes wind together, treating dizziness and headache caused by wind-phlegm rising.
Vertigo with nausea, heavy head and a greasy tongue coating.
Core pair of a classical formula — Ban Xia Bai Zhu Tian Ma Tang, Yi Xue Xin Wu (Cheng Guopeng)
Combining wind-extinguishing with blood-moving and upward-reaching action, the pair relieves headache and dizziness due to wind.
Head wind with dizziness and one-sided or generalized headache.
Core pair of a classical formula — Da Chuan Xiong Wan, Xuan Ming Lun Fang (Liu Wansu)
Together they calm the liver and extinguish wind more strongly than either alone, addressing dizziness, headache and tremor from ascendant liver yang or internal wind.
Core pair of a classical formula — Tian Ma Gou Teng Yin, Za Bing Zheng Zhi Xin Yi (Hu Guangci)
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
Show the study
Randomized controlled trial
1
0 verified · 1 unverified
Other clinical trial
0
Observational / case report
0
In vitro / animal
3
3 verified · 0 unverified
Show 3 studies
- Neuroprotective effect and herbal-drug pharmacokinetic interaction of Gastrodia elata extract on valproic acid
- Gastrodia elata Blume and Zanthoxylum schinifolium Siebold & Zucc Mixed Extract Suppress Platelet Aggregation and Thrombosis
- Comparative pharmacokinetics of gastrodin in rats after intragastric administration of free gastrodin, parishin and Gastrodia elata extract
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
Effectiveness of gastrodin for migraine: A meta-analysis
Sixteen randomised controlled trials with 1,332 subjects, retrieved from ten databases including CNKI, CBM, WanFang and VIP, were pooled. Gastrodin improved the response rate (RR 1.21, 95 per cent CI 1.17 to 1.27), reduced pain severity (MD -1.65, 95 per cent CI -2.28 to -1.02), reduced attack frequency (SMD -2.77) and shortened attack duration (SMD -1.64), and was reported as safe. The important caveats are that the trials are almost entirely Chinese-language, that the tested agent is isolated gastrodin rather than the crude rhizome, and that the effect sizes for frequency and duration are implausibly large for a migraine intervention, which points to small-study and reporting bias.
Gastrodia elata blume (Gastrodiae Rhizoma, Tianma) extract for cognitive enhancement in middle-aged adults with normal or mild impairment: A randomized, double-blind, placebo-controlled clinical trial
A 12-week randomised, double-blind, placebo-controlled trial in 100 participants aged 40 to 65 with normal or mildly impaired cognition, taking daily tablets of Gastrodia elata extract. The primary outcome, ADAS-cog total score, improved by -2.15 +/- 2.22 in the herb group against -0.92 +/- 2.03 on placebo. K-MMSE total score, BDNF and total antioxidant status also improved, but amyloid beta did not. No serious adverse events occurred. This is the strongest placebo-controlled human evidence for the whole extract rather than for isolated gastrodin.
Neuroprotective effect and herbal-drug pharmacokinetic interaction of Gastrodia elata extract on valproic acid
In vivo microdialysis in pilocarpine-induced epileptic rats showed that co-treatment with Gastrodia elata extract raised valproic acid concentrations in the brain and produced a synergistic anticonvulsant effect, reducing seizure severity, protecting hippocampal neurons and altering DOPAC and 5-HT levels. The effect was partially blocked by the OATP inhibitor cyclosporin A at 20 mg/kg intraperitoneally, showing that the increase in brain valproate was transporter-mediated at the blood-brain barrier. This is the clearest demonstrated pharmacokinetic interaction between Tian Ma and a conventional drug.
Gastrodia elata Blume and Zanthoxylum schinifolium Siebold & Zucc Mixed Extract Suppress Platelet Aggregation and Thrombosis
A mixed extract of Gastrodia elata and Zanthoxylum schinifolium inhibited collagen- and ADP-induced platelet aggregation dose-dependently in vitro and ex vivo and suppressed thrombus formation in vivo. The result supports an antiplatelet action for preparations containing Gastrodia elata, but because it was tested only as a two-herb mixture the contribution of Gastrodia alone cannot be separated out.
Comparative pharmacokinetics of gastrodin in rats after intragastric administration of free gastrodin, parishin and Gastrodia elata extract
Rats received intragastric gastrodin at 100 mg/kg, parishin at 116 mg/kg containing the same molar amount of gastrodin moiety, or Gastrodia elata extract at 2.3 g/kg on the same molar basis, with plasma gastrodin measured by UHPLC with fluorescence detection. The comparison establishes that the parishins function as gastrodin prodrugs on oral dosing, which is the pharmacokinetic justification for hydrolysing the parishins before assay when judging the potency of a batch of Tian Ma.
Historical Texts
Shen Nong Ben Cao Jing
Han dynastyKai Bao Ben Cao
Northern Song dynasty, 973 to 974 CEBen Cao Gang Mu
Ming dynasty, 1596References
- Zhan HD, Zhou HY, Sui YP, Du XL, Wang WH, Dai L, Sui F, Huo HR, Jiang TL. The rhizome of Gastrodia elata Blume – An ethnopharmacological review . Journal of Ethnopharmacology (2016) [DOI]
- Wu YN, Wen SH, Zhang W, Yu SS, Yang K, Liu D, Zhao CB, Sun J. Gastrodia elata BI.:A Comprehensive Review of Its Traditional Use, Botany, Phytochemistry, Pharmacology, and Pharmacokinetics . Evidence-Based Complementary and Alternative Medicine (2023) [DOI]
- Tang C, Wu B, Wu J, Zhang Z, Yu B. Novel Strategies Using Total Gastrodin and Gastrodigenin, or Total Gastrodigenin for Quality Control of Gastrodia elata . Molecules (2018) [DOI]
- Han J, Pang X, Liao B, Yao H, Song J, Chen S. An authenticity survey of herbal medicines from markets in China using DNA barcoding . Scientific Reports (2016) [DOI]
- Wang D, Liu W, Lu M, Xu Q. Neuropharmacological effects of Gastrodia elata Blume and its active ingredients . Frontiers in Neurology (2025) [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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