Yu Liang Shi

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Limonite (hydrated iron oxide, FeO(OH)·nH2O)

Not yet clinically reviewed

Pinyin: Yu Liang Shi
Limonite Clay Ironstone

Traditionally used for

  • Digestion
  • Bowel health
  • Menstrual & women's health

Cautions & contraindications

  • Pregnancy
Strong evidence · 5 studies

☯ TCM Properties

Category: astringent
Temperature: cool
Taste: sweet
Meridians: large intestine, stomach, liver
Functions:

Astringes the Intestines and s tops diarrhea; Restrains leakage of Body Fluids and inhibits and stops bleeding

Traditional Chinese Uses

Yu Liang Shi (禹餘糧, limonite — hydrated iron oxide) is a mineral astringent. Sweet and astringent, cool, entering the Large Intestine, Stomach and Liver, it binds the Intestines to check chronic diarrhoea and dysentery, stems abnormal uterine bleeding and leukorrhoea, and restrains the leakage of body fluids.

It is used for prolonged, unremitting diarrhoea and chronic dysentery from deficiency-cold of the Spleen and Stomach, often paired with Chi Shi Zhi (halloysite) as in Chi Shi Zhi Yu Yu Liang Tang for damage to the lower intestines with fecal leakage. For flooding-and-trickling uterine bleeding and vaginal discharge it is combined with tonifying and blood-stopping herbs. As a heavy mineral it is crushed and decocted first; it is inappropriate in acute damp-heat diarrhoea and is cautioned in pregnancy.

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Botanical Description

Yu Liang Shi (禹餘糧) is the Chinese materia medica name for limonite, a yellow-brown to dark brown mineral consisting principally of hydrated iron oxides (chiefly goethite, FeO(OH), with admixed clay and other earthy components). The medicinal-grade material is gathered as concretionary or earthy lumps, often hollow or kidney-shaped, traditionally said to occur near the legendary tomb of Yu the Great. Pieces are calcined and quenched in vinegar, then powdered for use. In TCM, Yu Liang Shi is classified as sweet, astringent, and neutral, entering the Stomach and Large Intestine channels, and is used to bind the intestines and stop diarrhea, stop uterine bleeding, and arrest leukorrhea. Classical indications include chronic diarrhea, dysentery, prolonged uterine bleeding, and abnormal vaginal discharge.

Active Constituents

Goethite, alpha-FeO(OH)

Iron oxyhydroxide mineral

Concentration: The dominant crystalline phase. Limonite is not a mineral species at all but a field term for a fine-grained mixture of hydrous iron oxides; the crystallographic work that settled the question concluded that what had been called limonite is goethite (Holser, Acta Crystallographica 1953). The Chinese Pharmacopoeia definition, basic ferric oxide FeO(OH), is therefore a nominal formula for a mixture, not the composition of a single phase.

Ferric oxyhydroxide is poorly soluble at intestinal pH, so most of an oral dose passes through unabsorbed and acts as a bulk adsorbent and mild astringent rather than as a source of systemic iron. The fraction that dissolves in gastric acid is the part that can chelate co-administered drugs and contribute to iron load, and no study has measured that fraction for the medicinal drug.

Lepidocrocite, hematite and amorphous ferrihydrite

Accessory iron oxide and oxyhydroxide phases

Concentration: Variable minor phases in natural limonite. The relative proportions differ between deposits and are not controlled by any monograph.

These phases differ from goethite in surface area and acid solubility, so batch-to-batch variation in the mix is one reason the dissolved-iron dose from the drug is not predictable.

Clay, silica and alumina gangue

Non-iron mineral matter

Concentration: Limonite nodules typically enclose clay and silica; the Chinese analytical literature on the drug has used Fe2O3 and Al2O3 together to characterise the ore. No pharmacopoeial content limit for iron, silica or alumina is set for this drug.

The aluminosilicate fraction contributes adsorptive surface of its own, so the drug is not a pure iron preparation even in a clean batch.

Arsenic

Metalloid contaminant (geochemically enriched)

Concentration: No published assay of medicinal Limonitum was located, so no figure can be quoted for this drug. What can be stated is the geochemical reason for concern: goethite and amorphous ferric oxyhydroxide are among the strongest natural scavengers of arsenate from groundwater, and arsenic sorbed to goethite is only partly reversible (Zhang et al. 2017; Mamindy-Pajany et al. 2011). Natural iron oxyhydroxide ores are therefore expected to carry arsenic, and Chinese analytical work on this drug has specifically used lead and arsenic as its marker harmful elements.

This is the safety-critical gap in the record. The Chinese Pharmacopoeia sets no arsenic limit for this monograph, and its general ceilings for lead, cadmium, arsenic, mercury and copper apply to plant-derived materials and decoction pieces rather than to mineral drugs, so nothing in routine quality control would catch an arsenic-rich batch.

Lead, cadmium and mercury

Heavy metal contaminants (not assayed in this drug)

Concentration: Not measured in any accessible published survey of medicinal Limonitum. No pharmacopoeial limit test for these elements applies to the monograph.

Recorded as an explicit gap rather than as a reassurance. Absence of an assay is not evidence of absence for a dug ore.

⚠ Drug Interactions

Levothyroxine

Moderate Evidence: Possible

Iron binds thyroxine directly. In 14 patients with primary hypothyroidism on stable replacement who took 300 mg ferrous sulfate with their thyroxine daily for 12 weeks, mean serum TSH rose from 1.6 to 5.4 mU/L and nine of the 14 became more symptomatic; mixing iron and thyroxine in vitro produced a poorly soluble purple complex (Campbell et al., Annals of Internal Medicine 1992). That trial used soluble ferrous sulfate. Limonite is ferric oxyhydroxide and is far less soluble than ferrous sulfate, so the dissolved iron dose from an ordinary decoction is smaller and has never been measured; the direction of the interaction is well established but its size in this setting is not.

Clinical note: Separate the mineral from levothyroxine by at least four hours. If a euthyroid patient is started on the mineral for more than a few weeks, recheck TSH.

Fluoroquinolone antibiotics

Major Evidence: Possible

Fluoroquinolones chelate divalent and trivalent metal cations at the 3-carboxyl and 4-oxo positions, forming poorly absorbed complexes. In three two-period crossover trials of eight healthy volunteers each, ferrous sulfate equivalent to 100 mg elemental iron reduced the AUC of norfloxacin by 73 percent, ciprofloxacin by 57 percent and ofloxacin by 25 percent (Lehto, Kivisto and Neuvonen, British Journal of Clinical Pharmacology 1994); an earlier study found the same for ciprofloxacin (Polk et al. 1989). Limonite is ferric oxyhydroxide and is far less soluble than ferrous sulfate, so the dissolved iron dose from an ordinary decoction is smaller and has never been measured; the direction of the interaction is well established but its size in this setting is not.

Clinical note: Do not co-administer. Separate by at least two hours before or six hours after the quinolone, and preferably suspend the mineral for the duration of the antibiotic course.

Tetracycline antibiotics

Major Evidence: Possible

Tetracyclines form stable chelates with iron. Neuvonen and Turakka showed in man that a range of iron salts inhibits tetracycline absorption (European Journal of Clinical Pharmacology 1974), and the affinity of tetracycline for aluminium and iron hydrous oxide surfaces is well characterised. Limonite is ferric oxyhydroxide and is far less soluble than ferrous sulfate, so the dissolved iron dose from an ordinary decoction is smaller and has never been measured; the direction of the interaction is well established but its size in this setting is not.

Clinical note: Separate by at least two hours, or suspend the mineral while the tetracycline course runs.

Levodopa

Moderate Evidence: Possible

Levodopa is a catechol and chelates ferric iron strongly. In a randomised crossover trial in eight normal subjects, 325 mg ferrous sulfate taken with 250 mg levodopa reduced peak levodopa concentration by 55 percent and AUC by 51 percent; ferrous iron is oxidised rapidly to the ferric state in the presence of levodopa at small-intestinal pH, and it is the ferric complex that binds (Campbell and Hasinoff, Clinical Pharmacology and Therapeutics 1989). Limonite is ferric oxyhydroxide and is far less soluble than ferrous sulfate, so the dissolved iron dose from an ordinary decoction is smaller and has never been measured; the direction of the interaction is well established but its size in this setting is not.

Clinical note: Separate by at least two hours in any patient on levodopa, and ask about new off-periods if the mineral has recently been added.

Oral iron supplements and iron-overload states

Theoretical Evidence: Theoretical

Yu Liang Shi is an iron ore, and the traditional processing of these drugs by calcination and vinegar quenching is aimed precisely at raising the dissolved ferrous fraction. No study has measured how much iron a patient actually absorbs from a decoction of the drug, so the added load cannot be quantified, but it is not zero and it is additive to any prescribed iron.

Clinical note: Avoid in haemochromatosis, transfusion-dependent anaemia and other iron-overload states. Count the mineral as an unquantified iron source when reviewing a patient already on iron replacement.

Yu Yu Liang (Limonitum) supplied under either name

Theoretical Evidence: Established

Yu liang shi is a recorded alias of yu yu liang, not a separate drug. Both names denote Limonitum, the same ore with the same nominal formula FeO(OH). Where a formula or a database carries both entries, a patient can receive a double dose of one mineral while appearing to receive two.

Clinical note: Treat the two entries as one drug when totalling a prescription. If both names appear in the same formula, confirm with the prescriber which was intended rather than dispensing both.

Chelation therapy and heavy-metal exposure workup

Theoretical Evidence: Theoretical

Mineral drugs are dug ores, and the Chinese Pharmacopoeia limits for lead, cadmium, arsenic, mercury and copper are written for plant-derived materials and decoction pieces, not for the mineral monographs. A patient taking one of these minerals long term is therefore on an uncharacterised source of arsenic and lead, which will confuse the interpretation of a blood lead, a urine arsenic or a response to chelation.

Clinical note: If a patient on a mineral drug has an unexplained raised blood lead or urinary arsenic, treat the herb itself as a candidate source and have the actual batch assayed rather than assuming an occupational or dietary cause.

Evidence Tier

Strong evidence · 5 studies

Recorded 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.

Verified: design read from PubMed for a DOI that resolves to the cited paper Unverified: taken from the study's recorded description

Clinical Studies

The effect of ferrous sulphate on the absorption of norfloxacin, ciprofloxacin and ofloxacin.

Lehto P; Kivisto KT; Neuvonen PJ (1994) British Journal of Clinical Pharmacology RCT Verified: Randomized controlled trial

Three separate two-period crossover trials, eight healthy volunteers each, single doses after an overnight fast. Ferrous sulfate corresponding to 100 mg elemental iron reduced the 0 to 24 hour AUC of norfloxacin by 73 percent, ciprofloxacin by 57 percent and ofloxacin by 25 percent, with matching falls in peak concentration and urinary recovery. The iron source was soluble ferrous sulfate, not a mineral iron oxide.

Effect of ferrous sulfate and multivitamins with zinc on absorption of ciprofloxacin in normal volunteers

Polk RE; Healy DP; Sahai J; Drwal L; Racht E (1989) Antimicrobial Agents and Chemotherapy RCT

Volunteer crossover study confirming that ferrous sulfate, and multivitamin preparations containing zinc, substantially reduce ciprofloxacin absorption. Establishes the interaction as a metal-cation chelation effect rather than something specific to one iron salt.

Inhibitory effect of various iron salts on the absorption of tetracycline in man

Neuvonen PJ; Turakka H (1974) European Journal of Clinical Pharmacology RCT Verified: Other clinical trial

Human study comparing several iron salts for their effect on tetracycline absorption, finding inhibition across the range tested. It is the primary human evidence that the tetracycline-iron interaction is a property of iron rather than of one particular salt, which is what makes extrapolation to a mineral iron drug reasonable in direction if not in magnitude.

Ferrous Sulfate Reduces Thyroxine Efficacy in Patients with Hypothyroidism

Campbell NRC; Hasinoff BB; Stalts H; Rao B (1992) Annals of Internal Medicine cohort Verified: Other clinical trial

Uncontrolled clinical trial in 14 patients with primary hypothyroidism on stable thyroxine, who took 300 mg ferrous sulfate with their thyroxine daily for 12 weeks. Mean TSH rose from 1.6 to 5.4 mU/L and nine of 14 developed more hypothyroid symptoms and signs, while the free thyroxine index did not change significantly. Mixing the two in vitro produced a poorly soluble purple iron-thyroxine complex.

Ferrous sulfate reduces levodopa bioavailability: Chelation as a possible mechanism

Campbell NRC; Hasinoff B (1989) Clinical Pharmacology and Therapeutics RCT Verified: Randomized controlled trial

Randomised crossover trial in eight normal subjects. A 325 mg ferrous sulfate tablet taken with 250 mg levodopa reduced peak levodopa concentration by 55 percent and AUC by 51 percent. Ferrous iron oxidises rapidly to ferric in the presence of levodopa at small-intestinal pH, and the ferric complex binds strongly; the authors noted the clinical significance remained to be established.

Historical Texts

Shen Nong Ben Cao Jing

Eastern Han, c. 200 CE
First record of Yu Yu Liang, under a name meaning the surplus grain of Yu the Great. Recorded aliases include tai yi yu liang, shi nao, bai yu liang and yu liang shi, and the drug is described as acting on cough with counterflow, alternating cold and heat, red and white discharge below, and blocked menses.

Shang Han Lun (Zhang Zhongjing)

Eastern Han, c. 200 CE
Source of Chi Shi Zhi Yu Yu Liang Tang, the two-mineral formula of Chi Shi Zhi with Yu Yu Liang, prescribed for diarrhoea that persists after treatment aimed at the upper gut has failed. This formula is the principal classical context in which the drug is still used.

Lei Gong Pao Zhi Lun

Southern and Northern Dynasties, attributed to Lei Xiao, c. 5th century
Warns against confusing Yu Yu Liang with shi zhong huang and with similar-looking nodular stones. The distinction matters mineralogically: the nodule has a hard limonite shell and a softer ochreous interior, and different parts of the same nodule have carried different drug names, so a name alone does not fix which material is in the packet.

Ben Cao Gang Mu (Li Shizhen)

Ming, 1596
Carries the drug forward with the accumulated synonym set and the nodule description. Li Shizhen also records shi zhong huang zi, the unset yellow material inside a Yu Yu Liang shell, as a separate entry, which is the clearest classical statement that the shell and the filling were treated as distinct drugs.

References

  1. Holser WT. Limonite is goethite . Acta Crystallographica (1953) [DOI]
  2. Zhang M; Dai M; Xia L; Song S. Comparison of Arsenic Adsorption on Goethite and Amorphous Ferric Oxyhydroxide in Water . Water, Air, and Soil Pollution (2017) [DOI]
  3. Mamindy-Pajany Y; Hurel C; Marmier N; Romeo M. Arsenic (V) adsorption from aqueous solution onto goethite, hematite, magnetite and zero-valent iron: Effects of pH, concentration and reversibility . Desalination (2011) [DOI]
  4. Han X; Luo JY; Liu QT; Li YJ; Xie YJ; Yang SH; Yang MH. Study on species and valence state of heavy metals and deleterious elements of mineral medicine . China Journal of Chinese Materia Medica (2015) [DOI]
  5. Xu Shan; Xu Liu; Xiang Tangyong; Zhu Ling; Gu Yi; Cai Baochang; Chen Zhipeng. Research Progress on Metallic Mineral Chinese Medicines . Journal of Nanjing University of Traditional Chinese Medicine (2021)

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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