Bezoar

How an accidental calculus in the gallbladder became a medicinal ingredient

Can bezoar, which is used for high fever or convulsions, be kept and taken like an over-the-counter home remedy? In short, there is insufficient evidence to support using it that way. Bezoar is simply a rare and expensive raw material; it is not, in itself, an emergency response medication.

It is precisely this gap that must be distinguished.

Bezoar is a specific type of calculus found in the gallbladder of cattle

Bezoar does not refer to bovine bile or human gallstones. The Korean Pharmacopoeia defines bezoar as Bos taurus var. domesticusa calculus that forms naturally inside the gallbladder of cattle. The standards require 20% or more conjugated bilirubin and include tests to exclude the mixture of turmeric, curcumin, synthetic colorants, starch, or white sugar. In other words, color and weight alone are insufficient; specific component standards and exclusion tests are part of the quality control.

Its rarity has led to the creation of substitutes and counterfeits

Because natural bezoar occurs rarely, artificial or in-vitro cultured substitutes are distributed to meet demand. However, natural bezoar and substitutes showed differences in components and in-vitro cell reactions. A study comparing natural bezoar with two substitutes reported that the substitutes had higher contents of taurine, cholic acid, and certain elements, and showed different survival responses in cardiac fibroblasts. However, this is not a comparison of clinical effects in humans.

Quality and safety reviews point out that information on the quality and clinical efficacy of natural and substitute bezoars is very limited. This means that the effectiveness of a product cannot be confirmed based solely on traditional use or signals from individual components.

Artificial bezoar, cultured bezoar, and ox bile are not the same raw materials

Artificial bezoar, in-vitro cultured bezoar, ox bile, and complex pills containing some bezoar are not the same raw materials as natural bezoar. Bovine gallstones, ox bile, and human gallstones are also distinct. A distinction must also be made between pure bezoar and complex pills containing bezoar. Since contraindications and interactions vary depending on the ingredients other than bezoar in complex pills, the entire ingredient list of the product must be shown to medical staff or a pharmacist.

First, identify whether it is natural, artificial, or a complex formulation

Bezoar is encountered as a powder or in pill form rather than in its raw state. However, under the same name, natural bezoar, artificial bezoar, in-vitro cultured bezoar, and complex pills containing bezoar are all different. Identifying the form is the first step in verifying quality standards. Whether it is a powder or a pill, it is reasonable to avoid expensive products where the natural or substitute status, content, source, or test results are unclear.

When taking it with medications or supplements, the entire complex pill must be reviewed

If you are looking at a complex pill rather than bezoar alone, contraindications and interactions vary depending on the ingredients other than bezoar. If you are currently taking prescription medications or supplements, you must show the entire ingredient list of the product to medical staff or a pharmacist for consultation. Please also remember that it does not replace prescription medication.

For high fever, convulsions, or decreased consciousness, evaluating the cause comes first

While there is a traditional image of using it to clear heat and open the orifices, high fever, convulsions, and decreased consciousness are symptoms that require immediate emergency care depending on the cause. It is not safe to administer Bezoar (Uhwang) or Bezoar complex pills first based on traditional uses. If there is a first-time convulsion, a convulsion lasting more than 5 minutes, repeated convulsions, failure to regain consciousness, difficulty breathing, or severe high fever, do not put anything in the mouth and contact 119 immediately.

Research on complex prescriptions cannot be applied to the effects of a single ingredient

In research on complex prescriptions containing Bezoar, it is difficult to separate the influence of other medicinal herbs and the formulation. Therefore, those results cannot be applied as the effect of natural Bezoar alone in humans. Considering the number of studies, consistency, and limitations, it is difficult to conclude that the clinical efficacy of Bezoar alone has been proven.

Who needs to take special caution?

There is a lack of highly reliable safety data regarding the use of natural Bezoar alone for infants, pregnancy, lactation, hepatobiliary diseases, and long-term administration. Therefore, it is reasonable not to self-medicate in these situations. One must first consider the age, duration, and cause of fever, convulsions, or changes in consciousness, as well as current medications and whether there are signs requiring emergency evaluation.

Three things to check before purchasing

Then, what should you look for? First, check whether it is natural Bezoar, artificial Bezoar, in vitro cultured Bezoar, or a complex pill containing Bezoar. Second, check if quality specifications can be verified, such as conjugated bilirubin levels and the exclusion of turmeric, curcuma, pigments, starch, and white sugar. Third, avoid expensive powder and pill products with unclear sources or test results.

Final Decision Criteria

The fact that it is rare and expensive should not be mistaken as evidence of strong efficacy. First verify whether it is a natural product, a substitute, or a complex preparation and check the quality tests; for high fever, convulsions, and decreased consciousness, prioritize 119 and cause evaluation over Bezoar. It is not a substitute for prescription medication; decide after consulting a medical professional or pharmacist about all the ingredients in the product.

References

1. Ministry of Food and Drug Safety Korean Pharmacopoeia: Bezoar.
2. Quality and safety issues related to Calculus Bovis and substitutes.
3. Taurine marker study of natural Calculus Bovis and substitutes.
4. Cultured and natural Calculus Bovis comparative preclinical study.

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This text explains the origin of the raw materials, the scope of research, and precautions before consumption. As this cannot replace individual diagnosis or treatment, please consult a medical professional if you are taking medication or if symptoms persist. If sudden and severe symptoms such as difficulty breathing or decreased consciousness occur after consumption, seek help from 119 or the emergency room.