Huperzine A supplement benefit and side effects, safety, dosage, benefit for cognitive decline and Alzheimer's disease and dementia
January 5 2019 by Ray Sahelian, M.D.

Huperzine A is an extract from a club moss (Huperzia serrata) that has been used for centuries in Chinese folk medicine. Huperzine's action has been attributed to its ability to strongly inhibit acetylcholinesterase, the enzyme that breaks down acetylcholine in the synaptic cleft. Acetylcholine is involved in memory and learning. By inhibiting the enzyme that breaks it down, more acetylcholine becomes available to stimulate neurons. Alzheimer’s disease is a condition where there’s a relative shortage of acetylcholine.
       

What does the research say?
 Several studies have been done over the past few years with huperzine A both in China and the United States. These studies have shown that Huperzine A is many times more effective and selective than tacrine (a cholinesterase-inhibiting pharmaceutical drug) in inhibiting cholinesterase (Cheng 1996). Huperzine A has also been found to be beneficial in patients with Alzheimer’s disease. Scientists at Zhejiang Medical University, in Hangzhou, China administered 200 mcg of huperzine A to fifty patients with Alzheimer’s disease for a period of eight weeks and compared the results to a group who received placebo pills (Xu 1995). The study was done in a double blind, placebo controlled and randomized manner. The results showed 58 percent of the patients treated with huperzine A had improvements in memory, cognition, and behavioral functions whereas only 36 percent of those on placebo improved. No severe side effects were found. Blood pressure, heart rate, electrocardiogram, electroencephalogram, liver and urine tests did not show any major abnormalities. The researchers say, "Huperzine A is a promising drug for symptomatic treatment of Alzheimer's disease."

 Source Naturals, Huperzine A, 100 mcg, 120 Tablets
Purchase Huperzine A, dosage

 This phytonutrient that helps maintain proper memory function. It accomplishes this by slowing the breakdown of acetylcholine, a process that accelerates with aging. Acetylcholine plays a vital role in the cognitive function of the mind by enabling the delivery of messages from neuron to neuron in your brain.

Supplement Facts: Huperzine A 50 mcg

 
Supplement Facts
Serving Size: 1 Tablet
  Amount Per Serving % DV
Huperzine A (Huperzia serrata leaf standardized extract) 100 mcg †
†Daily Value not established.

Suggested Use: For adults only. Take half or 1 huperzine capsule in the morning, or as directed by your physician. Do not take more than one week without medical supervision. We recommend frequent breaks since it can accumulate in the body.

Mind Power Rx
This natural mental enhancer is a sophisticated cognitive enhancement formula. It combines a delicate balance of brain circulation agents and neurotransmitter precursors with powerful natural brain chemicals that support:

Memory
Mental clarity
Concentration 
Alertness and Focus

The herbs in this mental improvement formula include: Ashwagandha, Bacopa, Fo-Ti, Ginkgo biloba,  Ginseng, Gotu kola, Mucuna pruriens, Reishi, and Rhodiola.  The nutrients and vitamins in Mind Power Rx include Acetyl-l-carnitine, Carnitine, Carnosine, Choline, DMAE, Inositol, Methylcobalamin, Pantothenic acid, Trimethylglycine, and Vinpocetine.

Potency
I was surprised to come across a study on rat brain that showed huperzine A to be more potent than other acetylcholinesterase inhibitor drugs such as donepezil and rivastigmine currently available on the market for the treatment of Alzheimer's disease.

Q. My wife has been prescribed Aricept for short term memory loss, and I just read your page on HupA where you reported studies that indicated that HupA was more effective than Aricept, for memory loss. She is hesitant to use the HupA rather than the Rx her doctor prescribed. And I am sure that she should not take both of them at the same time, but I hate for her to spend time on a less effective treatment.
   A. I don't have personal experience comparing the herbal extract versus the medication in patients, so I am not sure which would be appropriate to use with a patient. But the huperzine A is worth trying.

Benefits
Huperzine A may benefit those with Alzheimer's disease and perhaps also benefit older individuals with dementia. The role of huperzine as a mind booster in young individuals is not clear at this time.

Dementia
Cell Biochem Biophys. 2012. Treatment with Huperzine A improves cognition in vascular dementia patients. The participants were randomized to receive either vitamin C (100-mg bid) as placebo or Huperzine A (0.1-mg bid) for 12 consecutive weeks. The mini-mental state examination (MMSE), clinical dementia rating (CDR), and activities of daily living (ADL) scores were used for the assessment of cognition. The assessments were made prior to treatment, and 4, 8, and 12 weeks of the treatment. The adverse effects of the treatment were also recorded. After 12 weeks of treatment, the MMSE, CDR, and ADL scores significantly improved in the Huperzine A group, whereas the placebo group did not show any such improvement. No serious adverse events were recorded during the treatment. Conclusion: Huperzine A can significantly improve the cognitive function in patients with mild to moderate vascular dementia.

Cocaine addiction
Int J Neuropsychopharmacol. 2015. Safety and Preliminary Efficacy of the Acetylcholinesterase Inhibitor Huperzine A as a Treatment for Cocaine Use Disorder. Cholinergic transmission is altered by drugs of abuse and contributes to psychostimulant reinforcement. In particular, acetylcholinesterase inhibitors, like huperzine A, may be effective as treatments for cocaine use disorder. The current report describes results from a double-blind, placebo-controlled study in which participants were randomized to huperzine A (0.4 or 0.8mg) or placebo. Participants received randomized infusions of cocaine (0 and 40mg, IV) on days 1 and 9. On day 10, participants received noncontingent, randomized infusions of cocaine (0 and 20mg, IV) before making 5 choices to receive additional infusions. Huperzine A was safe and well-tolerated and compared with placebo, treatment with huperzine A did not cause significant changes in any cocaine pharmacokinetic parameters. The current study represents a significant contribution to the addiction field since it serves as the first published report on the safety and potential efficacy of huperzine A as a treatment for cocaine use disorder.

Huperzine A side effect, safety, caution, danger
Continuous use of high doses --such as 100 mcg or more-- may be toxic. Due to its strong anticholinesterase activity, huperzine a could cause a cholinergic reaction. Huperzine side effects could include sweating, nausea, vomiting, dizziness, and cramps. Nausea is quite common with high doses and can last a day in some cases.

If I take Huperzine A supplement for a week, how long of a break should I give myself before restarting it? You said it builds up in the body. Are we talking about the liver, kidneys? During the break, should I take something to build up or cleanse the liver? Can it be taken at the same time as Mind Power Rx?
    The best way to determine the ideal dosage for any one person is to take Huperzine A over a few days and determine what effects you notice. Then you can tell whether you need to take a break or not. If you get some of the adverse effects such as nausea, sweating, dizziness, etc, then it is time to take a break. Rather than taking another supplement to counteract the side effects from this herbal extract, it is best to take a break from it. We suggest not taking Mind Power Rx the same day as a huperzine a pill.

Testimonial
I'm a graduate student and started taking Huperzine A a few months ago. I stopped after a month and have been under mind bending pain. It feels as if my brain is swelling and on fire every night. It comes in waves followed by dullness. I'm very concerned and will be seeing a neurologist soon.
   A. This is the first time I have heard of this potential reaction. I doubt that it would still be due to Huperzine A after a month not being on it. And if it is, time should take care of it.

Huperzine A and cholinesterase inhibitors Aricept, Reminyl or Exelon.
Many people who take the cholinesterase inhibitors Aricept, Reminyl or Exelon want to know if they can combine these meds with Huperzine A supplements

Q. Is is generally considered appropriate or safe to take Hyperzine A whilst also taking a cholinesterase inhibitor (either Aricept, Reminyl or Exelon)?
   A. We don't suggest taking them the same day. It is best to try each one separately for a couple of weeks to determine the benefits and side effects of the medication and the benefits and side effects of Huperzine A. Once a person has a full understanding of how each of these drugs works and how the supplement works, then it is possible, under medical supervision, to combine them in very low dosages. It is not possible to predict what dosages will turn out to be appropriate. Another option is to alternate their use.

Combination with Coumadin, warfarin, aspirin, blood thinners
Q. My father has been taking Coumadin for the past 6 weeks for atrial fibrillation, which started in mid-February. Prior to this, he was taking a combined supplement with Huperzine A and Ginkgo, which seemed to help his memory and overall cognitive awareness. However, when he started the Coumadin, he stopped taking the Huperzine. He does not have Alzheimers or dementia, but at 86, and on dialysis for 2 years his memory has slowed down a bit, and the Huperzine seemed to be helping. Some of the articles I’ve read have said that neither Huperzine or Ginkgo should be taken with Coumadin. However, the posts on your site only mention interactions between Ginkgo and Coumadin / Warfarin, not Huperzine. Is it acceptable for him to take the single Huperzine A supplement while on Coumadin?
   A. I do not have any experience with the combination, but it would seem cautious not to mix the two at this time until more is known about any such interaction.

Research studies
Drugs R D. 2004.
Huperzine A, an alkaloid isolated from Huperzia serrata, is a putative nootropic agent developed by the Chinese Academy of Sciences. It is currently in phase III trials in China for the treatment of patients with Alzheimer's disease. The mechanism of action is suggested to be facilitated through the slow reversible inhibition of acetylcholinesterase. Marco Hi-Tech Joint Venture has exclusive worldwide marketing and distribution rights to huperzine A. Marco Hi-Tech Joint Venture is a corporation principally owned by Hi-Tech Pharmacal and Marco International, a global trading and finance firm formed to import huperzine A from China. Marco Hi-Tech Joint Venture also has rights to synthetic analogues of huperzine A. In July 2003, Savient Pharmaceuticals acquired the exclusive rights from Marco Hi-Tech to market huperzine A in Europe and the US. Clinical trials of huperzine A in elderly patients with age-associated memory loss are underway in the US, and a phase II study funded by an NCI grant is being planned.

Clinical efficacy and safety of huperzine Alpha in treatment of mild to moderate Alzheimer disease, a placebo-controlled, double-blind, randomized trial
Zhonghua Yi Xue Za Zhi. 2002.
Two hundred and two patients with the diagnosis of possible or probable AD from 15 centers the nationwide were randomly divided into two groups: huperzine Alpha group (given huperzine Alpha 400 micro g/day for 12 weeks) and placebo group. Different scales were used to evaluate the cognitive function, activity of daily life (ADL), non-cognitive disorders, and overall clinical efficacy. Safety evaluation was conducted every 6 weeks. In comparison with the baseline data, there was an improvement of 4.6 points in cognition assessed by ADAS-Cog (P = 0.000); an improvement of 2.7 points by MMSE, an improvement of 1.5 points in behavior and mood by ADAS-non-Cog with 59% of the patients being on the mend clinically; and an improvement of 2.4 points by ADL with the capacity of ADL improved by at least 10% among 32% of the patients. 70% of the patients in huperzine Alpha group scored 1 approximately 3 points, and 28% of them scored 1 approximately 2 points by CIBIC-plus. Mild and transient adverse events (edema of bilateral ankles and insomnia) were observed in 3% of huperzine Alpha treated patients. A safe and effective medicine, huperzine Alpha remarkably improves the cognition, behavior, ADL, and mood of AD patients.

Animal Studies
Comparative effects of huperzine A, donepezil and rivastigmine on cortical acetylcholine level and acetylcholinesterase activity in rats.
Neurosci Lett. 2004.
The cholinesterase inhibitors huperzine A, donepezil and rivastigmine were compared for their effects on extracellular acetylcholine concentration and acetylcholinesterase activity in the rat cortex. After i.p. injection, huperzine A, donepezil and rivastigmine dose-dependently elevated the concentration of acetylcholine. The duration of huperzine A was longest. The time courses of cortical acetylcholinesterase inhibition with middle doses of these agents mirrored the increases of acetylcholine at the same doses. However, acetylcholinesterase inhibition was disproportionately greater after middle dose of rivastigmine than doses of huperzine A and donepezil that increased acetylcholine to a similar extent. Muscle fasciculation appeared only after donepezil with a dose-dependent incidence and intensity. In molar terms, huperzine A was 8- and 2-fold more potent than donepezil and rivastigmine, respectively, in increasing cortical acetylcholine levels, with a longer-lasting effect.

Emails
Is huperzine's effect cumulative?
    Since this herbal extract has a long half life, my best guess is that the effects are cumulative.
Two years ago I lost my memory...(no Alzheimer's in our family!) I am 56 and have been menopausal for ten years now and have been using homeopathic remedies only...My life has been filled with many sources of stress which seemed to make it even more difficult. I seem to have lost my short term memory these past two years and was in a fog when trying to 'pull up' information...I took phosphatidyl serene for two years with little results and stumbled on a site on Huperzine.( I no longer take the PPS )I have been taking huperzine for about three months...50 mcg a day and noticed quite an improvement but I was BY NO MEANS back to my old self. I would have to rely on notes to my self which I would forget I wrote. My life has been changed since I found a site that offered that I need to take 200 mcg twice a day. I AM NOW BACK TO MY OLD SELF......I certainly hope this is not too much !
    Little research is available on the long term use of huperzine, it would be best to be monitored by a medical professional.

I have been taking huperzine a for two purposes for many years. There was a mention of it in two books that I have read; they are Brain Workout by Arthur Winter, M.D. and The Green Pharmacy by James Duke, PHD. I have Myasthenia Gravis. I remember asking my physician when my mom was diagnosed with Alzheimer's disease and I read about the role of acetylcholine in the brain, was there some connection to myasthenia gravis. He said of course not! Years later I showed him the the comment in Dr. Arthur Winter book that mentioned that the Chinese were using chinese moss tea containing Hup A to treat memory problems and Myasthenia Gravis. By that time Aricept was on the market and he suggested that I could try that or the hup a. I started taking hup a and the herb rosemary in 2002. They both really help me. I also take noni juice. Recently they came out with a noni extract which contains hup as well. I started taking the extract about six weeks ago. I now need less Mestinon the drug which I have been taking for 20 years for MG. I also have noticed that my memory is doing better as well.

My 21 year old niece has suffered epilepsy since childhood. Many of the drugs prescribed have side effects on her skin and sometimes swelling of the whole body. Right now she is on omega 3 and B vitamins. Can huperzine A help?
    it has not been tested for seizure disorders and it is not a supplement one would necessarily choose to treat epilepsy.

I saw your info for Mind Power Rx supplement and was wondering if it contains huperzine? If not, what is your opinion regarding adding this supplement when taking the other?
    It is better to take each supplement on a different day rather than combining, they are both potent.
        When you state it is better to take each supplement on a different day- you are referring to Mind Rx and huperzine? I am confused because Mind Rx seems to combine a number of supplements for brain functioning, for example acetyl L carnitine, vinpocetine and ginko. I have a supplement from another company which combines these and huperzine. (Although not the acetyl L carnitine which I've heard is best taken with these other three.) I need nutritional counseling? I really need some direction as you will hear everything on the internet and I am trying to sift through it all to try to make sense of what will be best for me. I am new to supplements and vitamins in general never having taken them before so I have very little experience and knowledge except for what I hear and read.
            If you are new to taking supplements, it is best to take a week or two with each supplement by itself so you know how they influence you. Only combine them if you have a good understanding on how each one influences you by itself. Also, when combining, realize that the effects can be quite potent and it is best to use lower dosages.

I have started to take Huperzine A for early symptoms of dementia. I also take Plavix and a small aspirin tablet daily as a result of blockages in heart arteries. Will it reduce or increase the effect of the Plavix or aspirin for the purpose of reducing formation of blood clots? I have noticed that purple areas have formed on my arms (hematomas?) since using Huperzine A (a few weeks).
   I have not seen any studies yet regarding the effects of these combinations, so I am not sure.

I've started taking Hup A 50 mcg because I've heard that it can help with Myasthenia Gravis. I've been waking up with symptoms and my mestinon isn't working the way I'd like it to. I've mentioned this to my neurologist (and I'm not sure if a time released mestinon is covered by my insurance). Because I have heard that Hup A lasts longer than mestinon, I've decided to try it at night instead of during the day.