Herbs & Botanicals · Herbs · Chinese red date (fruit) and sour jujube seed, with different evidence for each

Jujube (Ziziphus jujuba): Fruit and Seed

Q: What is jujube?

Jujube (red date, da zao) is the fruit of Ziziphus jujuba. The seed of a sour variety, Ziziphus jujuba var. spinosa, is called suan zao ren and is used in Chinese medicine for sleep. Fruit and seed are different products and the research on one does not apply to the other.

Q: Does jujube help you sleep?

The best evidence is for the seed, not the fruit. A 2023 review of 9 small trials found short-term improvements in self-reported sleep quality versus placebo, with mixed long-term results. An older review of Chinese herbs for insomnia found most trials poor and the evidence insufficient. Certainty is low.

Q: Is Suan Zao Ren Tang the same as jujube seed?

No. Suan Zao Ren Tang is a five-herb formula (suan zao ren, fu ling, chuan xiong, zhi mu and licorice). Trials of it or its modified versions test a combination, usually against a drug, so they cannot be credited to the seed alone.

Q: Does jujube help with anxiety?

There is very little evidence. A trial of dried jujube in people with metabolic syndrome found no change in anxiety or depression, though a stress score improved. A seed-based formula improved anxiety scores in people with insomnia, but it was a combination compared with a drug.

Q: Can jujube lower blood sugar or cholesterol?

In small trials the fruit lowered triglycerides and, in people with type 2 diabetes, fasting blood sugar and insulin. Results were mixed for cholesterol and blood pressure. A 2025 review called the evidence limited.

Q: Is jujube good for constipation?

Two trials, one with an extract and one with a syrup in children, reported benefit, but the first had an uneven placebo dropout and the second compared with a laxative, not placebo. The evidence is very low.

Q: Can I drive after taking jujube seed?

No study tested this. Because the seed is used as a sleep aid and sources list drowsiness and dizziness, avoid driving or machinery until you know how it affects you, especially with alcohol or sedatives.

Q: Does jujube interact with medicines?

Sources advise caution with diabetes medicines (possible low blood sugar), antidepressants including SSRIs, SNRIs and MAOIs, and sedatives. A rat study found fruit extracts raised CYP1A2 activity; nothing was found for CYP2C19 or for anticoagulants and antiplatelet drugs. Ask a doctor or pharmacist.

Q: Is jujube safe in pregnancy or when breastfeeding?

No safety study was found. MedicineNet says small amounts of the fruit as food are likely acceptable but advises avoiding medicinal use of jujube products. Ask a clinician first, especially for the seed.

Q: Can jujube harm the liver?

No liver injury cases were found, and a 2025 review found no significant change in AST or ALT. Evidence is short and small, and LiverTox was not read.

Ziziphus jujuba Mill. (fruit, da zao); Ziziphus jujuba var. spinosa (Bunge) Hu ex H.F.Chow (seed, suan zao ren); family Rhamnaceae · also called Jujube, red date, Chinese date, da zao (fruit); suan zao ren, sour jujube seed (seed)

Jujube is the sweet red fruit of Ziziphus jujuba, eaten fresh or dried and used in Chinese tonics. The seed of a sour variety, suan zao ren, is a separate herb used for sleep, often inside formulas such as Suan Zao Ren Tang. Reviews of small trials suggest the seed may improve self-reported sleep in the short term, and trials of the fruit suggest possible help with blood fats and blood sugar. The evidence is low to very low, trials are mostly small and regional, and many test combinations, so seed and fruit must be kept apart.

General information, not medical advice. Last substantive update October 25, 2026 · Not medically reviewed. A named clinician has not signed off on this page. How this page is made

About Jujube (Ziziphus jujuba): Fruit and Seed

Jujube is two different products. The fruit (da zao) is a food and tonic studied for blood fats, blood sugar and constipation. The seed of the sour variety (suan zao ren) is a traditional sleep herb. The sleep evidence for the seed is low certainty. The fruit evidence is low. Safety questions centre on sleepiness, low blood sugar with diabetes drugs, and antidepressants and sedatives.

What it is

Jujube fruit comes from Ziziphus jujuba Mill., accepted in GBIF in the buckthorn family Rhamnaceae. Suan zao ren is the seed of Ziziphus jujuba var. spinosa, an accepted variety in GBIF. Many papers call this plant Ziziphus spinosa.

Fruit and seed have different compounds. The seed contains jujubosides and spinosin; the fruit is described as rich in polysaccharides, polyphenols and fibre.

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What the sleep research shows

The 2023 review pooled 9 randomized trials of suanzaoren. Versus placebo, self-reported sleep quality improved in the short term; versus benzodiazepines or CBT, insomnia severity was lower at 4 weeks. Long-term effects were mixed. The 2012 review found only 8 of 217 Chinese-herb trials of fair quality and called the evidence insufficient.

A 12-person trial and Chinese formula trials point the same way, but formulas are combinations and were often compared with a drug. One Zizyphus-containing supplement mix did no better than placebo.

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What the fruit research shows

Trials of dried fruit powder or extract in Iran and nearby found lower triglycerides, and lower blood sugar and insulin in people with type 2 diabetes, with mixed results for cholesterol and blood pressure. A 2025 review called the evidence limited.

Constipation trials favoured jujube, but one was distorted by dropouts and the other had no placebo.

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At a glance

Traditional uses history, not proof

Fruit (da zao): nourishing food and a tonic for 'blood deficiency' in Chinese medicine
Seed (suan zao ren): sedative-hypnotic herb for sleep and calm for over 2000 years
Seeds, leaves and bark: digestive complaints, cough and as a laxative (traditional)

Studied for research

Sleep quality, seed: low certainty
Sleep and anxiety, seed formulas: very low (combinations)
Blood fats and waist, fruit: low
Blood sugar and insulin, fruit: low
Blood pressure, fruit: insufficient
Constipation: very low
Stress, anxiety and fatigue: insufficient to very low
PCOS: metabolic markers yes, pregnancy rate no

Main compounds

Seed: jujubosides A and B, spinosin, jujubogenin
Fruit: polysaccharides, polyphenols, flavonoids, triterpenoids
Fibre and amino acids (fruit)

Common forms

Fresh or dried fruit (food)
Fruit powder, syrup or extract (as used in trials)
Seed, alone or in formulas such as Suan Zao Ren Tang

Research links: Yang 2023: suanzaoren for sleep, systematic review (PubMed) · Ahmadi 2025: jujube fruit, lipids and sugar (PubMed) · MSK: Suan Zao Ren Tang · Yeung 2012: Chinese herbs for insomnia (PubMed) · Research Library · Genes & Biomarkers Library

The plant and its history

Accepted scientific name: Ziziphus jujuba Mill. (fruit, da zao); Ziziphus jujuba var. spinosa (Bunge) Hu ex H.F.Chow (seed, suan zao ren)
Naming authority: GBIF backbone API read 2026-10-25: Z. jujuba Mill. is ACCEPTED (key 3039423, species); var. spinosa (Bunge) Hu ex H.F.Chow is ACCEPTED as a variety (key 4928539). Many papers write the seed plant as 'Ziziphus spinosa'; a GBIF match for that name returned only the family Rhamnaceae (higher-rank match), so it was not confirmed as a separate accepted name.
Synonyms: Name: Ziziphus spinosa; Note: Name used in some papers for the seed plant; not confirmed in GBIF.; Name: Zizyphus jujuba; Note: Spelling variant used in older papers.
Common names: Jujube, red date, Chinese date (English); Da zao (fruit) (Chinese); Suan zao ren (seed) (Chinese); Sour jujube, wild jujube (seed plant) (English)
Botanical family: Rhamnaceae (buckthorn family)
Classification: Plantae > Rhamnaceae > Ziziphus > Ziziphus jujuba
Native range: Not verified. Sources say jujube fruit has been used in China and elsewhere for centuries; a review says production has spread worldwide, especially in Europe.
Habitat: Not verified.
What the plant looks like: Roots: Not verified.; Stems: MedicineNet describes a thorny shrub; not verified elsewhere.; Leaves: Used traditionally (leaf), per a 2017 review.; Flowers: Not verified.; Fruit: MedicineNet: olive-sized edible fruit with an apple-like texture and flavour.
Cultivation: Not verified.
Harvest and processing: Seed is the dried kernel of the sour jujube (var. spinosa); fruit is eaten fresh or dried. Detailed processing not verified.
Look-alikes and adulterants: Name: Ziziphus mauritiana (Indian jujube, ber); Note: MedicineNet says Z. jujuba and Z. mauritiana are the most studied species; they are different species and results do not transfer.; Name: Ziziphus spina-christi (sidr); Note: A different species; not evaluated here.
Sustainability and conservation: Not assessed in the sources read.

Traditional use and history history, not clinical proof

Tradition or era	Documented use	Source
Traditional Chinese medicine (fruit, da zao)	Used for 'blood deficiency' and as a nourishing food; common in tonic formulas.	p33324222
Traditional Chinese medicine (seed, suan zao ren)	Sedative-hypnotic herb used for over 2000 years for sleep and calm. A 2017 review says it is the second most commonly prescribed phytomedicine for insomnia in Taiwan; the 2026 spinosin review says over 2000 years of clinical use.	p28084039
Suan Zao Ren Tang formula	Five-herb insomnia formula from the classic Jin Gui Yao Lue; the most commonly prescribed insomnia formula in Taiwan, per MSK.	s-msk-szrt
Ethnopharmacology of seed, leaf and bark	Seeds, leaves and stem bark used for digestive disorders, gastric ulcers, cough, as a laxative and for high blood pressure; also fevers and skin infections in children in China.	p28084039
European regulation	European Pharmacopoeia and EMA monographs for the seed had not been completed as of 2017; not re-checked.	p28084039

Traditional use shows how a plant was used. It does not show that a supplement works or is safe today.

What is inside, and how it may work

What the plant contains and how those compounds act in cells and animals. Laboratory and animal mechanisms are not proven effects in people.

Main compounds

Compound	Family	Where it is concentrated	Activity studied	Level of evidence
Jujuboside A PubChem 51346169	triterpenoid saponin	Seed	Reported in lab and animal work to act on GABA and serotonin pathways, per MSK. ^{17 19}	Laboratory research
Jujuboside B PubChem 24721031	triterpenoid saponin	Seed	Same reported sleep-related pathways as jujuboside A, per MSK. ^{17 19}	Laboratory research
Spinosin PubChem 155692	flavone C-glycoside	Seed	Official quality marker of the seed; works on serotonergic and GABAergic signalling and on ERK/CREB/BDNF and Nrf2/HO-1 pathways in preclinical work; oral bioavailability under 1%. ^{13 17 19}	Animal research
Jujubogenin	triterpenoid sapogenin	Seed	Named by MSK as a bioactive component of the formula; CID not looked up. ¹⁷	Laboratory research
Polysaccharides, polyphenols, flavonoids and triterpenoids (fruit)	mixed	Fruit	Reviews list these in the fruit with antioxidant, lipid- and sugar-lowering and sedative effects, mostly in lab and animal studies. The seed plant review counts 354 compounds including 164 flavonoids and 74 triterpenoids. ^{12 32 3}	Animal research

Mechanisms, receptors and pathways

Target or pathway	Gene or receptor	What was found	Level
GABA and serotonin signalling (seed)	GABA receptors; serotonin (5-HT) signalling	The seed's saponins and flavonoids were reported to raise GABA-receptor expression and slow 5-HT breakdown in animal studies. ^{32 17}	Animal research
ERK/CREB/BDNF and Nrf2/HO-1 (spinosin)	ERK, CREB, BDNF, Nrf2, HO-1	Spinosin acted on these pathways in preclinical studies. ¹³	Animal research
Red blood cell production and iron recycling (fruit)	HIF-induced erythropoietin	Extract affected erythropoiesis and iron recycling in cell and animal models. ³	Animal research
Liver CYP1A2 enzyme	CYP1A2	Fruit extracts increased CYP1A2 activity in rats. ⁸	Animal research

Absorption, metabolism and elimination

Absorption: Spinosin oral bioavailability is under 1% in preclinical models, due to poor solubility and P-glycoprotein efflux.
Distribution: Limited blood-brain barrier penetration for spinosin in preclinical work.
Metabolism: Fruit extracts increased CYP1A2 activity in rats; not studied in humans.
Elimination: Not covered in the sources read.
Bioavailability: No human pharmacokinetic data for the seed compounds were found.

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Isolated compounds versus whole extracts

Fruit (da zao) and seed (suan zao ren) are different products with different compounds and uses. The seed is the sleep herb and is often used inside formulas; the fruit is a food studied for blood fats and sugar. Individual compounds (spinosin, jujubosides) have mostly been studied in animals and are poorly absorbed, so effects of the whole seed cannot be assumed from them.

Nutritional composition

Jujube fruit is eaten fresh or dried as food. Reviews describe fibre, polysaccharides, polyphenols, amino acids and fatty acids; specific nutrient amounts were not read. Dried jujube adds sugar and calories.

14benefits and uses looked at

32studies and sources checked

Low certaintybest evidence rating found

12lab markers tracked in trials

4 low certainty6 very low certainty4 not enough evidence

What is Jujube (Ziziphus jujuba): Fruit and Seed good for?

The main studied uses and how strong the human evidence is for each. Seed results (sleep) and fruit results (blood fats, sugar, gut) are kept separate. Most trials are small and many test combinations.

Sleep quality and insomnia: seed (suan zao ren) in reviews of trialsLow certaintyA 2023 review of 9 small trials found the seed improved self-reported sleep quality in the short term versus placebo. Long-term results were mixed and an older review judged the whole Chinese-herb insomnia evidence insufficient. This is the seed, not the fruit. Sleep: one tiny placebo-controlled trial of the seed aloneVery low certainty12 people in a cross-over feasibility trial had a better sleep-quality score on the seed than on placebo, with a borderline result. Sleep and anxiety: seed formulas (combinations)Very low certaintyFormulas built around the seed, such as Suan Zao Ren Tang, improved sleep and anxiety scores compared with lorazepam or added to lorazepam in Chinese trials. These are multi-herb combinations compared with a drug, not a placebo. Sleep: Zizyphus supplement mixNot enough evidenceA 171-person trial of a mixed supplement (Zizyphus, hops, magnesium and others) was no better than placebo. Stress and anxietyNot enough evidenceIn one trial of dried fruit a stress score fell but anxiety and depression scores did not change. No trial in people with an anxiety disorder. FatigueVery low certaintyA small Korean pilot of a three-herb tea containing jujube fruit found less fatigue than no tea. No placebo. Blood fats and waist size (fruit)Low certaintySmall trials and a 2025 review suggest the fruit may lower triglycerides and modestly help other blood fats, with mixed results for cholesterol. Blood sugar and insulin (fruit)Low certaintyFasting blood sugar fell in people with type 2 diabetes in a 2025 meta-analysis, and one trial found lower insulin. Other groups did not all improve. Blood pressure (fruit)Not enough evidenceLower blood pressure in one trial of people with type 2 diabetes; no change in another. Constipation (extract or syrup)Very low certaintyTwo trials favoured jujube, but one had 84% of the placebo group drop out and the other had no placebo. PCOSLow certaintyMetabolic markers improved but pregnancy rates did not differ from metformin, myoinositol or placebo. Chronic hives (add-on syrup)Very low certaintyHive scores were lower than with a control jujube syrup in one small trial. Liver protection during TB treatmentVery low certaintyA pilot of 17 people saw no liver toxicity in the jujube group; too small to prove protection. Anaemia and 'blood building'Not enough evidenceOnly cell and animal studies; no human trials found.

Benefits, one by one

Each card is a research question, not a promise. Tap a goal to filter. Open a card to see the studies, doses and limits.

Sleep quality and insomnia: sour jujube seed (suan zao ren) in reviews of trials

Low certainty

A 2023 review of 9 small trials found the seed improved self-reported sleep quality in the short term compared with placebo. Longer-term results were mixed. Older and newer reviews of Chinese herbs for insomnia disagree about how strong the evidence is.

3 studiesPlant part: seed of var. spinosa. Doses and preparations differed bet…

Studies, doses and limits

What the trials found

Yang 2023 pooled 9 randomized trials (785 people with insomnia disorder, 120 with sleep disturbance). Versus placebo, subjective sleep quality improved. Versus benzodiazepines or CBT, insomnia severity was lower at 4 weeks. Long-term effects were mixed and major adverse events were not increased. The earlier Yeung 2012 review of 217 Chinese-herb trials found only 8 of reasonable quality and judged the evidence insufficient; the 2025 network meta-analysis of 186 trials ranked suanzaoren 4th of 13 herbal interventions on sleep score and rated overall bias low-to-moderate. The abstracts do not say how many trials used the seed alone and how many used formulas.

Results

Short-term gains in self-reported sleep quality; no clear long-term benefit; the older, stricter review found no proof of benefit over placebo.

Effect sizes as reported

Versus placebo: standardised mean difference -0.58 (95% CI -1.04 to -0.11). Versus benzodiazepines/CBT at 4 weeks: -2.68 points on the insomnia severity scale (95% CI -5.50 to -0.22).

Why this rating

Small trials with variable quality, a mix of seed alone and formulas, and sleep measured mostly by questionnaire. The 2012 review found most trials poor; the 2023 review rated placebo-controlled studies low risk of bias but said larger trials are needed.

Form and dose studied

Plant part: seed of var. spinosa. Doses and preparations differed between trials. Seed (suan zao ren) results do not apply to the fruit (da zao), and fruit results do not apply to the seed.

Who was studied

Adults with insomnia or sleep disturbance, including people with cancer; most trials in China and Asia.

Limits

Many trials are Chinese-language, small and regional. Comparisons with benzodiazepines are not blinded in the same way as placebo comparisons. The newest network meta-analysis ranks treatments indirectly.

Why researchers looked

The seed (from Ziziphus jujuba var. spinosa) is one of the most widely used herbs for sleep in Chinese medicine.

Traditional use

Suan zao ren is a classic sleep and calming herb in traditional Chinese medicine, often used inside formulas such as Suan Zao Ren Tang. In Taiwan it is among the most-used herbal medicines for insomnia.

Proposed mechanism Animal research

In animal and lab work the seed's saponins and flavonoids (jujubosides, spinosin) act on GABA and serotonin signalling. This has not been shown to be how it works in people.

A proposed mechanism does not show that the effect happens in people.

The seed can cause daytime sleepiness. See the Safety tab before driving or combining with sedatives.

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Sleep: one small placebo-controlled trial of the seed alone (12 people)

Very low certainty

A tiny cross-over feasibility trial in Australia found better sleep-quality scores on the seed than on placebo, but with only 12 people and a borderline result.

1 studiesSeed (Ziziphus spinosa), 2 g daily as encapsulated granules.

Studies, doses and limits

What the trials found

Shergis 2021: 12 adults with insomnia took encapsulated Ziziphus spinosa seed granules (2 g/day) and placebo, each for 4 weeks, with a 4-week gap. Sleep quality (PSQI) was better on the seed; other scales were not significantly different. Diaries suggested more sleep time, better efficiency and shorter time to fall asleep after the seed. Only minor adverse events. Period effects were present.

Results

Better PSQI score on the seed; most other outcomes no different; feasibility goals met.

Effect sizes as reported

PSQI t = -2.276, df 10, 95% CI -3.3 to -0.04, p = 0.046

Why this rating

12 people, a feasibility design, a borderline p-value and period effects. It shows a trial is possible, not that the seed works.

Form and dose studied

Seed (Ziziphus spinosa), 2 g daily as encapsulated granules.

Who was studied

Adults with insomnia, Melbourne.

Limits

Not powered to prove benefit. One site.

Why researchers looked

To test whether a proper placebo-controlled trial of the seed alone is workable.

Traditional use

Sour jujube seed is used alone and in formulas for sleep.

Proposed mechanism Laboratory research

Not tested in this trial.

A proposed mechanism does not show that the effect happens in people.

Minor adverse events only; sedation not detailed in the abstract.

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Sleep and anxiety: Suan Zao Ren Tang and related formulas (combinations, not the seed alone)

Very low certainty

Trials of multi-herb formulas built around suan zao ren report better sleep scores than lorazepam alone or lorazepam combined with the formula. These are combinations, often compared with a drug rather than a placebo.

3 studiesFormulas: SZRT + ZZCT (Hu 2015); Jiawei Suanzaoren Decoction (Song 20…

Studies, doses and limits

What the trials found

Hu 2015 (119 people with insomnia and anxiety, China): Suan Zao Ren Tang plus Zhi Zi Chi Tang for 4 weeks improved insomnia, sleep quality and anxiety scores and was better than lorazepam on the insomnia severity index (P = 0.029), PSQI (P = 0.017) and wake after sleep onset (P = 0.008). Song 2020 (207 people, 12 weeks): Jiawei Suanzaoren Decoction added to lorazepam gave a larger insomnia-severity reduction and fewer side effects than lorazepam alone. MSK also reports small trials in methadone patients, climacteric women and cancer patients (read only as summaries on the MSK page).

Results

Formula improved sleep and anxiety scores and compared well with lorazepam; the add-on trial suggests formula plus lorazepam beats lorazepam alone.

Effect sizes as reported

Hu 2015: P values only in the abstract. Song 2020: abstract text partly corrupted, so no effect numbers are quoted.

Why this rating

Different formulas, compared with a drug rather than a placebo, with unclear blinding. These results cannot be credited to the seed or to jujube fruit. All regional Chinese trials.

Form and dose studied

Formulas: SZRT + ZZCT (Hu 2015); Jiawei Suanzaoren Decoction (Song 2020). Contents differ from the five-herb classic formula.

Who was studied

Adults with insomnia, often with anxiety, in China.

Limits

Add-on to a benzodiazepine does not show the herb works alone. Anxiety measured with a self-rating scale.

Why researchers looked

Suan Zao Ren Tang is a traditional five-herb formula for insomnia (suan zao ren, fu ling, chuan xiong, zhi mu, gan cao). It is the most commonly prescribed insomnia formula in Taiwan, according to MSK.

Traditional use

Described in the classical text Jin Gui Yao Lue.

Proposed mechanism Animal research

Jujubogenin, jujuboside A and B and spinosin affect GABA and serotonin pathways in lab and animal studies, according to MSK; no human mechanism data.

A proposed mechanism does not show that the effect happens in people.

Formulas contain other herbs (e.g. licorice). The sedative warnings on the Safety tab apply.

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Sleep: a Zizyphus-containing supplement mix did not beat placebo

Not enough evidence

A 171-person trial of a combination (milk-protein peptide, Zizyphus, hops, magnesium, vitamin B6) found no difference from placebo in sleep quality over 2 weeks.

1 studiesCombination product (LZComplex3).

Studies, doses and limits

What the trials found

Scholey 2017: otherwise healthy adults with mild insomnia took the combination (LZComplex3) or placebo for 2 weeks after a placebo run-in. Sleep quality improved in both groups with no meaningful difference; most secondary outcomes were also the same. Adverse events were similar, and two treatment-related events led to stopping in the active group. The authors note a strong placebo response.

Results

No difference from placebo.

Effect sizes as reported

No significant between-group difference on the PSQI change.

Why this rating

A combination product, so the effect of Zizyphus cannot be separated, and a strong placebo response may hide any effect.

Form and dose studied

Combination product (LZComplex3).

Who was studied

Healthy adults with mild insomnia.

Limits

Combination; industry-involved sponsor; short.

Why researchers looked

Commercial sleep supplement tested in mild acute insomnia.

Traditional use

Zizyphus is a traditional sleep herb.

Proposed mechanism Pharmacological theory

Not tested.

A proposed mechanism does not show that the effect happens in people.

Discontinuations in the active group were treatment-related.

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Stress, anxiety and mood: very little direct evidence

Not enough evidence

In one trial of jujube fruit powder in adults with metabolic syndrome, a stress score fell but anxiety and depression scores did not. For anxiety there is no trial of the fruit or the seed alone in people with an anxiety disorder.

3 studiesFruit powder 30 g/day (Parastouei); formula (Hu).

Studies, doses and limits

What the trials found

Parastouei 2024 (60 adults with metabolic syndrome, 30 g/day dried jujube powder for 8 weeks versus placebo) found no change in depression or anxiety scores (P > 0.05) but a larger fall in a stress score (-5.80 vs -2.86, p = 0.01); the authors flag weaknesses in blinding and herb potency testing. Hu 2015 reported improved Self-Rating Anxiety Scale scores with a seed-based formula. The MSK page mentions a modified formula with paroxetine in generalised anxiety, but that trial was not read.

Results

Stress score better, anxiety and depression not; formula trial anxiety score better.

Effect sizes as reported

Stress -5.80 vs -2.86 (p = 0.01); depression and anxiety p > 0.05

Why this rating

Stress was a secondary outcome in one small trial; anxiety evidence comes from a formula compared with a drug.

Form and dose studied

Fruit powder 30 g/day (Parastouei); formula (Hu).

Who was studied

Metabolic syndrome patients; insomnia patients with anxiety.

Limits

Secondary outcomes, small samples, no seed-alone anxiety trial.

Why researchers looked

Jujube is called 'calming' in traditional medicine.

Traditional use

Seed and fruit both appear in traditional calming formulas.

Proposed mechanism Animal research

Lab and animal work on seed saponins and flavonoids (GABA, serotonin) is the only mechanism data.

A proposed mechanism does not show that the effect happens in people.

See Safety tab.

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Fatigue: one small pilot of a three-herb tea containing jujube fruit

Very low certainty

A pilot in Korea found less fatigue after 4 weeks with a tea of astragalus, angelica and jujube fruit than with no tea. It had no placebo and cannot show jujube itself helps.

1 studiesTea of Astragali Radix, Angelicae gigantis Radix and Zizyphi Fructus.

Studies, doses and limits

What the trials found

Baek 2018: 40 adults with prolonged fatigue (35 completed) had the tea twice a day for 4 weeks or no intervention. Fatigue (Chalder scale) was lower in the tea group at 4 weeks; sleep quality improved within the tea group, and depression at 8 weeks.

Results

Lower fatigue versus no treatment at 4 weeks.

Effect sizes as reported

Significant at 4 weeks; numbers not in the abstract.

Why this rating

Pilot, 3-herb combination, no placebo, so expectation effects are likely and jujube cannot be credited.

Form and dose studied

Tea of Astragali Radix, Angelicae gigantis Radix and Zizyphi Fructus.

Who was studied

Adults with prolonged fatigue, Korea.

Limits

No placebo, tiny, combination.

Why researchers looked

Jujube fruit is a common 'tonic' ingredient in formulas for tiredness.

Traditional use

Da zao is added to many Chinese tonic formulas.

Proposed mechanism Pharmacological theory

Not tested.

A proposed mechanism does not show that the effect happens in people.

None reported in the abstract.

Blood fats and waist size (jujube fruit)

Low certainty

Small trials and a 2025 review suggest the fruit may lower triglycerides and modestly improve other blood fats, especially in people who already have high blood fats or metabolic syndrome. Results are uneven.

3 studiesDried fruit powder (30 g/day or 15 g/day) or fruit powder; fruit not …

Studies, doses and limits

What the trials found

Ahmadi 2025 pooled 7 studies (483 people): BMI, triglycerides fell; LDL and total cholesterol fell in some subgroups; HDL, AST and ALT did not change; the authors call the evidence quality limited. Parastouei 2024 (60 adults with metabolic syndrome, 30 g/day powder, 8 weeks): triglycerides, HDL and waist improved versus placebo, but total cholesterol, LDL, fasting glucose and blood pressure did not. Sabzghabaee 2013 (86 obese teens, 5 g three times daily powder, 1 month): total cholesterol and LDL were lower (p = 0.007 and 0.004), BMI and other lipids did not change; 16 dropped out.

Results

Triglycerides most consistent; cholesterol and HDL results mixed across trials.

Effect sizes as reported

Parastouei: waist -3.98 vs -0.51 (p = 0.01), TG -24.96 vs -0.73 (p = 0.03), HDL 2.83 vs 0.40 (p = 0.01). Pooled numbers not read.

Why this rating

Small regional trials with variable products, durations and diseases; the authors of the meta-analysis call the evidence limited; one trial noted blinding and potency-testing weaknesses.

Form and dose studied

Dried fruit powder (30 g/day or 15 g/day) or fruit powder; fruit not seed.

Who was studied

Teens with dyslipidemia; adults with metabolic syndrome or type 2 diabetes; Iran-based.

Limits

Mostly Iranian trials; short durations; product differences.

Why researchers looked

Jujube fruit is a traditional food-medicine and has fibre and plant compounds.

Traditional use

Da zao is eaten as food and used in tonics.

Proposed mechanism Animal research

Reviews describe lipid-lowering effects mainly in lab and animal studies (fibre, polysaccharides, flavonoids).

A proposed mechanism does not show that the effect happens in people.

Dried fruit is sweet and adds sugar and calories.

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Blood sugar and insulin (jujube fruit)

Low certainty

In small trials the fruit lowered fasting insulin and, in people with type 2 diabetes, blood sugar in a meta-analysis. Results in other groups were mixed and trials are small.

4 studiesDried fruit 30 g/day or hydroalcoholic extract 15 g/day.

Studies, doses and limits

What the trials found

Ahmadi 2025: fasting blood sugar fell significantly in people with type 2 diabetes. Farhadnejad 2025 (48 adults with type 2 diabetes and excess weight, 30 g dried jujube daily for 3 months): plasma insulin fell by up to 4.6 mIU/L versus control; antioxidant capacity and other markers did not differ. Parastouei 2024 found no fasting glucose change; Mashhadi 2026 (196 women with PCOS, 15 g/day extract, 12 weeks) found fasting glucose improved versus the other groups.

Results

Insulin and fasting glucose improved in some groups, not in metabolic syndrome patients.

Effect sizes as reported

Insulin up to -4.6 mIU/L (Farhadnejad); other pooled figures not read.

Why this rating

Small trials, several outcomes, mixed results between populations.

Form and dose studied

Dried fruit 30 g/day or hydroalcoholic extract 15 g/day.

Who was studied

Type 2 diabetes with excess weight; PCOS; metabolic syndrome.

Limits

HbA1c was not reported in the abstracts. Control group type unclear in one trial.

Why researchers looked

Fruit fibre and plant compounds may slow sugar absorption (lab idea only).

Traditional use

Used in Persian and Chinese traditional medicine.

Proposed mechanism Animal research

Animal and lab studies suggest effects on glucose handling; not shown in people.

A proposed mechanism does not show that the effect happens in people.

May lower blood sugar further in people on diabetes medicines; see Safety.

^{1 4 21 15}

Blood pressure (jujube fruit)

Not enough evidence

One trial in people with type 2 diabetes found lower blood pressure after 3 months of dried jujube; another in metabolic syndrome found no change.

3 studiesDried fruit 30 g/day.

Studies, doses and limits

What the trials found

Farhadnejad 2025: systolic fell by up to 7 and diastolic by up to 5 mmHg versus control. Parastouei 2024: no blood-pressure change. Rodriguez Villanueva 2017 lists hypotensive use in ethnopharmacology.

Results

Mixed: lower in one trial, no change in the other.

Effect sizes as reported

SBP up to -7 mmHg; DBP up to -5 mmHg

Why this rating

Two small trials point in different directions.

Form and dose studied

Dried fruit 30 g/day.

Who was studied

Adults with type 2 diabetes; metabolic syndrome.

Limits

Blood pressure was a secondary outcome.

Why researchers looked

Reports of lower blood pressure in animals.

Traditional use

Traditional use as a 'hypotensive' drug is described in a 2017 review.

Proposed mechanism Animal research

Not established.

A proposed mechanism does not show that the effect happens in people.

Possible extra effect with blood-pressure medicines; see Safety.

^{4 21 22}

Constipation (jujube extract or syrup)

Very low certainty

A 2008 extract trial and a 2025 children's syrup trial both reported benefit, but the first had a very uneven placebo dropout and the second compared with a laxative, not placebo.

3 studiesLiquid extract; syrup (products differ).

Studies, doses and limits

What the trials found

Naftali 2008: 37 adults with slow-transit constipation took liquid Ziziphus jujuba extract or placebo for 12 weeks; 84% of the placebo group dropped out because of severe constipation versus 12% of the extract group. Transit time and symptoms improved with the extract. Keihanian 2025: 90 children aged 2-10 (62 completed) had jujube syrup or polyethylene glycol (PEG); the jujube group had a better response score, less soiling and pain, and more regular stools, with no liver or kidney injury reported.

Results

Both trials favour jujube, but the design problems limit what can be concluded.

Effect sizes as reported

Naftali: transit time 12.2 to 3 particles in the extract group. Keihanian: p < 0.05 for the comparisons.

Why this rating

84% placebo dropout in the first trial makes it unreliable; the second trial compared with a drug without a placebo arm and lost 28 of 90 children.

Form and dose studied

Liquid extract; syrup (products differ).

Who was studied

Adults with chronic constipation; children aged 2-10.

Limits

Single-country trials; not placebo-controlled in children.

Why researchers looked

Jujube is traditionally used as a gentle laxative.

Traditional use

Described as a laxative in traditional medicine (2017 review).

Proposed mechanism Pharmacological theory

Fibre content may contribute (idea only).

A proposed mechanism does not show that the effect happens in people.

Jujube can also cause diarrhoea or constipation in some people (see Safety).

^{20 9 22}

PCOS: metabolic markers improved, pregnancy rate not

Low certainty

In a 196-woman trial, jujube extract improved cholesterol, triglycerides and fasting glucose compared with other groups but did not raise pregnancy rates versus metformin, myoinositol or placebo.

1 studiesHydroalcoholic extract, 15 g daily.

Studies, doses and limits

What the trials found

Mashhadi 2026: infertile women with PCOS got metformin 500 mg, myoinositol 2000 mg, Ziziphus jujuba hydroalcoholic extract 15 g or placebo for 12 weeks, with letrozole for ovulation. Pregnancy: 10, 7, 5 and 4 respectively (p > 0.05). Cholesterol, triglycerides, HDL and fasting glucose improved with jujuba. One participant reported mild constipation.

Results

No fertility benefit shown; metabolic markers improved.

Effect sizes as reported

Pregnancies 10 / 7 / 5 / 4 of 49 per group; metabolic p < 0.05

Why this rating

One trial; the main outcome was not met.

Form and dose studied

Hydroalcoholic extract, 15 g daily.

Who was studied

Infertile women with PCOS, Iran.

Limits

Single trial; a strong dose of extract.

Why researchers looked

PCOS often comes with insulin resistance; jujube was tested on both metabolic and fertility outcomes.

Traditional use

Not described in the sources read.

Proposed mechanism Pharmacological theory

Not established.

A proposed mechanism does not show that the effect happens in people.

Pregnancy and breastfeeding advice is on the Safety tab.

¹⁵

Chronic hives (add-on syrup)

Very low certainty

One trial found a jujube syrup added to an antihistamine lowered hive activity scores, but the comparison group also received a jujube syrup.

2 studiesFruit syrup 7.5 mL twice daily plus cetirizine.

Studies, doses and limits

What the trials found

Zare 2023: 64 people with chronic spontaneous urticaria not controlled on cetirizine received 7.5 mL jujube syrup twice daily or a plain jujube syrup control for 4 weeks. The urticaria activity score was lower in the intervention group (p = 0.001 over follow-up, p = 0.046 on day 28) and sleep quality improved in both groups, more in the intervention group.

Results

Lower hive scores versus the control syrup.

Effect sizes as reported

UAS p = 0.001 over follow-up; p = 0.046 at day 28

Why this rating

The control group received a jujube syrup, and the trial was small.

Form and dose studied

Fruit syrup 7.5 mL twice daily plus cetirizine.

Who was studied

Adults with chronic hives.

Limits

Small, one city; unclear what the control syrup contained.

Why researchers looked

Added when antihistamines alone did not control hives.

Traditional use

Used in Persian traditional medicine.

Proposed mechanism Pharmacological theory

Not established.

A proposed mechanism does not show that the effect happens in people.

A latex-jujube cross-reaction is reported; see Safety.

^{31 11}

Liver protection during TB treatment (tiny pilot)

Very low certainty

In 17 people on tuberculosis drugs, none of the jujube-syrup group developed liver toxicity at week 2 versus about a quarter of the placebo group. This pilot cannot prove protection.

1 studiesFruit syrup 10 mL/day.

Studies, doses and limits

What the trials found

Maddahi 2022: 17 people finished (8 jujube, 9 placebo). At week 2, 27.3% of the placebo group developed hepatotoxicity versus none in the jujube group (p = .037). Cough and quality of life also improved.

Results

No liver toxicity in the jujube group in a tiny sample.

Effect sizes as reported

0 vs 27.3% at week 2

Why this rating

Pilot; 17 people; a few events.

Form and dose studied

Fruit syrup 10 mL/day.

Who was studied

People with pulmonary tuberculosis, Iran.

Limits

Tiny sample.

Why researchers looked

Anti-TB drugs often injure the liver; jujube was tested as protection.

Traditional use

Not described in the sources read.

Proposed mechanism Pharmacological theory

Not established.

A proposed mechanism does not show that the effect happens in people.

This is a safety-adjacent finding, not a reason to take jujube with TB drugs without a doctor.

¹⁴

Anaemia and 'blood building' (cell and animal studies only)

Not enough evidence

Jujube fruit is a traditional 'blood-nourishing' food in China. A 2020 review found support only in cells and animals, not in human trials.

1 studiesFruit extracts in lab and animal studies.

Studies, doses and limits

What the trials found

Chen 2020 summarises cell and animal work and proposes the fruit as a possible supplement for anaemia prevention; no human anaemia trials are described in the abstract.

Results

No human data.

Effect sizes as reported

None

Why this rating

No human trials found.

Form and dose studied

Fruit extracts in lab and animal studies.

Who was studied

None in humans.

Limits

No human evidence.

Why researchers looked

Traditional blood deficiency use.

Traditional use

Traditionally used for 'blood deficiency'.

Proposed mechanism Animal research

In cell and animal models the extract affected red-cell production and iron recycling.

A proposed mechanism does not show that the effect happens in people.

Anaemia needs a medical diagnosis.

Connections to the rest of health

How Jujube (Ziziphus jujuba): Fruit and Seed connects to the rest of our health knowledge graph. Every link says what kind of connection it is. A safety link (for example to the liver) is a warning, not a benefit. A study that merely mentions a topic never creates a benefit link.

Explore every connection: goals, body systems, organs, symptoms, genes

Kind of connection Connected to Search

A. Wellness goals

Connected to	Kind of connection	Evidence status	Context	Studies
Better Sleep	Demonstrated clinical effect	Low certainty	Sleep quality and insomnia: sour jujube seed (suan zao ren) in reviews of trials: A 2023 review of 9 small trials found the seed improved self-reported sleep quality in the short term compared with placebo. Longer-term results were mixed. Older and newer reviews of Chinese herbs for insomnia disagree about how strong the evidence is. Sleep and anxiety: Suan Zao Ren Tang and related formulas (combinations, not the seed alone): Trials of multi-herb formulas built around suan zao ren report better sleep scores than lorazepam alone or lorazepam combined with the formula. These are combinations, often compared with a drug rather than a placebo.	^{29 30 10 7 26 17}
Sleep Quality	Demonstrated clinical effect	Low certainty	Sleep quality and insomnia: sour jujube seed (suan zao ren) in reviews of trials: A 2023 review of 9 small trials found the seed improved self-reported sleep quality in the short term compared with placebo. Longer-term results were mixed. Older and newer reviews of Chinese herbs for insomnia disagree about how strong the evidence is.	^{29 30 10}
Better Sleep	Potential benefit	Very low certainty	Sleep: one small placebo-controlled trial of the seed alone (12 people): A tiny cross-over feasibility trial in Australia found better sleep-quality scores on the seed than on placebo, but with only 12 people and a borderline result.	²⁵
Anxiety Support	Demonstrated clinical effect	Very low certainty	Sleep and anxiety: Suan Zao Ren Tang and related formulas (combinations, not the seed alone): Trials of multi-herb formulas built around suan zao ren report better sleep scores than lorazepam alone or lorazepam combined with the formula. These are combinations, often compared with a drug rather than a placebo.	^{7 26 17}
Calm Relaxation	Demonstrated clinical effect	Very low certainty	Sleep and anxiety: Suan Zao Ren Tang and related formulas (combinations, not the seed alone): Trials of multi-herb formulas built around suan zao ren report better sleep scores than lorazepam alone or lorazepam combined with the formula. These are combinations, often compared with a drug rather than a placebo.	^{7 26 17}
Better Sleep	Biological association	Not enough evidence	Sleep: a Zizyphus-containing supplement mix did not beat placebo: A 171-person trial of a combination (milk-protein peptide, Zizyphus, hops, magnesium, vitamin B6) found no difference from placebo in sleep quality over 2 weeks.	²⁴
Stress Reduction	Potential benefit	Not enough evidence	Stress, anxiety and mood: very little direct evidence: In one trial of jujube fruit powder in adults with metabolic syndrome, a stress score fell but anxiety and depression scores did not. For anxiety there is no trial of the fruit or the seed alone in people with an anxiety disorder.	^{21 7 17}
Anxiety Support	Potential benefit	Not enough evidence	Stress, anxiety and mood: very little direct evidence: In one trial of jujube fruit powder in adults with metabolic syndrome, a stress score fell but anxiety and depression scores did not. For anxiety there is no trial of the fruit or the seed alone in people with an anxiety disorder.	^{21 7 17}
Mood Balance	Potential benefit	Not enough evidence	Stress, anxiety and mood: very little direct evidence: In one trial of jujube fruit powder in adults with metabolic syndrome, a stress score fell but anxiety and depression scores did not. For anxiety there is no trial of the fruit or the seed alone in people with an anxiety disorder.	^{21 7 17}
Reduce Fatigue	Potential benefit	Very low certainty	Fatigue: one small pilot of a three-herb tea containing jujube fruit: A pilot in Korea found less fatigue after 4 weeks with a tea of astragalus, angelica and jujube fruit than with no tea. It had no placebo and cannot show jujube itself helps.	²
Energy Boost	Potential benefit	Very low certainty	Fatigue: one small pilot of a three-herb tea containing jujube fruit: A pilot in Korea found less fatigue after 4 weeks with a tea of astragalus, angelica and jujube fruit than with no tea. It had no placebo and cannot show jujube itself helps.	²
Cholesterol Balance	Demonstrated clinical effect	Low certainty	Blood fats and waist size (jujube fruit): Small trials and a 2025 review suggest the fruit may lower triglycerides and modestly improve other blood fats, especially in people who already have high blood fats or metabolic syndrome. Results are uneven.	^{1 21 23}
Metabolic Health	Demonstrated clinical effect	Low certainty	Blood fats and waist size (jujube fruit): Small trials and a 2025 review suggest the fruit may lower triglycerides and modestly improve other blood fats, especially in people who already have high blood fats or metabolic syndrome. Results are uneven. Blood sugar and insulin (jujube fruit): In small trials the fruit lowered fasting insulin and, in people with type 2 diabetes, blood sugar in a meta-analysis. Results in other groups were mixed and trials are small.	^{1 21 23 4 15}
Weight Management	Demonstrated clinical effect	Low certainty	Blood fats and waist size (jujube fruit): Small trials and a 2025 review suggest the fruit may lower triglycerides and modestly improve other blood fats, especially in people who already have high blood fats or metabolic syndrome. Results are uneven.	^{1 21 23}
Heart Health	Demonstrated clinical effect	Low certainty	Blood fats and waist size (jujube fruit): Small trials and a 2025 review suggest the fruit may lower triglycerides and modestly improve other blood fats, especially in people who already have high blood fats or metabolic syndrome. Results are uneven.	^{1 21 23}
Blood Sugar Balance	Demonstrated clinical effect	Low certainty	Blood sugar and insulin (jujube fruit): In small trials the fruit lowered fasting insulin and, in people with type 2 diabetes, blood sugar in a meta-analysis. Results in other groups were mixed and trials are small.	^{1 4 21 15}
Blood Pressure Support	Potential benefit	Not enough evidence	Blood pressure (jujube fruit): One trial in people with type 2 diabetes found lower blood pressure after 3 months of dried jujube; another in metabolic syndrome found no change.	^{4 21 22}
Heart Health	Potential benefit	Not enough evidence	Blood pressure (jujube fruit): One trial in people with type 2 diabetes found lower blood pressure after 3 months of dried jujube; another in metabolic syndrome found no change.	^{4 21 22}
Digestive Support	Potential benefit	Very low certainty	Constipation (jujube extract or syrup): A 2008 extract trial and a 2025 children's syrup trial both reported benefit, but the first had a very uneven placebo dropout and the second compared with a laxative, not placebo.	^{20 9 22}
Womens Wellness	Biological association	Low certainty	PCOS: metabolic markers improved, pregnancy rate not: In a 196-woman trial, jujube extract improved cholesterol, triglycerides and fasting glucose compared with other groups but did not raise pregnancy rates versus metformin, myoinositol or placebo.	¹⁵
Fertility Support	Biological association	Low certainty	PCOS: metabolic markers improved, pregnancy rate not: In a 196-woman trial, jujube extract improved cholesterol, triglycerides and fasting glucose compared with other groups but did not raise pregnancy rates versus metformin, myoinositol or placebo.	¹⁵
Metabolic Health	Biological association	Low certainty	PCOS: metabolic markers improved, pregnancy rate not: In a 196-woman trial, jujube extract improved cholesterol, triglycerides and fasting glucose compared with other groups but did not raise pregnancy rates versus metformin, myoinositol or placebo.	¹⁵
Inflammation Balance	Potential benefit	Very low certainty	Chronic hives (add-on syrup): One trial found a jujube syrup added to an antihistamine lowered hive activity scores, but the comparison group also received a jujube syrup.	^{31 11}
Healthy Skin	Potential benefit	Very low certainty	Chronic hives (add-on syrup): One trial found a jujube syrup added to an antihistamine lowered hive activity scores, but the comparison group also received a jujube syrup.	^{31 11}
Liver Support	Potential benefit	Very low certainty	Liver protection during TB treatment (tiny pilot): In 17 people on tuberculosis drugs, none of the jujube-syrup group developed liver toxicity at week 2 versus about a quarter of the placebo group. This pilot cannot prove protection.	¹⁴

B. Body systems

Connected to	Kind of connection	Evidence status	Context	Studies
Sleep Recovery	Biological association	Low certainty	Studied for: Sleep quality and insomnia: sour jujube seed (suan zao ren) in reviews of trials Studied for: Sleep: one small placebo-controlled trial of the seed alone (12 people)	^{29 30 10 25 7 26 17 24}
Nervous System	Biological association	Low certainty	Studied for: Sleep quality and insomnia: sour jujube seed (suan zao ren) in reviews of trials Studied for: Sleep and anxiety: Suan Zao Ren Tang and related formulas (combinations, not the seed alone)	^{29 30 10 7 26 17 21 2}
Stress Mood	Biological association	Very low certainty	Studied for: Sleep and anxiety: Suan Zao Ren Tang and related formulas (combinations, not the seed alone) Studied for: Stress, anxiety and mood: very little direct evidence	^{7 26 17 21}
Metabolism Weight	Biological association	Low certainty	Studied for: Blood fats and waist size (jujube fruit) Studied for: Blood sugar and insulin (jujube fruit)	^{1 21 23 4 15}
Cardiovascular System	Biological association	Low certainty	Studied for: Blood fats and waist size (jujube fruit) Studied for: Blood pressure (jujube fruit)	^{1 21 23 4 22 3}
Endocrine System	Biological association	Low certainty	Studied for: Blood sugar and insulin (jujube fruit) Studied for: PCOS: metabolic markers improved, pregnancy rate not	^{1 4 21 15}
Digestive System	Biological association	Very low certainty	Studied for: Constipation (jujube extract or syrup)	^{20 9 22}
Reproductive System	Biological association	Low certainty	Studied for: PCOS: metabolic markers improved, pregnancy rate not	¹⁵
Integumentary System	Biological association	Very low certainty	Studied for: Chronic hives (add-on syrup)	^{31 11}
Immune System	Biological association	Very low certainty	Studied for: Chronic hives (add-on syrup)	^{31 11}
Hepatic System	Biological association	Very low certainty	Studied for: Liver protection during TB treatment (tiny pilot)	¹⁴

G. Root causes and contributing factors

Connected to	Kind of connection	Evidence status	Context	Studies
Medication side effects	Drug or supplement interaction	Not enough evidence	MSK and MedicineNet warn about combining with antidepressants and sedatives; no trials of the combination safety. MSK and MedicineNet warn of combining with antidepressants and sedatives; no interaction trials. Preparation or compound: Seed and seed formulas with sedatives and antidepressants	^{17 16}

I. Biomarkers

Connected to	Kind of connection	Evidence status	Context	Studies
Blood glucose	Adverse effect or risk	Low certainty	Trials show lower blood sugar; extra care with diabetes medicines. Preparation or compound: Fruit	^{1 4}
Sleep quality score (PSQI, self-reported)	Biological association	Very low certainty	Measured in trials: lowered. A lab change is not the same as a health benefit.	^{25 24 7}
Insomnia severity (ISI)	Biological association	Low certainty	Measured in trials: lowered. A lab change is not the same as a health benefit.	^{29 7}
Stress score (questionnaire)	Biological association	Very low certainty	Measured in trials: lowered. A lab change is not the same as a health benefit.	²¹
Fatigue severity (Chalder Fatigue Scale)	Biological association	Very low certainty	Measured in trials: lowered. A lab change is not the same as a health benefit.	²
Triglycerides	Biological association	Low certainty	Measured in trials: lowered. A lab change is not the same as a health benefit.	^{21 1}
Total cholesterol and LDL	Biological association	Very low certainty	Measured in trials: mixed. A lab change is not the same as a health benefit.	^{23 21 1}
HDL cholesterol	Biological association	Very low certainty	Measured in trials: mixed. A lab change is not the same as a health benefit.	^{21 1}
Fasting blood sugar	Biological association	Low certainty	Measured in trials: mixed. A lab change is not the same as a health benefit.	^{1 21 15}
Fasting insulin	Biological association	Very low certainty	Measured in trials: lowered. A lab change is not the same as a health benefit.	⁴
Systolic and diastolic blood pressure	Biological association	Not enough evidence	Measured in trials: mixed. A lab change is not the same as a health benefit.	^{4 21}
Waist circumference	Biological association	Very low certainty	Measured in trials: lowered. A lab change is not the same as a health benefit.	²¹
Colonic transit time and constipation symptoms	Biological association	Very low certainty	Measured in trials: lowered. A lab change is not the same as a health benefit.	²⁰

J. Genes, receptors and enzymes

Connected to	Kind of connection	Evidence status	Context	Studies
CYP1A2	Preliminary mechanism	Animal	Rat study: increased activity after fruit extracts.	⁸

K. Biological pathways

Connected to	Kind of connection	Evidence status	Context	Studies
GABA receptors and serotonin signalling	Preliminary mechanism	Animal	Proposed route for the seed's calming effects in animal studies.	^{32 17}
ERK/CREB/BDNF and Nrf2/HO-1	Preliminary mechanism	Animal	Pathways affected by spinosin in preclinical work.	¹³

L. Active compounds

Connected to	Kind of connection	Evidence status	Context	Studies
Jujuboside A	Biological association	In vitro	Reported in lab and animal work to act on GABA and serotonin pathways, per MSK. Preparation or compound: Seed	^{17 19}
Jujuboside B	Biological association	In vitro	Same reported sleep-related pathways as jujuboside A, per MSK. Preparation or compound: Seed	^{17 19}
Spinosin	Biological association	Animal	Official quality marker of the seed; works on serotonergic and GABAergic signalling and on ERK/CREB/BDNF and Nrf2/HO-1 pathways in preclinical work; oral bioavailability under 1%. Preparation or compound: Seed	^{13 17 19}
Jujubogenin	Biological association	In vitro	Named by MSK as a bioactive component of the formula; CID not looked up. Preparation or compound: Seed	¹⁷
Polysaccharides, polyphenols, flavonoids and triterpenoids (fruit)	Biological association	Animal	Reviews list these in the fruit with antioxidant, lipid- and sugar-lowering and sedative effects, mostly in lab and animal studies. The seed plant review counts 354 compounds including 164 flavonoids and 74 triterpenoids. Preparation or compound: Fruit	^{12 32 3}

Each connection is stored with the ingredient, the connected record, the kind of connection, the evidence status, the supporting studies, the preparation or compound involved, and a review date (last reviewed October 25, 2026).

Evidence at a glance: what changed in 12 lab markers

Tap a number to show only those markers. Counts are markers, not people.

Metabolic22 Other62

The evidence

The research centre for Jujube (Ziziphus jujuba): Fruit and Seed. Every record here was checked against PubMed or the publisher's page; we never list a study we have not verified.

Evidence by outcome

Sleep quality and insomnia: sour jujube seed (suan zao ren) in reviews of trials 3 studies Low certainty Sleep: one small placebo-controlled trial of the seed alone (12 people) 1 studies · 12 people in trials Very low certainty Sleep and anxiety: Suan Zao Ren Tang and related formulas (combinations, not the seed alone) 3 studies · 326 people in trials Very low certainty Sleep: a Zizyphus-containing supplement mix did not beat placebo 1 studies · 171 people in trials Not enough evidence Stress, anxiety and mood: very little direct evidence 3 studies · 179 people in trials Not enough evidence Fatigue: one small pilot of a three-herb tea containing jujube fruit 1 studies · 40 people in trials Very low certainty Blood fats and waist size (jujube fruit) 3 studies · 146 people in trials Low certainty Blood sugar and insulin (jujube fruit) 4 studies · 304 people in trials Low certainty Blood pressure (jujube fruit) 3 studies · 108 people in trials Not enough evidence Constipation (jujube extract or syrup) 3 studies · 127 people in trials Very low certainty PCOS: metabolic markers improved, pregnancy rate not 1 studies · 196 people in trials Low certainty Chronic hives (add-on syrup) 2 studies · 64 people in trials Very low certainty Liver protection during TB treatment (tiny pilot) 1 studies · 17 people in trials Very low certainty Anaemia and 'blood building' (cell and animal studies only) 1 studies Not enough evidence

Bars show how many studies we found for each outcome, not how well it works. People are added up across trials only (reviews are not added, to avoid double counting).

How we rate evidence

High certainty

Several well-run trials or reviews agree; further research is unlikely to change the picture much.

Moderate certainty

Good trials point the same way, but some doubt remains.

Low certainty

Small, short or inconsistent trials. The finding could change with better research.

Very low certainty

Very little or very weak human data. Treat as a possibility only.

Mixed findings

Trials or reviews disagree with each other.

Not enough evidence

Not enough human research to say either way.

Evidence against

Good research found no benefit, or found harm.

We take the reviewers' own risk-of-bias and GRADE statements where they exist, and otherwise judge from study size, design, consistency, directness and whether a product matches what is sold. Many publications do not make evidence high. Method note: We searched PubMed, read the abstract of every PubMed study cited, read the MSK Suan Zao Ren Tang page and a MedicineNet consumer page, and checked names in GBIF and NCBI Taxonomy and compounds in PubChem. NCCIH has no jujube page; EMA could not be read.

Study library: every study we checked 32

Design Research type Plant part Year from Search

Study	Design	People	Product, dose, length	Result
Ahmadi 2025 Impact of jujube fruit on serum lipid profile, glycemic index, and liver function: a systematic review and meta-analysis Nutr Diabetes · PMID 40399274 · DOI	Meta-analysis	483 7 clinical studies, 483 participants (English and Persian papers)	Jujube fruit (forms and doses varied) fruit Not stated in abstract Not stated in abstract · vs various	Jujube significantly reduced BMI and triglycerides and fasting blood sugar in people with type 2 diabetes. LDL and total cholesterol fell in some subgroups. HDL, AST and ALT did not change significantly. Results varied by dose, duration and disease type. Significant but pooled numbers not read in abstract Methods, limits and funding Outcomes: BMI, lipids, blood sugar, AST, ALT Limitations: Authors say overall evidence quality is limited; few, small, mostly regional trials. Funding and conflicts: Authors declare none. Read: abstract
Baek 2018 Three-Component Herbal Tea Alleviates Prolonged Fatigue and Improves Sleep Quality: A Randomized Controlled Pilot Study Explore (NY) · PMID 30482676 · DOI	Controlled trial	40 40 adults with prolonged fatigue (35 completed), Korea	Herbal tea of Astragali Radix, Angelicae gigantis Radix and Zizyphi Fructus (a combination - NOT jujube alone) fruit within a combination Not stated in abstract 4 weeks · vs no intervention (not placebo)	Fatigue was lower in the tea group than in controls at 4 weeks; sleep quality improved within the tea group; depression improved at 8 weeks. Controls did not change. Significant difference at 4 weeks; numbers not in abstract Methods, limits and funding Outcomes: Chalder Fatigue Scale; sleep; depression; quality of life Limitations: No placebo, so expectation effects are likely; combination of three herbs; pilot. Funding and conflicts: Not stated in abstract record. Read: abstract
Chen 2020 A Review of Edible Jujube, the Ziziphus jujuba Fruit: A Heath Food Supplement for Anemia Prevalence Front Pharmacol · PMID 33324222 · DOI	Narrative review animal		Jujube fruit extracts and compounds fruit Not stated in abstract Not stated in abstract	In cell and animal models jujube extract affected red-cell production and iron recycling. Traditionally used in China for 'blood deficiency'. Flavonoids, polysaccharides and triterpenoids are proposed active parts. No human anaemia trials summarised in the abstract. Methods, limits and funding Limitations: Mostly cell and animal findings. Funding and conflicts: No conflicts declared. Read: abstract
Farhadnejad 2025 Effect of dried Ziziphus Jujube Consumption on Plasma Insulin, Blood Pressure, Oxidative Stress, and Advanced Glycation End Products in Diabetic Patients with Excess Weight: A Randomized Controlled Trial Int J Prev Med · PMID 40964206 · DOI	Controlled trial	48 48 adults with type 2 diabetes and excess weight in Iran (24 per group)	Dried jujube fruit, 30 g/day fruit Not stated in abstract 3 months · vs control group	After adjustment, systolic BP fell by up to 7 mmHg, diastolic by up to 5 mmHg and plasma insulin by up to 4.6 mIU/L versus control. No difference in antioxidant capacity, MDA or CML. SBP up to -7 mmHg; DBP up to -5 mmHg; insulin up to -4.6 mIU/L Methods, limits and funding Outcomes: Fasting insulin, blood pressure, oxidative stress markers, AGEs Limitations: Small; control group type (placebo or none) not clear from abstract; food-level amount. Funding and conflicts: Authors declare none. Registration: IRCT20181210041913N1 Read: abstract
GBIF Secretariat 2026 GBIF backbone: Ziziphus jujuba Mill. (key 3039423) GBIF species API · Source	Identity n/a		unspecified Not stated in abstract Not stated in abstract	Read 2026-10-25 via species/match: Ziziphus jujuba Mill., rank SPECIES, status ACCEPTED, family Rhamnaceae. Methods, limits and funding Read: full-text
GBIF Secretariat 2026 GBIF backbone: Ziziphus jujuba var. spinosa (Bunge) Hu ex H.F.Chow (key 4928539) GBIF species API · Source	Identity n/a		unspecified Not stated in abstract Not stated in abstract	Read 2026-10-25 via species/match: rank VARIETY, status ACCEPTED, family Rhamnaceae. Methods, limits and funding Read: full-text
Hu 2015 Suan zao ren tang in combination with zhi zi chi tang as a treatment protocol for insomniacs with anxiety: a randomized parallel-controlled trial Evid Based Complement Alternat Med · PMID 25793006 · DOI	Controlled trial	119 119 people with insomnia and anxiety (60 formula, 59 lorazepam) in China	Suan Zao Ren Tang plus Zhi Zi Chi Tang (a multi-herb formula, NOT the seed alone) seed within a formula Not stated in abstract 4 weeks · vs lorazepam tablet	The formula improved all four measures. Versus lorazepam, ISI (P = 0.029), PSQI (P = 0.017) and wake after sleep onset (P = 0.008) were better. One person in the formula group had side effects. P values as listed; mean differences not given in abstract Methods, limits and funding Outcomes: Polysomnography, ISI, PSQI, Self-Rating Anxiety Scale Limitations: Open comparison with a drug; unclear blinding in the abstract; formula not seed alone; regional single-country trial. Funding and conflicts: Not stated in abstract record. Read: abstract
Jing 2015 Effects of Ziziphus jujuba fruit extracts on cytochrome P450 (CYP1A2) activity in rats Chin J Nat Med · PMID 26253491 · DOI	Animal research animal	Rats	Jujube fruit water extract (1.0 g/kg) and ethanol extract (3.6 g/kg) fruit Not stated in abstract 10 days pretreatment · vs untreated rats	Extracts lowered phenacetin levels (AUC down 43.2% water, 15.5% ethanol) and raised acetaminophen formation, meaning higher CYP1A2 activity. Authors advise caution with CYP1A2-metabolised drugs. AUC phenacetin -43.2% / -15.5% Methods, limits and funding Outcomes: Phenacetin and acetaminophen pharmacokinetics; CYP1A2 activity Limitations: Rats; high extract amounts; human relevance unknown. Funding and conflicts: Not stated in abstract record. Read: abstract
Keihanian 2025 Comparison of Ziziphus jujube Mill. Syrup versus polyethylene glycol in children with functional constipation: a randomized clinical trial Sci Rep · PMID 39799261 · DOI	Controlled trial	90 90 eligible children aged 2-10 (62 completed), Iran	Ziziphus jujuba syrup, 1-5 cc/kg/day fruit (syrup; part not stated in abstract) Not stated in abstract 3 months follow-up · vs polyethylene glycol (PEG)	The jujube group had a better average response score, less soiling and pain, and better stool frequency and adherence than PEG. Only the PEG group reported (self-limiting) side effects. No liver or kidney injury reported. p < 0.05 for those comparisons Methods, limits and funding Outcomes: Response score, encopresis, pain, stool frequency, safety labs Limitations: Compared with a drug, not placebo; 28 of 90 not analysed; regional single-centre; authors say more safety work is needed. Funding and conflicts: Authors declare none. Read: abstract
Li 2025 Chinese herbal medicine for insomnia: A systematic review and network meta-analysis Medicine (Baltimore) · PMID 40826721 · DOI	Meta-analysis	186 randomized trials of 13 Chinese herbal interventions for insomnia	13 herbal interventions including suanzaoren (as one of the ranked interventions) seed (suanzaoren) among others Not stated in abstract Not stated in abstract · vs other herbal interventions and conventional drugs	Suanzaoren ranked 4th of 13 for PSQI score among the top five treatments (guipi decoction first). Reviewers rated risk of bias low-to-moderate. They concluded some herbal medicines may be effective and safe alternatives. Rank order only in the abstract; no pooled effect numbers read Methods, limits and funding Outcomes: PSQI sleep score, effective rate, adverse reactions Limitations: Network ranking is indirect evidence; abstract does not give effect sizes or say whether the suanzaoren arm was seed alone. The 'robust evidence' wording is the authors' own and is stronger than the older 2012 review. Funding and conflicts: Authors declare none. Read: abstract
Lombardi 2005 Latex-jujube cross-reactivity: case report and immunological study Allergy · PMID 15932393 · DOI	Case report	Case report (title only; details not read)	Jujube fruit fruit Not stated in abstract Not stated in abstract	Title reports cross-reactivity between latex and jujube. No abstract is indexed, so no details were read. Methods, limits and funding Limitations: Title only. Read: summary-only
Lu 2021 Research advances in bioactive components and health benefits of jujube (Ziziphus jujuba Mill.) fruit J Zhejiang Univ Sci B · PMID 34128368 · DOI	Narrative review animal		Jujube fruit fruit Not stated in abstract Not stated in abstract	Lists polysaccharides, polyphenols, amino acids, nucleotides, fatty acids, fibre and alkaloids in the fruit, with reported effects (antioxidant, lipid-lowering, blood-sugar-lowering, sedative) that are mainly lab and animal findings. Methods, limits and funding Limitations: Narrative review; abstract only. Read: abstract
Lu 2026 Spinosin: A Critical Updated Review on Pharmacology, Pharmacokinetics, Toxicity and Translational Bottlenecks Molecules · PMID 42588418 · DOI	Narrative review animal		Spinosin (flavone C-glycoside of the seed) seed Not stated in abstract Not stated in abstract	Spinosin is the official quality marker of the seed. Oral bioavailability below 1% in preclinical work and limited brain entry (P-glycoprotein efflux). Toxicology studies support a favourable profile but long-term toxicity and human pharmacokinetics are missing. Methods, limits and funding Limitations: Mostly animal data. Funding and conflicts: No conflicts declared. Read: abstract
Maddahi 2022 The efficacy of Jujube syrup on the prevention of drug-induced hepatotoxicity in pulmonary tuberculosis patients: A pilot randomized double-blind placebo-controlled clinical trial Pharmacol Res Perspect · PMID 34939363 · DOI	Controlled trial	17 17 people completing (8 jujube, 9 placebo) on anti-tuberculosis drugs, Iran	Jujube syrup, 10 cc/day fruit Not stated in abstract 4 weeks · vs placebo syrup	At week 2, 27.3% of the placebo group developed liver toxicity and none in the jujube group (p = .037). 0 versus 27.3% (liver toxicity at week 2) Methods, limits and funding Outcomes: Liver enzymes; cough; quality of life Limitations: Pilot; 17 people finished; the finding rests on a handful of events. Funding and conflicts: None stated in abstract. Read: abstract
Mashhadi 2026 Effects of Ziziphus jujuba, metformin, and myoinositol on pregnancy rates and metabolic parameters in infertile women with PCOS: a randomized controlled trial J Ovarian Res · PMID 41618368 · DOI	Controlled trial	196 196 infertile women with PCOS (49 per group), Iran	Ziziphus jujuba hydroalcoholic extract, 15 g daily fruit (extract; part not stated in abstract) Not stated in abstract 12 weeks · vs metformin, myoinositol or placebo	No significant difference in pregnancy (jujuba 10, metformin 7, myoinositol 5, placebo 4). Cholesterol, triglycerides, HDL and fasting glucose improved versus other groups. No serious adverse effects; one person reported mild constipation. Pregnancies: 10 / 7 / 5 / 4 of 49 per group (p > 0.05) Methods, limits and funding Outcomes: Pregnancy (primary); fasting glucose, lipids, insulin resistance Limitations: Primary outcome not met; registration listed as an ethics number in the abstract. Funding and conflicts: Authors declare none. Read: abstract
MedicineNet (consumer drug reference) Wild Jujube: Benefits, Medicinal Uses, Side Effects MedicineNet · Source	Authoritative guidance		unspecified Not stated in abstract Not stated in abstract	Says wild jujube may lower blood sugar (caution with antidiabetic drugs), advises stopping at least 2 weeks before surgery, advises checking with a doctor before combining with antidepressants (serotonin syndrome, 'rare'), lists drowsiness and low blood sugar as common side effects, says no interactions are listed, and advises avoiding medicinal use in pregnancy and breastfeeding (small amounts of fruit as food likely acceptable). Methods, limits and funding Limitations: Consumer reference, not a regulator; no references are cited for these statements in the text read. Treated as guidance only. Read: full-text
Memorial Sloan Kettering Cancer Center Suan Zao Ren Tang (herb page) MSK About Herbs · Source	Authoritative guidance		unspecified Not stated in abstract Not stated in abstract	Formula page (5 herbs: Suan Zao Ren, Fu Ling, Chuan Xiong, Zhi Mu, Gan Cao). Lists side effects (sleep disruption, dizziness, dry mouth, facial rash, urinary urgency, constipation, diarrhea, fatigue, lethargy, sweating), says contraindications 'none known', and says that because of its sedative effects the formula may interact with SSRIs/SNRIs and MAOIs. Reports small trials with lorazepam, methadone patients and cancer patients. Methods, limits and funding Limitations: About the FORMULA, not the seed alone. No pregnancy section on the page. Read: full-text
NCBI 2026 NCBI Taxonomy: Ziziphus jujuba (taxid 326968) NCBI Taxonomy esearch · Source	Identity n/a		unspecified Not stated in abstract Not stated in abstract	Read 2026-10-25: esearch for Ziziphus jujuba returns taxid 326968. Methods, limits and funding Read: summary-only
NCBI PubChem 2026 PubChem compound records: jujuboside A, jujuboside B, spinosin PubChem PUG REST · Source	Identity n/a		unspecified Not stated in abstract Not stated in abstract	Name lookup 2026-10-25: jujuboside A = CID 51346169; jujuboside B = CID 24721031; spinosin = CID 155692 (C28H32O15). Formula checked for spinosin only. Methods, limits and funding Read: summary-only
Naftali 2008 Ziziphus jujuba extract for the treatment of chronic idiopathic constipation: a controlled clinical trial Digestion · PMID 19142004 · DOI	Controlled trial	37 37 patients with chronic constipation and slow transit, Israel	Liquid Ziziphus jujuba extract unspecified Not stated in abstract 12 weeks · vs placebo	18 got the extract and 19 placebo. 2 (12%) of the extract group and 16 (84%) of the placebo group dropped out because of severe constipation. Transit time and symptom scores improved more with the extract. The authors concluded the extract is effective and safe. Transit time 12.2 to 3 particles at week 11 (extract group) Methods, limits and funding Outcomes: Transit time, symptoms, quality of life Limitations: The very uneven dropout (84% on placebo) makes the comparison unreliable. Small. Funding and conflicts: Not stated in abstract record. Read: abstract
Parastouei 2024 The effects of jujube (Ziziphus jujube) on metabolic and mental health outcomes in patients with metabolic syndrome: A randomized controlled trial Complement Ther Med · PMID 38648942 · DOI	Controlled trial	60 60 adults with metabolic syndrome in Iran (30 per group)	Dried jujube fruit powder, 30 g/day split in two portions fruit Not stated in abstract 8 weeks · vs placebo powder	No effect on fasting glucose, total cholesterol, LDL, blood pressure, depression or anxiety. Waist circumference (-3.98 vs -0.51 cm, p=0.01), triglycerides (-24.96 vs -0.73, p=0.03), HDL (2.83 vs 0.40, p=0.01) and a stress score (-5.80 vs -2.86, p=0.01) improved versus placebo. As listed in results Methods, limits and funding Outcomes: Lipids, fasting glucose, waist, blood pressure; depression, anxiety, stress Limitations: Authors note weaknesses in blinding and in testing herb purity and potency; small; several secondary outcomes. Funding and conflicts: Authors declare none. Read: abstract
Rodriguez Villanueva 2017 Experimental and Clinical Pharmacology of Ziziphus jujuba Mills. Phytother Res · PMID 28084039 · DOI	Narrative review		Ziziphus jujuba fruit, seed, leaf, bark multiple Not stated in abstract Not stated in abstract	Says the seed of var. spinosa (Suan Zao Ren) is the second most used herbal medicine for insomnia in Taiwan. States the European Pharmacopoeia Commission was unable to prepare a monograph on Ziziphi spinosae semen as planned and that the EMA had not yet made recommendations (as of 2017). Methods, limits and funding Limitations: Abstract only, 2017: regulatory position may have changed. Funding and conflicts: Not stated in abstract record. Read: abstract
Sabzghabaee 2013 Effect of Zizyphus jujuba fruits on dyslipidemia in obese adolescents: a triple-masked randomized controlled clinical trial Med Arch · PMID 23848030	Controlled trial	86 86 obese adolescents aged 12-18 with dyslipidemia (70 completed), Iran	Jujube fruit powder, 5 g three times a day fruit Not stated in abstract 1 month · vs placebo powder	Total cholesterol and LDL-C were lower in the jujube group (p = 0.007 and p = 0.004). BMI and other lipids did not change significantly. The total-cholesterol figures printed in the abstract look misprinted, so they are not quoted here. p = 0.007 (total cholesterol), p = 0.004 (LDL-C) Methods, limits and funding Outcomes: Fasting glucose and blood lipids Limitations: One month; 16 of 86 dropped out; abstract numbers inconsistent; both groups got diet and activity advice; teens only. Funding and conflicts: Not stated in abstract record. Read: abstract
Scholey 2017 Exploring the Effect of Lactium and Zizyphus Complex on Sleep Quality: A Double-Blind, Randomized Placebo-Controlled Trial Nutrients · PMID 28218661 · DOI	Controlled trial	171 171 otherwise healthy adults with mild acute insomnia	LZComplex3 (a combination: lactium milk protein hydrolysate, Zizyphus, hops, magnesium and vitamin B6) - NOT jujube alone unspecified (Zizyphus part not stated in abstract) Not stated in abstract 2 weeks after a 7-day placebo run-in · vs placebo	Sleep quality improved in both groups; no significant difference between groups on the main outcome or most secondary outcomes. Similar adverse-event rates; two treatment-related events led to permanent stopping in the active group. Strong placebo response. No significant between-group difference in PSQI change Methods, limits and funding Outcomes: PSQI sleep quality; daytime functioning, mood, cognition, stress Limitations: Combination product so the effect of Zizyphus cannot be separated; short; strong placebo response. Funding and conflicts: Sponsor was involved in the design; several authors report industry payments (see paper). Read: abstract
Shergis 2021 Medicinal seeds Ziziphus spinosa for insomnia: A randomized, placebo-controlled, cross-over, feasibility clinical trial Complement Ther Med · PMID 33385511 · DOI	Controlled trial	12 12 adults with insomnia in Melbourne, Australia (cross-over, all completed)	Ziziphus spinosa seed, encapsulated granules (2 g daily) seed Not stated in abstract 2-week run-in, 4 weeks treatment, 4-week wash-out, 4 weeks other treatment · vs placebo	PSQI was better on the seed than on placebo; other outcomes were not significantly different. Sleep diaries showed gains in total sleep time, efficiency and onset time after the seed but not after placebo. Minor adverse events only. Period effects were present. PSQI t = -2.276, df 10, p = 0.046 (95% CI -3.3 to -0.04) Methods, limits and funding Outcomes: PSQI, Insomnia Severity Index, mood, quality of life, sleep diaries Limitations: Feasibility trial of 12 people; borderline significance; period effects; not powered to prove benefit. Funding and conflicts: Not stated in abstract record. Read: abstract
Song 2020 Efficacy and Safety of Jiawei Suanzaoren Decoction Combined with Lorazepam for Chronic Insomnia: A Parallel-Group Randomized Controlled Trial Evid Based Complement Alternat Med · PMID 32089719 · DOI	Controlled trial	207 207 people with chronic insomnia analysed (China)	Jiawei Suanzaoren Decoction (a modified multi-herb formula) plus lorazepam seed within a formula Not stated in abstract 12 weeks · vs lorazepam alone	Both groups improved. The authors report the add-on group had a higher insomnia-severity reduction rate at weeks 4, 8 and 12 and fewer adverse effects than lorazepam alone. Parts of the PubMed abstract text are garbled, so only the conclusion is relied on. Not reliably readable in the abstract Methods, limits and funding Outcomes: Insomnia Severity Index, anxiety and depression scales, SF-36, treatment-emergent symptoms Limitations: Add-on to a drug, so it does not show the herb works alone; abstract has repeated, corrupted text; not blinded to a placebo. Funding and conflicts: Authors declare none. Read: abstract
Sun 2019 Analysis and health risk assessment of aflatoxin B1 residue in Ziziphi Spinosae Semen Zhongguo Zhong Yao Za Zhi · PMID 32237340 · DOI	Laboratory in-vitro	72 72 seed samples from different growing areas in China	Ziziphi Spinosae Semen (seed) seed Not stated in abstract Not stated in abstract	32 of 72 samples (44.4%) had aflatoxin B1; average 5.42 and maximum 55.09 ug/kg. Common use carried a low risk; high consumption a higher risk. 44.4% contaminated Methods, limits and funding Outcomes: Aflatoxin B1 contamination and exposure risk Limitations: Chinese-language paper, abstract only; sampled in one study period. Read: abstract
Xu 2023 Heavy metal contamination and risk assessment in winter jujube (Ziziphus jujuba Mill. cv. Dongzao) Food Chem Toxicol · PMID 36736610 · DOI	Laboratory in-vitro	212 212 fresh winter jujube samples from four main Chinese growing areas	Fresh winter jujube fruit (cultivar Dongzao) fruit Not stated in abstract Not stated in abstract	More than 99% of samples were at safe levels and none posed risk to adults on average. Chromium and cadmium could pose a low cancer risk to children at the 90th percentile of concentration. Over 99.06% of samples at safe levels Methods, limits and funding Outcomes: Eight heavy metals and risk assessment Limitations: One cultivar, fresh fruit from China; not the dried fruit or seed sold as supplements. Read: abstract
Yang 2023 The Herbal Medicine Suanzaoren (Ziziphi Spinosae Semen) for Sleep Quality Improvements: A Systematic Review and Meta-analysis Integr Cancer Ther · PMID 37014010 · DOI	Meta-analysis	905 9 randomized trials: 785 people with insomnia disorder and 120 with sleep disturbance (cancer and non-cancer)	Suanzaoren (Ziziphi Spinosae Semen); the abstract does not say how many trials used the seed alone and how many used formulas seed Not stated in abstract Not stated in abstract · vs placebo, benzodiazepines, CBT or usual care	Versus placebo, sleep quality improved (SMD -0.58). Versus benzodiazepines or CBT, insomnia severity was lower at 4 weeks. Long-term effects were mixed. No increase in major adverse events. Placebo-controlled studies had low risk of bias. SMD -0.58 versus placebo; MD -2.68 points versus benzodiazepines/CBT at 4 weeks (SMD 95% CI -1.04 to -0.11; MD 95% CI -5.50 to -0.22) Methods, limits and funding Outcomes: Patient-reported sleep quality; insomnia severity; adverse events Limitations: Small trials, variable quality; authors call for a sufficiently powered trial. Trial-level seed-versus-formula detail not read (abstract only). Funding and conflicts: Authors disclose spouse links to microbiome companies and grants from two Chinese-medicine companies outside this work. Registration: PROSPERO CRD42021281943 Read: abstract
Yeung 2012 Chinese herbal medicine for insomnia: a systematic review of randomized controlled trials Sleep Med Rev · PMID 22440393 · DOI	Systematic review	217 randomized trials of Chinese herbal medicine for insomnia (Chinese and English)	Chinese herbal medicine, single herbs and formulas; Suan Zao Ren was the most-used single herb, Gui Pi Tang the most-used formula seed (for Suan Zao Ren) Not stated in abstract Not stated in abstract · vs placebo or Western medication	Only 8 of 217 trials scored Jadad 3 or more and 7 of those 8 had high risk of bias in at least one domain. In the better trials herbal medicine was similar to placebo (3 studies) and to Western medication (3 studies). Evidence judged insufficient. Adverse events similar to placebo and fewer than with Western medication. Not pooled as a single number in the abstract Methods, limits and funding Outcomes: Insomnia efficacy, safety, composition Limitations: Poor methodological quality; few trials in the pooled analyses. Funding and conflicts: Not stated in abstract record. Read: abstract
Zare 2023 The Added-on of Ziziphus jujube Syrup in the Treatment of Chronic Spontaneous Urticaria Resistant to Standard-Dose of Secondary-generation H1 Antihistamine: A Double-Blind Randomized Clinical Trial Iran J Med Sci · PMID 38094286 · DOI	Controlled trial	64 64 people with chronic hives not controlled by antihistamine, Shiraz, Iran	Ziziphus jujube fruit syrup, 7.5 mL twice a day, plus cetirizine 10 mg nightly fruit Not stated in abstract 4 weeks · vs plain jujube syrup (control) plus cetirizine	Hive activity score was lower in the intervention group during follow-up and at day 28. Sleep quality improved in both groups, more in the intervention group. UAS p = 0.001 over follow-up; p = 0.046 at day 28 Methods, limits and funding Outcomes: Urticaria activity score; quality of life including sleep Limitations: The control also received a jujube syrup, so this does not test jujube against nothing; small. Funding and conflicts: None declared. Registration: IRCT20190304042916N1 Read: abstract
Zheng 2026 Ziziphus jujuba var. spinosa: a systematic review of phytochemistry, pharmacology, and sustainable resource utilization of its multiple plant parts J Pharm Pharmacol · PMID 41592108 · DOI	Systematic review animal		Sour jujube (var. spinosa) seeds, fruit, leaves, roots multiple Not stated in abstract Not stated in abstract	Identified 354 compounds including 164 flavonoids and 74 triterpenoids. Seed sedative-hypnotic effects were studied through GABA receptor expression and slowed breakdown of serotonin (5-HT) signalling. Fruit, leaf and root are under-studied. Methods, limits and funding Limitations: Mostly lab and animal evidence; some authors work for a biotechnology company. Funding and conflicts: Two authors are affiliated with a biotechnology company. Read: abstract

What we do not know yet

No placebo-controlled trial of the fruit for sleep or anxiety.
The seed alone has only one tiny placebo trial; most trials are formulas.
No driving, interaction or pregnancy safety studies.
Nothing on anticoagulants or CYP2C19.
Most body-system trials come from one region with varying products.
Full texts were not read.

How new research is added

New studies are found by a saved PubMed search and placed in a review queue. A person reads each one before it changes any rating or safety wording.

Lab markers

What changed in blood or saliva tests during trials. A changed number is not the same as feeling or being healthier, and we give no "normal ranges".

Metabolic 4

▼

Triglycerides

Lowered in trials

A type of blood fat; high levels are linked with heart and metabolic disease.

Low certainty

Results and what it means

Why it was measured

Commonly tracked in metabolic syndrome.

Statistical vs. clinical meaning

Statistically significant; clinical size not judged in the abstracts.

Safety implication

None stated.

Study	Result	People	Product
²¹	-24.96 vs -0.73 (p = 0.03)	60 adults with metabolic syndrome	Dried jujube powder 30 g/day for 8 weeks
¹	Significant reduction in the pooled analysis (numbers not read)	7 studies, 483 people	Jujube fruit

^{21 1}

↕

HDL cholesterol

Mixed results in trials

So-called 'good' cholesterol.

Very low certainty

Results and what it means

Why it was measured

Tracked with lipids.

Statistical vs. clinical meaning

One trial up, pooled analysis no change.

Safety implication

None stated.

Study	Result	People	Product
²¹	Rose 2.83 vs 0.40 (p = 0.01)	60 adults with metabolic syndrome	Dried jujube 30 g/day
¹	No significant pooled change	7 studies	Jujube fruit

^{21 1}

↕

Fasting blood sugar

Mixed results in trials

Blood sugar after an overnight fast.

Low certainty

Results and what it means

Why it was measured

Standard diabetes marker.

Statistical vs. clinical meaning

Mixed across populations.

Safety implication

Possible low blood sugar if combined with diabetes drugs (see Safety).

Study	Result	People	Product
¹	Significant decrease in people with type 2 diabetes	Pooled studies	Jujube fruit
²¹	No significant change	Metabolic syndrome	Dried jujube 30 g/day
¹⁵	Improved versus other groups (p < 0.05)	196 women with PCOS	Extract 15 g/day for 12 weeks

^{1 21 15}

▼

Fasting insulin

Lowered in trials

Insulin level in the blood after fasting.

Very low certainty

Results and what it means

Why it was measured

Marker of insulin resistance.

Statistical vs. clinical meaning

One small trial.

Safety implication

None stated.

Study	Result	People	Product
⁴	Fell by up to 4.6 mIU/L versus control (P < 0.05)	48 adults with type 2 diabetes and excess weight	Dried jujube 30 g/day for 3 months

⁴

Other 8

▼

Sleep quality score (PSQI, self-reported)

Lowered in trials

A questionnaire about the past month of sleep; lower scores mean better reported sleep.

Very low certainty

Results and what it means

Why it was measured

Standard measure of how people say they sleep.

Statistical vs. clinical meaning

A questionnaire score; the minimum change that matters to a person is not given in the abstracts.

Safety implication

Better reported sleep does not show less sedation or safe driving.

Study	Result	People	Product
²⁵	PSQI better on seed than placebo (t = -2.276, p = 0.046, 95% CI -3.3 to -0.04)	12 adults with insomnia	Ziziphus spinosa seed 2 g/day vs placebo, cross-over
²⁴	No significant difference between combination and placebo; both improved	171 adults with mild insomnia	LZComplex3 (combination) vs placebo
⁷	PSQI lower with formula than lorazepam (P = 0.017)	119 insomniacs with anxiety	SZRT + ZZCT formula vs lorazepam

^{25 24 7}

▼

Insomnia severity (ISI)

Lowered in trials

A short questionnaire that scores how severe insomnia is.

Low certainty

Results and what it means

Why it was measured

Used to judge clinical insomnia severity.

Statistical vs. clinical meaning

Statistically significant but borderline in the meta-analysis (CI close to zero).

Safety implication

None stated.

Study	Result	People	Product
²⁹	Mean difference -2.68 points vs benzodiazepines or CBT at 4 weeks (95% CI -5.50 to -0.22)	Pooled adults with insomnia	Suanzaoren vs benzodiazepines/CBT
⁷	ISI lower with formula than lorazepam (P = 0.029)	119 insomniacs with anxiety	SZRT + ZZCT vs lorazepam

^{29 7}

▼

Stress score (questionnaire)

Lowered in trials

A self-rated stress scale; lower is better. The abstract does not name the exact scale.

Very low certainty

Results and what it means

Why it was measured

Measures perceived stress.

Statistical vs. clinical meaning

A secondary outcome in one small trial; depression and anxiety were not changed.

Safety implication

None stated.

Study	Result	People	Product
²¹	Stress score -5.80 vs -2.86 versus placebo (p = 0.01)	60 adults with metabolic syndrome	Dried jujube fruit powder 30 g/day for 8 weeks

²¹

▼

Fatigue severity (Chalder Fatigue Scale)

Lowered in trials

A questionnaire that scores physical and mental tiredness.

Very low certainty

Results and what it means

Why it was measured

Primary outcome of the tea pilot.

Statistical vs. clinical meaning

No placebo and a three-herb mix.

Safety implication

None stated.

Study	Result	People	Product
²	Fatigue lower in the tea group than controls at 4 weeks; numbers not in the abstract	40 adults with prolonged fatigue (35 completed)	Astragalus, angelica and jujube fruit tea vs no intervention

↕

Total cholesterol and LDL

Mixed results in trials

Blood cholesterol markers linked to heart risk.

Very low certainty

Results and what it means

Why it was measured

Often tracked in dyslipidemia.

Statistical vs. clinical meaning

Opposite results in two trials.

Safety implication

None stated.

Study	Result	People	Product
²³	Total cholesterol and LDL lower in the jujube group (p = 0.007 and 0.004)	70 obese teens completing	Fruit powder 15 g/day for 1 month
²¹	No significant change in total cholesterol or LDL	60 adults with metabolic syndrome	Dried jujube 30 g/day for 8 weeks

^{23 21 1}

↕

Systolic and diastolic blood pressure

Mixed results in trials

Pressure in the arteries when the heart beats and rests.

Not enough evidence

Results and what it means

Why it was measured

Tracked for heart risk.

Statistical vs. clinical meaning

Opposite results; small trials.

Safety implication

Possible additive effect with blood pressure drugs (reasoned, not studied).

Study	Result	People	Product
⁴	Systolic down by up to 7 mmHg and diastolic by up to 5 mmHg vs control	Type 2 diabetes with excess weight	Dried jujube 30 g/day
²¹	No significant change	Metabolic syndrome	Dried jujube 30 g/day

^{4 21}

▼

Waist circumference

Lowered in trials

Waist measurement, a marker of belly fat.

Very low certainty

Results and what it means

Why it was measured

Part of the metabolic syndrome definition.

Statistical vs. clinical meaning

One trial.

Safety implication

None stated.

Study	Result	People	Product
²¹	-3.98 vs -0.51 (p = 0.01)	60 adults with metabolic syndrome	Dried jujube 30 g/day

²¹

▼

Colonic transit time and constipation symptoms

Lowered in trials

How long markers take to pass through the bowel, and symptom scores.

Very low certainty

Results and what it means

Why it was measured

Measures constipation objectively.

Statistical vs. clinical meaning

84% placebo dropout.

Safety implication

None stated.

Study	Result	People	Product
²⁰	Transit time 12.2 to 3 particles at week 11 in the extract group	37 adults with chronic constipation	Liquid extract vs placebo

²⁰

Safety

What studies and official sources say about side effects, medicines and who should check first. Each point shows what kind of evidence it comes from.

Main points to know 7

Sedation and driving (mainly the seed and seed formulas). The seed (suan zao ren) is used to help sleep, and MSK cites 'sedative effects' for the formula. Side effects of the formula listed by MSK include dizziness, lethargy and fatigue, and MedicineNet lists drowsiness. No driving or alertness study was found. It is sensible to assume it can cause sleepiness and not to drive or use machinery until you know how it affects you, especially with alcohol or other sedatives. This is reasoning from the sedative effect, not a tested driving result. Authoritative guidance ^{17 16 29}
Diabetes medicines and blood sugar. Trials of the fruit found lower fasting blood sugar in people with type 2 diabetes (meta-analysis) and lower insulin (one trial). MedicineNet warns that jujube may lower blood sugar and to use caution with antidiabetic drugs. No trial tested jujube together with diabetes drugs for low blood sugar. Anyone on insulin or sugar-lowering tablets should check blood sugar more often and tell their doctor. Authoritative guidance ^{1 4 16}
Blood pressure medicines. One trial of dried fruit in people with type 2 diabetes found systolic pressure fell by up to 7 mmHg. Another trial in metabolic syndrome found no blood pressure change. No sources describe an interaction with blood pressure drugs; an added effect is possible in theory, so people on blood pressure medicines should keep checking their readings. Pharmacological theory ^{4 21}
Antidepressants and other serotonin-related drugs. MSK says the formula's sedative effects may interact with SSRI/SNRI and MAOI drugs. MedicineNet advises checking with a doctor before combining with antidepressants and mentions serotonin syndrome as rare. No case report or trial of such an interaction was found, so the strength of this warning is theoretical. Authoritative guidance ^{17 16}
Sedatives, sleeping pills and alcohol. Two Chinese trials gave a seed formula together with lorazepam and report fewer side effects than lorazepam alone, but they do not test safety of the combination in everyday use. Adding any sedating herb to benzodiazepines, sleeping pills, opioids or alcohol could increase drowsiness; ask a doctor or pharmacist. Controlled trial ^{26 7}
Pregnancy and breastfeeding. No pregnancy or breastfeeding safety study was found. MedicineNet says small amounts of the fruit as food are likely acceptable but advises avoiding medicinal use of jujube products in pregnancy and breastfeeding. The traditional caution for the seed is not documented in a source we could read. One trial in infertile women with PCOS gave extract before ovulation induction and reported no serious adverse effects. Authoritative guidance ^{16 15}
Quality and contamination. Aflatoxin B1 (a mould toxin) was found in 44.4% of 72 seed samples in China, mostly at low levels but up to 55 ug/kg. Fresh winter jujube fruit samples were mostly safe for adults but chromium and cadmium could pose a low risk to children at the high end. No pesticide-residue study of jujube products was read. Laboratory ^{27 28}

Side effects 7

Effect	How often	Severity and recovery	Evidence
Sleepiness, dizziness, lethargy Listed for the formula (MSK) and the herb (MedicineNet); no frequencies given.	Not established	mild Not stated	Authoritative guidance ^{17 16}
Constipation or diarrhoea, dry mouth, rash, sweating, urinary urgency MSK lists these for Suan Zao Ren Tang, a five-herb formula, not the seed alone.	Not established	mild Not stated	Authoritative guidance ¹⁷
Mild constipation Fruit extract 15 g/day for 12 weeks in women with PCOS.	1 participant reported it in a 196-woman trial arm of 49	mild Not stated	Controlled trial ¹⁵
Low blood sugar MedicineNet lists it as common; trials show blood sugar can fall.	Not established	Not stated Not stated	Authoritative guidance ^{16 1}
Minor adverse events Seed 2 g/day.	Described as minor in a 12-person trial	mild Not stated	Controlled trial ²⁵
Adverse events no more common than placebo Reviews of seed and Chinese-herb trials; small trials may miss rare harms.	No increase in major adverse events across 9 trials	Not stated Not stated	Meta-analysis ^{29 30}
Allergy in latex-allergic people (latex-jujube cross-reactivity) Case report: only the title was read, as no abstract is indexed.	Not established	Not stated Not stated	Case report ¹¹

Liver

No NIH LiverTox entry for jujube or suan zao ren was found or read (a Bookshelf search found three records but their titles could not be read). No human case reports of liver injury from jujube were found. A meta-analysis found no significant change in AST or ALT, a children's trial reported no liver or kidney injury, and a tiny TB-drug pilot saw no liver toxicity in the jujube group. These are reassuring but short and small. ^{1 9 14}

How often. No frequency of liver injury is given in any source read.

Monitoring. No agency monitoring advice found. People with liver disease or on liver-affecting drugs should ask their doctor.

This is a safety connection. It is not evidence that Jujube (Ziziphus jujuba): Fruit and Seed supports liver health.

Medicines and supplements 8

With	Why it matters	Importance	Evidence	What to do
Sedatives: benzodiazepines (e.g. lorazepam), sleeping pills, opioids, alcohol, other sleep herbs sedative	Additive sleepiness is expected from a sleep herb.	Trials gave a seed formula with lorazepam without extra adverse events, but they did not test safety of the combination.	Controlled trial Not enough evidence ^{26 7 17}	Ask a doctor or pharmacist before combining.
SSRI and SNRI antidepressants, MAOIs antidepressant	MSK links this to the formula's sedative effects; MedicineNet mentions serotonin syndrome as rare.	No case report or trial found.	Authoritative guidance Not enough evidence ^{17 16}	Do not start without telling the prescriber.
Diabetes medicines (insulin, sulfonylureas, metformin) antidiabetic	Fruit trials show lower blood sugar and insulin.	Risk of low blood sugar is theoretical; no combination trial.	Authoritative guidance Not enough evidence ^{16 1 4}	Monitor blood sugar and tell your doctor.
Blood pressure medicines antihypertensive	One trial saw lower pressure; another did not.	Additive effect possible in theory only.	Pharmacological theory Not enough evidence ^{4 21}	Keep checking blood pressure.
Drugs cleared by CYP1A2 (for example caffeine, theophylline, some antipsychotics) cytochrome-P450	Rat study: fruit extracts raised CYP1A2 activity and lowered phenacetin levels (AUC down 43.2% water extract, 15.5% ethanol extract).	No human data; the authors advise caution with CYP1A2 drugs.	Animal research Very low certainty ⁸	Ask a pharmacist; no action is needed for ordinary fruit eaten as food.
Drugs cleared by CYP2C19 (for example omeprazole, clopidogrel, some antidepressants) cytochrome-P450	No study of jujube or the seed on CYP2C19 was found in this search.	Not known.	Pharmacological theory Not enough evidence	No data either way; treat as unknown.
Anticoagulants and antiplatelet drugs (warfarin, apixaban, aspirin, clopidogrel) anticoagulant	No source read says jujube or the seed affects bleeding or clotting, and none lists an interaction. MedicineNet states there are no listed interactions.	Not studied.	Authoritative guidance Not enough evidence ¹⁶	Not found in the sources; tell the prescriber about any herb you take, especially before surgery.
Surgery and anaesthesia perioperative	MedicineNet advises stopping at least 2 weeks before surgery because of possible effects on anaesthesia and blood sugar.	Guidance only; no study.	Authoritative guidance Not enough evidence ¹⁶	Tell the surgical team.

Who should check first 5

Situation	Advice	Evidence
Pregnancy and breastfeeding (medicinal products, especially the seed)	Avoid medicinal products; small food amounts of the fruit are probably acceptable.	Authoritative guidance ¹⁶
People on diabetes drugs, antidepressants, or sedatives	Speak to a doctor or pharmacist first.	Authoritative guidance ^{17 16}
Latex allergy	Cross-reaction has been reported in one case; take care with the fruit.	Case report ¹¹
Before surgery	Stop medicinal use at least 2 weeks before, per MedicineNet.	Authoritative guidance ¹⁶
Children	A children's syrup trial found no liver or kidney injury in 30 children over 3 months but is a single regional study; use under medical advice.	Controlled trial ⁹

Overdose, product quality and regulators

Summary. No human poisoning reports were found. A review of spinosin says toxicology studies support a favourable profile but long-term toxicity and human pharmacokinetic data are lacking. The fruit is a common food.

Animal. The spinosin review (animal data) found a favourable toxicology profile; specifics not read beyond the abstract.

Human doses studied. Trial amounts are not given here; ask a doctor or pharmacist about amounts.

High dose or long term signals. Longest trial found: 3 months. No long-term data.

Overdose response. MedicineNet says there is no overdose information and it is unlikely to cause serious symptoms; this is consumer guidance only.

Genotoxicity. Not stated in the sources read.

Toxic plant parts. No toxic plant part is named in the sources read. Ziziphus spina-christi and Z. mauritiana are different species and were not evaluated here.

Seed samples in China often contained low aflatoxin B1; fresh fruit was mostly safe for heavy metals. Pesticide residues in supplements were not assessed in the sources read.

Aflatoxin B1 in the seed. 32 of 72 seed samples (44.4%) were contaminated; average 5.42 ug/kg, maximum 55.09 ug/kg. Common intake carried low risk; high consumption higher risk. ²⁷

Heavy metals in fresh winter jujube. Over 99% of 212 samples were at safe levels; chromium and cadmium could pose a low cancer risk to children at the 90th percentile. ²⁸

Pesticide residues. No pesticide study of jujube fruit or seed products was read. Not found.

Species and part mix-ups. Papers use 'jujube', 'wild jujube', 'Ziziphus spinosa' and 'sour jujube' loosely; the seed (var. spinosa) and fruit (Z. jujuba) are different products. ^{16 32}

Body	Action	Date
NIH NCCIH (United States)	Not found. NCCIH pages for jujube and suan zao ren returned 404.
Memorial Sloan Kettering Cancer Center (United States)	Has a page on the Suan Zao Ren Tang formula (not the seed or fruit alone). Lists side effects, says contraindications none known, and warns of possible interaction with SSRIs/SNRIs and MAOIs. source

When to get medical help

Severe allergic reaction: swelling of the face or throat, trouble breathing, hives all over (especially if you have a latex allergy).
Signs of very low blood sugar if you take diabetes medicines: shaking, sweating, confusion, fainting.
Agitation, high fever, stiff muscles, fast heartbeat with an antidepressant (possible serotonin syndrome, per MedicineNet).
Extreme drowsiness or being unable to wake properly after taking a sleep herb with sedatives or alcohol.
Yellow skin or eyes, dark urine or severe stomach pain (possible liver problem).

Stop the supplement and contact a clinician or emergency service. In the US, Poison Control is 1-800-222-1222.

General information only, not medical advice. Ask a clinician or pharmacist before use, especially with medicines, in pregnancy or with a health condition. See the Natural Remedy Safety guide.

Frequently asked questions

What is jujube?

Jujube (red date, da zao) is the fruit of Ziziphus jujuba. The seed of a sour variety, Ziziphus jujuba var. spinosa, is called suan zao ren and is used in Chinese medicine for sleep. Fruit and seed are different products and the research on one does not apply to the other.

^{5 6 22}

Does jujube help you sleep?

The best evidence is for the seed, not the fruit. A 2023 review of 9 small trials found short-term improvements in self-reported sleep quality versus placebo, with mixed long-term results. An older review of Chinese herbs for insomnia found most trials poor and the evidence insufficient. Certainty is low.

^{29 30 10}

Is Suan Zao Ren Tang the same as jujube seed?

No. Suan Zao Ren Tang is a five-herb formula (suan zao ren, fu ling, chuan xiong, zhi mu and licorice). Trials of it or its modified versions test a combination, usually against a drug, so they cannot be credited to the seed alone.

^{17 7 26}

Does jujube help with anxiety?

There is very little evidence. A trial of dried jujube in people with metabolic syndrome found no change in anxiety or depression, though a stress score improved. A seed-based formula improved anxiety scores in people with insomnia, but it was a combination compared with a drug.

^{21 7}

Can jujube lower blood sugar or cholesterol?

In small trials the fruit lowered triglycerides and, in people with type 2 diabetes, fasting blood sugar and insulin. Results were mixed for cholesterol and blood pressure. A 2025 review called the evidence limited.

^{1 4 21 23}

Is jujube good for constipation?

Two trials, one with an extract and one with a syrup in children, reported benefit, but the first had an uneven placebo dropout and the second compared with a laxative, not placebo. The evidence is very low.

^{20 9}

Can I drive after taking jujube seed?

No study tested this. Because the seed is used as a sleep aid and sources list drowsiness and dizziness, avoid driving or machinery until you know how it affects you, especially with alcohol or sedatives.

^{17 16}

Does jujube interact with medicines?

Sources advise caution with diabetes medicines (possible low blood sugar), antidepressants including SSRIs, SNRIs and MAOIs, and sedatives. A rat study found fruit extracts raised CYP1A2 activity; nothing was found for CYP2C19 or for anticoagulants and antiplatelet drugs. Ask a doctor or pharmacist.

^{16 17 8}

Is jujube safe in pregnancy or when breastfeeding?

No safety study was found. MedicineNet says small amounts of the fruit as food are likely acceptable but advises avoiding medicinal use of jujube products. Ask a clinician first, especially for the seed.

^{16 15}

Can jujube harm the liver?

No liver injury cases were found, and a 2025 review found no significant change in AST or ALT. Evidence is short and small, and LiverTox was not read.

^{1 9 14}

Are jujube products clean and safe?

Quality varies. Aflatoxin B1, a mould toxin, was found in 44% of 72 seed samples in a Chinese study, mostly at low levels. Fresh fruit samples were mostly safe for heavy metals. No pesticide study was read. Choose products that name the plant part and show third-party testing.

^{27 28}

Have regulators approved jujube for sleep?

No regulator approval was found. NCCIH has no jujube page, and a 2017 review said European monograph work on the seed was not complete. Check with a pharmacist about status in your country.

²²

Editorial transparency

Written by: AlternativeMed editorial team. Research compiled with AI assistance, then checked against PubMed records.
Medical review: None. This page has not been reviewed by a physician or pharmacist.
First published: 2026-10-25
Last substantive update: 2026-10-25
How we research: We searched PubMed, read the abstract of every PubMed study cited, read the MSK Suan Zao Ren Tang page and a MedicineNet consumer page, and checked names in GBIF and NCBI Taxonomy and compounds in PubChem. NCCIH has no jujube page; EMA could not be read.
How we rate evidence: See "How we rate evidence" in the Evidence tab.
Independence: No product is promoted on this page. No affiliate links are shown. Some trials were funded or involve industry and are flagged in each record.

Sources 32

Each source was opened and checked. Where we read only the abstract, it says so. The small numbers in the text point here.

Ahmadi M, Shirafkan H, Mozaffarpur SA, et al.. Impact of jujube fruit on serum lipid profile, glycemic index, and liver function: a systematic review and meta-analysis. Nutr Diabetes. 2025. PMID 40399274. DOI 10.1038/s41387-025-00378-7. (abstract)
Baek Y, Kim H, Mun S, et al.. Three-Component Herbal Tea Alleviates Prolonged Fatigue and Improves Sleep Quality: A Randomized Controlled Pilot Study. Explore (NY). 2018. PMID 30482676. DOI 10.1016/j.explore.2018.05.001. (abstract)
Chen J, Tsim KWK. A Review of Edible Jujube, the Ziziphus jujuba Fruit: A Heath Food Supplement for Anemia Prevalence. Front Pharmacol. 2020. PMID 33324222. DOI 10.3389/fphar.2020.593655. (abstract)
Farhadnejad H, Hedayati M, Sahranavard S, et al.. Effect of dried Ziziphus Jujube Consumption on Plasma Insulin, Blood Pressure, Oxidative Stress, and Advanced Glycation End Products in Diabetic Patients with Excess Weight: A Randomized Controlled Trial. Int J Prev Med. 2025. PMID 40964206. DOI 10.4103/ijpvm.ijpvm_144_24. (abstract)
GBIF Secretariat. GBIF backbone: Ziziphus jujuba Mill. (key 3039423). GBIF species API. 2026. (full-text)
GBIF Secretariat. GBIF backbone: Ziziphus jujuba var. spinosa (Bunge) Hu ex H.F.Chow (key 4928539). GBIF species API. 2026. (full-text)
Hu LL, Zhang X, Liu WJ, et al.. Suan zao ren tang in combination with zhi zi chi tang as a treatment protocol for insomniacs with anxiety: a randomized parallel-controlled trial. Evid Based Complement Alternat Med. 2015. PMID 25793006. DOI 10.1155/2015/913252. (abstract)
Jing XY, Peng YR, Wang XM, et al.. Effects of Ziziphus jujuba fruit extracts on cytochrome P450 (CYP1A2) activity in rats. Chin J Nat Med. 2015. PMID 26253491. DOI 10.1016/S1875-5364(15)30054-6. (abstract)
Keihanian F, Maleknejad S, Saeidinia A, et al.. Comparison of Ziziphus jujube Mill. Syrup versus polyethylene glycol in children with functional constipation: a randomized clinical trial. Sci Rep. 2025. PMID 39799261. DOI 10.1038/s41598-025-85801-w. (abstract)
Li W, Wang Q, Dang C, et al.. Chinese herbal medicine for insomnia: A systematic review and network meta-analysis. Medicine (Baltimore). 2025. PMID 40826721. DOI 10.1097/MD.0000000000043789. (abstract)
Lombardi C, Mistrello G, Roncarolo D, et al.. Latex-jujube cross-reactivity: case report and immunological study. Allergy. 2005. PMID 15932393. DOI 10.1111/j.1398-9995.2005.00829.x. (summary-only)
Lu Y, Bao T, Mo J, et al.. Research advances in bioactive components and health benefits of jujube (Ziziphus jujuba Mill.) fruit. J Zhejiang Univ Sci B. 2021. PMID 34128368. DOI 10.1631/jzus.B2000594. (abstract)
Lu K, Wang C, Li J. Spinosin: A Critical Updated Review on Pharmacology, Pharmacokinetics, Toxicity and Translational Bottlenecks. Molecules. 2026. PMID 42588418. DOI 10.3390/molecules31152567. (abstract)
Maddahi SZ, Jokar A, Kamalinejad M, et al.. The efficacy of Jujube syrup on the prevention of drug-induced hepatotoxicity in pulmonary tuberculosis patients: A pilot randomized double-blind placebo-controlled clinical trial. Pharmacol Res Perspect. 2022. PMID 34939363. DOI 10.1002/prp2.902. (abstract)
Mashhadi F, Ghaebi NK, Rakhshandeh H, et al.. Effects of Ziziphus jujuba, metformin, and myoinositol on pregnancy rates and metabolic parameters in infertile women with PCOS: a randomized controlled trial. J Ovarian Res. 2026. PMID 41618368. DOI 10.1186/s13048-025-01867-0. (abstract)
MedicineNet (consumer drug reference). Wild Jujube: Benefits, Medicinal Uses, Side Effects. MedicineNet. . (full-text)
Memorial Sloan Kettering Cancer Center. Suan Zao Ren Tang (herb page). MSK About Herbs. . (full-text)
NCBI. NCBI Taxonomy: Ziziphus jujuba (taxid 326968). NCBI Taxonomy esearch. 2026. (summary-only)
NCBI PubChem. PubChem compound records: jujuboside A, jujuboside B, spinosin. PubChem PUG REST. 2026. (summary-only)
Naftali T, Feingelernt H, Lesin Y, et al.. Ziziphus jujuba extract for the treatment of chronic idiopathic constipation: a controlled clinical trial. Digestion. 2008. PMID 19142004. DOI 10.1159/000190975. (abstract)
Parastouei K, Nashtar SB, Al-Attar Z, et al.. The effects of jujube (Ziziphus jujube) on metabolic and mental health outcomes in patients with metabolic syndrome: A randomized controlled trial. Complement Ther Med. 2024. PMID 38648942. DOI 10.1016/j.ctim.2024.103041. (abstract)
Rodriguez Villanueva J, Rodriguez Villanueva L. Experimental and Clinical Pharmacology of Ziziphus jujuba Mills.. Phytother Res. 2017. PMID 28084039. DOI 10.1002/ptr.5759. (abstract)
Sabzghabaee AM, Khayam I, Kelishadi R, et al.. Effect of Zizyphus jujuba fruits on dyslipidemia in obese adolescents: a triple-masked randomized controlled clinical trial. Med Arch. 2013. PMID 23848030. (abstract)
Scholey A, Benson S, Gibbs A, et al.. Exploring the Effect of Lactium and Zizyphus Complex on Sleep Quality: A Double-Blind, Randomized Placebo-Controlled Trial. Nutrients. 2017. PMID 28218661. DOI 10.3390/nu9020154. (abstract)
Shergis JL, Hyde A, Meaklim H, et al.. Medicinal seeds Ziziphus spinosa for insomnia: A randomized, placebo-controlled, cross-over, feasibility clinical trial. Complement Ther Med. 2021. PMID 33385511. DOI 10.1016/j.ctim.2020.102657. (abstract)
Song MF, Chen LQ, Shao QY, et al.. Efficacy and Safety of Jiawei Suanzaoren Decoction Combined with Lorazepam for Chronic Insomnia: A Parallel-Group Randomized Controlled Trial. Evid Based Complement Alternat Med. 2020. PMID 32089719. DOI 10.1155/2020/3450989. (abstract)
Sun MF, Dou XW, Zhang L, et al.. Analysis and health risk assessment of aflatoxin B1 residue in Ziziphi Spinosae Semen. Zhongguo Zhong Yao Za Zhi. 2019. PMID 32237340. DOI 10.19540/j.cnki.cjcmm.20190624.202. (abstract)
Xu M, Chen Q, Kong X, et al.. Heavy metal contamination and risk assessment in winter jujube (Ziziphus jujuba Mill. cv. Dongzao). Food Chem Toxicol. 2023. PMID 36736610. DOI 10.1016/j.fct.2023.113645. (abstract)
Yang M, Wang H, Zhang YL, et al.. The Herbal Medicine Suanzaoren (Ziziphi Spinosae Semen) for Sleep Quality Improvements: A Systematic Review and Meta-analysis. Integr Cancer Ther. 2023. PMID 37014010. DOI 10.1177/15347354231162080. (abstract)
Yeung WF, Chung KF, Poon MM, et al.. Chinese herbal medicine for insomnia: a systematic review of randomized controlled trials. Sleep Med Rev. 2012. PMID 22440393. DOI 10.1016/j.smrv.2011.12.005. (abstract)
Zare H, Nabavizdeh SH, Jaladat AM, et al.. The Added-on of Ziziphus jujube Syrup in the Treatment of Chronic Spontaneous Urticaria Resistant to Standard-Dose of Secondary-generation H1 Antihistamine: A Double-Blind Randomized Clinical Trial. Iran J Med Sci. 2023. PMID 38094286. DOI 10.30476/IJMS.2023.95531.2690. (abstract)
Zheng X, Fu W, Lin X, et al.. Ziziphus jujuba var. spinosa: a systematic review of phytochemistry, pharmacology, and sustainable resource utilization of its multiple plant parts. J Pharm Pharmacol. 2026. PMID 41592108. DOI 10.1093/jpp/rgaf133. (abstract)

Education, not medical advice. This page is for general information. It does not diagnose or treat any condition and is not a substitute for care from a qualified health professional. Natural does not automatically mean safe. Ask a clinician or pharmacist before changing your care, especially if you take medication, are pregnant or breastfeeding, or have a health condition.