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**Saibokuto** is a traditional Japanese Kampo medicine formulated as a mixture of extracts from 10 medicinal herbs. It is primarily prescribed for conditions such as bronchial asthma, anxiety neurosis, infantile asthma, bronchitis, and immune-mediated diseases. Mechanistically, Saibokuto has been shown to exert its effects through modulation of the immune response, inhibition of leukotriene synthesis by selectively inhibiting 5-lipoxygenase activity, reduction of histamine release from mast cells, suppression of various cytokines including IL-3 and IL-4, and increasing interferon-gamma production. It also enhances airway epithelial mucociliary transport and demonstrates anxiolytic-like effects in animal models. Saibokuto is used for both physical symptoms (respiratory, immune, gastrointestinal) and psychological symptoms (anxiety, depressed mood), and is occasionally prescribed to aid glycemic control in insulin resistance syndrome via immune system modulation. Notable side effects can include interstitial pneumonia, pseudoaldosteronism, myopathy, hepatic dysfunction, and jaundice[1][4][5][6][8][10].
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