Hi Lacey, you’re on the right track! Yes, the 20:1 extract should make the dosage lower for most people. I am hesitant to recommend a higher dosage at first, especially if you already have kidney problems. Higher doses (360mg/day compared to 180 mg/day) were associated with slightly higher RA improvements in one clinical study that used an ethanol/ethyl acetate extract over 20 weeks. 500mg caps would be a large amount. The best we can do is to approximately determine an effective, safe RA dosage based on that study and the quality and strength of commercially available extracts. With this in mind, I suggest you start with a lower dosage and slowly increase it if you don’t experience side effects. If only 200mg caps are available, you can start with those (1 cap/day). If you don’t have kidney problems, you could even try taking 400mg/day, which is indeed high. In that case, I suggest caution. Listen to your body, track your response and side effects. If you experience side effects, reduce the dosage or stop taking the supplement.
All the best,
Ana

Thanks, Lacey. Kidney or liver damage has been reported in about 6% of the cases. First of all, it’s recommended to keep the dosage under 120 mg/day. Start with a lower dose and carefully monitor your reaction. It would be best to consult a doctor if you plan to use it for kidney disease and/or take any prescription medications. Since oxidative stress from triptolide is involved in the damage, the safest way to reduce the likelihood of organ damage is with well-researched antioxidants like vitamin C, resveratrol, quercetin, and NRF2 boosters (such as sulforaphane). You don’t need to use all of them, any single one should offer you a degree of protection. You may want to read through our post about NRF2 as well: https://selfhacked.com/blog/about-nrf2-and-natural-ways-to-increase-it/. Hope this helps!

Thanks, Lacey! 20:1 extracts are typical, although the studies often don’t specify the ratio (or the extract type varies). The higher the ratio, the more potent the extract. Capsulated extracts will usually state the quantity in mg as well. For example, 200 mg per capsule of the 20:1 extract. If the one you have is in powder form, this makes dosing a bit more difficult. You would need to measure the powder on a small scale to dose it precisely–200 mg of the powder for a 200mg dose.