Andrographis

January 8, 2005

Andrographis

Parts used and where grown

Andrographis originated in the plains of India, and it also grows in China. The leaves and flowers are used medicinally.

Andrographis has been used in connection with the following conditions (refer to the individual health concern for complete information):

Rating Health Concerns

3Stars

Common coldImmune functionInfection

2Stars

Dysentery

1Star

HIV infectionIndigestionViral hepatitis

3Stars Reliable and relatively consistent scientific data showing a substantial health benefit.

2Stars Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.

1Star For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support and/or minimal health benefit.

Historical or traditional use (may or may not be supported by scientific studies)

Andrographis has long been used in traditional Indian andChinese herbal medicine. The most common reported uses were for digestive problems (as is the case with most non-toxic bitter herbs such as andrographis), snakebite, and infections ranging from malaria to dysentery.1 2 Interestingly, some of these uses have been validated by modern scientific research. Although the roots were sometimes used in traditional medicine, the leaves and flowers are now more commonly used.

Active constituents

The major constituents in andrographis are diterpene lactones known as andrographolides. These bitter constituents are believed to have immune-stimulating, anti-inflammatory, fertility-decreasing, liver-protective, and bile secretion-stimulating actions.3 Though some older studies suggested andrographis was antibacterial, modern research has been unable to confirm this finding.4

Several double-blind clinical trials have found that andrographis can help reduce symptom severity in people with common colds. 5 6 7 8 9 Though the earliest clinical trial among these showed modest benefits, later studies have tended to be more supportive. Standardized andrographis extract combined with eleuthero (Siberian ginseng), known as Kan jang, has also been shown in a double-blind clinical trial to reduce symptoms of the common cold.10

A preliminary uncontrolled study using isolated andrographolide found that while it tended to decrease viral load and increase CD4 lymphocyte levels in people with HIV infection, at the amount used, the preparation led to side effects, including headache, fatigue, a bitter/metallic taste in the mouth, and elevated liver enzymes (which returned to normal after the medication was stopped).11 It is unknown whether the andrographolides used in this study directly killed HIV or had an immune-strengthening effect.

Andrographis has proven helpful in combination with antibiotics for people with dysentery, a severe form of diarrhea. 12 It has also shown preliminary benefit for people with chronic viral hepatitis. 13

How much is usually taken?

Andrographis is generally available as capsules with dried herb or as standardized extracts (containing 11.2 mg andrographolides per 200 mg of extract). For dried herb, 500–3,000 mg are taken three times per day. In clinical trials, 100 mg of a standardized extract were taken two times per day to treat the common cold.14 For indigestion, andrographis may be taken as a tea. Use 1 teaspoon (5 grams) of the herb for each cup (250 ml) of hot water. Allow the mixture to stand for 10–15 minutes before drinking (sip before meals).

Are there any side effects or interactions?

Some people develop intestinal upset when taking andrographis. If this occurs, reduce the amount taken or take it with meals. Headache, fatigue, a bitter/metallic taste, and elevated liver enzymes were reported in one trial with HIV-infected people taking high doses of isolated andrographolides.15 This has not been reported in people using whole andrographis or standardized extracts at the amounts recommended above. As with all bitter herbs, andrographis may aggravate ulcers and heartburn. The safety of andrographis during pregnancy and breast-feeding is unknown.

At the time of writing, there were no well-known drug interactions with andrographis.

References

1. Nadkarni AK, Nadkarni KM. Indian Materia Medica vol 1. Bombay: Popular Prakashan, 1976, 101–3.

2. Bensky D, Gamble A, Kaptchuk T. Chinese Herbal Medicine Materia Medica Revised Edition. Seattle: Eastland Press, 1993, 95.

3. Bone K. The story of Andrographis paniculata, a new “immune system” herb. Nutrition & Healing 1998;Sept:3, 4, 8, 9 [review].

4. Leelarasamee A, Trakulsomboon S, Sittisomwong N. Undetectable anti-bacterial activity of Andrographis paniculata (Burma) Wall. ex ness. J Med Assoc Thai1990;73:299–304.

5. Thamlikitkul V, Dechatiwongse T, Theerapong S, et al. Efficacy of Andrographis paniculata, Nees for pharyngotonsillitis in adults. J Med Assoc Thai 1991;74:437–42.

6. Melchior J, Palm S, Wikman G. Controlled clinical study of standardized Andrographis paniculata extract in common cold–a pilot trial. Phytomedicine 1996;3:314–8.

7. Hancke J, Burgos R, Caceres D, Wikman G. A double-blind study with a new monodrug Kan Jang: decrease of symptoms and improvement in recovery from commoncolds. Phytother Res 1995;9:559–62.

8. Cáceres DD, Hancke JL, Burgos RA, et al. Use of visual analogue scale measurements (VAS) to assess the effectiveness of standardized Andrographis paniculataextract SHA-10 in reducing the symptoms of common cold. A randomized double blind-placebo study. Phytomedicine 1999;6:217–23.

9. Caceres DD, Hancke JL, Burgos RA, et al. Use of visual analogue scale measurements (VAS) to asses the effectiveness of standardized Andrographis paniculataextract SHA-10 in reducing the symptoms of common cold. A randomized double blind-placebo study. Phytomedicine 1999;6:217–23.

10. Melchior J, Spasov AA, Ostrovskij OV, et al. Double-blind, placebo-controlled pilot and phase III study of activity of standardized Andrographis paniculataHerba Ness extract fixed combination (Kan jang) in the treatment of uncomplicated upper-respiratory tract infection. Phytomedicine 2000;7:341–50.

11. Calabrese C, Berman SH, Babish JG, et al. A phase I trail of andrographolide in HIV positive patients and normal volunteers. Phytother Res 2000;14:333–8.

12. Thanagkul B, Chaichantipayut C. Double-blind study of Andrographis paniculata Nees and tetracycline in acute diarrhea and bacillary dysentery. RamathibodiMed J 1985;8:57–61.

13. Chaturvedi GN, Tomar GS, Tiwari SK, Singh KP. Clinical studies on kalmegh (Andrographis paniculata) in infective hepatitis. J Int Inst Ayurveda 1983;2:208–11.

14. Bone K. The story of Andrographis paniculata, a new “immune system” herb. Nutrition & Healing 1998;September:3, 4, 8, 9 [review].

15. Calabrese C, Berman SH, Babish JG, et al. A phase I trail of andrographolide in HIV positive patients and normal volunteers. Phytother Res 2000;14:333–8.../Images/LogoCpyrt.gif

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The information presented in Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience,or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed,treatment with prescription or over-the-counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problemand before using any supplements or before making any changes in prescribed medications. Information expires March 2005.

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Andrographis

Botanical name: Andrographis paniculata

Common names: Chiretta, Chuan xin lian, Kalmegh, KirataList of 7 items• Botany• Helpful for• Traditional use• How it works• Amount to take• Side Effects & Interactions• Referenceslist end

Parts used and where grown

Andrographis originated in the plains of India, and it also grows in China. The leaves and flowers are used medicinally.

Andrographis has been used in connection with the following conditions (refer to the individual health concern for complete information):

RatingHealth Concerns3Stars

Common coldImmune functionInfection2Stars

Dysentery1Star

HIV infectionIndigestionViral hepatitis3Stars Reliable and relatively consistent scientific data showing a substantial health benefit.2Stars Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.1Star For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support and/or minimal healthbenefit.

Historical or traditional use (may or may not be supported by scientific studies)

Andrographis has long been used in traditional Indian andChinese herbal medicine.The most common reported uses were for digestive problems (as is the case with most non-toxic bitter herbs such as andrographis), snakebite, andinfectionsranging from malaria to dysentery.1 2 Interestingly, some of these uses have been validated by modern scientific research. Although the roots were sometimesused in traditional medicine, the leaves and flowers are now more commonly used.

Active constituents

The major constituents in andrographis are diterpene lactones known as andrographolides. These bitter constituents are believed to haveimmune-stimulating,anti-inflammatory, fertility-decreasing, liver-protective, and bile secretion-stimulating actions.3 Though some older studies suggested andrographis wasantibacterial, modern research has been unable to confirm this finding.4

Several double-blind clinical trials have found that andrographis can help reduce symptom severity in people withcommon colds.5 6 7 8 9 Though the earliest clinical trial among these showed modest benefits, later studies have tended to be more supportive. Standardized andrographisextract combined witheleuthero(Siberian ginseng), known as Kan jang, has also been shown in a double-blind clinical trial to reduce symptoms of the common cold.10

A preliminary uncontrolled study using isolated andrographolide found that while it tended to decrease viral load and increase CD4 lymphocyte levels inpeople withHIV infection,at the amount used, the preparation led to side effects, including headache, fatigue, a bitter/metallic taste in the mouth, and elevated liver enzymes (whichreturned to normal after the medication was stopped).11 It is unknown whether the andrographolides used in this study directly killed HIV or had an immune-strengtheningeffect.

Andrographis has proven helpful in combination withantibioticsfor people with dysentery, a severe form ofdiarrhea.12 It has also shown preliminary benefit for people with chronic viralhepatitis.13

How much is usually taken?

Andrographis is generally available as capsules with dried herb or as standardized extracts (containing 11.2 mg andrographolides per 200 mg of extract).For dried herb, 500–3,000 mg are taken three times per day. In clinical trials, 100 mg of a standardized extract were taken two times per day to treatthecommon cold.14 Forindigestion,andrographis may be taken as a tea. Use 1 teaspoon (5 grams) of the herb for each cup (250 ml) of hot water. Allow the mixture to stand for 10–15 minutesbefore drinking (sip before meals).

Are there any side effects or interactions?

Some people develop intestinal upset when taking andrographis. If this occurs, reduce the amount taken or take it with meals. Headache, fatigue, a bitter/metallictaste, and elevated liver enzymes were reported in one trial with HIV-infected people taking high doses of isolated andrographolides.15 This has not beenreported in people using whole andrographis or standardized extracts at the amounts recommended above. As with all bitter herbs, andrographis may aggravateulcersandheartburn.The safety of andrographis duringpregnancyand breast-feeding is unknown.