Andrographis (Andrographis paniculata) is a bitter herb containing andrographolide that modulates immune function, inhibits NF-κB inflammatory pathways, and activates Nrf2 antioxidant systems, with strong clinical evidence from meta-analyses showing it significantly reduces duration and severity of upper respiratory infections, typically supplemented at 400-1,200mg daily of extract standardized to 4-12% andrographolide, though it should be used cautiously due to potential allergic reactions in sensitive individuals.
Alternative Names: Andrographis paniculata, Kalmegh, King of Bitters, Bhunimba, Chuan Xin Lian, Green Chiretta, Indian Echinacea, Creat
Categories: Herb, Adaptogen, Bitter, Immunomodulator
Primary Longevity Benefits
- Immune system support
- Anti-inflammatory effects
- Antioxidant protection
- Liver protection
Secondary Benefits
- Respiratory health support
- Digestive system support
- Cardiovascular health
- Antimicrobial properties
- Fever reduction
- Blood glucose regulation
- Neuroprotection
Mechanism of Action
Andrographis paniculata exerts its therapeutic effects through multiple mechanisms, primarily attributed to its bioactive compounds, with andrographolide being the most studied and potent constituent. As an immunomodulator, andrographolide enhances both innate and adaptive immune responses. It stimulates natural killer (NK) cell activity, increases macrophage phagocytosis, and modulates T-cell function, particularly by promoting the differentiation of T-helper cells. This balanced immune enhancement helps the body respond effectively to pathogens without triggering excessive inflammation.
The anti-inflammatory properties of andrographolide are mediated through inhibition of nuclear factor-kappa B (NF-κB) signaling, a master regulator of inflammatory responses. By preventing the nuclear translocation of NF-κB, andrographolide reduces the production of pro-inflammatory cytokines such as tumor necrosis factor-alpha (TNF-α), interleukin-1 beta (IL-1β), and interleukin-6 (IL-6). Additionally, andrographolide inhibits cyclooxygenase-2 (COX-2) and inducible nitric oxide synthase (iNOS), further contributing to its anti-inflammatory effects. Andrographis exhibits potent antioxidant activity through multiple pathways.
It directly scavenges free radicals and reactive oxygen species (ROS) while enhancing endogenous antioxidant systems. Andrographolide activates nuclear factor erythroid 2-related factor 2 (Nrf2), a transcription factor that regulates the expression of antioxidant enzymes including superoxide dismutase (SOD), catalase, glutathione peroxidase, and heme oxygenase-1 (HO-1). This dual approach to oxidative stress management provides comprehensive cellular protection. In the respiratory system, andrographolide reduces mucus hypersecretion, bronchial smooth muscle contraction, and airway inflammation, explaining its efficacy in respiratory conditions.
It inhibits histamine release and stabilizes mast cells, contributing to its anti-allergic properties. Andrographis demonstrates hepatoprotective effects by preserving hepatocyte integrity, enhancing liver detoxification pathways, and reducing oxidative damage to liver cells. It increases glutathione levels and activates phase II detoxification enzymes, supporting the liver’s natural detoxification processes. The antimicrobial properties of andrographolide involve multiple mechanisms.
It disrupts bacterial cell membranes, inhibits bacterial protein synthesis, and interferes with bacterial quorum sensing. Against viruses, andrographolide inhibits viral replication, prevents viral attachment to host cells, and modulates host immune responses to viral infection. In the cardiovascular system, andrographolide improves endothelial function, reduces platelet aggregation, and modulates lipid metabolism. It activates nitric oxide synthase (NOS) to increase nitric oxide production, promoting vasodilation and healthy blood flow.
For metabolic regulation, andrographolide enhances insulin sensitivity by activating AMP-activated protein kinase (AMPK) and improves glucose uptake in peripheral tissues. It also inhibits alpha-glucosidase, reducing postprandial glucose spikes. The neuroprotective effects of andrographolide involve reducing neuroinflammation, inhibiting microglial activation, and protecting neurons from oxidative damage. It crosses the blood-brain barrier and modulates neurotransmitter systems, potentially explaining its effects on cognitive function and neuroprotection.
These diverse mechanisms of action work synergistically to produce the wide range of therapeutic effects observed with Andrographis paniculata supplementation.
Optimal Dosage
Disclaimer: The following dosage information is for educational purposes only. Always consult with a healthcare provider before starting any supplement regimen, especially if you have pre-existing health conditions, are pregnant or nursing, or are taking medications.
The standard recommended dosage of Andrographis paniculata extract ranges from 400-1,200 mg per day, typically divided into 2-3 doses. Most clinical studies showing beneficial effects have used extracts standardized to contain 4-12% andrographolide, the primary active compound. For standardized extracts, this translates to approximately 20-100 mg of andrographolide daily, depending on the specific condition being addressed and individual response.
By Condition
| Condition | Dosage | Notes |
|---|---|---|
| Upper Respiratory Tract Infections (Common Cold, Sinusitis) | 400-1,200 mg of standardized extract (containing 4-12% andrographolide) daily, divided into 2-3 doses | Most clinical studies have used 400 mg three times daily for 3-5 days at the onset of symptoms. Higher doses within this range may be more effective for reducing symptom severity and duration. Treatment should begin at the first sign of symptoms for optimal results. |
| Immune Support (Preventative) | 200-400 mg of standardized extract daily | Lower doses are typically used for preventative purposes and general immune support, particularly during cold and flu season. Long-term use at this dosage appears to be well-tolerated in most individuals. |
| Inflammatory Conditions | 600-1,200 mg of standardized extract daily, divided into 2-3 doses | Higher doses within this range are typically used for inflammatory conditions. Effects may take 2-4 weeks to become noticeable. Should be used under healthcare provider supervision for chronic inflammatory conditions. |
| Liver Support | 800-1,200 mg of standardized extract daily, divided into 2-3 doses | Studies on hepatoprotective effects have typically used higher doses within the recommended range. May be particularly beneficial for individuals with elevated liver enzymes or those exposed to hepatotoxic substances. |
| Digestive Support | 400-800 mg of standardized extract daily, divided into 2-3 doses | The bitter properties of Andrographis stimulate digestive function. Taking before meals may enhance digestive benefits. May cause initial digestive discomfort in some individuals due to its bitter nature. |
| Fever Reduction | 600-1,200 mg of standardized extract daily, divided into 3-4 doses | Traditional use for fever involves more frequent dosing. Should not replace appropriate medical care for persistent or high fevers. |
By Age Group
| Age Group | Dosage | Notes |
|---|---|---|
| Adults (18-65 years) | 400-1,200 mg of standardized extract daily | Standard adult dosage range, well-tolerated with minimal side effects when used as directed. |
| Older adults (65+ years) | 400-800 mg daily, starting with lower doses | Older adults may benefit from starting at the lower end of the dosage range and gradually increasing as tolerated. Potential for drug interactions may be higher in this population due to polypharmacy. |
| Children (6-17 years) | Weight-based dosing, typically 5-10 mg/kg of standardized extract daily, divided into 2-3 doses | Limited clinical data in pediatric populations. Should only be used under healthcare provider supervision. Some traditional systems use reduced doses for children, but safety and efficacy have not been well-established in clinical trials. |
| Children under 6 years | Not recommended without medical supervision | Safety and efficacy have not been established in very young children. |
Timing Recommendations
Andrographis is typically taken with meals to minimize potential gastrointestinal discomfort due to its bitter nature. Dividing the daily dose into 2-3 administrations may improve tolerance and efficacy. For acute conditions like upper respiratory infections, more frequent dosing (3-4 times daily) at the onset of symptoms may provide better results. For preventative use or chronic conditions, twice-daily dosing is generally sufficient.
Some practitioners recommend taking the last dose of the day at least 2-3 hours before bedtime to prevent potential sleep disturbances in sensitive individuals.
Duration Of Use
Acute Conditions: For acute conditions like common cold or sinusitis, Andrographis is typically used for 3-10 days. Clinical studies have shown benefits within this timeframe with minimal side effects.
Chronic Conditions: For chronic conditions, Andrographis has been used safely in clinical trials for up to 3 months. Long-term use beyond this period should include periodic breaks (e.g., 1 week off after 2-3 months of use) and should be monitored by a healthcare provider.
Preventative Use: For seasonal preventative use (e.g., during cold and flu season), cycles of 4-8 weeks followed by a 1-2 week break are commonly recommended by practitioners.
Special Considerations
The bitter taste of Andrographis may cause initial digestive discomfort in some individuals, which typically subsides with continued use. Starting with lower doses and gradually increasing can help minimize this effect. Individuals with autoimmune conditions should use with caution due to the immune-stimulating properties of Andrographis. Those planning surgery should discontinue use at least 2 weeks before scheduled procedures due to potential effects on blood clotting, though clinical significance is uncertain.
Andrographis may interact with certain medications, particularly those affecting blood pressure, blood glucose, or immune function, so consultation with a healthcare provider is recommended for individuals on medication.
Bioavailability
Absorption Rate
Andrographolide, the primary active compound in Andrographis paniculata, has relatively low oral bioavailability, estimated at approximately 2.67% in animal studies.
This limited bioavailability is primarily due to poor water solubility, extensive first-pass metabolism in the liver, and degradation in the gastrointestinal tract. Human pharmacokinetic studies have shown that andrographolide reaches peak plasma concentrations (Cmax) within 1.5-2 hours after oral administration, indicating relatively rapid absorption
despite the overall low bioavailability.
Enhancement Methods
| Method | Description | Effectiveness |
|---|---|---|
| Standardized extracts | Extracts standardized to contain higher percentages of andrographolide (typically 4-12%) provide more consistent bioavailability compared to crude herb preparations. | Moderate improvement in bioavailability and consistency |
| Liposomal formulations | Encapsulating andrographolide in phospholipid vesicles protects it from degradation in the GI tract and enhances cellular uptake. | Studies show 3-5 fold increase in bioavailability compared to standard extracts |
| Phytosome complexes | Binding andrographolide to phospholipids creates a complex with improved lipid solubility and membrane permeability. | Can increase bioavailability by 2-3 times compared to uncomplexed andrographolide |
| Nanoparticle formulations | Reducing particle size to nanoscale dimensions increases surface area and dissolution rate. | Emerging research shows potential for 4-6 fold increase in bioavailability |
| Consumption with dietary fats | Taking Andrographis with a meal containing moderate amounts of healthy fats may enhance absorption. | Modest improvement in bioavailability, approximately 1.5-2 fold increase |
| Piperine co-administration | Black pepper extract containing piperine may inhibit enzymes responsible for andrographolide metabolism. | Preliminary studies suggest potential 30-60% increase in bioavailability |
Timing Recommendations
Andrographis is best taken with meals to improve absorption and minimize potential gastrointestinal discomfort due to its bitter nature. A meal containing moderate amounts of healthy fats may further enhance absorption. Dividing the daily dose into 2-3 administrations throughout the day helps maintain more consistent blood levels of active compounds, as andrographolide has a relatively short half-life of approximately 6-8 hours.
For acute conditions like upper respiratory infections, more frequent dosing (3-4 times daily) at the onset of symptoms may provide better results by maintaining therapeutic levels of active compounds.
Metabolism And Elimination
Primary Metabolic Pathways: Andrographolide undergoes extensive Phase I and Phase II metabolism in the liver. The major metabolic pathways include: 1) Reduction of the α,β-unsaturated lactone moiety, 2) Sulfation and glucuronidation of hydroxyl groups, 3) Dehydrogenation reactions. The primary metabolites include sulfate conjugates, glucuronide conjugates, and dehydroandrographolide.
Enzymes Involved: Cytochrome P450 enzymes (particularly CYP3A4 and CYP2C19) are involved in Phase I metabolism. UDP-glucuronosyltransferases (UGTs) and sulfotransferases (SULTs) are responsible for Phase II conjugation reactions.
Elimination Routes: Metabolites are primarily excreted through the kidneys in urine (approximately 80%) with a smaller portion eliminated via biliary excretion in feces (approximately 20%).
Half Life: The elimination half-life of andrographolide in humans is approximately 6-8 hours, necessitating multiple daily doses for sustained therapeutic effects.
Factors Affecting Bioavailability
| Factor | Impact |
|---|---|
| Formulation type | Standardized extracts, liposomal formulations, and nanoparticle preparations significantly improve bioavailability compared to crude herb preparations. |
| Food intake | Consumption with meals, particularly those containing moderate amounts of fat, can enhance absorption by 1.5-2 fold compared to fasting conditions. |
| Individual variations in metabolism | Genetic polymorphisms in CYP enzymes, particularly CYP3A4 and CYP2C19, can significantly affect andrographolide metabolism and bioavailability. |
| Age | Older adults may experience altered drug metabolism and elimination, potentially affecting andrographolide bioavailability and half-life. |
| Concurrent medications | Drugs that induce or inhibit CYP3A4 may alter andrographolide metabolism. CYP3A4 inducers (e.g., rifampin, phenytoin) may decrease bioavailability, while inhibitors (e.g., ketoconazole, grapefruit juice) may increase it. |
| Liver function | Impaired liver function may result in reduced metabolism and potentially higher bioavailability of andrographolide, necessitating dose adjustments. |
| Gastrointestinal pH and transit time | Variations in stomach pH and intestinal transit time can affect dissolution and absorption of andrographolide. |
Tissue Distribution
After absorption, andrographolide distributes widely throughout the body tissues. Animal studies have shown significant distribution to the liver, kidneys, spleen, and lungs, with lower concentrations in the brain due to limited blood-brain barrier penetration. The volume of distribution (Vd) is relatively large, indicating extensive tissue distribution. Andrographolide and its metabolites have been detected in various tissues up to 48 hours after administration,
despite the relatively short plasma half-life, suggesting tissue retention of certain metabolites.
Bioavailability Of Other Compounds
While andrographolide is the most studied compound in Andrographis, the plant contains other bioactive diterpenoid lactones including neoandrographolide, 14-deoxy-11,12-didehydroandrographolide, and 14-deoxyandrographolide. These compounds generally have bioavailability profiles similar to andrographolide, with some variations. Neoandrographolide appears to have slightly better oral bioavailability (approximately 3.8%) compared to andrographolide. 14-deoxy-11,12-didehydroandrographolide has shown enhanced blood-brain barrier penetration compared to andrographolide, which may contribute to its reported neuroprotective effects.
The flavonoids present in Andrographis, including 7-O-methylwogonin and apigenin, have variable bioavailability but generally undergo extensive Phase II metabolism similar to other plant flavonoids.
Safety Profile
Safety Rating
Side Effects
| Effect | Frequency | Severity | Notes |
|---|---|---|---|
| Taste alteration (bitter taste) | Common (10-25% of users) | Mild | Most common side effect, typically transient and resolves with continued use or when taken with food |
| Gastrointestinal discomfort (nausea, diarrhea, abdominal discomfort) | Common (5-15% of users) | Mild to moderate | More common at higher doses; can be minimized by taking with food and starting with lower doses |
| Headache | Uncommon (2-5% of users) | Mild | Typically resolves without intervention; may be related to changes in blood pressure in sensitive individuals |
| Fatigue | Uncommon (2-5% of users) | Mild | Usually transient and resolves with continued use |
| Allergic reactions (skin rash, urticaria) | Rare (less than 1% of users) | Mild to severe | More common in individuals with known allergies to plants in the Acanthaceae family |
| Anaphylactic reactions | Very rare (case reports only) | Severe | Several case reports have been documented, particularly in Australia; individuals with history of severe allergies should use with caution |
| Lymphadenopathy (swollen lymph nodes) | Rare (less than 1% of users) | Mild to moderate | May be related to immune-stimulating effects; typically resolves upon discontinuation |
| Elevated liver enzymes | Very rare (case reports only) | Mild to moderate | Paradoxical effect given hepatoprotective properties; monitoring recommended for long-term use |
Contraindications
| Condition | Recommendation | Notes |
|---|---|---|
| Pregnancy | Contraindicated | Traditional use as an abortifacient; insufficient safety data; potential uterine stimulant effects |
| Breastfeeding | Contraindicated | Insufficient safety data; active compounds may pass into breast milk |
| Known allergy to Andrographis or plants in the Acanthaceae family | Contraindicated | Risk of allergic reactions including anaphylaxis |
| Autoimmune disorders (e.g., multiple sclerosis, rheumatoid arthritis, lupus) | Use with caution under medical supervision | Immune-stimulating properties may potentially exacerbate autoimmune conditions |
| Scheduled surgery | Discontinue 2 weeks before surgery | Theoretical concern about potential antiplatelet effects and interaction with anesthesia |
| Hypotension (low blood pressure) | Use with caution | May enhance hypotensive effects; monitor blood pressure |
| Gallbladder disease or gallstones | Use with caution | Bitter properties may stimulate bile production |
| Bleeding disorders | Use with caution | Theoretical concern about mild antiplatelet effects |
Drug Interactions
| Drug Class | Examples | Interaction Severity | Mechanism | Recommendation |
|---|---|---|---|---|
| Anticoagulants/Antiplatelets | Warfarin, aspirin, clopidogrel | Moderate | Potential additive antiplatelet effects | Monitor for increased bleeding risk; consider dose adjustment or alternative therapy |
| Antihypertensives | ACE inhibitors, calcium channel blockers, beta-blockers | Moderate | Potential additive hypotensive effects | Monitor blood pressure; may require dose adjustment of medications |
| Immunosuppressants | Cyclosporine, tacrolimus, corticosteroids | Moderate to severe | May counteract immunosuppressive effects due to immune-stimulating properties | Generally avoid combination; use only under close medical supervision if necessary |
| Hypoglycemic medications | Insulin, metformin, sulfonylureas | Moderate | Potential additive hypoglycemic effects | Monitor blood glucose levels; may require dose adjustment of medications |
| CYP1A2 substrates | Theophylline, clozapine, olanzapine | Moderate | Potential inhibition of CYP1A2, increasing levels of these drugs | Monitor for increased side effects of these medications; consider dose adjustment |
| CYP3A4 substrates | Many medications including certain statins, benzodiazepines | Mild to moderate | Potential inhibition of CYP3A4, affecting metabolism of these drugs | Monitor for altered drug effects; consider dose adjustment if necessary |
| P-glycoprotein substrates | Digoxin, certain anticancer drugs | Mild to moderate | Potential inhibition of P-glycoprotein, affecting drug transport | Monitor drug levels and effects; consider dose adjustment if necessary |
Upper Limit
No definitive upper limit has been established. Clinical studies have used doses up to 1,800 mg of standardized extract daily for short periods without significant adverse effects in most individuals. However, for general safety, staying within the recommended range of 400-1,200 mg daily is advised for most users. Higher doses increase the risk of gastrointestinal side effects and potential drug interactions.
Long Term Safety
Clinical Data: Clinical studies have demonstrated safety for up to 3 months of continuous use at recommended doses. Limited data exists for longer-term use, though traditional use in some cultures suggests safety with intermittent use over extended periods.
Monitoring Recommendations: For long-term use (beyond 3 months), periodic monitoring of liver function, blood pressure, and blood glucose is recommended, particularly in individuals with pre-existing conditions or those taking medications. Taking periodic breaks (e.g., 1 week off after 2-3 months of use) may reduce the risk of potential adverse effects with long-term use.
Population Differences: Safety profiles appear similar across different adult populations, though individual sensitivity varies. Limited data exists for pediatric populations, and caution is warranted in children, pregnant women, and individuals with autoimmune conditions.
Special Populations
| Population | Considerations |
|---|---|
| Elderly | May be more sensitive to effects due to age-related changes in drug metabolism and elimination; start with lower doses and monitor for side effects; increased potential for drug interactions due to polypharmacy |
| Children | Limited safety data; use only under healthcare provider supervision; weight-based dosing recommended if used; traditional use suggests safety at appropriate doses, but clinical evidence is limited |
| Pregnant/breastfeeding women | Contraindicated due to traditional use as an abortifacient and insufficient safety data; potential uterine stimulant effects; active compounds may pass into breast milk |
| Individuals with autoimmune disorders | Use with caution due to immune-stimulating properties; may potentially exacerbate autoimmune conditions; medical supervision recommended if used |
| Individuals with liver disease | Paradoxical effects possible; while generally hepatoprotective, rare cases of elevated liver enzymes have been reported; monitor liver function if used |
| Individuals with hypotension | May enhance hypotensive effects; monitor blood pressure; start with lower doses |
Allergic Potential
Risk Factors: History of allergies to plants in the Acanthaceae family; history of multiple plant allergies; atopic individuals may be at higher risk
Manifestations: Range from mild skin rash to severe anaphylactic reactions in rare cases; urticaria, pruritus, and angioedema have been reported
Geographic Variations: Higher incidence of allergic reactions reported in Australia compared to other regions, possibly due to genetic factors or specific product formulations
Management: Discontinue use immediately if allergic symptoms develop; seek medical attention for severe reactions; consider allergy testing before use in high-risk individuals
Toxicity Data
Acute Toxicity: Animal studies show very low acute toxicity with LD50 values >17 g/kg body weight in rodents, indicating wide safety margin
Subchronic Toxicity: 90-day studies in animals show no significant adverse effects at doses equivalent to 5-10 times human therapeutic doses
Genotoxicity: No evidence of mutagenic or genotoxic effects in standard assays
Reproductive Toxicity: Animal studies suggest potential effects on fertility and fetal development, supporting contraindication during pregnancy
Organ Specific Toxicity: No significant organ toxicity observed at therapeutic doses; rare case reports of hepatotoxicity at high doses or with prolonged use
Regulatory Status
Fda Status
Classification: Dietary Supplement
Approval Status: Not FDA-approved for treatment of any medical condition
Regulatory Framework: Regulated under the Dietary Supplement Health and Education Act (DSHEA) of 1994
Allowed Claims: Structure/function claims related to immune support and general health maintenance are permitted with appropriate disclaimer. Disease claims are not permitted without FDA approval.
Manufacturing Requirements: Must be produced in compliance with Current Good Manufacturing Practices (cGMP) for dietary supplements
Safety Status: No formal FDA safety evaluation specifically for Andrographis; considered safe when used as directed based on history of use and available research
International Status
Eu
- Traditional Herbal Medicinal Product (THMP) in some countries; Food Supplement in others
- Regulated under the Traditional Herbal Medicinal Products Directive (2004/24/EC) when registered as THMP; under Food Supplements Directive (2002/46/EC) when marketed as supplement
- Traditional use registration allows specific health claims based on long-standing traditional use. As a food supplement, health claims are restricted under European Food Safety Authority (EFSA) regulations.
- Regulatory status varies between EU member states; some countries have specific monographs or regulations for Andrographis
Thailand
- Essential Medicine (for specific indications); Traditional Medicine
- Included in Thailand’s National List of Essential Medicines for treatment of non-infectious diarrhea and common cold
- Approved for specific therapeutic claims related to upper respiratory tract infections and mild diarrhea
- Significant government support for research, cultivation, and clinical use; considered part of national healthcare strategy
India
- Ayurvedic Medicine; Listed in Indian Pharmacopoeia
- Regulated under the Drugs and Cosmetics Act as an Ayurvedic medicine
- Traditional Ayurvedic claims permitted when marketed as Ayurvedic medicine; more restricted when marketed as general supplement
- Long history of traditional use provides regulatory advantages; included in various national health programs
Australia
- Listed Complementary Medicine
- Regulated by the Therapeutic Goods Administration (TGA)
- Requires Australian Register of Therapeutic Goods (ARTG) listing
- Low-level claims related to traditional use and general health maintenance are permitted with supporting evidence
- Subject to increased scrutiny following reports of allergic reactions; TGA issued safety review in 2015
Canada
- Natural Health Product (NHP)
- Regulated under the Natural Health Products Regulations
- Requires Natural Product Number (NPN) for legal sale
- Specific health claims may be permitted with supporting evidence; several Andrographis products have approved claims for immune support and relief of cold symptoms
- Health Canada has issued specific monographs outlining approved uses and dosages
China
- Traditional Chinese Medicine; Listed in Chinese Pharmacopoeia
- Regulated by the National Medical Products Administration (NMPA)
- Traditional uses as documented in the Chinese Pharmacopoeia are permitted
- Long history of use in traditional Chinese medicine provides established regulatory status
Clinical Trial Status
Completed Trials: Over 30 clinical trials investigating various health effects of Andrographis have been completed, with particular focus on respiratory infections, inflammatory conditions, and immune function
Ongoing Trials: Several clinical trials are currently ongoing, investigating effects on respiratory infections (including COVID-19), inflammatory bowel disease, and metabolic parameters
Research Gaps: Larger, long-term clinical trials are still needed to fully establish safety and efficacy for chronic conditions; more research needed on specific standardized extracts and optimal dosing regimens
Labeling Requirements
Us: Supplement Facts panel listing active ingredients and amounts, Net quantity of contents, Name and place of business of manufacturer, packer, or distributor, Directions for use, Disclaimer: ‘These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.’, Disease claims (claims to diagnose, treat, cure, or prevent disease), Misleading statements about efficacy or safety, Not recommended during pregnancy or breastfeeding, Consult healthcare provider before use if taking medications or have medical conditions, Discontinue use if allergic reactions occur
International Variations: Labeling requirements vary significantly by country, with some jurisdictions (e.g., Canada, Australia) requiring specific cautionary statements and others imposing stricter limitations on permitted claims.
Safety Assessments
Formal Evaluations: Australian TGA conducted safety review in 2015 following reports of allergic reactions; European Medicines Agency (EMA) has evaluated safety for specific products registered as Traditional Herbal Medicinal Products
Safety Data: Generally recognized as safe for most adults when used as directed; most common adverse effects are mild gastrointestinal symptoms; rare allergic reactions have been reported, particularly in Australia
Monitoring Systems: Subject to standard adverse event reporting systems for dietary supplements/herbal medicines in various countries; increased monitoring in Australia following allergic reaction reports
Regulatory Challenges
Variation in international regulatory frameworks creates challenges for global marketing, Standardization issues – different products may contain varying levels of active compounds, Balancing traditional use evidence with modern clinical trial requirements, Managing safety concerns related to allergic reactions while maintaining appropriate access, Addressing quality control issues in global supply chain
Future Regulatory Considerations
Potential Developments: Increased regulatory recognition based on growing clinical evidence base, Development of more specific monographs and quality standards in various jurisdictions, Potential for approved health claims in some markets based on accumulating research, Possible increased scrutiny of quality control and standardization requirements, Development of specific warning requirements related to allergic reaction potential
Advocacy Efforts: Various industry associations and research organizations are working to advance regulatory recognition of evidence-based botanical supplements including Andrographis
Product Registration Examples
Synergistic Compounds
| Compound | Synergy Mechanism | Evidence Rating | Research Notes |
|---|---|---|---|
| Eleutherococcus senticosus (Siberian Ginseng) | Combines Andrographis’s anti-inflammatory and antimicrobial properties with Eleutherococcus’s adaptogenic and immune-modulating effects for enhanced immune support. Both herbs support different aspects of immune function, creating a more comprehensive immune response. | 3 | Clinical studies have shown that the combination (marketed as Kan Jang) is more effective for respiratory infections than either herb alone. A fixed combination has been used successfully in several randomized controlled trials. |
| Echinacea species | Echinacea primarily stimulates innate immunity (macrophages, NK cells) while Andrographis modulates both innate and adaptive immunity with stronger anti-inflammatory effects, providing complementary immune support. | 2 | Preliminary studies suggest enhanced immune-modulating effects when combined; limited clinical trials on the specific combination. |
| Vitamin C (Ascorbic Acid) | Vitamin C enhances immune cell function and provides antioxidant support that complements Andrographis’s immune-modulating and anti-inflammatory properties. | 2 | Theoretical synergy based on complementary mechanisms; limited direct research on the combination. |
| Zinc | Zinc supports immune function through multiple mechanisms including thymic hormone production and lymphocyte differentiation, complementing Andrographis’s effects on immune cell activation and cytokine modulation. | 2 | Theoretical synergy based on complementary immune support mechanisms; commonly combined in commercial formulations. |
| Glycyrrhiza glabra (Licorice) | Licorice contains compounds that enhance bioavailability of other herbs and provides complementary anti-inflammatory and antiviral effects through different mechanisms than Andrographis. | 3 | Traditional combination in several herbal systems; clinical studies on multi-herb formulations containing both herbs show efficacy for respiratory conditions. |
| Schisandra chinensis | Schisandra’s hepatoprotective and adaptogenic properties complement Andrographis’s anti-inflammatory and immune-modulating effects, particularly beneficial for liver protection and stress response. | 2 | Used together in traditional formulations; limited modern research on the specific combination. |
| Piperine (Black Pepper Extract) | Piperine inhibits drug-metabolizing enzymes and P-glycoprotein efflux pumps, potentially enhancing the bioavailability of andrographolide and other active compounds in Andrographis. | 2 | Preliminary studies suggest piperine may increase andrographolide bioavailability by 30-60%; clinical significance requires further investigation. |
| Ginger (Zingiber officinale) | Ginger’s anti-inflammatory compounds (gingerols, shogaols) work through complementary pathways to Andrographis, enhancing overall anti-inflammatory effects while ginger’s warming properties balance Andrographis’s cooling nature. | 2 | Traditional combination in several herbal systems; preliminary research suggests complementary effects on inflammatory pathways. |
| Astragalus membranaceus | Astragalus primarily enhances immune function through macrophage activation and increased antibody production, while Andrographis has stronger anti-inflammatory and antiviral properties, creating a balanced immune response. | 2 | Traditional combination in Chinese medicine; limited modern research on the specific combination. |
| Silymarin (Milk Thistle Extract) | Both compounds provide hepatoprotection through different mechanisms – silymarin primarily through membrane stabilization and antioxidant effects, Andrographis through modulation of detoxification enzymes and anti-inflammatory pathways. | 2 | Theoretical synergy based on complementary hepatoprotective mechanisms; limited direct research on the combination. |
| Curcumin | Both compounds have anti-inflammatory properties through different but complementary mechanisms – curcumin primarily through inhibition of COX-2 and NF-κB, Andrographis through multiple pathways including NF-κB inhibition and Nrf2 activation. | 2 | In vitro studies suggest enhanced anti-inflammatory effects; clinical evidence is limited. |
| Probiotics (particularly Lactobacillus and Bifidobacterium species) | Probiotics support gut microbiome health and mucosal immunity, while Andrographis provides systemic immune support and anti-inflammatory effects, creating a comprehensive approach to immune function. | 2 | Emerging research suggests potential benefits for gut-immune axis; limited clinical studies on the specific combination. |
| N-Acetylcysteine (NAC) | NAC’s mucolytic and antioxidant properties complement Andrographis’s anti-inflammatory and antimicrobial effects, particularly beneficial for respiratory conditions. | 1 | Theoretical synergy based on complementary mechanisms; no direct research on the combination. |
| Berberine-containing herbs (e.g., Berberis aristata, Coptis chinensis) | Berberine provides strong antimicrobial effects through different mechanisms than Andrographis, while both compounds have complementary effects on glucose metabolism and inflammation. | 2 | Traditional combination in several herbal systems; preliminary research suggests complementary effects on metabolic parameters. |
| Phospholipids (as in phytosome formulations) | Forming complexes with phospholipids enhances the bioavailability of andrographolide by improving its lipid solubility and membrane permeability. | 3 | Studies show 2-3 fold increase in bioavailability of andrographolide when formulated as phytosomes. |
Antagonistic Compounds
Cost Efficiency
Relative Cost
Low to Medium
Cost Per Effective Dose
Range: $0.30 – $1.50 per day for standard effective dose (400-1,200 mg of standardized extract)
Factors Affecting Cost: Standardization level (andrographolide content), Brand reputation and research backing, Form (capsules typically more expensive than tablets), Organic certification, Additional ingredients or specialized formulations, Country of origin and manufacturing standards
Price Comparison: $0.20 – $0.50 per effective daily dose, $0.50 – $1.00 per effective daily dose, $1.00 – $1.50+ per effective daily dose
Value Analysis
Cost Optimization Strategies
| Strategy | Details |
|---|---|
| Focus on standardization rather than brand | Look for products standardized to contain 4-12% andrographolide rather than paying premium solely for brand name. The andrographolide content is the primary determinant of efficacy. |
| Bulk purchasing | Buying larger quantities (e.g., 2-3 month supply) typically reduces cost per dose by 10-25%. |
| Seasonal use | For immune support, using Andrographis during high-risk periods (cold and flu season) rather than year-round can optimize cost-effectiveness. |
| Tablet vs. capsule formulations | Tablet forms are often 10-30% less expensive than capsules while providing similar benefits. |
| Timing of use for acute conditions | For upper respiratory infections, starting at the first sign of symptoms has shown greater efficacy in clinical trials, potentially reducing total amount needed. |
Insurance Coverage
Conventional Insurance: Rarely covered by conventional health insurance in most countries.
Health Savings Accounts: May be eligible for purchase using Health Savings Accounts (HSAs) or Flexible Spending Accounts (FSAs) in some jurisdictions with appropriate documentation.
National Healthcare Systems: Covered under Thailand’s national healthcare system for specific indications; generally not covered in most Western healthcare systems.
Economic Impact Analysis
Preventive Value: Research suggests potential economic benefits through prevention and reduced duration of common respiratory infections. One study estimated potential savings of $1.2-2.4 billion annually in the US if used widely for reducing duration of common cold (based on reduced sick days and healthcare utilization).
Productivity Considerations: Reduction in duration of illness by 1-3 days as shown in clinical trials could significantly impact productivity, particularly during cold and flu season.
Comparative Effectiveness: Limited formal cost-effectiveness analyses exist, but available data suggest favorable cost-effectiveness ratios for upper respiratory infections compared to symptomatic treatments.
Market Trends
Pricing Trends: Prices have remained relatively stable over the past decade, with modest increases generally in line with inflation. Increasing demand, particularly following COVID-19 pandemic, has not significantly impacted pricing due to relatively easy cultivation and processing.
Market Segmentation: Growing differentiation between basic products and premium formulations with enhanced bioavailability or specialized delivery systems, with corresponding price stratification.
Future Projections: Likely to remain relatively affordable due to sustainable cultivation practices and increasing market competition, though premium formulations with enhanced bioavailability may command higher prices.
Regional Cost Variations
| Region | Relative Cost | Notes |
|---|---|---|
| Southeast Asia (Thailand, India) | Very Low | Native growing regions with established cultivation and processing infrastructure; often available as traditional preparations at very low cost |
| Europe | Medium to High | Higher costs associated with importation, regulatory compliance, and premium positioning of many products |
| North America | Medium | Wide range of products available from basic to premium; increasing competition has helped maintain reasonable pricing |
| Australia | Medium to High | Higher regulatory hurdles following safety reviews have contributed to somewhat higher prices |
Sustainability Impact On Cost
Andrographis is relatively easy to cultivate and grows quickly, making it a sustainable and renewable resource. This contributes to its relatively low cost compared to many other botanical supplements. Increasing demand has led to expanded cultivation rather than unsustainable wild harvesting in most regions, helping maintain stable pricing.
Stability Information
Shelf Life
Properly manufactured and stored Andrographis products typically have a shelf life of 2-3 years from the date of manufacture. This varies by formulation, with dried herb having a shorter shelf life (1-2 years) compared to standardized extracts in capsule or tablet form (2-3 years). The primary factor affecting shelf life is the stability of andrographolide and related diterpenoid lactones, which can degrade over time, particularly when exposed to heat, light, moisture, or oxygen.
Storage Recommendations
| Condition | Recommendation | Rationale |
|---|---|---|
| Temperature | Store at room temperature (15-25°C or 59-77°F). Avoid exposure to high temperatures above 30°C (86°F). | Andrographolide and related compounds are susceptible to thermal degradation. Studies show accelerated degradation at temperatures above 30°C, with significant loss of active compounds when exposed to temperatures above 40°C for extended periods. |
| Light exposure | Store in the original, opaque container or in a dark place protected from direct light, especially sunlight. | Andrographolide is photosensitive and undergoes photodegradation when exposed to UV light. Studies show approximately 15-20% degradation of andrographolide when exposed to direct sunlight for 30 days. |
| Humidity | Store in a dry place with relative humidity below 60%. | Moisture promotes hydrolysis of the lactone ring in andrographolide and related compounds, leading to loss of biological activity. Powdered herb and extracts are particularly susceptible to moisture absorption. |
| Container considerations | Keep in the original, tightly closed container. If transferring to another container, use an airtight, opaque container with a desiccant if possible. | Minimizes exposure to air, light, and moisture, which can all contribute to degradation of active compounds. |
| Refrigeration | Not necessary for dry forms (capsules, tablets, dried herb). Liquid extracts may benefit from refrigeration after opening. | Refrigeration is generally not required for stability of dry products but may help preserve freshness of liquid formulations by slowing oxidation and potential microbial growth. |
Degradation Factors
| Factor | Impact | Notes |
|---|---|---|
| Oxidation | Moderate to high | Andrographolide contains an α,β-unsaturated γ-lactone moiety that is susceptible to oxidation. Oxidative degradation leads to loss of biological activity. Exposure to air, especially in powdered forms, accelerates oxidation. |
| Hydrolysis | High | The lactone ring in andrographolide is susceptible to hydrolysis in the presence of moisture, particularly in acidic or basic conditions. Hydrolysis of the lactone ring results in loss of biological activity. |
| Heat exposure | Moderate to high | Thermal degradation occurs at elevated temperatures, with significant degradation observed above 40°C. Long-term exposure even to moderate heat (30-35°C) can reduce potency over time. |
| Light exposure | Moderate | UV light catalyzes oxidation reactions and direct photodegradation of andrographolide and related compounds. Blue and UV wavelengths have the strongest degradative effect. |
| pH extremes | High | Andrographolide is most stable at slightly acidic to neutral pH (5-7). Strong acidic or alkaline conditions accelerate hydrolysis of the lactone ring. This is particularly relevant for liquid formulations and when considering gastric stability. |
Stability Differences By Form
| Form | Stability Profile | Special Considerations |
|---|---|---|
| Dried herb | Moderate stability when properly dried and stored; susceptible to moisture absorption and oxidation due to large surface area. | Should be stored with desiccant in airtight containers; quality deteriorates more rapidly than processed forms. |
| Powdered herb | Lower stability than whole dried herb due to increased surface area exposed to air and potential moisture absorption. | More susceptible to oxidation; should be stored with desiccant and used within 1 year of processing for optimal potency. |
| Capsules | Good stability when properly manufactured and stored; vegetable capsules may be more susceptible to moisture than gelatin capsules. | Stability enhanced by addition of antioxidants in some formulations; enteric coating may provide additional protection. |
| Tablets | Generally the most stable solid oral form due to compressed nature and typically low moisture content. | Excipients and manufacturing process can significantly affect stability; coated tablets provide additional protection against environmental factors. |
| Liquid extracts (tinctures) | Moderate stability; alcohol content provides some preservation, but compounds may still undergo gradual degradation. | Higher alcohol content (>30%) improves stability; should be protected from light; may develop precipitation over time which may not indicate loss of potency. |
| Standardized extracts | Variable depending on specific formulation and processing methods; generally more stable than crude herb preparations. | Stability often enhanced by standardization process and addition of stabilizers; quality varies significantly between manufacturers. |
Stability Testing Methods
High-Performance Liquid Chromatography (HPLC) for monitoring andrographolide content over time, Accelerated stability testing under controlled temperature and humidity conditions (typically 40°C/75% RH) to predict long-term stability, Real-time stability testing under recommended storage conditions, Photostability testing under defined light conditions, Dissolution testing for solid oral dosage forms to ensure consistent release of active compounds, Microbial testing to ensure continued safety throughout shelf life
Indicators Of Degradation
| Indicator | Significance | Action Recommended |
|---|---|---|
| Color changes | Yellowing or browning of powdered herb or extracts may indicate oxidation or other chemical changes. | If significant color change is observed, consider replacing the product. |
| Odor changes | Development of musty or rancid odors may indicate degradation or contamination. | Discard product if unusual odors develop. |
| Physical changes | Clumping of powder, softening or hardening of capsules/tablets, or unusual residue in liquid extracts may indicate moisture exposure or other quality issues. | Discard product if significant physical changes are observed. |
| Taste changes | While Andrographis is naturally very bitter, unusually bitter or unpleasant taste (for liquid forms) may indicate degradation. | Discontinue use if taste is significantly different from when first opened. |
| Reduced efficacy | Noticeable reduction in expected therapeutic effects may indicate loss of active compounds. | Consider replacing with fresh product if expected benefits are not observed. |
Transport Considerations
Andrographis products should be protected from extreme temperatures during transport. Prolonged exposure to temperatures above 30°C (86°F) or below freezing should be avoided. For international shipping or transport through varying climate zones, temperature-controlled shipping may be advisable for premium products. Proper packaging with moisture barriers and protection from physical damage is important to maintain product integrity.
Bulk raw materials are particularly susceptible to damage during transport and should be packaged with desiccants and in moisture-resistant containers.
Sourcing
Natural Sources
- Andrographis paniculata is a herbaceous plant native to India, Sri Lanka, and other parts of South and Southeast Asia. It is now cultivated in many tropical and subtropical regions worldwide, including Thailand, China, Indonesia, Malaysia, and parts of the Caribbean and Central America.
- The plant grows to a height of 30-110 cm and has lance-shaped leaves with small white flowers with purple spots. It thrives in a variety of habitats but prefers moist, shaded areas with well-drained soil.
- The medicinal parts primarily used are the aerial portions (leaves and stems), which contain the highest concentration of bioactive compounds, particularly andrographolide and related diterpenoid lactones.
Cultivation Methods
| Method | Description | Advantages | Disadvantages |
|---|---|---|---|
| Traditional cultivation | Seeds are sown at the beginning of the rainy season in prepared nursery beds and transplanted to fields after 25-30 days. Plants are typically harvested when they begin flowering, approximately 90-120 days after planting. | Well-established practices; suitable for small-scale farmers; minimal environmental impact. | Variable yields and active compound content depending on environmental conditions; labor-intensive. |
| Commercial cultivation | Larger-scale production using optimized growing conditions, controlled irrigation, and sometimes fertilization. May involve mechanized harvesting and processing. | Higher yields; more consistent production; economies of scale. | Higher resource requirements; potential environmental impact from intensive farming practices. |
| Organic cultivation | Grown without synthetic pesticides or fertilizers, using natural pest control methods and organic soil amendments. | Reduced chemical residues; potentially higher market value; environmental sustainability. | Potentially lower yields; more labor-intensive; higher production costs. |
| Tissue culture propagation | Laboratory-based micropropagation techniques to produce genetically identical plants with consistent phytochemical profiles. | Consistent active compound content; rapid multiplication of elite genotypes; disease-free planting material. | Higher technical requirements; more expensive; limited scale. |
Extraction Methods
Water extraction (decoction/infusion)
Alcohol extraction (tincture)
Supercritical fluid extraction
Hydroalcoholic extraction
Quality Considerations
Andrographolide content
Harvest timing
Post-harvest handling
Species authentication
Contaminant testing
Geographical Considerations
India
Thailand
China
Indonesia and Malaysia
Sustainability Aspects
- Andrographis paniculata is not currently considered endangered or threatened in the wild. It is a relatively fast-growing annual plant that can be sustainably cultivated.
- Wild harvesting does occur in some regions, which may lead to local population pressures if not managed properly.
- The plant is relatively easy to cultivate and can be grown in a variety of conditions, making it suitable for sustainable agricultural practices.
- Some regions have established cultivation programs that include seed banks and genetic conservation efforts to maintain biodiversity within the species.
- Climate change may affect traditional growing regions, potentially shifting optimal cultivation areas in the future.
Commercial Considerations
Standardization
Pricing factors
Market trends
Supply chain considerations
Historical Usage
Traditional Systems
Historical Milestones
| Period | Developments |
|---|---|
| Ancient period (pre-1000 CE) | Documented in classical Ayurvedic texts including the Charaka Samhita and Sushruta Samhita; early use in traditional Chinese medicine texts. |
| Colonial period (17th-19th centuries) | European documentation of indigenous use in India and Southeast Asia; inclusion in pharmacopoeias of colonial powers; early scientific investigations of medicinal properties. |
| Early 20th century | Isolation and identification of andrographolide as the primary active compound (1911); increased scientific interest in pharmacological properties; standardization of extraction methods. |
| Mid-20th century | Inclusion in the Indian Pharmacopoeia (1966); development of standardized extracts; early clinical studies on efficacy for infectious diseases. |
| 1970s-1980s | Increased research on immunomodulatory and anti-inflammatory properties; development of the standardized extract SHA-10 in Sweden; early controlled clinical trials. |
| 1990s-2000s | Expansion of research into molecular mechanisms; increased number of clinical trials; development of various standardized extracts; growing international market presence. |
| 2000s-Present | Advanced research on specific molecular targets; investigation of novel applications including metabolic disorders and cancer; development of enhanced delivery systems; increased regulatory scrutiny and quality standards. |
Historical Spread
Origin: Native to India, Sri Lanka, and other parts of South Asia
Geographical Expansion: Spread throughout Southeast Asia, including Thailand, Indonesia, Malaysia, and southern China, both through natural distribution and deliberate cultivation for medicinal purposes.
Modern Global Distribution: Now cultivated in many tropical and subtropical regions worldwide, including parts of the Caribbean, Central and South America, and Africa. Global trade has made Andrographis products available worldwide, with significant markets in Europe, North America, and Australia.
Cultural Significance
India: Known as ‘Maha-tikta’ (King of Bitters) due to its extremely bitter taste; considered one of the primary bitter tonics in Ayurveda; featured in traditional stories about its discovery by sages for treating fevers.
Thailand: Recognized as a national medicinal herb; included in Thailand’s National List of Essential Medicines for treatment of common cold and pharyngotonsillitis; subject of government promotion for domestic cultivation and use.
China: Included in the Chinese Pharmacopoeia; considered one of the important ‘heat-clearing’ herbs; featured in traditional formulations for infectious and inflammatory conditions.
Modern Context: Increasingly recognized globally as an evidence-based herbal medicine; subject of scientific research validating many traditional uses; symbol of the integration of traditional knowledge with modern scientific validation.
Historical Preparation Evolution
Traditional Methods: Historically prepared as decoctions, powders, and poultices using simple water or alcohol extraction methods. Often combined with honey or other substances to mask the extreme bitterness.
Technological Advancements: Evolution from crude preparations to standardized extracts with defined andrographolide content; development of modern extraction techniques including supercritical fluid extraction; creation of enhanced delivery systems including liposomal formulations and phytosomes.
Dosage Evolution: Traditional dosing often based on empirical observation and handed down through generations. Modern standardization has led to more precise dosing based on andrographolide content rather than crude herb weight.
Historical Vs Modern Usage
Similarities
- Primary use for infectious conditions, particularly respiratory infections
- Recognition of bitter properties as medicinally important
- Use for liver protection and digestive disorders
- Application for inflammatory conditions
Differences
- Modern focus on standardized extracts vs. traditional whole herb preparations
- Contemporary emphasis on specific molecular mechanisms vs. traditional energetic explanations
- Modern preventative use for immune support vs. traditional focus on treating active infections
- Investigation of novel applications not described in traditional systems, such as metabolic disorders and neuroprotection
- Integration into conventional healthcare in some countries vs. historical use primarily in traditional medicine systems
Key Historical Texts
| Text | Approximate Date | Significance |
|---|---|---|
| Charaka Samhita | 1000 BCE – 200 CE | Early Ayurvedic text describing the use of ‘Kalmegh’ for fever and liver disorders |
| Bencao Gangmu (Compendium of Materia Medica) | 1578 CE | Comprehensive Chinese medicine text by Li Shizhen documenting the properties and uses of ‘Chuan Xin Lian’ |
| Pharmacographia Indica | 1890-1893 | Colonial-era documentation of Indian medicinal plants including Andrographis, bridging traditional knowledge and Western scientific understanding |
| Thai Traditional Pharmacopoeia | Various editions from 20th century | Official documentation of ‘Fa Thalai Jone’ as an important medicinal herb in Thai traditional medicine |
Scientific Evidence
Evidence Rating
Key Studies
Meta Analyses
Ongoing Trials
Clinical trial investigating Andrographis for mild COVID-19 (NCT04440345), Study on Andrographis for non-alcoholic fatty liver disease (ChiCTR2000032925), Investigation of Andrographis for irritable bowel syndrome (ACTRN12618000023291)
Research Gaps
Long-term safety and efficacy studies (>6 months), Optimal dosing strategies for different health conditions, Comparative effectiveness studies against conventional treatments, Pharmacokinetic studies in special populations (elderly, pediatric), Mechanisms of action for neurological and metabolic effects, Standardization of extracts and quality control methods, Effects on gut microbiome composition and function
Expert Opinions
| Expert | Opinion |
|---|---|
| Dr. Xiao-Yang Hu, University of Southampton | Andrographis has demonstrated consistent benefits for upper respiratory tract infections across multiple clinical trials, with particularly strong evidence for symptom reduction when initiated early. |
| Dr. Edzard Ernst, University of Exeter | While evidence supports the use of Andrographis for respiratory infections, more rigorous clinical trials are needed for other traditional uses. Safety concerns regarding allergic reactions warrant caution. |
| Dr. Joanne Barnes, University of Auckland | The pharmacological activities of andrographolide are well-documented in preclinical studies, but translation to clinical efficacy requires further investigation for many conditions. Standardization of products remains a challenge. |
Population Specific Evidence
| Population | Evidence Strength | Key Findings |
|---|---|---|
| Adults with upper respiratory tract infections | Strong | Multiple randomized controlled trials and meta-analyses show significant reduction in symptom severity and duration compared to placebo. |
| Patients with inflammatory bowel disease | Moderate | Limited clinical trials suggest potential benefits for ulcerative colitis, with efficacy comparable to mesalazine in one study. |
| Individuals with liver disorders | Moderate (preclinical), Limited (clinical) | Strong preclinical evidence for hepatoprotective effects; limited clinical data in humans with liver diseases. |
| Patients with metabolic disorders | Limited | Preclinical studies suggest benefits for glucose metabolism and lipid profiles; few clinical trials with mixed results. |
| Children | Limited | Few clinical studies specifically in pediatric populations; traditional use suggests safety at appropriate doses. |
| Elderly | Limited | Limited studies focusing specifically on elderly populations; included in some general adult studies with subgroup analyses. |
Traditional Vs Modern Evidence
Traditional Uses Supported
- Upper respiratory infections (strong clinical evidence)
- Fever reduction (moderate clinical evidence)
- Liver protection (strong preclinical, limited clinical evidence)
- Digestive disorders (moderate preclinical, limited clinical evidence)
Traditional Uses Unsupported
- Malaria (limited modern evidence despite traditional use)
- Skin conditions (insufficient clinical evidence)
- Venomous bites (insufficient clinical evidence)
Novel Applications
- Inflammatory bowel disease (emerging clinical evidence)
- Metabolic syndrome components (emerging preclinical evidence)
- Neuroprotection (promising preclinical evidence)
Disclaimer: The information provided is for educational purposes only and is not intended as medical advice. Always consult with a healthcare professional before starting any supplement regimen, especially if you have pre-existing health conditions or are taking medications.