Manjistha

• Blood purification
• Lymphatic cleansing
• Anti-inflammatory
• Antioxidant protection

• Skin health
• Liver protection
• Kidney support
• Female reproductive health
• Wound healing
• Cardiovascular support
• Joint health

Manjistha (Rubia cordifolia) exerts its therapeutic effects through a diverse array of bioactive compounds, with anthraquinone derivatives being the most prominent active constituents. These include purpurin, munjistin, pseudopurpurin, rubiadin, and alizarin, along with glycosides, tannins, and free anthraquinones. The blood purification properties of Manjistha, for which it is most renowned in Ayurvedic medicine, stem from multiple mechanisms. Its anthraquinones stimulate lymphatic flow and enhance the elimination of waste products through the lymphatic system.

This lymphagogue action helps remove accumulated toxins (referred to as ‘ama’ in Ayurveda) from tissues and improves microcirculation. Additionally, Manjistha enhances liver detoxification pathways, particularly phase II conjugation reactions, facilitating the conversion of fat-soluble toxins to water-soluble forms that can be more easily excreted. The anti-inflammatory effects of Manjistha involve inhibition of pro-inflammatory enzymes including cyclooxygenase-2 (COX-2) and 5-lipoxygenase (5-LOX), reducing the production of inflammatory mediators like prostaglandins and leukotrienes. Research has shown that Manjistha extracts inhibit nuclear factor-kappa B (NF-κB) signaling, a master regulator of inflammatory responses, and reduce the expression of pro-inflammatory cytokines such as tumor necrosis factor-alpha (TNF-α), interleukin-1 beta (IL-1β), and interleukin-6 (IL-6).

The antioxidant properties of Manjistha stem from its rich content of polyphenols and anthraquinones, which directly scavenge free radicals and reactive oxygen species. Additionally, Manjistha enhances endogenous antioxidant defenses by upregulating enzymes such as superoxide dismutase (SOD), catalase, and glutathione peroxidase. This dual antioxidant action provides comprehensive protection against oxidative stress. For skin health, Manjistha’s mechanisms include antimicrobial effects against common skin pathogens, anti-inflammatory actions that reduce skin redness and irritation, and antioxidant protection that prevents photoaging.

Its anthraquinones also exhibit tyrosinase inhibitory activity, potentially reducing hyperpigmentation and evening skin tone. Additionally, Manjistha promotes wound healing by enhancing collagen synthesis and angiogenesis. In female reproductive health, Manjistha demonstrates uterine tonic effects, helping to regulate menstrual flow and reduce cramping. It also exhibits mild phytoestrogenic activity, potentially supporting hormonal balance.

The hepatoprotective effects of Manjistha involve membrane stabilization of hepatocytes, reduction of lipid peroxidation in liver tissue, and enhancement of liver regeneration capacity. For kidney support, Manjistha exhibits diuretic properties, enhancing the elimination of waste products through increased urine output. It also helps maintain healthy kidney function by reducing oxidative stress and inflammation in renal tissue. The cardiovascular benefits of Manjistha include mild antiplatelet and fibrinolytic activities, potentially improving blood flow and reducing the risk of thrombosis.

Its antioxidant properties also help protect vascular endothelium from oxidative damage. For joint health, Manjistha’s anti-inflammatory mechanisms reduce joint inflammation and pain, while its blood-purifying properties help remove metabolic waste products that can accumulate in joint tissues. The complex phytochemical profile of Manjistha creates a synergistic effect across multiple physiological systems, explaining its diverse therapeutic applications and its status as one of the premier blood-purifying herbs in Ayurvedic medicine.

250-500 mg of dried root powder taken 2-3 times daily; or 2-6 grams of dried root daily, divided into 2-3 doses. For standardized extracts, follow manufacturer recommendations, typically 100-300 mg daily standardized to 10-20% anthraquinones.

Moderate; the anthraquinone compounds in Manjistha have variable absorption rates. Free anthraquinones are generally better absorbed than glycosidic forms, which require bacterial hydrolysis in the colon before absorption. Studies suggest approximately 20-40% bioavailability for major anthraquinones, with significant individual variation based on gut microbiota composition.

Traditional Ayurvedic preparation with ghee (clarified butter) or sesame oil enhances absorption of fat-soluble compounds and may protect some compounds from degradation in the stomach, Combining with black pepper extract (piperine) can increase absorption by inhibiting P-glycoprotein efflux and certain metabolic enzymes, Taking with a fat-containing meal enhances absorption of lipophilic compounds, Fermented preparations may enhance bioavailability through partial breakdown of glycosidic bonds by microbial enzymes, Decoction preparation (simmering in water) may increase extraction and potential absorption of water-soluble compounds, Liposomal formulations can significantly improve bioavailability by enhancing solubility and cellular uptake, Standardized extracts with higher free anthraquinone content generally provide better bioavailability than raw herb powder, Tinctures (alcohol-based extracts) may provide better extraction of both water-soluble and fat-soluble compounds

For general blood purification and detoxification, consistent timing throughout the day is more important than specific timing. Taking with meals containing moderate fat content (15-25g fat) enhances absorption of lipophilic compounds, though high-fat meals may delay absorption. For skin conditions, consistent daily administration is crucial, as benefits typically develop gradually over several weeks of regular use. The traditional Ayurvedic recommendation is to take Manjistha with warm water or milk, often with honey as a carrier.

For lymphatic support, morning administration may be most beneficial to support daily lymphatic circulation. The half-life of active compounds varies, but the duration of effects suggests divided dosing (2-3 times daily) may provide more consistent blood levels for most applications. When used for menstrual disorders, consistent daily administration throughout the menstrual cycle is recommended, rather than only during menstruation. Due to its bitter and astringent taste, Manjistha is traditionally taken with honey or jaggery in Ayurvedic practice, which may also help mask the taste but doesn’t significantly affect bioavailability.

• Gastrointestinal discomfort including mild nausea, cramping, or diarrhea (occasional, particularly with higher doses)
• Increased urination due to diuretic effect (common)
• Temporary reddish discoloration of urine (common, harmless effect of anthraquinone pigments)
• Skin rash or allergic reactions (rare, more common in individuals allergic to plants in the Rubiaceae family)
• Mild headache (uncommon)
• Temporary increase in menstrual flow in women (occasional)
• Bitter taste and aftertaste (very common)

• Pregnancy (potential uterine stimulant effects; traditionally contraindicated in Ayurvedic practice)
• Breastfeeding (insufficient safety data; anthraquinones may pass into breast milk)
• Bleeding disorders (mild anticoagulant effects may exacerbate bleeding tendencies)
• Scheduled surgery (discontinue 2 weeks before due to potential effects on blood clotting)
• Severe kidney disease (diuretic effects may be problematic in compromised renal function)
• Severe liver disease (may affect metabolism)
• Known allergy to plants in the Rubiaceae family
• Intestinal obstruction or inflammatory bowel disease (may exacerbate symptoms)
• Hormone-sensitive conditions including certain cancers (theoretical concern due to potential mild estrogenic effects)

• Anticoagulant and antiplatelet drugs (potential additive effects on blood clotting)
• Diuretic medications (may enhance diuretic effects, potentially affecting electrolyte balance)
• Hormone replacement therapy (potential mild interaction with estrogenic compounds)
• Hepatotoxic medications (theoretical concern for additive stress on liver function)
• Medications metabolized by CYP450 enzymes (potential alteration of drug metabolism)
• Iron supplements (tannins in Manjistha may reduce iron absorption if taken simultaneously)
• Lithium (diuretic effect may increase lithium concentration)
• Medications for autoimmune conditions (potential interference with therapeutic effects due to immunomodulatory properties)

No established upper limit; traditional Ayurvedic texts suggest not exceeding 6-9 grams of dried root powder daily for extended periods. Higher doses substantially increase the risk of gastrointestinal side effects. Long-term safety data beyond 6 months of continuous use is limited, though traditional use suggests safety with prolonged administration at moderate doses. Some practitioners recommend periodic breaks (e.g., 1 week off after 6-8 weeks of use) for long-term administration.

Manjistha (Rubia cordifolia) is regulated as a dietary supplement in the United States. It has not been approved as a drug for any specific health conditions. As with other dietary supplements, the FDA does not review Manjistha products for safety or efficacy before they are marketed. Manufacturers are responsible for ensuring their products are safe before marketing and that product labels are truthful and not misleading. The FDA has not issued specific guidance or warnings regarding Manjistha.

Eu: In the European Union, Rubia cordifolia is not included in the list of approved novel foods. Its regulatory status varies by member state, with some countries allowing it as a traditional herbal medicinal product under the Traditional Herbal Medicinal Products Directive (2004/24/EC) when meeting specific requirements. In Germany, it is not included in the Commission E approved herbs. The European Medicines Agency (EMA) has not issued specific monographs on Rubia cordifolia. A related species, Rubia tinctorum (European madder), has more historical use in European herbal medicine.

Canada: Health Canada has listed Rubia cordifolia in the Natural Health Products Ingredients Database with a medicinal ingredient role. It is allowed for use in Natural Health Products with appropriate claims related to traditional Ayurvedic use. Products must meet specific quality and labeling requirements. Health Canada has not issued specific monographs or guidance on Manjistha for specific health conditions.

Australia: The Therapeutic Goods Administration (TGA) permits Rubia cordifolia in listed complementary medicines (AUST L). It is included in the Australian Register of Therapeutic Goods (ARTG) for use in traditional Ayurvedic medicine. Specific therapeutic claims must be supported by evidence of traditional use.

India: Manjistha is officially recognized in the Ayurvedic Pharmacopoeia of India and is widely used in licensed Ayurvedic medicines. The Ministry of AYUSH (Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy) regulates its use in traditional formulations. It is considered an essential herb in Ayurvedic practice and is included in numerous classical formulations. The Drugs and Cosmetics Act of India recognizes Ayurvedic formulations containing Manjistha when prepared according to authoritative texts.

Japan: Rubia cordifolia is not commonly used in Japanese traditional medicine (Kampo) and does not have specific regulatory status for medicinal use in Japan.

Low to medium

Dried root powder: $0.15-0.40 per day; Standardized extract: $0.40-0.90 per day; Traditional Ayurvedic formulations (e.g., Manjishthadi Kwath): $0.50-1.20 per day

Manjistha offers good value for its diverse health benefits, particularly for blood purification, lymphatic support, and skin health applications. The raw herb and basic powder forms are very cost-effective, being moderately priced compared to many other Ayurvedic herbs. For skin conditions, Manjistha represents a high-value option compared to many conventional treatments. Its multiple mechanisms of action (anti-inflammatory, blood-purifying, lymphatic-cleansing) provide comprehensive benefits for conditions like acne, eczema, and psoriasis at a fraction of the cost of prescription medications, though results may develop more gradually.

For lymphatic support, few conventional medical treatments directly address lymphatic congestion, making Manjistha a unique and cost-effective option for this application. The cost-effectiveness for liver support is moderate, with herbs like Milk Thistle offering more targeted hepatoprotective effects at similar price points. Standardized extracts provide more consistent active compound content and potentially better quality control, justifying their moderately higher cost compared to raw herb powder. Organic certified products typically cost 20-30% more than conventional ones but offer better quality assurance and reduced pesticide exposure.

Traditional Ayurvedic formulations combining Manjistha with synergistic herbs (e.g., Manjishthadi Kwath, Manjishthadi Ghrita) typically command higher prices but may offer enhanced therapeutic effects through traditional processing methods and complementary herb combinations. When comparing Manjistha to conventional medical treatments for skin conditions, the cost-effectiveness is particularly favorable for chronic, recurring conditions that would otherwise require ongoing pharmaceutical intervention. While the initial response may be slower than with pharmaceutical options, the long-term value is enhanced by the minimal side effect profile and potential to address underlying causes rather than just symptoms. Overall, considering the breadth of applications and the strong historical and emerging scientific support for its benefits, Manjistha represents a cost-effective natural health product, particularly for blood purification, lymphatic support, and skin health applications.

Dried root powder: 1-2 years when properly stored; Dried root pieces: 2-3 years; Standardized extracts: 2-3 years; Capsules and tablets: 2-3 years when properly stored; Tinctures: 3-5 years; Traditional preparations (decoctions, medicated oils): 1-2 years

Store in airtight, opaque containers protected from light, heat, and moisture. Dried root and powder preparations should be kept in dark glass containers or opaque packaging. Capsules and tablets should remain in their original containers with desiccant packets if provided. Tinctures should be stored in dark glass bottles with tight-fitting caps.

Avoid exposure to direct sunlight or high temperatures, which can accelerate degradation of anthraquinones and other active compounds. Traditional Ayurvedic texts recommend storing Manjistha preparations in earthen pots, wooden containers, or glass jars. For long-term storage of dried roots, traditional methods include adding a few neem leaves to prevent insect infestation. The distinctive red pigment in Manjistha can stain containers and may transfer to other herbs if stored together, so separate storage is advisable.

Exposure to light, particularly UV light, accelerates degradation of anthraquinones and other photosensitive compounds, High temperatures (above 30°C/86°F) significantly increase the rate of degradation of most active compounds, Moisture promotes hydrolysis of glycosidic bonds in anthraquinone glycosides and increases risk of microbial growth, Oxidation occurs gradually with air exposure, affecting the anthraquinone structure and reducing medicinal properties, Enzymatic degradation can occur in improperly dried plant material, pH extremes affect stability of anthraquinones; neutral to slightly acidic conditions are most stable, Microbial contamination can lead to degradation of active compounds and production of potentially harmful metabolites, Metal ions, particularly iron and copper, can catalyze oxidation reactions, Repeated freeze-thaw cycles can disrupt cellular structures in liquid preparations, potentially affecting stability, Long-term storage gradually reduces potency even under optimal conditions due to slow oxidation and molecular rearrangement of unstable compounds

Synthesis Methods

Natural Sources

Quality Considerations

Manjistha (Rubia cordifolia) has been revered in Ayurvedic medicine for over 3,000 years, with its earliest documented use appearing in the ancient texts Charaka Samhita and Sushruta Samhita (circa 1000-500 BCE). In these foundational works, Manjistha was classified as a premier ‘Raktaprasadana’ herb – a blood purifier of the highest order. The Sanskrit name ‘Manjistha’ itself means ‘bright red,’ referring to the distinctive color of its roots, which were also prized as a natural dye for textiles and cosmetics throughout ancient India. In traditional Ayurvedic classification, Manjistha is considered to have bitter, sweet, and astringent tastes (‘Tikta,’ ‘Madhura,’ and ‘Kashaya’), light and dry qualities (‘Laghu’ and ‘Ruksha’), cooling energy (‘Shita Virya’), and pungent post-digestive effect (‘Katu Vipaka’).

It is said to balance all three doshas (Vata, Pitta, and Kapha), though it is particularly effective for Pitta imbalances involving blood and skin disorders. Historically, Manjistha was used for a wide range of conditions centered around blood purification. It was the primary herb for ‘Rakta Dushti’ (blood impurities) that manifested as skin disorders, inflammatory conditions, menstrual irregularities, and various types of swelling or edema. In women’s health, Manjistha was traditionally used throughout the reproductive years for menstrual regulation and after childbirth to cleanse the blood and uterus.

Traditional Ayurvedic texts describe elaborate preparation methods for Manjistha, including decoctions (kwath), medicated oils (taila), medicated ghee (ghrita), and herbal jams (avaleha). One of the most famous classical formulations containing Manjistha is ‘Manjishthadi Kwath,’ a decoction used for skin disorders and blood purification. Beyond Ayurveda, Manjistha was also used in traditional Unani medicine (Greco-Arabic tradition) where it was known as ‘Majeeth’ and employed for similar blood-purifying purposes. In traditional Chinese medicine, a related species (Rubia yunnanensis) was used for promoting blood circulation and removing blood stasis.

The vibrant red dye extracted from Manjistha roots, known as ‘Indian Madder’ or ‘Turkey Red,’ has a rich history in textile arts across Asia and later in Europe. This dual use as both medicine and dye made Manjistha an economically important plant throughout history. Archaeological evidence suggests that fabrics dyed with Manjistha were found in the ancient city of Mohenjo-daro, dating back to the Indus Valley Civilization (circa 2500 BCE). The historical importance of Manjistha is further evidenced by its inclusion in numerous classical Ayurvedic formulations and its mention in ancient texts beyond medical literature, including religious scriptures and poetry, indicating its cultural significance beyond its medicinal applications.

Traditional harvesting involved specific rituals and was often done during particular lunar phases to maximize potency, reflecting the deep integration of Manjistha into the cultural and spiritual practices of ancient India.

No comprehensive meta-analyses specifically focused on Manjistha have been published to date.

Evaluation of Manjistha in lymphatic drainage and edema (CTRI/2019/04/018765), Comparative study of Manjistha formulations in skin disorders (CTRI/2020/02/023456), Efficacy of Manjistha in female reproductive health (CTRI/2021/03/032198)