Reliable
and relatively consistent scientific data showing a substantial health benefit. Contradictory, insufficient, or preliminary studies
suggesting a health benefit or minimal health benefit. 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 and Chinese 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.12 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.56789 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 (To view, roll mouse over the "References" heading; to hide, click on the heading)
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 Thai 1990;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 common colds.
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
paniculata extract 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 paniculata
extract 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
paniculata Herba 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.
Ramathibodi Med 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.
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 problem and before using any supplements or
before making any changes in prescribed medications. Information expires June 2009.
