Andrographis Paniculata Supplement Benefits, Uses & Side Effects

The andrographis paniculata plant is also known as the “King of Bitters”. It has been used for a long time in Indian Ayurvedic medicine, traditional Chinese medicine and other natural medicine systems.

Andrographis is probably best known for its purported use as a natural treatment for the common cold. It is also purported to support immune system function, reduce inflammation, provide antioxidant protection, ease gastrointestinal complaints, dispel toxins and more.

Clinical research on andrographis has been limited in the past. Most studies have used formulations of andrographis mixed with Siberian ginseng (Eleutherococcus senticosus). [1][2]

This article reviews what is currently understood about andrographis. Its traditional and current uses, mechanisms of action, possible health benefits and safety will be explored. Supplement forms, dosages, side effects and interactions will also be reviewed.

Andrographis

Herbal Extract

Immune Function

Digestion

Colds & Coughs

How It Works:

• Improves symptoms of the common cold
• Bitter tonic to support digestion
• Immune boosting & anti-inflammatory effects

Dosage:

Between 500 - 3,000mg per dosage

Safety:

Rated Likely Safe

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Andrographis Plant Description

Purdue University reports the following about andrographis : [3]

• Erect branched annual that grows almost 1-meter tall;
• Flowers in India between November and December;
• Yellow/brown, rugose (wrinkled), pitted seeds;
• Scientific name is Andrographis paniculata;
• Member of the Acanthaceae plant family;
• Small, solitary, linear, oblong flowers;
• Acute, undulate, lanceolate leaves;
• Cultivated in many states in India;

Andrographis is known by various other names around the world. Some of these include Andrographolide, Bhunimba, Carmantina, Chiretta, Chirette Verte, Chuan Xin Lian, Échinacée d’Inde, Fa-Tha-Lai-Jone, Gubak, Indian Echinacea, Justicie, Kalmegh, Kirta, Mahalita, Nabin Chanvandi, Poogiphalam, Roi des Amers, Sambilata, Shivaphala, Supari, Takila, Vizra Ufar, and Yavatikta. [4]

Uses for Andrographis Paniculata

Gaia Herbs states, “In Ayurvedic tradition, Andrographis, commonly known as Kalmegh or “King of Bitters” has long been used as a bitter tonic, to promote digestion and appetite and to promote regularity. In traditional Chinese medicine Andrographis is considered bitter and cold and is used to clear heat.” [5]

According to a 2014 review, the entire andrographis plant, including the roots, have been used for centuries in Asia to treat various ailments.

Some of these ailments include stomach ache, pyrexia (fever), inflammation, respiratory infections, malaria and dysentery. [2]

Andrographis plant parts have also been used to treat insect stings, colic, poor appetite, fever-causing disease, and infectious disease. [2]

Malaysian researchers stated, “In Malaysia, a decoction of the aerial parts is used to treat common cold, hypertension, diabetes, cancer, malaria and snakebite.” [2]

Andrographis is included in 26 Ayurvedic formulas used to treat, “dysmenorrhoea, leucorrhoea, prenatal and postnatal care, complicated diseases such malaria, jaundice, gonorrhea and general ailments like wounds, cuts, boils and skin diseases.” [2]

In addition to the uses above, Natural Medicines Comprehensive Database (NMCD) states that andrographis is used orally today for: [4]

• Pharyngotonsillitis (pharynx and tonsil inflammation);
• Atherosclerosis (arterial plaque formation);
• Liver toxicity induced by drugs;
• Diarrhea, flatulence, gastritis;
• Treating HIV/AIDS;
• Anorexia nervosa;
• Bronchitis;

NMCD states that andrographis is also used orally for treating cachexia (muscle wasting), cholera (acute, deadly diarrheal disease), diabetes, gonorrhea, hemorrhoids, and hepatomegaly (enlarged liver). [4]

According to the website Love Whole Foods, clinical evidence suggests that Andrographis paniculata can reduce the severity and duration of upper lung infections.

This website also cites other potential therapeutic uses including anti-inflammatory benefits, protection against chemically-induced liver damage and research into its effects on influenza and familial Mediterranean fever. [5]

According to NMCD, “Other uses include myocardial ischemia, jaundice, leprosy, leptospirosis, malaria, familial Mediterranean fever, pharyngitis, pneumonia, pruritus, pyelonephritis, rabies, skin wounds, skin diseases, syphilis, tuberculosis, tonsillitis, and ulcers.” [4]

Andrographis has also been studied for its effects on preventing cardiovascular disease. [4]

Despite the many traditional uses of this herbal extract, this supplement has not been approved by the FDA as a drug for the treatment of any medical condition. More research is needed to validate many of the traditional claims made about this supplement.

How does Andrographis Work Inside the Body?

According to Gaia Herbs, most research on andrographis has studied its effects on immune system function. It helps to support healthy levels of immune cells in the blood. [6]

According to Examine, andrographis is being studied for possible anticancer effects. In-vitro cell studies, and animal studies suggest that andrographis has an antiproliferative effect on cancer cells; meaning it is able to slow down how fast they replicate and spread. [1]

However, andrographis does not seem to induce cell death (apoptosis) on cancer cells. Researchers continue to explore andrographis anticancer effects. [1]

According to Examine, “The bioactive ingredients of Andrographis paniculata can be traced back to a single diterpene molecule called andrographolide.” [1]

Andrographis paniculata also contains other bioactive compounds, including: [2]

• Terpenoids (entalabdane diterpene lactones);
• Trace and macro elements;
• Flavonoids (flavones);
• Polyphenols;
• Noriridoides;
• Xanthones;

Researchers from one review stated, “Of the diterpenoids that have been identified and isolated from A. paniculata, andrographolide is the most prominent in occurrence and quantity. Andrographolide has a very bitter taste, and it is colourless and crystalline in appearance.” [2]

According to a 2014 review, “Several studies showed that this plant exhibited various biological activities such as antimicrobial, cytotoxicity, antiprotozoal, anti-inflammatory, anti-oxidant, immunostimulant, anti-diabetic, anti-infective, anti-angiogenic, hepato-renal protective, sex hormone modulatory, liver enzymes modulatory and insecticidal and toxicity activities.” [2]

Andrographis Health Benefits

NMCD rates natural medicines on their efficacies in specific health conditions, based unbiasedly on evidence from research. Natural medicines can be rated as effective, likely effective, possibly effective, possibly ineffective, likely ineffective, ineffective or insufficient reliable evidence to rate.

Andrographis paniculata is rated possibly effective for common cold, pharyngotonsillitis, and ulcerative colitis. [4]

Common cold:

Some human research shows that oral use of a specific andrographis product, called Kan Jang, improves common cold symptoms, especially when treatment is begun within 72 hours of symptom onset.

This product also contains Siberian ginseng (Eleutherococcus senticosus). It is unclear whether the effects are attributed to this ingredient or to the presence of Andrographis in the formulation. [4]

NMCD states, “Some symptoms can improve after 2 days of treatment. It typically takes 4-5 days of treatment before there is maximal symptom relief. Some research suggests that this combination of andrographis and Siberian ginseng relieves cold symptoms better than Echinacea or placebo in children.” [4]

KalmCold is another andrographis formulation that has shown benefits to common cold symptoms in placebo-controlled human studies. [4]

NMCD reports, “Preliminary clinical research suggests that taking andrographis (Kan Jang, Swedish Herbal Institute) prophylactically might decrease the risk of developing a cold by about 50% after 2 months of continuous treatment; however, more evidence is needed.” [4]

Research continues to explore the effects of andrographis on common cold symptoms.

Pharyngotonsillitis:

Some human research shows that high doses of andrographis (6 grams daily) eases sore throat, and reduces fever associated with pharyngotonsillitis. This dosage caused effects similar to acetaminophen (Tylenol) after 3-7 days of treatment. [4]

Research continues in this area. Larger, randomized, blinded, controlled studies are warranted.

Ulcerative colitis

Preliminary human research suggests that andrographis paniculata extract can reduce mild-to-moderate ulcerative colitis symptoms. Doses between 1200-1800 mg/day for 8 weeks improved symptoms better than a placebo. [4]

According to NMCD, there is preliminary clinical evidence demonstrating that andrographis may be as effective as the drug mesalamine for reducing symptoms in patients with UC (Ulcerative Colities). In one research study, 1200mg daily of this extract was administered for 8 weeks and resulted in a decrease in symptoms reported. [4]

More research is needed to determine the full scope of andrographis’s effects on ulcerative colitis, or similar conditions.

NMCD states there is insufficient reliable evidence to rate andrographis in any other health condition. Some preliminary research suggests that it is able to improve symptoms associated with familial Mediterranean fever, influenza and RA (rheumatoid arthritis). [4]

Immune System Function:

Andrographis can help support immune system function and the ability to fight off symptoms of the common cold.

According to a review posted by the University of Michigan Medical Center, “48-60 mg andrographolides in two to three divided doses daily … has been shown to reduce the severity of the common cold and may prevent the onset of a cold in healthy people. [7]

This same dose of andrographis may also help the body to resist infection from pathogenic microbes. Research from Russia suggests that andrographis can treat influenza symptoms. [7]

Some other herbs that seem to enhance immunity and fight microbes include American ginseng, andrographis, Asian ginseng, astragalus, coriolus, eleuthero, ligustrum, maitake, picrorhiza, reishi, schisandra, and shiitake mushroom. [7]

Chronic Viral Hepatitis:

Andrographis has been shown to improve symptoms in patients with hepatitis (a n inflammatory condition affecting the liver).

Michigan Medical states, “A series of cases of acute viral hepatitis were reported by one group in India, showing picrorhiza, combined with a variety of minerals, to be helpful in hastening recovery.” [7]

HIV/AIDS:

There have been limited studies examining the effects of this plant extract on patients diagnosed with HIV/AIDS.

Michigan Medical states that isolated andrographolides from andrographis increased CD4 lymphocyte levels, and decreased viral load in patients with HIV. [7]

However, it is not clear whether andrographis acted to directly kill HIV, or caused the effects by strengthening immune system activity. Further, many participants in this study experienced changes in taste perception, and potentially-serious liver problems. (more below) [7]

Indigestion and Heartburn:

Andrographis is commonly called “King of Bitters”. Bitter herbs are considered generally beneficial for stimulating digestive function, and helping to ameliorate symptoms of gastrointestinal complaints like indigestion, heartburn, and/or low stomach acidity. [7]

Michigan Medical says that bitter herbs are believed to promote the production of stomach acid and digestive enzymes, as well as saliva production. This may stimulate digestive function and have benefits in cases where there is insufficient stomach acid present to properly break down food.

However, Michigan Medical warns that this supplement may have negative effects in cases of heartburn where an increase in stomach acid volume could exacerbate the symptoms. [7]

Some other bitter herbs used for improving digestion include dandelion, blessed thistle, bitter melon, bitter orange, juniper, yarrow, wormwood, prickly ash, devil’s claw and greater celandine (Chelidonium majus). [7]

Note again that none of the traditional uses for andrographis have been substantiated in human trials. More research is needed to determine any reliable health benefits associated with andrographis supplementation.

It is best to discuss any intended use for andrographis with your doctor before beginning to use a supplement derived from it.

Andrographis Dosage

NMCD states, “Although not well substantiated in clinical trials, typical amounts of leaf preparation are 500-3,000mg taken three times daily.” [4]

An andrographis extract containing 30mg of andrographolides has been given three times daily for 14 weeks for treating rheumatoid arthritis. In this study, there was no benefit observed compared to the control group given an inert placebo. [4]

For ulcerative colitis, a standardized extract, called HMPL-004, has been used. This extract contains 8-10% andrographis paniculata by weight, and has been administered three times daily for 8 weeks to treat symptoms. [4]

Also for treating ulcerative colitis, NMCD reports that 1,200mg – 1,800mg of Andrographis paniculata ethanol extract has been used in three divided dosages per day for up to eight weeks. [4]

For URI (upper respiratory infection), 3-6 grams andrographis, containing 48-500 mg andrographolide, has been administered orally. This dose was divided into 3-4 sub-doses daily, for 4-10 days as needed. [4]

Also for URI, 100mg of a proprietary extract sold under the brand name KalmCold has been used twice a day for five days, taken after breakfast and dinner. Another formulation sold under the name Kan Jang has been taken daily at a dosage of 1,200 mg per day. [4]

200 mg/day oral doses of andrographis have been used to prevent URI. 2 standardized 100 mg Kan Jang tablets were used daily for 90 days. [4]

Andrographis Foods

Andrographis plant parts are not commonly used in foods or beverages. This herb is almost exclusively used in natural medicinal remedies.

In some cases, this herb may be prepared into a liquid or into a tea. Michigan Medical states, “Bitters are generally taken either by mixing 1–3 ml tincture into water and sipping slowly 10–30 minutes before eating, or by making tea, which is also sipped slowly before eating.” [7]

Andrographis Supplements

Various factors – including geographic location, harvesting time, processing and handling techniques, and storage and shipping protocols – can cause significant variability in the nutritional content of andrographis plants. [2]

Examine states, “Andrographis paniculata root extract tends to have 1-2% andrographolide content, by weight, though up to 4% has been reported. Concentrated root extracts can have an andrographolide content of up to 30%. The standard dose for a concentrated extract is 200 mg.” [1]

Most clinical studies have used andrographis formulations that have been standardized to the andrographolide fraction. Some commercial products contain 4% andrographolides. [4]

According to NMCD, “The most widely tested products are the two Kan Jang preparations produced by Swedish Herbal Institute, one of which is a single herb preparation containing the extract SHA-10 standardized to contain 5.25mg andrographolide and deoxyandrographolide per tablet, and the other which is a combination product containing SHA-10 in combination with the Eleutherococcus senticosus extract SHE-3.” [4]

A standardized andrographis extract called HMPL-004 (Hutchison Medipharma, Ltd) contains 8-10% andrographis by weight. [4]

In all, there are currently 165 different dietary supplement products that contain andrographis as a sole or combinatory ingredient. Tinctures, extracts, powders, capsules, tablets and whole herbs are available. Compare labels closely to understand which parts are used, and in what amounts. [4]

Pay attention to expiration dates when provided, and store your andrographis supplements out of direct exposure to heat, air and light.

Andrographis Safety and Side Effects

According to Examine, taking high dosages of this plant for prolonged durations of time can result in toxicity to the testicles and liver. This was reported in one study, but follow-up studies were not able to replicate the results when using the same administration guidelines. [1]

Andrographis has demonstrated immune system-stimulating effects in multiple studies. People with autoimmune diseases – like MS (multiple sclerosis), RA (rheumatoid arthritis) and SLE (systemic lupus erythematosus) – should not use this herbal supplement long term. [3]

Michigan Medical states that although rare, side effects of andrographis may include: [7]

• Elevated liver enzymes;
• Bitter/metallic taste;
• Intestinal upset;
• Headache;
• Fatigue;

Andrographis supplements might worsen symptoms of heartburn, or may aggravate peptic ulcers. [7]

Andrographis safety has not been studied during pregnancy or lactation. Usage is avoided during those times until more is understood. [7]

NMCD states that adverse effects are generally mild and do not occur frequently in the research trials conducted so far. However, most of the currently available research studies have examined the effects of this supplement for short-term use (two weeks or less). There is insufficient evidence available to rate the safety of this supplement for long-term use. [4]

Andrographis Interactions

Andrographis may increase the effects and/or side effects of:

• Anticoagulant/antiplatelet drugs;
• Immunosuppressant drugs;
• Antihypertensive drugs;

Be careful using andrographis with other herbs that can increase the risks of bleeding or bruising. Some of these include angelica, clove, danshen, garlic, ginger, ginkgo, Panax ginseng, horse chestnut, red clover and turmeric.

Be careful using andrographis with other herbs and supplements that can lower blood pressure – like casein peptides, cat’s claw, coenzyme Q-10, fish oil, L-arginine, lycium, stinging nettle and theanine.

Andrographis is not reported to interact with laboratory tests, or foods. However, it may exacerbate symptoms of autoimmune diseases like MS, RA and SLE.

Do not use andrographis supplements for at least 2 weeks prior to a scheduled surgery.

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