Centella Asiatica (Gotu Kola) Uses, Benefits, Safety & Interactions

Centella asiatica, also commonly called gotu kola, is a creeping plant that is in the parsley family (Apiaceae).

For thousands of years in India, Indonesia, and China, gotu kola has been used in traditional medicine for a wide range of preventive and curative purposes.

It is an herbaceous evergreen plant that has a long history of use in Indian Ayurvedic medicine for wound healing and leprosy, as well as aiding meditation.

It has also been used in traditional medicines to promote longevity, increase energy, and enhance sexual function. It is purported to have adaptogenic effects, supporting homeostasis and stress-relief.

As a dietary supplement, it is sometimes used as a cognitive enhancer, circulatory aid, and skin rejuvenator. It is also taken to promote anxiety relief and heart health.

This article will review what is known about the history, uses, and possible benefits of gotu kola, as well as the safety, side effects, and interactions that are possible when using a Centella asiatica supplement.

Gotu Kola

Herbal Supplement

Longevity

Energy

Concentra- tion

How It Works:

• Used in India for longevity & vitality
• Supports energy levels & adrenal function
• Boosts concentration & circulation

Dosage:

Between 300 - 600 mg per day

Safety:

Rated Possibly Safe

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Centella asiatica Plant Description

Centella asiatica is a frost-sensitive perennial evergreen plant that can grow in semi-shaded or unshaded areas.

According to Plants for a Future, Centella asiatica is able to grow in high pH (alkaline), low pH (acidic), and neutral pH soil. [4]

It grows best in moist or wet soil and is suitable for sandy (light), loamy (medium) and clay (heavy) soils.

Gotu kola plants typically grow to about 8 inches in height, and about 40 inches in width. The plants flower in July and August, and the seeds ripen in August and September.

The plant contains both male and female organs and is able to self-pollinate. Pollination also occurs by insects.

The University of Maryland Medical Center (UMM) states that Centella asiatica has no discernible taste or smell. It grows in and around locations with plenty of water, and develops white/pink/light purple flowers and small, ovular fruits. [1]

According to Gaia Herbs, gotu kola develops small fan-shaped green leaves that resemble the left and right hemispheres of the brain. Yogis have used this herb for thousands of years because they believe it develops the crown chakra and supports deep meditation practices. [2]

The above-ground parts of Centella including the leaves and flowers are used to make herbal supplements and extracts.

Plants for a Future states that gotu kola can be harvested all year long in some locations. Some reports state that the dried plant loses much of its medicinal properties when exposed to air. Freshly harvested leaves and stems may offer more potency. [4]

Do not confuse gotu kola with kola nut. The kola nut is the fruit of the kola tree and contains caffeine. Gotu kola is not a stimulant and has no caffeine. [1]

Traditional Uses of Gotu Kola

According to Examine.com, Centella asiatica is mainly used as a nootropic to enhance cognitive function.

It is also used traditionally for skin health, wound healing, and cardiovascular health. It has also been used for rheumatism and anxiety. [3]

Like horse chestnut (Aesculus hippocastanum) and Bacopa monnieri, some clinical trials have shown that gotu kola may benefit chronic venous insufficiency (CVI). [1, 2, 3]

The University of Maryland Medical Center states that gotu kola has been used traditionally to improve wound healing and enhance mental clarity, as well as for various skin conditions including leprosy, psoriasis, eczema, and acne. [1]

Some people refer to Centella asiatica as “The Fountain of Life.” According to one Chinese legend, an ancient herbalist lived more than 200 years because of routine use of this natural plant medicine. [1]

According to the UMM, it has also been used in the past for syphilis, epilepsy, stomach ulcers, fever, hepatitis, fatigue, diarrhea, and asthma. [1]

Gaia states that herbalists will recommend this herb for “balancing activities in the nervous system.” It is purported to maintain normal function of neurotransmitters.

It is also purported to improve memory, alertness, and to help the body and brain adapto to stress. [4]

Centella leaf and root have been used for many centuries to promote hair, skin, and nail health.

According to the UMM, “Numerous clinical trials have shown that Gotu Kola indeed has beneficial dermatologic effects by helping to support the connective tissue that line many of the external surfaces of the body including the scalp and skin.” [1]

According to Gaia, the herb supports the structural integrity of skin and connective tissues. It is also purported to maintain normal skin keratinization, which is important for formation of nail and hair tissue. [1]

Common Centella Asiatica Uses

The Natural Medicines Comprehensive Database (NMCD) states that Centella Asiatica is used orally for various purposes including: [5]

• Atherosclerosis (“hardening” of the arteries)
• Chronic venous insufficiency (CVI)
• Cognitive function
• Deep vein thrombosis
• Diabetic microangiopathy
• Improving memory and cognitive performance
• Systemic lupus erythematosus (SLE)
• Urinary tract infection (UTI)
• Varicose veins
• Wound healing

According to the NMCD oral Centella supplements are also used for anxiety, depression, fatigue, common cold, influenza, sunstroke, elephantiasis, tuberculosis, shingles, asthma, and anemia. [5]

This herbal extract is also sometimes used orally for gastrointestinal complaints like diarrhea, dysentery (bloody diarrhea), indigestion, gastritis, peptic ulcer disease, and abdominal pain. [5]

Some additional oral uses include tonsillitis, pleurisy, hepatitis, jaundice, amenorrhea (absence of menstruation), contraception, to increase longevity, and as an aphrodisiac. [5]

Centella asiatica is used topically for scars, striae gravidarum (stretch marks), keloids (a type of raised scar), hemorrhoids, and wound healing. [5]

According to Plants for a Future, it is an adaptogen in eastern medicine. It is thought to help the body adapt to stress and normalize systemic functioning and bodily processes on various levels at the same time. [4]

In in vitro (cultured cell) and animal research, this herb demonstrates a number of effects including analgesic, anticonvulsant, antimicrobial, anti-inflammatory, anticancer, cardioprotective, gastrointestinal, nervine (balances nerves), sedative effects, and wound healing effects. [4]

The information on uses and benefits of Centella asiatica are primarily from traditional medicine and anecdotal reports. There is limited human research available to evaluate claims that it acts as an adaptogen or promotes homeostasis.

The Natural Medicines Comprehensive Database rates this herb as Possibly Effective for chronic venous insufficiency. Multiple clinical trials show benefits for this condition.

Preliminary studies have been conducted for other purported uses, but more clinical trials are needed to determine therapeutic efficacy.

At this time, Centella Asiatica extract is not approved by the FDA as a drug to prevent or treat any medical conditions.

Centella Asiatica Health Benefits

The NMCD states that the aboveground parts of this plant are used in dietary supplement. Gotu kola leaf and stem contain various bioactive compounds including: [5]

• Asiatic acid, madecassic acid, asiaticoside A (madecassoside), and asiaticoside B
• Essential oils
• Flavone derivatives like quercetin and kaempferol
• Flavonoids
• Saponin-containing triterpene acids
• Sesquiterpenes, stigmasterol, sitosterol, and isothankuniside

According to a pharmacological review from the Indian Journal of Pharmaceutical Sciences, “Triterpenoid saponins, the primary constituents of Centella asiatica are manly believed to be responsible for its wide therapeutic actions.” [6]

The NMCD rates gotu kola as Possibly Effective for venous insufficiency. Using a specific oral product, Centellase, daily for between 4-8 weeks improved circulation and reduce edema in people with CVI. [5]

This herb has also been studied for insomnia, scleroderma, anxiety, atherosclerosis, deep vein thrombosis, varicose veins, diabetic microangiopathy, and enhancing cognitive function. [5]

Additional clinical trials are needed to determine therapeutic efficacy for these uses. The FDA has not approved Centella asiatica as a drug to prevent or treat any conditions.

Centella Asiatica for Brain Function

Preliminary clinical evidence suggests that asiaticoside derivatives from this plant may support brain function. Extracts from this plant have been found to exhibit neuroprotective properties.

Asiatic acid, asiaticoside 6, and SM2 may help to protect nerves inside the brain from beta-amyloid toxicity, which is a common marker in Alzheimer’s disease. [5]

However, it is too early to determine whether this supplement can influence the risk of developing Alzheimer’s disease in humans.

It is hypothesized that Centella asiatica may work by increasing how far neuronal dendrites reach in the brain. It does not seem to have any effect on the number of neurons present. [3]

Researchers think that administration of this herb extends dendrite reach by activating MAPKs (mitogen-activated protein kinases). MAPK activation increases release of BDNF (brain-derived neurotrophic factor), a growth factor that increases nerve cell growth. [3]

Several studies have attempted to examine the effects of this plant for cognitive function without producing definitive results.

It is sometimes used in combination with other Ayurvedic herbs, such as in CognoBlend® which also contains Bacopa monneria, Gingko biloba, cat’s claw, and rosemary extract.

Another combination supplement contains 160mg Ginkgo biloba, 68mg gotu kola, and 180mg decosahexaenoic acid (DHA). This supplement was taken for four months without producing a significant benefit for cognitive function.

Some users report that Centella asiatica has a time delay before its cognitive-enhancing effects may be noticed. According to anecdotal user reviews, the effects begin to be noticeable after about 2 weeks of usage.

Anxiolytic Effects

This herb has been studied for anxiety and appears to exhibit some anxiolytic effects. This means that it reduces experiences of anxiousness.

In vitro studies have shown that Centella asiatica may bind to both GABA (gamma aminobutyric acid) and CCK (cholecystokinin) receptors. Stimulating GABA receptors may be responsible for the anti-anxiety effect.

It has been hypothesized that activation of GABA receptors may also promote analgesic (pain-relieving), anticonvulsant, and sedative effects, however this hypothesis has not been tested in any research trials yet. [5]

Some evidence suggests that use of oral gotu kola supplements may decrease the acoustic startle response (ASR), in healthy people. This startle response has been validated as a test of anxiety levels.

Centella is said to induce calming, relaxing, slightly-sedative effects. [5] More research is needed to determine whether this supplement is effective for alleviating anxiety in clinical settings.

Venous Insufficiency and Wound Healing

Asiaticoside and madecassoside are two triterpenoid saponin compounds found in Centella asiatica.

It is thought that these constituents may be responsible for the benefits to wound healing and venous insufficiency as they have been seen to have anti-inflammatory effects. [5]

Gotu kola also seems to increase release of an inflammation mediator called IL-6 (interleukin-6). Researchers think this might be responsible for the positive effects on venous insufficiency.

buUpregulated IL-6 release may also cause the antirheumatic effects proposed for this supplement. [3]

This herb may slow down activities of a group of enzymes that break down collagen, the primary structural protein found in skin and connective tissues. It also seems to simultaneously increase the rate that collagen is synthesized. [3]

A terpenoid extract from this plant improved remodeling in connective tissue in animal models. This is linked to increase activity of fibroblasts, increased epithelial turnover, decreased capillary permeability, and greater collagen synthesis. [5]

In in vitro and animal research, Centella asiatica has been shown to increase type 1 collagen synthesis, relative to type 2 collagen synthesis.

Type 2 collagen is linked to hypertrophic scarring; meaning excessive scar tissue growth. By increasing type 1 collagen, scarring may be reduced. [5]

Both animal and preliminary human research has shown gotu kola to speed up wound healing. These effects are attributed to collagen preserving/increasing effects. Centella also seems to tighten the skin, helping to smooth out wrinkles and increase firmness. [3]

Asiaticoside constituents in Centella might decrease wound healing times by upregulating the production of collagen and of long, unbranched polysaccharides called glycosaminoglycans. [5]

This increased production of collagen is thought to have beneficial effects elsewhere in the body as well.

Arterial plaques are associated with atherosclerosis, coronary artery disease (CAD), and heart disease in general. When arterial plaques are structurally weak, they are more likely to rupture and cause embolism (artery obstruction/clotting). [5]

It has been proposed that a terpenoid extract in this plant may help to stabilize arterial plaque structure by increasing collagen composition. This might decrease the risk for plaque rupturing and subsequent embolisms. [5]

Additional Health Benefits

Preliminary clinical evidence suggests that asiaticosides in this herb might also have both preventive and curative effects on gastrointestinal ulcers.

It is thought that the antiulcer effects may be due to strengthening mucosal linings, increasing mucin (a component of mucous) production, and inhibiting damage from free radicals like superoxide. [5]

Centella asiatica has been used in traditional as a contraceptive. While there is no evidence that supplementing can decrease fertility, preliminary evidence shows that an isolated extract of purified isothankuniside might. [5] More research is needed to determine efficacy.

In in vitro studies Gotu kola extracts have demonstrated antibacterial activities against Pseudomonas pyocyaneus, Trichoderma mentagrophytes, and Entamoeba histolytica.

Antiviral activity against HSVII (herpes simplex virus II) has also been observed. [5]

There is interest in using Centella asiatica for cancer. In preliminary in vitro studies, dried powder extracts have induced antitumor and cytotoxic effects.

This compound seems to selectively target cancerous cells, while leaving healthy cells unaffected. [5] These effects will need to be studied further in animal and clinical human trials.

While this plant has a wide range of uses in herbal medicine practices, many of these uses have not been validated by research studies. More research is needed to establish therapeutic efficacy.

Dosage Guidelines

UMM reports that Centella Asiatica supplements are available in tablet, capsule, powder, liquid extract, tincture, and ointment forms. [1]

The recommended dosage will vary based on the purpose of use, the format of the supplement, and individual differences between users.

NMCD reports the following oral dosages that have been used in some clinical studies involving adults: [5]

• 120 mg, three times daily before and after flying to prevent deep vein thrombosis
• 60 mg extract, three times daily for atherosclerosis
• 60 mg, twice daily for diabetic microangiopathy
• 60-180 mg, once daily for venous insufficiency

NMCD states that a 1% gotu kola cream has been administered topically for wound healing.

Dosages will vary depending on the concentration of the extract used. Before taking this supplement to address a specific health goal, consult with a doctor to determine the recommended dosage and appropriate use for your needs.

Centella Asiatica Side Effects

The Natural Medicines Comprehensive Database has rated Centella Asiatica as Possibly Safe when used orally or topically and appropriately.

Topical use during pregnancy or while breastfeeding is also rated Possibly Safe.

However, there is insufficient information to determine whether it is safe for pregnant or nursing women in the form of a dietary supplement. Out of an abundance of cation, it is recommended to avoid use.

Gotu kola supplements are generally well-tolerated in healthy adults. In some people, this supplement might cause gastrointestinal problems, like nausea and stomach upset. It may also cause sleepiness. [5]

Using this herb topically can cause allergic reactions like contact dermatitis and eczema in some people. This can manifest as itching, burning, redness, and/or development of papules (small raised bumps). [5]

There is some concern for toxicity associated with excessive consumption of gotu kola extract. There are a few cases of liver poisoning (hepatotoxicity) associated with oral administration of this herb.

It is unknown if the herb itself caused the liver toxicity/failure or if there were possible toxic contaminants in the supplements taken.

Additionally, the dosages used in these cases are unknown. It is not known if a higher dosage is more likely to cause harmful liver effects than a lower dosage.

In a trial that monitored liver function, 120 mg/day for 6 months showed no changes in hepatic function.

It is recommended that people with existing liver disease or dysfunction avoid taking Centella supplements because of potential hepatotoxicity concerns. Do not combine this supplement with alcohol or other substances that can damage the liver.

If you are interested in using a this supplement, it is recommended that you discuss it with your primary healthcare provider. Your doctor will be able to recommend a dosage for your needs to help minimize side effects and prevent potential interactions.

Drug Interactions & Contraindications

According to WebMD and the NMCD, Centella asiatica might interact with the following CNS depressant medications:

• clonazepam (Klonopin)
• lorazepam (Ativan)
• phenobarbital (Donnatal)
• zolpidem (Ambien) [7]

Because of possible CNS depressant effects, it is recommended to discontinue using this supplement at least 2 weeks prior to any scheduled surgery.

It may also interact with hepatotoxic drugs that can damage the liver including the following:

• acetaminophen (Tylenol)
• amiodarone (Cordarone)
• carbamazepine (Tegretol)
• isoniazid (INH)
• methotrexate (Rheumatrex)
• methyldopa (Aldomet)
• fluconazole (Diflucan)
• itraconazole (Sporanox)
• erythromycin (Erythrocin, Ilosone)
• phenytoin (Dilantin)
• lovastatin (Mevacor)
• pravastatin (Pravachol)
• simvastatin (Zocor)
• Many others [7]

Use of this supplement should be avoided in combination with other herbs or supplements that can damage the liver or cause changes in liver metabolism. Some examples of herbs that have been found to increase liver enzyme levels include:

Herbs and supplements that can damage the liver including:

• androstenedione
• chaparral
• comfrey
• DHEA
• germander
• niacin
• pennyroyal oil
• red yeast [5]

Centella Asiatica should also be avoided in combination with herbs and supplements that can cause sedation, unless taken under the consultation of a qualified healthcare professional. Some herbs with sedative effects include:

• 5-HTP
• calamus
• California poppy
• catnip
• hops
• Jamaican dogwood
• kava
• St. John’s wort
• skullcap
• valerian
• yerba mansa [5]

To reduce the risk of adverse reactions, consult with a doctor to determine whether this supplement is appropriate for you. This is especially important if you are currently taking prescription medications or are being treated for an existing medical condition.

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