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Andrographis is a shrub found throughout India and other Asian countries that is sometimes called "Indian echinacea." It has been used historically in epidemics, including the Indian flu epidemic in 1919, during which andrographis was credited with stopping the spread of the disease.1
-------------------------------------------------------------------------------- What Is Andrographis Used for Today? Over the last decade, andrographis has become popular in Scandinavia as a treatment for colds. It is beginning to become available in the United States as well. Reasonably good evidence tells us that it can reduce the severity of cold symptoms. It may also help prevent colds. Although we don't know how andrographis might work for colds, some evidence suggests that it might stimulate immunity.2 Interestingly, the ingredient of andrographis used for standardization purposes, andrographolide, does not appear to affect the immune system as much as the whole plant extract. Preliminary studies in animals also suggest that andrographis may offer benefits for preventing heart disease.3,4,5 In addition, highly preliminary studies suggest that andrographis may help protect the liver from toxic injury, perhaps more successfully than the more famous liver-protective herb milk thistle.6,7,8 It also appears to stimulate gallbladder contraction.9 Andrographis does not appear to have any antibacterial effects.10 -------------------------------------------------------------------------------- What Is the Scientific Evidence for Andrographis? Reducing Cold Symptoms Three double-blind placebo-controlled studies enrolling a total of about 250 participants have found that andrographis significantly reduces the duration and severity of cold symptoms.11,12,13 For example, a 4-day double-blind placebo-controlled trial of 158 adults with colds found that treatment with andrographis significantly reduced cold symptoms.14 Participants were given either placebo or 1,200 mg daily of an andrographis extract standardized to contain 5% andrographolide. The results showed that by day 2 of treatment, and even more by day 4, individuals who were given the actual treatment experienced significant improvements in symptoms as compared to participants in the placebo group. The greatest response was seen in earache, sleeplessness, nasal drainage, and sore throat, but other cold symptoms improved as well. Similar benefits were seen in two double-blind placebo-controlled studies of an herbal combination treatment containing both andrographis and Eleutherococcus, enrolling a total of over 200 individuals.15 Another double-blind study, which involved 152 adults, compared the effectiveness of andrographis (in doses of 3 g per day or 6 g per day, for 7 days) to acetaminophen for the treatment of sore throat and fever.16 The higher dose of andrographis (6 g) decreased symptoms of fever and throat pain, as did acetaminophen, while the lower dose of andrographis (3 g) did not. There were no significant side effects in either group. Preventing Colds According to one double-blind placebo-controlled study, andrographis may increase resistance to colds.17 A total of 107 students, all 18 years old, participated in this 3-month-long trial that used a dried extract of andrographis. Fifty-four of the participants took two 100-mg tablets standardized to 5.6% andrographolide daily—considerably less than the 1,200 to 6,000 mg per day that has been used in studies on treatment of colds. The other 53 students were given placebo tablets with a coating identical to the treatment. Then, once a week throughout the study, a clinician evaluated all the participants for cold symptoms. By the end of the trial, only 16 people in the group using andrographis had experienced colds, compared to 33 of the placebo-group participants. This difference was statistically significant, indicating that andrographis reduces the risk of catching a cold by a factor of two as compared to placebo. -------------------------------------------------------------------------------- Dosage A typical dosage of andrographis is 400 mg 3 times a day. Doses as high as 1,000 to 2,000 mg 3 times daily have been used in some studies. Andrographis is usually standardized to its content of andrographolide, typically 4 to 6%. -------------------------------------------------------------------------------- Safety Issues Andrographis has not been associated with any side effects in human studies. In one study, participants were monitored for changes in liver function, blood counts, kidney function, and other laboratory measures of toxicity.18 No problems were found. However, some animal studies have raised concerns that andrographis may impair fertility. One study found that male rats became infertile when fed 20 mg of andrographis powder daily.19 In this case, the rats stopped producing sperm and showed physical changes in some of the testicular cells involved in sperm production. Researchers also detected evidence of degeneration of other anatomical structures in the testicles. However, another study showed no evidence of testicular toxicity in male rats that were given up to 1 g per kilogram body weight daily for 60 days, so this issue remains unclear.20 One group of female mice also did not fare well on high dosages of andrographis.21 When fed 2 g per kilogram body weight daily for 6 weeks (thousands of times higher than the usual human dose), all female mice failed to get pregnant when mated with males of proven fertility. Meanwhile, of the control females, 95.2% got pregnant when mated with a similar group of male mice. While andrographis is probably not a useful form of birth control, these results are worrisome and suggest the need for more research. Safety in young children, pregnant or nursing women, or those with severe liver or kidney disease has not been established. Also, because andrographis may stimulate gallbladder contraction, it should not be used by individuals with gallbladder disease except under physician supervision. References 1. Hancke J, Burgos R, Caceres D, et al. A double-blind study with a new monodrug Kan Jang: decrease of symptoms and improvement in the recovery from common colds. Phytother Res. 1995;9:559–562. 2. Puri A, Saxena R, Saxena RP, et al. Immunostimulant agents from Andrographis paniculata. J Nat Prod. 1993;56:995–999. 3. Zhao HY, Fang WY. Antithrombotic effects of Andrographis paniculata nees in preventing myocardial infarction. Chin Med J (Engl). 1991,104:770–775. 4. Zhang CY, Tan BK. Mechanisms of cardiovascular activity of Andrographis paniculata in the anaesthetized rat. J Ethnopharmacol. 1997;56:97–101. 5. Wang DW, Zhao HY. Prevention of atherosclerotic arterial stenosis and restenosis after angioplasty with Andrographis paniculata nees and fish oil. Chin Med J (Engl). 1994;107:464–470. 6. Visen PKS, Shukla B, Patnaik GK, et al. Andrographolide protects rat hepatocytes against paracetamol-induced damage. J Ethnopharmacol. 1993;40:131–136. 7. Kapil A, Koul IB, Banerjee SK, et al. Antihepatotoxic effects of major diterpenoid constituents of Andrographis paniculata.Biochem Pharmacol. 1993;46:182–185. 8. Handa SS, Sharma A. Hepatoprotective activity of andrographolide from Andrographis paniculata against carbontetrachloride. Indian J Med Res. 1990;92:276–283. 9. Shukla B, Visen PKS, Patnaik GK, et al. Choleretic effect of andrographolide in rats and guinea pigs. Planta Med. 1992;58:146–149. 10. 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. 11. Caceres 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;6:217–223. 12. Melchior J, Palm S, Wikman G. Controlled clinical study of standardized Andrographis paniculata extract in common cold—a pilot trial. Phytomedicine. 1996/1997;34:315–318. 13. Hancke J, Burgos R, Caceres D, et al. A double-blind study with a new monodrug Kan Jang: decrease of symptoms and improvement in the recovery from common colds. Phytother Res. 1995;9:559–562. 14. Caceres 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;6:217–223. 15. Melchior J, Spasov AA, Ostrovskij OV, et al. Double-blind, placebo-controlled pilot and phase III study of activity of standardized Andrographis paniculata Herba Nees extract fixed combination (Kan jang) in the treatment of uncomplicated upper-respiratory tract infection. Phytomedicine. 2000;7:341–350. 16. Thamlikitkul V, Dechatiwongse T, Theerapong S, et al. Efficacy of Andrographis paniculata (Nees) for pharyngotonsillitis in adults. J Med Assoc Thai.1991;74:437–442. 17. Caceres DD, Hancke JL, Burgos RA, et al. Prevention of common colds with Andrographis paniculata dried extract: A pilot double blind trial. Phytomedicine 1997;4:101–104. 18. Hancke J, Burgos R, Caceres D, et al. A double-blind study with a new monodrug Kan Jang: decrease of symptoms and improvement in the recovery from common colds. Phytother Res. 1995;9:559–562. 19. Akbarsha MA, Manivannan B, Shahul Hamid K, et al. Antifertility effect of Andrographis paniculata (Nees) in male albino rat. Indian J Exp Biol. 1990;28:421–426. 20. Burgos RA, Caballero EE, Sanchez NS, et al. Testicular toxicity assessment of Andrographis paniculata dried extract in rats. J Ethnopharmacol. 1997;58:219–224. 21. Zoha MS, Hussain AHM, Choudhury SAR. Antifertility effect of Andrographis paniculata in mice. Bangladesh Med Res Counc Bull. 1989;15:34–37. |
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