Herb Of The Week - Gotu Kola

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Gotu Kola (Centella asiatica)

 

 

 

Evidence

 

 

Scientists have studied gotu kola for the following health problems:

 

 

 

Anxiety

 

Preliminary studies suggest that gotu kola may help treat anxiety. More

scientific information is needed before gotu kola can be recommended

 

Diabetic complications (venous insufficiency, microangiopathy,

neuropathy)

 

Some studies show that gotu kola may help improve blood flow in leg

veins and may help with blood vessel damage and nerve damage caused by

diabetes. However, more information is needed before gotu kola can be

recommended for these problems.

 

Varicose veins, venous insufficiency

 

Gotu kola extracts may also have benefits in treating varicose veins and

chronic venous insufficiency. Further research is needed.

 

Edema (swelling)

 

Gotu kola has also been used reduce edema in patients with diabetes and

in at-risk patients during long flights.

 

Wound healing

 

Preliminary data show that gotu kola may help wounds from various causes

to heal. Further research is needed before a recommendation can be made.

 

Cerebrovascular disease

 

Preliminary research shows that gotu kola may benefit patients at risk

of developing stroke. Further study is needed to confirm these results.

 

Postphlebitic syndrome

 

Preliminary research showed improvement in patients with postphlebitic

syndrome. Further research is needed to confirm these results.

 

Gastric ulceration

 

Several animal studies show benefits in the treatment of gastric ulcer

by gotu kola. High-quality studies in humans are necessary before a

recommendation can be made.

 

Periodontal disease

 

Preliminary study evaluating the effectiveness of gotu kola and punica

granatum together showed a general reduction in signs and symptoms of

chronic periodontitis. More information is needed before a conclusion

can be drawn.

 

 

 

Unproven Uses

 

 

Gotu kola has been suggested for many other uses, based on tradition or

on scientific theories. However, these uses have not been thoroughly

studied in humans, and there is limited scientific evidence about safety

or effectiveness. Some of these suggested uses are for conditions that

are potentially very serious and even life-threatening. You should

consult a health care provider before using gotu kola for any unproven

use.

 

 

Abscesses

Alcoholic liver disease

Alzheimer's disease

Anemia

Antioxidant

Aphrodisiac

Arthritis

Asthma

Birth control

Bladder problems

Blood purifier

Bronchitis

Bruises

Burns

Cancer

Cellulitis

Cholera

Cognitive impairment

Colds

Cutaneous tuberculosis

Dehydration

Depression

Diarrhea

Diuretic

Eczema

Epilepsy

Eye problems

Fatigue

Fever

Fungal infections

Gastritis

Gum disease

Hair loss

Hemorrhoids

Hepatitis

Herpes

High blood pressure

Hot flashes Immune system boosting

Infections

Inflammation

Jaundice

Keloid prevention

Leprosy

Libido

Liver diseases

Longevity

Lupus

Malaria

Memory enhancement

Menstrual period problems

Mental disorders

Mood changes

Nerve tonic

Pain

Psoriasis

Radiotherapy protection

Restless legs

Scabies

Scar healing

Scleroderma

Shigella infection

Shingles

Skin graft donor wounds

Sleep disorders

Snakebites

Stomach ulcer

Stretch marks

Sunstroke

Syphilis

Tonsillitis

Tuberculosis

Urinary retention

Urinary tract infection

Vaginal discharge

 

 

 

Potential Dangers

 

 

Allergies

 

 

Reports exist of allergic rash from using gotu kola on the skin. People

with allergies to gotu kola, asiaticoside, asiatic acid, madecassic acid

or any other parts of gotu kola should avoid using gotu kola.

 

 

Side Effects

 

 

Gotu kola seems to be well tolerated when taken by mouth. Stomach

discomfort and nausea have been reported in studies. In theory, gotu

kola may cause drowsiness and may raise blood cholesterol and blood

sugar levels. Therefore, people with diabetes should avoid gotu kola.

Animal studies show that gotu kola may lower the chances of becoming

pregnant, but it is not clear if this effect occurs in humans. One

animal study suggests that an ingredient of gotu kola, asiaticoside, may

have weak cancer-causing effects when applied to the skin.

 

 

Pregnancy And Breast-Feeding

 

 

Gotu kola is not recommended during pregnancy or breast-feeding because

there are not enough scientific studies on the effects of this herb.

 

 

 

Interactions

 

 

Interactions with drugs, supplements and other herbs have not been

thoroughly studied. The interactions listed below have been reported in

scientific publications. If you are taking prescription drugs, speak

with your health care provider or pharmacist before using herbs or

dietary supplements.

 

 

Interactions With Drugs

 

 

Gotu kola may increase the amount of drowsiness caused by some drugs.

Examples include benzodiazepines, such as lorazepam (Ativan);

barbiturates, such as phenobarbital; narcotics, such as codeine; and

alcohol. Caution is advised while driving or operating machinery. In

theory, gotu kola may increase cholesterol levels and may work against

cholesterol-lowering drugs.

 

 

Gotu kola may raise blood sugar levels and may work against drugs that

lower blood sugar levels. Patients taking oral drugs for diabetes or

using insulin should be monitored closely by their health care provider

while using gotu kola. Dosing adjustments may be necessary. In theory,

dexamethasone and phenylbutazone may decrease any wound-healing

abilities of gotu kola.

 

 

Interactions With Herbs And Dietary Supplements

 

 

Gotu kola may raise blood sugar levels. People using herbs or

supplements that may alter blood sugar levels, such as bitter

<http://www.intelihealth.com/IH/ihtIH/WSIHW000/8513/31402/348736.html?d=

dmtContent> melon (Momordica charantia), should be monitored closely by

their health care provider while using gotu kola. Dosing adjustments may

be necessary.

 

 

 

Dosing

 

 

The doses listed below are based on scientific research, publications or

traditional use. Because most herbs and supplements have not been

thoroughly studied or monitored, safety and effectiveness may not be

proven. Brands may be made differently, with variable ingredients even

within the same brand. Combination products often contain small amounts

of each ingredient and may not be effective. Appropriate dosing should

be discussed with a health care provider before starting therapy; always

read the recommendations on a product's label. The dosing for unproven

uses should be approached cautiously, because scientific information is

limited in these areas.

 

 

Adults (Aged 18 Or Older)

 

 

Oral administration:Doses of 60 to 180 milligrams, divided throughout

the day, have been taken by mouth in either tablet or extract form.

Centella asiatica juice has been administered orally at 200 milligrams

per kilogram and 600 milligrams per kilogram twice daily for five days.

 

 

Children (Younger Than 18)

 

 

There is not enough scientific evidence to recommend gotu kola for

children at this time.

 

 

 

Summary

 

 

Gotu kola has been applied in Ayurvedic, traditional Chinese medice, and

other folk medicine practices for use in various conditions, including

depression and anxiety. This herbal is also commonly used in treating

wounds in areas such as India, China and Europe. Although gotu kola has

been suggested for many conditions, there is not enough research in

humans to recommend it for any health problem.

 

 

Gotu kola may cause drowsiness, raise blood sugar levels, or increase

cholesterol levels. People with diabetes should avoid gotu kola. Safety

is not known for children or pregnant women. Asiaticoside, an ingredient

normally isolated in centella asiatica, has also been isolated in

another plant called schefflera. Consult your health care provider

immediately if you have side effects.

 

 

The information in this monograph was prepared by the professional staff

at Natural Standard, based on thorough systematic review of scientific

evidence. The material was reviewed by the Faculty of the Harvard

Medical School with final editing approved by Natural Standard.

 

 

 

Resources

 

 

1. Natural Standard: <http://www.naturalstandard.com/> An

organization that produces scientifically based reviews of complementary

and alternative medicine (CAM) topics

 

2. National Center <http://nccam.nih.gov/> for Complementary and

Alternative Medicine (NCCAM): A division of the U.S. Department of

Health & Human Services dedicated to research

 

 

Selected Scientific Studies: Gotu Kola

 

 

Natural Standard reviewed more than 150 articles to prepare the

professional monograph from which this version was created.

 

 

Some of the more recent studies are listed below:

 

 

1. Arpaia MR, Ferrone R, et al. Effects of Centella asiatica

extract on mucopolysaccharide metabolism in subjects with varicose

veins. Int J Clin Pharmacol Res 1990;10(4):229-233.

 

2. Belcaro GV, Grimaldi R, et al. Improvement of capillary

permeability in patients with venous hypertension after treatment with

TTFCA. Angiology 1990;Jul, 41(7):533-540.

 

3. Belcaro GV, Rulo A, et al. Capillary filtration and ankle edema

in patients with venous hypertension treated with TTFCA. Angiology

1990;Jan, 41(1):12-18.

 

4. Bilbao I, Aguirre A, et al. Allergic contact dermatitis from

butoxyethyl nicotinic acid and Centella asiatica extract. Contact

Dermatitis 1995;Dec, 33(6):435-436.

 

5. Boiteau P, Ratsimamanga AR. Asiaticoside extracted from Centella

asiatica and its therapeutic uses in cicatrization of experimental and

refractory wounds (leprosy, cutaneous tuberculosis and lupus). Therapie

1956;11(1):125-149.

 

6. Bradwejn J, Zhou Y, Koszycki D, et al. A double-blind,

placebo-controlled study on the effects of Gotu Kola (Centella asiatica)

on acoustic startle response in healthy subjects. J Clin Psychopharmacol

2000;20(6):680-684.

 

7. Cataldi A, Gasbarro V, et al. Effectiveness of the combination

of alpha tocopherol, rutin, melilotus, and centella asiatica in the

treatment of patients with chronic venous insufficiency. Minerva

Cardioangiol 2001;Apr, 49(2):159-163.

 

8. Cesarone MR, Incandela L, et al. Evaluation of treatment of

diabetic microangiopathy with total triterpenic fraction of Centella

asiatica: a clinical prospective randomized trial with a

microcirculatory model. Angiology 2001;Oct, 52(Suppl 2):S49-S54.

 

9. Cesarone MR, Belcaro G, et al. Microcirculatory effects of total

triterpenic fraction of Centella asiatica in chronic venous

hypertension: measurement by laser Doppler, TcPO2-CO2, and leg

volumetry. Angiology 2001;Oct, 52(Suppl 2):S45-S48.

 

10. Cesarone MR, Incandela L, et al. Flight microangiopathy in

medium- to long-distance flights: prevention of edema and

microcirculation alterations with total triterpenic fraction of Centella

asiatica. Angiology 2001;Oct, 52(Suppl 2):S33-S37.

 

11. Cesarone MR, Belcaro G, et al. Increase in echogenicity of

echolucent carotid plaques after treatment with total triterpenic

fraction of Centella asiatica: a prospective, placebo-controlled,

randomized trial. Angiology 2001;Oct, 52(Suppl 2):S19-S25.

 

12. Cesarone MR, Belcaro G, De Sanctis MT, et al. Effects of the

total triterpenic fraction of Centella asiatica in venous hypertensive

microangiopathy: a prospective, placebo-controlled, randomized trial.

Angiology 2001;52(10 suppl 2):S15-S18.

 

13. Cesarone MR, Laurora G, et al. The microcirculatory activity of

Centella asiatica in venous insufficiency: a double-blind study. Minerva

Cardioangiol 1994;Jun, 42(6):299-304.

 

14. Cesarone MR, Laurora G, et al. Activity of Centella asiatica in

venous insufficiency. Minerva Cardioangiol 1992;Apr, 40(4):137-143.

 

15. Danese P, Carnevali C, et al. Allergic contact dermatitis due to

Centella asiatica extract. Contact Dermatitis 1994;Sep, 31(3):201.

 

16. Darnis F, Orcel L, et al. Use of a titrated extract of Centella

asiatica in chronic hepatic disorders. Sem Hop 1979;Nov 8-15,

55(37-38):1749-1750.

 

17. De Sanctis MT, Belcaro G, Incandela L, et al. Treatment of edema

and increased capillary filtration in venous hypertension with total

triterpenic fraction of Centella asiatica: a clinical, prospective,

placebo-controlled, randomized, dose-ranging trial. Angiology 2001;52(10

Suppl 2):S55-S59.

 

18. Dattner AM. From medical herbalism to phytotherapy in

dermatology: back to the future. Dermatol Ther 2003;16(2):106-113.

 

19. Dutta T, Basu UP. Crude extract of Centella asiatica and

products derived from its glycosides as oral antifertility agents.

Indian J Exp Biol 1968;Jul, 6(3):181-182.

 

20. Gonzalo Garijo MA, Revenga Arranz F, et al. Allergic contact

dermatitis due to Centella asiatica: a new case. Allergol Immunopathol

(Madr) 1996;May-Jun, 24(3):132-134.

 

21. Huriez C. Action of the titrated extract of Centella Asiatica in

the cicatrization of leg ulcers (10 mg tablets): apropos of 50 cases.

Lille Med 1971;17(Suppl 3):574-579.

 

22. Incandela L, Cesarone MR, et al. Total triterpenic fraction of

Centella asiatica in chronic venous insufficiency and in high-perfusion

microangiopathy. Angiology 2001;Oct, 52(Suppl 2):S9-S13.

 

23. Incandela L, Cesarone MR, et al. Modification of the

echogenicity of femoral plaques after treatment with total triterpenic

fraction of Centella asiatica: a prospective, randomized,

placebo-controlled trial. Angiology 2001;Oct, 52(Suppl 2):S69-S73.

 

24. Incandela L, Belacaro G, Cesarone MR, et al. Treatment of

diabetic microangiopathy and edema with total triterpenic fraction of

Centella asiatica: a prospective, placebo-controlled randomized study.

Angiology 2001;52(10 suppl 2):S27-S31.

 

25. Incandela L, Belcaro G, De Sanctis MT, et al. Total triterpenic

fraction of Centella asiatica in the treatment of venous hypertension: a

clinical, prospective, randomized trial using a combined

microcirculatory model. Angiology 2001;52(10 Suppl 2):S61-S67.

 

26. Montecchio GP, Samaden A, et al. Centella Asiatica Triterpenic

Fraction (CATTF) reduces the number of circulating endothelial cells in

subjects with post phlebitic syndrome. Haematologica 1991;May-Jun,

76(3):256-259.

 

27. Nebout M. Results of a controlled experiment of the titrated

extract of Centella asiatica in a leper population with perforative foot

lesions. Bull Soc Pathol Exot Filiales 1974;Sep-Oct, 67(5):471-478.

 

28. Pointel JP, Boccalon H, et al. Titrated extract of Centella

asiatica (TECA) in the treatment of venous insufficiency of the lower

limbs. Angiology 1987;Jan, 38(1 Pt 1):46-50.

 

29. Sastravaha G, Yotnuengnit P, et al. Adjunctive periodontal

treatment with Centella asiatica and Punica granatum extracts: a

preliminary study. J Int Acad Periodontol 2003;Oct, 5(4):106-115.

 

Be aware that the U.S. Food and Drug Administration does not strictly

regulate herbs and dietary supplements. There is no guarantee of

strength, purity or safety of products containing or claiming to contain

gotu kola. Decisions to use herbs or supplements should be carefully

considered. Individuals using prescription drugs should discuss taking

herbs or supplements with their pharmacists or health care providers

before starting.

 

 

Last updated November 19, 2002