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Andrographis
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Andrographis

Andrographis, an herbaceous plant native to South Asian countries like India, China, Thailand and Sri Lanka, has a rich history deeply rooted in traditional medicine systems. Renowned for its potent medicinal properties, Andrographis has garnered significant attention in both ancient and contemporary herbal practices. 

Its diverse phytochemical composition, including bioactive compounds such as andrographolides, contributes to its wide array of therapeutic applications. 

Traditionally, Andrographis has been utilized for its immune-supporting properties, particularly in addressing respiratory ailments and common infections. 

In recent years, scientific research has delved into its potential benefits, ranging from its anti-inflammatory and antimicrobial effects to its purported role in supporting liver health and even potentially combating cancer. 

As interest in natural remedies continues to grow, understanding the uses, dosage, and safety considerations of Andrographis becomes increasingly important for individuals seeking alternative approaches to health and well-being.

What is Andrographis?

Definition and Botanical Background

Andrographis (also known as Andrographis paniculata) is a medicinal herb with a long history of use in traditional medicine systems, particularly in South Asian countries like India, China, and Thailand. 

It belongs to the Acanthaceae family and is characterized by its slender stems, lance-shaped leaves, and small white or purple flowers. It is quite adaptable to various climates and soil types, making it a resilient and widely cultivated herb. 

Historical and Cultural Significance of Andrographis

Andrographis holds significant cultural and historical importance, particularly in traditional medicine systems of South Asian countries like India, China, and Thailand. 

Known as "King of Bitters" in Ayurveda, Andrographis has been revered for centuries for its medicinal properties, earning a place in ancient texts and folklore.

 In traditional practices it has been used to treat a variety of ailments including fever, respiratory infections, digestive disorders, and liver conditions. Its resilience in various climates and soils has made it a staple in herbal medicine gardens and a symbol of health and vitality in many cultures. 

Today the historical and cultural significance of Andrographis continues to influence its utilization and recognition in modern herbal medicine practices around the world.

Phytochemical Composition and Active Compounds

Its phytochemical composition is particularly notable for its abundance of bioactive compounds, including andrographolides, flavonoids, and diterpenes. Among these, andrographolides are the most studied and well-known, contributing significantly to Andrographis' medicinal properties. 

Andrographis’ historical and cultural significance is extensive, as it has been traditionally used to treat a range of ailments including respiratory infections, fever, digestive disorders, and liver conditions. 

Pharmacology of Andrographolides

Modern pharmacological studies have demonstrated that andrographolide exhibits anti-inflammatory, antibacterial, antivirus, antitumor, and immune-regulating effects, making it potentially beneficial in treating cardiovascular-cerebrovascular diseases, protecting liver and gallbladder health, and promoting immune health and overall wellness.  [14.]

It effectively treats fever caused by pneumococcus and hemolytic Streptococcus mutans by inhibiting PGE2 and cAMP levels in the hypothalamus. Additionally, andrographolide demonstrates antagonistic effects against various viruses including the Hong Kong virus (HKV), Ebola virus (EBOV), and respiratory syncytial virus (RSV), and has shown inhibition of HIV, SARS, and viral myocarditis ST2 in vitro.  [14.]

Andrographolide also provides protection against myocardial ischemia, ischemia-reperfusion injury, and atherosclerosis by scavenging free radicals, inhibiting platelet aggregation, and regulating lipid disorder. [14.]

Furthermore, it enhances liver function by increasing bile flow and bile salt production, reversing reductions caused by toxins like paracetamol, thereby improving liver function.

What is Andrographis Used For?

Andrographis has many uses in modern clinical settings.  

Immune support and respiratory health: Andrographis is widely used for its immune-modulating properties, particularly in supporting respiratory health. Research suggests that Andrographis may help reduce the severity and duration of symptoms associated with respiratory infections such as the common cold, flu, and sinusitis. 

Its ability to stimulate the immune system and inhibit viral replication makes it a valuable option for bolstering immunity against bacterial and viral pathogens.  [1., 7., 15.] 

Anti-inflammatory properties: Andrographis exhibits significant anti-inflammatory effects, which can benefit individuals suffering from inflammatory conditions such as arthritis, inflammatory bowel disease (IBD), and allergies.  [3.]

By reducing inflammation and modulating immune responses, Andrographis may help alleviate pain, swelling, and discomfort associated with these conditions.

Antimicrobial activity: Andrographis possesses potent antimicrobial properties, making it effective against a wide range of bacteria, viruses, and fungi. Studies have shown that Andrographis extracts can inhibit the growth and replication of pathogens responsible for various infections, including respiratory infections, gastrointestinal infections, and skin infections. 

This antimicrobial activity contributes to Andrographis' usefulness in treating infectious diseases and promoting overall health.  [1., 7., 15.] 

Liver health and detoxification: Andrographis is known for its hepatoprotective properties, meaning it supports liver health and function. It has been shown to promote liver detoxification processes, enhance bile flow, and protect against liver damage caused by toxins and oxidative stress. These effects make Andrographis a valuable herb for individuals with liver conditions such as fatty liver disease, hepatitis, and toxin exposure.  [13.]

Potential anticancer effects: emerging research suggests that Andrographis may have potential anticancer effects, with studies indicating its ability to inhibit the growth and spread of cancer cells in various types of cancer, including breast, prostate, and colon cancer. 

While further research is needed to fully understand its mechanisms of action and efficacy in cancer treatment, Andrographis shows promise as a complementary therapy for cancer patients.  [10.]

Other reported benefits: In addition to the above, Andrographis has been studied for its potential benefits in managing diabetes, supporting cardiovascular health, and improving cognitive function. It may also have antioxidant properties that help protect cells from damage caused by free radicals. While more research is needed to confirm these effects, Andrographis continues to be explored for its therapeutic potential in various clinical settings.  [2., 8., 9.]

How Much Andrographis Should I Take?

General Dosage Guidelines

In clinical practice, determining the appropriate dosage of Andrographis involves considering various factors to ensure safe and effective use. General dosage guidelines typically recommend a daily intake of standardized Andrographis extract ranging from 300 to 600 milligrams, although larger doses have been used short-term.  [4., 5., 11., 12.]

However, individual factors such as the severity of the condition being treated, the patient's age, weight, and overall health status, as well as the form and concentration of Andrographis preparation, should also be taken into account when determining dosage.

Factors Influencing Appropriate Dosage

Several factors may influence the appropriate dosage of Andrographis for a patient. These include the specific health condition being targeted, the patient's individual response to treatment, and any underlying health conditions or medications they may be taking. Additionally, healthcare providers should consider the patient's tolerance to herbal supplements and any potential contraindications or interactions with other medications or supplements.

Safety Considerations and Potential Side Effects

Safety considerations and potential side effects are crucial aspects to address when prescribing Andrographis in clinical practice. While Andrographis is generally well-tolerated, some individuals may experience mild gastrointestinal symptoms such as nausea, diarrhea, or abdominal discomfort. 

Rarely, allergic reactions including anaphylaxis may occur in sensitive individuals. 

Interactions with Medications and Other Supplements

Clinicians should also be aware of potential interactions between Andrographis and certain medications, particularly antihypertensives, immunosuppressants and anticoagulants, which may require dosage adjustments or careful monitoring when used concomitantly. 

Overall, close monitoring of patients and adherence to recommended dosages can help minimize the risk of adverse effects while maximizing the therapeutic benefits of Andrographis in clinical practice.

How to Take Andrographis

Various preparations of andrographis are available, including capsules, tablets, tinctures, and teas.  Each offers unique advantages in terms of dosage flexibility and ease of administration. 

Capsules and tablets are convenient options for precise dosing, allowing patients to easily incorporate andrographis into their daily routine.

Tinctures, on the other hand, offer a liquid form of andrographis that can be easily absorbed by the body, making them suitable for individuals with difficulty swallowing or those who prefer liquid supplements. 

Andrographis teas provide a soothing and comforting way to consume the herb, often combined with other complementary herbs for enhanced therapeutic effects. 

Patients typically take these preparations orally, following dosage instructions provided by healthcare providers or product labels, and may adjust the dosage based on individual needs and treatment goals.

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[1.] Adiguna SP, Panggabean JA, Atikana A, Untari F, Izzati F, Bayu A, Rosyidah A, Rahmawati SI, Putra MY. Antiviral Activities of Andrographolide and Its Derivatives: Mechanism of Action and Delivery System. Pharmaceuticals (Basel). 2021 Oct 28;14(11):1102. doi: 10.3390/ph14111102. PMID: 34832884; PMCID: PMC8619093.

[2.] Awang K, Abdullah NH, Hadi AH, Fong YS. Cardiovascular activity of labdane diterpenes from Andrographis paniculata in isolated rat hearts. J Biomed Biotechnol. 2012;2012:876458. doi: 10.1155/2012/876458. Epub 2012 Mar 28. PMID: 22536026; PMCID: PMC3321480.

[3.] Burgos RA, Alarcón P, Quiroga J, Manosalva C, Hancke J. Andrographolide, an Anti-Inflammatory Multitarget Drug: All Roads Lead to Cellular Metabolism. Molecules. 2020 Dec 22;26(1):5. doi: 10.3390/molecules26010005. PMID: 33374961; PMCID: PMC7792620.

[4.] Burgos, R. A., Hancke, J. L., Bertoglio, J. C., Aguirre, V., Arriagada, S., Calvo, M., and Caceres, D. D. Efficacy of an Andrographis paniculata composition for the relief of rheumatoid arthritis symptoms: a prospective randomized placebo-controlled trial. Clin Rheumatol. 2009;28(8):931-946

[5.] Hancke JL, Srivastav S, Cáceres DD, Burgos RA. A double-blind, randomized, placebo-controlled study to assess the efficacy of Andrographis paniculate standardized extract (ParActin®) on pain reduction in subjects with knee osteoarthritis. Phytother Res. 2019;33(5):1469-1479.

[6.] Hossain MS, Urbi Z, Sule A, Hafizur Rahman KM. Andrographis paniculata (Burm. f.) Wall. ex Nees: a review of ethnobotany, phytochemistry, and pharmacology. ScientificWorldJournal. 2014;2014:274905. doi: 10.1155/2014/274905. Epub 2014 Dec 24. PMID: 25950015; PMCID: PMC4408759. 

[7.] Intharuksa A, Arunotayanun W, Yooin W, Sirisa-Ard P. A Comprehensive Review of Andrographis paniculata (Burm. f.) Nees and Its Constituents as Potential Lead Compounds for COVID-19 Drug Discovery. Molecules. 2022 Jul 13;27(14):4479. doi: 10.3390/molecules27144479. PMID: 35889352; PMCID: PMC9316804.

[8.] Islam MT. Andrographolide, a New Hope in the Prevention and Treatment of Metabolic Syndrome. Front Pharmacol. 2017 Aug 23;8:571. doi: 10.3389/fphar.2017.00571. PMID: 28878680; PMCID: PMC5572404.

[9.] Ma, J., Zheng, M., Zhang, X. et al. Ethanol extract of Andrographis paniculata alleviates aluminum-induced neurotoxicity and cognitive impairment through regulating the p62-keap1-Nrf2 pathway. BMC Complement Med Ther 23, 441 (2023). https://doi.org/10.1186/s12906-023-04290-4

[10.] Paul S, Roy D, Pati S, Sa G. The Adroitness of Andrographolide as a Natural Weapon Against Colorectal Cancer. Front Pharmacol. 2021 Nov 2;12:731492. doi: 10.3389/fphar.2021.731492. PMID: 34795581; PMCID: PMC8592893.

[11.] Tang, T., Targan, S. R., Li, Z. S., Xu, C., Byers, V. S., and Sandborn, W. J. Randomised clinical trial: herbal extract HMPL-004 in active ulcerative colitis - a double-blind comparison with sustained release mesalazine. Aliment.Pharmacol Ther 2011;33(2):194-202.

[12.] 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

[13.] Qin X, Wang X, Tian M, et al. The role of Andrographolide in the prevention and treatment of liver diseases. Phytomedicine. 2023;109:154537. doi:https://doi.org/10.1016/j.phymed.2022.154537

[14.] Yan Y, Fang LH, Du GH. Andrographolide. Natural Small Molecule Drugs from Plants. 2018 Feb 1:357–62. doi: 10.1007/978-981-10-8022-7_60. PMCID: PMC7122281. 

[15.] Zhang L, Bao M, Liu B, Zhao H, Zhang Y, Ji X, Zhao N, Zhang C, He X, Yi J, Tan Y, Li L, Lu C. Effect of Andrographolide and Its Analogs on Bacterial Infection: A Review. Pharmacology. 2020;105(3-4):123-134. doi: 10.1159/000503410. Epub 2019 Nov 6. PMID: 31694037.

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