Andrographis Paniculata benefit and side effects
eview of research studies and use for immune system enhancement
January 2 2017 by Ray Sahelian, M.D.

Benefits and side effects of this herbal supplement
Andrographis paniculata is a shrub found throughout India and other Asian countries. It has become popular in Scandinavia for use during winter season for immune support. It is also a popular herb in Chiinese medicine. Side effects are minimal but little long term studies are available to know for certain. It is a good idea to take breaks from use.

What's in andrographis herb or plant?
Some of the
compounds or substances are diterpene lactones known as andrographolides.  Andrographis contains andrographolide, deoxyandrographolide and neoandrographolide, 5,7, tetramethoxyflavanone and 5-hydroxy-7, trimethoxyflavone, as well as several other flavonoids and polyphenols.

Potential benefit, what the studies say

Antioxidant benefit found in chemicals in the plant
Antioxidant and anti-inflammatory activities of the plant Andrographis paniculata Nees.
Immunopharmacol Immunotoxicol. 2006. Amala Cancer Research Centre, Thrissur, Kerala, India.
Extract of Andrographis paniculata was found to inhibit formation of oxygen derived free radicals such as superoxide hydroxyl radicals lipid peroxidation and nitric oxide in in vitro system. In vivo studies using mice models also showed significant inhibition in PMA induced superoxide and nitric oxide formation.

Andrographis paniculata treatment prevents BHC induced increase in the activities of enzymes y-Glutamyl transpeptidase, glutathione-S-transferase and lipid peroxidation. The activities of antioxidant enzymes like superoxide dismutase, catalase, glutathione peroxidase and the levels of glutathione were decreased following BHC effect. Administration of andrographis showed protective effects in the activity of superoxide dismutase, catalase, glutathione peroxidase, glutathione reductase as well the level of glutathione. The activity of lipid peroxidase was also decreased. The result indicate antioxidant and hepatoprotective action of andrographis.

Andrographis paniculata contains many flavonoids, which have anti-inflammatory properties. Andrographolide, an active component, inhibits inflammatory responses by rat neutrophils.

Anti-inflammatory Activity of New Compounds from Andrographis paniculata by NF-kappaB Transactivation Inhibition.
J Agric Food Chem. 2010.
Previous studies showed that the ethyl acetate fraction of Andrographis paniculata possessed anti-inflammatory activity. This study further isolated these active compounds from bioactivity-guided chromatographic fractionation and identified eight pure compounds. Reporter gene assay indicated that 5-hydroxy-7,8-dimethoxyflavone, 5-hydroxy-7,8-dimethoxyflavanone, a mix of beta-sitosterol and stigmasterol, ergosterol peroxide, dehydroandrographolide, and a new compound, didehydroandrographolide, significantly inhibited the transcriptional activity of NF-kappaB in LPS/IFN-gamma stimulated macrophages.  All of the compounds significantly decreased TNF-alpha, IL-6, macrophage inflammatory protein-2 (MIP-2), and nitric oxide (NO) secretions from LPS/IFN-gamma stimulated cells.

Cancer prevention or treatment, anti-tumor
There is some laboratory evidence that compounds in andrographis plant have potential benefits in vitro, but it is too early to say whether taking an andrographis supplement will have such an effect in humans. However, several studies need to be done in humans that show it to be effective as an oral supplement. Plus, we have no idea of the appropriate dosage and length of time of use.

Front Biosci (Elite Ed). 2015 Jan 1. Andrographolide and analogues in cancer prevention. Andrographis paniculata is a medicinal plant traditionally used for treatment of cough and cold, fever, laryngitis, and several infectious diseases. Extracts of A. paniculata have shown versatile potency against various diseases including cancer. The active biomolecules of A. paniculata mainly are lactone and diterpene. Andrographolide induced both intrinsic and extrinsic apoptosis pathway in different cancer cells via expression of different anti-apoptotic protein like Bax, p53, and activated caspases. Andrographolide was successfully used as an antineoplastic drug in cancer chemotherapy. Andrographolide inhibited the growth of human breast, prostate, and hepatoma tumors. Andrographolide and analogues need to be subjected to further clinical and biomedical studies in cancer chemoprevention. Andrographolide could be potent anticancer agent when used in combination with other chemotherapeutic agents.

Andrographolide isolated from Andrographis paniculata induces cell cycle arrest and mitochondrial-mediated apoptosis in human leukemic HL-60 cells.
Planta Med. 2005. Department of Biology and Chemistry, City University of Hong Kong, Hong Kong SAR, China.
The in vitro cytotoxicities of the ethanol extract of Andrographis paniculata extract and its main diterpenoid components were evaluated in various cancer cells. Andrographis paniculata extract was found to be significantly growth inhibitory to human acute myeloid leukemic HL-60 cells. It is concluded that Andrographis extract and andrographolide induce cell cycle arrest and affect an intrinsic mitochondria-dependent pathway of apoptosis by regulating the expression of some pro-apoptotic markers in HL-60 cells.

Anticancer and immunostimulatory compounds from Andrographis paniculata.
Discovery Research, Dr. Reddy's Laboratories, Miyapur, Hyderabad, India.
J Ethnopharmacol. 2004.
In the present study, we evaluated the anticancer and immunomodulatory activity andrographis paniculata in human cancer and immune cells. Andrographolide showed anticancer activity and significantly inhibits the proliferation of HT-29 (colon cancer) cells and augments the proliferation human peripheral blood lymphocytes at low concentrations.

Cholesterol or high triglyceride levels
J Med Assoc Thai. 2015. Effect of Andrographis paniculata Extract on Triglyceride Levels of the Patients with Hypertriglyceridemia: A Randomized Controlled Trial. Andrographolide, a main active compound of Andrographispaniculata has been shown to possess hypolipidemic effects in animals. In patients with modest high triglyceride levels, andrographis extract reduced triglyceride levels comparable to the effect of gemfibrozil 300 mg/day. Andrographis paniculata might be used as an alternative medicine in treating patients with high triglycerides.

Colds and flu, upper respiratory infection, URI
Long known in traditional Asian medicine as an immune system booster, Andrographis paniculata has demonstrated significant activity in fighting common cold, flu, and upper respiratory infections. Two randomized double-blind, placebo-controlled parallel group clinical trials were performed to investigate the effect of a standardized extract (SHA-10) fixed combination (Kan jang) in the treatment of uncomplicated upper-respiratory tract infections. In both studies, throat symptoms were found to show the most significant improvement.

I was thinking of adding it to my daily routine for the winter, but then I saw where you site said take no more than 14 days.
   I prefer immune stimulating herbs, such as andrographis paniculata, not to be used all the time without breaks, and that is my personal opinion, another doctor may have a different viewpoint. There is a risk of overstimulating the immune system with certain herbs, perhaps in rare cases leading to or aggravating autoimmune conditions. Hence, the cautious approach of taking breaks. When it is mentioned that it is used in the winter season, this does not mean it is used every day of the winter season.

Andrographis paniculata in the Treatment of Upper Respiratory Tract Infections: A Systematic Review of Safety and Efficacy.
Planta Med. 2004.
The leaves of Andrographis paniculata are used as a medicinal herb in the treatment of infectious diseases. Data suggest that it is superior to placebo in alleviating the subjective symptoms of uncomplicated upper respiratory tract infection. There is also preliminary evidence of a preventative effect.

Q. Can andrographis pill be taken with an antibiotic?
   A. I have not seen studies regarding its use with antibiotics.

Diabetes, blood sugar control
The ethanolic extract of andrographis  possesses antidiabetic property. Its antidiabetic effect may be attributed at least in part to increased glucose metabolism.

Familial Mediterranean Fever. FMF
Andrographis, in combination with other herbs, may be helpful.
Double-blind, placebo-controlled, randomized, pilot clinical trial of ImmunoGuard -- a standardized fixed combination of Andrographis paniculata Nees, with Eleutherococcus senticosus Maxim, Schizandra chinensis Bail. and Glycyrrhiza glabra extracts in patients with Familial Mediterranean Fever.
Phytomedicine. 2003.

Graves disease
I have had Graves disease, had radiation tablet which destroyed my thyroid 12 years ago. I think andrographis can be beneficial to me, and would appreciate more information regarding this.  
   We have not seen any studies evaluating its role in the treatment of post radiation thyroid problems.

Herpes Simplex, and HIV
Andrographolide may inhibit HIV-induced cell cycle dysregulation, leading to a rise in CD4(+) lymphocyte levels in HIV-1 infected individuals. Andrographis paniculata inhibits herpes simplex I activity in vitro.

Immune system
Most flavonoids have anti-microbial activity and have a positive effect on the immune system. Andrographis has demonstrated significant activity in fighting common cold, flu, and upper respiratory infections.

Anti-malarial activity of some xanthones isolated from the roots of Andrographis paniculata.
J Ethnopharmacol. 2004.

Mind and mental effect
Andrographis extract exhibited a significant alteration in behavior pattern and a reduction in spontaneous motility in animals. The extract also produced a prolongation of the pentobarbitone-induced sleeping time and lowered the body temperature in different experimental animal models.

Multiple sclerosis and fatigue
BMC Neurol. 2016. Andrographis paniculata decreases fatigue in patients with relapsing-remitting multiple sclerosis: a 12-month double-blind placebo-controlled pilot study. Andrographis, a medicinal plant, has shown anti-inflammatory, neuroprotective and antifibrotic effects in animal models as well as clinical efficacy in different studies, including an anti-fatigue effect in autoimmune diseases such as rheumatoid arthritis. In multiple sclerosis (MS), fatigue is rated as one of the most common and disabling symptoms. In the present trial, we investigated the effect of A. paniculata on relapse rate and fatigue in relapsing-remitting MS patients receiving interferon beta. A randomised double-blind placebo-controlled trial assessed the effects of 170 mg of A. paniculata dried extract tablet b.i.d. p.o. on relapse rate and fatigue. Patients treated with Andrographis showed a significant reduction in fatigue. No statistically significant differences were observed for relapse rate or inflammatory parameters, with a trend in reducing new lesions among the A. paniculata group. One patient in the A. paniculata group presented with a mild and transient skin rash, which was alleviated with anti-histamine treatment for three weeks.The herb was well tolerated in patients and no changes in clinical parameters were observed. Andrographis significantly reduces fatigue in patients with MS receiving interferon beta in comparison to placebo and only interferon beta treatment.

Rheumatoid arthritis
Efficacy of an Andrographis paniculata composition for the relief of rheumatoid arthritis symptoms: a prospective randomized placebo-controlled trial.
Clin Rheumatol. 2009. Burgos RA, Hancke JL, Bertoglio JC. Institute of Pharmacology and Morphophysiology, Universidad Austral de Chile, Valdivia, Chile.
Andrographis paniculata possesses anti-inflammatory effects, attributed to the main constituent andrographolide proposed as alternative in the treatment of autoimmune disease. A prospective, randomized, double blind, and placebo-controlled study in patients with rheumatoid arthritis was performed. Tablets (Paractin) made of an extract of A. paniculata (30% total andrographolides) were administered three times a day for 14 weeks, after a 2-week washout period to 60 patients with active RA. The intensity of joint pain decreased in the active vs placebo group at the end of treatment, although these differences were not statistically significant. A significant diminishing in tender joint, number of swollen joints, total grade of swollen joint, number of tender joints, total grade of swollen joints was observed within the group with the active drug. Moreover, it was associated to a reduction of rheumatoid factor, IgA, and C4. These findings suggest that this herb could be a useful natural complement in the treatment of rheumatoid arthritis; however, a larger trial and a more extended period of treatment is necessary in order to corroborate these results.

Sperm health research
I read a study about andrographis showing some cellular damage to rat's testicles. I was told by an herbalist, that the herb does inhibit sperm production, temporarily. I was using the herb for Lyme disease. Why doesn't some one do a complete study on this herb? What do you think about the dangers of the herb?
   A. Research funding for herbal supplements such as andrographis is limited. The effect of an herb or medication in rodents may not be similar in humans particularly since the dosages given in rodents during a study is often many times higher than what humans would ingest. One human study does not show harm to sperm production.

A phase I clinical study of Andrographis paniculata fixed combination Kan Jang versus ginseng and valerian on the semen quality of healthy male subjects.
Phytomedicine. 2005. Mkrtchyan A, Panosyan V, Panossian A. Republican Medical Scientific Centre of Dermatology and Diseases Disseminated by Sexual Contacts, Yerevan, Armenia.
The safety of different doses of Kan Jang--a fixed combination of Andrographis paniculata special extract (SHA-10) and Acanthopanax senticosus--compared to two extensively used medicinal plants, Valeriana officinalis and Panax ginseng in the form of standardized extracts, has been examined. Our results indicate that Andrographis paniculata special extract (SHA-10) and Acanthopanax senticosus, ginseng and valerian are safe with respect to effects on human male sterility when administered at dose levels corresponding to approximately 3 times the human daily dose.

Summary and review
Andrographis paniculata has been evaluated in the laboratory and has shown potential in a number of conditions, however, since human research is lacking, the potential health benefits and side effects are, at this time, not fully known. If you do plan to use it, take at least 2 days off a week and one week off a month. It is also not clear how andrographis herb would interact with other herbs that influence the immune system such as astragalus root herb, echinacea, goldenseal herb, and others.

Andrographis side effects, safety, risks
Thus far no major andrographis side effects have been reported in the medical literature.

Other products sold online

Planetary Herbals, Full Spectrum Andrographis, 400 mg, 60 Tablets

Supplement Facts
Serving Size: 1 Tablet
  Amount Per Serving % DV
Calcium 43 mg 4%
Andrographis Aerial Parts Extract
(standardized to 10% andrographolides)
300 mg
Andrographis Aerial Parts
(Andrographis paniculata)
100 mg
Daily Value not established.

Dosage, how much to take: Take one pill a few times a week a few minutes before any meal.
Supplement Facts
Andrographis Standardized 300 mg Extract (10% andrographolides)
Andrographis paniculata herb 100 mg

Other products sold online
Nature's Way, Andrographis, Standardized, 60 Vcaps
Purchase Andrographis supplement pill or other immune herbs.

Purchase Andrographis paniculata supplement 400 mg, where to buy

This herb commonly used in China, India and other countries in subtropical and Southeast Asia. Both the fresh and dried leaves, as well as the fresh juice of the whole plant, have been used in a variety of cultures. In traditional Chinese herbalism, it is used to support healthy digestive, cardiovascular and urinary systems. In Sweden, it has been used for more than 10 years as a primary herb for the winter season for immune support.