In Sweden, pharmacists are more likely to recommend andrographis to stave off a cold than echinacea. In the last few years, Andrographis paniculata, an ancient weedy shrub native to India and Southern Asia, has become one of the best-selling cold remedies in Scandinavia. Not only does it rival echinacea's ability to effectively treat cold and flu symptoms, but at lower doses, it may help prevent colds as well.
Although andrographis' virtues as an immune system booster are only beginning to receive recognition in Western medicine, Indian and Chinese healing systems have used it numerous ways for centuries.
For example, in India, andrographis was widely credited for arresting the 1919 Indian flu epidemic, says J. Hancke, M.D., with the Max Planck Institute, who led two double-blind placebo-controlled studies on the herb in Sweden (Phytomedicine, 1997). In one study involving 107 18-year-old students, half took 200 mg of andrographis (standardized to contain 5.6 percent andrographolides—the active constituent) daily for three months. The other half took placebo. By the end of the trial, 16 students in the andrographis group had developed colds, compared with 33 students in the control group.
In another study, andrographis reduced cold symptom severity (Phytomedicine, 1999). Of 158 adults with colds, participants given 1,200 mg daily of andrographis (standardized to contain 5.6 percent andrographolides) experienced significant improvements by the second day of treatment, and improved further by day four, compared with participants who received placebo. The symptoms that improved the most were earache, sleeplessness, nasal drainage and sore throat, though other cold symptoms improved as well.
In traditional Chinese medicine, andrographis is known as a cooling, detoxifying herb. "It is sometimes combined with isatis root and dandelion to make a patented Chinese remedy called Chuan Xin Lian," says Chinese herbalist Letha Hadady. "Andrographis is known to detoxify fire poison, which means it has anti-inflammatory and antimicrobial action," she says.
"The Chinese herbal Materia Medica recommends Chuan Xin Lian for inflammatory problems and infections of the lungs, throat and urinary tract as well as skin sores," Hadady says. "I would use it for sore throat, swollen glands, colds with thick yellow or green mucus and as an adjunct remedy for red inflamed acne and for fever conditions that have mucus. It is safer than echinacea for long-term use because it is not drying and weakening." Andrographis is also frequently used in traditional Chinese medicine to treat HIV, cardiovascular disease, liver and gastro-intestinal problems, according to Hadady.
Todd Nelson, M.D., in Denver, Colo., says andrographis helps his patients with flu symptoms. "I have 70 to 80 percent effectiveness [with andrographis] in reducing intensity and duration of symptoms if taken within 24 hours of onset," he says. "The combination of echinacea and andrographis, together with vitamin C and bioflavinoids, is very effective [for severe flu symptoms]," Nelson says.
He says that he has never observed adverse effects, and that he would not exclude prescribing it with any other treatment. Once more research is published on andrographis, Nelson says, "it could become the next big immune booster."
Andrographis is available in formulas standardized to contain between 4 percent and 50 percent andrographolides. The dose depends on the strength of the preparation. Some herbalists believe that andrographolides do not affect the immune system as much as the whole-plant extract; others disagree. "One would have to be in the camp of the [standardized] andrographolide extract because that is where the research is," says Janet Zand, OMD, in Los Angeles. "The whole-herb research is lacking in general, since a plant's quality can vary widely depending on soil and other factors," she says. Nevertheless, she says, andrographis herb tea or tonic is commonly used in India both as a cold remedy and preventative.
Research has found andrographis to be safe at low to moderate doses (in the cold studies, doses ranged from 200 mg to 6 g). But preliminary evidence suggests that it may temporarily reduce fertility in mice, though this has not been shown in humans, and subesequent research did not repeat these findings. The andrographolide constituent may also cause dose-related increases in liver enzymes, such as ALT, which return to normal when use is discontinued (Phytotherapy Research, 2000).
There are currently two primary distributors offering andrographis cold treatments in the United States. San Clemente, Calif.-based Metagenics produces Andrographis Plus, and the Swedish Herbal Institute, based in Portsmouth, N.H., produces Kan Jang, a single-source andrographis capsule.
The herb is also available for non-cold treatments in at least two other compounds: Jarrow Formulas' Tribulus Complex, which the company says enhances energy, endurance and recuperation, supports immune function and counters physical stress. Holistic International in Calgary, Alberta, Canada, produces a liver support compound called Stimuliv, which contains andrographis.
Although andrographis is already widely used and readily available in Europe and Asia, it is still difficult for American consumers to find. "No Whole Foods store carries it," says Li Mae, supplements buyer for Whole Foods in Richardson, Texas. Zand believes this could change very soon. "I have spoken with Jim Coin, the owner of Botanical Labs, and he is interested in creating a product. So I think there are people waiting in the wings to see if the herb gets airlifted."
Scott Bias of Paradise Herbs in Fountain Valley, Calif., says that his company has a formula based on the Chinese patent containing 50 percent andrographis, which will be available early September.
Julian Friedland is a freelance writer and instructor of philosophy at Metropolitan State College in Denver.
Natural Foods Merchandiser volume XXII/number 8/p. 39, 42