How does gotu kola work

To do this, rub a dime-sized amount on to the inside of your forearm. Given its perceived ability to treat anxiety, stress, and depression, gotu kola may also be used to treat the insomnia that sometimes accompanies these conditions. Some consider this herbal remedy to be a safe alternative to prescription medications used to treat insomnia and other sleep disorders. Although older research does suggest that gotu kola can help treat sleep disorders , additional studies are needed to confirm these findings.

How to use: Take to mg of gotu kola extract 3 times per day for up to 14 days at a time. According to a review , gotu kola can reduce the appearance of stretch marks. This may help prevent new stretch marks from forming, as well as help heal any existing marks. How to use: Apply a topical cream containing 1 percent gotu kola extract to the affected area several times per day. Researchers in a study on rats found that wound dressing containing gotu kola had healing effects on multiple types of wounds.

This includes clean cuts by sharp objects, irregular tears caused by blunt-force trauma, and infected tissue. How to use: Apply an ointment containing 1 percent gotu kola extract to the affected area several times per day.

If your wound is deep or otherwise severe, see your doctor before use. The anti-inflammatory properties of gotu kola may be useful in treating arthritis. In fact, one study on collagen-induced arthritis in rats found that oral administration of gotu kola reduced joint inflammation, cartilage erosion, and bone erosion. Its antioxidant effect also had a positive effect on the immune system.

According to one animal study , gotu kola can be used to suppress the toxic side effects of the antibiotic isoniazid. Isoniazid is used to treat and prevent tuberculosis. Rats were given mg of gotu kola for 30 days before they were given the antibiotic.

These rats experienced less toxicity overall. Rats that did experience toxicity in the liver and kidneys resumed to near-normal levels after being given gotu kola.

How to use: Take 30 to 60 drops of liquid gotu kola extract 3 times per day for up to 14 days at a time. Gotu kola is generally well tolerated. In some cases, it can cause headache, upset stomach, and dizziness. The authors also noted that a lack of medical supervision and knowledge about how gotu kola might react with medications made the herb potentially dangerous to use.

The Memorial Sloan Kettering Cancer Center also highlight the lack of trials in humans and call for further testing before the effectiveness of gotu kola as a wound treatment can be confirmed. According to one review of studies , gotu kola may help support the functioning of the brain and nervous system, improve memory, and protect against aging. However, more recent studies do not support some of these claims. A study found that gotu kola may improve alertness and reduce anger but did not substantiate the other findings.

Meanwhile, in a study , researchers looked at people who had experienced cognitive impairment following a stroke. They found that few, if any, improvements were associated with using gotu kola, compared with folic acid.

However, the authors noted that some participants experienced some improvement in long-term memory after taking the herbal extract.

According to Winchester Hospital , an older study of 40 participants found that gotu kola helped improve the startle response. This is relevant because, as the hospital explains, easy startling is associated with anxiety. Learn about evidence-based supplements for anxiety here. Some reported side effects of gotu kola include:. Although there is limited relevant data, it is possible that gotu kola can interact with prescription or over-the-counter medications.

It is crucial to consult a doctor before using gotu kola. Make sure that the doctor knows about all ongoing medications and treatments. Gotu kola may provide some health benefits and may particularly support the functioning of the veins. However, there is very little scientific evidence behind most claims that manufacturers make about gotu kola.

In one study, derivatives of asiatic acid derivatives were shown to exert significant neuroprotective effects on cultured cortical cells by their potentiation of the cellular oxidative defence mechanism.

Therefore, these agents were proved to be efficacious in protecting neurons from the oxidative damage caused by exposure to excess glutamate[ 37 ]. Another study demonstrated the protective effects of asiaticoside derivatives against beta-amyloid neurotoxicity when tested on B cell cultures and hippocampal slices.

Out of 28 of the asiaticoside derivatives three components, including asiatic acid, showed a strong inhibition of beta-amyloid- and free radical-induced cell death. A laboratory study was reported in which aqueous extract of CA was found to be effective in inhibiting gastric lesions induced by ethanol administration[ 39 ]. The authors concluded that the CA extract presumably strengthened the gastric mucosal barrier and reduced the damaging effects of free radicals.

Animal studies showed that CA extracts inhibited gastric ulceration induced by cold and restraint stress, in rats. The antiulcer activity was compared to famotidine H 2 -antagonist and sodium valproate antiepleptic or antiseizure. Both the drugs and the herb extract showed a dose-dependent reduction of gastric ulceration, which, except for the antiulcer effect of famotidine, could be reversed with bicucullin methiodide specific GABA A antagonist [ 40 ]. Moreover, it is known that GABA and its agonists inhibit the central cholinergic action by affecting the turnover rate of acetylcholine in the rat brain[ 41 ].

Yet, another study was conducted to evaluate the possible anti-ulcerogenic activity of fresh juice of CA against ethanol-, aspirin-, cold-restraint stress- and pyloric ligation induced gastric ulcers in rats.

CA extracts showed little or no effect on offensive acid-pepsin secretion. It also decreased cell shedding indicating fortification of mucosal barrier.

Author concluded that the ulcer protective effect of CAE may be due to strengthening of the mucosal defensive factors[ 42 ]. One study showed that CA and its constituents, asiaticosides have an anti-inflammatory property that was brought about by inhibition of nitric oxide NO and thus facilitating ulcer healing[ 43 ]. Some other researchers also showed the efficacy of CA through preclinical and clinical studies for healing gastric ulcers[ 44 , 47 ].

CA has also been investigated to demonstrate its role in periodontal therapy[ 48 ]. The effects of CA upon pain antinociception and inflammation in rodent models were reported[ 49 ]. The aqueous CAE revealed significant antinociceptive activity with both the models similar to aspirin but less potent than morphine and significant antiinflammatory activity comparable to mefenamic acid.

These results suggested that the aqueous CA extracts possesses antinociceptive and antiinflammatory activities which justified the traditional use of this plant in the treatment of inflammatory conditions or rheumatism[ 50 ]. Recently, antirheumatoid arthritic effect of madecassoside in type II collagen-induced arthritis CIA in mice was studied to investigate the therapeutic potential and underlying mechanisms of madecassoside on CIA[ 51 ].

Also, a histopathological examination indicated that madecassoside alleviated infiltration of inflammatory cells and synovial hyperplasia as well as provided protection against joint destruction. In vitro , madecassoside was proved to be ineffective in the activation of macrophages caused by lipopolysaccharide[ 51 ]. It was concluded in the study that madecassoside substantially prevented mouse CIA, and might be the major active constituent of CA responsible for its clinical uses in rheumatoid arthritis and that the underlying mechanisms of action may be mainly through regulating the abnormal humoral and cellular immunity as well as protecting from joint destruction[ 51 ].

Previous studies have suggested that CA could be useful in preventing radiation-induced behavioural changes during clinical radiotherapy[ 52 , 53 ].

The plant extracts were also tested for its radioprotective properties at a sublethal dose 8 Gy of Co 60 gamma radiation[ 52 ]. Body weight loss of the animals in the drug treated group was significantly less in comparison with the animals that were given radiation only[ 53 ].

A study reported the intracellular activities of an aqueous CAE against herpes simplex viruses, in vitro , containing both anti HSV-1 and antiHSV-2 activities[ 54 , 55 ]. However, no cytotoxic effects were detected against normal cell lines. The oral administration of the extracts crude or purified retarded the development of solid and ascites tumours in mice[ 56 ]. Antimycotic activity of CA was also reported[ 57 ].

The efficacy of CA in the treatment of depression, anxiety, and sleep disorders have been tested on small animals and are believed to be associated with its brahmoside and brahminoside constituents or saponin glycosides[ 58 ]. Most of the clinical studies on Asian CA have been realized with alcoholic or aqueous extracts. Both in vivo clinical studies and human monolayer cell culture experiments have concluded that asiatic acid influences collagen synthesis. The selective action of the local application of triterpenoid fraction of CAE for wound healing and emphasized the role of asiaticoside in the increased levels of antioxidants enzymatic and nonenzymatic , which were also implied for the accelerated wound healing[ 59 — 60 ].

It is now known that angiogenesis plays an important role in wound healing since the newly formed blood vessels help the hypoxic wounds to attain normoxic conditions. Asiaticoside prompted angiogenesis in both in vivo and in vitro models[ 61 ].

In cases of vascular injury, thrombosis, acute myocardial infarction, and other peripheral vascular diseases, a higher number of circulating endothelial cells was detected.

For example, in one study, patients with post phlebetic syndrome PPS showed a greater number of circulating endothelial cells compared to the normal subjects[ 62 ]. During a three-week treatment with CA triterpenic fraction CATF , PPS patients who received 90 mg CATF daily in three divided dosages showed a statistical significant decrease in circulating endothelial cells, thereby indicating the effectiveness of CA in protecting the integrity of vascular intima.

The lower number of circulating endothelial cells was attributed to the protective effect of CATF on vascular intima integrity[ 62 ].

The extract of CA was tested on 94 patients suffering from venous insufficiency of the lower limbs[ 63 ]. A statistical significant difference in favour of TECA groups was observed in the parameters checked for lower limbs and edema; also the overall evaluation was shown positive for the TECA treated groups compared to the placebo[ 63 ]. CATF proved to be effective on microcirculation and capillary permeability. After four weeks of treatment significant improvements were observed in a concentration-dependent manner in the parameters tested, such as filtration rate, ankle edema, and ankle circumference.

No significant changes were observed in placebo and control subjects treated with CATF[ 64 ]. The results also confirmed the efficacy of CATF in a dose-dependent manner[ 65 ]. The effects of the CATF on enzymes involved in mucopolysaccharide metabolism supported the hypothesis that the extract acts on basic metabolism in the connective tissues of the vascular wall[ 66 ]. The levels of basal serum uronic acid and enzymes involved in mucopolysaccharide metabolism beta-glucuronidase, beta-N-acetylglucosaminidase, and arylsulfatase were elevated in patients with varicose veins, indicating an increased muco-polysaccharide turnover.

A double-blind, placebo-controlled study was conducted to check the effects of an oral standardized CA product in two doses 30 mg bid and 60 mg bid in 87 patients with chronic venous hypertensive microangiopathy[ 67 ]. Microcirculatory parameters were shown to be improved as compared to placebo in dose dependent manner, with the higher dose improving symptoms more significantly. Another study reported the beneficial effects of an oral standardized CA product 60 mg three times a day over a 2 month period in vascular permeability and microcirculation as assessed by laser Doppler flowmetry[ 68 ].

The results showed a combined improvement of the microcirculation and capillary permeability in all patients 10 normal subjects, 22 patients with moderate, superficial venous hypertension, and 12 patients with postphlebitic limbs and severe venous hypertension.

Another study in patients with severe venous hypertension due to deep venous disease reported that a standardized CA extract was acutely effective in reducing capillary filtration and edema in individuals with venous hypertensive microangiopathy[ 69 ].

CA preparations were found helpful in decreasing the stretch marks striae gravidarum that many women develop during pregnancy[ 70 ]. A placebo-controlled study of pregnant women compared application of a cream containing a CAE, vitamin E alpha tocopherol , and collagen-elastin hydrolysates to placebo[ 70 ].

Application of the compounded cream was associated with fewer women developing stretch marks than in placebo. Application of topical CA preparations were shown to be beneficial in decreasing the scarring seen during wound healing, appearing to be related to the stimulation of maturation of the scar by the production of type I collagen and the resulting decrease in the inflammatory reaction and myofibroblast production[ 71 ].

In a randomized, double-blind, vehicle-controlled, half-side comparison study, undertaken to determine if it could also improve mild-to-moderate atopic dermatitis in adults, eighty-eight participants were randomly applied the treatment ointment and the placebo control to either the left or right side of the body for 4 weeks 2 applications per day after which erythema, edema, oozing, and excoriation were assessed[ 72 ].

No significant improvements were detected in the treatment group as compared to the control group; however, further analysis of patients living in colder climates showed a significant improvement in the treated areas.

Because the ointment consisted of the combination of herbs, it was suggested that further studies using each individual herb and studies using a parallel group design were required to be performed.

In the study, after 2 months, cognitive function as assessed by event-related potential and the computerized assessment battery test and mood using Bond-Lader visual analogue was determined. The greatest improvements in mood and cognitive function were detected in those receiving the mg dose of CA extract. A double-blind, placebo-controlled study investigated the anxiolytic activity of CA in human subjects[ 74 ]. The authors concluded that the findings suggested CA's anxiolytic activity in humans.

Very recently, a study was conducted in sixty elderly subjects in age group 65 and above, using diagnostic tools like Mini Mental State Examination scoring MMSE scoring , wherein activities of daily living and Yesavage geriatric depression scale were evaluated[ 75 ].

The mean MMSE scoring showed significant improvement after administration of CA for 6 months in elderly with mild cognitive impairment MCI at dosage of mg twice a day mg daily. A favourable improvement is observed in depression and other age related conditions like Hypertension, peripheral neuritis, insomnia, loss of appetite, constipation indicative of multiple useful clinical effects of CA especially in the age-related cognitive decline in elderly.

CA has no known toxicity in recommended doses. Side effects are rare but may include skin allergy and burning sensations with external use , headache, stomach upset, nausea, dizziness, and extreme drowsiness which tend to occur with high doses of the herb. The fresh plant may have a low potential for skin irritation. A Contact dermatitis has been reported on a few occasions using topical preparations[ 76 ].

Subcutaneous injections can trigger allergic reactions, cause pain at the injection site, or cause discoloration. Side effects occur less often when using intramuscular injections. Orally consuming an excessive amount of CA i. Also, it is postulated that chronic treatment may prevent women from becoming pregnant by causing spontaneous abortion[ 77 ].

As there is little or no information regarding the safety of this herb during breast feeding, nursing mothers are advised to refrain from taking this herb. During prolonged treatment, especially with higher doses, the metabolism of active constituents slows down and can produce toxicity, so it was suggested that this pharmacokinetic phenomena should be considered during pharmacotherapy for effective and safe treatment[ 78 ].

The use of CA for more than 6 weeks is not recommended in the literature. People taking the herb for an extended period of time up to 6 weeks should take a 2-week break before taking the herb again. The standardized CA extracts and asiaticoside were well tolerated in experimental animals especially by oral route. There have been no reports documenting negative interactions between CA and medications to date.

Since high doses of CA can cause sedation, it was warned that individuals should refrain from taking this herb with medications that promote sleep or reduce anxiety[ 80 ]. Theoretically, CA was postulated to interfere with blood glucose levels and thus also possibly interfere with the existing hypoglycaemic therapy and cholesterol lowering agents[ 81 ].

A typical daily dose of CA reported was approximately mg of dried leaves or infusion, single-dose capsules mg to mg, thrice daily , a mg concentrated extract, also available in capsules.

Other preparations include Madecassol tablets 10 mg 3 times daily, tincture 1 ml, and Emdecassol ointment twice daily[ 10 ]. The present review is indicative of multiple useful clinical effects of Centella asiatica especially in the age-related cognitive decline.

Further long-term studies will help determine the exact mechanism by which CA influences age-related changes in mood and cognitive function. J Clin Psychopharmacol. Chemical, pharmacological and clinical profile of the East Asian medical plant Centella asiatica. Dietary supplements used in the treatment of depression, anxiety, and sleep disorders. Lippincotts Prim Care Pract. Flight microangiopathy in medium- to long-distance flights: prevention of edema and microcirculation alterations with total triterpenic fraction of Centella asiatica.

DerMarderosian A, ed. Gotu Kola. Plant-derived micronutrients suppress monocyte adhesion to cultured human aortic endothelial cell layer by modulating its extracellular matrix composition. J Cardiovasc Pharmacol. A clinical study on the management of generalized anxiety disorder with Centella asiatica.

Nepal Med Coll J. Kuhn M, Winston D. Philadelphia, PA: Lippincott; Antioxidant and cytotoxic activities of Centella asiatica L Urb. Int J Mol Sci. Titrated extract of centella asiatica TECA in the treatment of venous insufficiency of the lower limbs. Asiaticoside-induced elevation of antioxidant levels in healing wounds. Phytother Res. Neuronutrient impact of Ayurvedic Rasayana therapy in brain aging. Emerging role of Centella asiatica in improving age-related neurological antioxidant status.

Exp Gerontol. A review of the microcirculation in skin in patients with chronic venous insufficiency: the problem and the evidence available for therapeutic options. An in vitro investigation of herbs traditionally used for kidney and urinary system disorders: Potential therapeutic and toxic effects. Nephrology Carlton. Medicinal Uses and Indications Treatment Venous insufficiency and varicose veins When blood vessels lose their elasticity, blood pools in the legs and fluid leaks out of the blood vessels.

Wound healing and skin lesions Gotu kola has chemicals called triterpenoids. Anxiety These same chemicals, triterpenoids, seem to reduce anxiety and increase mental function in mice. Scleroderma A single study of 13 women with scleroderma found that gotu kola decreased joint pain and skin hardening, and improved finger movement.