Andrographis is commonly found in herbal immune formulas. Australia’s TGA allows such supplements to claim, ‘support healthy immune system function’, and  ‘relieve symptoms of common colds and flu’. And many of these product names refer to defending, shielding or protecting the immune system.

Is this reputation justified? Yes! Andrographis has a long history of supporting immune function via traditional medicine systems throughout Asia.[1][2] Additionally, many research groups have concluded positive results against respiratory infections, including influenza and COVID-19.[3][4][5][6][7]

But is there more to this herb than just immune support? Can it positively affect other human body systems and health conditions? And how can we safely utilise this ancient medicinal herb? Let’s find out!

Figure 1. Andrographis paniculata

A variety of traditional uses

Gut health: While Andrographis is known by at least 35 different names in a variety of languages[8], it is also known by the moniker ‘King of Bitters’, due to its strong elemental taste. Bitter herbs stimulate bitter receptors throughout the digestive tract and trigger enhanced digestion via increased output of digestive enzymes. This helps the gut digest food more efficiently, enabling better absorption of nutrients.

Furthermore, recent research has confirmed protective effects of Andrographis on the gut. Studies have shown that andrographolide, one of the herbs main chemical constituents, alleviates damage leading to stomach ulcers caused by alcohol and pharmaceuticals.[9][10][11]

Andrographolide has also shown similar benefits in ulcerative colitis (UC), dramatically reducing disease activity.[12][13][14][15] In addition, another trial compared Andrographis to the UC medication mesalazine for 8 weeks. Results indicated comparable symptom reduction, however mucosal healing was achieved in 53% of the Andrographis patients vs 40% in the mesalazine group..[16]

Anti-inflammatory activity: Several constituents, including andrographolide, suppress the release of inflammatory cytokines stimulated by influenza virus.[17] They inhibit multiple pathways all of which play a critical role in the initiation of lung inflammation.[18][19]

Human cell studies have concluded that Andrographis inhibits allergic mediators.[20]

                   Table 1. Medicinal uses of Andrographis paniculata[21][22][23][24][25][26]

And a clinical trial performed on rheumatoid arthritis patients utilising Andrographis revealed that the herb effectively reduced inflammatory markers and relieved symptoms, and that the treatment boasted a good safety profile.[27]

Antioxidant: Andrographis has shown potent antioxidant properties in many research models.[28] Andrographolide blocks free radicals and supports expression of Nrf2, a master-regulator protein that protects against oxidative damage.[29][30][31] Andrographolide supported Nrf2 expression and led to reduced oxidative stress in human liver cells.[32]

Additionally, andrographolide has also demonstrated strong antioxidant effects in cardiovascular[33] and respiratory[34][35] diseases, as well as in arthritis.[36]

 

Safe use of Andrographis

As with all medicines, herbal and pharmaceutical, Andrographis should be used with care. A 2020 systematic review found that although serious adverse events were very rare, non-serious events was common.[37] The authors concluded that prospective users should consult their health practitioners prior to using Andrographis.

Recommended safety guidelines to be aware of:

• Andrographis is not recommended for children, pregnant or lactating women
• If you have an autoimmune condition speak to your health practitioner prior to use
• If you take pharmaceutical medications seek your health practitioner’s advice on whether Andrographis is safe to take alongside your medications
• Ensure you read the warnings on products before purchase
• If you have allergies or have experienced one or more anaphylactic reactions, speak to your health practitioner before use

If you’re curious about trying Andrographis, speak to your doctor, pharmacist or natural medicine practitioner before taking this herb. Professional guidance and informed decision-making are the best course of action when it comes to your health.

Ancient wisdom meets modern science

Finally, if Andrographis does become part of your health regime, appreciate a medicinal herb that’s been cultivated and utilised by ancient healers for centuries. The king of bitters already commands a significant place amongst the thousands of traditional medicines… now modern researchers are starting to realise this and tap into its many potential benefits.

[1] Hossain MS, Urbi Z, Sule A, Rahman KH. Andrographis paniculata (Burm. f.) Wall. ex Nees: a review of ethnobotany, phytochemistry, and pharmacology. The Scientific World Journal. 2014;2014(1):274905.

[2] Okhuarobo A, Falodun JE, Erharuyi O, Imieje V, Falodun A, Langer P. Harnessing the medicinal properties of Andrographis paniculata for diseases and beyond: a review of its phytochemistry and pharmacology. Asian Pacific journal of tropical disease. 2014 Jun 1;4(3):213-22.

[3] Saxena RC, Singh R, Kumar P, Yadav SC, Negi MP, Saxena VS, Joshua AJ, Vijayabalaji V, Goudar KS, Venkateshwarlu K, Amit A. A randomized double-blind placebo controlled clinical evaluation of extract of Andrographis paniculata (KalmCold) in patients with uncomplicated upper respiratory tract infection. Phytomedicine. 2010 Mar;17(3-4):178-85. doi: 10.1016/j.phymed.2009.12.001. Epub 2010 Jan 25. PMID: 20092985.

[4] Hu X-Y, Wu R-H, Logue M, Blondel C, Lai LYW, Stuart B, et al. (2017) Andrographis paniculata (Chuān Xīn Lian) for symptomatic relief of acute respiratory tract infections in adults and children: A systematic review and meta-analysis. PLoS ONE 12(8): e0181780. https://doi.org/10.1371/journal.pone.0181780

[5] Canessa C. Andrographis paniculata (Burm. f.)(Nees) and Infection A Critical Review to assess the efficacy of Andrographis paniculata (Burm. f.)(Nees) in the prevention and treatment of infections.

[6] Shanker K, Rangnekar H, Wele A, Soni P, Gaikwad P, Pal A, Bawankule DU, Chanda D. A randomized controlled pilot study of add-on therapy of CIM-MEG19 (standardized Andrographis paniculata formulation) in mild to moderate COVID-19. Phytomedicine Plus. 2023 Feb 1;3(1):100398.

[7] Benjaponpitak A, Sawaengtham T, Thaneerat T, Wanaratna K, Chotsiri P, Rungsawang C, Bhubhanil S, Charoensuk S, Benjaponpitak S, Lapmanee S, Sirinavin S. Effect of Andrographis paniculata treatment for patients with early-stage COVID-19 on the prevention of pneumonia: A retrospective cohort study. medRxiv. 2023 Mar 18:2023-03.

[8] Hossain MS, Urbi Z, Sule A, Rahman KH. Andrographis paniculata (Burm. f.) Wall. ex Nees: a review of ethnobotany, phytochemistry, and pharmacology. The Scientific World Journal. 2014;2014(1):274905.

[9] Saranya P, Geetha A, Selvamathy SN. A biochemical study on the gastroprotective effect of andrographolide in rats induced with gastric ulcer. Indian journal of pharmaceutical sciences. 2011 Sep;73(5):550.

[10] Yao H, Wu Z, Xu Y, Xu H, Lou G, Jiang Q, Fan W, Liu W, Zheng C, Gao Y, Wang Y. Andrographolide attenuates imbalance of gastric vascular homeostasis induced by ethanol through glycolysis pathway. Scientific Reports. 2019 Mar 21;9(1):4968.

[11] Liu YH, Zhang ZB, Zheng YF, Chen HM, Yu XT, Chen XY, Zhang X, Xie JH, Su ZQ, Feng XX, Zeng HF. Gastroprotective effect of andrographolide sodium bisulfite against indomethacin-induced gastric ulceration in rats. International immunopharmacology. 2015 Jun 1;26(2):384-91.

[12] Zhang L, Cao N, Wang Y, Wang Y, Wu C, Cheng X, Wang C. Improvement of oxazolone-induced ulcerative colitis in rats using andrographolide. Molecules. 2019 Dec 24;25(1):76.

[13] Jing M, Wang Y, Xu L. Andrographolide Derivative AL‐1 Ameliorates Dextran Sodium Sulfate‐Induced Murine Colitis by Inhibiting NF‐κB and MAPK Signaling Pathways. Oxidative Medicine and Cellular Longevity. 2019;2019(1):6138723.

[14] Yang Y, Yan H, Jing M, Zhang Z, Zhang G, Sun Y, Shan L, Yu P, Wang Y, Xu L. Andrographolide derivative AL-1 ameliorates TNBS-induced colitis in mice: involvement of NF-кB and PPAR-γ signaling pathways. Scientific Reports. 2016 Jul 20;6(1):29716.

[15] Kim N, Lertnimitphun P, Jiang Y, Tan H, Zhou H, Lu Y, Xu H. Andrographolide inhibits inflammatory responses in LPS-stimulated macrophages and murine acute colitis through activating AMPK. Biochemical Pharmacology. 2019 Dec 1;170:113646.

[16] Tang T, Targan SR, Li ZS, Xu C, Byers VS, Sandborn WJ. Randomised clinical trial: herbal extract HMPL‐004 in active ulcerative colitis–a double‐blind comparison with sustained release mesalazine. Alimentary pharmacology & therapeutics. 2011 Jan;33(2):194-202.

[17] Verweij MC, Wellish M, Whitmer T, Malouli D, Lapel M, Jonjić S, Haas JG, DeFilippis VR, Mahalingam R, Früh K. Varicella viruses inhibit interferon-stimulated JAK-STAT signaling through multiple mechanisms. PLoS pathogens. 2015 May 14;11(5):e1004901.

[18] Cai W, Chen S, Li Y, Zhang A, Zhou H, Chen H, Jin M. 14-Deoxy-11, 12-didehydroandrographolide attenuates excessive inflammatory responses and protects mice lethally challenged with highly pathogenic A (H5N1) influenza viruses. Antiviral research. 2016 Sep 1;133:95-105.

[19] Ding Y, Chen L, Wu W, Yang J, Yang Z, Liu S. Andrographolide inhibits influenza A virus-induced inflammation in a murine model through NF-κB and JAK-STAT signaling pathway. Microbes and infection. 2017 Dec 1;19(12):605-15.

[20] Chandrasekaran CV, Gupta A, Agarwal A. Effect of an extract of Andrographis paniculata leaves on inflammatory and allergic mediators in vitro. Journal of ethnopharmacology. 2010 May 27;129(2):203-7.

[21] Chopra RN. Glossary of Indian Medicinal Plants.

[22] Jarukamjorn K, Kondo S, Chatuphonprasert W, Sakuma T, Kawasaki Y, Nemoto N. Gender-associated modulation of inducible CYP1A1 expression by andrographolide in mouse liver. European Journal of Pharmaceutical Sciences. 2010 Mar 18;39(5):394-401.

[23] Saxena S, Jain DC, Bhakuni RS, Sharma RP. Chemistry and pharmacology of Andrographis species. Indian drugs. 1998;35(8):458-67.

[24] Perry LM, Metzger J. Medicinal plants of East and Southeast Asia: attributed properties and uses. 1980.

[25] Panossian A, Davtyan T, Gukassyan N, Gukasova G, Mamikonyan G, Gabrielian E, Wikman G. Effect of andrographolide and Kan Jang–fixed combination of extract SHA-10 and extract SHE-3–on proliferation of human lymphocytes, production of cytokines and immune activation markers in the whole blood cells culture. Phytomedicine. 2002 Jan 1;9(7):598-605.

[26] Poolsup N, Suthisisang C, Prathanturarug S, Asawamekin A, Chanchareon U. Andrographis paniculata in the symptomatic treatment of uncomplicated upper respiratory tract infection: systematic review of randomized controlled trials. Journal of Clinical Pharmacy and Therapeutics. 2004 Feb;29(1):37-45.

[27] Burgos RA, Hancke JL, Bertoglio JC, Aguirre V, Arriagada S, Calvo M, Cáceres DD. Efficacy of an Andrographis paniculata composition for the relief of rheumatoid arthritis symptoms: a prospective randomized placebo-controlled trial. Clinical rheumatology. 2009 Aug;28:931-46.

[28] Mussard E, Cesaro A, Lespessailles E, Legrain B, Berteina-Raboin S, Toumi H. Andrographolide, a natural antioxidant: An update. Antioxidants. 2019 Nov 20;8(12):571.

[29] Liang E, Liu X, Du Z, Yang R, Zhao Y. Andrographolide Ameliorates Diabetic Cardiomyopathy in Mice by Blockage of Oxidative Damage and NF‐κB‐Mediated Inflammation. Oxidative Medicine and Cellular Longevity. 2018;2018(1):9086747.

[30] Vomund S, Schäfer A, Parnham MJ, Brüne B, Von Knethen A. Nrf2, the master regulator of anti-oxidative responses. International journal of molecular sciences. 2017 Dec 20;18(12):2772.

[31] Ngo V, Duennwald ML. Nrf2 and oxidative stress: A general overview of mechanisms and implications in human disease. Antioxidants. 2022 Nov 27;11(12):2345.

[32] Khole S, Mittal S, Jagadish N, Ghosh D, Gadgil V, Sinkar V, Ghaskadbi S. Andrographolide enhances redox status of liver cells by regulating microRNA expression. Free Radical Biology and Medicine. 2019 Jan 1;130:397-407.

[33] Wu T, Peng Y, Yan S, Li N, Chen Y, Lan T. Andrographolide ameliorates atherosclerosis by suppressing pro-inflammation and ROS generation-mediated foam cell formation. Inflammation. 2018 Oct;41:1681-9.

[34] Peng S, Gao J, Liu W, Jiang C, Yang X, Sun Y, Guo W, Xu Q. Andrographolide ameliorates OVA-induced lung injury in mice by suppressing ROS-mediated NF-κB signaling and NLRP3 inflammasome activation. Oncotarget. 2016 Dec 12;7(49):80262.

[35] Yin JN, Li YN, Gao Y, Li SB, Li JD. Andrographolide plays an important role in bleomycin-induced pulmonary fibrosis treatment. International Journal of Clinical and Experimental Medicine. 2015;8(8):12374.

[36] Luo S, Li H, Liu J, Xie X, Wan Z, Wang Y, Zhao Z, Wu X, Li X, Yang M, Li X. Andrographolide ameliorates oxidative stress, inflammation and histological outcome in complete Freund’s adjuvant-induced arthritis. Chemico-biological interactions. 2020 Mar 1;319:108984.

[37] Worakunphanich W, Thavorncharoensap M, Youngkong S, Thadanipon K, Thakkinstian A. Safety of Andrographis paniculata: A systematic review and meta‐analysis. Pharmacoepidemiology and Drug Safety. 2021 Jun;30(6):727-39.