How It Works
Bottom Line: Gotu kola has not been shown to treat or prevent cancer.
Gotu kola is a plant extract that contains many biologically active compounds. Although this botanical has been studied extensively in the laboratory, very few studies have been conducted in humans. Laboratory studies have found a range of effects including improved wound healing and anti-inflammatory effects. Studies in humans have suggested that gotu kola can decrease venous pressure in people with venous insufficiency and may be able to relieve anxiety.
Purported Uses
To treat burns
Laboratory data suggest that gotu kola aids in wound healing, but human data is lacking.
To lower high blood pressure
No scientific evidence supports this use. Several clinical trials show that gotu kola can reduce venous hypertension in patients with chronic venous insufficiency, but there is no evidence that this herb can treat typical (arterial) high blood pressure.
To treat psoriasis
Laboratory experiments suggest that gotu kola can reduce inflammation, but there is no proof from clinical trials that it can treat psoriasis.
For sedation
One preliminary study in humans found that gotu kola can decrease people's "startle response."
To treat chronic venous insufficiency
Several clinical trials support this use.
Research Evidence
Anxiety:
A group of researchers looked into the ability of gotu kola to reduce anxiety. They did this by measuring something called the acoustic startle response (ASR) in 40 volunteers. Half of the volunteers were randomly given a single 12 gram dose of gotu kola, and 20 were given a placebo pill, and their ASR was measured 30 and 60 minutes later. Volunteers who took gotu kola had a smaller ASR (meaning they were less easily startled than people in the placebo group). However, volunteers who took gotu kola did not report having a less anxious mood, so it is still unclear whether this botanical will be effective in reducing anxiety.
Chronic venous insufficiency:
In a randomized, controlled trial, 94 patients with venous insufficiency were assigned to take either (1) 120 mg/day of gotu kola, (2) 60 mg/day of gotu kola, or (3) a placebo pill. After two months, people who were taking gotu kola, regardless of the dose, had an improvement in the symptoms of heaviness and edema (swelling) in their legs compared to people taking the placebo pill. In addition, people taking gotu kola had better venous tone than people taking the placebo.
Warnings
Gotu kola should not be confused with kolanut. Gotu kola does not contain any caffeine and has not been shown to have stimulant properties.
Depending on where gotu kola is grown, the content of active compounds in this herb can vary widely. Products should have standardized content of the following compounds: asiaticoside, asiatic acid, madecassic acid, and madecassoside.
This product is regulated by the F.D.A. as a dietary supplement. Unlike approved drugs, supplements are not required to be manufactured under specific standardized conditions. This product may not contain the labeled amount or may be contaminated. In addition, it may not have been tested for safety or effectiveness.
Do Not Take If
Side Effects
Contact dermatitis
Pruritus (itching)
Sensitivity to light
Headache
Reduced fertility may occur in women wishing to become pregnant.
Scientific Name
Centella asiatica, Hydrocotyle asiatica
Common Name
Indian pennywort, hydrocotyle, mandukaparni, madecassol, TECA, centelase, tsubo-kusa, luei gong gen, idrocotyle, kaki kuda
Clinical Summary
Extracts from the leaf and the entire plant of gotu kola are used for a variety of conditions including venous insufficiency, varicose veins, wound healing, scleroderma, and scars. In vivo analysis indicates that madecassoside, an active constituent of gotu kola, may have protective effects against arthritis
(5) and myocardial infarction
(4).
Topical application of asiaticoside extracted from gotu kola enhanced burn wound healing
(6). Gotu kola may improve cognitive function and mood in the elderly
(7). In addition, several studies demonstrate a reduction in lower extremity edema with gotu kola as compared to placebo for patients with chronic venous insufficiency
(1) (2) (3).
Possible adverse effects include headache, contact dermatitis, and pruritus.
Purported uses
Burns
Cancer treatment
Circulatory disorders
GI disorders
Hypertension
Memory loss
Psoriasis
Scars
Sedation
Varicose veins
Constituents
Amino Acids: Alanine and serine (major components)
Terpenoids: Triterpenes, asiaticoside, brahmoside and brahminoside (saponin glycosides), aglycones, asiaticentoic acid, centellic acid, centoic acid and madecassic acid
Sesquiterpenes: Caryophyllene, trans-B-farnesene
Volatile Oils: Germacrene D
Alkaloid: Hydrocotylin
Flavones: Quercetin, kaempferol, sesquiterpenes, stigmasterol, and sitosterol
Other Constituents: Vallerine, fatty acids, resin, and tannins
(8)
Mechanism of Action
The triterpenoids are considered to be the active constituents in gotu kola. The glycoside madecassoside has anti-inflammatory properties. Asiaticoside, a constituent of gotu kola, appears to promote wound healing by stimulating collagen and glycosaminoglycan synthesis as well as angiogenesis (6). It also elevates blood glucose and cholesterol levels. There is preliminary evidence that gotu kola might have sedative and analgesic properties (9).
Warnings
Gotu kola should not be confused with kolanut. Gotu kola does not contain any caffeine and has not been shown to have stimulant properties.
There are wide variations in terpenoid concentrations depending on the location in which gotu kola is grown. Products should be standardized as to asiaticoside, asiatic acid, madecassic acid, and madecassoside content.
Adverse Reactions
Reported: Contact dermatitis, pruritus, photosensitization, and headache; reduced fertility may occur in women wishing to become pregnant.
Toxicity: Hyperglycemia, hyperlipidemia, and sedation have occurred following consumption of higher doses.
Herb-Drug Interactions
Anti-hyperlipidemics: Theoretically gotu kola may interfere with cholesterol lowering agents.
Literature Summary and Critique
References
- Cesarone MR, et al. Effects of the total triterpenic fraction of Centella asiatica in venous hypertensive microangiopathy: a prospective, placebo-controlled, randomized trial. Angiology 2001;52(Suppl 2):S15-18.
- Cesarone MR, et al. Evaluation of treatment of diabetic microangiopathy with total triterpenic fraction of Centella asiatica: a clinical prospective randomized trial with a microcirculatory model. Angiology 2001;52(Suppl 2):S49-54.
- Pointel JP, et al. Titrated extract of Centella asiatica (TECA) in the treatment of venous insufficiency of the lower limbs. Angiology 1987;38:46-50.
- Bian GX, Li GG, Yang Y, et al. Madecassoside reduces ischemia-reperfusion injury on regional ischemia induced heart infarction in rat.Biol Pharm Bull. Mar 2008;31(3):458-463.
- Liu M, Dai Y, Yao X, et al. Anti-rheumatoid arthritic effect of madecassoside on type II collagen-induced arthritis in mice. Int Immunopharmacol. Nov 2008;8(11):1561-1566.
- Kimura Y, Sumiyoshi M, Samukawa K, et al. Facilitating action of asiaticoside at low doses on burn wound repair and its mechanism. Eur J Pharmacol. Apr 28 2008;584(2-3):415-423.
- Wattanathorn J, Mator L, Muchimapura S, et al. Positive modulation of cognition and mood in the healthy elderly volunteer following the administration of Centella asiatica. J Ethnopharmacol. Mar 5 2008;116(2):325-332.
- Newall CA, et al. Herbal Medicines: A Guide for Health-Care Professionals. London: The Pharmaceutical Press; 1996.
- DerMarderosian A, editor. The Review of Natural Products. St. Louis: Facts and Comparisons; 1999.
- Bradwein J, et al. A double-blind, placebo-controlled study on the effects of gotu kola (Centella asiatica) on acoustic startle response in healthy subjects. J Clin Psychopharmacol 2000;20:680-4.
- Klovekorn W, Tepe A, Danesch U. A randomized, double-blind, vehicle-controlled, half-side comparison with a herbal ointment containing Mahonia aquifolium, Viola tricolor and Centella asiatica for the treatment of mild-to-moderate atopic dermatitis. Int J Clin Pharmacol Ther. Nov 2007;45(11):583-591.
