Gotu Kola

  • Gotu kola is a creeping plant native to subtropical and tropical climates. Gotu kola has a long history of use in Ayurvedic medicine (the traditional medicine of India) to promote wound healing and slow the progress of leprosy. It was also reputed to prolong life, increase energy, and enhance sexual potency. 1 Other uses of gotu kola included treating skin diseases, anxiety, diarrhea, menstrual disorders, vaginal discharge, and venereal disease.
    Based on these many traditional indications, gotu kola was accepted as a drug in France in the 1880s. British physicians in Africa used a special extract to treat leprosy.
  • What Is Gotu Kola Used for Today?

    The best-documented use of gotu kola is to treat chronic venous insufficiency , a condition closely related to varicose veins. In these conditions, blood pools in the legs, causing aching, pain, heaviness, swelling, fatigue, and unsightly visible veins. Preliminary double-blind, placebo-controlled studies indicate that gotu kola extract provides improvement in major venous insufficiency symptoms, reducing swelling, pain, fatigue, sensation of heaviness, and fluid leakage from the veins. 4-8 However, no studies have evaluated whether regular use of gotu kola can make visible varicose veins disappear, or prevent new ones from developing.
    Gotu kola has also been suggested as a treatment for hemorrhoids because they are a type of varicose vein, but there is no direct evidence that it is helpful for this purpose.
    Like other herbs used for the treatment of varicose veins, gotu kola is thought to work by strengthening connective tissues. This has led to trials of gotu kola extracts for preventing or treating keloid scars , and treating anal fissures, bladder ulcers, burns , cellulite, dermatitis, liver cirrhosis , periodontal disease , scleroderma , and wounds . 9,10,11,17 However, again, there is no real evidence as yet that gotu kola is effective for any of these conditions.
    One study provides weak evidence that gotu kola might be helpful for anxiety . 2
    Gotu kola has a reputation for improving memory, and the positive results from a study in rats performed in 1992 produced a temporary rush of public interest in gotu kola as a " brain booster ". 3 However, benefits in humans have not been demonstrated.
    Gotu kola should not be confused with the caffeine-containing kola nut , used in original recipes for Coca-Cola.
  • What Is the Scientific Evidence for Gotu Kola?

    Venous Insufficiency/Varicose Veins
    There is significant, but not definitive, scientific evidence for the effectiveness of gotu kola for the treatment of varicose veins/venous insufficiency4-8 .
    For example, a 2-month double-blind, placebo-controlled study of 94 people with venous insufficiency of the lower limb compared the benefits of gotu kola extract at 120 mg daily and 60 mg daily against a placebo. 7 The results showed a significant dose-related improvement in the treated groups in symptoms such as subjective heaviness, discomfort, and edema.
    Another 2-month study of double-blind design enrolled 90 people with varicose veins and compared the benefits of gotu kola at 60 mg and 30 mg daily against placebo. 6 Again, the results showed improvements in both treated groups, but greater improvement at the higher dose.
    In one study of people with venous insufficiency, 2 weeks of treatment with gotu kola extracts was shown to reduce the time necessary for the swelling to disappear. 4
    Another study of double-blind design followed 87 people with varicose veins and compared the benefits of gotu kola at 60 mg and 30 mg daily against placebo. 6 Again, the results showed improvements in both treated groups, but greater improvement at the higher dose.
    Anxiety
    Gotu kola has been used in traditional Ayurvedic medicine to treat anxiety . Because evidence suggests that easy startling is related to anxiety, researchers have attempted to test this use by measuring the acoustic startle response. 12 In this double-blind, placebo-controlled trial, 40 study participants were given either gotu kola or placebo and then subjected to sudden loud noises. Researchers measured eye blinks and found a significantly reduced startle response in those treated with gotu kola. This suggests, but doesn't prove, that gotu kola may be helpful for anxiety.
  • Dosage

    The usual dosage of gotu kola is 20 to 60 mg 3 times daily of an extract standardized to contain 40% asiaticoside, 29% to 30% asiatic acid, 29% to 30% madecassic acid, and 1% to 2% madecassoside. When using it for venous insufficiency, give gotu kola at least 4 weeks to work.
    For the prevention of keloid scars (a purpose for which gotu kola has not been proven effective), the herb is typically taken for 3 months prior to surgery, and for another 3 months afterwards.
  • Safety Issues

    When taken orally, gotu kola seldom causes any side effects other than the occasional allergic skin rash, and safety studies suggest that it is essentially non-toxic. 13 . However, one animal study hints that gotu kola might have carcinogenic effects if applied topically to the skin. 14
    Although gotu kola has not been proven safe for pregnant or nursing women, studies in rabbits suggest that it does not harm fetal development, 15 and Italian physicians have given it to pregnant women. 16 Safety in young children and those with severe liver or kidney disease has not been established.
  • References

    1 Kartnig T. Clinical applications of Centella asiatica (L.) . Herbs Spices Med Plants . 1988;3:145-173.

    2 Bradwejn J, Zhou Y, Koszycki D, 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;20:680-684.

    3 Nalini K, Aroor AR, Karanth KS, et al. Effect of Centella asiatica fresh leaf aqueous extract on learning and memory and biogenic amine turnover in albino rats. Fitoterapia . 1992;63:232-237.

    4 Belcaro GV, Grimaldi R, Guidi G. Improvement of capillary permeability in patients with venous hypertension after treatment with TTFCA. Angiology. 1990;41: 533-540.

    5 Belcaro GV, Rulo A, Grimaldi R. Capillary filtration and ankle edema in patients with venous hypertension treated with TTFCA. Angiology. 1990;41:12-18.

    6 Cesarone MR, Laurora G, De Sactis MT, et al. The microcirculatory activity of Centella asiatica in venous insufficiency. A double-blind study [translated from Italian]. Minerva Cardioangiol . 1994;42:299-304.

    7 Pointel JP, Boccalon H, Cloarec M, et al. Titrated extract of Centella asiatica (TECA) in the treatment of venous insufficiency of the lower limbs. Angiology . 1987;38:46-50.

    8 Cesarone MR, Laurora G, De Sanctis MT, et al. Activity of Centella asiatica in venous insufficiency [in Italian; English abstract]. Minerva Cardioangiol . 1992;40:137-143.

    9 Kartnig T. Clinical applications of Centella asiatica (L.) . Herbs Spices Med Plants . 1988;3:145-173.

    10 Bosse JP, Papillon J, Frenette G, et al. Clinical study of a new antikeloid agent. Ann Plast Surg. 1979;3:13-21.

    11 Shukla A, Rasik AM, Jain GK, et al. In vitro and in vivo wound healing activity of asiaticoside isolated from Centella asiatica.J Ethnopharmacol. 1999;65:1-11.

    12 Bradwejn J, Zhou Y, Koszycki D, 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;20:680-684.

    13 Kartnig T. Clinical applications of Centella asiatica (L.) . Herbs Spices Med Plants . 1988;3:145-173.

    14 Laerum OD, Iversen OH. Reticuloses and epidermal tumors in hairless mice after topical skin applications of cantharidin and asiaticoside. Cancer Res . 1972;32:1463-1469.

    15 Bosse JP, Papillon J, Frenette G, et al. Clinical study of a new antikeloid agent. Ann Plast Surg. 1979;3:13-21.

    16 Basellini A, Agus GB, Antonucci E, et al. Varices in pregnancy (an up-date) [translated from Italian]. Ann Obstet Ginecol Med Perinat . 1985;106:337-341.

    17 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. 2007;45:583-591.

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