Overview:

Gotu kola (Centella asiatica) has been used as a medicinal herb for thousands of years in India, China, and Indonesia. It was used to heal wounds, improve mental clarity, and treat skin conditions such as leprosy and psoriasis. Some people use it to treat respiratory infections such as colds, and it has a history of use for that purpose in China. It has been called "the fountain of life" because legend has it that an ancient Chinese herbalist lived for more than 200 years as a result of using the herb.

Historically, gotu kola has also been used to treat syphilis, hepatitis, stomach ulcers, mental fatigue, epilepsy, diarrhea, fever, and asthma. Today, American and European herbalists use gotu kola most often to treat chronic venous insufficiency (a condition where blood pools in the legs). It's also used in ointments to treat psoriasis and help heal minor wounds.

Gotu kola should not be confused with kola nut (Cola nitida). Unlike kola nut, gotu kola has no caffeine, and is not a stimulant.

Plant Description:

Gotu kola is a perennial plant native to India, Japan, China, Indonesia, South Africa, Sri Lanka, and the South Pacific. A member of the parsley family, it is tasteless and odorless. It thrives in and around water. It has small fan-shaped green leaves with white or light purple-to-pink flowers, and it bears small oval fruit. The leaves and stems of the gotu kola plant are used for medicinal purposes.

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. That causes the legs to swell (venous insufficiency). Several small studies suggest gotu kola may help reduce swelling and improve circulation. In a study of 94 people with venous insufficiency, those who took gotu kola had a significant improvement in symptoms compared to those who took placebo. In another study of people with varicose veins, ultrasound tests showed improvements in the vascular tone (meaning there was less leakage) of those who took gotu kola.

Wound healing and skin lesions

Gotu kola contains chemicals called triterpenoids. In animal and lab studies, these compounds appear to help heal wounds. For example, some studies indicate that triterpenoids strengthen the skin, boost antioxidants in wounds, and increase blood supply to the area. Based on these findings, gotu kola has been used topically (applied to the skin) for minor burns, psoriasis, prevention of scar formation following surgery, and prevention or reduction of stretch marks.

You can find gotu kola in many topical preparations for wound healing. Ask your health care provider.

Anxiety

Triterpenoids (the compounds found in gotu kola) seem to decrease anxiety and increase mental function in mice. One human study found that people who took gotu kola were less likely to be startled by a new noise than those who took placebo. Since the "startle noise" response can be an indicator of anxiety, researchers theorize that gotu kola might help reduce anxiety symptoms. But the dose used in this study was very high, so it's impossible to say how gotu kola might be used to treat anxiety.

Scleroderma

A single study of 13 women with scleroderma found that gotu kola decreased joint pain and skin hardening, and improved finger movement.

Insomnia

Gotu kola acts as a sedative when given to animals in tests. Because of that effect, it is sometimes suggested to help people with insomnia. But no human studies have been done to see whether it works and whether it's safe.

Dosage and Administration:

Gotu kola is available in teas and as dried herbs, tinctures, capsules, tablets, and ointments. Products should be stored in a cool, dry place and used before the expiration date on the label.

Pediatric

Gotu kola is not recommended for those under 18 years old.

Adult

The adult dosage of gotu kola varies depending on the condition being treated. Your health care provider can help you choose the right dose for you.

The standard dose of gotu kola (Centella asiatica) varies depending on the preparation. Most studies have used standardized extracts:

• Dried herb -- you can make a tea of the dried leaf, three times daily.
• Powdered herb (available in capsules) -- 1,000 - 4,000 mg, three times a day
• Tincture (1:2 w/v, 30 % alcohol) 30 - 60 drops (equivalent to 1.5 - 3 mL -- there are 5 mL in a teaspoon), three times daily.
• Standardized extract -- 50 - 250 mg, two to three times daily. Standardized extracts should contain 40 % asiaticoside, 29 - 30 % asiatic acid, 29 - 30 % madecassic acid, and 1 - 2 % madecassoside. Doses used in studies mentioned in the Treatment section range from 20 mg (for scleroderma) up to 180 mg (in one study for venous insufficiency, although most of the studies for this condition were conducted using 90 - 120 mg daily).

Precautions:

Gotu kola has been used in some studies that lasted up to one year. However, in some people gotu kola may affect the liver. It's best not to use gotu kola for more than 6 weeks without talking to your doctor. You may need to take a 2-week break before taking the herb again.

Asiaticoside, a major component of gotu kola, has also been associated with tumor growth in mice. Anyone with a history of precancerous or cancerous skin lesions -- such as squamous cell, basal cell skin cancer, or melanoma -- should not use gotu kola.

People with liver disease, or who take medications that affect the liver, should not take gotu kola.

Side Effects

Side effects are rare but may include skin allergy and burning sensations (with external use), headache, stomach upset, nausea, dizziness, and extreme drowsiness. These side effects tend to occur with high doses of gotu kola.

Women

Women who are pregnant or trying to become pregnant should not use gotu kola, because animal studies have shown a reduction in fertility after taking gotu kola. Researchers don't know whether gotu kola is safe to take when you are breast-feeding, so nursing mothers should avoid it.

Pediatric Use

Gotu kola is not recommended for children.

Geriatric Use

People older than 65 should take gotu kola at a lower than standard dose. Your health care provider can help you determine the right dose for you, which can be increased slowly over time.

Interactions and Depletions:

Gotu kola may interact with the following medications:

Cholesterol-lowering drugs (including statins) -- In animal studies, gotu kola increased cholesterol levels. It may also raise cholesterol levels in humans, although no studies have been done.

Diabetes medications -- In animal studies, gotu kola seems to increase blood sugar levels. People with diabetes should not take gotu kola without first talking to their doctor.

Diuretics (water pills) -- Gotu kola appears to have diuretic effects, meaning it helps rid the body of excess fluid. Taking diuretic medications and gotu kola could cause your body to lose too much fluid, upsetting the balance of electrolytes you need. The same is true of taking gotu kola with herbs that have diuretic effects, such as green tea, astragalus, or gingko.

Sedatives -- Because of gotu kola's sedative effects, it might increase the effect of other medications taken to relieve anxiety or insomnia. It might also increase the effects of herbs taken for anxiety or insomnia, such as valerian.

Alternative Names:

Brahmi; Centella; Centella asiatica; Hydrocotyle; Indian pennywort; Luei gong gen; Marsh pennywort