Centella asiatica · herb
Evidence tier: weak
A connective tissue and circulatory tonic, supports veins, wound healing, and gentle cognitive clarity. Used in both Ayurveda and TCM for thousands of years.
Triterpene saponins, principally asiaticoside and madecassoside, are proposed to stimulate collagen synthesis and support the integrity of the vascular endothelium and connective tissue. That is the standard laboratory account and it maps onto the two uses with any support at all, wound healing and venous tone. The additional GABA A mediated anxiolytic mechanism the seed asserts is a laboratory finding, not a demonstrated clinical effect, and should not be stated as fact.
Weak on efficacy and carrying a real liver signal, which is the opposite of how the seed presents it. Start with safety, because it is the fact that changes decisions: NIH LiverTox assigns Centella asiatica a likelihood score C, meaning a PROBABLE rare cause of clinically apparent liver injury. LiverTox describes cases of acute liver injury with jaundice, hepatocellular in pattern, arising 3 to 8 weeks after starting and resolving over 1 to 2 months after stopping; the mechanism is unknown and presumed idiosyncratic, possibly immune mediated. The injury is usually self limited and mild to moderate, which is the honest mitigation, but a score C is a signal, not a clearance, and it sits in the same band as valerian. On efficacy, the best supported use is venous insufficiency and it is modest. The systematic review by Chong and Aziz (2013) pooled the randomised trials and found improvement in microcirculatory measures such as transcutaneous gas pressures, ankle swelling rate and venoarteriolar response, alongside reports of improved leg heaviness, pain and oedema. But it also found that MOST of the studies were characterised by inadequate reporting and therefore unclear risk of bias, which the authors say may threaten the validity of the conclusions, and that three of the eight studies produced no quantitative data at all. That is a modest, poorly reported literature, not a clinical endorsement. Wound healing and skin repair is the use Europe's regulator actually recognises, on a traditional basis. Cognition and memory, the use the seed claims regulatory backing for, is not supported and not recognised.
60 to 180 mg of standardised extract daily, or 1 to 2 g of dried herb as tea. Given LiverTox score C and the reported 3 to 8 week latency to injury, prolonged continuous high dose use is the pattern to avoid; cycling off and stopping at any sign of jaundice, dark urine or right upper quadrant pain is the sensible guidance.
60 to 180 mg standardised extract daily, or 1 to 2 g dried herb as tea. Allow 4 to 8 weeks for skin and circulation effects.
Generally well tolerated. Rare hepatotoxicity reported with prolonged high dose use; cycle off after 6 to 8 weeks.
Pregnancy: avoid
Breastfeeding: avoid
Active compounds: asiaticoside, madecassoside, asiatic acid, madecassic acid
Remedies using Gotu Kola · Browse by body system · Check it against what you take
*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.