Gotu Kola

Plant Part Used

Leaf/whole plant.

Active Constituents

Terpenoid saponins (asiaticosides, triterpenes, brahmoside, brahminoside); flavonoids; asiatic acid.(1),(24)

[span class=alert]This section is a list of chemical entities identified in this dietary supplement to possess pharmacological activity. This list does not imply that other, yet unidentified, constituents do not influence the pharmacological activity of this dietary supplement nor does it imply that any one constituent possesses greater influence on the overall pharmacological effect of this dietary supplement.[/span]

Introduction

Gotu kola is a tropical plant native to India and Indonesia, and has traditionally been used to promote wound healing, increase energy and enhance cognitive function. It is reported to have a positive effect on tissues, specifically skin, connective tissue, lymph, and mucous membranes.(2),(3),(4) Gotu kola does not contain any caffeine and is not related in any way to kola nut. Research has promoted gotu kola primarily for venous insufficiency, soft tissue inflammation and infection, and for wound healing.(5),(6),(7)

Dosage Info

Dosage Range

50-200mg (standardized extract) 2-3 times daily.

Most Common Dosage

50mg (standardized extract), 2 times a day.

Standardization

[span class=doc]Standardization represents the complete body of information and controls that serve to enhance the batch to batch consistency of a botanical product, including but not limited to the presence of a marker compound at a defined level or within a defined range.[/span]

The most current available medical and scientific literature indicates that this dietary supplement should be standardized to 10-40% asiaticosides, 29-30% asiatic acid, 29-30% madecassic acid, and 1-2% madecassoside.

Uses

Frequently Reported Uses

  • Phlebitis
  • Pressure Sores
  • Scleroderma
  • Sores
  • Cellulitis
  • Keloids
  • Lesions
  • Cuts
  • Varicosities

Other Reported Uses

  • Memory/cognitive support
  • Sedative

Toxicities & Precautions

General

No known toxicity.

Side Effects

Topical application may, on rare occasion, cause dermatitis. (8)

Pregnancy/ Breast Feeding

Based on pharmacology, do not use in pregnancy due to emmenogogue and abortifacient effects.

If nursing, consult a physician before use.

Age Limitations

Do not use in children under 2 years of age unless recommended by a physician.

Pharmacology

Wound Healing

As stated above, gotu kola extracts have been used traditionally for wound healing, and research has been increasingly supportive for these claims.(1) A laboratory animal study reported that various formulations (ointment, cream, and gel) of an aqueous extract of gotu kola applied to open wounds in rats (applied topically 3 times daily for 24 days)with the result of increased cellular proliferation and collagen synthesis at the wound site, as shown by an increase in collagen content and tensile strength.(9) The authors found that the gotu kola treated wounds epithelialized faster and the rate of wound contraction was higher when compared to the control wounds. Healing was more prominent with the gel product. It is believed to have an effect on keratinization, which aids in thickening skin in areas of infection.(10)

Asiaticoside, a constituent in gotu kola, has been reported to possess wound healing activity by increasing collagen formation and angiogenesis.(11),(25) In one laboratory animal study, the effects of asiaticoside on antioxidant levels was examined, as antioxidants have been reported to play a role in the wound healing process.(12) The authors concluded that asiaticosides may enhance induction of antioxidants at an initial stage of wound healing, but continued application of the preparation seem not to increase the antioxidant levels in wound healing.

Gotu kola preparations may also be helpful in decreasing the stretch marks (striae gravidarum) that many women develop during pregnancy. A placebo-controlled study of 100 pregnant women compared application of a cream containing a gotu kola extract, vitamin E (alpha tocopherol), and collagen-elastin hydrolysates to placebo.(13) Application of the compounded cream was associated with less women developing stretch marks than in placebo.

Application of preparations of gotu kola topically may also be beneficial in decreasing the scarring seen during wound healing, appearing to be related to the stimulation of maturation of the scar by the production of type I collagen and the resulting decrease in the inflammatory reaction and myofibroblast production.(14)

Venous Insufficiency

One of gotu kola’s primary effects appears to be on connective tissues by strengthening weakened veins.(15) Gotu kola may assist in the maintenance of connective tissue. In the treatment of scleroderma, gotu kola may also assist in stabilizing connective tissue growth, reducing its formation.(4) It reportedly stimulates the formation of hyaluronidase and chondroitin sulfate, as well as exerting a balancing effect on the connective tissue.(16)

Gotu kola has been reported to act on the connective tissues of the vascular wall, being effective in hypertensive microangiopathy and venous insufficiency and decreasing capillary filtration rate by improving microcirculatory parameters.(17) A double-blind, placebo-controlled study of the effects of an oral standardized gotu kola product in 87 patients with chronic venous hypertensive microangiopathy was conducted.(6) The gotu kola product was given for 60 days (30 mg twice daily and 60 mg twice) versus placebo. Microcirculatory parameters were improved as compared to placebo and seemed to be dose dependent, with the higher dose improving symptoms more significantly.

Another study reported the beneficial effects of an oral standardized gotu kola product (60mg three times a day) in vascular permeability and microcirculation as assessed by laser Doppler flowmetry.(18) The results showed a combined improvement of the microcirculation and capillary permeability in all patients (10 normal subjects, 22 patients with moderate, superficial venous hypertension, and 12 patients with postphlebitic limbs and severe venous hypertension). Another study in patients with severe venous hypertension due to deep venous disease reported that a standardized gotu kola product was acutely effective in reducing capillary filtration and edema in individuals with venous hypertensive microangiopathy.(19)

Memory/Cognitive Function

Several laboratory studies have found that gotu kola extracts help decrease cognitive impairment in rat models of Alzheimer’s disease (AD) and stimulating property on neuronal dendrites of hippocampal region. The mechanism of neuroprotection includes enhancement of the phosphorylation of cyclic AMP response element binding protein (CREB) and inhibition of ERK/RSK signaling pathway.(26) A small randomized, placebo-controlled, double-blind study in healthy volunteers found that gotu kola extract can improve age-related cognitive decline and positively affect mood.(27)

Sedation

Gotu kola has been traditionally used as a sedative agent in many Eastern cultures, with the effects contributed mainly to the brahmoside and brahminoside constituents.(20) A double-blind, placebo-controlled study investigated the anxiolytic activity of gotu kola in human subjects.(21) The authors concluded that these findings suggest that gotu kola has anxiolytic activity in humans and the anxiolytic activity may in part be due to binding to cholecystokinin receptors and cholinergic enhancement.

Other Uses

Of interest is that in vitro use of a gotu kola aqueous extract reported intracellular activities against herpes simplex viruses, containing both anti-HSV-1 and –2 activities.(22)

A laboratory study of a gotu kola extract was reported effective in inhibiting gastric lesions induced by ethanol administration.(23) The authors concluded that the gotu kola extract presumably strengthened the gastric mucosal barrier and reduced the damaging effects of free radicals.

References

  1. View Abstract: Brinkhaus B, Lindner M, Schuppan D, et al. Chemical, Pharmacological and Clinical Profile of the East Asian Medical Plant Centella asiatica. Phytomedicine. Oct2000;7(5):427-48.
  2. View Abstract: Suguna L, et al. Effects of Centella asiatica Extract on Dermal Wound Healing in Rats. Indian J Exp Biol. 1996;34(12):1208-11.
  3. View Abstract: Hausen BM. Centella asiatica (Indian Pennywort), an Effective Therapeutic But a Weak Sensitizer. Contact Dermatitis. 1993;29(4):175-79.
  4. View Abstract: Tenni R, et al. Effect of the Triterpenoid Fraction of Centella asiatica on Macromolecules of the Connective Matrix in Human Skin Fibroblast Cultures. Ital J Biochem. 1988;37(2):69-77.
  5. View Abstract: Maquart FX, et al. Stimulation of Collagen Synthesis in Fibroblast Cultures by a Triterpene Extracted from Centella asiatica. Connect Tissue Res. 1990;24(2):107-20.
  6. View Abstract: Cesarone MR, et al. The Microcirculatory Activity of Centella asiatica in Venous Insufficiency. A Double-blind Study. Minerva Cardioangiol. 1994;42(6):299-304.
  7. View Abstract: Shukla A, Rasik AM, Jain GK, Shankar R, et al. In Vitro and In Vivo Wound Healing Activity of Asiaticoside Isolated from Centella asiatica. J Ethnopharmacol. Apr1999;65(1):1-11.
  8. Danese P, et al. Allergic Contact Dermatitis Due to Centella asiatica Extract. Contact Dermatitis. 1994;31(3):201.
  9. View Abstract: Sunilkumar, Parameshwarajah S, Shivakumar HG. Evaluation of Topical Formulations of Aqueous Extract of Centella asiatica on Open Wounds in Rats. Indian J Exp Biol. Jun1998;36(6):569-72.
  10. View Abstract: Poizot A, et al. Modification of the Kinetics of Healing after Iterative Exeresis in the Rat. Action of a Triterpenoid and Its Derivatives on the Duration of Healing. C R Acad Sci Hebd Seances Acad Sci D. 1978;286(10):789-92.
  11. Rosen H, Blumenthal A, McCallum J. Effect of Asiaticoside on Wound Healing in the Rat. Proc Soc Exp Biol Med. May1967;125(1):279-80.
  12. View Abstract: Shukla A, Rasik AM, Dhawan BN. Asiaticoside-induced Elevation of Antioxidant Levels in Healing Wounds. Phytother Res. Feb1999;13(1):50-4.
  13. View Abstract: Young GL, Jewell D. Creams for Preventing Stretch Marks in Pregnancy. Cochrane Database Syst Rev. 2000;(2):CD000066.
  14. View Abstract: Widgerow AD, Chait LA, Stals R, et al. New Innovations in Scar Management. Aesthetic Plast Surg. May2000;24(3):227-34.
  15. Allegra C. Comparative Capillaroscopic Study of Certain Bioflavonoids and Total Triterpenic Fractions of Centella asiatica in Venous Insufficiency. Clin Ter. 1981;99:507-13.
  16. View Abstract: Darnis F, et al. Use of a Titrated Extract of Centella asiatica in Chronic Hepatic Disorders. Sem Hop. 1979;55(37-38):1749-50.
  17. View Abstract: Cesarone MR, Laurora G, De Sanctis MT, et al. Activity of Centella asiatica in Venous Insufficiency. Minerva Cardioangiol. Apr1992;40(4):137-43.
  18. View Abstract: Belcaro GV, Grimaldi R, Guidi G. Improvement of Capillary Permeability in Patients with Venous Hypertension after Treatment with TTFCA. Angiology. Jul1990;41(7):533-40.
  19. View Abstract: De Sanctis MT, Incandela L, Cesarone MR, et al. Acute Effects of TTFCA on Capillary Filtration in Severe Venous Hypertension. Panminerva Med. Jun1994;36(2):87-90.
  20. Ramaswamy AS, et al. Pharmacological Studies on Centella asiatica. Linn. J Res Indian Med. 1970;4:160-75.
  21. View Abstract: 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. Dec2000;20(6):680-4.
  22. View Abstract: Yoosook C, Bunyapraphatsara N, Boonyakiat Y, et al. Anti-herpes Simplex Virus Activities of Crude Water Extracts of Thai Medicinal Plants. Phytomedicine. Jan2000;6(6):411-9.
  23. View Abstract: Cheng CL, Koo MW. Effects of Centella asiatica on Ethanol Induced Gastric Mucosal Lesions in Rats.Life Sci. Oct2000;67(21):2647-53.
  24. Yu QL, Duan HQ, Takaishi Y, Gao WY. A novel triterpene from Centella asiatica.Molecules. 4 Sep 2006;11(9):661-665.
  25. Kimura Y, Sumiyoshi M, Samukawa K, Satake N, Sakanaka M. Facilitating action of asiaticoside at low doses on burn wound repair and its mechanism. Eur J Pharmacol. 28 Apr 2008;584(2-3):415-423. Epub 21 Feb 2008.
  26. Xu Y, Cao Z, Khan I, Luo Y. Gotu Kola (Centella asiatica) extract enhances phosphorylation of cyclic AMP response element binding protein in neuroblastoma cells expressing amyloid beta peptide. J Alzheimers Dis. Apr 2008;13(3):341-349.
  27. 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. 5 Mar 2008;116(2):325-332. Epub 4 Dec 2007.