Andrographis

English Name: Creat , Green Chirayta, King of bitters.

Common (Indian) Name:

Hindi: Kalmegh, Kiryat, Mahatit,
Gujrati: Kiriyata, Olikiriyat
Marathi: Olen Kirayat,
Canarese: Nelabevu gida
Sanskrit: Bhuinimb, Kirata, Mahateet
Malyalam: Nilaveppu, Kiriyatta,
Telugu: Nela Vemu
Tamil: Nilavempui

Family: Acanthaceae

Distribution: Kalmegh is an annual herb found through India, specially in dense forests.It is under cultivation in many states of India.

Botany: It is an erect branched annual, 0.3-0.9 meters high, branches sharply quadrangular winged in the upper part; leave - lanceolate, acute, undulate, pale beneath; Flowers small, solitary distant, in axillary or terminal racemes or panicles, bracts lanceolate; Corolla - 2 lipped, upper lip 2-toothed, lower 2 lobed, rose coloured; Flowers - Capsule, linear - oblong, acute at both ends; Seeds many, rugosely pitted, yellowish brown. Flowering time in India is November - December.

Useful parts: Whole plant.

Medicinal Properties: According to Ayurveda the plant is bitter, acrid, cooling, laxative, vulnerary, antipyretic, antiperiodic, anti-inflammatory, expectorant, depurative, soporific, anthelmintic, digestive and useful in hyperdispsia, buring sensation, wounds, ulcers, chronic fever, malarial and intermittent fevers, inflammations, cough, bronchitis, skin diseases, leprosy, colic, flatulence, diarrhoea, dysentery, haemorrhoids etc. Kalmegh is also a reputed Homoeopathic drug. In Bengal (India), household medicine known as "Alui" is prepared from fresh leaves and is given to children suffering from stomach complaints. Recent experimental finding indicated that Kalmegh is having antityphoid and antibiotic properties. It has been proved to be hepatopratective drug.

Chemical Constituents: Kalmegh contains bitter principles andrographolide, a bicyclic diterpenoid lactone and Kalmeghin (upto 2.5%). The leaves contain the maximum active principle content while in the stem it is in lesser amount.

Cultivation: In India, it is cultivated as rainy season (Kharif) crop. Any soil having fair amount of organic matter is suitable for commercial cultivation of this crop. About 400 gms. seed are sufficient for one hectare. The spacing is maintained 30 × 15 cm. No major insect and disease infestation has been reported. The plants at flowering stage (90–120 days after sowing) is cut at the base leaving 10–15 cm stem for plant regeneration. About 50–60 days after first harvest, final harvest is performed. In Indian condition, the yield varies between 2000–2500 Kg dry herb per hectare.

Historical or traditional use (may or may not be supported by scientific studies): Andrographis has long been used in traditional Indian and Chinese herbal medicine. The most common reported uses were for digestive problems (as is the case with most non-toxic bitter herbs such as andrographis), snakebite, and infections ranging from malaria to dysentery.1 2 Interestingly, some of these uses have been validated by modern scientific research. Although the roots were sometimes used in traditional medicine, the leaves and flowers are now more commonly used.

Active constituents: The major constituents in andrographis are diterpene lactones known as andrographolides. These bitter constituents are believed to have immune-stimulating, anti-inflammatory, fertility-decreasing, liver-protective, and bile secretion-stimulating actions.3 Though some older studies suggested andrographis was antibacterial, modern research has been unable to confirm this finding.4

Several double-blind clinical trials have found that andrographis can help reduce symptom severity in people with common colds.5 6 7 8 9 Though the earliest clinical trial among these showed modest benefits, later studies have tended to be more supportive. Standardized andrographis extract combined with eleuthero (Siberian ginseng), known as Kan jang, has also been shown in a double-blind clinical trial to reduce symptoms of the common cold.10

A preliminary uncontrolled study using isolated andrographolide found that while it tended to decrease viral load and increase CD4 lymphocyte levels in people with HIV infection, at the amount used, the preparation led to side effects, including headache, fatigue, a bitter/metallic taste in the mouth, and elevated liver enzymes (which returned to normal after the medication was stopped).11 It is unknown whether the andrographolides used in this study directly killed HIV or had an immune-strengthening effect.

Andrographis has proven helpful in combination with antibiotics for people with dysentery, a severe form of diarrhea.12 It has also shown preliminary benefit for people with chronic viral hepatitis.13

How much is usually taken? Andrographis is generally available as capsules with dried herb or as standardized extracts (containing 11.2 mg andrographolides per 200 mg of extract). For dried herb, 500–3,000 mg are taken three times per day. In clinical trials, 100 mg of a standardized extract were taken two times per day to treat the common cold.14 For indigestion, andrographis may be taken as a tea. Use 1 teaspoon (5 grams) of the herb for each cup (250 ml) of hot water. Allow the mixture to stand for 10–15 minutes before drinking (sip before meals).

Are there any side effects or interactions? Some people develop intestinal upset when taking andrographis. If this occurs, reduce the amount taken or take it with meals. Headache, fatigue, a bitter/metallic taste, and elevated liver enzymes were reported in one trial with HIV-infected people taking high doses of isolated andrographolides.15 This has not been reported in people using whole andrographis or standardized extracts at the amounts recommended above. As with all bitter herbs, andrographis may aggravate ulcers and heartburn. The safety of andrographis during pregnancy and breast-feeding is unknown.

At the time of writing, there were no well-known drug interactions with andrographis.

References:

1. Nadkarni AK, Nadkarni KM. Indian Materia Medica vol 1. Bombay: Popular Prakashan, 1976, 101–3.

2. Bensky D, Gamble A, Kaptchuk T. Chinese Herbal Medicine Materia Medica Revised Edition. Seattle: Eastland Press, 1993, 95.

3. Bone K. The story of Andrographis paniculata, a new “immune system” herb. Nutrition & Healing 1998;Sept:3, 4, 8, 9 [review].

4. Leelarasamee A, Trakulsomboon S, Sittisomwong N. Undetectable anti-bacterial activity of Andrographis paniculata (Burma) Wall. ex ness. J Med Assoc Thai 1990;73:299–304.

5. Thamlikitkul V, Dechatiwongse T, Theerapong S, et al. Efficacy of Andrographis paniculata, Nees for pharyngotonsillitis in adults. J Med Assoc Thai 1991;74:437–42.

6. Melchior J, Palm S, Wikman G. Controlled clinical study of standardized Andrographis paniculata extract in common cold–a pilot trial. Phytomedicine 1996;3:314–8.

7. Hancke J, Burgos R, Caceres D, Wikman G. A double-blind study with a new monodrug Kan Jang: decrease of symptoms and improvement in recovery from common colds. Phytother Res 1995;9:559–62.

8. Cáceres DD, Hancke JL, Burgos RA, et al. Use of visual analogue scale measurements (VAS) to assess the effectiveness of standardized Andrographis paniculata extract SHA-10 in reducing the symptoms of common cold. A randomized double blind-placebo study. Phytomedicine 1999;6:217–23.

9. Caceres DD, Hancke JL, Burgos RA, et al. Use of visual analogue scale measurements (VAS) to asses the effectiveness of standardized Andrographis paniculata extract SHA-10 in reducing the symptoms of common cold. A randomized double blind-placebo study. Phytomedicine 1999;6:217–23.

10. Melchior J, Spasov AA, Ostrovskij OV, et al. Double-blind, placebo-controlled pilot and phase III study of activity of standardized Andrographis paniculata Herba Ness extract fixed combination (Kan jang) in the treatment of uncomplicated upper-respiratory tract infection. Phytomedicine 2000;7:341–50.

11. Calabrese C, Berman SH, Babish JG, et al. A phase I trail of andrographolide in HIV positive patients and normal volunteers. Phytother Res 2000;14:333–8.

12. Thanagkul B, Chaichantipayut C. Double-blind study of Andrographis paniculata Nees and tetracycline in acute diarrhea and bacillary dysentery. Ramathibodi Med J 1985;8:57–61.

13. Chaturvedi GN, Tomar GS, Tiwari SK, Singh KP. Clinical studies on kalmegh (Andrographis paniculata) in infective hepatitis. J Int Inst Ayurveda 1983;2:208–11.

14. Bone K. The story of Andrographis paniculata, a new “immune system” herb. Nutrition & Healing 1998;September:3, 4, 8, 9 [review].

15. Calabrese C, Berman SH, Babish JG, et al. A phase I trail of andrographolide in HIV positive patients and normal volunteers. Phytother Res 2000;14:333–8