Centella Asiatica or gotu kola

Centella Asiatica (Gotu Kola)

  • Vitamins & Supplements
  • Updated September 25, 2018

Centella asiatica is an herbal medicine used in Ayurvedic and traditional Chinese medicine that is commonly used as a cognitive enhancer. Some clinical studies suggest modest benefits in a few cognitive functions, but a large meta-analysis failed to show significant improvements. Centella asiatica contains bioactive compounds that provided numerous benefits for brain health in laboratory studies, but these haven't been confirmed in humans. Centella asiatica is considered to be safe with mild side effects, although a few cases of liver toxicity have been reported.

Evidence

Centella asiatica has been tested in numerous clinical trials, though all of the studies were small. Our search identified:

  • 1 meta-analysis (of 11 trials testing Centella asiatica alone or a combination of supplements including Centella asiatica)
  • 1 clinical trial (in patients with vascular cognitive impairment)
  • Numerous preclinical studies

Potential Benefit

Small clinical trials have shown potential benefit for a few cognitive functions with Centella asiatica treatment [1]; however, a meta-analysis of 11 randomized controlled trials testing its effects reported no significant differences between treatment and placebo on any cognitive functions [2]. In an exploratory clinical study of patients with post-stroke vascular cognitive impairment, treatment with Centella asiatica extract did not improve overall cognitive functions compared to that observed with folic acid treatment [3]. However, delayed recall memory was significantly improved in patients treated with Centella asiatica compared to folic acid. No differences were seen in other cognitive functions, including executive function, naming, attention, language, abstraction, or orientation.

In preclinical models of Alzheimer's disease, extracts of Centella asiatica decreased beta-amyloid levels and oxidative stress [4], prevented the shrinkage of neuronal processes [5], and protected against beta-amyloid-associated toxicity and behavioral abnormalities [6]. In models of cognitive decline, Centella asiatica treatment significantly improved memory performance, decreased markers of cell death, increased antioxidant defense, and reversed mitochondrial deficits [5][7][8]. There are many components to Centella asiatica, of which Asiatic acid has been the most studied in preclinical models. Asiatic acid does cross the blood-brain-barrier? and produces antioxidant and neuroprotective effects [9], though these findings have not been confirmed in humans.

For Dementia Patients

No studies have reported whether Centella asiatica can improve cognitive function or slow decline in people with dementia. In preclinical models of Alzheimer's disease, extracts of Centella asiatica lowered behavioral deficits, reduced biological markers of Alzheimer's disease, protected against toxicity from beta-amyloid, reduced oxidative stress, and prevented the shrinkage of neuronal processes [4][5][6][9].

Safety

In a meta-analysis of 11 randomized controlled trials testing the effects of Centella asiatica on cognitive function, no adverse effects were reported in any studies testing it alone [2]. In combination therapies, side effects were comparable to or lower than those for placebo and included gastrointestinal discomfort, flatulence, nausea, headache, decreased appetite, sedation, and rash. Other studies have reported constipation, abdominal bloating, and itchiness [3].

There has been a report of three women who developed jaundice and hepatitis after taking Centella asiatica for 20-60 days [10]. They improved after discontinuation and treatment with a bile acid. It is unclear whether the liver toxicity is associated with a specific brand, preparation, or dose. People with liver disease should not take Centella asiatica.

Drug interactions are not well-documented, though theoretically, Centella asiatica may interact with antiepileptic drugs (e.g., phenytoin, valproate, and gabapentin) [11].

NOTE: This is not a comprehensive safety evaluation or complete list of potentially harmful drug interactions. It is important to discuss safety issues with your physician before taking any new supplement or medication.

How to Use

Centella asiatica is an herbal medicine used in Ayurvedic and traditional Chinese medicine. It is also known as gotu kola, Asiatic pennywort, Indian pennywort, jal brahmi, mandookaparni, and tsubokusa. Gotu kola is available over-the-counter as whole herbs, powder, capsules, or liquid extracts. Dose ranges noted in Drugs.com are 30-90 mg/day for extracts and 1.5-4.0 g/day for the crude form, but much higher doses have been used in clinical studies [3]. A review on Centella asiatica noted that the extraction method, biochemical profile, and dosage information of the extract are not standardized [12], and therefore potencies and qualities may vary across preparations.

Learn More

Information on dosing, side effects, and drug interactions with Centella asiatica (Gotu kola) from Drugs.com

Check for drug-drug and drug-supplement interactions on Drugs.com

References

  1. Wattanathorn J, Mator L, Muchimapura S et al. (2008) Positive modulation of cognition and mood in the healthy elderly volunteer following the administration of Centella asiatica. J Ethnopharmacol 116, 325-332.
  2. Puttarak P, Dilokthornsakul P, Saokaew S et al. (2017) Effects of Centella asiatica (L.) Urb. on cognitive function and mood related outcomes: A Systematic Review and Meta-analysis. Sci Rep 7, 10646.
  3. Farhana KM, Malueka RG, Wibowo S et al. (2016) Effectiveness of Gotu Kola Extract 750 mg and 1000 mg Compared with Folic Acid 3 mg in Improving Vascular Cognitive Impairment after Stroke. Evid Based Complement Alternat Med 2016, 2795915.
  4. Dhanasekaran M, Holcomb LA, Hitt AR et al. (2009) Centella asiatica extract selectively decreases amyloid beta levels in hippocampus of Alzheimer's disease animal model. Phytother Res 23, 14-19.
  5. Gray NE, Zweig JA, Murchison C et al. (2017) Centella asiatica attenuates Abeta-induced neurodegenerative spine loss and dendritic simplification. Neurosci Lett 646, 24-29.
  6. Soumyanath A, Zhong YP, Henson E et al. (2012) Centella asiatica Extract Improves Behavioral Deficits in a Mouse Model of Alzheimer's Disease: Investigation of a Possible Mechanism of Action. Int J Alzheimers Dis 2012, 381974.
  7. Prakash A, Kumar A (2013) Mitoprotective effect of Centella asiatica against aluminum-induced neurotoxicity in rats: possible relevance to its anti-oxidant and anti-apoptosis mechanism. Neurol Sci 34, 1403-1409.
  8. Veerendra Kumar MH, Gupta YK (2003) Effect of Centella asiatica on cognition and oxidative stress in an intracerebroventricular streptozotocin model of Alzheimer's disease in rats. Clin Exp Pharmacol Physiol 30, 336-342.
  9. Ahmad Rather M, Justin Thenmozhi A, Manivasagam T et al. (2018) Asiatic acid nullified aluminium toxicity in in vitro model of Alzheimer's disease. Front Biosci (Elite Ed) 10, 287-299.
  10. Jorge OA, Jorge AD (2005) Hepatotoxicity associated with the ingestion of Centella asiatica. Rev Esp Enferm Dig 97, 115-124.
  11. Gotu kola. Drugs.com.
  12. Lokanathan Y, Omar N, Ahmad Puzi NN et al. (2016) Recent Updates in Neuroprotective and Neuroregenerative Potential of Centella asiatica. Malays J Med Sci 23, 4-14.