Centella asiatica: benefits, dosage, contraindications
Other name(s)
Tiger herb, Asian hydrocotyle, Gotu Kola
Scientific name(s)
Centella asiatica
Family or group:
Plants
Active ingredients:
Asiatic acid
Asiaticosides
Triterpenic acids
Madecassic acid
Indications
Scoring methodology
EFSA approval.
Venous insufficiency ✪✪✪✪✪
Several randomized double-blind studies show improvements in circulation measures, such as resting peri-malleolar skin blood flow and symptoms such as edema and heaviness of the lower limbs in patients suffering from lower limb venous insufficiency or hypertensive venous microangiopathy. In another study, the oral administration of 90 mg of a triterpenic fraction of Centella per day for 3 weeks to 15 patients with chronic venous insufficiency resulted in a significant reduction in the number of circulating endothelial cells to levels found in normal subjects. Effective doses appear to be those providing at least 60 mg of total triterpenic fraction of Centella asiatica per day.
Posologie
Oral: leaf, aerial parts
60 - 180 mg
8 weeks
Adults, Seniors
dry extract
Synergies
Microcirculatory effects of total triterpenic fraction of Centella asiatica in chronic venous hypertension: measurement by laser Doppler, TcPO2-CO2, and leg volumetry.
Total triterpenic fraction of Centella asiatica in the treatment of venous hypertension: a clinical, prospective, randomized trial using a combined microcirculatory model.
Effects of the total triterpenic fraction of Centella asiatica in venous hypertensive microangiopathy: a prospective, placebo-controlled, randomized trial.
[Centella asiatica extract in venous pathology of the lower limbs and its evaluation as compared with tribenoside]
Capillary filtration and ankle edema in patients with venous hypertension treated with TTFCA.
Phlebotonics for venous insufficiency
E/S/C/O/P: 2nd Edition of the ESCOP Monographs
Chemical, pharmacological and clinical profile of the East Asian medical plant Centella asiatica
Treatment of edema and increased capillary filtration in venous hypertension with total triterpenic fraction of Centella asiatica: a clinical, prospective, placebo-controlled, randomized, dose-ranging trial.
Burns ✪✪✪✪✪
Clinical research has shown that applying a cream containing 3% Centella asiatica once a day to second-degree burns increases the rate of re-epithelialization and complete healing by about 7 days compared with 1% silver sulfadiazine cream. The Centella asiatica cream also appears to reduce dryness, itching, irritation, and to improve healing compared with silver sulfadiazine. Moreover, other research conducted in adults with second-degree burns shows that applying a gauze dressing containing 5% Centella and 2.5% aloe reduces healing time by 1.5 days and the length of hospital stay by 1.7 days compared with using a dressing containing 0.5% chlorhexidine acetate.
Posologie
Topical: leaf, aerial parts
Adults
alcoholic extract, cream
Synergies
Atherosclerosis ✪✪✪✪✪
Some preliminary research suggests that taking an extract of Centella asiatica at 60 mg orally three times a day for 12 months helps stabilize low-density atherosclerotic plaques. Stabilizing these plaques could reduce the risk of rupture and embolism. Other preliminary research suggests that taking 225 mg of Centella asiatica and 150 mg of maritime pine in two doses per day for 3 months reduces plaque height and length and increases plaque echogenicity and stability compared with control. Other research conducted in adults with atheromatous plaques and no other cardiovascular risk factors shows that daily intake of 100 mg of Centella asiatica extract and 100 mg of maritime pine for a period of up to 4 years reduces plaque progression and increases their echogenicity compared with maritime pine alone or no treatment. Taking Centella asiatica and maritime pine is also associated with a reduced rate of vascular events, including angina, myocardial infarction, minor transient ischemic attacks and minor strokes, compared with taking maritime pine alone or no treatment.
Posologie
Oral use: leaf, aerial parts
100 - 225 mg
Centellicum, standardized extract, dry extract
Synergies
Modification of the echogenicity of femoral plaques after treatment with total triterpenic fraction of Centella asiatica: a prospective, randomized, placebo-controlled trial
Increase in echogenicity of echolucent carotid plaques after treatment with total triterpenic fraction of Centella asiatica: a prospective, placebo-controlled, randomized trial
Carotid plaque stabilization induced by the supplement association Pycnogenol® and centella asiatica (Centellicum®)
Skin healing ✪✪✪✪✪
Several clinical studies have shown that taking Centella asiatica orally (60 or 90 mg/day or 150 mg/day of a triterpenic fraction of Centella) or applying it topically (gel, cream) improves post-surgical wound healing, reduces the formation of keloids (abnormal healing is characterized by hypertrophy and thickening of the skin tissue), decreases the inflammatory reaction and redness, and improves the uniformity and regularity of the scar, nnnnnn
Posologie
Topical, oral: leaf, aerial parts
60 - 450 mg
gel, Centellicum, cream, dry extract
New innovations in scar management
The Effects of a Standardized Extract of Centella asiatica on Postlaser Resurfacing Wound Healing on the Face: A Split-Face, Double-Blind, Randomized, Placebo-Controlled Trial
Chemical, pharmacological and clinical profile of the East Asian medical plant Centella asiatica
Centella asiatica (Centellicum®) facilitates the regular healing of surgical scars in subjects at high risk of keloids
A Prospective Randomized Double-blind study of silicone gel plus Herbal Extracts Versus Placebo in Pre-sternal hypertrophic scar prevention and amelioration
E/S/C/O/P: 2nd Edition of the ESCOP Monographs
Diabetic microangiopathy ✪✪✪✪✪
Taking a Centella asiatica extract at 60 mg orally twice a day for 6 to 12 months improves circulation and reduces edema in patients with diabetic microangiopathy.
Posologie
Oral: leaf, aerial parts
120 mg
standardized extract, dry extract
Evaluation of treatment of diabetic microangiopathy with total triterpenic fraction of Centella asiatica: a clinical prospective randomized trial with a microcirculatory model
Edema ✪✪✪✪✪
Preliminary clinical research shows that Centella asiatica reduces edema and improves measures of circulation in patients traveling by plane for more than 3 hours.
Posologie
Oral: leaf, aerial parts
120 mg
standardized extract, dry extract
Efficacy of Functional Foods, Beverages, and Supplements Claiming to Alleviate Air Travel Symptoms: Systematic Review and Meta-Analysis
Flight microangiopathy in medium- to long-distance flights: prevention of edema and microcirculation alterations with total triterpenic fraction of Centella asiatica
Cognitive performance ✪✪✪✪✪
The results of clinical studies as described in a meta-analysis of 11 studies revealed that there is no strong evidence to support the effect of Centella asiatica on the improvement of overall cognitive function. However, it may improve working memory. A combination of Centella asiatica with other plants may improve attention and concentration, executive function, and information processing speed. It may also improve mood disorders in terms of vigilance and reduction of reported anger.
Posologie
Oral: leaf, aerial parts
750 mg
2 months
standardized extract, dry extract
Effects of Centella asiatica (L.) Urb. on cognitive function and mood related outcomes: A Systematic Review and Meta-analysis
Mitoprotective Effects of Centella asiatica (L.) Urb.: Anti-Inflammatory and Neuroprotective Opportunities in Neurodegenerative Disease
Exploring the Role of “Brahmi” (Bacopa monnieri and Centella asiatica) in Brain Function and Therapy
Positive modulation of cognition and mood in the healthy elderly volunteer following the administration of Centella asiatica
Indian Medicinal Herbs and Formulations for Alzheimer's Disease, from Traditional Knowledge to Scientific Assessment
Wrinkles ✪✪✪✪✪
In a meta-analysis, studies suggest that C. asiatica or its pentacyclic triterpenoids reduce periorbital wrinkles. Moreover, C. asiatica may be more effective than Pueraria mirifica but possibly less than tretinoin (the acidic form of vitamin A). C. asiatica increased skin hydration, which may explain the anti-wrinkle action, whereas tretinoin did not have this effect.
Posologie
Topical: leaf, aerial parts
12 - weeks
gel, cream
Anxiety ✪✪✪✪✪
In a double-blind, placebo-controlled study conducted in healthy volunteers, the anxiolytic effect of Centella was evaluated by measuring the acoustic startle response (ASR). The ASR model is based on the universal startle reaction to unexpected stimuli (for example, loud acoustic signals).nnSubjects were randomly assigned to receive a single oral dose of 12 g of powdered herb mixed with 300 ml of grape juice with 1 mg of celery salt or a placebo (grape juice and celery salt only). Compared with placebo, Centella significantly attenuated the maximal amplitude of the ASR 30 minutes and 60 minutes after treatment. No significant effects were observed on mood, heart rate, or blood pressure.nnAnother 8-week open-label study used a hydroethanolic extract of Centella asiatica leaves (500 mg twice daily) in 33 adults with generalized anxiety disorder. The results showed that Centella asiatica reduced anxiety by 26% at the end of the study, in addition to reductions in stress and depression.nnAlthough the results are encouraging, the use of a nonvalidated rating scale and inadequate reporting limit confidence in the findings.nn
Posologie
Oral: leaf, aerial parts
1000 - 12000 mg
standardized extract, dry extract
Emotional balance ✪✪✪✪✪
Centella asiatica has been used for centuries in traditional Ayurvedic and Chinese medicine to treat a range of conditions, including anxiety, and to provide relaxation that facilitates meditation. Research conducted on rats has associated the triterpenes of Centella asiatica with increased brain levels of serotonin, norepinephrine and dopamine, as well as reduced serum levels of corticosterone.
Posologie
Oral: leaf, aerial parts
1000 - 12000 mg
standardized extract, dry extract
Properties
Wound healing
When skin cells are exposed to Centella asiatica extracts, they appear to show increased type I collagen synthesis and enhanced fibroblast proliferation (cells that secrete the extracellular matrix and allow the skin to be supple and elastic). There is also evidence that asiaticosides may promote wound healing by stimulating the synthesis of collagen and glycosaminoglycans. In addition, asiaticoside and other terpenoids may improve wound healing and scar formation through anti-inflammatory activity. Preliminary research shows that asiaticosides increase antioxidant levels in the wound during the proliferative phase of healing, which may prevent oxidative damage during healing.
Usages associés
Venotonic
Triterpenoid saponins (for example, asiaticoside, madecassoside) appear to promote wound healing and reduce venous pressure in venous insufficiency. The terpenoid extract seems to improve remodeling of connective tissue by increasing fibroblast activity, stimulating collagen synthesis, increasing epithelial turnover, and decreasing capillary permeability. The terpenoid extract may help stabilize arterial plaques by increasing collagen within plaques. Plaques with low collagen content are structurally weak and are associated with an increased risk of rupture and embolism.
Usages associés
Microcirculatory effect
The effects of Centella asiatica on alterations of microcirculation and edema were evaluated in passengers who traveled by plane for more than 3 hours and who suffered from mild to moderate superficial venous disease and varicose veins. The results showed that subjects who received a total triterpenic fraction of Centella had less ankle swelling compared with the control group.
Usages associés
Neurological
Animal research evidence shows that Centella asiatica extract may protect the brain from oxidative damage and excitotoxicity induced by the glutamate. This suggests that it could be beneficial for certain neurodegenerative conditions whose pathogenesis is related to glutamate. Some researchers believe that derivatives of asiaticoside, asiatic acid, asiaticoside 6, and SM2 may play a role in Alzheimer's disease. Preliminary evidence indicates that they may protect neurons from beta-amyloid toxicity. In vitro evidence suggests that Centella asiatica may bind to cholecystokinin (CCK) and GABA receptors, which may be responsible for the reported anxiolytic effects. Effects on GABA could also lead to sedative, anticonvulsant, and analgesic effects. Centella asiatica has been used for thousands of years to stimulate memory. Centella extract has been shown to increase the availability of acetylcholine (ACh) in the brain, likely by preventing its breakdown.
Usages associés
Antimicrobial
Centella Asiatica extracts appear to have in vitro antibacterial activity against Pseudomonas pyocyaneus, Trichoderma mentagrophytes, and Entamoeba histolytica. It also appears to have antiviral activity against herpes simplex type II.
Gastroprotective
There is preliminary evidence that asiaticosides may have preventive and therapeutic effects on gastrointestinal ulcers. The anti-ulcer mechanisms may be due to an increase in mucin secretion and the suppression of the harmful effects of free radicals. In addition, asiaticoside and other terpenoids present in Centella asiatica may improve the healing of gastric ulcers through anti-inflammatory activity. Furthermore, some preliminary research shows that Centella asiatica reduces gastric ulcers induced by physiological stress by increasing the levels of GABA.
Cognitive function
Dendrites and axons can change over time and in response to environmental signals. Learning something new, for example, leads to dendrite elongation. But this natural signaling mechanism in the brain's neurons degrades over time. Several studies have shown how Centella asiatica can reverse this degradation. An in vivo study in rats, conducted by scientists at Oregon Health & Science University in Portland, Oregon, showed that administration of ethanolic Centella in the drinking water led to rapid axon development, suggesting that Centella asiatica is useful for accelerating the repair of damaged neurons. Another study showed that rats given Centella asiatica leaf extract had a 105% increase in dendrite growth. It is well established that dendrites are essential for memory formation.
Usages associés
Calcium transient prevalence across the dendritic arbor predicts place field properties
Enhancement of hippocampal CA3 neuronal dendritic arborization by Centella asiatica (Linn) fresh leaf extract treatment in adult rats
Safe dosage
Adults 18 years and older: 600 mg - 2400 mg
The dose used is 0.6 g of the dried plant as an infusion, tincture or extract, up to four times a day. All studies show that extracts expressed as the total triterpenoid fraction of Centella asiatica improved the parameters studied. The doses used were between 60 and 180 mg/day of this fraction, generally divided into two or three. External use: At least 1% of Centella asiatica extracts.
Children 3 years and older: 100 mg - 300 mg
The adult dose adjusted to the child's weight.
Interactions
Médicaments
HEPATOTOXIC: moderate interaction
There is concern that Centella may cause hepatotoxicity in some patients. Theoretically, concomitant use with other potentially hepatotoxic medications could increase the risk of developing liver damage. Some of these medications include acarbose, amiodarone, atorvastatin, azathioprine, carbamazepine, cerivastatin, diclofenac, felbamate, fenofibrate, fluvastatin, gemfibrozil, isoniazid, itraconazole, ketoconazole, leflunomide, lovastatin, methotrexate, nevirapine, niacin, nitrofurantoin, pioglitazone, pravastatin, pyrazinamide, rifampin, ritonavir, rosiglitazone, simvastatin, tacrine, tamoxifen, terbinafine, valproic acid, and zileuton.
Precautions
Liver disorders: avoid
Centella may be associated with cases of hepatotoxicity. Theoretically, centella could exacerbate liver problems in patients already suffering from liver disease such as hepatitis. It has been hypothesized that the terpenic active constituents of Centella may produce liver injury by promoting apoptosis and altering cell membranes. The presence of autoantibodies and granulomas also supports an immune-mediated mechanism. Advise these patients to avoid taking Centella asiatica.
Surgical intervention: avoid
Centella has depressant effects on the CNS. Theoretically, it could cause additive CNS depression when combined with anesthesia and other medications during and after surgical procedures. Advise patients to stop taking Centella asiatica at least 2 weeks before a surgical procedure.
Breastfeeding: avoid
There is not enough reliable information available on the safety of Centella when taken orally during pregnancy or breastfeeding; avoid using it. Topical use, however, is permitted.
Contraindications
Pregnancy: contraindicated
There is not enough reliable information available on the safety of Centella when taken orally during pregnancy.
