Centella asiatica: benefits, dosage, contraindications
Other name(s)
Tiger Grass, Asian Hydrocotyle, Gotu Kola
Scientific name(s)
Centella asiatica
Family or group:
Plants
Active ingredients:
Asiatic acid
Asiaticosides
Triterpenic acids
Madecassic acid
Indications
Rating methodology
EFSA approval.
Venous insufficiency ✪✪✪✪✪
Several double-blind randomized studies show improvements in circulation measures, such as perimalleolar skin flow at rest, and symptoms such as edema and leg heaviness 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 led to a significant reduction in circulating endothelial cell counts, reaching levels found in normal subjects. Effective doses seem 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 on second-degree burns increases the rate of re-epithelialization and complete healing by about 7 days compared to 1% silver sulfadiazine cream. Centella Asiatica cream also appears to reduce dryness, itching, irritation, and improve healing compared to silver sulfadiazine. Furthermore, other research conducted in adults with second-degree burns shows that applying a gauze dressing containing 5% centella and 2.5% aloe reduces the healing time by 1.5 days and the length of hospitalization by 1.7 days compared to using a 0.5% chlorhexidine acetate dressing.
Posologie
Topical: leaf, aerial parts
Adults
alcoholic extract, cream
Synergies
Atherosclerosis ✪✪✪✪✪
Some preliminary research shows that taking a centella asiatica extract 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. Further preliminary research shows that taking 225 mg of centella asiatica and 150 mg of maritime pine in two doses per day for 3 months reduces the height and length of plaques and increases plaque echogenicity and stability compared to control. Other research conducted in adults with atheromatous plaques and no other cardiovascular risk factors shows that taking 100 mg of centella asiatica extract and 100 mg of maritime pine daily for up to 4 years reduces plaque progression and increases echogenicity compared to maritime pine alone or no treatment. Taking centella asiatica and maritime pine is also associated with a reduced rate of vascular events, including myocardial infarction, minor transient ischemic attacks, and minor strokes, compared to maritime pine alone or no treatment.
Posologie
Oral: 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 centella triterpenic fraction) or through topical application (gel, cream) improves post-surgical healing, reduces keloid formation (an abnormal healing characterized by skin tissue hypertrophy and thickening), decreases inflammatory reactions and redness, and enhances the homogeneity and smoothness of the scar.
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 circulation measures 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 ✪✪✪✪✪
Study results as described in a meta-analysis of 11 studies revealed there is no strong evidence to support the effect of centella asiatica on improving 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 alertness and reduce 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 peri-orbital wrinkles. Additionally, C. asiatica might be more effective than Pueraria Mirifica but perhaps less than tretinoin (an acid form of vitamin A). C. asiatica increased skin hydration, which might explain the anti-wrinkle effect, whereas tretinoin did not have this action.
Posologie
Topical: leaf, aerial parts
12 - weeks
gel, cream
Anxiety ✪✪✪✪✪
In a double-blind, placebo-controlled study conducted on 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 (e.g., loud acoustic signals). Subjects 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 to the placebo, Centella significantly attenuated the maximum amplitude of the ASR 30 minutes and 60 minutes after treatment. No significant effect was observed on mood, heart rate, or blood pressure. Another open-label 8-week study used the hydroethanolic extract of Centella Asiatica leaves (500 mg twice daily) in 33 adults with generalized anxiety disorders. Results showed that Centella Asiatica reduced anxiety by 26% at the end of the study, along with a reduction in stress and depression. Although the results are encouraging, the use of an unvalidated rating scale and inadequate reporting limit confidence in the results.
Posologie
Orally: 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 ailments, including anxiety, and to provide relaxation that aids meditation. Research conducted on rats has linked Centella Asiatica's triterpenes to increased brain levels of serotonin, norepinephrine, and dopamine, as well as reduced serum corticosterone levels.
Posologie
Orally: leaf, aerial parts
1000 - 12000 mg
standardized extract, dry extract
Properties
Healing
When skin cells are exposed to Centella Asiatica extracts, they appear to have an increased synthesis of type I collagen and promote fibroblast proliferation (cells that secrete the extracellular matrix and allow for flexible and elastic skin). There is also evidence that asiaticosides might promote wound healing by stimulating collagen and glycosaminoglycan synthesis. Moreover, asiaticoside and other terpenoids might improve 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 (e.g., asiaticoside, madecassoside) seem to promote wound healing and decrease venous pressure in venous insufficiency. The terpenoid extract appears to improve connective tissue remodeling by increasing fibroblast activity, stimulating collagen synthesis, increasing epithelial renewal, and decreasing capillary permeability. The terpenoid extract might contribute to stabilizing arterial plaques by increasing collagen within the plaques. Low-collagen plaques are structurally weak and are associated with an increased risk of rupture and embolism.
Usages associés
Microcirculatory effect
The effects of Centella Asiatica on impaired microcirculation and edema have been evaluated in passengers traveling by airplane for more than 3 hours, suffering from mild to moderate superficial venous disease and varicose veins. The results showed that subjects receiving a total triterpenic fraction of Centella exhibited less ankle edema compared to the control group.
Usages associés
Neurological
Evidence from animal research indicates that Centella Asiatica extract can protect the brain from oxidative damage and glutamate-induced excitotoxicity. This suggests it could be beneficial for certain neurodegenerative conditions related to glutamate. Some researchers think that derivatives of asiaticoside, asiatic acid, asiaticoside 6, and SM2 could play a role in Alzheimer's disease. Preliminary evidence suggests they might protect neurons from beta-amyloid toxicity. In vitro evidence suggests that Centella Asiatica might bind to cholecystokinin (CCK) receptors and GABA receptors, which might be responsible for 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 enhance memory. Extracts of Centella have 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 seems to have antiviral activity against Herpes Simplex type II.
Gastroprotective
Preliminary evidence suggests that asiaticosides might have preventive and therapeutic effects on gastrointestinal ulcers. The anti-ulcer mechanisms may be due to increased mucin secretion and suppression of the harmful effects of free radicals. Furthermore, asiaticoside and other terpenoids present in Centella Asiatica could improve gastric ulcer healing through anti-inflammatory activity. Additionally, some preliminary research shows that Centella Asiatica reduces stress-induced gastric ulcers by raising GABA levels.
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 brain neurons degrades over time. Several studies have shown how Centella Asiatica can reverse this degradation. An in vivo study on rats conducted by scientists from Oregon Health & Science University in Portland (Oregon) showed that administering ethanolic Centella in drinking water resulted in rapid axonal 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 arbour predicts place field properties
Enhancement of hippocampal CA3 neuronal dendritic arborization by Centella asiatica (Linn) fresh leaf extract treatment in adult rats
Safety dosage
Adult from 18 years: 600 mg - 2400 mg
The dose used is 0.6 g of the dried plant in the form of an infusion, tincture, or extract, up to four times a day. All studies show that extracts expressed in the total triterpenic 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.
Child from 3 years: 100 mg - 300 mg
The adult dose adjusted for the child's weight.
Interactions
Médicaments
HEPATOTOXIC : moderate interaction
There is concern that Centella may cause hepatotoxicity in some patients. Theoretically, concurrent use with other potentially hepatotoxic drugs could increase the risk of developing liver damage. Some of these drugs 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 can be linked to cases of hepatotoxicity. Theoretically, Centella could exacerbate liver problems in patients already suffering from liver disease such as hepatitis. It has been hypothesized that Centella's terpenic active principles can produce liver injuries by promoting apoptosis and altering cell membranes. The presence of autoantibodies and granulomas also promotes 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 interventions. Advise patients to stop taking Centella asiatica at least 2 weeks before surgery.
Nursing women : avoid
There is not enough reliable information available on the safety of Centella when ingested orally during pregnancy or breastfeeding; avoid using it. However, topical use is allowed.
Contraindications
Pregnant women : prohibited
There is not enough reliable information available on the safety of Centella when ingested orally during pregnancy.
