Andrographis

Andrographis works primarily through its active compound andrographolide, which modulates immune function and reduces inflammation. It stimulates antibody production and activates white blood cells, enhancing the body's natural defense mechanisms. Andrographolide also inhibits pro-inflammatory cytokines and blocks NF-kappaB signaling pathways, which helps reduce inflammation and fever. Additionally, the herb demonstrates direct antimicrobial properties against certain bacteria and viruses. These combined immunomodulatory and anti-inflammatory actions explain its traditional use for infections. (Evidence Level: C, Traditional)

Yes, andrographis has several important drug interactions. It should not be combined with immunosuppressant medications, as it stimulates immune function and may counteract these drugs. Due to potential blood-thinning effects, andrographis may increase bleeding risk when taken with anticoagulants like warfarin or antiplatelet drugs such as aspirin. It may also interact with blood pressure medications. Always consult a healthcare provider before combining andrographis with prescription medications, especially if you have autoimmune conditions or bleeding disorders. (Evidence Level: C)

For adults treating upper respiratory infections, the typical dosage is 200mg of standardized extract containing 30% andrographolide, taken 2-3 times daily during active illness. This equates to approximately 60-90mg of andrographolide per dose. For preventive use, lower doses may be appropriate. Standardized extracts are preferred over whole herb preparations for consistent dosing. Always follow product label instructions, as concentrations vary between manufacturers. Duration of use is typically limited to the acute illness period. (Evidence Level: C)

No, andrographis is considered unsafe during pregnancy. The herb has demonstrated strong anti-fertility effects in research and may stimulate uterine contractions, potentially leading to miscarriage. Traditional use has included andrographis as a contraceptive agent. Women who are pregnant or trying to conceive should avoid this herb entirely. Breastfeeding women should also avoid andrographis due to insufficient safety data. If you become pregnant while taking andrographis, discontinue use immediately and consult your healthcare provider. (Evidence Level: C)

Clinical evidence supports andrographis for reducing the severity and duration of upper respiratory tract infections. Multiple randomized controlled trials suggest that standardized extracts can decrease symptom scores for sore throat, cough, and nasal congestion when taken within the first few days of illness. The herb appears most effective when started early in the infection course. While evidence is promising, most studies have been conducted outside the United States, and larger trials are needed. Overall, andrographis shows moderate effectiveness for acute respiratory infections. (Evidence Level: C)

Common side effects of andrographis include gastrointestinal upset, diarrhea, nausea, and loss of appetite, largely due to its intensely bitter taste. Some users report fatigue, headache, and dizziness. Allergic reactions, including skin rashes and itching, can occur, particularly in those sensitive to plants in the Acanthaceae family. Taste alterations and reduced appetite are frequently reported. Side effects are generally mild and reversible upon discontinuation. Taking with food may reduce gastrointestinal discomfort. (Evidence Level: C)