Andrographis for Health & Longevity - Quick Reference Sheet

Andrographis for Health & Longevity

Created on 09/05/2026 – Quick Reference based on Evidence Review created using AI4L / Opus 5 – Audit

A bitter plant that quiets inflammatory signalling. The strongest case is the oldest: taken within a day or two of a cold or sore throat, it shortens and softens symptoms. Beyond that the picture thins. Stomach upset and skin reactions are common though mild, taste disturbance drives people to stop, and retail products are routinely below label. (Full Review)

Protocol

Standard acute respiratory dose
200 mg standardized extract daily
Or 400 mg three times daily of a lower-strength extract; 5–7 days, started within 36–48 hours of onset
Standard inflammatory-condition dose
300–600 mg daily
30%-andrographolide extract for joint conditions; 280–340 mg andrographolide in multiple sclerosis; 1,800 mg extract in ulcerative colitis
Single versus split dosing
Split
Oral bioavailability is non-linear; two or three divided doses sustain plasma concentration far better
Time to effect
Respiratory symptoms
Days 3–5
Separation appears by day 3, clearest by day 5
Joint pain
28 days
Knee pain, stiffness and physical-function scores
Fatigue
Months
Multiple sclerosis fatigue scores at 12 months

Benefits

Contraindications
  • Pregnancy at any stage, and breastfeeding
  • Men actively trying to conceive
  • Prior hypersensitivity to Andrographis, andrographolide or Acanthaceae plants
  • Active liver disease or cholestasis (Child-Pugh B or C, or transaminases above 3× the upper limit of normal)
  • Bleeding disorders, or within 14 days of planned surgery
  • Autoimmune disease on immunosuppressants without prescriber oversight
  • Children under 18 outside a supervised trial protocol
Key Interactions
  • Immunosuppressants and biologics (ciclosporin, tacrolimus)
  • Antiplatelet and anticoagulant drugs (warfarin, clopidogrel)
  • Antihypertensives (amlodipine, losartan)
  • Glucose-lowering drugs (metformin, insulin)
  • Narrow-therapeutic-index drugs cleared by UGT2B7 (morphine, valproate)
  • CYP1A2, CYP2C9 and CYP3A4 substrates (theophylline, statins)
  • Over-the-counter medicines (ibuprofen, paracetamol)
  • Anti-inflammatory or antiplatelet supplements (fish oil, ginkgo)
  • Glucose- or lipid-lowering supplements (berberine, red yeast rice)
  • Eleutherococcus senticosus
  • Vaccination and elective surgery

Risk & Side Effects

  • High: Gastrointestinal upset; hypersensitivity reactions including anaphylaxis
  • Medium: Altered taste
  • Low: Transient liver-enzyme elevation; additive bleeding risk with antiplatelet drugs
  • Speculative: Male reproductive toxicity; kidney toxicity at very high doses

Monitoring

Marker Target Why
ALT (alanine aminotransferase) 10–26 U/L (men), 8–22 U/L (women) Most sensitive marker of enzyme drift
AST (aspartate aminotransferase) 10–26 U/L Pairs with ALT: liver vs muscle origin
Total bilirubin 0.3–1.0 mg/dL Detects bile-flow impairment ALT can miss
hs-CRP Below 1.0 mg/L Target the anti-inflammatory case rests on
Fasting triglycerides Below 80 mg/dL Only metabolic endpoint with a positive trial
Complete blood count with differential Eosinophils below 3% of white cells Early objective signal of allergic response
eGFR Above 90 mL/min/1.73 m² Addresses the rodent kidney-toxicity signal
Fasting glucose 75–86 mg/dL Detects additive glucose lowering
Seated blood pressure Below 120/80 mmHg Catches additive hypotension

Cadence: Baseline before the first dose. A 5–7 day respiratory course warrants no laboratory follow-up. Continuous use warrants a liver panel at 8–12 weeks, then every 6 months; lipids and inflammatory markers at 8–12 weeks, then annually.

Qualitative Assessment

  • Days from first symptom to full recovery, across at least three respiratory illnesses
  • Morning joint stiffness duration in minutes, recorded on waking
  • Fatigue on a consistent 0–10 scale at the same hour each day
  • Taste: any persistent bitter or metallic sensation between doses
  • Stool frequency and form, the earliest signal of gastrointestinal intolerance
  • Skin: new itching, flushing or rash anywhere on the body