Andrographis paniculata
Kalmegh
King of Bitters
Chuan Xin Lian
Green Chiretta
Creat
Indian Echinacea
Sambiloto

---
canonical_name: Andrographis
alternate_names: Andrographis paniculata, Kalmegh, King of Bitters, Chuan Xin Lian, Green Chiretta, Creat, Indian Echinacea, Sambiloto
canonical_topic: Andrographis for Health & Longevity
short_topic_lc: andrographis
creation_date: 2026-0715-0119
creator_ai_fullname: Opus 4.8
---

# Andrographis for Health & Longevity

Evidence Review created on 07/15/2026 using [AI4L](https://github.com/forever-healthy/AI4L) / Opus 4.8

**Also known as:** Andrographis paniculata, Kalmegh, King of Bitters, Chuan Xin Lian, Green Chiretta, Creat, Indian Echinacea, Sambiloto

## Motivation

Andrographis (*Andrographis paniculata*, often called "King of Bitters") is a bitter-tasting herb from South and Southeast Asia. Its leaves have been used for centuries in traditional Indian and Chinese medicine to ease fevers, colds, and digestive complaints. The plant's most-studied active substance, andrographolide, is thought to work mainly by calming the body's inflammation signals and by nudging the immune system toward a balanced response.

Today the herb is widely sold as a supplement, most often to shorten common colds and to support the immune system through the winter season. Standardized extracts have been tested in dozens of small clinical trials, and one large pooled analysis of cold and flu studies found it eased cough and sore throat faster than a placebo. Interest has since broadened to joint comfort, blood-sugar balance, and general inflammation, which connects the herb to the wider goals of healthy aging.

This review examines what the evidence shows about Andrographis for people focused on long-term health and longevity. It weighs the benefits, the safety signals, sensible dosing, quality concerns, and the open questions that current research has yet to settle.

**[Benefits](#expected-benefits) - [Risks](#potential-risks--side-effects) - [Protocol](#therapeutic-protocol) - [Conclusion](#conclusion)**

## Recommended Reading

This section lists high-quality, high-level overviews of Andrographis from clinical experts and the broader research literature.

* [The Top 20 Natural Remedies for Cold and Flu](https://chriskresser.com/the-top-20-natural-remedies-for-cold-and-flu/) - Chris Kresser

A practitioner overview that describes Andrographis as a primary herb for early cold and flu, including its evidence base and the practical timing and dosing that shape real-world use.

* [Common Cold](https://www.lifeextension.com/protocols/infections/common-cold) - Life Extension

An integrative protocol that situates Andrographis among evidence-based options for shortening respiratory infections, summarizing key trials and typical standardized-extract doses.

* [Experimental and Clinical Pharmacology of Andrographis paniculata and Its Major Bioactive Phytoconstituent Andrographolide](https://pubmed.ncbi.nlm.nih.gov/23634174/) - Jayakumar et al., 2013

A narrative review connecting the herb's traditional uses to its measured effects on inflammation, cardiovascular signaling, blood platelets, and fertility, giving a broad mechanistic map of andrographolide.

* [Andrographis paniculata (Burm. f.) Wall. ex Nees: A Review of Ethnobotany, Phytochemistry, and Pharmacology](https://pubmed.ncbi.nlm.nih.gov/25950015/) - Hossain et al., 2014

A thorough review of the plant's history, chemistry, and pharmacology that catalogues the many diterpenoid and flavonoid compounds behind its reported activities.

* [Physiological Activities of the King of Bitters (Andrographis paniculata): A Review](https://pubmed.ncbi.nlm.nih.gov/37719535/) - Bhaisare et al., 2023

A recent narrative review summarizing antibacterial, antioxidant, antidiabetic, anti-inflammatory, and anticancer activity alongside a concise toxicity profile.

## Grokipedia

* [Andrographis paniculata](https://grokipedia.com/page/Andrographis_paniculata)

The article provides a broad reference overview of the plant's taxonomy, cultivation, phytochemistry, and traditional and clinical uses.

## Examine

* [Andrographis paniculata](https://examine.com/supplements/andrographis-paniculata/)

Examine's evidence-graded page summarizes the human trial data for common cold, joint pain, and other outcomes, along with dosing and safety caveats.

## ConsumerLab

* [Andrographis for Colds, Arthritis and More](https://www.consumerlab.com/answers/andrographis-colds-arthritis/andrographis/)

ConsumerLab reviews the clinical uses, dosing, and safety of Andrographis and, notably, reports independent testing showing many marketed products contain far less active compound than labeled.

## Systematic Reviews

The following systematic reviews and meta-analyses represent the highest-tier synthesized evidence on Andrographis, prioritized by relevance, size, and recency.

* [Andrographis paniculata (Chuān Xīn Lián) for symptomatic relief of acute respiratory tract infections in adults and children: A systematic review and meta-analysis](https://pubmed.ncbi.nlm.nih.gov/28783743/) - Hu et al., 2017

Pooling 33 randomized controlled trials (7,175 patients), this is the largest synthesis of respiratory data, finding the herb improved cough and sore throat versus placebo, though the authors flagged generally poor study quality.

* [Safety of Andrographis paniculata: A systematic review and meta-analysis](https://pubmed.ncbi.nlm.nih.gov/33372366/) - Worakunphanich et al., 2021

The most focused safety synthesis to date, quantifying that serious adverse events are very rare while non-serious events (mostly digestive and skin-related) are common, concluding the oral herb is generally safe.

* [Adverse Effects of Andrographolide Derivative Medications Compared to the Safe use of Herbal Preparations of Andrographis paniculata: Results of a Systematic Review and Meta-Analysis of Clinical Studies](https://pubmed.ncbi.nlm.nih.gov/35153776/) - Shang et al., 2022

An important safety analysis of 262 studies showing that injectable andrographolide derivatives carry a real anaphylaxis risk, whereas oral herbal preparations are essentially safe — a key route-dependent distinction.

* [Herbal Medicines for the Treatment of Active Ulcerative Colitis: A Systematic Review and Meta-Analysis](https://pubmed.ncbi.nlm.nih.gov/38612967/) - Iyengar et al., 2024

A meta-analysis of herbal therapies in ulcerative colitis that found Andrographis did not significantly outperform placebo for clinical response or remission, tempering earlier optimism about the herb for bowel inflammation.

* [Exploring the clinical effects of Andrographis paniculata-derived compounds, its extract, or derivatives for the treatment of COVID-19: a systematic review and meta-analysis](https://pubmed.ncbi.nlm.nih.gov/40822451/) - Prabhakornritta et al., 2025

Pooling six randomized trials (660 adults), this recent review found no significant effect on fever or cough resolution or on inflammatory markers in mild-to-moderate COVID-19, illustrating the gap between mechanistic promise and clinical results.

## Mechanism of Action

Andrographis acts largely through andrographolide, a labdane diterpenoid lactone (a plant compound built on a two-ring carbon skeleton). Its central and best-supported action is inhibition of NF-κB (nuclear factor kappa B, a master switch that turns on genes driving inflammation). By blocking this pathway, andrographolide reduces production of inflammatory messengers such as TNF-α (tumor necrosis factor alpha, a pro-inflammatory signaling protein), IL-6 (interleukin-6, another inflammatory signal), and various prostaglandins.

Several complementary mechanisms are proposed:

* **Antioxidant defense:** Andrographolide activates Nrf2 (a protein that switches on the cell's own antioxidant genes), raising internal defenses against oxidative stress.

* **Inflammasome suppression:** It dampens the NLRP3 inflammasome (a cellular alarm complex that triggers inflammatory bursts), a pathway increasingly linked to age-related disease.

* **Immune modulation:** Rather than simply stimulating immunity, the herb appears to balance it — increasing lymphocyte (a type of white blood cell) activity and antibody responses in some settings while restraining overactive inflammation in others.

* **Antiviral and antibacterial action:** In laboratory studies andrographolide interferes with viral replication and bacterial signaling, supporting its traditional use in infection.

Competing interpretations exist. Some researchers argue the immune-balancing framing is oversimplified, noting that many effects are demonstrated only at high laboratory concentrations that oral dosing may not reach in human tissue. Others counter that clinical symptom benefits in respiratory infection imply meaningful activity despite modest blood levels.

As a compound, andrographolide has a short half-life (roughly 2 hours) and poor oral bioavailability owing to rapid metabolism. It is cleared mainly by sulfation and glucuronidation (attachment of small molecules that make it water-soluble for excretion) and can influence several liver enzymes of the CYP (cytochrome P450, the main family of drug-metabolizing enzymes) system, including CYP1A2, CYP2C9, and CYP3A4, as well as the P-glycoprotein drug transporter.

## Historical Context & Evolution

Andrographis has a documented history of medicinal use stretching back centuries in Ayurvedic and traditional Chinese medicine, where the bitter aerial parts were used for fevers, "heat" conditions, liver complaints, digestive upset, and infectious illness. In India it is a classic remedy for liver disorders and fevers; in China (as Chuan Xin Lian) it features in formulas for sore throat and respiratory infection.

Its move into modern health optimization began in the late twentieth century, when Scandinavian and Thai researchers standardized extracts and ran the first controlled trials for the common cold. A widely cited finding was that a fixed Andrographis extract, taken preventively over a winter, roughly halved the number of colds compared with placebo — a headline result that drove commercial interest.

Historical laboratory research also raised safety questions that remain relevant. Mid-twentieth-century and later animal studies reported that very high doses could impair male fertility and, separately, that the plant had contraceptive-like effects, echoing a traditional reputation as an anti-fertility agent. These findings were later probed in human and follow-up animal work with mixed results, and the current standing is unsettled rather than "disproven": ordinary supplement doses have not shown clear reproductive harm in people, but the animal signal has not been fully explained.

Scientific opinion continues to evolve. Early enthusiasm for respiratory benefit has been partly tempered by later reviews highlighting weak trial quality, while newer interest in the herb's anti-inflammatory and metabolic actions has opened fresh research directions on either side of the ledger.

## Expected Benefits

Benefits below are grouped by the strength of supporting evidence. A dedicated search of clinical trials, meta-analyses, and expert sources was performed to capture the herb's full benefit profile before writing this section.

### High 🟩 🟩 🟩

#### Relief of Upper Respiratory Tract Infection Symptoms

The best-supported use is easing the symptoms of colds and other upper respiratory tract infections (infections of the nose, throat, and airways). A meta-analysis of 33 randomized controlled trials (RCTs — studies that randomly assign participants to treatment or placebo) covering 7,175 patients found the herb reduced cough and sore throat and shortened time to recovery, likely through combined antiviral and anti-inflammatory action. The main limitation is that most contributing trials were methodologically weak, so the effect size is uncertain even though the direction is consistent.

**Magnitude:** Versus placebo, cough improved by a standardized mean difference (SMD, a way of expressing effect size across different scales) of −0.39 (95% confidence interval, or CI, the plausible range for the true effect: −0.67 to −0.10) and sore throat by −1.13 (95% CI −1.37 to −0.89).

### Medium 🟩 🟩

#### Prevention of Common Colds

Beyond treating an active cold, taking Andrographis preventively through cold season appears to lower how often colds occur. Several early double-blind trials of standardized extracts reported meaningfully fewer infections in those taking the herb, consistent with its immune-balancing mechanism. Evidence is graded Medium because the supporting trials are older, relatively small, and used specific proprietary extracts that may not represent all products.

**Magnitude:** In preventive dosing over about three months, the proportion of people catching a cold fell by roughly half (on the order of 30% with the herb versus 60% with placebo in the most-cited trial).

#### Knee Osteoarthritis Pain Relief

Standardized Andrographis extracts (often the branded ParActin form) have reduced knee pain and stiffness in osteoarthritis, the wear-related joint disease. The proposed mechanism is suppression of joint inflammation via NF-κB blockade. Several placebo-controlled trials support a benefit, though sample sizes are modest and many were industry-sponsored, which warrants some caution.

**Magnitude:** In 90-day placebo-controlled trials, knee pain and function scores improved significantly more than placebo, with reductions on the order of 30–50% from baseline in the better studies.

### Low 🟩

#### Rheumatoid Arthritis Symptom Relief

In rheumatoid arthritis (an autoimmune disease attacking the joints), a small placebo-controlled trial of a standardized extract added to usual care reported fewer tender and swollen joints and less fatigue. The effect fits the herb's anti-inflammatory profile, but the evidence rests on a single small study, so confidence is low.

**Magnitude:** Over 14 weeks, tender/swollen joint counts and fatigue improved significantly versus placebo (roughly a 20–30% greater reduction than the control group) in one 60-patient trial.

#### Ulcerative Colitis Improvement ⚠ Conflicted

For ulcerative colitis (an inflammatory disease of the large bowel), a purified Andrographis extract showed early promise in mid-stage trials but did not hold up in later pooled analysis. The evidence is directly conflicted: an earlier phase-2 trial suggested benefit, while a large phase-3 program was terminated and a 2024 meta-analysis found no significant advantage over placebo.

**Magnitude:** A phase-2 trial reported clinical response around 60% versus 40% for placebo at 8 weeks, but pooled analysis found no significant difference in response (relative risk 0.95) or remission (relative risk 1.31).

#### Glycemic and Metabolic Support

Small human studies and abundant animal data suggest Andrographis may modestly improve blood-sugar handling, possibly by increasing GLP-1 (glucagon-like peptide-1, a gut hormone that stimulates insulin release) and improving insulin sensitivity. This is relevant to longevity given the central role of metabolic health, but human evidence is limited to small, short trials.

**Magnitude:** Small trials report modest reductions in fasting insulin and insulin-resistance scores (on the order of 10–20%) rather than large changes in blood sugar.

### Speculative 🟨

#### Reduced Chronic ("Inflammaging") Inflammation for Longevity

By dampening NF-κB and the NLRP3 inflammasome, Andrographis could in theory lower the smoldering, low-grade inflammation that accompanies aging and drives many age-related diseases. This longevity-relevant rationale is strong mechanistically but rests largely on laboratory and animal work, with human trials showing inconsistent changes in inflammatory markers.

#### Anticancer Activity

Andrographolide slows the growth of many cancer cell types in the laboratory and in animal models, acting on cell-death and inflammation pathways. No controlled human trials establish a cancer-prevention or treatment benefit, so this remains a mechanistic and preclinical signal only.

#### Liver Protection

Traditional use as a liver tonic is echoed by animal studies where andrographolide protects against chemical and fatty-liver injury. Human evidence is sparse and indirect, and — as noted in the risks section — the herb can occasionally raise liver enzymes, so any protective role is unproven in people.

#### Neuroprotection and Multiple Sclerosis Support

In small trials in multiple sclerosis (an autoimmune disease of the nervous system), andrographolide reduced fatigue and was studied for its effect on brain tissue loss, and laboratory work suggests broader nerve-protective activity. The human data are preliminary, drawn from very small studies, and not yet confirmed.

## Benefit-Modifying Factors

* **Genetic polymorphisms:** Variation in CYP2C9 and CYP3A4 (liver enzymes that metabolize andrographolide) and in the P-glycoprotein transporter may alter how much active compound reaches the tissues, potentially shifting both benefit and drug-interaction risk between individuals.

* **Baseline inflammation and biomarkers:** People starting with higher baseline inflammation (for example elevated hs-CRP, a sensitive marker of body-wide inflammation) or higher fasting insulin may have more room to benefit from an anti-inflammatory, insulin-sensitizing herb than those already in optimal ranges.

* **Sex-based differences:** Most respiratory trials enrolled both sexes without clear divergence, but the historical male-fertility signal means benefit-versus-risk calculations differ for men considering long-term high-dose use.

* **Pre-existing health conditions:** Those with inflammatory or autoimmune joint and bowel conditions are the populations in whom benefits have been most studied; conversely, people with autoimmune disease driven by immune overactivity may respond unpredictably given the herb's immune-balancing effects.

* **Age-related considerations:** Older adults — the group most affected by "inflammaging," osteoarthritis, and frequent infections — are plausibly the best-positioned to benefit, though they also tend to take more interacting medications and clear compounds more slowly.

## Potential Risks & Side Effects

Risks below are grouped by strength of evidence. A dedicated review of trial safety data, pharmacovigilance analyses, and drug-reference sources was performed to capture the full side-effect profile.

### High 🟥 🟥 🟥

#### Gastrointestinal Disturbance

The most common adverse effects are digestive: nausea, diarrhea, loss of appetite, and abdominal discomfort, consistent with the herb's intense bitterness and effect on the gut. These are typically mild and resolve on stopping. A safety meta-analysis classed non-serious events as "very common."

**Magnitude:** Pooled non-serious adverse events occurred at roughly 100 per 1,000 patients (about 10%) in randomized trials, with digestive complaints among the most frequent.

#### Allergic and Skin Reactions

Skin and hypersensitivity reactions — rash, itching, and hives (urticaria, raised itchy welts) — are among the most frequently reported non-serious effects. They generally resolve after discontinuation but signal that some people are sensitive to the herb.

**Magnitude:** Not quantified in available studies.

### Medium 🟥 🟥

#### Anaphylaxis ⚠ Conflicted

Severe, life-threatening allergic reactions (anaphylaxis, a rapid whole-body allergic collapse) have been reported, but the evidence is route-dependent and therefore conflicted. Serious reactions cluster almost entirely around injectable andrographolide derivatives used in some countries, not the oral herb, which shows a very low serious-event rate.

**Magnitude:** With injectable derivatives, one review documented 55 cases of anaphylactic shock and several deaths; by contrast, serious adverse events from oral herbal preparations pooled to about 0.02 per 1,000 patients.

#### Additive Blood Pressure Lowering

Andrographis extracts can relax blood vessels and modestly lower blood pressure. On its own this is usually minor, but combined with blood-pressure medication or other hypotensive agents it can contribute to dizziness or excessive lowering, especially in older adults.

**Magnitude:** Not quantified in available studies.

### Low 🟥

#### Liver Enzyme Elevation

Although promoted as a liver-protective herb, Andrographis has occasionally been linked to mild elevations in liver enzymes, signaling low-grade liver stress. Reports are infrequent and generally reversible, and a causal role is not firmly established for standardized oral products.

**Magnitude:** In COVID-19 trials, mild liver-enzyme elevations were the main adverse events and resolved without severe complications; precise incidence is not well quantified.

#### Additive Blood-Sugar Lowering

Because the herb can nudge blood sugar downward, combining it with diabetes medication or other glucose-lowering agents raises a theoretical risk of hypoglycemia (blood sugar falling too low). Evidence is limited to small trials and mechanism.

**Magnitude:** Not quantified in available studies.

#### Reduced Male Fertility ⚠ Conflicted

High doses impaired sperm quality and testicular structure in some animal studies, and the plant has a traditional anti-fertility reputation. The evidence is conflicted: several follow-up animal studies and limited human data at ordinary doses did not confirm harm, leaving the signal unresolved.

**Magnitude:** Not quantified in available studies.

### Speculative 🟨

#### Autoimmune Overstimulation

Because Andrographis can activate parts of the immune system, there is a theoretical concern it could aggravate autoimmune conditions or interfere with immune-suppressing therapy. This is speculative and somewhat paradoxical, since the herb has also been trialed as an anti-inflammatory in autoimmune disease.

#### Pregnancy Loss (Abortifacient Potential)

Traditional use and some animal data suggest the herb may threaten pregnancy or act against implantation. On this precautionary basis, and absent safety data, use in pregnancy is generally avoided; the human risk is unquantified.

#### Increased Bleeding Risk

Andrographolide can reduce platelet clumping in laboratory studies, raising a theoretical bleeding risk, particularly around surgery or alongside blood-thinning drugs. No clinical bleeding events are well documented, so this remains speculative.

## Risk-Modifying Factors

* **Genetic polymorphisms:** Individuals with reduced-function CYP2C9 or CYP3A4 variants may accumulate higher andrographolide levels, potentially amplifying both side effects and interactions with co-administered medications.

* **Baseline biomarkers:** Pre-existing elevations in liver enzymes or a tendency to low blood pressure or low blood sugar identify people in whom the herb's hepatic, hypotensive, or glucose-lowering effects are more likely to cross into harm.

* **Sex-based differences:** The reproductive-toxicity signal is specific to males, making men — particularly those trying to conceive — the group for whom this risk weighs heaviest.

* **Pre-existing health conditions:** Autoimmune disease, bleeding disorders, gallbladder obstruction (the herb stimulates bile), and pregnancy each raise the risk profile and are relative or absolute reasons for caution.

* **Age-related considerations:** Older adults often take multiple medications (blood thinners, blood-pressure and diabetes drugs) that interact additively with Andrographis, and slower drug clearance can heighten exposure.

## Key Interactions & Contraindications

* **Anticoagulant and antiplatelet drugs:** Warfarin, direct oral anticoagulants, aspirin, and clopidogrel — **caution/monitor.** Andrographolide's antiplatelet activity may add to bleeding risk. Mitigation: avoid around surgery and monitor for bruising or bleeding.

* **Antihypertensive drugs:** ACE inhibitors (angiotensin-converting enzyme inhibitors, which relax blood vessels), calcium channel blockers, and diuretics — **caution.** Additive blood-pressure lowering may cause dizziness. Mitigation: monitor blood pressure when starting.

* **Antidiabetic drugs:** Metformin, sulfonylureas (glipizide, glyburide), and insulin — **caution/monitor.** Additive glucose lowering may risk hypoglycemia; a pharmacokinetic study also paired the herb with metformin. Mitigation: monitor blood sugar and watch for low-glucose symptoms.

* **Immunosuppressants:** Cyclosporine, tacrolimus, and corticosteroids — **caution.** The herb's immune-activating effects could theoretically oppose immunosuppression (for example after organ transplant). Mitigation: transplant recipients should avoid it.

* **Over-the-counter medications:** Nonsteroidal anti-inflammatory drugs (NSAIDs, such as ibuprofen) may add to both antiplatelet and gastrointestinal effects — **monitor.** Other OTC (over-the-counter) cold remedies overlap in purpose but pose no specific danger.

* **CYP-metabolized drugs:** Because andrographolide can modulate CYP1A2, CYP2C9, and CYP3A4 and the P-glycoprotein transporter, blood levels of drugs cleared by these routes (many statins, some blood thinners, certain immune drugs) could shift — **caution.** Mitigation: separate timing and monitor where a narrow-therapeutic-window drug is involved.

* **Supplements with additive effects:** Immune-active herbs (echinacea, elderberry), blood-pressure-lowering supplements (garlic, CoQ10), glucose-lowering supplements (berberine, cinnamon), and antiplatelet supplements (ginkgo, high-dose fish oil, garlic) can each compound the herb's corresponding effect — **monitor** for excessive lowering or bleeding.

* **Other interventions:** Overlap with other anti-inflammatory botanicals (curcumin, boswellia) is generally complementary but can amplify gastrointestinal upset.

* **Populations who should avoid it:** Pregnant or breastfeeding women (potential pregnancy loss); people with known Andrographis or Acanthaceae-family allergy (anaphylaxis risk); organ-transplant recipients and others on essential immunosuppression; those with active bleeding disorders or within roughly 2 weeks of scheduled surgery; and people with gallbladder duct obstruction.

## Risk Mitigation Strategies

* **Start low and use short courses:** Begin at the low end of the dose range and use time-limited courses (for example during an acute cold or for a defined preventive block) rather than open-ended daily use, reducing cumulative exposure that underlies most theoretical risks.

* **Take with food:** Dosing with meals blunts the digestive upset that is the most common side effect and softens the herb's bitterness, improving tolerability.

* **Screen and monitor for interactions:** Before starting, review medications for blood thinners, blood-pressure drugs, diabetes drugs, and immunosuppressants; where these overlap, monitor blood pressure, blood sugar, or bleeding signs as relevant to prevent additive harm.

* **Pause around surgery:** Stop the herb at least 1–2 weeks before any planned surgery or dental procedure to avoid its potential antiplatelet, bleeding-related effect.

* **Check liver enzymes with prolonged use:** For courses beyond a few weeks, obtain baseline and periodic liver-enzyme testing (for example at 4–8 weeks) to catch the uncommon liver-stress signal early.

* **Avoid in defined high-risk groups:** Exclude use in pregnancy, in men actively trying to conceive (given the unresolved fertility signal), and in transplant recipients, sidestepping the risks least worth taking.

* **Choose oral, avoid injectables:** Use only oral standardized herbal preparations, which carry a very low serious-event rate, and avoid injectable andrographolide derivatives, which account for essentially all documented anaphylaxis and deaths.

## Therapeutic Protocol

* **Standard dose (acute infection):** Leading practitioners and clinical trials commonly use standardized extracts supplying roughly 60 mg or more of andrographolide daily, often as ~400 mg of a standardized extract taken two to three times per day, started as early as possible in an illness (within the first 36–48 hours) for best effect.

* **Standard dose (joint or preventive use):** For osteoarthritis and general anti-inflammatory use, branded standardized extracts (such as ParActin) are typically dosed around 300 mg per day; preventive cold-season regimens have used lower daily doses of standardized extract over several weeks.

* **Competing approaches:** A symptom-focused, short-course approach (used at the first sign of infection, favored in Western herbal and integrative practice) contrasts with a preventive daily-dosing approach through cold season (popularized by the Scandinavian standardized-extract trials); neither is established as superior, and both are presented as legitimate options.

* **Expert and product lineage:** The preventive respiratory approach traces to the Swedish Herbal Institute's fixed-combination extract (Kan Jang), while the joint-and-inflammation approach centers on the ParActin standardized extract developed by HP Ingredients.

* **Best time of day:** Doses are usually spread across the day with meals; there is no strong circadian rationale, and food timing (to reduce bitterness and stomach upset) matters more than clock time.

* **Half-life and dosing frequency:** Because andrographolide has a short half-life of roughly 2 hours, split dosing two to three times daily is preferred over a single daily dose to maintain exposure.

* **Single versus split dosing:** Split dosing is standard; single large doses are neither more effective nor better tolerated given rapid clearance.

* **Genetic considerations:** No validated pharmacogenetic dosing exists, but reduced-function CYP2C9 or CYP3A4 variants may warrant conservative dosing because of slower breakdown of andrographolide.

* **Sex-based considerations:** Men concerned about fertility may prefer short courses over continuous long-term use given the unresolved reproductive signal.

* **Age considerations:** Older adults should start at the low end and account for interacting medications and slower clearance.

* **Baseline biomarkers:** Baseline liver enzymes, blood pressure, and blood sugar help individualize dosing and flag those who need closer monitoring.

* **Pre-existing conditions:** Autoimmune disease, bleeding tendency, and gallbladder disease should steer dosing decisions and, in some cases, argue against use.

## Discontinuation & Cycling

* **Lifelong versus short-term:** Andrographis is best regarded as a short-term or cyclical intervention (for acute infections or defined preventive blocks) rather than an indefinite lifelong supplement, since its strongest evidence is for time-limited use.

* **Withdrawal effects:** No withdrawal syndrome or dependence has been described; the herb can be stopped abruptly without rebound effects.

* **Tapering:** No tapering protocol is required given the absence of withdrawal effects.

* **Cycling:** Cycling is commonly practiced — for example short acute courses, seasonal preventive blocks, or on/off patterns — to limit continuous immune stimulation and cumulative exposure, though no formal cycling schedule has been validated in trials.

* **Practical pattern:** A typical approach is a several-day course at illness onset, or a preventive block through the highest-risk weeks of cold season, followed by a break.

## Sourcing and Quality

* **Standardization to andrographolide:** The most important quality marker is standardization to a stated andrographolide content (commonly 10–30%); unstandardized "whole herb" powders vary widely and may be under-dosed.

* **Third-party testing:** Independent testing is essential — ConsumerLab has reported that many marketed Andrographis products contain far less active compound than labeled, and some none at all — so verified certificates of analysis and third-party seals matter.

* **Species authentication and contaminants:** Look for confirmation of correct species (*Andrographis paniculata*, not adulterants) and testing for heavy metals and microbial contamination, which affect botanical products generally.

* **Reputable formulations:** Well-characterized branded extracts such as ParActin and the Kan Jang fixed combination have the most clinical backing; reputable supplement brands that publish testing data are preferable to unbranded bulk powders.

* **Form and route:** Choose oral capsules or tablets of standardized extract; avoid injectable andrographolide derivatives, which are the source of the serious safety signals.

## Practical Considerations

* **Time to effect:** For an active cold, symptom relief typically appears within 1–2 days; preventive benefits build over weeks of consistent use; joint-pain improvements generally take several weeks to a few months.

* **Common pitfalls:** Starting too late in an infection (missing the early window), using low-quality or under-dosed products, being deterred by the strong bitter taste, and taking the herb continuously without breaks are the most frequent mistakes.

* **Regulatory status:** In the United States, Andrographis is sold as a dietary supplement and is not an FDA-approved drug; it is used within traditional-medicine frameworks elsewhere, and injectable andrographolide derivatives are regulated medicines in some countries but not marketed in the US.

* **Cost and accessibility:** Standardized Andrographis is inexpensive and widely available, so cost and access are not meaningful barriers.

* **Taste and formulation:** The intense bitterness (the source of the "King of Bitters" name) makes capsules preferable to powders or teas for most users.

## Interaction with Foundational Habits

* **Sleep:** The interaction is largely neutral — Andrographis is not a stimulant and is unlikely to disrupt sleep; any indirect benefit would come from reducing the inflammation and infection symptoms that impair rest. It can be taken in the evening with a meal without expected sleep interference.

* **Nutrition:** The interaction is direct and generally favorable — the herb's bitterness stimulates digestive secretions and bile flow, and taking it with food both improves tolerance and aligns with traditional use as a digestive bitter; no specific nutrient depletion is established, and no special diet is required.

* **Exercise:** The interaction is potentially blunting but speculative — as with other strong anti-inflammatory and antioxidant compounds, there is a theoretical concern that heavy dosing around training could dampen the beneficial inflammatory signals that drive adaptation. A practical precaution is to separate dosing from the immediate post-workout window if muscle or strength gains are a priority.

* **Stress management:** The interaction is indirect and mild — Andrographis is sometimes grouped with adaptogenic herbs and may modestly influence stress-related inflammation, but robust human data on cortisol or the stress response are lacking, so it should not be relied on as a stress-management tool.

## Monitoring Protocol & Defining Success

Before starting, a baseline assessment establishes reference values for the organs and pathways most likely to be affected — chiefly the liver, blood pressure, and blood sugar — so that any later change can be interpreted. Ongoing monitoring is light for short courses but more structured for prolonged or preventive use: check liver enzymes at roughly 4–8 weeks after starting continuous use, then every 6–12 months, and monitor blood pressure and blood sugar more often in people on interacting medications.

| Biomarker | Optimal Functional Range | Why Measure It? | Context/Notes |
|-----------|--------------------------|-----------------|---------------|
| ALT | ~10–25 U/L | Detects liver stress from prolonged use | Alanine aminotransferase, a liver enzyme; conventional labs flag only >40–55 U/L; fasting not required; pair with AST |
| AST | ~10–25 U/L | Complements ALT for liver monitoring | Aspartate aminotransferase, a liver enzyme; mildly raised by intense exercise; interpret alongside ALT |
| hs-CRP (high-sensitivity C-reactive protein) | <1.0 mg/L (ideally <0.5) | Tracks whether inflammation is falling | Avoid testing during active infection, which transiently elevates it |
| Fasting glucose | 70–85 mg/dL | Watches for additive blood-sugar lowering | Requires overnight fast; check more often if on diabetes drugs |
| Systolic blood pressure | 110–120 mmHg | Watches for additive blood-pressure lowering | Measure seated after rest; relevant if on antihypertensives |
| Platelet function / bleeding signs | No easy bruising or bleeding | Flags the theoretical antiplatelet effect | Clinical observation rather than a routine lab; relevant around surgery |

* Baseline testing (above) should be completed before beginning prolonged or preventive use, not only inferred from later results.

* Ongoing testing cadence: liver enzymes at about 4–8 weeks of continuous use, then every 6–12 months; blood pressure and blood sugar at 1–2 weeks after starting if on interacting drugs, then periodically.

Qualitative markers to track:

* Frequency and severity of colds and respiratory infections over a season
* Energy levels and post-illness recovery time
* Joint comfort and stiffness (for those using it for joint pain)
* Digestive comfort (appetite, nausea, bowel habits)
* Any new rash, itching, or hives, which warrant stopping the herb

## Emerging Research

* **Metabolic and blood-pressure trials in obesity:** Two newly registered controlled studies from an Indonesian university are comparing Andrographis (Sambiloto) against brisk-walking exercise for blood glucose ([NCT06520501](https://clinicaltrials.gov/study/NCT06520501), not-yet-recruiting, ~30 participants) and blood pressure ([NCT06520527](https://clinicaltrials.gov/study/NCT06520527), not-yet-recruiting, ~30 participants) in people with obesity — directly probing the herb's longevity-relevant metabolic effects.

* **Large antiviral prevention trial:** A phase-3 Thai study ([NCT05019326](https://clinicaltrials.gov/study/NCT05019326), ~3,060 participants) compared *Andrographis paniculata* against another botanical and control for preventing progression in early COVID-19, one of the largest Andrographis trials attempted, though its status is currently listed as unknown.

* **Joint-structure imaging trial:** A completed 336-day study of the ParActin extract used magnetic-resonance imaging to assess joint-space narrowing in knee osteoarthritis ([NCT04833946](https://clinicaltrials.gov/study/NCT04833946), ~80 participants), moving beyond symptom scores toward structural disease progression.

* **Respiratory evidence quality:** Future respiratory research could strengthen or weaken the case depending on whether large, well-designed trials confirm the symptom benefits suggested by weaker studies; the largest meta-analysis to date ([Hu et al., 2017](https://pubmed.ncbi.nlm.nih.gov/28783743/)) explicitly called for better trials.

* **Inflammation biomarker uncertainty:** Emerging synthesis is mixed on whether the herb measurably lowers inflammation in people — a recent COVID-19 meta-analysis ([Prabhakornritta et al., 2025](https://pubmed.ncbi.nlm.nih.gov/40822451/)) found no significant change in inflammatory markers, a finding that, if repeated, would weaken the "inflammaging" longevity rationale.

* **Unresolved reproductive safety:** Better human data on male fertility remain a key open question; resolving the animal-versus-human discrepancy could meaningfully shift the risk profile for long-term users.

## Conclusion

Andrographis is a bitter medicinal herb with a long traditional history and a modern reputation built mainly on easing colds and other respiratory infections. Its most consistent human evidence points to faster relief of cough and sore throat and, with preventive use, fewer colds through the season, likely reflecting a combination of calming inflammation and balancing the immune response. Beyond infection, the herb shows encouraging but weaker signals for joint pain and blood-sugar handling, and a mechanistically appealing but still-unproven role in lowering the chronic, low-grade inflammation tied to aging.

The overall evidence base is uneven. Respiratory findings rest on many trials of generally poor quality, several other uses come from single small studies, and results for bowel inflammation and inflammatory markers have been disappointing or conflicting. Safety is reassuring for the oral herb, whose serious reactions are rare, though digestive upset and allergic skin reactions are common, and unresolved questions linger around male fertility, pregnancy, and additive effects with blood thinners, blood-pressure, and diabetes treatments; the severe reactions on record trace almost entirely to injectable forms, not the supplement. For those weighing it as part of a long-term health strategy, Andrographis reads as a modestly supported, low-cost option whose promise for healthy aging outruns the current proof.

**[Top](#top) - [Benefits](#expected-benefits) - [Risks](#potential-risks--side-effects) - [Protocol](#therapeutic-protocol)**


Korean Angelica
Giant Angelica
Cham-dang-gui
Korean Dang-gui
AGN

---
canonical_name: Angelica gigas Nakai
alternate_names: Korean Angelica, Giant Angelica, Cham-dang-gui, Korean Dang-gui, AGN
canonical_topic: Angelica gigas Nakai for Health & Longevity
short_topic_lc: angelica_gigas_nakai
creation_date: 2026-0716-0134
creator_ai_fullname: Opus 4.8
---

# Angelica gigas Nakai for Health & Longevity

Evidence Review created on 07/16/2026 using [AI4L](https://github.com/forever-healthy/AI4L) / Opus 4.8

**Also known as:** Korean Angelica, Giant Angelica, Cham-dang-gui, Korean Dang-gui, AGN

## Motivation

*Angelica gigas* Nakai, usually called Korean angelica, is a tall purple-flowered herb native to Korea, China, and Japan whose dried root has been a staple of traditional East Asian medicine for centuries. Interest in it today centers on a small family of natural compounds in the root — chiefly decursin, decursinol angelate, and their shared breakdown product decursinol — which laboratory work links to effects on inflammation, nerve signaling, hormones, and tumor cells. Root extracts standardized to these compounds are sold in the United States and Korea as supplements for memory and pain.

The plant is worth a careful look because it sits at an unusual crossroads: a long folk record for treating pain, poor circulation, and women's health complaints, alongside a large and growing modern laboratory literature, yet only a handful of small human trials — most testing the root inside multi-herb blends rather than on its own. This gap between promising cell and animal findings and thin human proof is the central tension a reader must weigh.

This review examines what the evidence does and does not show about Korean angelica across cognition, pain, hormonal and metabolic health, and cancer biology, and how its quality and sourcing shape any interpretation.

**[Benefits](#expected-benefits) - [Risks](#potential-risks--side-effects) - [Protocol](#therapeutic-protocol) - [Conclusion](#conclusion)**

## Recommended Reading

This section collects high-level overviews that introduce Korean angelica, its signature compounds, and the current state of research across its main health claims.

* [Top 15 Herbs and Spices for Joint Health](https://www.lifeextension.com/wellness/herbs-spices/herbs-and-spices-for-joint-health) - Sonali Ruder

  This consumer-facing article places Korean angelica among evidence-informed botanicals for joint comfort, summarizing its antioxidant and inflammation-modulating rationale in plain language for a health-oriented audience.

* [Angelica gigas: Signature Compounds, In Vivo Anticancer, Analgesic, Neuroprotective and Other Activities, and the Clinical Translation Challenges](https://pubmed.ncbi.nlm.nih.gov/35876033/) - Lü et al., 2022

  The most comprehensive modern overview, covering the pharmacology of decursin, decursinol angelate, and decursinol, the human pharmacokinetic data, and the sourcing and dosing hurdles that limit clinical use.

* [Neuroprotective and Cognitive Enhancement Potentials of Angelica gigas Nakai Root: A Review](https://pubmed.ncbi.nlm.nih.gov/28452965/) - Sowndhararajan & Kim, 2017

  A focused survey of the memory and neuroprotection literature, useful for understanding the mechanistic basis behind the herb's marketing for brain health.

* [Anticancer potential of decursin, decursinol angelate, and decursinol from Angelica gigas Nakai: A comprehensive review and future therapeutic prospects](https://pubmed.ncbi.nlm.nih.gov/39479643/) - Sestito et al., 2024

  A recent review of the cancer-cell biology of the pyranocoumarins, including their proposed targets and the biotechnology efforts to produce them at scale.

* [Anti-cancer and Other Bioactivities of Korean Angelica gigas Nakai (AGN) and Its Major Pyranocoumarin Compounds](https://pubmed.ncbi.nlm.nih.gov/22583405/) - Zhang et al., 2012

  An earlier foundational review that first pulled together the anticancer, hormonal, and metabolic activities of the root, providing helpful historical context for later work.

No in-depth, dedicated coverage of *Angelica gigas* could be located from Rhonda Patrick, Peter Attia, Andrew Huberman, or Chris Kresser through either general web search or on-site search; only Life Extension among the priority sources covers the herb directly, so the remaining entries are qualifying narrative reviews.

## Grokipedia

* [Angelica gigas](https://grokipedia.com/page/Angelica_gigas)

  The dedicated Grokipedia entry describes the botany, traditional uses, phytochemistry, and reported pharmacological activities of the plant, offering a broad orienting summary.

## Examine

No dedicated Examine.com article for *Angelica gigas* was found.

Because Korean angelica is a botanical supplement and not a prescription medication, the note reserved for prescription drugs does not apply here.

## ConsumerLab

No dedicated ConsumerLab.com article for *Angelica gigas* was found.

Because Korean angelica is a botanical supplement and not a prescription medication, the note reserved for prescription drugs does not apply here.

## Systematic Reviews

No systematic reviews or meta-analyses for Angelica gigas Nakai were found on PubMed as of July 16, 2026.

## Mechanism of Action

Korean angelica's activity is attributed mainly to three pyranocoumarins — decursin, decursinol angelate, and decursinol — plus the coumarin glycoside nodakenin. Decursin and decursinol angelate are near-identical isomers (molecules with the same atoms arranged slightly differently) that are rapidly converted in the body to decursinol, the compound that dominates the bloodstream after an oral dose.

The proposed mechanisms are broad:

* **Hormone-receptor modulation:** Decursin and decursinol angelate can block the androgen receptor (the docking site that male hormones such as testosterone use to switch on genes), which underlies the interest in prostate health; in breast-cancer cells they also suppress both estrogen-driven and estrogen-independent growth.

* **Anti-angiogenesis and pro-apoptosis:** They suppress VEGFR-2 signaling — the vascular endothelial growth factor receptor pathway that grows new blood vessels — and trigger programmed cell death (apoptosis) in many cultured tumor lines.

* **Anti-inflammatory and antioxidant signaling:** The compounds inhibit NF-κB (a master switch that turns on inflammatory genes) and activate the Nrf2/HO-1 axis (a cell's built-in antioxidant defense system, heme oxygenase-1), while engaging AMPK (the cell's energy-sensing enzyme).

* **Nervous-system effects:** Decursin and decursinol inhibit acetylcholinesterase (the enzyme that breaks down acetylcholine, a memory-signaling chemical), protect neurons from amyloid-beta (the sticky protein tied to Alzheimer's disease) and from glutamate overexcitation, and produce pain relief that appears to act within the central nervous system.

Where mechanisms compete, the picture is genuinely mixed: the same molecules are reported to lower estrogen signaling in tumor cells yet the whole-root blends are marketed for menopausal relief, and decursin is described as both antioxidant and, at high concentrations in some cancer models, pro-oxidant. These context-dependent effects mean whole-extract behavior cannot be predicted from any single pathway.

Key pharmacological properties are now partly defined in humans. After oral intake, decursin and decursinol angelate are hydrolyzed quickly, so decursinol is the main circulating and brain-penetrating species; decursinol crosses the blood-brain barrier (the protective filter around the brain). Its half-life in people is on the order of a few hours. Metabolism runs through liver cytochrome P450 enzymes (CYP, a family of drug-processing enzymes), with decursinol angelate acting as a mechanism-based inhibitor of CYP2A6 and the compounds also interacting with CYP3A; the parent compounds additionally inhibit P-glycoprotein (P-gp, a pump that expels drugs from cells).

## Historical Context & Evolution

* **Original use:** In traditional Korean and Chinese medicine the dried root — *Cham-dang-gui* — was prescribed as a blood tonic and sedative to treat anemia, painful or irregular menstruation, poor circulation, arthritic and abdominal pain, and general debility. It is a distinct species from Chinese *Angelica sinensis* (Dong quai) and Japanese *Angelica acutiloba*, and the three are chemically different, which historically caused confusion in the herbal trade.

* **Path to health optimization:** Modern interest began when Korean pharmacologists isolated decursin and decursinol in the late twentieth century and reported anticancer and memory effects in cell and animal models. From the 2000s, U.S. and Korean groups (notably at Pennsylvania State University) characterized the pyranocoumarins' pharmacology and pharmacokinetics, and root extracts standardized to decursin/decursinol angelate began to be marketed for memory and pain.

* **Findings, not just reception:** The early animal work is concrete rather than anecdotal — long-term extract or decursinol dosing protected mice from amyloid-beta-induced memory loss, and decursin reduced scopolamine-induced amnesia — and these findings have been repeatedly reproduced across independent laboratories.

* **Evolving opinion:** The scientific view has shifted from early enthusiasm toward cautious realism. Reviewers now emphasize that the human evidence remains thin and that unresolved questions — whether blood levels plateau at higher doses, and whether repeated use changes metabolism — must be answered before clinical claims are justified. Nothing here is settled: the preclinical case continues to strengthen while rigorous human confirmation is still pending.

## Expected Benefits

Benefits are framed for a proactive, risk-aware adult evaluating Korean angelica as an optimization tool, with attention to how much of the human signal comes from combination products rather than the root alone.

### Medium 🟩 🟩

#### Relief of Urinary Symptoms in Prostate Enlargement

In a 12-week randomized controlled trial (RCT — a study that randomly assigns participants to treatment or placebo), a standardized mixture of *Angelica gigas* and *Astragalus membranaceus* (SHPro) improved urinary symptoms in men with benign prostatic hyperplasia (BPH — a noncancerous enlargement of the prostate that obstructs urine flow). Improvements reached significance for the International Prostate Symptom Score (IPSS — a standard urinary-symptom questionnaire) and its incomplete-emptying item, alongside gains on the International Index of Erectile Function (IIEF — a questionnaire measuring sexual function). The evidence basis is a single 84-man trial of a two-herb combination, so the root's independent contribution cannot be isolated, and the finding awaits replication with Korean angelica alone.

**Magnitude:** Significant improvement versus placebo in total IPSS (p=0.02) and the incomplete-emptying subscore (p<0.001) over 12 weeks in an 84-participant RCT of a combination product.

#### Reduction of Menopausal Symptoms

Korean angelica is a component of EstroG-100, a standardized blend with *Cynanchum wilfordii* and *Phlomis umbrosa* that has been tested in menopausal women, including earlier placebo-controlled work and a more recent single-arm study. Reported benefits include lower somatic, urogenital, and psychological complaint scores without changes in blood pressure or body-mass index. The mechanism is uncertain and may involve mild hormone-receptor modulation; as with the prostate data, the signal comes from a multi-herb product rather than isolated root, limiting how much can be attributed to *Angelica gigas* specifically.

**Magnitude:** Menopause Rating Scale scores improved significantly from baseline (p<0.01) over 12 weeks in studies of roughly 60 women each (combination product).

### Low 🟩

#### Cognitive and Memory Support

This is the herb's flagship marketed use, resting on a consistent preclinical record: decursin and decursinol inhibit acetylcholinesterase, protect neurons from amyloid-beta, and improve memory in chemically impaired rodents, while human pharmacokinetic studies confirm decursinol reaches the brain. What is missing is any controlled human cognitive trial, so the grade stays Low despite biologically plausible and reproducible animal data. Effects in healthy, cognitively normal adults are unknown.

**Magnitude:** Not quantified in available studies.

#### Analgesic (Pain-Relieving) Effects

Traditional use for menstrual, arthritic, and abdominal pain is echoed by animal work in which decursinol reduces responses in both inflammatory and nerve-injury pain models, apparently by acting within the central nervous system. U.S. supplements standardized to decursinol are sold specifically for pain. Human efficacy data are absent, and the traditional and preclinical basis places this at Low.

**Magnitude:** Not quantified in available studies.

#### Anti-Fatigue and Exercise Endurance

An 8-week RCT of a blend of deer antler (*Cervus elaphus*), *Angelica gigas*, and *Astragalus membranaceus* in people with chronic fatigue reported improved fatigue scores and measurable gains in aerobic capacity and time to exhaustion. The proposed basis is antioxidant and anti-inflammatory support of muscle recovery. The single trial and combination format keep this Low, and the root's standalone effect is again unclear.

**Magnitude:** Significant increases versus placebo in maximal exercise time (p<0.01) and maximal oxygen uptake (VO2max — a measure of aerobic fitness; p=0.04) in an 80-participant, 8-week RCT of a combination product.

#### Anti-Inflammatory and Antioxidant Activity

Across cell and animal models the extract and its coumarins lower inflammatory signaling (NF-κB), raise antioxidant defenses (Nrf2/HO-1), and reduce tissue damage in colitis, liver-injury, and ischemia models. This activity plausibly underlies several downstream claims, but it has not been quantified with human biomarkers, so it is graded Low as a standalone benefit.

**Magnitude:** Not quantified in available studies.

### Speculative 🟨

#### Anticancer Potential

The largest body of literature concerns cancer: decursin and decursinol angelate block the androgen receptor, suppress new blood-vessel growth, and induce cell death across prostate, breast, lung, colon, blood, and other tumor lines, and early-phase human trials in prostate cancer are underway. However, no human efficacy data exist, blood levels achievable from oral supplements may be far below active concentrations, and this remains a research hypothesis rather than a usable benefit.

#### Metabolic and Lipid Effects

Small completed human studies and animal work suggest possible effects on blood triglycerides, blood sugar, and fat-cell formation (via β-catenin signaling — a cell pathway that controls growth and fat-cell development), positioning the herb as a speculative metabolic aid. Results are unpublished or preliminary and mechanistically incomplete.

#### Neuroprotection Against Age-Related Decline

Beyond memory, root extract and decursin protect the blood-brain barrier and brain tissue after simulated stroke and shield neurons from excitotoxic and oxidative injury in animals, raising the speculative possibility of resilience against age-related neurological decline. No human longevity or neurodegeneration outcomes have been studied.

#### Hair Growth Support

Topical and oral decursin/root extract promoted hair regrowth in mouse skin by modulating inflammatory signals, hinting at a cosmetic application. Evidence is limited to a single animal context with no human confirmation.

## Benefit-Modifying Factors

* **Genetic polymorphisms:** Because decursinol angelate inactivates CYP2A6 and the compounds are handled by CYP3A, individuals with slow- or fast-metabolizing variants of these liver enzymes (naturally occurring gene differences that change how fast drugs are cleared) may achieve different blood levels and therefore different benefit from the same dose.

* **Baseline biomarker levels:** Those starting with higher inflammatory markers, poorer lipid or glucose profiles, or more pronounced urinary or menopausal symptoms have more room to improve, so measurable benefit is likeliest in people who are symptomatic at baseline rather than already optimized.

* **Sex-based differences:** The human evidence is sex-partitioned by indication — prostate/urinary benefits are male-specific, while the menopausal-symptom data are female-specific — and the herb's hormone-receptor activity means responses may differ by sex hormone environment.

* **Pre-existing health conditions:** Hormone-sensitive conditions, prostate disease, and chronic pain or fatigue syndromes define the populations most likely to notice an effect; healthy asymptomatic users have essentially no efficacy data.

* **Age-related considerations:** Most candidate benefits (urinary symptoms, cognition, joint comfort) are age-associated, so older adults within the target audience are the most relevant responders, though age-related changes in liver metabolism and polypharmacy also raise interaction risk.

## Potential Risks & Side Effects

Risks are framed for a proactive adult who may combine Korean angelica with other supplements or medications. Overall the herb has been well tolerated in short human trials, and no serious adverse events have been attributed to it.

### Medium 🟥 🟥

#### Mild Gastrointestinal and General Adverse Events

In controlled human trials of Korean angelica-containing products, adverse events were infrequent, mild, and largely indistinguishable from placebo, comprising gastrointestinal upset, musculoskeletal aches, and occasional skin reactions. Severity was low and events were reversible, with investigators judging most as unrelated to the product. The evidence basis is short (8–12 week) trials of combination formulas, so longer-term and monotherapy tolerability is less certain.

**Magnitude:** Approximately 10 mild adverse events among ~39 treated participants over 12 weeks in the prostate RCT, with no serious events.

### Low 🟥

#### Drug-Metabolism and Transporter Interactions

The most credible risk is pharmacokinetic rather than toxic: decursinol angelate is a mechanism-based inhibitor of the liver enzyme CYP2A6, the compounds interact with CYP3A, and the parent pyranocoumarins inhibit P-glycoprotein. In principle this could raise blood levels of co-administered drugs that depend on these pathways, an effect demonstrated in cell and animal systems but not yet measured clinically. Reversibility is expected once the herb is stopped, but the mechanism-based CYP2A6 effect can persist until new enzyme is made.

**Magnitude:** Not quantified in available studies.

#### Hormonal Modulation (Androgen and Estrogen Activity)

Because the coumarins can block the androgen receptor and alter estrogen-driven cell growth, there is a theoretical risk of unwanted hormonal effects, particularly relevant to people with hormone-sensitive cancers or those on hormone therapy. Direction of effect is context-dependent and the human hormonal impact of supplement-level doses is unknown, keeping this Low but worth monitoring.

**Magnitude:** Not quantified in available studies.

### Speculative 🟨

#### Bleeding Risk from Coumarin Content

As a coumarin-containing botanical, Korean angelica is often flagged for a theoretical additive bleeding risk with blood thinners, although its pyranocoumarins are structurally different from the anticoagulant 4-hydroxycoumarins and no clinical bleeding events have been reported. The concern is precautionary and based on chemical class rather than observed cases.

#### Photosensitivity

Some Apiaceae-family plants contain furocoumarins that cause sun sensitivity; while *Angelica gigas* is dominated by non-phototoxic pyranocoumarins, trace furocoumarin content cannot be excluded, so increased sunburn susceptibility is a speculative concern without documented human cases.

#### Hepatic Effects at High Doses

Although the compounds are broadly liver-protective in animal fibrosis models, any concentrated botanical extract carries a speculative possibility of liver strain at high or prolonged doses, especially given the CYP-inhibitory activity; no human hepatotoxicity signal has been reported.

## Risk-Modifying Factors

* **Genetic polymorphisms:** Variants in CYP2A6 and CYP3A that slow clearance could raise exposure and amplify interaction risk, while individual differences in these drug-processing enzymes may make some users more susceptible to interaction effects than others.

* **Baseline biomarker levels:** People with already elevated liver enzymes, abnormal clotting markers, or hormone-sensitive baselines warrant more caution, as they have less physiological reserve if an adverse effect emerges.

* **Sex-based differences:** The androgen- and estrogen-modulating activity means risk context differs by sex — androgen-receptor blockade is more consequential in men with prostate disease, while estrogen-pathway effects matter more for women with hormone-sensitive conditions.

* **Pre-existing health conditions:** Hormone-sensitive cancers, bleeding disorders, liver disease, and pregnancy are the conditions that shift the risk profile upward; healthy users face mainly the low interaction risk.

* **Age-related considerations:** Older adults in the target range are more likely to take interacting medications and to have reduced hepatic clearance, so age raises the practical importance of the drug-interaction risks even though direct toxicity remains low.

## Key Interactions & Contraindications

* **Prescription drug interactions:** Caution is warranted with anticoagulants and antiplatelet agents (warfarin, apixaban, clopidogrel) on theoretical additive-bleeding grounds; with substrates of CYP3A and CYP2A6 (e.g., certain statins, benzodiazepines, and the nicotine-metabolizing pathway); and with P-glycoprotein substrates (e.g., digoxin), where inhibition could raise drug levels.

* **Over-the-counter medication interactions:** Combining with over-the-counter pain relievers that affect bleeding (aspirin, ibuprofen and other nonsteroidal anti-inflammatory drugs) could theoretically add to bleeding risk; sedating antihistamines may compound the herb's traditional sedative effect.

* **Supplement interactions:** Additive effects are plausible with other CYP-inhibiting or coumarin-containing botanicals (grapefruit extract, *Angelica sinensis*/Dong quai, other coumarin-rich herbs) and with sedative or sleep supplements.

* **Supplements with additive effects:** Sedative or calming supplements (valerian, magnesium, GABA — gamma-aminobutyric acid, the brain's main calming signal) may potentiate drowsiness, and other bleeding-modulating supplements (high-dose fish oil, ginkgo, garlic) may add to the theoretical bleeding concern.

* **Other intervention interactions:** Because the coumarins block the androgen receptor and modulate estrogen signaling, overlap with hormone therapies, anti-androgen treatments, or hormone-blocking cancer drugs could be additive or interfering and should be treated as a caution.

* **Populations who should avoid it:** Pregnant and breastfeeding women (traditional uterine/menstrual activity and lack of safety data), people with hormone-sensitive cancers, those with bleeding disorders or scheduled surgery, and anyone on the interacting drug classes above should avoid or use only under supervision.

* **Representative named agents:** Where a drug class is named above, representative members are given in parentheses (e.g., "CYP3A substrates (simvastatin, midazolam)"; "P-glycoprotein substrates (digoxin)") to make the interaction concrete.

* **Severity and consequence:** Each interaction should be read as a caution rather than an absolute contraindication, except in pregnancy and active hormone-sensitive cancer, where avoidance is advised; the main clinical consequences of concern are increased bleeding, raised levels of co-administered drugs, and unwanted hormonal effects.

* **Mitigating actions:** Where use is considered despite an interaction, separating dosing times, starting low, monitoring the relevant marker (e.g., clotting time on anticoagulants), and stopping the herb 1–2 weeks before surgery are the practical mitigations.

* **Population thresholds:** Avoidance is most clearly indicated for defined groups — any trimester of pregnancy, active or recent hormone-sensitive malignancy, diagnosed bleeding disorder, or surgery within about 2 weeks — rather than only broad categories.

## Risk Mitigation Strategies

* **Low starting dose with gradual increase:** Begin at the lowest labeled dose of a standardized extract and increase over 1–2 weeks only if tolerated, which limits gastrointestinal upset and lets any hormonal or sedative effect surface at a low, reversible level.

* **Medication reconciliation before starting:** Review all prescription drugs, especially anticoagulants and CYP3A/CYP2A6/P-glycoprotein substrates, and separate dosing or avoid the herb where an interaction is plausible, mitigating the risk of raised drug levels or bleeding.

* **Perioperative discontinuation:** Stop the herb at least 1–2 weeks before any scheduled surgery or dental procedure to mitigate the theoretical additive-bleeding risk from its coumarin content.

* **Hormone-status screening:** Avoid use with active or recent hormone-sensitive cancer or during hormone therapy, and prefer medical supervision if hormonal conditions exist, directly addressing the androgen- and estrogen-modulation risk.

* **Sun-exposure prudence at high doses:** Given the speculative furocoumarin/photosensitivity concern, use sun protection if taking high doses, mitigating potential increased sunburn susceptibility.

* **Periodic liver and clotting checks:** For prolonged or high-dose use, periodic liver-enzyme and, where relevant, clotting-time monitoring (for example every 3–6 months) addresses the speculative hepatic and bleeding risks before they become clinically significant.

## Therapeutic Protocol

* **Standard practitioner approach:** Practitioners and manufacturers typically use an ethanol (alcohol) root extract standardized to decursin plus decursinol angelate, taken orally once or twice daily; U.S. products such as decursinol-standardized extracts are marketed for memory and pain, while Korean products emphasize whole-root or blended formulas.

* **Competing approaches:** Two main approaches coexist without one being clearly superior — a whole-root/traditional-decoction approach used in East Asian herbal practice, versus a standardized-pyranocoumarin extract approach favored by Western supplement makers; combination formulas (with *Astragalus*, deer antler, or menopause blends) represent a third, product-specific route that dominates the human trial evidence.

* **Popularizing sources:** The standardized decursin/decursinol angelate extract approach was advanced largely by Korean and U.S. academic groups (including Pennsylvania State University investigators), while decursinol-standardized pain products were popularized in the U.S. supplement market (e.g., Life Extension's decursinol offerings).

* **Best time of day:** No rigorous timing studies exist; given the traditional sedative reputation and decursinol's central activity, evening dosing is often suggested when the goal is sleep or relaxation, whereas split daytime dosing suits pain or cognitive goals.

* **Expected half-life:** After oral dosing the main circulating compound, decursinol, has a half-life of roughly a few hours in humans, so effects from a single dose are relatively short-lived.

* **Single versus split dosing:** Because of that short half-life, twice-daily split dosing is commonly used to maintain more even blood levels through the day, while single evening dosing is reserved for sleep-oriented use.

* **Genetic considerations:** Individuals with slow-metabolizing CYP2A6 or CYP3A variants may reach higher decursinol levels and could need lower doses, an area where pharmacogenetic guidance is currently theoretical rather than established.

* **Sex-based differences:** Dosing evidence is indication- and sex-specific (prostate/urinary protocols studied in men, menopausal protocols in women), and no unisex optimal dose has been defined.

* **Age-related considerations:** Older adults may clear the compounds more slowly and are more likely to take interacting drugs, so conservative dosing is prudent at the older end of the target range.

* **Baseline biomarker considerations:** Baseline liver function and, for prostate or menopausal use, the relevant symptom scores or hormone markers help set expectations and a starting dose.

* **Pre-existing condition considerations:** Protocol choice should account for hormone-sensitive conditions, bleeding risk, and concurrent medications, favoring lower doses and supervision where these are present.

## Discontinuation & Cycling

* **Lifelong versus short-term:** There is no evidence that Korean angelica must be taken lifelong; it is best viewed as a targeted, time-limited intervention (for example a defined trial of 8–12 weeks) aligned with the durations tested in human studies.

* **Withdrawal effects:** No withdrawal syndrome has been described; given the short half-life, abrupt discontinuation is not expected to cause rebound effects.

* **Tapering:** Formal tapering is not required, though users combining it with sedatives or hormone-active agents may prefer a gradual stop to observe any change.

* **Cycling:** Whether cycling preserves efficacy is unknown; a practical, evidence-agnostic pattern is to reassess after a defined trial and pause if no benefit is observed, partly because of the open question of whether repeated use alters the herb's own metabolism.

* **Presentation of considerations:** Each of the above should be treated as provisional guidance drawn from pharmacology and trial durations rather than from dedicated discontinuation studies, which have not been performed.

## Sourcing and Quality

* **Source and species verification:** Confirm the product is genuinely *Angelica gigas* Nakai and not the frequently confused *Angelica sinensis* (Dong quai) or *Angelica acutiloba*, which have different chemistry; reputable products name the species and plant part (root).

* **Standardization to what to look for:** Prefer extracts standardized to defined decursin and decursinol angelate (or decursinol) content, since pyranocoumarin levels vary widely with cultivation site and harvest time and are the presumed active fraction.

* **Third-party testing:** Because botanical supplements are loosely regulated, choose brands with third-party testing or certification (for identity, potency, and contaminants such as heavy metals and pesticides), which is the main safeguard for a niche imported root.

* **Reputable sources:** Established supplement makers that publish certificates of analysis and standardize their decursinol content (for example Life Extension's decursinol-standardized products) are preferable to unverified imported bulk root or powder.

* **Formulation considerations:** Note whether a product is a single-herb standardized extract or a multi-herb blend, since most human data come from specific combination formulas and results may not transfer to a generic single-herb powder.

## Practical Considerations

* **Time to effect:** For symptom-based uses (urinary, menopausal, fatigue) the human trials measured benefit over 8–12 weeks, so a fair trial is on the order of two to three months rather than days; acute pain or sleep effects, if present, would appear within hours given the short half-life.

* **Common pitfalls:** The commonest mistakes are buying an unstandardized or species-mislabeled product, expecting single-herb results from data generated with combination formulas, and overlooking drug interactions with anticoagulants or CYP-dependent medications.

* **Regulatory status:** In the United States and Korea, Korean angelica is sold as a dietary supplement, not an approved drug; its uses are unapproved/off-label from a regulatory standpoint, and quality control rests on the manufacturer rather than a regulator.

* **Cost and accessibility:** Standardized extracts are a niche import but are not exceptionally expensive; availability is greater in Korea and through specialty U.S. supplement retailers than in mainstream stores.

* **Presentation:** Each consideration above is a practical, decision-relevant point for a user weighing a defined trial of the supplement.

## Interaction with Foundational Habits

* **Sleep:** The interaction is potentially direct and potentiating — the root has a traditional sedative reputation and decursinol acts centrally, so evening dosing may aid relaxation but could add to the effect of other sedatives; there is no evidence it disrupts sleep.

* **Nutrition:** The interaction is indirect — as a fat-associated coumarin extract, absorption may be modestly improved when taken with food, and there are no established nutrient depletions; whole-diet quality remains the dominant factor for the metabolic endpoints the herb is speculatively linked to.

* **Exercise:** The interaction may be indirect and mildly potentiating for endurance — the anti-fatigue combination trial reported improved aerobic capacity, plausibly through antioxidant and anti-inflammatory support of recovery — but there is no evidence it blunts training adaptations, and timing around workouts has not been studied.

* **Stress management:** The interaction is indirect — animal models suggest anti-anxiety and antidepressant-like effects and interaction with calming (GABA) signaling, so the herb may modestly support the stress response, though no human stress or cortisol data exist and stress-reduction practices remain primary.

## Monitoring Protocol & Defining Success

Baseline testing before starting is sensible mainly to screen for interaction and hormonal risks and to set a reference for the chosen goal; the following biomarkers cover the most relevant checks, and ongoing monitoring should follow the cadence noted below.

Baseline labs are worth obtaining before starting, particularly liver function and, depending on the goal, prostate or hormonal markers, so that any change can be interpreted against a known starting point.

Ongoing monitoring is reasonable at roughly 8–12 weeks (the length of the human trials) to judge response, and then every 3–6 months for anyone on prolonged use, with clotting time checked sooner if the herb is combined with agents affecting bleeding.

| Biomarker | Optimal Functional Range | Why Measure It? | Context/Notes |
|-----------|--------------------------|-----------------|---------------|
| ALT / AST (liver enzymes) | ALT ~10–26 U/L; AST ~10–26 U/L | Screen for and track liver strain given CYP-inhibitory activity | Conventional labs allow up to ~40 U/L; functional targets are tighter. Fasting not required |
| PSA (prostate-specific antigen) | < 1.0 ng/mL (age-dependent) | Relevant reference for men using it for urinary/prostate goals | PSA is a blood marker of prostate activity; avoid ejaculation and vigorous cycling 48 h before testing |
| INR / clotting time | ~0.8–1.1 (if not on anticoagulants) | Detect additive bleeding effect when combined with blood thinners | INR is a standardized clotting measure; check sooner if co-administered with anticoagulants |
| hs-CRP (high-sensitivity C-reactive protein) | < 1.0 mg/L | Track the anti-inflammatory claim objectively | A general marker of body-wide inflammation; avoid testing during acute illness |
| Estradiol / testosterone (as relevant) | Sex- and age-specific optimal range | Watch for unwanted hormonal shifts given receptor activity | Best drawn in the morning; interpret against sex-specific reference ranges |

Qualitative markers that a user can track alongside labs include the following:

* Sleep quality and ease of relaxation, especially with evening dosing
* Day-to-day pain levels and joint comfort
* Energy, fatigue, and exercise tolerance
* Cognitive clarity and memory for cognitively oriented users
* For men, urinary flow, urgency, and completeness of emptying

## Emerging Research

Research is framed for a proactive adult tracking whether stronger human evidence is coming, and it deliberately includes work that could either strengthen or weaken the case for the herb.

* **Standardized extract in early prostate cancer:** A Phase 1/2 trial of AGN-INM176 in prostate-cancer patients with rising prostate-specific antigen is recruiting, testing whether the standardized extract affects disease markers ([NCT06600698](https://clinicaltrials.gov/study/NCT06600698); ~45 participants).

* **Acute dose safety and pharmacokinetics:** A completed Phase 1 study of AGN-Cogni.Q examined acute-dose safety and blood-level dose-response in prostate-cancer patients, informing whether achievable human exposure reaches active concentrations ([NCT05375539](https://clinicaltrials.gov/study/NCT05375539); 12 participants).

* **Immune-cell effects in humans:** A completed study assessed Korean angelica dietary supplements and their effect on human innate immune cells, a direct test of an immunomodulatory claim ([NCT03630328](https://clinicaltrials.gov/study/NCT03630328); 15 participants).

* **Human pharmacokinetics of the pyranocoumarins:** An early-phase study characterized the pharmacokinetics of decursin/decursinol angelate (CognIQ), underpinning dose design for future efficacy trials ([NCT02114957](https://clinicaltrials.gov/study/NCT02114957); 20 participants).

* **Metabolic endpoints:** A completed 100-participant study evaluated an *Angelica gigas* extract for effects on blood triglycerides, a direction that could support or fail to support the speculative metabolic claim ([NCT03079648](https://clinicaltrials.gov/study/NCT03079648); 100 participants).

* **Translational and mechanistic reviews to watch:** Recent syntheses argue that resolving sourcing consistency, dose optimization, and whether blood levels plateau at higher doses is the key to any clinical future ([Lü et al., 2025](https://pubmed.ncbi.nlm.nih.gov/39779619/)), while novel delivery work such as decursin-loaded nanovesicles targeting atherosclerosis-related macrophages illustrates efforts to overcome the herb's poor exposure ([Chen et al., 2025](https://pubmed.ncbi.nlm.nih.gov/40285666/)).

## Conclusion

Korean angelica is a traditional East Asian root whose modern appeal rests on a small set of natural compounds — decursin, its close relative decursinol angelate, and their shared breakdown product decursinol — that laboratory studies tie to effects on inflammation, nerve signaling, hormones, and tumor cells. Its most likely real-world benefits, based on human testing, are modest relief of urinary symptoms in men with an enlarged prostate and of menopausal complaints in women, though both come from multi-herb blends rather than the root alone. Its best-known marketed uses, for memory and pain, are supported mainly by animal work and by confirmation that the active compound reaches the brain, but not yet by controlled human results.

The main drawbacks are practical rather than dangerous: short human trials show good tolerability with only mild side effects, while the clearest concern is the potential to change how the body processes other medicines, alongside caution around hormone-sensitive conditions, bleeding, and pregnancy. Overall the evidence base is early and uneven — a large and consistent laboratory record paired with only a handful of small, mostly combination-product human studies. For someone weighing it, the honest summary is genuine biological promise held back by thin human proof and by real questions about product quality and how much active compound actually gets absorbed.

**[Top](#top) - [Benefits](#expected-benefits) - [Risks](#potential-risks--side-effects) - [Protocol](#therapeutic-protocol)**