An inexpensive, widely available Indian stem extract with a long traditional record and a broad but shallow research base. The most consistent findings are modest blood-sugar lowering in type 2 diabetes and relief of hay-fever-type nasal symptoms, from small studies of uneven quality. Against this sits uncommon, unpredictable, occasionally severe liver inflammation with immune features. (Full Review)
| Marker | Target | Why |
|---|---|---|
| ALT | 10–26 U/L (men), 10–19 U/L (women) | Earliest and most sensitive signal of hepatocellular injury |
| AST | 10–26 U/L | Confirms and grades injury signalled by ALT |
| Total bilirubin | 0.2–1.0 mg/dL | Distinguishes enzyme elevation from clinically significant injury |
| ALP and GGT | ALP 40–90 U/L; GGT below 20 U/L | Separates hepatocellular from cholestatic (bile-flow) patterns |
| ANA and IgG | ANA negative; IgG 700–1,400 mg/dL | Identifies the autoimmune phenotype in which reported injury clustered |
| HbA1c | 4.8–5.4% | Primary efficacy endpoint for metabolic use |
| Fasting glucose | 75–90 mg/dL | Detects both response and additive hypoglycaemia on drug therapy |
| Blood eosinophil count | 0–200 cells/µL | Tracks the allergic response the herb was shown to reduce |
| hs-CRP | Below 1.0 mg/L | Tracks the systemic inflammation the immunomodulation claim targets |
Cadence: Liver enzymes at 4–6 weeks, again at 12 weeks, then every 3 months for as long as use continues, with an additional panel 4–6 weeks after stopping. Efficacy markers are re-checked at 12 weeks.