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Gotu Kola

Other common name(s): centella, pennywort, Madekassol

Scientific/medical name(s): Centella asiatica, Hydrocotyle asiatica

Description

Gotu kola is a swamp plant that grows naturally in Madagascar, India, Sri Lanka, Indonesia, and many parts of South Africa. Its dried leaves and stems are used in herbal remedies. The active compounds in gotu kola are called saponins, or triterpenoids. Gotu kola is also used in Ayurvedic and Chinese medicine to treat skin wounds. Gotu kola is not related to the kola (cola) nut and contains no caffeine or stimulants.

Overview

Some clinical trials have looked at the use of gotu kola and its compounds in people with poor blood flow, usually in the legs. These limited studies suggest that gotu kola may help reduce swelling in the legs and feet, although more scientific studies are needed. Other research that has looked at gotu kola in humans has been limited by small numbers of patients and problems in study methods. Although at least one laboratory study of tumor cells showed reduced cell growth with gotu kola, available scientific evidence does not support claims of its effectiveness for treating cancer or any other disease in humans.

How is it promoted for use?

Proponents claim that gotu kola possesses numerous curative qualities. Some practitioners maintain that gotu kola reduces fever and relieves congestion caused by colds and upper respiratory infections. Some women use gotu kola for birth control, and some herbalists claim that gotu kola is an antidote for poisonous mushrooms and arsenic poisoning. Some believe that it can be applied externally to treat snakebites, herpes, fractures, and sprains.

In some folk medicine traditions, gotu kola is used to treat syphilis, rheumatism, leprosy, mental illness, and epilepsy. It is also used to stimulate urination and to relieve physical and mental exhaustion, diarrhea, eye diseases, inflammation, asthma, high blood pressure, liver disease, dysentery, urinary tract infections, eczema, and psoriasis. Some manufacturers of the herbal supplement claim gotu kola can be used to treat cancer as well.

What does it involve?

Gotu kola is available in capsules, eye drops, extracts, powder, and ointments from health food stores and over the Internet. Dried gotu kola can be made into a tea. Recommended dosage depends on the condition being treated.

What is the history behind it?

Gotu kola has a long history in the folk medicines of India, Indonesia, Sri Lanka, and Madagascar and is still widely used in these countries today. It has been used for generations in India to promote relaxation, improve memory, and aid meditation. In traditional Chinese medicine, the herb is believed to promote longevity. The Chinese name for gotu kola translates to "fountain of youth." A Sri Lankan legend says that elephants have long lives because they eat gotu kola.

What is the evidence?

Animal and laboratory studies of gotu kola have shown promising results for some uses, but further research will be needed to determine its benefits for humans. One group of gotu kola compounds that has been extracted and tested in clinical trials is called total triterpenic fraction of Centella asiatica (TTFCA). A few clinical trials in humans have suggested that extracts of gotu kola and TTFCA, when taken by mouth, were more helpful than a placebo at reducing swelling of the legs and feet due to varicose veins and poor circulation, a condition called chronic venous insufficiency. It seemed to reduce the “leakage” of blood vessels that seems to contribute to swelling. Further research is needed to determine whether these results will hold true. It is also important to remember that extracted chemicals such as TTFCA are not the same as the herb itself. Studies of extracts may not show the same results as studies using the raw plant.

One study in India reported that gotu kola extract slowed the development of tumors in mice and increased their life span. Other studies with rats showed that gotu kola extract had calming effects and prevented ulcers. Animal studies have shown that gotu kola, when applied to the skin or taken by mouth, seems to promote collagen production in wounds, which contributes to healing.

Laboratory studies showed that fresh gotu kola juice slowed the growth of tumor cells, but not as much as more purified extracts from the plant. Laboratory studies have also suggested that extracts of gotu kola could be useful in the treatment of scleroderma and for the prevention and treatment of Alzheimer disease. A small number of laboratory studies conducted in India and Europe suggest that an ointment or gel made from gotu kola may speed wound healing. None of these studies have been done on humans, although some of the wound-healing studies also looked promising in rodent tests.

Although animal and laboratory studies look promising for some of these uses, further studies are necessary to determine whether the results hold true for humans. More well-controlled research is needed to understand whether gotu kola will play any role in cancer treatment.

Are there any possible problems or complications?

This product is sold as a dietary supplement in the United States. Unlike companies that produce drugs (which must provide the FDA with results of detailed testing showing their product is safe and effective before the drug is approved for sale), the companies that make supplements do not have to show evidence of safety or health benefits to the FDA before selling their products. Supplement products without any reliable scientific evidence of health benefits may still be sold as long as the companies selling them do not claim the supplements can prevent, treat, or cure any specific disease. Some such products may not contain the amount of the herb or substance that is written on the label, and some may include other substances (contaminants). Though the FDA has written new rules to improve the quality of manufacturing processes for dietary supplements and the accurate listing of supplement ingredients, these rules do not take full effect until 2010. And, the new rules do not address the safety of supplement ingredients or their effects on health when proper manufacturing techniques are used.
Most such supplements have not been tested to find out if they interact with medicines, foods, or other herbs and supplements. Even though some reports of interactions and harmful effects may be published, full studies of interactions and effects are not often available. Because of these limitations, any information on ill effects and interactions below should be considered incomplete.

Gotu kola is generally considered safe; however there are no large clinical studies in humans to fully document side effects. When used on the skin, possible side effects include a burning sensation, itching, or allergic rash. Stomach irritation and nausea have been observed when the herb is taken by mouth. Drowsiness has been reported, especially when the herb is taken in larger doses. High doses of gotu kola have been reported to increase blood sugar and raise cholesterol levels. A few cases of hepatitis (liver inflammation) have been reported in people taking gotu kola. It may increase sensitivity to the sun, so avoid sunlight or use sunscreen while taking it. This herb can cause allergic reactions in some. Gotu kola impairs fertility in mice, but human effects are less well known.

In addition, the potential interactions between gotu kola and other drugs and herbs should be considered. Some of these combinations may be dangerous. Always tell your doctor and pharmacist about any herbs you are taking.

Women who are pregnant or breast-feeding should not use this herb. Relying on this type of treatment alone and avoiding or delaying conventional medical care for cancer may have serious health consequences.

Additional resources

More information from your American Cancer Society

The following information on complementary and alternative therapies may also be helpful to you. These materials may be found on our Web site (www.cancer.org) or ordered from our toll-free number (1-800-ACS-2345).

Dietary Supplements: What Is Safe?

The ACS Operational Statement on Complementary and Alternative Methods of Cancer Management

Complementary and Alternative Methods and Cancer

Placebo Effect

Learning About New Ways to Treat Cancer

Learning About New Ways to Prevent Cancer

References

Awang DV. Gotu kola. Can Pharm J. 1998;131:42-46.

Babu TD, Kuttan G, Padikkala J. Cytotoxic and anti-tumour properties of certain taxa of Umbelliferae with special reference to Centella asiatica (L.) Urban J Ethnopharmacol. 1995;48:53-57.

Fetrow CW, Avila JR. Professional's Handbook of Complementary & Alternative Medicines. Philadelphia, PA: Lippincott Williams & Wilkins; 2004.

Gnanapragasam A, Ebenezar KK, Sathish V, Govindaraju P, Devaki T. Protective effect of Centella asiatica on antioxidant tissue defense system against adriamycin induced cardiomyopathy in rats. Life Sci. 2004;76:585-597.

Gotu kola. Memorial Sloan-Kettering Cancer Center Web site. Accessed at www.mskcc.org/mskcc/html/69242.cfm on June 5, 2008.

Gruenwald J. PDR for Herbal Medicines. 3rd ed. Montvale, NJ: Thomson PDR; 2004.

Jorge OA, Jorge AD. Hepatotoxicity associated with the ingestion of Centella asiatica. Rev Esp Enferm Dig. 2005;97:115-124.

Pointel JP, Boccalon H, Cloarec M, Ledevehat C, Joubert M. Titrated extract of Centella asiatica (TECA) in the treatment of venous insufficiency of the lower limbs. Angiology. 1987;38:46-50.

Sunilkumar, Parameshwaraiah S, Shivakumar HG. Evaluation of topical formulations of aqueous extract of Centella asiatica on open wounds in rats. Indian J Exp Biol. 1998;36:569-572.

Veerendra Kumar MH, Gupta YK. Effect of Centella asiatica on cognition and oxidative stress in an intracerebroventricular streptozotocin model of Alzheimer's disease in rats. Clin Exp Pharmacol Physiol. 2003;30:336-342.

Note: This information may not cover all possible claims, uses, actions, precautions, side effects or interactions. It is not intended as medical advice, and should not be relied upon as a substitute for consultation with your doctor, who is familiar with your medical situation.


Last Medical Review: 11/28/2008
Last Revised: 11/28/2008