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Gotu Kola (Centella asiatica)

Proposed Uses: Venous Insufficiency/Varicose Veins; Anal Fissures; Anxiety; Burn Healing; Cellulite; Hemorrhoids; Improving Mental Performance; Keloid Scars; Liver Cirrhosis; Periodontal Disease; Scleroderma; Wound Healing

Gotu kola is a creeping plant native to subtropical and tropical climates. Gotu kola has a long history of use in Ayurvedic medicine to promote wound healing and slow the progress of leprosy. It was also reputed to prolong life, increase energy, and enhance sexual potency.  Other uses of gotu kola included treating skin diseases, anxiety, diarrhea, menstrual disorders, vaginal discharge, and venereal disease.

Based on these many traditional indications, gotu kola was accepted as a drug in France in the 1880s. British physicians in Africa used a special extract to treat leprosy.

The best-documented use of gotu kola is to treat chronic venous insufficiency, a condition closely related to varicose veins. In these conditions, blood pools in the legs, causing aching, pain, heaviness, swelling, fatigue, and unsightly visible veins.

Preliminary double-blind, placebo-controlled studies indicate that gotu kola extract provides improvement in major venous insufficiency symptoms, reducing swelling, pain, fatigue, sensation of heaviness and fluid leakage from the veins.  However, no studies have evaluated whether regular use of gotu kola can make visible varicose veins disappear, or prevent new ones from developing.

Gotu kola has also been suggested as a treatment for hemorrhoids because they are a type of varicose vein, but there is no direct evidence that it is helpful for this purpose.

Like other herbs used for the treatment of varicose veins, gotu kola is thought to work by strengthening connective tissues. This has led to trials of gotu kola extracts for preventing or treating keloid scars, and treating anal fissures, bladder ulcers, burns, cellulite, dermatitis, liver cirrhosis, periodontal disease, scleroderma, and wounds. However, again there is no real evidence as yet that gotu kola is effective for any of these conditions.

One study provides weak evidence that gotu kola might be helpful for anxiety.

Gotu kola has a reputation for improving memory, and the positive results from a study in rats performed in 1992 produced a temporary rush of public interest in gotu kola as a " brain booster".  However, benefits in humans have not been demonstrated.

Dosage
The usual dosage of gotu kola is 20 to 60 mg 3 times daily of an extract standardized to contain 40% asiaticoside, 29 to 30% asiatic acid, 29 to 30% madecassic acid, and 1 to 2% madecassoside. When using it for venous insufficiency, give gotu kola takes at least 4 weeks to work.

For the prevention of keloid scars, (a purpose for which gotu kola has NOT been proven effective) the herb is typically taken for 3 months prior to surgery, and for another 3 months afterwards.

Safety Issues
When taken orally, gotu kola seldom causes any side effects other than the occasional allergic skin rash, and safety studies suggest that it is essentially non-toxic. However, one animal study hints that gotu kola might have carcinogenic effects if applied topically to the skin.

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