Herbs & Supplements:
Gotu Kola
Centella asiatica

Principal Proposed Uses
  • Varicose Veins
Other Proposed Uses
  • Hemorrhoids, Keloid Scars, Burn Healing, Wound Healing, Anal Fissures, Bladder Ulcers, Perineal Lesions, Liver Cirrhosis, Scleroderma, Anxiety, Improving Mental Performance

Gotu kola is a creeping plant native to subtropical and tropical climates. In India and Indonesia, gotu kola has a long history of use to promote wound healing and slow the progress of leprosy. It was also reputed to prolong life, increase energy, and enhance sexual potency.¹ 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.

What Is Gotu Kola Used for Today?

In the 1970s, Italian and other European researchers found evidence that gotu kola could significantly improve symptoms of varicose veins, particularly overall discomfort, tiredness, and swelling. Gotu kola has also been suggested as a treatment for hemorrhoids because they are a type of varicose vein.

Like other herbs used for the treatment of varicose veins, gotu kola appears to have a generally beneficial effect on connective tissues. Along these lines, it has been used to prevent the development of keloid (bulging, enlarged) scars following surgery, as well as to soften existing keloids. Gotu kola has also been tried as a treatment for improving burn and wound healing and to alleviate the symptoms of the connective tissue disease scleroderma.

A recent study suggests that gotu kola might be helpful for anxiety.²

Gotu kola has a reputation for improving memory, and the positive results from a study of rats performed in 1992 produced a temporary rush of public interest.³ However, benefits in humans have not been demonstrated.

Gotu kola should not be confused with the caffeine-containing kola nut, used in original recipes for Coca-Cola.

What Is the Scientific Evidence for Gotu Kola?

Venous Insufficiency and Other Connective Tissue Disorders

There is significant scientific evidence for the effectiveness of gotu kola in varicose veins/venous insufficiency.

A vacuum suction chamber has been used in some gotu kola studies to evaluate the rate of fluid leakage in venous insufficiency. It produces swelling when applied to the skin of the ankle. When leg veins are leaking a lot of fluid, this swelling takes longer to disappear.

In one study of people with venous insufficiency, 2 weeks of treatment with gotu kola extracts was shown to reduce the time necessary for the swelling to disappear.⁴

A placebo-controlled study (whether it was double-blind was not stated) of 52 patients with venous insufficiency compared the effects of gotu kola extract at 180 mg daily and 90 mg daily against placebo.⁵ After 4 weeks of treatment, researchers observed improvement in various measurements of vein function in all treated patients, but not in the placebo group. They also found that the higher dose was more effective than the lower dose. This kind of dose responsiveness is generally taken as good evidence that a treatment is actually effective.

Another study of double-blind design followed 87 people with varicose veins and compared the benefits of gotu kola at 60 mg and 30 mg daily against placebo.⁶Again, the results showed improvements in both treated groups, but greater improvement at the higher dose.

A double-blind study of 94 individuals with venous insufficiency of the lower limb compared the benefits of gotu kola extract at 120 mg daily and 60 mg daily against a placebo.⁷ The results also showed a significant dose-related improvement in the treated groups in symptoms such as subjective heaviness, discomfort, and edema.

A 1992 review of all the gotu kola studies available concluded that gotu kola extract provides a dose-related improvement in venous insufficiency symptoms, reducing foot swelling, ankle edema, and fluid leakage from the veins.⁸

Although the subject is far from completely understood, it appears that gotu kola may improve the structure and function of the connective tissue in the body, keeping veins stronger and also possibly reducing the symptoms of other connective-tissue diseases. Along these lines, numerous clinical reports and preliminary studies suggest that gotu kola extracts may be useful in treating keloids, burns, wounds, anal fissures, bladder ulcers, dermatitis, hemorrhoids, perineal lesions, periodontal disease, cellulite, liver cirrhosis, and scleroderma.^9,10 Animal studies of purified asiaticoside, one of gotu kola's constituents, have also found a wound healing effect.¹¹ While some of these studies are intriguing and make a good case for further research, none can be regarded as definitive.

Anxiety

Gotu kola has been used in traditional medicine to treat anxiety. Because evidence suggests that easy startling is related to anxiety, researchers have attempted to test this use by measuring the acoustic startle response.¹² In this double-blind placebo-controlled trial, 40 study participants were given either gotu kola or placebo and then subjected to sudden loud noises. Researchers measured eye blinks and found a significantly reduced startle response in those treated with gotu kola. This suggests, but doesn't prove, that gotu kola may be helpful for anxiety.

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. Be patient, because gotu kola takes at least 4 weeks to work.

For the prevention of keloid scars, the herb is usually taken for 3 months prior to surgery, and for another 3 months afterwards.

Safety Issues

Orally, gotu kola appears to be nontoxic.¹³ It seldom causes any side effects other than the occasional allergic skin rash. However, there are some concerns that gotu kola may be carcinogenic if applied topically to the skin.¹⁴

Although gotu kola has not been proven safe for pregnant or nursing women, studies in rabbits suggest that it does not harm fetal development,¹⁵ and Italian physicians have given it to pregnant women.¹⁶ Safety in young children and those with severe liver or kidney disease has not been established.

Last reviewed March 2002 by Medical Review Board

Back to Top