Friday, July 08, 2005

Astragalus (Astragalus membranaceus)

Astragalus (Astragalus membranaceus)


Background


Astragalus products are derived from the roots of Astragalus membranaceus or related species, which are native to China. In traditional Chinese medicine, astragalus is commonly found in mixtures with other herbs, and is used in the treatment of numerous ailments, including heart, liver, and kidney diseases, as well as cancer, viral infections, and immune system disorders. Western herbalists began using astragalus in the 1800s as an ingredient in various tonics. The use of astragalus became popular in the 1980s based on theories about anti-cancer properties, although these proposed effects have not been clearly demonstrated in reliable human studies.

Some medicinal uses of astragalus are based on its proposed immune stimulatory properties, reported in preliminary laboratory and animal experiments, but not conclusively demonstrated in humans. Most astragalus research has been conducted in China, and has not been well designed or reported.

Gummy sap (tragacanth) from astragalus is used as a thickener (ice cream), emulsifier, denture adhesive, and anti-diarrheal agent.

Synonyms


Astragalus trigonus, Astragalus gummifera, Astragalus mollissimus, Astragalus lentiginosus , astragel, baak kei, beg kei, bei qi, buck qi, Fabacea (family) , goat's horn, goat's thorn, green dragon, gum dragon, gum tragacanthae, gummi tragacanthae, hoang ky, hog gum, huang-chi, Huang Qi, huangoi, huangqi, hwanggi, ji cao, Leguminosae (family), locoweed, membranous milk vetch, milk vetch, mongolian milk, mongolian milk vetch, neimeng hhuangqi, ogi, ougi, radix astragali, spino santo, Syrian tragacanth, tai shen, tragacanth, wong kei, yellow vetch, Zhongfengnaomitong.

Selected combination products that include this agent : Astragalus-Power, Baoyuan Dahuang, Biomune OSF Plus, Bu Zhong Yi Qi Tang, CH-100, Chi Power, Chinese Thermo-Chi, Deep Defense, Energy Boost Tincture, Equi-lizer Fast Start, Excel Energy, Fast Start, Fit America Natural Weight Control Aid, Formula One, Formula 3, Formula 3 Cell Activator, Fu-Zheng, Han-Dan-Gan-Le, Herbal Balance, Intra, Jian Yan Ling (JYL), Jiangtangjia, Magic Herb Diet Plus Formula + Chromium Picolinate, Man-Shen-Ling (MSL), Master Herb with Chromium Picolinate, Megawatt, Nature's Nutrition Formula One, Nature's Power Trim Super Fat Burner, New Image, New Image Plus, Sanhuang, Shengxue Mixture (SXM), Shen-Qi, Shi-quan-da-bu-tang (SQT), Thermojetics Beige, Tri-Chromaleane, Ultra Energy Now, Vita Chromaleane, Yi-qi Huo-xue injection (YHI), Yogi Herbal Tea.

Evidence

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Uses based on scientific evidenceGrade*Cancer
Although early laboratory and animal studies report increased immune cell function and reduced cancer cell growth associated with the use of astragalus, there is no reliable human evidence in these areas. Due to a lack of well-designed research, a firm conclusion cannot be drawn.

C
Chemotherapy side effects
In Chinese medicine, astragalus-containing herbal mixtures are sometimes used with the intention to reduce side effects of cancer treatments. Due to a lack of well-designed research, a firm conclusion cannot be drawn.
C
Low white blood cell count
Astragalus has been suggested as an immune system stimulant in preliminary laboratory and animal research, and in traditional accounts. There are published reports from China of white blood cell counts increasing during the use of astragalus preparations, although details are limited. Reliable scientific study has not been conducted in this area. High quality human research is necessary before a firm conclusion can be drawn.
C
Immune stimulation
Astragalus has been suggested as an immune system stimulant in preliminary laboratory and animal research, and in traditional accounts. Reliable human studies are lacking. High quality human research is necessary before a firm conclusion can be drawn.
C
Anti-viral activity
Anti-viral activity has been reported with the use of astragalus in laboratory and animal studies. Limited human research has examined the use of astragalus for viral infections in the lung, heart (pericarditis), liver (hepatitis B and C), cervix (papilloma virus), and in HIV disease. Studies have included combinations of astragalus with the drug interferon, or as a part of herbal mixtures. However, most studies have been small and poorly designed. Due to a lack of well-designed research, no firm conclusions can be drawn.
C
Upper respiratory tract infection
Astragalus is often used in Chinese medicine as a part of herbal mixtures to prevent or treat upper respiratory tract infections. Anti-viral activity has been reported in laboratory and animal studies, and in limited human reports. However, most studies have been small and poorly designed. Due to a lack of well-designed research, no firm conclusions can be drawn.
C
Coronary artery disease
In Chinese medicine, herbal mixtures containing astragalus have been used to treat heart diseases. There are several human case reports of reduced symptoms and improved heart function, although these are not well described. High quality human research is necessary before a conclusion can be drawn.
C
Heart failure
In Chinese medicine, herbal mixtures containing astragalus have been used to treat various heart diseases. There are several human case reports of reduced symptoms and improved heart function, and diuretic ("water pill") effects, although these are not well described. High quality human research is necessary before a conclusion can be drawn.
C
Myocarditis/endocarditis (heart infections)
Anti-viral activity has been reported in laboratory studies and animal models of myocarditis/endocarditis. Human research is limited in this area, and further research is necessary before a conclusion can be drawn.
C
Renal failure
Several animal and human studies report that kidney damage from toxins and kidney failure may be improved with the use of astragalus-containing herbal mixtures. Overall, this research has been poorly designed and reported. Astragalus alone has not been well evaluated. Better quality research is necessary before a conclusion can be drawn.
C
Liver protection
Several animal and human studies report that astragalus may protect the liver from damage related to toxins or hepatitis B and C. Overall, this research has been poorly designed and reported. Astragalus alone has not been well evaluated. Better quality research is necessary before a conclusion can be drawn.
C
ya you betcha
* Key to grades
A: Strong scientific evidence for this use;
B: Good scientific evidence for this use;
C: Unclear scientific evidence for this use;
D: Fair scientific evidence against this use (it may not work);
F: Strong scientific evidence against this use (it likely does not work).


Uses based on tradition or theory
The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Adrenal insufficiency (Addison's disease), aging, AIDS/HIV, allergies, Alzheimer's disease, anemia, angina, ankylosing spondylitis, anorexia, antifungal, antimicrobial, antioxidant, asthma, blood thinner, bone-marrow suppression from cancer or HIV, bronchitis, cervicitis, "chi deficiency" (fatigue, weakness, loss of appetite), chronic fatigue syndrome, chronic hepatitis, cleanser, cyclosporine-induced immune suppression, dementia, demulcent, denture adhesive (astragalus sap), diabetes, diabetic foot ulcers, diabetic neuropathy, diarrhea, digestion enhancement, diuretic (urination stimulant), edema, fatigue, fever, gangrene, gastrointestinal disorders, genital herpes, graft-versus-host disease, hearing damage from toxins/gentamicin, heart attack, hemorrhage (bleeding), hemorrhoids, high cholesterol, high blood pressure, hyperthyroid, insomnia, joint pain, laxative, leprosy, leukemia, liver disease, low blood platelets, lung cancer, memory, menstrual disorders, metabolic disorders, minimal brain dysfunction, myalgia (muscle pain), myasthenia gravis, nephritis, night sweats, palpitations, pelvic congestion syndrome, postpartum fever, postpartum urinary retention, prostatitis, rectal prolapse, rotovirus enterocolitis (infants), shortness of breath, sperm motility, stamina/endurance enhancement, stomach ulcer, stroke, sweating (excessive), systemic lupus erythematosus (SLE), tissue oxygenation, uterine prolapse, uterine bleeding, weight loss, wound healing.

Dosing

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Standardization

Standardization involves measuring the amount of certain chemicals in products to try to make different preparations similar to each other. It is not always known if the chemicals being measured are the "active" ingredients. Anecdotal reports have recommended astragalus to be standardized to a minimum of 0.4% 4-hydroxy-3-methoxy-isoflavone-7-glycoside per dose. However, since astragalus is often added to herbal mixtures with unclear amounts used, standardization is not always possible.

Adults (18 years and older)

General use by mouth : In Chinese medicine, astragalus is used in soups, teas, extracts, and pill form. In practice and in most scientific studies, astragalus is one component of multi-herb mixtures. Therefore, precise dosing of astragalus alone is not clear. Safety and effectiveness are not clearly established for any particular dose. Various doses of astragalus have been used or studied, including 250 to 500 milligrams of extract taken 4 times daily; 1 to 30 grams of dried root taken daily (doses as high as 60 grams have been reported); or 500 to 1000 milligrams of root capsules taken 3 times daily. Dosing of tinctures or fluid extracts depends on strength of preparations.

Note : In theory, consumption of the tragacanth (gummy sap derived from astragalus) may reduce absorption of drugs taken by mouth, and should be taken at separate times.

Children (younger than 18 years)

There is not enough scientific data to recommend astragalus for use in children.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

In theory, patients with allergies to members of the Leguminosae (pea) family may react to astragalus. Cross-reactivity with quillaja bark (soapbark) has been reported for astragalus gum tragacanth.

Side Effects and Warnings

Some species of astragalus have caused poisoning in livestock, although these types are usually not used in human preparations (which primarily include Astragalus membranaceus ). Livestock toxicity, referred to as "locoweed" poisoning, has occurred with species that contain swainsonine ( Astragalus lentiginosus, Astragalus mollissimus, Astragalus nothrosys, Astragalus pubentissimus, Astragalus thuseri, Astragalus wootoni ), or in species that accumulate selenium ( Astragalus bisulcatus, Astragalus flavus, Astragalus praelongus, Astragalus saurinus, Astragalus tenellus ).

Overall, it is difficult to determine the side effects or toxicity of astragalus, because it is most commonly used in combination with other herbs. There are numerous reports of side effects ranging from mild to deadly in the United States Food and Drug Administration computer database, although most of these are with multi-ingredient products, and cannot be attributed to astragalus specifically. Astragalus used alone and in recommended doses is traditionally considered to be safe, although safety is not well studied. The most common side effects appear to be mild stomach upset and allergic reactions. In the United States, tragacanth (astragalus gummy sap) has been classified as GRAS (generally recognized as safe) for food use, but astragalus does not have GRAS status.

Based on preliminary animal studies and limited human research, astragalus may decrease blood sugar levels. Caution is advised in patients with diabetes or hypoglycemia, and in those taking drugs, herbs, or supplements that affect blood sugar. Serum glucose levels may need to be monitored by a healthcare professional, and medication adjustments may be necessary.

Based on anecdotal reports and preliminary laboratory research, astragalus may increase the risk of bleeding. Caution is advised in patients with bleeding disorders or taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary.

Preliminary reports of human use in China have noted decreased blood pressure at doses below 15 grams and increased blood pressure at doses above 30 grams. Animal research suggests possible blood pressure lowering effects. Due to a lack of well-designed studies, no firm conclusions can be drawn. Nonetheless, people with abnormal blood pressure or taking blood pressure medications should use caution and be monitored by a qualified healthcare professional. Palpitations have been noted in human reports in China.

Based on animal study, astragalus may act as a diuretic and increase urination. In theory, this may lead to dehydration or metabolic abnormalities. There is one report of pneumonia in an infant after breathing in an herbal medicine powder including Astragalus sarcocolla .

Astragalus may increase growth hormone levels.

Pregnancy and Breastfeeding

There is not enough scientific evidence to recommend the safe use of Astragalus membranaceus during pregnancy or breastfeeding. Studies of toxic astragalus species, such as Astragalus lentiginosus or Astragalus mollissimus (locoweed) have reported harmful effects during animal pregnancies, leading to abortions or abnormal heart development.

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Zong PP, Yan TY, Gong MM. [Clinical and experimental studies of effects of Huayu decoction on scavenging free radicals]. Zhongguo Zhong Xi Yi Jie He Za Zhi 1993;13(10):591-3, 579.
Zuo L, Guo H. [Quantitative study on synergistic effect of radix astragali A6 and acyclovir against herpes simplex virus type I by polymerase chain reaction]. Zhongguo Zhong Xi Yi Jie He Za Zhi 1998;18(4):233-235.
January 01, 2004

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