Asian medicinal herb with strong evidence for shortening cold and flu symptoms. Recognized by WHO and used clinically in Nordic countries for decades. Remarkably safe in herbal form, but injectable derivatives can be dangerous.
Traditions: Ayurveda, Traditional Chinese Medicine, Western herbalism (modern)
Multiple traditions agree on use.
Known as Kalmegh. Used for fever, respiratory infections, digestive disorders, and urinary tract infections. Traditional dose: 1.5-3g powdered herb three times daily.
Known as Chuan Xin Lian. Used for heat-clearing and detoxifying, particularly for fever and infections.
Adopted in Nordic countries by 1985, used clinically for common cold. Included in WHO monograph 2002 after review by 120+ experts in 50+ countries.
Andrographis has robust evidence for reducing cold and flu symptoms, particularly sore throat. A meta-analysis of 33 trials with 7,175 participants found significant improvements in cough and sore throat. Safety profile is excellent for oral preparations - serious adverse events occur in only 0.02 per 1,000 patients. Emerging evidence for inflammatory conditions like ulcerative colitis and rheumatoid arthritis.
33 RCTs, 7,175 participants. Sore throat improvement SMD -1.13 (p<0.0001), cough improvement SMD -0.39. Adverse events minimal, mainly GI.
13 studies: serious adverse events 0.02 per 1,000 patients (extremely rare). Non-serious events 102.6 per 1,000 (frequent but mild, mainly GI and skin).
224 participants. HMPL-004 1,800mg/day: 60% clinical response vs 40% placebo (p=0.0183). Well tolerated.
44 participants, 24 months. 280mg/day andrographolide reduced brain atrophy 36.5% vs placebo (p=0.08 trending). EDSS improved significantly (p=0.042).
Most studied form. For colds: 60mg andrographolides 3× daily for 3-5 days. For chronic conditions: 300-600mg extract daily.
Taste: Extremely bitter, astringent. Known as 'King of Bitters' for good reason. Honey helps but doesn't eliminate bitterness.
Traditional preparation. Extremely bitter - add honey. Less standardized than extracts but matches traditional use.
Traditional WHO-recommended dose for common cold. Can take in capsules or mix with water. Very bitter.
Andrographis has something most herbs lack: strong traditional use AND strong modern evidence for the same condition. This convergence is rare and worth noting.
Strong evidence (multiple RCTs and meta-analyses):
Moderate evidence (single or limited RCTs):
Limited/inconclusive evidence:
Critical finding: The evidence is strongest for what it’s been used for traditionally - acute respiratory infections. The chronic inflammatory conditions show promise but need larger studies.
Ayurveda:
Traditional Chinese Medicine:
WHO Recognition (2002):
Nordic adoption:
The pattern across traditions is consistent: bitter herb for infections (especially respiratory), fever, inflammation. Modern research validates these specific uses with measurable outcomes.
Timing matters: Start at first symptoms (scratchy throat, fatigue, congestion).
Standardized extract (most convenient, most studied):
What to expect: Most people in trials noticed sore throat relief within 1-2 days. The meta-analysis showed strongest effects on throat symptoms, moderate effects on cough. You’re comparing against your baseline - does this cold resolve faster or with less intensity than usual?
Traditional decoction (if you can handle bitter):
Standardized extract:
What worked in trials:
Timeline expectations:
Andrographis earned its name “King of Bitters” honestly. It’s very bitter.
Solutions:
Most people opt for capsules. The taste isn’t worth fighting unless you’re committed to traditional preparations.
For colds (3-5 day trial):
For chronic conditions (8-12 week trial):
Baseline (before starting):
Weekly tracking:
Compare:
Stop immediately if:
For acute colds:
For chronic inflammation:
What they report (from trials): Faster recovery from colds (1-2 days sooner), less severe sore throat, reduced joint pain and stiffness, improved function in daily activities, better fatigue management.
What they report: “Didn’t shorten my cold,” “made my stomach upset,” “too bitter to continue.”
Injectable andrographolide derivatives: Analysis of 9,490 participants found 55 anaphylactic reactions and 3 deaths from injectable forms [10]. NEVER use injections - oral herbal preparations only.
There’s no way around it: andrographis is one of the most bitter herbs you’ll encounter.
The Sanskrit name kalmegh and Chinese chuan xin lian both reference this intense bitterness. In traditional systems, this wasn’t a flaw - the bitter taste was considered therapeutically important for “clearing heat” and treating infections.
Modern science doesn’t support taste-as-medicine, but the bitterness does correlate with andrographolide content (the active compound). More bitter = more andrographolides.
Practical reality: Most people take capsules to avoid the taste. If you’re using decoctions or powder, honey helps but won’t eliminate bitterness. Traditional practitioners mixed it with ghee, milk, honey, and warming spices (cardamom, cinnamon) to make it tolerable.
If you absolutely can’t handle bitter herbs, this isn’t your plant. The capsules work, but if you can’t even tolerate the occasional bitter burp, choose a different option.
Standardization:
Studied products:
What to look for:
Why it matters: Andrographolide content varies widely in non-standardized products. Poor bioavailability means you need consistent, high-quality extracts to match the doses used in successful trials. One study found bioavailability enhancement of 131-196% with specific formulation strategies [11] - suggesting commercial products may vary dramatically in actual effectiveness.
This is a well-studied herb with strong safety data and good evidence for shortening colds - particularly sore throat. The WHO endorsement and decades of Nordic clinical use add confidence beyond just RCT data.
When it works: You might notice your cold resolving 1-2 days faster than usual, with less severe sore throat. For chronic inflammatory conditions, benefits build over 8-12 weeks - reduced pain, improved function, better quality of life. In one MS trial, brain atrophy reduced by 36.5% over 24 months [4].
When it doesn’t: Some people get no cold-shortening benefit. About 10% get mild GI upset (usually resolves in days). If you’re in the “no benefit” group, you’ve still gained useful information - try echinacea or elderberry instead.
Safety is a strength: With serious adverse events at 0.02 per 1,000 patients, this is one of the safest herbal medicines studied. The main risk is the injectable derivatives (which you should never use anyway).
Start with acute use: Try it for your next cold. Take 60mg andrographolides three times daily at first symptoms for 3-5 days. Track whether your cold resolves faster or milder than usual. If it helps, you have a reliable tool. If not, move on - there are other good options.
For chronic conditions: Consult a knowledgeable practitioner. The evidence is promising but not definitive, and you’ll need 8-12 weeks to know if you respond.
Duration: For acute colds: 3-5 days. For chronic inflammatory conditions: minimum 8-12 weeks to assess benefit.
What to notice:
For colds: Start at first symptom. Take 60mg andrographolides (or ~200mg extract) three times daily with food. Most people notice sore throat relief within 1-2 days. Continue for 3-5 days total. For chronic conditions: Start with 300mg extract daily for 2 weeks, increase to 600mg if tolerated. Effects build over 8-12 weeks. Take with food to minimize GI upset. If you get mild diarrhea (10% of people), it typically resolves within days - reduce dose if bothersome.
Generally considered: safe
Contraindications:
Pregnancy/Nursing: Contraindicated in pregnancy (traditional use and animal data suggest reproductive risks). No safety data for breastfeeding - avoid.
Extremely safe in oral herbal form. Meta-analysis of 13 studies: serious adverse events 0.02 per 1,000 patients (essentially negligible). Common mild effects: GI upset (10%), mild diarrhea (resolves within days), occasional skin reactions. CRITICAL WARNING: Injectable andrographolide derivatives have caused 55 anaphylactic reactions and 3 deaths - NEVER use injectable forms, only oral herbal preparations. No documented drug interactions in clinical trials. May cause transient blood pressure reduction (monitor if on antihypertensives). Long-term safety (>3 months) not well studied - consider periodic breaks. One review noted 'easily ignored' concerns about nephrotoxicity and reproductive toxicity - monitoring kidney function for extended use may be prudent.