Centella Asiatica (Gotu Kola)
A triterpene-rich herb with real evidence for venous insufficiency and connective tissue — it stimulates collagen synthesis and strengthens vein walls, which is why it appears in cellulite and scar protocols.
Moderate for chronic venous insufficiency — several randomised trials and a Cochrane-adjacent literature show reduced oedema and improved capillary filtration with TTFCA. Moderate for topical wound healing and scar quality. Weak for cellulite specifically (small trials, soft endpoints). Weak and inconsistent for anxiety and cognition. Effects take 4–12 weeks.
Centella asiatica (gotu kola) has been used in Ayurvedic and traditional Chinese medicine for centuries, and unlike most traditional botanicals it has a plausible, well-characterised mechanism: its triterpenes — asiaticoside, madecassoside, asiatic acid and madecassic acid — stimulate type I and III collagen synthesis, modulate fibroblast activity, and improve capillary integrity. The strongest clinical evidence is in chronic venous insufficiency, where the standardised total triterpenic fraction (TTFCA / TECA) reduces ankle oedema, capillary leakage and heaviness. Topically it accelerates wound healing and improves scar quality. The cognitive and anxiolytic claims are far weaker — small trials, mixed results.
- Form
- Standardised extract is what matters. TTFCA / TECA (total triterpenic fraction, ~40% asiaticoside + asiatic and madecassic acids) is the form used in venous trials. Otherwise look for an extract standardised to 10–20% triterpenes. Topical creams (madecassoside 0.1–1%) for scars and wounds. Raw powdered leaf is far weaker and inconsistently dosed.
- Dose
- 60–180 mg/day of TTFCA (trials commonly 60 mg two to three times daily), or 500–1,000 mg/day of a standardised extract. Topical: apply twice daily.
- Timing
- With food, split across the day. Absorption is better with a meal containing fat.
- Schedule
- Daily. Venous and skin endpoints take 4–12 weeks; assess at 3 months. Traditional practice cycles 6 weeks on / 2 weeks off, though there's no trial basis for it.
- Side effects
- Usually well tolerated. GI upset, nausea and headache at higher doses. Contact dermatitis with topical use. Rare but real: case reports of hepatotoxicity with prolonged oral use — stop and get liver enzymes checked if you develop fatigue, dark urine or jaundice.
- Interactions
- Sedatives, benzodiazepines and alcohol — possible additive sedation. Hepatotoxic drugs (including high-dose paracetamol/acetaminophen and statins) — theoretical additive liver stress. Diabetes and cholesterol medications — may modestly affect glucose and lipids.
- Contraindications
- Pregnancy and breastfeeding (insufficient safety data; traditionally avoided). Active liver disease or a history of drug-induced liver injury. Scheduled surgery — stop 2 weeks before if combining with sedatives.
- Lab markers
- ALT / AST if using continuously beyond 6 weeks — the hepatotoxicity signal is rare but worth monitoring. Otherwise track the endpoint itself: ankle circumference or oedema for venous use, photographs for skin.
- Food sources
- Eaten as a leafy vegetable and in juices across Sri Lanka, Thailand, Indonesia and Vietnam (pennywort). Culinary amounts are nutritionally useful but well below the triterpene doses used in trials.
Pairs with
Pycnogenol and grape seed extract (the same venous/microcirculation target, different polyphenols). Collagen peptides and vitamin C (substrate plus the cofactor for the collagen synthesis it stimulates). Horse chestnut for venous tone.
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