Herbal Monograph
Gotu kola
Centella asiatica (L.) Urb.
Apiaceae
Cooling nervine tonic and cognitive enhancer that strengthens connective tiss...
Overview
Plant Description
Low-growing, creeping, stoloniferous perennial herb, typically 5-15 cm tall but spreading indefinitely by slender, green to reddish-green stolons (runners) that root at the nodes. Stems are slender, glabrous to slightly pubescent, prostrate and creeping, forming dense mats of vegetation. Leaves simple, alternate but clustered at the nodes, reniform (kidney-shaped) to orbicular, 2-6 cm wide, with crenate to dentate margins, long-petioled (petioles 5-15 cm, arising from the node clusters), palmately veined with 5-7 prominent veins radiating from the petiole attachment point; leaf surface glabrous, somewhat fleshy, light to dark green. Inflorescence a simple, fasciculate umbel (typically 3-6 flowers) arising on a short peduncle from the leaf axils; flowers small (3-4 mm), inconspicuous, sessile to short-pedicellate; petals 5, white to pinkish or mauve, ovate; stamens 5; ovary inferior with 2 styles. Fruit a laterally compressed, reticulate cremocarp (schizocarp), 3-5 mm long, with prominent ribs, splitting into two mericarps at maturity. Root system fibrous, arising from the nodes of the stolons. The entire plant is aromatic when crushed, with a mildly sweet, herbaceous scent.
Habitat
Moist to wet, shady to semi-shady areas including stream banks, ditches, marshy ground, wet meadows, paddy field margins, swamp forests, and damp lowland areas. Thrives in tropical and subtropical climates with high humidity and consistent moisture. Grows well in partial shade but tolerates full sun if moisture is adequate. Prefers fertile, humus-rich, moist to waterlogged soils with slightly acidic to neutral pH (6.0-7.0). Found from sea level up to approximately 700 m elevation, though occasionally higher in tropical montane regions.
Distribution
Pantropical distribution. Native to tropical and subtropical regions of Asia, including India, Sri Lanka, Southeast Asia (Malaysia, Indonesia, Thailand, Vietnam, Philippines), China (southern provinces), Japan, and extending to northern Australia. Also native to parts of tropical Africa, Madagascar, and some Pacific Islands. Naturalized in tropical regions of the Americas, including parts of the southeastern United States (Florida, Louisiana, Texas, the Carolinas), Central America, and northern South America. Widely cultivated across South and Southeast Asia for medicinal, culinary, and cosmetic use. Major commercial production in India, Sri Lanka, Madagascar, and Southeast Asia.
Parts Used
Aerial parts — whole herb (leaves, petioles, and stolons)
Preferred: Fresh leaves and juice for traditional use; dried aerial parts for infusions and powder; standardized triterpene fraction extract (TTFCA/ECa 233) for clinical applications; tincture (fresh or dried herb in ethanol-water menstruum)
The whole aerial plant is the primary medicinal drug. The leaf is the most valued portion due to its high concentration of triterpene saponins (asiaticoside, madecassoside). In Ayurvedic practice, the whole fresh plant including stolons is traditionally used. The European Pharmacopoeia monograph (Centellae asiaticae herba) specifies the dried, cut aerial parts. The WHO monograph (Herbae Centellae) specifies the dried aerial parts. In traditional Asian use, fresh leaves are consumed as food (salad, juice, sambal) or applied as a poultice. Standardized commercial extracts are typically prepared from the whole dried aerial parts. The root is not commonly used medicinally, though some traditional preparations include it.
Key Constituents
Triterpene saponins (centellosides)
The triterpene saponins (centellosides) are the principal active constituents of Centella asiatica and the basis for standardized commercial extracts. The four major centellosides — asiaticoside, madecassoside, asiatic acid, and madecassic acid — collectively account for the plant's wound-healing, venotropic, cognitive-enhancing, and anxiolytic activities. Standardized extracts such as TTFCA (Titrated Triterpenic Fraction of Centella Asiatica — containing 40% asiaticoside, 30% asiatic acid, 30% madecassic acid) and ECa 233 (containing standardized asiaticoside and madecassoside) are used in clinical trials and commercial formulations. The centellosides stimulate collagen synthesis via activation of fibroblasts, promote GAG (glycosaminoglycan) production, and strengthen the vascular wall endothelium, which collectively explain the wound-healing and venotropic effects. James and Dubery (2009) provided a comprehensive phytochemical review of the triterpene saponins and their pharmacological significance. Concentration of centellosides varies substantially by geographic ecotype — Indian and Madagascan chemotypes tend to have higher asiaticoside, while Southeast Asian chemotypes may vary.
Flavonoids
The flavonoid fraction contributes antioxidant, anti-inflammatory, and vasculoprotective activity that complements the primary triterpene saponin fraction. Flavonoids may contribute to the neuroprotective effects observed in cognitive studies and provide synergistic support for the venotropic action of the centellosides. The flavonoid content is generally lower in concentration than the triterpene fraction and is not the basis for standardization in most commercial extracts.
Polyacetylenes
Polyacetylenes are a minor constituent class but may contribute to the wound-healing and antimicrobial properties of topical centella preparations. Their role in systemic effects from oral preparations is likely minimal.
Amino acids and vitamins
The amino acid and vitamin content is most relevant when centella is consumed as a fresh food or juice in traditional use. These constituents contribute to the overall nutritive tonic quality attributed to the plant in Ayurvedic tradition. In concentrated extracts standardized to triterpene saponins, the amino acid and vitamin content is negligible.
Volatile oils and other constituents
Minor constituent classes that collectively contribute to the pharmacological complexity of whole-plant centella preparations. The phytosterols and tannins support anti-inflammatory and wound-healing activity. The volatile oil fraction is too small to be clinically significant as an essential oil but may contribute marginally to the overall pharmacological profile.
Herbal Actions
Centella asiatica is a true nervine tonic — a herb that nourishes and strengthens the nervous system over time with sustained use. Distinguished from nervine relaxants (which calm acutely) and nervine stimulants (which stimulate acutely), the nervine tonic action implies a gradual, cumulative restoration of nervous system function with regular use. In Ayurveda, this is described as the Medhya Rasayana (intellect-rejuvenating) property. The mechanism involves multiple pathways: enhancement of dendritic branching and neurite outgrowth, increase in brain-derived neurotrophic factor (BDNF) expression, antioxidant protection of neural tissue, modulation of acetylcholinesterase activity, and anti-neuroinflammatory effects. Wattanathorn et al. (2008) demonstrated improved cognitive function and working memory in elderly volunteers after 2 months of centella extract supplementation.
[1, 7, 12, 17]Enhances cognitive function, learning, and memory through multiple mechanisms: (1) promotion of dendritic arborization and synaptogenesis — Mohandas Rao et al. (2006) demonstrated increased dendritic branching and intersections in the hippocampus and amygdala of neonatal rats treated with centella extract; (2) modulation of neurotransmitter systems including cholinergic, GABAergic, and monoaminergic pathways; (3) antioxidant protection of neural tissue from oxidative stress; (4) anti-neuroinflammatory activity via inhibition of NF-kB and reduction of pro-inflammatory cytokines in the CNS; (5) enhanced BDNF and nerve growth factor (NGF) expression. Both traditional use across multiple Asian medical systems and modern preclinical and clinical evidence support the nootropic classification.
[1, 7, 18, 19]Reduces anxiety
Reduces anxiety through modulation of GABAergic neurotransmission and corticosterone (cortisol) pathways. Bradwejn et al. (2000) conducted a randomized, double-blind, placebo-controlled trial in 40 healthy adults demonstrating that a single dose of centella extract (12 g) significantly attenuated the acoustic startle response (ASR), a validated physiological measure of anxiety, compared to placebo. The startle response attenuation suggests a direct anxiolytic effect on the amygdala-mediated fear circuit. Animal studies confirm anxiolytic activity with reduced corticosterone levels, increased GABA levels in the brain, and modulation of serotonergic pathways. The anxiolytic action is distinct from sedation — centella calms anxiety while enhancing rather than impairing cognitive function.
[1, 6, 12]One of the most extensively documented wound-healing herbs in the pharmacopeial literature. Centella promotes wound healing through multiple mechanisms: (1) stimulation of fibroblast proliferation and type I and III collagen synthesis via upregulation of TGF-beta and activation of the Smad signaling pathway; (2) increased tensile strength of newly formed connective tissue; (3) promotion of angiogenesis at the wound site; (4) enhanced glycosaminoglycan (GAG) synthesis; (5) modulation of the inflammatory phase of wound healing to optimize repair. Shukla et al. (1999) demonstrated that oral asiaticoside treatment significantly accelerated wound healing in streptozotocin-diabetic rats, increasing hydroxyproline content, tensile strength, collagen content, and epithelialization. The wound-healing action applies to both topical and oral routes of administration.
[1, 11, 15, 16]Broadly strengthens and restores connective tissue integrity throughout the body. Stimulates collagen synthesis and GAG production in skin, blood vessel walls, tendons, and other connective tissue structures. This action extends beyond wound healing to include: strengthening of venous and capillary walls (venotonic effect), reduction of excessive scar and keloid formation (anti-fibrotic modulation of collagen deposition), improvement of skin elasticity and dermal thickness, and potential support for joint and connective tissue integrity. The connective tissue tonic action is the unifying mechanism behind the diverse dermatological, vascular, and wound-healing applications.
[1, 15, 16]Strengthens venous wall integrity and improves venous return. The triterpene saponins stimulate collagen synthesis in venous endothelium and smooth muscle, reduce capillary permeability, and improve microcirculation. TTFCA (Titrated Triterpenic Fraction of Centella Asiatica) has been extensively studied for chronic venous insufficiency (CVI) in multiple clinical trials. Cesarone et al. (2001) demonstrated that TTFCA 60 mg twice daily for 8 weeks significantly improved microcirculatory parameters, reduced ankle edema, and improved subjective symptoms in patients with severe venous hypertension. The venotonic action is well-established in European phytotherapy and is the basis for registered phytomedicines in several European countries.
[1, 8, 9, 15]In Ayurvedic classification, Centella asiatica is one of the four Medhya Rasayana herbs (intellect-rejuvenating tonics) listed in the Charaka Samhita. The Rasayana (rejuvenative) classification implies adaptogenic properties — enhancing the body's resistance to stress, promoting longevity, and supporting overall vitality. Modern research provides partial support: centella modulates the hypothalamic-pituitary-adrenal (HPA) axis, reduces corticosterone levels under stress, provides antioxidant neuroprotection against stress-induced oxidative damage, and supports cognitive function under stress conditions. However, centella does not meet all criteria of the classic Brekhman/Lazarev adaptogen definition as rigorously as herbs like Withania somnifera (ashwagandha) or Eleutherococcus senticosus. The adaptogenic classification is best understood within the Ayurvedic Rasayana framework rather than the pharmacological adaptogen definition.
[1, 17, 18]Reduces inflammation
Demonstrates anti-inflammatory activity via multiple mechanisms: inhibition of NF-kB-mediated pro-inflammatory gene expression, reduction of iNOS and COX-2 expression, suppression of pro-inflammatory cytokines (TNF-alpha, IL-1beta, IL-6), and antioxidant-mediated reduction of inflammatory oxidative stress. The anti-inflammatory action is relevant to both wound healing (modulation of the inflammatory phase) and neuroprotection (reduction of neuroinflammation). Madecassoside has been identified as a particularly potent anti-inflammatory centelloside.
[15, 16]Therapeutic Indications
Nervous System
Cognitive decline, poor memory, and impaired concentration
A primary traditional and modern indication. Wattanathorn et al. (2008) conducted a randomized, placebo-controlled trial of standardized centella extract (250 mg, 500 mg, or 750 mg daily) in 28 healthy elderly participants over 2 months. The 750 mg dose significantly improved cognitive performance on the working memory factor (P < 0.01), self-rated mood, and calmness/contentedness, suggesting dose-dependent nootropic and mood-enhancing effects. Dev et al. (2009) reviewed the evidence for centella's nootropic activity, confirming multiple mechanisms including enhanced cholinergic neurotransmission, increased BDNF, antioxidant neuroprotection, promotion of dendritic arborization, and anti-neuroinflammatory effects. In Ayurveda, centella is one of the four Medhya Rasayana (intellect-rejuvenating) herbs prescribed for enhancing dhi (learning), dhriti (retention), and smriti (recall). Used by students, elderly individuals, and those recovering from neurological illness.
[1, 7, 18, 19]Anxiety and stress-related nervousness
Bradwejn et al. (2000) demonstrated in a randomized, double-blind, placebo-controlled study (n=40 healthy adults) that a single dose of centella extract (12 g) significantly reduced the acoustic startle response peak amplitude, a validated objective measure of anxiety state, compared to placebo (P = 0.04). This suggests a direct anxiolytic effect mediated through the amygdala and brainstem startle circuitry. Additional support comes from Jana et al. (2010), who showed that centella extract (500 mg twice daily for 60 days) significantly reduced anxiety and depression scores in 33 patients with generalized anxiety disorder. Unlike benzodiazepines, centella reduces anxiety while simultaneously enhancing cognitive function — making it particularly valuable for individuals whose anxiety impairs their mental performance.
[1, 6, 10, 12]Meditation support and spiritual practice
Traditional use across Hindu, Buddhist, and Taoist contemplative traditions as a meditation-enhancing herb. In Ayurvedic tradition, centella is described as a Sattvic herb that promotes clarity of consciousness, calm awareness, and balanced mental function conducive to meditation and spiritual development. Sri Lankan tradition holds that elephants, noted for their longevity and memory, consume centella — hence one of its folk names. Taoist herbalism regards it as a promoter of spiritual awareness and longevity. These traditional claims are consistent with the combined nootropic (clarity-enhancing) and anxiolytic (calming without sedating) pharmacological profile, which would support focused, calm awareness during contemplative practice. No clinical trials specifically evaluating meditation enhancement.
[1, 18]Neurodegenerative disease support (adjunctive)
Preclinical evidence suggests potential neuroprotective applications in Alzheimer's disease, Parkinson's disease, and other neurodegenerative conditions. Mechanisms include: inhibition of beta-amyloid plaque formation and tau hyperphosphorylation (Alzheimer's), antioxidant protection of dopaminergic neurons (Parkinson's), anti-neuroinflammation via NF-kB inhibition, and promotion of neurite outgrowth and synaptic plasticity. Shinomol et al. (2011) reviewed the evidence for centella's neuroprotective potential and concluded that the herb warrants clinical investigation for neurodegenerative disorders. However, clinical trial evidence in diagnosed neurodegenerative disease is extremely limited, and these applications remain investigational. Not a substitute for standard medical treatment.
[17, 18, 19]dermatological
Wound healing (acute and chronic wounds, burns, post-surgical)
One of the most thoroughly documented wound-healing indications in herbal medicine. The WHO monograph and multiple pharmacopeias recognize centella for wound healing. Mechanism involves stimulation of fibroblast proliferation, enhanced collagen synthesis (types I and III), increased wound tensile strength, promotion of angiogenesis, and modulation of the inflammatory phase. Shukla et al. (1999) demonstrated in streptozotocin-diabetic rats that oral asiaticoside (1 mg/kg) significantly increased hydroxyproline content, tensile strength, collagen content, and epithelialization compared to controls. Both topical and oral routes are effective. Used for surgical wounds, traumatic wounds, burns (including radiation burns), diabetic ulcers, and chronic non-healing wounds. Topical application of centella-based creams and ointments is widely used in dermatological practice across Asia and Europe.
[1, 11, 15, 16]Keloids, hypertrophic scars, and pathological scarring
Centella modulates collagen metabolism to promote orderly, regulated collagen deposition rather than excessive, disorganized fibrosis characteristic of keloids and hypertrophic scars. Asiaticoside increases collagen synthesis but simultaneously modulates the ratio of type I to type III collagen, promoting a more normal tissue architecture. It also increases the activity of tissue inhibitor of metalloproteinases (TIMP) and modulates TGF-beta signaling to prevent excessive fibrosis. Traditional and clinical use for prevention and treatment of keloids is well-documented. Topical application of centella-based preparations is used prophylactically on surgical wounds and sites prone to keloid formation. Several centella-based scar treatment products are commercially available in Europe and Asia.
[1, 15, 16]Psoriasis, eczema, and inflammatory dermatoses (adjunctive)
Traditional use in Ayurveda and Sri Lankan medicine for chronic inflammatory skin conditions. The anti-inflammatory action (NF-kB inhibition, reduction of pro-inflammatory cytokines) and promotion of healthy connective tissue repair provide a pharmacological rationale. Limited clinical evidence for these specific indications — primarily case reports and traditional use data. Used as a topical application and orally as an adjunct to conventional treatment.
[1, 15]Cardiovascular System
Chronic venous insufficiency (CVI) and venous hypertension
The best-established clinical indication in European phytotherapy, supported by multiple randomized controlled trials. TTFCA (Titrated Triterpenic Fraction of Centella Asiatica) at doses of 60-120 mg daily has been studied extensively. Cesarone et al. (2001) demonstrated in a randomized, placebo-controlled trial (n=40) that TTFCA 60 mg twice daily for 8 weeks significantly improved microcirculatory parameters (transcutaneous PO2 and PCO2, laser Doppler flux) and reduced ankle edema in patients with severe venous hypertension. Incandela et al. (2001) showed similar improvements in venous hypertension and microangiopathy. The mechanism involves strengthening of venous wall connective tissue via stimulation of collagen synthesis, reduction of capillary permeability, improvement of venous tone, and anti-inflammatory effects on the vascular endothelium. TTFCA is registered as a phytomedicine for CVI in several European countries (Italy, France).
[1, 8, 9, 15]Varicose veins
Clinical improvement in symptoms of varicose veins (heaviness, pain, swelling, cramping) with oral TTFCA supplementation. The mechanism is identical to the CVI indication — strengthening of venous wall integrity and improvement of venous return. Several clinical studies have demonstrated symptomatic improvement and reduction in venous distensibility with TTFCA treatment. Used in combination with compression therapy and lifestyle modifications as part of a comprehensive approach to venous disease.
[1, 8, 15]Microangiopathy (diabetic and hypertensive)
TTFCA has demonstrated improvement in microcirculatory parameters in patients with diabetic microangiopathy and hypertensive microangiopathy. Incandela et al. (2001) demonstrated that TTFCA treatment improved capillary filtration rate, skin flux at laser Doppler, and transcutaneous gas measurements in patients with venous microangiopathy. The improvement in microcirculation is attributed to strengthening of capillary wall connective tissue and reduction of capillary permeability.
[1, 8, 9]connective tissue
Cellulite (panniculopathy)
Some clinical use of centella preparations (both topical and oral) for improvement of cellulite appearance, based on the connective tissue-strengthening and microcirculation-improving properties. The rationale is that cellulite involves weakened dermal connective tissue and impaired microcirculation. Limited controlled clinical trial data. Commonly included in topical anti-cellulite formulations in the European cosmetics market.
[15]Scleroderma and connective tissue fibrosis (adjunctive)
Limited clinical reports of centella extract improving skin elasticity and reducing fibrosis in localized scleroderma. The modulation of collagen metabolism — promoting orderly synthesis while preventing excessive fibrosis — provides a theoretical rationale. This remains an investigational application and is not a substitute for rheumatological management.
[1, 15]Energetics
Temperature
cool
Moisture
slightly moist
Taste
Tissue States
heat/excitation, atrophy/weakness
In Ayurvedic energetics, Centella asiatica is classified as: Rasa (taste) — tikta (bitter), kashaya (astringent), madhura (sweet); Guna (quality) — laghu (light); Virya (potency) — shita (cooling); Vipaka (post-digestive taste) — madhura (sweet). It pacifies all three doshas but is especially effective for Pitta (due to its cooling nature) and Vata (due to its nervine tonic and rejuvenative properties). It is classified as a Sattvic herb — one that promotes clarity, calmness, and spiritual awareness (Sattva guna) rather than agitation (Rajas) or inertia (Tamas). This Sattvic quality is why Centella holds such a prominent place in contemplative and meditative traditions. In Western herbal energetics, the cooling quality makes centella appropriate for conditions with heat signs (inflammation, irritability, restless agitation) while the sweet post-digestive taste reflects its nourishing, tonic quality — it builds and restores rather than merely sedating. The slightly moist quality (not drying) supports its connective tissue trophorestorative action. Centella is particularly well-suited for individuals with a hot, depleted, anxious presentation — where nervous exhaustion coexists with heat and inflammation. It combines well with warming circulatory stimulants like Zingiber officinale (ginger) when additional warmth is needed, or with cooling nervines like Melissa officinalis (lemon balm) for a strongly cooling, anxiety-calming formula.
Traditional Uses
Ayurvedic medicine (India and Sri Lanka)
- Medhya Rasayana (intellect-rejuvenating tonic) — one of four primary Medhya herbs listed in the Charaka Samhita
- Enhancement of dhi (learning), dhriti (retention), and smriti (recall)
- Nervous debility, mental fatigue, and cognitive decline in the elderly
- Anxiety, insomnia, and mental restlessness (as a Sattvic nervine)
- Wound healing — applied topically and taken orally for cuts, burns, ulcers, and surgical wounds
- Skin diseases including leprosy, eczema, psoriasis, and chronic skin ulcers
- Balya (strengthening tonic) for general debility and convalescence
- Vayasthapana (age-preserving) — used as a longevity and anti-aging tonic
- Support for meditation and spiritual practice (Sattvic herb that promotes clarity)
"Centella asiatica holds a place of extraordinary importance in Ayurvedic medicine, where it is known as Mandukaparni ('frog-leaf,' from the shape of its leaves resembling a sitting frog). It is listed as a Medhya Rasayana in the Charaka Samhita (circa 2nd century BCE/CE), one of the foundational texts of Ayurveda. The Charaka Samhita describes four principal Medhya Rasayana herbs: Mandukaparni (Centella asiatica), Yashtimadhu (Glycyrrhiza glabra), Guduchi (Tinospora cordifolia), and Shankhapushpi (Convolvulus pluricaulis). IMPORTANT NOTE ON NAMING: In some Ayurvedic traditions, particularly in North India, 'Brahmi' refers to Bacopa monnieri, while 'Mandukaparni' refers to Centella asiatica. In some South Indian and classical texts, 'Brahmi' may refer to Centella asiatica. This naming confusion has led to significant errors in both traditional practice and modern research. The two plants are botanically, phytochemically, and pharmacologically distinct. Sushruta, in the Sushruta Samhita, describes centella for wound healing and skin diseases. The Sattvic classification places centella among herbs that promote mental clarity and spiritual awareness — making it a favored herb among yogis, monks, and contemplatives in the Hindu and Buddhist traditions."
Traditional Chinese Medicine
- Ji Xue Cao (accumulated snow grass) — clears heat and resolves toxins
- Promotes urination and reduces edema (damp-heat conditions)
- Used for jaundice and hepatitis (damp-heat in the liver/gallbladder)
- Traumatic injuries, wounds, and abscesses — clears heat-toxin from wound sites
- Sore throat and fever from toxic heat
- Summer heat conditions with dampness
"In Traditional Chinese Medicine, Centella asiatica is known as Ji Xue Cao (also written Ji Xue Cao or Luo De Da). It is classified as an herb that clears heat and resolves toxins (Qing Re Jie Du Yao). Its properties are described as bitter and acrid in taste, cool in nature, entering the Liver and Spleen channels. TCM uses centella primarily for damp-heat conditions including jaundice, urinary tract infections, and abscesses, as well as for traumatic wounds and toxic heat conditions. The TCM application differs somewhat from the Ayurvedic emphasis on cognitive enhancement and nervous system tonic — reflecting the different theoretical frameworks of the two medical systems. However, both traditions recognize the cooling nature and wound-healing properties."
Sri Lankan traditional medicine
- Daily consumption of fresh leaves as a longevity food and general health tonic
- Memory enhancement and prevention of cognitive decline in the elderly
- Treatment of wounds, skin ulcers, and leprosy
- Digestive tonic and appetite stimulant
- Respiratory conditions including asthma and bronchitis
"Centella asiatica is one of the most revered herbs in Sri Lankan traditional medicine (Deshiya Chikitsa), where it is known as Gotukola (the original source of the common English name 'gotu kola'). A well-known Sri Lankan proverb states: 'Two leaves a day keep old age away,' referring to the daily consumption of a few fresh centella leaves as a health-maintaining practice. Fresh centella is consumed daily as a food — in sambal (a condiment), as a salad green, or juiced — and this dietary use is considered as important as its medicinal applications. The association between centella and elephants in Sri Lankan folklore (elephants are believed to eat centella, contributing to their longevity and excellent memory) further reinforces the plant's reputation as a memory and longevity tonic. Centella is widely cultivated in home gardens throughout Sri Lanka for daily consumption."
[1]
Southeast Asian traditional medicine (Malaysia, Indonesia, Thailand, Vietnam)
- Pegaga (Malaysia) / Daun kaki kuda (Indonesia) — eaten as fresh salad and used as a general health tonic
- Wound healing and treatment of skin infections
- Fever reduction and treatment of infections
- Postpartum recovery tonic for new mothers
- Memory enhancement and support for studying (given to children and students)
- Poultice for boils, abscesses, and infected wounds
"Across Southeast Asia, Centella asiatica is both a common food plant and an important traditional medicine. In Malaysia (pegaga), Thailand (bua bok), Indonesia (daun kaki kuda or pegagan), and Vietnam (rau ma), the fresh leaves are consumed as a salad, in drinks, and in various culinary preparations. This dual food-medicine status reflects the traditional belief in centella as a daily health-maintaining tonic, similar to its use in Sri Lanka. In Malaysian traditional medicine, pegaga is used as a general health tonic, memory enhancer, and wound healer. In Thai traditional medicine, bua bok is used to treat wounds and reduce fever. In Vietnamese folk medicine, rau ma juice is consumed for its cooling, detoxifying properties and as a general health drink, especially in hot weather."
African traditional medicine
- Wound healing and treatment of skin ulcers (particularly in East African and Southern African traditions)
- Treatment of leprosy and skin diseases
- General tonic and blood purifier
- Fever and infection management
"Centella asiatica has a history of use in African traditional medicine, particularly in regions of East Africa, Southern Africa, and Madagascar where the plant grows natively. In Madagascar, centella (called talapetraka) is widely used and is the source of some commercially cultivated material for the European pharmaceutical market. Traditional applications center on wound healing and skin disease treatment. The Madagascan use of centella is particularly well-documented and contributed to the early European pharmaceutical interest in the plant, notably the development of TTFCA preparations in France beginning in the 1960s."
Modern Research
Centella asiatica extract and acoustic startle response (anxiolytic effect) in healthy adults
Randomized, double-blind, placebo-controlled trial evaluating the effect of a single dose of centella extract (12 g) on the acoustic startle response (ASR) in 40 healthy adult volunteers. The ASR is a validated psychophysiological measure of anxiety — its attenuation reflects reduced amygdala-mediated fear reactivity.
Findings: Centella extract significantly attenuated the peak acoustic startle response amplitude compared to placebo (P = 0.04) at 30 and 60 minutes post-dose. There was also a trend toward reduced self-rated anxiety on the Visual Analog Mood Scale (VAMS), though this did not reach statistical significance. The finding suggests that centella has a direct, measurable anxiolytic effect on brainstem-mediated startle circuitry and the amygdala fear network, providing objective physiological evidence for the traditional anxiolytic claims.
Limitations: Single-dose study; does not address chronic dosing. Healthy volunteers (not anxiety disorder patients). Relatively large single dose (12 g) compared to typical supplementation doses. Small sample size (n=40, 20 per group). The preparation was described as 'Centella asiatica' but standardization to specific centellosides was not reported.
[6]
Cognitive enhancement in healthy elderly volunteers with standardized Centella asiatica extract
Randomized, placebo-controlled trial evaluating the cognitive and mood effects of standardized Centella asiatica extract (250 mg, 500 mg, or 750 mg daily) in 28 healthy elderly participants (mean age 65 years) over a 2-month treatment period.
Findings: The 750 mg daily dose significantly improved cognitive performance on the working memory factor of the cognitive test battery (P < 0.01) compared to placebo. Self-rated contentedness and calmness were also significantly improved. The 250 mg and 500 mg doses showed trends toward improvement but did not reach significance for all cognitive measures. The results suggest a dose-dependent nootropic and mood-enhancing effect of standardized centella extract in elderly individuals, supporting the traditional Medhya Rasayana (intellect-rejuvenating) classification.
Limitations: Small sample size (n=28 total across 4 groups — approximately 7 per group). Healthy elderly volunteers (not cognitively impaired patients). Short treatment duration (2 months). Single-center study. Limited cognitive battery. The study was likely underpowered to detect smaller effect sizes.
[7]
TTFCA for chronic venous insufficiency and venous hypertension — microcirculatory effects
Randomized, placebo-controlled clinical trial evaluating the effect of TTFCA (Titrated Triterpenic Fraction of Centella Asiatica, 60 mg twice daily) on microcirculatory parameters in 40 patients with severe venous hypertension and ankle edema over 8 weeks of treatment.
Findings: TTFCA treatment significantly improved microcirculatory parameters compared to placebo: increased transcutaneous PO2 (indicating improved tissue oxygenation), decreased transcutaneous PCO2 (indicating improved CO2 clearance), and improved laser Doppler flux (indicating enhanced microcirculation). Ankle circumference (edema) was significantly reduced. Subjective symptoms (heaviness, pain, edema sensation) were also significantly improved. The results demonstrated that TTFCA exerts measurable, clinically meaningful effects on venous microcirculation and tissue perfusion.
Limitations: Small sample size (n=40, 20 per group). Single-center study. Short duration (8 weeks). The study used surrogate endpoints (microcirculatory parameters) rather than patient-centered outcomes as the primary endpoint. No long-term follow-up.
[8]
TTFCA for venous hypertensive microangiopathy — capillary filtration and permeability
Controlled clinical trial evaluating the effect of TTFCA (60 mg twice daily for 6 weeks) on capillary filtration rate and microcirculatory parameters in patients with venous hypertensive microangiopathy.
Findings: TTFCA significantly improved capillary filtration rate (a measure of capillary permeability — lower values indicate less leakage from capillaries), increased resting skin flux at laser Doppler, and improved transcutaneous gas exchange parameters (PO2 increased, PCO2 decreased). These improvements indicate that TTFCA strengthens capillary walls, reduces pathological capillary permeability, and improves tissue perfusion in patients with venous microvascular disease.
Limitations: Relatively small study. Surrogate microcirculatory endpoints. Short treatment duration. Limited demographic data. Single-center study.
[9]
Asiaticoside-promoted wound healing in diabetic animal model
Experimental study evaluating the wound-healing effects of oral asiaticoside (0.2 mg/kg and 1 mg/kg body weight) in streptozotocin-induced diabetic rats with punch-biopsy wounds, compared to untreated diabetic and non-diabetic controls.
Findings: Oral asiaticoside at 1 mg/kg significantly increased hydroxyproline content (a marker of collagen synthesis), tensile strength of healed wounds, collagen content, and epithelialization compared to untreated diabetic controls. The asiaticoside-treated diabetic wounds approached the healing parameters of non-diabetic control animals. Histological examination confirmed more organized collagen deposition and improved angiogenesis in treated wounds. The study demonstrates that asiaticoside can promote wound healing even in the impaired healing environment of diabetes.
Limitations: Animal study — results may not directly translate to human diabetic wounds. Specific animal model (streptozotocin rat) may not fully replicate human diabetic wound pathophysiology. Two dose levels only. Short follow-up period.
[11]
Comprehensive review of Centella asiatica pharmacology and clinical evidence
Systematic review of preclinical and clinical studies on Centella asiatica, covering wound healing, chronic venous insufficiency, cognitive and neurological effects, and safety. Published in the American Journal of Clinical Dermatology.
Findings: The review confirmed well-established clinical evidence for TTFCA in chronic venous insufficiency, supported by multiple randomized controlled trials demonstrating improvement in microcirculation, reduction of edema, and symptomatic relief. Wound-healing evidence was confirmed by both animal studies and clinical use. The review identified cognitive enhancement and neuroprotection as promising emerging indications supported by preclinical evidence and limited clinical data. Safety was assessed as favorable, with contact dermatitis identified as the most common adverse effect of topical use. The review concluded that centella triterpene saponins represent a well-validated class of phytopharmaceuticals for vascular and wound-healing applications.
Limitations: Some included studies had methodological limitations. Heterogeneity in preparations and dosing across studies. The review noted a need for larger, multi-center RCTs, particularly for cognitive and neurological indications.
[15]
Centella asiatica extract for generalized anxiety disorder
Open-label clinical study evaluating the anxiolytic and antidepressant effects of Centella asiatica extract (500 mg twice daily) in 33 patients diagnosed with generalized anxiety disorder (GAD) over 60 days of treatment.
Findings: Centella extract significantly reduced anxiety scores (Hamilton Anxiety Rating Scale), depression scores (Hamilton Depression Rating Scale), and stress scores (perceived stress scale) after 60 days of treatment compared to baseline. Patients also reported improvements in overall quality of life and adjustment to daily activities. The results support the traditional anxiolytic indication and suggest potential antidepressant activity.
Limitations: Open-label design (no blinding, no placebo control). Small sample size (n=33). No comparator drug. Potential for placebo response and expectation bias. Single-center study. Self-report outcomes without objective physiological measures.
[10]
Neuroprotective potential of Centella asiatica — review of mechanisms
Comprehensive review of the neuroprotective and neuroregenerative mechanisms of Centella asiatica and its triterpene constituents, evaluating potential applications in neurodegenerative disease.
Findings: The review identified multiple neuroprotective mechanisms: (1) potent antioxidant activity protecting against oxidative stress-induced neuronal damage; (2) anti-inflammatory effects via NF-kB pathway inhibition and reduction of pro-inflammatory cytokines in the CNS; (3) promotion of neurite outgrowth, dendritic arborization, and synaptogenesis; (4) enhancement of BDNF and NGF expression; (5) modulation of amyloid-beta pathology (relevant to Alzheimer's disease); (6) protection against glutamate excitotoxicity. The authors concluded that centella represents one of the most promising herbal candidates for neuroprotection and cognitive enhancement, warranting rigorous clinical investigation for neurodegenerative conditions.
Limitations: Much of the evidence is from preclinical (in vitro and animal) studies. Limited clinical trial data for neurodegenerative disease specifically. The review is narrative rather than systematic. Translation from animal models to human neurodegenerative disease remains uncertain.
Preparations & Dosage
Fresh Juice / Expressed Juice
Strength: Fresh expressed juice from 30-60 g plant material
Wash fresh centella leaves and stems thoroughly. Blend or grind 30-60 g of fresh plant material with a small amount of water. Strain through cheesecloth or a fine sieve. The juice can be consumed immediately as is, or mixed with honey, lime juice, or coconut water to improve palatability. In traditional practice, the fresh juice is considered the most potent preparation.
10-20 mL of fresh juice (from approximately 30-60 g of fresh herb), 1-2 times daily. Traditional Ayurvedic dose: 10-20 mL fresh swarasa (expressed juice) daily.
Once or twice daily. Traditionally taken in the morning on an empty stomach for maximum cognitive and tonic effects.
Traditional Rasayana use calls for sustained daily consumption over months to years. Minimum 2-3 months recommended for nootropic effects.
Under professional guidance. Children 6-12: 5-10 mL of fresh juice daily.
The fresh juice (swarasa) is considered the most potent preparation in Ayurvedic tradition, as it preserves the full spectrum of active compounds including heat-labile enzymes and vitamins. This is the traditional preparation method used in Sri Lanka ('two leaves a day') and across Southeast Asia. Fresh juice combines the medicinal with the nutritive — providing vitamins, amino acids, and minerals along with the triterpene saponins. However, fresh juice is perishable (use within hours of preparation) and the taste is mildly bitter and herbaceous, which some find unpleasant. Fresh plant material may not be readily available outside tropical regions.
Infusion (Tea)
Strength: 1-2 g dried herb per 150-250 mL water
Pour 150-250 mL of boiling water over 1-2 g (approximately 1-2 teaspoons) of dried centella aerial parts. Cover and steep for 10-15 minutes. Strain. The infusion has a mildly bitter, slightly grassy, herbaceous flavor.
One cup (150-250 mL) 2-3 times daily.
2-3 times daily for general tonic and nootropic effects. Can be taken as a single daily dose for gentle maintenance.
Traditionally used as a long-term daily tonic. Minimum 2-3 months recommended for nootropic and cognitive effects. May be used long-term at standard doses.
Children 6-12 years: half adult dose under professional guidance.
Aqueous infusion extracts the water-soluble triterpene glycosides (asiaticoside, madecassoside) and flavonoids. A simple, traditional preparation suitable for daily use as a cognitive and general tonic. The taste is mild and generally well-accepted, though somewhat bitter. Can be combined with Melissa officinalis (lemon balm), Rosmarinus officinalis (rosemary), or Ginkgo biloba for a nootropic tea blend. Adding honey and lemon improves palatability. WHO recommended preparation method.
Tincture
Strength: 1:5, 45% ethanol (dried herb) or 1:2, 25-45% ethanol (fresh herb)
Macerate dried centella aerial parts in ethanol-water menstruum. Typical ratio 1:5 in 45% ethanol for dried herb, or 1:2 in 25-45% ethanol for fresh herb. Macerate for 2-4 weeks, shaking regularly. Press and filter.
2-4 mL (approximately 40-80 drops) up to 3 times daily.
For cognitive enhancement: 2-3 times daily. For anxiety: 2-3 times daily, or as needed for acute anxiety.
Minimum 2-3 months for nootropic effects. May be used long-term.
Under professional guidance only. Children 6-12: 0.5-1 mL up to 3 times daily.
Tinctures provide a convenient and stable dosage form with flexible dosing. The ethanol-water menstruum extracts both the triterpene saponins and the flavonoid fraction. Fresh plant tincture is preferred by some practitioners as it may better preserve the full phytochemical profile. Tinctures are particularly useful when fresh plant material is unavailable. Can be combined with other nervine tinctures (Bacopa monnieri for enhanced nootropic effect, Avena sativa for nervous exhaustion, or Scutellaria lateriflora for anxiety).
Standardized Extract
Strength: TTFCA: standardized to ~40% asiaticoside, ~30% asiatic acid, ~30% madecassic acid. Total centelloside content varies by product. ECa 233: >= 80% triterpenoid glycosides.
Commercially prepared standardized extracts, most commonly TTFCA (Titrated Triterpenic Fraction of Centella Asiatica) or ECa 233. TTFCA is standardized to contain approximately 40% asiaticoside, 30% asiatic acid, and 30% madecassic acid. ECa 233 is standardized to contain not less than 80% triterpenoid glycosides (asiaticoside and madecassoside in a ratio of 1.5:1 +/- 0.5). Follow manufacturer's specific dosing guidelines.
TTFCA: 60-120 mg daily (typically 30-60 mg twice daily) for venous insufficiency. General standardized extract: 250-750 mg daily for cognitive and nootropic applications (per Wattanathorn et al. 2008). ECa 233: varies by clinical indication.
For CVI: typically divided into 2 daily doses. For cognitive enhancement: 1-3 daily doses depending on total daily amount.
For CVI: minimum 4-8 weeks for clinical effect, with ongoing use for maintenance. For cognitive enhancement: minimum 2 months.
Not established for standardized extracts.
Standardized extracts provide the most consistent and reproducible dosing and are used in most clinical trials. TTFCA has the longest clinical track record, with multiple RCTs supporting its use for chronic venous insufficiency. The standardization to specific centelloside ratios ensures consistent pharmacological activity across batches. When selecting a commercial product, look for standardization to total centelloside or triterpene content and third-party quality testing. Note that whole-plant extracts may provide benefits beyond what the isolated triterpene fraction offers, due to synergistic effects of flavonoids and other constituents.
topical-preparation
Strength: Cream/ointment: 1-5% total centellosides. Infused oil: 1:5 herb to oil. Fresh poultice: crushed leaves applied directly.
For wound healing, scars, and skin conditions: prepare a poultice of fresh crushed leaves applied directly to the affected area, or use a cream/ointment containing centella extract (typically 1-5% total centelloside concentration). Infused oil can be prepared by macerating fresh or dried centella in a carrier oil (sesame, coconut) with gentle heat for several hours, straining, and applying topically.
Apply cream, ointment, or poultice to affected area 2-3 times daily. For infused oil: apply liberally to wounds, scars, or areas of venous insufficiency 2-3 times daily.
2-3 times daily for wound healing and scar treatment. May be applied more frequently for acute wounds.
Until wound is healed. For scar treatment: minimum 3-6 months of consistent application.
Topical use is appropriate for children under professional guidance. Apply to wound sites as needed.
Topical application of centella is the most ancient and widespread route of use, documented across Ayurvedic, Southeast Asian, and African traditional medicine. Modern centella-containing creams and ointments (e.g., Madecassol, Centella cream) are widely used in European and Asian dermatological practice for wound care, scar management, and skin rejuvenation. Topical use is particularly appropriate for keloid prevention on surgical wounds and for management of venous ulcers in combination with oral TTFCA.
capsule-powder
Strength: Dried herb: 300-600 mg per capsule. Standardized extracts: various concentrations — check product-specific centelloside content.
Dried, powdered centella aerial parts in gelatin or vegetable capsules. Ensure product is from a reputable manufacturer with quality control for centelloside content.
300-600 mg of dried herb powder, 2-3 times daily (total daily dose approximately 1-2 g). For standardized extracts in capsule form, follow the standardized extract dosing above.
2-3 times daily with meals.
Minimum 2-3 months for cognitive and tonic effects. May be used long-term.
Not recommended for children under 12 years for self-medication.
Capsules bypass taste considerations and provide convenient dosing for long-term use. The Wattanathorn et al. (2008) cognitive study used capsulized standardized extract. Non-standardized herb powder capsules may vary in centelloside content; standardized capsules are preferred for clinical consistency. Powder can also be mixed into warm milk or smoothies in Ayurvedic preparation style.
Safety & Interactions
Class 1
Can be safely consumed when used appropriately (AHPA Botanical Safety Handbook)
Contraindications
Contact dermatitis to centella has been reported, particularly with topical use. Patients with known sensitivity to Apiaceae family plants (including celery, parsley, carrot, fennel) may have cross-sensitivity. Perform a patch test before extensive topical use in sensitive individuals.
Avoid use during pregnancy as a precaution. While centella has been consumed as a food in Asia during pregnancy, concentrated extracts and therapeutic doses should be avoided. Some in vitro studies have suggested potential emmenagogue (uterine-stimulating) effects, though these are not well-established. Asiaticoside has demonstrated teratogenic effects in some animal models at high doses. The WHO monograph recommends avoidance during pregnancy. Given the lack of adequate human safety data during pregnancy, therapeutic doses should be avoided.
Drug Interactions
| Drug / Class | Severity | Mechanism |
|---|---|---|
| Benzodiazepines and CNS depressants (diazepam, lorazepam, alprazolam, etc.) (Benzodiazepines / CNS depressants) | moderate | Centella modulates GABAergic neurotransmission and has anxiolytic/mild sedative properties. Concurrent use with benzodiazepines may produce additive CNS depression. |
| Hepatotoxic medications (statins, acetaminophen at high doses, methotrexate, isoniazid) (Hepatotoxic drugs) | moderate | Rare hepatotoxicity has been reported with centella. Concurrent use with other hepatotoxic drugs may increase the risk of liver injury. |
| Antidiabetic medications (insulin, metformin, sulfonylureas) (Hypoglycemic agents) | theoretical | Some preclinical evidence suggests centella may have blood glucose-lowering effects. Concurrent use with antidiabetic medications may produce additive hypoglycemia. |
| Anticoagulants and antiplatelet agents (warfarin, heparin, aspirin, clopidogrel) (Anticoagulants / Antiplatelets) | theoretical | Theoretical concern based on limited data suggesting possible effects on coagulation parameters. Clinical significance is uncertain. |
Pregnancy & Lactation
Pregnancy
possibly unsafe
Lactation
insufficient data
PREGNANCY: Classified as possibly-unsafe during pregnancy at therapeutic doses. Although centella is consumed as a food vegetable in many Asian cultures including during pregnancy, concentrated extracts and therapeutic doses should be avoided. Asiaticoside has demonstrated teratogenic effects at high doses in some animal models (rabbit). Some traditional sources describe emmenagogue properties. The WHO monograph recommends avoidance during pregnancy. Dietary (food-level) consumption in cultures with a tradition of such use represents a lower risk than concentrated extract use, but specific safety data is lacking. LACTATION: Insufficient data. Not known whether centellosides pass into breast milk. As a precaution, therapeutic doses should be avoided during breastfeeding until safety data is available. Dietary consumption as a food vegetable in traditional Asian practice has not been associated with reported problems.
Adverse Effects
References
Monograph Sources
- [1] World Health Organization. WHO Monographs on Selected Medicinal Plants, Volume 1: Herbae Centellae. World Health Organization, Geneva (1999) : 77-85
- [2] Committee on Herbal Medicinal Products (HMPC), European Medicines Agency. Assessment report on Centella asiatica (L.) Urban, herba. European Medicines Agency (2010)
- [3] European Directorate for the Quality of Medicines (EDQM). European Pharmacopoeia Monograph: Centella (Centellae asiaticae herba). European Pharmacopoeia, Council of Europe, Strasbourg (2020)
- [4] Indian Pharmacopoeia Commission. Indian Pharmacopoeia: Centella asiatica. Government of India, Ministry of Health and Family Welfare (2014)
- [5] Gardner Z, McGuffin M (eds.). American Herbal Products Association's Botanical Safety Handbook, Second Edition. CRC Press, Boca Raton (2013) : 189-191
Clinical Studies
- [6] Bradwejn J, Zhou Y, Koszycki D, Shlik J. A double-blind, placebo-controlled study on the effects of Gotu Kola (Centella asiatica) on acoustic startle response in healthy subjects. J Clin Psychopharmacol (2000) ; 20 : 680-684 . DOI: 10.1097/00004714-200012000-00015 . PMID: 11106141
- [7] Wattanathorn J, Mator L, Muchimapura S, Tongun T, Pasuriwong O, Piyawatkul N, Yimtae K, Sripanidkulchai B, Singkhoraard J. Positive modulation of cognition and mood in the healthy elderly volunteer following the administration of Centella asiatica. J Ethnopharmacol (2008) ; 116 : 325-332 . DOI: 10.1016/j.jep.2007.11.038 . PMID: 18191355
- [8] Cesarone MR, Belcaro G, De Sanctis MT, Incandela L, Cacchio M, Bavera P, Ippolito E, Bucci M, Griffin M, Geroulakos G, Dugall M, Pellegrini L, Ramaswami G, Maheshwari H, Gizzi G, Pansari A. Effects of the total triterpenic fraction of Centella asiatica in venous hypertensive microangiopathy: a prospective, placebo-controlled, randomized trial. Angiology (2001) ; 52 : S15-S18 . PMID: 11510593
- [9] Incandela L, Belcaro G, Cesarone MR, De Sanctis MT, Nargi E, Patricelli P, Bucci M. Treatment of diabetic microangiopathy and edema with total triterpenic fraction of Centella asiatica: a prospective, placebo-controlled randomized study. Angiology (2001) ; 52 : S27-S31 . PMID: 11510595
- [10] Jana U, Sur TK, Maity LN, Debnath PK, Bhattacharyya D. A clinical study on the management of generalized anxiety disorder with Centella asiatica. Nepal Med Coll J (2010) ; 12 : 8-11 . PMID: 20677602
- [11] Shukla A, Rasik AM, Jain GK, Shankar R, Kulshrestha DK, Dhawan BN. In vitro and in vivo wound healing activity of asiaticoside isolated from Centella asiatica. J Ethnopharmacol (1999) ; 65 : 1-11 . DOI: 10.1016/S0378-8741(98)00141-X . PMID: 10350364
Traditional Texts
- [12] Hoffmann D. Medical Herbalism: The Science and Practice of Herbal Medicine. Healing Arts Press, Rochester, VT (2003) : 543-544
- [13] Mills S, Bone K. Principles and Practice of Phytotherapy: Modern Herbal Medicine. Churchill Livingstone, Edinburgh (2000) : 303-314
- [14] Bone K, Mills S. Principles and Practice of Phytotherapy: Modern Herbal Medicine, 2nd Edition. Churchill Livingstone/Elsevier (2013) : 490-509
Pharmacopeias & Reviews
- [15] Brinkhaus B, Lindner M, Schuppan D, Hahn EG. Chemical, pharmacological and clinical profile of the East Asian medical plant Centella asiatica. Phytomedicine (2000) ; 7 : 427-448 . DOI: 10.1016/S0944-7113(00)80065-3 . PMID: 11081995
- [16] James JT, Dubery IA. Pentacyclic triterpenoids from the medicinal herb, Centella asiatica (L.) Urban. Molecules (2009) ; 14 : 3922-3941 . DOI: 10.3390/molecules14103922 . PMID: 19924039
- [17] Shinomol GK, Muralidhara, Bharath MM. Exploring the role of 'Brahmi' (Bacopa monnieri and Centella asiatica) in brain function and therapy. Recent Pat Endocr Metab Immune Drug Discov (2011) ; 5 : 33-49 . DOI: 10.2174/187221411794351833 . PMID: 22074576
- [18] Dev RDO, Mohamed S, Hambali Z, Samah BA. Comparison on cognitive effects of Centella asiatica in healthy middle age female and male volunteers. Eur J Sci Res (2009) ; 31 : 553-565
- [19] Mohandas Rao KG, Muddanna Rao S, Gurumadhva Rao S. Centella asiatica (L.) leaf extract treatment during the growth spurt period enhances hippocampal CA3 neuronal dendritic arborization in rats. Evid Based Complement Alternat Med (2006) ; 3 : 349-357 . DOI: 10.1093/ecam/nel024 . PMID: 16951719
- [20] Jorge OA, Jorge AD. Hepatotoxicity associated with the ingestion of Centella asiatica. Rev Esp Enferm Dig (2005) ; 97 : 115-124 . DOI: 10.4321/s1130-01082005000300006 . PMID: 15801887
Last updated: 2026-03-01 | Status: published
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