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Can gotu kola help cure varicose veins?

BACKGROUNDGotu kola is one of the common names for Centella asiatica. This small, creeping plant is native to India and other parts of Asia. It is used as a leafy green in vegetarian dishes, and also in Ayurveda, the traditional medicine of India.

Followers of certain Indian gurus take gotu kola every day as an aid to meditation. Because elephants were seen to munch on the plant, it was believed to promote longevity. In the 1960s, it became popular in the West when a popular book on herbal remedies claimed it contained “vitamin X”. This was said to be a tonic for the brain and to promote long, healthy life. Such a substance has never been identified, though claims still occasionally surface that the herb promotes brain health.

Over the centuries, gotu kola has been used as a treatment for many conditions. More recent scientific investigations have revealed contradictory results. However, helpful results were found for chronic venous insufficiency (CVI). This condition manifests itself in various ways, one being varicose veins. In CVI, the valves of the veins do not work properly, which leads to blood pooling in the legs. Fluid can leak from the veins, causing swelling and pain. Varicose veins can develop as the veins become dilated and discoloured.

Treatments are available, including compression stockings, but these can be uncomfortable. Much interest has developed in herbal remedies for varicose veins and CVI. Horse-chestnut seed extract is the best supported of these for varicose veins, but gotu kola has received much attention for CVI.

EVIDENCE FROM STUDIESA large number of biologically active compounds have been extracted from gotu kola. In animal tests, various effects have been shown, especially healing of skin injuries and growth of tissues involved in maintaining healthy blood vessels. These findings led to a small number of studies involving patients with CVI and varicose veins.

A cream made from gotu kola has been found to improve the healing of chronic skin conditions and surgical wounds. However, control groups were not included in these studies.

Better designed studies have been conducted with oral capsules. People with varicose veins have elevated levels of certain enzymes, and these were significantly reduced after taking gotu kola for three months.

A double-blind trial involved almost 100 patients who had CVI for an average of 14 years. After three months, significant improvements occurred in leg swelling, limb heaviness and other symptoms. In another randomised study of 40 patients with a condition similar to CVI, those taking gotu kola had less ankle swelling and more general improvement than those taking placebo. A third study showed similar benefits, although a fourth found no differences between the extract and placebo.

PROBLEMATIC ASPECTSLarge doses of gotu kola can cause drowsiness. There have also been reports of people’s cholesterol levels increasing significantly when taking gotu kola. This is due, it is thought, to ingredients in the herb stimulating the body to produce cholesterol. Those with high cholesterol or taking cholesterol-lowering agents should not use gotu kola.

RECOMMENDATIONSFurther research is needed to confirm the findings for gotu kola, but the results to date are generally positive. Given that few treatment options are available for those with CVI or varicose veins, a trial period with gotu kola may be warranted.

The clinical trials have typically used 60-120mg of extract daily, with the most commonly used one called total triterpenoid fraction of Centella asiatica (TTFCA). Note that gotu kola is unrelated to the kola nut, and contains no caffeine. Rather than being a stimulant, it can cause drowsiness, and should be taken with caution when driving.