Pegaga:
The Herb That
Earned Its
Reputation —
and Where
It Did Not.
Centella asiatica has been eaten as ulam by Malaysians for as long as anyone has documented Malaysian food culture. The Orang Asli used it as medicine. Ayurvedic texts describe it as a brain tonic. Traditional Chinese medicine values it for longevity. Modern pharmaceutical companies extracted its active compounds and created a globally sold wound-healing cream. The herb is real. The question is which claims it actually earned — and which were borrowed from its reputation.
Pegaga is Malaysia’s most famous medicinal herb. It appears in more health product marketing, more wellness blogs, and more traditional medicine references than almost any other Malaysian plant. And in a comparative study testing 25 tropical plants for antioxidant activity, it ranked below ulam raja — the herb most Malaysians eat as a background garnish without a second thought.
This is not a dismissal of pegaga. The herb has genuine, well-documented properties that ulam raja does not share — particularly in wound healing, venous health, and skin integrity. But it is the kind of honest context that The Wrong Default framework exists to provide. The most famous is not always the most potent. The most overlooked is sometimes the most active. And the full picture of pegaga — what it genuinely does, and what the evidence for the cognitive claims actually shows — is more nuanced and more interesting than the marketing says.
Before the compounds, the history, or the preparation guide — here is what the evidence actually established.
- The pharmaceutical industry has already validated pegaga’s wound-healing compounds. Madecassol — a globally sold prescription cream containing asiaticoside extracted from Centella asiatica — is used in hospitals for post-surgical wound care, burns, and keloid management. When a pharmaceutical company extracts a plant compound and builds a regulated medical product around it, that is the highest possible validation that compound is real and active.
- A systematic review of 8 clinical trials (University of Malaya, 2013) found that Centella asiatica significantly improved microcirculatory parameters in chronic venous insufficiency — the condition behind varicose veins, leg heaviness, ankle swelling, and impaired circulation in the lower limbs. This is clinical trial evidence, not anecdote. The mechanism: asiaticoside strengthens connective tissue in blood vessel walls and reduces capillary permeability.
- The famous “brain herb” reputation for cognitive enhancement is more complicated than most sources admit. A meta-analysis published in Scientific Reports reviewed 11 randomised controlled trials. It found no significant differences across cognitive function domains compared to placebo. What it did find: improved alertness and reduced anger at one hour after treatment. A separate study in 28 healthy elderly participants showed improved working memory at 750mg. The honest verdict: cognitively promising, not yet proven.
- BDNF — Brain-Derived Neurotrophic Factor — is genuinely upregulated by Centella asiatica in animal studies and in the prefrontal cortex of rats at higher doses. BDNF is one of the most important molecules for brain plasticity, learning, and neuroprotection. A Phase 1 clinical trial at Oregon Health and Science University is currently recruiting participants with mild cognitive impairment and early Alzheimer’s disease specifically to measure target engagement of Centella asiatica extract on brain neuronal viability and mitochondrial activity.
- High-dose concentrated pegaga supplements have documented cases of hepatotoxicity (liver damage). At culinary amounts eaten as ulam — a handful of fresh leaves — this is not a concern. At therapeutic doses of concentrated standardised extract, liver function monitoring is warranted. This safety note appears in almost no Malaysian health content about pegaga. It should.
The Herb That Three Civilisations Independently Decided Was for the Brain
Centella asiatica has one of the broadest traditional medicine footprints of any plant in Asia. Three major traditional medicine systems — Ayurveda, traditional Chinese medicine, and traditional Malay/Indonesian medicine — all identified it independently and all assigned it, among other uses, to brain and cognitive health. This convergence across isolated systems is one of the strongest signals in ethnopharmacology that a plant is doing something real.
The primary Malay name across Malaysia, Singapore, and Brunei. Eaten as ulam, served with nasi, found in morning markets, and used in traditional Malay medicine for wounds, fever, and as a tonic.
The most widely used English name, derived from Sinhalese. Extensively used in Sri Lanka and India as a food and medicine. “Kola” means leaf in Sinhalese.
Jī xuě cǎo — “snow-accumulated grass.” Used in traditional Chinese medicine for heat-clearing, detoxification, and promoting wound healing. Also known as 崩大碗 (bēng dà wǎn) in Cantonese-speaking regions.
One of the most important herbs in Ayurvedic medicine. Specifically documented as a Medhya Rasayana — a brain rejuvenating tonic. Sanskrit texts describe it for enhancing intellect, memory, and longevity.
In some Indian regions pegaga is called Brahmi, though this name more commonly refers to Bacopa monnieri. The two plants are sometimes confused. Both are used for cognitive enhancement. They are different plants with overlapping traditional uses.
“Horse’s hoof leaf” — named for the distinctive kidney or fan-shaped leaf that resembles a horse’s hoof print. An older Malay name still heard in some regions alongside the more common “pegaga.”
- ~3000 BCECentella asiatica documented in ancient Sri Lanka. Used as a long-life tonic and brain herb. According to some historical accounts, it was the herb that gave the legendary Sri Lankan king Aruna his remarkable longevity. Whether true or legend, the assignment of the plant to cognitive longevity is ancient.
- ~1000 BCEDetailed in Sushruta Samhita, one of the foundational Ayurvedic medical texts, as a Medhya Rasayana. Medhya Rasayana means a preparation that specifically rejuvenates the intellect and memory. It is in a category reserved for herbs with specific brain-enhancing properties. This placement in Ayurvedic classification represents one of the earliest deliberate traditions of cognitive-targeted herbal medicine.
- Traditional eraFully integrated into traditional Malay medicine (Perubatan Melayu Tradisional) and Orang Asli healing practice across the Malay Peninsula. Used topically for wound healing, internally for fever, and as a daily ulam for general health. The Orang Asli specifically used it for wound treatment — anticipating what the pharmaceutical industry would later confirm with asiaticoside.
- 1940s–1970sEuropean researchers begin isolating the active triterpene compounds — asiaticoside, asiatic acid, madecassoside, and madecassic acid. French pharmaceutical company Bayer develops Madecassol, a standardised extract cream for wound healing. This commercialisation marks the transition of pegaga from traditional herb to pharmaceutical ingredient.
- 2000–presentModern clinical trials. Systematic reviews of venous insufficiency evidence (University of Malaya, 2013). Human trials on cognitive effects showing mixed but promising results. Oregon Health and Science University Phase 1 trial on mild cognitive impairment currently recruiting (2024–2026). The evidence base is maturing — more honest than the marketing, more promising than the sceptics suggest.
The Most Consistently Present Herb in Malaysian Traditional Medicine. Across Every Community.
Pegaga’s presence in Malaysian food and medicine crosses every ethnic and cultural line. The Malay community eats it as ulam, uses it in traditional medicine, and knows it by name from childhood. The Chinese Malaysian community recognises it as 积雪草 and uses it in traditional preparations. Indian Malaysians know it from Ayurvedic tradition as Mandukaparni or Brahmi. The Orang Asli communities across multiple ethnic groups have used it medicinally for generations.
This cross-cultural universality in Malaysia is unusual. Most herbs are strongly associated with one tradition. Pegaga belongs to all of them simultaneously. That convergence — independent recognition across Malay, Chinese, Indian, and Orang Asli traditions — is part of what makes it special. When four separate knowledge systems with no shared communication arrive at the same plant, that is a signal worth taking seriously.
The morning market in any Malaysian town will have a stall selling fresh pegaga leaves in bunches, alongside the ulam spread. The herb juice stall at the night market will have pegaga juice alongside wheatgrass. The traditional medicine shop will stock it dried. It is simultaneously a food, a daily tonic, and a targeted medicine — depending on who is using it and how.
The Wrong Default here is subtle. Pegaga was never fully removed from the Malaysian diet or medicine chest. The drift is again in intention — the shift from eating it regularly as part of the default ulam spread to purchasing it occasionally as a supplement capsule with inflated cognitive claims. The traditional preparation — fresh leaves as ulam, eaten raw, consistently — remains the most accessible and arguably the most complete delivery of its phytochemical profile.
The Chemistry That Earned the Pharmaceutical Validation
Centella asiatica’s pharmacological profile is built primarily around four triterpene compounds that are found in very few other plants. These are not common flavonoids. They are unusual pentacyclic triterpene saponins and their aglycones — a class of compounds whose structure and biological activity are genuinely distinctive.
The Primary Wound-Healing Compound
The main triterpene glycoside. Asiaticoside stimulates fibroblast proliferation, collagen and glycosaminoglycan synthesis, and re-epithelialisation. It also has antioxidant activity that reduces free radical damage in healing tissue. The active ingredient in Madecassol cream — the globally used pharmaceutical wound-healing preparation. Found at 0.5–3.7% of dry leaf weight. Also stimulates VEGF expression (angiogenesis — formation of new blood vessels) critical for wound healing.
Anti-inflammatory & Skin-Regenerating Aglycone
The aglycone (sugar-free form) of asiaticoside. Inhibits release of pro-inflammatory cytokines (TNF-α, IL-6, IL-1β) and reduces TGF-β, PDGF, and VEGF in the inflammatory phase of wound healing. Directly promotes collagen synthesis in fibroblasts. Also demonstrated neuroprotective activity through mitochondrial protection and reduction of amyloid-beta-induced oxidative stress. The compound most studied for Alzheimer’s disease relevance.
Connective Tissue & Vascular Integrity
The second major triterpene glycoside. Found at 0.29–6.09% of dry weight. Strengthens connective tissue in blood vessel walls — the mechanism behind pegaga’s documented effects on venous insufficiency and varicose veins. Reduces capillary permeability and improves microcirculatory parameters. Works alongside asiaticoside in the standardised extract TTFCA (total triterpenic fraction of Centella asiatica) used in clinical trials for venous insufficiency. Also anti-inflammatory through NF-κB inhibition.
Anti-inflammatory & Antioxidant Support
The aglycone form of madecassoside. Anti-inflammatory, antioxidant, and contributes to the overall triterpene activity. Less studied than asiatic acid but present in meaningful quantities and contributes to the synergistic effect of the whole extract. The four triterpenes working together — asiaticoside, asiatic acid, madecassoside, madecassic acid — produce effects that isolated single-compound preparations do not fully replicate.
The Neuroprotective Phenolics
Alongside the triterpenes, Centella asiatica contains caffeoylquinic acids — a class of phenolic compounds. These have been specifically linked to its neuroprotective effects. A study found that caffeoylquinic acid compounds from C. asiatica increase dendritic arborization in hippocampal neurons (more dendritic branching = more synaptic connections = better memory capacity) and improve age-related locomotion deficits. This is the most mechanistically compelling neuroprotective evidence from the plant beyond the BDNF finding.
Antioxidant Support
Centella asiatica also contains quercetin, kaempferol, and related flavonoids alongside its signature triterpenes. These contribute antioxidant activity, anti-inflammatory effects, and neuroprotection through standard flavonoid mechanisms. However, the flavonoid content of pegaga is lower than ulam raja — which is why comparative antioxidant studies place ulam raja above pegaga. The triterpenes are what make pegaga distinctive; the flavonoids are supporting players.
Three Areas of Evidence — Three Different Stories
The strongest evidence: asiaticoside and asiatic acid promote collagen synthesis, fibroblast proliferation, and re-epithelialisation across multiple wound types including burns, diabetic ulcers, surgical wounds, and scars.
This is where the evidence is unambiguous. Multiple clinical trials, multiple mechanisms, pharmaceutical validation, and a globally sold medical product. The mechanism in wound healing operates across all three phases: the inflammatory phase (reducing cytokines, limiting excessive immune response), the proliferative phase (stimulating fibroblasts, promoting collagen and glycosaminoglycan synthesis, triggering angiogenesis), and the remodelling phase (normalising connective tissue structure).
Innovative delivery systems including hydrogels, nanoemulsions, and microneedle patches incorporating Centella asiatica extracts have been clinically tested and shown to accelerate wound healing, reduce wound size, and improve recovery times. The 2024 systematic review in MDPI Pharmaceutics consolidated this evidence: topical Centella asiatica preparations have strong, consistent clinical evidence for wound healing across multiple wound types.
For everyday Malaysians: this is the justification for the traditional practice of applying crushed pegaga leaves to cuts and skin injuries. The mechanism is documented. The practice was correct.
Centella asiatica significantly improved microcirculatory parameters in chronic venous insufficiency across 8 clinical trials — leg heaviness, ankle swelling, pain, and objective microcirculation measures all improved.
Chronic venous insufficiency (CVI) is the condition that causes varicose veins, leg heaviness, ankle swelling, and impaired circulation in the lower limbs — affecting a significant proportion of adults worldwide and a common complaint in Malaysian clinical settings. A University of Malaya systematic review identified 8 clinical trials meeting inclusion criteria for Centella asiatica and CVI.
The pooled data showed significant improvements in microcirculatory parameters including transcutaneous partial pressure of O₂ and CO₂ (measures of tissue oxygenation), rate of ankle swelling, and venoarteriolar response. Three additional trials reported significant subjective improvements in leg heaviness, pain, and oedema without providing full quantitative data. The mechanism: asiaticoside strengthens connective tissue in blood vessel walls, improves their flexibility and tension, reduces capillary permeability, and has antiplatelet activity reducing venous stasis.
The review authors noted methodological limitations in many of the included trials and called for more rigorous future research. The honest reading: the evidence is real and consistent, but the quality of individual studies is variable. This is promising clinical evidence, not definitive proof.
Meta-analysis found NO significant differences across cognitive function domains vs placebo. BUT improved alertness and reduced anger. AND individual studies show BDNF upregulation and improved working memory at higher doses.
This is the most important section to read carefully — because the cognitive reputation of pegaga runs significantly ahead of what the clinical evidence consistently shows.
What the meta-analysis found: Eleven RCTs reviewed. No statistically significant differences in the cognitive function domains of attention, memory, executive function, or processing speed when comparing Centella asiatica to placebo across all studies combined. The effect size for cognitive improvement was not significant at the pooled level.
What individual studies found: A randomised placebo-controlled study with 28 healthy elderly participants found that 750mg significantly improved working memory and enhanced brain activity measured by event-related potentials (N100 component) over 2 months. Participants also reported mood improvements. A separate study found an inverted U-shaped dose response — medium doses showed the best effect, not the highest doses.
The BDNF finding: Animal studies consistently show BDNF upregulation in the hippocampus and prefrontal cortex after Centella asiatica administration. BDNF is the primary neurotrophin for brain plasticity, synaptic strengthening, and neuroprotection. The link between BDNF upregulation and improved cognitive outcomes in humans is established in other contexts (exercise, caloric restriction). Whether Centella asiatica’s BDNF upregulation translates to meaningful cognitive benefit in humans at dietary doses remains under investigation.
The honest verdict: Pegaga’s cognitive effects are real in some studies, at some doses, in some populations — particularly for mood (alertness, anger reduction) and working memory at 750mg doses. The effect is not consistent enough across all studies to make confident cognitive enhancement claims. The Alzheimer’s disease and mild cognitive impairment angle is the most promising and is now in Phase 1 human trials. The field is moving. Watch this space — but do not overstate current evidence.
A globally sold prescription wound-healing cream containing asiaticoside from Centella asiatica. Used clinically for burns, post-surgical wounds, keloids, and skin repair. The highest validation a plant compound can receive.
Systematic review of 8 RCTs showed significant improvement in microcirculatory parameters. University of Malaya, 2013. Leg heaviness, ankle swelling, pain, and tissue oxygenation all improved.
The dose showing improved working memory in healthy elderly subjects over 2 months. Below this dose, cognitive effects in trials are less consistent. Well above what you get from a handful of ulam.
Oregon Health and Science University currently recruiting for Phase 1 clinical trial on Centella asiatica in mild cognitive impairment and early Alzheimer’s disease. The most rigorous human evidence is in progress.
From Ulam to Targeted Use — Five Methods
Five Ways to Use Pegaga — From Everyday to Specific
Fresh leaves as ulam is the foundation. Everything else builds on or departs from it. Here is what each method delivers.
Fresh young leaves eaten raw alongside every meal.
This is the original and most complete delivery method. The young leaves (smaller, more tender, less bitter) are the best choice. Wash thoroughly and eat raw with sambal belacan, budu, or any strong condiment. The whole-food matrix delivers asiaticoside, asiatic acid, madecassoside, caffeoylquinic acids, and flavonoids together — the synergistic profile that standardised single-compound supplements do not fully replicate.
One important note on dose: a realistic handful of fresh ulam (approximately 30–50g) delivers significantly less asiaticoside than the 750mg standardised extract dose used in cognitive studies. The ulam preparation is the baseline health maintenance form. The therapeutic forms involve higher concentrations.
Fresh leaves blended with water, a squeeze of lime, and optional honey.
The traditional juice preparation concentrates the active compounds compared to whole-leaf ulam while retaining all the water-soluble compounds including caffeoylquinic acids and some triterpene glycosides. Use young leaves, blend with a small amount of water, strain, add lime and a small amount of raw honey. Drink on an empty stomach or before meals. This is the preparation form most commonly found at Malaysian herb juice stalls.
From a pharmacological perspective, juicing delivers higher concentrations than whole-leaf ulam and is appropriate for people seeking the venous health or general antioxidant effects. It does not reach the concentrations of standardised pharmaceutical extracts used in clinical trials.
Dried leaves steeped in warm water (70–80°C) for 5–10 minutes.
Shade-dried pegaga leaves steeped as tea is a traditional preparation that retains most of the triterpene and phenolic content while reducing bitterness. Use 1 to 2 teaspoons of dried leaf per cup. Do not boil — the triterpene glycosides are relatively heat-stable, but high-temperature boiling can degrade some phenolic compounds and reduce flavour quality. Suitable for daily consumption as a general tonic.
Crushed fresh leaves or prepared extract applied to wounds, cuts, and skin.
The traditional practice of applying crushed pegaga leaves directly to wounds is pharmacologically validated. Asiaticoside and asiatic acid in the fresh leaf promote collagen synthesis and reduce inflammation at the wound site. The antimicrobial properties of the extract provide additional protection against infection. For minor cuts and wounds: crush fresh clean leaves and apply. For more significant wounds or burns: Madecassol or equivalent pharmaceutical preparations containing standardised asiaticoside extract are more reliable and consistent.
Pegaga-based skincare products (serums, creams, and toners marketed as “Cica” products — the Korean beauty industry’s term for Centella asiatica) use the wound-healing mechanism to promote skin barrier repair, reduce redness, and calm irritated skin.
For targeted venous health or cognitive goals: standardised extract, 500–750mg per day.
For people seeking the venous insufficiency or cognitive effects documented in clinical trials, standardised extracts standardised to total triterpene content (asiaticoside + asiatic acid + madecassoside + madecassic acid) are the most consistent form. The clinical trials for venous insufficiency used TTFCA — total triterpenic fraction of Centella asiatica — at 30–60mg twice daily. The cognitive studies showing working memory improvement used 750mg per day.
Safety note: At supplemental doses, liver function monitoring is warranted for extended use. Choose reputable suppliers with documented standardisation. Stop and consult your doctor if you notice yellowing of skin or eyes, dark urine, or abdominal pain — signs of potential liver stress.
What the Reputation Says — and What the Evidence Actually Shows
“Pegaga is the best Malaysian herb for antioxidants.”
This is one of the most repeated claims in Malaysian health content — and one of the most directly contradicted by published comparative research. The study testing 25 tropical plants for DPPH and FRAP antioxidant activity ranked Cosmos caudatus (ulam raja) above Centella asiatica (pegaga). The 2012 study directly comparing four herbs including both pegaga and ulam raja also placed ulam raja first. Pegaga’s strength is not its antioxidant profile — it is its triterpene chemistry. These are fundamentally different pharmacological profiles. Pegaga does things ulam raja cannot do. But the “best antioxidant herb” label belongs, on the current evidence, to ulam raja.
“Eating pegaga ulam every day significantly boosts your memory.”
The cognitive evidence for pegaga is real — in some studies, at some doses. The working memory improvement was documented in healthy elderly participants at 750mg standardised extract for 2 months. The meta-analysis of 11 RCTs found no significant difference in cognitive function across all studies combined. The honest translation: eating fresh pegaga as daily ulam delivers some neuroprotective compounds (caffeoylquinic acids, triterpenes) and may contribute to long-term brain health as part of a diverse diet. The dramatic cognitive enhancement implied by most pegaga marketing is not what the consistent clinical picture shows. The most promising cognitive applications are in the disease context — mild cognitive impairment and early Alzheimer’s — where the Phase 1 trial is now testing specifically.
“Pegaga supplements are safe to take in high doses without any monitoring.”
High-dose concentrated Centella asiatica extracts have documented cases of hepatotoxicity — liver damage. This is not common, but it is documented in the medical literature and acknowledged by regulatory bodies in multiple countries. At culinary amounts (a handful of fresh leaves as ulam, a cup of pegaga juice) this risk is not relevant. At therapeutic supplemental doses — particularly standardised extract capsules at 500mg or above taken for extended periods — liver function monitoring is a reasonable precaution. If you are taking pegaga supplements regularly and notice fatigue, yellowing of skin or eyes, dark urine, or abdominal pain, stop and consult a doctor. This safety note should appear in every pegaga health article. It almost never does.
“Putting crushed pegaga on a wound is just a traditional belief.”
This is one of the clearest examples in the entire AJHerbs library of traditional knowledge correctly identifying a pharmacological mechanism centuries before the laboratory explained it. The Orang Asli application of crushed pegaga leaves to wounds, the traditional Malay poultice practice, and the Ayurvedic topical use all deliver asiaticoside and asiatic acid directly to the wound site. These compounds promote fibroblast proliferation, collagen synthesis, anti-inflammatory effects, and re-epithelialisation — all confirmed in clinical trials. The pharmaceutical industry validated this by creating Madecassol — a cream containing the same compound. Traditional knowledge was not guessing. It was observing, correctly, over generations.
“Pegaga is only good for brain health — everything else is secondary.”
The cognitive reputation of pegaga is the most marketed and the most famous. But the clinical evidence for venous insufficiency — 8 clinical trials showing improved microcirculatory parameters — is actually more consistent and more robust than the cognitive evidence. For people with varicose veins, leg heaviness, ankle swelling, or impaired lower-limb circulation, pegaga has a genuine, clinically documented benefit that most Malaysian health content does not emphasise. Similarly, the wound-healing evidence has pharmaceutical validation that the cognitive evidence does not. The herb’s most evidence-backed uses are not the ones it is most marketed for.
“Men should not eat too much pegaga because it affects fertility.”
Malaysian studies on Sprague-Dawley rats (Yunianto et al.) found antispermatogenic effects at high doses of concentrated Centella asiatica extract. This finding is real and should be acknowledged. However, it is at pharmacological doses of concentrated extract — not at dietary amounts of fresh leaf consumed as ulam. The dose makes the difference. A man who eats pegaga ulam regularly is not consuming anything close to the doses that produced reproductive effects in rat studies. At culinary amounts, there is no evidence of reproductive harm in humans. At very high supplemental doses for extended periods, men who are trying to conceive might exercise caution — but this applies to supplements, not to the herb as food.
What is well-documented: Wound healing — the strongest evidence in the library, with pharmaceutical validation (Madecassol), multiple clinical trials, and fully understood mechanisms across all three wound-healing phases. Venous insufficiency — 8 clinical trials showing improved microcirculatory parameters; mechanism understood (asiaticoside strengthening connective tissue in vessel walls). BDNF upregulation in animal studies and human prefrontal cortex at higher doses — genuine neurotrophic activity. Mood improvement (alertness, anger reduction) in human trials. Individual studies showing working memory improvement at 750mg in healthy elderly. Caffeoylquinic acids increasing dendritic arborization in hippocampal neurons — mechanistically compelling neuroprotection. The four signature triterpene compounds (asiaticoside, asiatic acid, madecassoside, madecassic acid) are unique, well-characterised, and pharmacologically active.
What requires honest qualification: The cognitive function claims run significantly ahead of the consistent clinical evidence. Meta-analysis of 11 RCTs found no significant difference across cognitive domains at the pooled level. The working memory improvement is in some studies, not all. The Alzheimer’s disease and MCI evidence is promising but in Phase 1 trials — the most rigorous human evidence is still in progress. The antioxidant ranking of pegaga is below ulam raja in published comparative studies. High-dose supplement hepatotoxicity is documented and under-reported in popular health content. Male fertility effects at pharmacological doses in animal studies need acknowledgment.
The bottom line: Pegaga is a genuinely valuable herb with a pharmacological profile unlike any other Malaysian plant. Its triterpene chemistry is unique and pharmaceutical-grade validated for wound healing. Its venous health evidence is real and clinically meaningful. Its cognitive effects are promising and under active Phase 1 investigation for the most important clinical application. Eat it as ulam regularly. Use the topical preparation on wounds. Consider standardised extract for venous health. Do not expect it to dramatically sharpen your memory at ulam-serving doses — but do not dismiss its neuroprotective potential, which is emerging. Statements here have not been evaluated by any regulatory authority and are not intended to diagnose, treat, cure, or prevent any disease.
Liver toxicity at high doses: Documented cases of hepatotoxicity with high-dose concentrated Centella asiatica supplements. At culinary amounts as ulam or juice: not a concern. At supplemental doses (500mg+ standardised extract) for extended periods: monitor for signs of liver stress (fatigue, yellow skin, dark urine, abdominal pain). Consult your doctor if using therapeutically.
Pregnancy: Avoid therapeutic doses during pregnancy. Some studies suggest uterotonic effects at high concentrations. Culinary consumption as part of normal diet has a long traditional safety record; therapeutic supplementation during pregnancy warrants caution.
Male fertility (supplements only): At pharmacological doses, animal studies document antispermatogenic effects. Not relevant at dietary amounts. Men actively trying to conceive should avoid high-dose concentrated extract supplementation until more human data is available.
Drug interactions: Centella asiatica may interact with sedative medications and cholesterol-lowering drugs. Consult your doctor if on these medications before beginning supplementation.
Skin sensitisation: Some people develop contact dermatitis from topical Centella asiatica preparations. Test on a small skin area before widespread topical application.
References & Sources (click to expand)
- Chong, N.J. & Aziz, Z. (2013). A Systematic Review of the Efficacy of Centella asiatica for Improvement of the Signs and Symptoms of Chronic Venous Insufficiency. Evidence-Based Complementary and Alternative Medicine, 2013:627182. PMC3594936. [8 clinical trials, venous insufficiency, microcirculatory parameters]
- Wattanathorn, J. et al. (2008). Positive modulation of cognition and mood in the healthy elderly volunteer following the administration of Centella asiatica. Journal of Ethnopharmacology. [28 subjects, 750mg, 2 months, working memory, N100 ERP]
- Puttarak, P. et al. (2017). Effects of Centella asiatica (L.) Urb. on cognitive function and mood related outcomes: A Systematic Review and Meta-analysis. Scientific Reports, 7:10646. PMC5587720. [11 RCTs, no significant cognitive effect pooled, improved alertness and mood]
- Sari, D.C.R. et al. (2022). Centella asiatica (Gotu kola) ethanol extract up-regulates hippocampal BDNF, TrkB and ERK1/2 signaling. [Chronic stress model, BDNF upregulation mechanism]
- Gray, N.E. et al. (2018). Centella asiatica L. Phytosome Improves Cognitive Performance by Promoting Bdnf Expression in Rat Prefrontal Cortex. Nutrients, 12(2):355. MDPI. [BDNF upregulation in prefrontal cortex confirmed]
- Rowe, K. et al. (2024). Centella asiatica and its caffeoylquinic acid and triterpene constituents increase dendritic arborization of mouse primary hippocampal neurons. Frontiers in Aging. PMC11232923. [Dendritic arborization, synaptic connections, hippocampal neurons]
- Orhan, I.E. (2023). Centella asiatica (L.) Urban: From Traditional Medicine to Modern Medicine with Neuroprotective Potential. Evidence-Based Complementary and Alternative Medicine. [Comprehensive neuroprotective review]
- Cabrini, D.A. et al. (2023). Centella asiatica and Its Metabolite Asiatic Acid: Wound Healing Effects and Therapeutic Potential. MDPI Metabolites, 13(2):276. PMC9966672. [Wound healing mechanisms, collagen synthesis, clinical evidence]
- Multiple authors (2024). Topical Application of Centella asiatica in Wound Healing: Recent Insights into Mechanisms and Clinical Efficacy. MDPI Pharmaceutics, 16:1252. PMC11510310. [Innovative delivery systems, clinical trials, diabetic ulcers, burns]
- NCT05591027 (2022–2026). Safety and Target Engagement of Centella asiatica in Cognitive Impairment. Oregon Health and Science University. Phase 1 RCT, 48 participants, MCI and early AD, recruiting. ClinicalTrials.gov.
- Yunianto, I. et al. (2010). Antispermatogenic and antifertility effect of Pegaga (Centella asiatica L) on the testis of male Sprague-Dawley rats. Clinical Therapeutics, 161:235–239. [Male fertility, high-dose animal study]
- Gray, N.E. et al. (2016). Centella asiatica Attenuates Hippocampal Mitochondrial Dysfunction and Apoptosis in Mice with Cognitive Impairment. [Mitochondrial protection, Alzheimer’s relevance]
- Brinkhaus, B. et al. (2000). Chemical, pharmacological and clinical profile of the East Asian medical plant Centella asiatica. Phytomedicine, 7(5):427–448. [Comprehensive profile including hepatotoxicity documentation]
- Cesarone, M.R. et al. (1994). The microcirculatory activity of Centella asiatica in venous insufficiency. A double-blind study. Minerva Cardioangiol, 42(6):299–304. [Key clinical trial for venous insufficiency]