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Astragalus

 

Natural Standard Monograph, Copyright © 2013 (www.naturalstandard.com). Commercial distribution prohibited. This monograph is intended for informational purposes only, and should not be interpreted as specific medical advice. You should consult with a qualified health care professional before making decisions about therapies and/or health conditions.

Related Terms

  • Astragaloside I, astragaloside II, astragaloside III, astragaloside IV, Astragalus adsurgens spp., Astragalus beckari, Astragalus bibullatus (Fabaceae), Astragalus bisulcatus spp., A.Gray (two-grooved milkvetch), Astragalus canadensis, Astragalus caspicus Bieb., Astragalus cicer, Astragalus compactus Lam., Astragalus complanatus R.Br., Astragalus corniculatus Bieb. (Fabaceae), Astragalus drummondii, Astragalus gummifer spp., Astragalus gummifera, Astragalus icmadophilus, Astragalus incanus, Astragalus lentiginosus (spotted locoweed), Astragalus membranaceus spp., Astragalus mollissimus (wooly locoweed), Astragalus mongholicus spp, Astragalus polysaccharide, Astragalus propinquus, Astragalus sahendi, Astragalus saponin, Astragalus sieberi DC., Astragalus sinicus (Chinese milkvetch), Astragalus sinicus L., Astragalus trigonus, Astragalus wiedemannianus Fischer, astragel, baak kei, beg kei, bei qi, buck qi, calycosin, Chinese milkvetch, Fabaceae (family), formononetin, gaba-aminobytyric acid, goat's horn, goat's thorn, green dragon, gum dragon, gum tragacanthae, gummi tragacanthae, hoang ky, hog gum, Huang Qi, huang-chi, huangoi, huangqi, Huangqi Guizhi Wuwu Tang (HQGZWWT), hwanggi, isoflavonoids, ji cao, Leguminosae (family), locoweed, membranous milk vetch, milk vetch, milkvetch, Mongolian milk, Mongolian milk vetch, neimeng huangqi, ogi, ononin, ougi, Phaca membranacea Fisch., radix Astragali, radix Astragali (Huangqi), radix Astragali mongolici (Huangqi), radix Astragali seu Hedysari, spino santo, spotted locoweed, swainsonine, Syrian tragacanth, tai shen, tragacanth, trigonoside I, trigonoside II, trigonoside III, wooly locoweed, wong kei, yellow leader, yellow vetch, Zhongfengnaomitong.

Background

  • Astragalus has been used for centuries in traditional Chinese medicine (TCM), in combination with other herbs, to stimulate the immune system. It is also used as an adjunct in chemotherapy to reduce possible adverse effects, such as leucopenia (low white blood cell count). Based on traditional use and clinical experience, astragalus is generally considered to be safe.
  • Preliminary data suggest several potential uses for astragalus when combined with other herbs; it is not clear if astragalus alone will have the same effects. Well-designed clinical trials evaluating astragalus on its own are needed before a conclusion can be drawn.
  • Astragalus is a huge genus of over 2,000 species. The main medicinal species, Astragalus membranaceus and Astragalus mongholicus, must be distinguished from other astragalus species that may be toxic, such as Astragalus mollissimus (locoweed).
  • Gummy sap (called tragacanth) from astragalus is used as a thickener in ice cream, a denture adhesive, and an antidiarrheal agent.

Evidence

 

Uses based on scientific evidence 

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare professional.

Grade* 

Allergic rhinitis 

According to one study, astragalus, as part of a combination formulation, decreased runny nose in seasonal allergic rhinitis. More well-designed trials are needed.

C 

Anorexia 

A combination of herbs including astragalus showed significant benefit in treating anorexia. However, the effects of astragalus cannot be determined from this study, and well designed monotherapy trials are needed before a conclusion can be drawn.

C 

Aplastic anemia 

Astragalus-containing herbal combination formulas may have beneficial effects in treating aplastic anemia.

C 

Asthma 

Limited evidence suggests that a single administration of astragalus, in addition to an application of strong red light and electromagnetic field (EMF) neutralizer to the respiratory centers of an abnormal medulla oblongata may have beneficial effects on severe asthma triggered by asbestos inhalation. Additional studies on astragalus therapy alone are needed before a conclusion can be drawn.

C 

Athletic performance 

According to early research, an astragalus-containing combination formula may reduce fatigue and increase athletic performance. Further research is needed before a conclusion can be drawn.

C 

Attention deficit disorder 

Limited evidence suggests that a combination product including astragalus may be effective in reducing symptoms associated with attention-deficit disorder, compared to Ritalin®, but that it may not exhibit greater efficacy. Well-designed trials examining astragalus alone are needed.

C 

Burns 

Few studies have investigated astragalus in burn patients. Further research is required before a conclusion can be drawn.

C 

Cerebral palsy 

Limited evidence suggests that astragalus may be beneficial for children with cerebral palsy. Further research is needed.

C 

Chemotherapy 

In Chinese medicine, astragalus-containing herbal mixtures are sometimes used with the intention of reducing the side effects of cancer treatments. Due to a lack of well-designed research, a firm conclusion cannot be drawn.

C 

Chronic fatigue syndrome 

Limited evidence suggests that a combination including astragalus may decrease fatigue-related symptoms. However, the effects of astragalus cannot be determined from this study. Additional well-designed trials examining astragalus alone are needed before a conclusion can be drawn.

C 

Cognitive function 

Limited evidence suggests that astragalus, as part of a combination therapy, may improve cognitive function. However, the effects of astragalus alone cannot be determined. More research is required in this field before a conclusion can be drawn.

C 

Diabetes 

There is some evidence that astragalus can improve the effectiveness of conventional diabetes therapies. More research is required in this field before a conclusion can be drawn.

C 

Diabetic complications 

There is some evidence that astragalus as part of a combination may be an effective cure on diabetic foot ulcers. However, the effects of astragalus alone cannot be determined. More well-designed trials of astragalus alone are needed before a conclusion can be drawn.

C 

Heart disease 

Evidence suggests that astragalus may be beneficial in patients with various heart conditions. However, because of the design and analysis limitations of most studies, the clinical efficacy data are inconclusive.

C 

Helicobacter pylori infection 

Limited evidence suggests that astragalus, as part of a combination formula, may be effective in reducing H. pylori infections. More well-designed trials of astragalus alone are needed before a conclusion can be drawn.

C 

Hepatitis 

Research suggests that astragalus may have antihepatitis effects. Additional research is needed in this area.

C 

Herpes 

Some studies suggest that astragalus may inhibit herpes viruses. Additional research is needed in this area.

C 

HIV 

Antiviral effects have been reported in early studies. Additional studies are warranted.

C 

Immune stimulation 

Several small studies report that astragalus may stimulate and improve immune system function in conditions such as the common cold, blood disorders, cancer, and HIV/AIDS. Further research is needed in this area.

C 

Infection 

Few studies have investigated the effect of astragalus on infections. Further research is required before a conclusion can be drawn.

C 

Kidney failure 

Research suggests that astragalus may be effective in kidney disease. However, there is insufficient evidence to support this claim.

C 

Liver protection 

Research suggests that astragalus may be effective in cirrhosis. Further research is required before a conclusion can be made.

C 

Menopausal symptoms 

There is unclear evidence as to whether astragalus is helpful for reducing menopausal symptoms. Limited research has reported on the use of a combination product, and thus the effects of astragalus alone are unknown.

C 

Menstrual disorders 

Limited evidence suggests that astragalus, as part of a combination formula, may be beneficial in menstrual disorders. More well-designed trials of astragalus alone are needed before a conclusion can be drawn.

C 

Mental performance 

Some evidence suggests that astragalus may aid in the mental performance of children with low IQ. Further, well-designed clinical trials are required before recommendations can be made.

C 

Myasthenia gravis 

Limited evidence suggests that astragalus, as part of a combination formula, may be beneficial in myasthenia gravis. More well-designed trials of astragalus alone are needed before a conclusion can be drawn.

C 

Neck pain 

Limited evidence suggests that astragalus, as part of a combination therapy, may offer pain relief in patients with chronic neck pain. However, the effects of astragalus alone cannot be determined. More research is required before a conclusion can be drawn.

C 

Prostate inflammation 

Limited evidence suggests that astragalus, as part of a combination formula, may be beneficial in chronic prostate inflammation. More well-designed trials of astragalus alone are needed before a conclusion can be drawn.

C 

Smoking cessation 

Astragalus has been used traditionally to aid in smoking cessation. Well-designed clinical trials are required before recommendations can be made.

C 

Stroke 

Limited evidence suggests that astragalus, as part of a combination formula, may be effective in treating stroke. More well-designed trials of astragalus alone are needed before a conclusion can be drawn.

C 

Systemic lupus erythematosus 

Astragalus has been shown to improve immune parameters in patients with systemic lupus erythematosus. More studies are needed before a conclusion can be drawn.

C 

Tuberculosis 

Limited evidence suggests the potential for benefit of astragalus in patients with tuberculosis. Further well-designed clinical trials are required before recommendations can be made.

C 

Upper respiratory tract infection 

Astragalus is often used in Chinese medicine as a part of herbal mixtures to prevent or treat upper respiratory tract infections. Due to a lack of well-designed research, no firm conclusions can be drawn.

C 

Viral myocarditis 

Several studies suggest that astragalus may improve symptoms of viral myocarditis (heart inflammation). However, these studies are small and poorly designed. Larger, higher-quality studies are needed in this area.

C 

Weight loss 

Limited evidence suggests that astragalus, as part of a combination formula, may be useful for weight loss. More well-designed trials of astragalus alone are needed before a conclusion can be drawn.

C 

 

*Key to grades: 

A: Strong scientific evidence for this use;
B: Good scientific evidence for this use;
C: Unclear scientific evidence for this use;
D: Fair scientific evidence against this use (it may not work);
F: Strong scientific evidence against this use (it likely does not work).

For full grading rationale, click here.

Uses based on tradition or theory 

The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified health care professional

Altitude sickness (acute), adaptogen, adrenal insufficiency (Addison's disease), aggression, aging, allergies, Alzheimer's disease, anemia, ankylosing spondylitis, antibacterial, antidepressant, antifungal, anti-inflammatory, antimicrobial, antioxidant, antitumor, antiviral, anxiety, astringent, atopic dermatitis, beta-thalassemia, blood circulation, blood vessel disorders, bone loss, bone marrow suppression (from cancer or HIV), brain injuries (minimal brain dysfunction), bronchitis, cancer, cardiac abnormalities (hypertrophy, pulmonary heart disease), cardiac ischemia, cardiovascular disorders, cervicitis (inflammation of the cervix), chest congestion, chronic illness, cleanser, colitis, colon cancer, colorectal cancer, common cold, connective tissue disorders (visceral fibrosis), cytomegalovirus, dementia, demulcent (soothes inflamed tissue), denture adhesive (astragalus sap), dermatitis, diabetic microangiopathy, diabetic nephropathy, diarrhea, digestion enhancement, diuretic (urination stimulant), ear infection, exhaustion, expectorant (removes phlegm), fatigue, fever, gangrene, gastric cancer, gastrointestinal disorders, genetic damage (X-ray-induced chromosomal damage), graft healing, hearing damage from toxins/gentamicin, hematopoiesis (stimulation of blood cell production), hemorrhage (bleeding), hemorrhoids, high blood pressure, high cholesterol, hyperthyroidism, infertility, insomnia, jaundice (obstructive), joint pain, kidney disease (chronic, insufficiency, microalbuminuria, nephritic syndrome, nephropathy, renal fibrosis, vascular renal hypertension), kidney stones, labor, laxative, leprosy, leukemia, loss of appetite, lung cancer, male fertility (sperm motility), memory, metabolic disorders, multiple sclerosis, muscle wasting/weakness (after illness), myalgia (muscle pain), myocardial ischemia, nephritis, neuroprotective (nerve protective), night sweats, osteoarthritis, osteoporosis, pain, palpitations, Parkinson's disease, pelvic congestion syndrome, postpartum fever, postpartum urinary retention, psoriasis, pulmonary fibrosis, qi deficiency and blood-stasis syndrome in heart disease (Eastern medicine) (fatigue, weakness, loss of appetite), radioprotection, rectal prolapse, renal impairment, rheumatoid arthritis, seizure disorders, sepsis, shortness of breath, skin care, spleen disorders (insufficiency), stomach ulcers, stress, sweating (excessive), swelling, thrombocytopenia (low blood platelets), tissue oxygenation, tonic, tonsillitis, urinary tract infection, uterine bleeding, uterine prolapse, vaccine adjunct, viral infection (infectious bursa disease virus (veterinary use)), vitality, wound healing.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare professional before starting a new therapy. Consult a healthcare professional immediately if you experience side effects.

Allergies

  • Avoid with known allergy or hypersensitivity to Astragalus membranaceus, its constituents, or other members of the Fabaceae family. In theory, patients with allergies to members of the Leguminosae (pea) family may react to astragalus. Cross-reactivity with quillaja bark (soapbark) has been reported.
  • A positive skin reaction to Huangqi powder injection has been reported.

Side Effects and Warnings

  • Use cautiously in patients using immunosuppressant agents or those who have autoimmune disease, as astragalus may stimulate the immune system.
  • Astragalus may increase the risk of bleeding. Caution is advised in patients with bleeding disorders or those taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary.
  • Astragalus may lower blood sugar levels. Caution is advised in patients with diabetes or hypoglycemia, and in those taking drugs, herbs, or supplements that affect blood sugar. Blood glucose levels may need to be monitored by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.
  • Astragalus may lower blood pressure. At higher doses, it may raise blood pressure. Caution is advised in patients with high blood pressure or those taking herbs or supplements that affect blood pressure.
  • Use cautiously with anesthetics, beta-blockers, central nervous system (CNS) stimulants, colchicines, dopamine agonists, drugs that increase urination, drugs that reduce vascular pressure, growth hormones, immune suppressants, interferons, and neuromuscular blockers, due to possible additive effects.
  • Astragalus may also cause chest pain, dehydration, diarrhea and other mild gastrointestinal effects, inflammation of the nasal passages and sinus cavities, increased growth hormone levels, increased urination, inflammation of the vulva (the external female genitalia), metabolic abnormalities, nerve-stimulating effects, neurological syndromes, palpitations, pneumonia, and sore throat.
  • Use cautiously during pregnancy or breastfeeding, due to harmful effects seen in preliminary studies.
  • Avoid with known allergy or hypersensitivity to Astragalus membranaceus, its constituents, or other members of the Fabaceae family. In theory, patients with allergies to members of the Leguminosae (pea) family may react to astragalus. Cross-reactivity with quillaja bark (soapbark) has been reported. A positive skin reaction to Huangqi powder injection has been reported.

Pregnancy and Breastfeeding

  • Astragalus is not recommended during pregnancy or breastfeeding, due to harmful effects seen in preliminary studies.

Interactions

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare professional before starting a new therapy.

Interactions with Drugs

  • In theory, consumption of the tragacanth (gummy sap) derived from astragalus may reduce the absorption of agents taken by mouth. Therefore, tragacanth and other agents should be taken at separate times.
  • Astragalus may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants (blood thinners) such as warfarin (Coumadin®) or heparin, antiplatelet drugs such as clopidogrel (Plavix®), and nonsteroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).
  • Astragalus may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar. Patients taking insulin or drugs for diabetes by mouth should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.
  • Astragalus may lower blood pressure. At higher doses, it may raise blood pressure. Caution is advised in patients taking drugs, herbs, or supplements that affect blood pressure.
  • Sedatives may decrease the effects of astragalus. Examples of sedatives include benzodiazepines such as lorazepam (Ativan®) or diazepam (Valium®), barbiturates such as phenobarbital, narcotics such as codeine, some antidepressants, and alcohol.
  • Astragalus may also interact with anesthetics, antiaging agents, antiarthritic agents, antibiotics, anticancer agents, anti-inflammatory agents, antiobesity agents, antiseizure agents, antiviral agents, beta-blockers, cholesterol-lowering agents, CNS stimulants, colchicine, cyclophosphamide, dimethyl sulfoxide (DMSO), dopamine agonists, drugs for anxiety, drugs that are toxic to the liver, drugs that decrease vascular pressure, drugs that increase urination, drugs that protect against radiation, drugs with hormone activity, gastrointestinal agents, growth hormone, hematological agents, immunosuppressants, inotropes, interferons, nalbuphine, neuromuscular blockers, neuroprotective agents, osteoporosis agents, procarbazine, propoxyphene, sedatives, steroids, and vaccines.

Interactions with Herbs and Dietary Supplements

  • In theory, consumption of the tragacanth (gummy sap) derived from astragalus may reduce absorption of agents taken by mouth. Therefore, tragacanth and other agents should be taken at separate times.
  • Astragalus may lower blood sugar levels. Caution is advised when using herbs or supplements that may also lower blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.
  • Astragalus may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.
  • Astragalus may lower blood pressure. At higher doses, it may raise blood pressure. Caution is advised in patients taking herbs or supplements that affect blood pressure.
  • Herbs and supplements with sedative effects may decrease the effects of astragalus.
  • Astragalus may also interact with amino acids, anesthetics, antiadrenergic herbs and supplements, antiaging herbs and supplements, antiarthritic agents, antibacterials, anticancer agents, anti-inflammatory herbs and supplements, antiobesity herbs and supplements, antioxidants, antiseizure herbs and supplements, antiviral agents, beta-blockers, bone herbs and supplements, cholesterol-lowering agents, chronotropic herbs and supplements, dopamine agonists, gastrointestinal agents, growth hormone, hematological herbs and supplements, herbs and supplements for anxiety, herbs and supplements for the heart, herbs and supplements that are toxic to the liver, herbs and supplements that decrease vascular pressure, herbs and supplements that increase urination, herbs and supplements that protect against radiation, herbs and supplements with hormone activity, immunosuppressants, inotropic herbs and supplements, neuroprotective herbs and supplements, Rauwolfia alkaloids, rhizoma Ligustici Chuanxiong, sedatives, selenium, and stimulants.

Authors

Selected References

Natural Standard developed the above evidence-based information based on a systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

  1. Firenzuoli F, Gori L, Di Simone L, et al. Important bias in the Astragalus meta-analysis. J Clin Oncol 2006;24(19):3215-6; author reply 3216-7.
  2. Gao ZY, Zhang JC, Xu H, et al. [Analysis of relationships among syndrome, therapeutic treatment, and Chinese herbal medicine in patients with coronary artery disease based on complex networks]. Zhong Xi Yi Jie He Xue Bao 2010;8(3):238-243.
  3. Haines CJ, Lam PM, Chung TK, et al. A randomized, double-blind, placebo-controlled study of the effect of a Chinese herbal medicine preparation (Dang Gui Buxue Tang) on menopausal symptoms in Hong Kong Chinese women. Climacteric 2008;11(3):244-51.
  4. Kobayashi H, Mizuno N, Teramae H, et al. The effects of Hochu-ekki-to in patients with atopic dermatitis resistant to conventional treatment. Int J Tissue React 2004;26(3-4):113-117.
  5. Kusum M, Klinbuayaem V, Bunjob M, et al. Preliminary efficacy and safety of oral suspension SH, combination of five chinese medicinal herbs, in people living with HIV/AIDS ; the phase I/II study. J Med Assoc Thai 2004;87(9):1065-1070.
  6. Lee HJ, Lee JH. Effects of medicinal herb tea on the smoking cessation and reducing smoking withdrawal symptoms. Am J Chin Med 2005;33(1):127-138.
  7. Liu ZG, Xiong ZM, Yu XY. [Effect of astragalus injection on immune function in patients with congestive heart failure]. Zhongguo Zhong Xi Yi Jie He Za Zhi 2003;23(5):351-353.
  8. McCulloch M, See C, Shu XJ, et al. Astragalus-based Chinese herbs and platinum-based chemotherapy for advanced non-small-cell lung cancer: meta-analysis of randomized trials. J Clin Oncol 2006;24(3):419-30.
  9. Natural Standard Research Collaboration, Chief Editors: Ulbricht C, Basch E, Natural Standard Herb and Supplement Reference - Evidence-Based Clinical Reviews, USA: Elsevier/Mosby, 2005.
  10. Sheng B, He D, Zhao J, et al. The protective effects of the traditional Chinese herbs against renal damage induced by extracorporeal shock wave lithotripsy: a clinical study. Urol Res 2010;
  11. Tan BK, Vanitha J. Immunomodulatory and antimicrobial effects of some traditional Chinese medicinal herbs: a review. Curr Med Chem 2004;11(11):1423-1430.
  12. Weng XS. [Treatment of leucopenia with pure Astragalus preparation--an analysis of 115 leucopenic cases]. Zhongguo Zhong Xi Yi Jie He Za Zhi 1995;15(8):462-464.
  13. Wu XS, Chen HY, Li M. [Clinical observation on effect of combined use of Astragalus and compound salviae injection in treating acute cerebral infarction]. Zhongguo Zhong Xi Yi Jie He Za Zhi 2003;23(5):380-381.
  14. Yin X, Zhang S, Kong Y, et al. Observation on efficiency of jiangtang capsule in treating diabetes mellitus type 2 with hyperlipidemia. Chinese Journal of Integrated Traditional and Western Medicine 2001;7(3):214-216.
  15. Zhang JG, Gao DS, Wei GH. [Clinical study on effect of Astragalus injection on left ventricular remodeling and left ventricular function in patients with acute myocardial infarction]. Zhongguo Zhong Xi Yi Jie He Za Zhi 2002;22(5):346-348.
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