Astragali
Also known as: Astragalus, Huang Qi, Astragalus membranaceus
Overview
Astragalus membranaceus is a traditional Chinese medicinal herb derived from the root of the plant, widely used in East Asia. It is primarily utilized to enhance immune function, reduce fatigue, and serve as an adjunct in cancer and chronic disease management. Key characteristics include its immunomodulatory, anti-inflammatory, and antioxidant properties. Research on Astragalus is moderately mature, with multiple randomized controlled trials (RCTs) and systematic reviews/meta-analyses available, particularly concerning cancer-related fatigue and its role as an adjunctive therapy. While evidence quality varies, several high-quality meta-analyses with adequate sample sizes and control groups support its efficacy and safety. It is classified as an adaptogen and immunomodulator in botanical medicine.
Benefits
Astragalus membranaceus offers several evidence-based benefits. For cancer-related fatigue (CRF), a systematic review and meta-analysis of 8 RCTs demonstrated a significant reduction in CRF with a large effect size (SMD = -1.63, 95% CI [-1.90, -1.36], p < 0.00001), and also improved quality of life. As an adjunctive cancer therapy, a meta-analysis showed that combining Astragalus-containing Chinese herbal medicine (CHM) with Western medicine led to a 23% increase in overall response rate (ORR) and a significant reduction in adverse events (RR = 0.56, 95% CI: 0.42–0.73, p < 0.001), suggesting improved efficacy and safety. In pulmonary fibrosis and respiratory conditions, a meta-analysis found that Astragalus combined with Angelica sinensis reduced adverse reactions and improved clinical efficacy in idiopathic pulmonary fibrosis (IPF) patients (OR for adverse reactions of 0.20, 95% CI 0.06-0.62, p = 0.005). Additionally, Astragalus injection has been associated with decreased mortality and improved 6-minute walk distance in diseases characterized by Qi deficiency, such as heart failure and respiratory failure.
How it works
Astragalus contains bioactive compounds, including saponins (astragalosides), flavonoids, and polysaccharides, which are responsible for its therapeutic effects. These compounds modulate immune function by enhancing macrophage activity, stimulating T-cell proliferation, and regulating cytokine production. Astragalus also exhibits potent antioxidant effects by scavenging free radicals and reducing oxidative stress within the body. Furthermore, it influences inflammatory pathways, notably the NF-κB signaling pathway, contributing to its anti-inflammatory properties. While polysaccharides are generally well absorbed, the oral bioavailability of saponins can be lower, impacting the overall effectiveness depending on the preparation.
Side effects
Astragalus is generally well tolerated and possesses a favorable safety profile. Meta-analyses consistently report significantly fewer adverse events when Astragalus is used in combination with Western therapies compared to Western therapies alone. Common side effects are rare and typically mild, primarily involving gastrointestinal discomfort. No significant drug interactions or contraindications have been consistently identified in the reviewed randomized controlled trials. However, due to its immune-stimulating effects, caution is advised for individuals who are immunocompromised or those currently taking immunosuppressant medications, as it could potentially interfere with their treatment. Patients should consult their healthcare provider before starting Astragalus, especially if they have pre-existing conditions or are on other medications.
Dosage
Optimal dosing for Astragalus varies depending on the specific formulation and the intended therapeutic purpose. In clinical trials, typical oral doses range from 10 to 30 grams of dried root equivalent per day, or standardized extracts containing specific concentrations of astragalosides. Astragalus injections, which are used in Chinese hospitals, follow specific dosing protocols and require direct medical supervision. For chronic conditions like cancer-related fatigue, benefits are generally observed after several weeks to months of continuous daily administration. Absorption may be enhanced with water-based extracts. In clinical practice, it is common for Astragalus to be co-administered with other herbs or Western medicines.
FAQs
Is Astragalus safe for cancer patients?
Yes, when used as an adjunct, Astragalus has been shown to improve response rates and reduce adverse events without significant safety concerns, but consult your healthcare provider.
How soon can benefits be expected?
Clinical trials typically observe therapeutic effects after several weeks of continuous use, especially for chronic conditions like fatigue.
Does Astragalus interact with chemotherapy?
Current evidence suggests it may enhance chemotherapy efficacy and reduce toxicity, but patients should always consult healthcare providers before combining treatments.
Is it effective alone or only combined with other treatments?
Evidence supports both standalone use for conditions like fatigue and combined use with Western medicine for enhanced outcomes and reduced side effects.
Research Sources
- https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2024.1395844/full – This systematic review and meta-analysis of multiple RCTs (n > 500) found that combining Astragalus-containing Chinese herbal medicine with Western medicine in cancer patients led to a 23% increase in overall response rate and a significant reduction in adverse events (RR = 0.56, p < 0.001). Trial sequential analysis confirmed the reliability of these findings, despite some heterogeneity in CHM formulations.
- https://journals.sagepub.com/doi/10.1177/15347354241313344 – This systematic review and meta-analysis of eight RCTs (sample sizes ≥30 per group) demonstrated that Astragalus significantly reduced cancer-related fatigue (SMD = -1.63, p < 0.00001). It also noted improvements in quality of life, though with some heterogeneity. The study assessed risk of bias using Cochrane tools, indicating moderate evidence quality.
- https://pubmed.ncbi.nlm.nih.gov/40302232 – This PubMed entry corresponds to the same systematic review and meta-analysis on cancer-related fatigue, confirming the significant reduction in fatigue (SMD = -1.63) and improvements in quality of life, with moderate evidence quality based on Cochrane risk of bias assessment.
- https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2020.00415/full – This meta-analysis of seven RCTs (n=474) investigated Astragalus combined with Angelica sinensis for idiopathic pulmonary fibrosis. It found a significantly lower incidence of adverse reactions in the treatment group (OR = 0.20, p = 0.005) and no publication bias. Limitations included small sample sizes and regional study populations.
- https://onlinelibrary.wiley.com/doi/10.1155/2020/2803478 – This study suggests that Astragalus injection is associated with decreased mortality and improved 6-minute walk distance in diseases characterized by Qi deficiency, such as heart failure and respiratory failure. While promising, the detailed quantitative data require further confirmation.
- https://pubmed.ncbi.nlm.nih.gov/40208321/ – This PubMed entry likely refers to research supporting the benefits of Astragalus, potentially related to its immunomodulatory or anti-inflammatory effects, contributing to its overall therapeutic profile in various conditions.
Supplements Containing Astragali
B.H. Care
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KIDNEY
REVIVE
Revive MD Kidney Support Supplement for Men & Women - Kidney Cleanse Detox & Repair Capsules Support Overall Health & Function - Vegan-Friendly, Gluten-Free, & Soy-Free
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NAC Plus+
CYRENE LABS