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Astragalus membranaceous

Also known as: Astragalus propinquus, Huang Qi, Milkvetch root, Astragalus membranaceus

Overview

Astragalus membranaceus is a perennial plant native to China and Mongolia, widely recognized and utilized in Traditional Chinese Medicine (TCM). The root of the plant is the primary part used for its medicinal properties. It is commonly employed for its potential benefits in cardiovascular support, immune modulation, anti-fatigue effects, and as an adjunctive therapy in cancer treatment. Key characteristics attributed to Astragalus include its immunomodulatory, anti-inflammatory, antioxidant, and cardioprotective properties. Research on Astragalus is growing, with an increasing number of clinical trials and meta-analyses, particularly focusing on its applications in cardiovascular health and cancer-related fatigue. While evidence quality varies, multiple randomized controlled trials (RCTs) and systematic reviews support its efficacy in specific indications, making it a subject of significant scientific interest.

Benefits

Astragalus membranaceus offers several evidence-based benefits, particularly in cardiovascular health and cancer support. For cardiovascular health, a 2024 systematic review and meta-analysis of RCTs demonstrated that Astragalus, when combined with conventional therapy, significantly improved left ventricular remodeling (LVR) in patients with heart failure with reduced ejection fraction (HFrEF). This suggests its potential to delay disease progression and enhance cardiac function, with clinically meaningful improvements observed over weeks to months of treatment. In the context of cancer, a 2025 systematic review and meta-analysis of eight RCTs found that Astragalus significantly reduced cancer-related fatigue, showing a large effect size (SMD = −1.63) and improving patients' quality of life. Furthermore, meta-analyses indicate that Astragalus-containing herbal combinations, when used as an adjunctive therapy with Western medicine in cancer patients, can improve overall response rates and significantly reduce adverse events, with a relative risk reduction of adverse events by 44%. These benefits appear clinically meaningful, with improvements in cardiac remodeling parameters and fatigue scales typically observed over weeks to months of consistent use.

How it works

Astragalus membranaceus exerts its therapeutic effects primarily through modulating immune responses, reducing oxidative stress, and exhibiting anti-inflammatory actions. It enhances the function of macrophages and lymphocytes, key components of the immune system. Its antioxidant activity helps to neutralize free radicals, thereby reducing cellular damage. Anti-inflammatory effects are mediated through the regulation of various cytokines. In cardiovascular contexts, its cardioprotective effects likely involve inhibiting myocardial fibrosis and apoptosis, leading to improved ventricular structure and function. At a molecular level, Astragalus interacts with pathways such as NF-κB and MAPK, and supports mitochondrial protection mechanisms. The active constituents, including saponins, flavonoids, and polysaccharides, contribute to these diverse biological activities, with moderate bioavailability.

Side effects

Astragalus membranaceus is generally considered well-tolerated and exhibits a favorable safety profile in clinical trials. Common side effects are rare and typically mild, primarily limited to occasional gastrointestinal discomfort. High-quality studies have not reported significant drug interactions or contraindications, suggesting its compatibility with many conventional medications. Notably, when combined with Western medicine in cancer patients, a lower incidence of adverse events has been observed, further supporting its safety as an adjunctive therapy. However, caution is advised for special populations, such as pregnant women, due to a lack of sufficient research data in these groups. While generally safe, individuals with autoimmune conditions should consult a healthcare professional before use, as its immunomodulatory effects could theoretically impact disease activity, although this has not been widely reported as an adverse effect.

Dosage

Clinical trials investigating Astragalus membranaceus have utilized varying dosages, but typical oral recommendations range from 9 to 30 grams of raw herb equivalent daily. Standardized extracts are also available, offering more consistent potency. The optimal dose can depend on the specific indication and the formulation used. In cardiovascular and oncology settings, Astragalus is frequently used in combination with conventional therapies. There are no specific timing restrictions reported for its administration; it is generally taken daily. While absorption may potentially be enhanced when co-administered with other herbs or bioavailability enhancers, using standardized formulations can improve consistency in therapeutic effects. There are no widely established upper limits or safety thresholds beyond the typical therapeutic ranges, but adherence to recommended dosages is advised.

FAQs

Is Astragalus safe for long-term use?

Current evidence supports the safety of Astragalus for short to medium-term use. However, long-term safety data are still limited, and ongoing research is needed to fully assess its effects over extended periods.

Can it be used with conventional medications?

Yes, Astragalus can often be used alongside conventional medications, particularly in cardiovascular and cancer care. Research suggests that its combination with standard treatments may even reduce adverse events.

How soon do benefits appear?

Improvements in conditions like fatigue and cardiac function have been observed within weeks to months of consistent Astragalus supplementation, indicating that its effects are not immediate but accrue over time.

Is it effective alone or only in combination?

Benefits of Astragalus have been noted both as a monotherapy and as an adjunctive therapy. However, its use in combination with standard medical care is common, especially in chronic conditions.

Research Sources

https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2024.1345797/full – This systematic review and meta-analysis investigated the effects of Astragalus membranaceus in patients with heart failure with reduced ejection fraction (HFrEF). It found that Astragalus, when combined with conventional therapy, significantly improved left ventricular remodeling, suggesting a beneficial role in cardiac function and disease progression. The study assessed risk of bias using Cochrane guidelines.
https://pmc.ncbi.nlm.nih.gov/articles/PMC12041688/ – This meta-analysis, published in 2025, examined the efficacy of Astragalus membranaceus in reducing cancer-related fatigue. It included eight randomized controlled trials and concluded that Astragalus significantly reduced fatigue with a large effect size and improved the quality of life for cancer patients. The evidence quality was rated as moderate by GRADE assessment.
https://pubmed.ncbi.nlm.nih.gov/40302232 – This meta-analysis, also published in 2025, focused on the use of Astragalus-containing Chinese herbal medicine as an adjunctive therapy with Western medicine in cancer patients. It reported improved overall response rates and a significant reduction in adverse events (RR=0.56, p<0.001), indicating a beneficial safety profile when combined with conventional cancer treatments. Trial sequential analysis confirmed adequate power.