Showing posts with label diabetes. Show all posts
Showing posts with label diabetes. Show all posts

Thursday, March 26, 2009

Diabetes Mellitus [type 2] Diet Menu plan and Guidelines


Contrary to what you may have heard, there is no " diabetes diet,"  per se -- and that's good news! The foods recommended for a diabetes diet to control blood glucose (or sugar) are good for those with diabetes -- and everyone else. This means that you and your family can eat the same healthy foods at mealtime. However, for people with diabetes, the total amounts of carbohydrates consumed each day must be monitored carefully. Of the different components of nutrition --carbohydrates, fats, and proteins -- carbohydrates have the greatest influence on blood sugar levels. Most people with diabetes also have to monitor total fat consumption and protein intake, too.


To keep your blood sugar levels in check, you need to make healthy food choices, exercise regularly, and take the medicines your health care provider prescribes. A dietitian can provide in-depth nutrition education to help you develop a personalized meal plan that fits your lifestyle and activity level, and meets your medical needs.

Learn the ABCs of a Diabetes Diet
The goal of nutrition for people with diabetes is to attain the ABCs of diabetes. The A stands for the A1c or hemoglobin A1c test, which measures average blood sugar over the previous 3 months. B is for blood pressure, and C is for cholesterol. People with diabetes should attain as near as normal blood glucose control (HbA1c), blood pressure, and healthy cholesterol level.

Alcohol and Diabetes

Use discretion when drinking alcohol on a diabetes diet. Alcohol is processed in the body very similarly to the way fat is processed, and alcohol provides almost as many calories as fat. If you choose to drink alcohol, only drink it occasionally and when your blood sugar level is well-controlled. It's a good idea to check with your doctor to be sure drinking alcohol is acceptable.

Diabetes and Glycemic Index

For years, researchers have tried to determine what causes blood sugar levels after meals to soar too high in those with diabetes. Potential culprits have included sugar, carbohydrates, and starches, among other foods. The glycemic index is a ranking that attempts to measure the 
influence that each particular food has on blood sugar levels. It takes into account the type of carbohydrate in a meal and its effect on blood sugars.

Foods that are low on the glycemic index appear to have less of an impact on blood sugar levels after meals. People who eat a lot of low glycemic index foods tend to have lower total body fat levels. High glycemic index foods generally make blood sugar levels higher. People who eat a lot of high glycemic index foods often have higher levels of body fat, as measured by the body mass index (BMI).

Talk to your doctor, a registered dietitian, or a diabetes educator and ask if the glycemic index might work to help gain better control of your blood sugar levels.

The glycemic load takes into account the effect of the amount of carbohydrates in a meal. Both the type of carbohydrate and the amount have an effect on blood sugars.


Eating Right on a Diabetes Diet

If you have diabetes, it's important to eat right every day to keep your blood sugar levels even and stay healthy. 

Here's some easy tips:

* Be sure to eat a wide variety of foods. Having a colorful plate is the best way to ensure that you are eating plenty of fruits, vegetables, meats, and other forms of protein such as nuts, dairy products, and grains/cereals.

* Eat the right amount of calories to maintain a healthy weight.

* Choose foods high in fiber such as whole grain breads, fruit, and cereal. They contain important vitamins and minerals. You need 25 to 35 grams of fiber per day. Studies suggest that people with type 2 diabetes who eat a high fiber diet can improve their blood sugar and cholesterol levels. Similar results have been suggested in some studies in people with type 1 diabetes.

Serving Sizes and Diabetes


Be sure to eat only the amount of food in your diabetes meal plan. Excess calories result in excess fat and excess weight. In people with type 2 diabetes, excess body fat means less sensitivity to insulin.
Weight loss in overweight and obese people with type 2 diabetes helps improve blood sugars and reduces those risk factors which lead to heart disease. Your dietitian can help you determine the appropriate serving sizes you need, depending on if you need to maintain your weight, gain weight, or lose weight, and if you have high or low blood sugar levels.

* In women with gestational diabetes, it's important to eat multiple meals and snacks per day as recommended.

* Do not skip meals.

* Eat meals and snacks at regular times every day. If you are taking a diabetes medicine, eat your meals and take your medicine at the same times each day.


Note: 
If you are taking some of the newer diabetes medicines, some of these tips may not apply to you; ask your health care provider the tips you should follow.

The Sweet Truth about Food and Diabetes

You might have heard that, as a person with diabetes, you shouldn't have any table sugar. While some health care providers continue to promote this, many -- realizing that the average person lives in the real world and will probably indulge in a bit of sugar every now and then -- have adopted a more forgiving view. Most experts now say that small amounts of sugar are fine, as long as they are part of an overall healthy meal plan. Table sugars do not raise your blood sugar any more than similar amounts of calories from starches, which is found in many foods that we consume. It is important to remember that sugar is just one type of carbohydrate.

When eating sugar, keep these tips in mind:

* Read food labels. Learn how to determine how much sugar or carbohydrates 
are in the foods that you eat.

* Substitute, don't add. When you eat a sugary food, such as cookies, cakes, or candies, substitute them for another carbohydrate or starch (for example, potatoes) that you would have eaten that day. Make sure that you account for this in your carbohydrate budget for the day. If it is added to your meal for the day, then remember to adjust your insulin dose for the added carbohydrates so you can continue to maintain glucose control as much as possible. In other words, readjust your medications if you do add sugars to you meals.

* Sugary foods can be fattening. Many foods that have a lot of table sugar are very high in calories and fat. If you are watching your weight (and many people with diabetes must), you need to eat these foods in moderation!

* Check your blood sugar after eating sugary foods and talk to your health care provider about how to adjust your insulin if needed when eating sugars.

* Ultimately, the total grams of carbohydrates -- rather than what the source of the sugar is -- is what needs to be accounted for in the nutritional management of the person with diabetes.


Diabetes Diet Myths

Before you start a diabetes diet, get the facts. So many people believe that having diabetes means you must avoid sugar and carbohydrates at all cost, load up on protein, and prepare "special" diabetic meals apart from the family's meals. Wrong! Most individuals with diabetes can continue to enjoy their favorite foods, including desserts, as long as they monitor the calories, carbs, and other key dietary components and keep a regular check on their blood glucose levels.

Diabetes Diet Q&A
What Is the TLC Diet for Diabetes?

People with diabetes who have abnormal cholesterol levels will likely be placed on a diet known as a "TLC" diet. The TLC diet will help reduce the intake of cholesterol- raising nutrients. As part of this diet you may be asked to lose weight and increase physical activity levels -- all 
of these are components that will help lower bad LDL cholesterol. Looking at food labels will help you become more knowledgeable about your intake of fats and cholesterol.

Specifically, the TLC diet calls for the following:

* Total fat consumption should be 25%-35% or less of total calories eaten
per day.

* Saturated fats should be less than 7% of total calories eaten in a day.

* Polyunsaturated fats (from liquid vegetable oils and margarines low in trans fats) should be up to 10% of the total calories per day consumed.

* Monounsaturated fats (derived from vegetable sources like plant oils and nuts) should be up to 20% of total calories per day eaten.

* Carbohydrates should be 50%-60% of total calories per day eaten

* We should eat 20-30 grams of fiber per day. These can be derived from oats, barley, psyllium, and beans.

* The amounts of protein in the diet should equal about 15%-20% of total calories eaten per day.

* Cholesterol content of the diet should be less than 200 milligrams per 
day.


How Much Fat Is Acceptable on a Diabetes Diet?

People with diabetes have higher than normal risk for heart disease, stroke, and disease of the small blood vessels in the body. Controlling blood pressure and limiting the amount of fats in the diet will help reduce the risk of these complications.

Limiting the amounts of saturated fats, increasing the amount of regular exercise, and receiving medical treatment can lower bad LDL cholesterol. This has been repeatedly shown in medical studies to help people with diabetes reduce their risk of heart disease and reduce the risk of death if a heart attack does occurs in a diabetic person.

Can I Use Artificial Sweeteners on a Diabetes Diet?

Artificial sweeteners can be added to a variety of foods and beverages without adding more carbohydrates to your diabetes diet. Using non-caloric artificial sweeteners instead of sugar also greatly reduces calories in your favorite foods.

Keep in mind that foods with artificial sweeteners are not necessarily 'no' carbohydrates foods. Many have carbohydrates; therefore, you must read the food labels to determine the gram amounts per serving that these have in order to take into account the effect that these carbohydrates have on your glycemic control. Foods labeled with artificial sweeteners can affect your blood sugars.

As long as you are aware of the content of carbohydrates you can adjust  your meal or medication to maintain blood glucose control. Sugar free means no sugar has been added, but you must remember these foods still contain carbohydrates which does affect your blood sugars.

Examples of artificial sweeteners you can use include:
* Aspartame
* Acesulfame-k
* Saccharine
* Sucralose
* Other non-nutritive sweeteners

Pregnant or breastfeeding women should avoid saccharine, and people who suffer from phenylketonuria should not use aspartame. People with phenylketonuria are unable to metabolize phenylalanine, an amino acid that's a common part of many proteins.

Some artificial sweeteners -- such as xylitol, mannitol, and sorbitol -- have some calories and do slightly increase blood sugar levels.

The American Diabetes Association cautions that eating too much of any artificial sweetener can cause gas and diarrhea.

Wednesday, March 25, 2009

Leading a Heart Healthy Lifestyle is Important For Women of Every Age( cuer for heart disease,cholestrol,diabetes,blood pressure)


Long considered a man's problem, heart disease now affects more female than males. Heart disease is responsible for 52 percent of all deaths in American women, claiming 250,000 female lives every year - more than all forms of cancer.  

Fortunately, much is known today about preventing and monitoring heart disease through lifestyle changes, which makes it possible to control many of your risk factors. To begin leading a heart healthier lifestyle, you first need to better understand heart disease.

What is heart disease?

Heart disease is the term used to describe a number of ailments affecting the heart, blood vessels and arteries.  
These conditions include:

Coronary Artery Disease - also referred to as coronary heart disease, this is a disease caused by fat, cholesterol and plaque build-up inside the artery walls, making them narrow. Coronary artery disease occurs when the heart does not get the oxygen and nutrients that it needs to function properly because of decreased blood flow.

Valvular Heart Disease - a disease that occurs when any of the four heart valves is damaged and becomes leaky (incompetent) , causing backflow of blood when the valve should be closed, or narrowed (stenosis), which makes it difficult for blood to flow forward.

Congestive Heart Failure - a condition caused by a variety of other conditions - including high blood pressure, coronary artery disease and valvular heart disease - that develops when the heart cannot adequately pump blood through the body.  

What is your risk for heart disease?

It is important to understand the risk factors that impact your likelihood of developing heart disease. Luckily, many of these factors are within your control. Answering the following questions and assessing your own risk for heart disease is the first step toward a heart healthy lifestyle.  

Do you have a family history of early heart disease?  

The tendency toward certain heart disease risk factors may be inherited. The presence of an immediate female family member (mother or sister) with coronary heart disease before age 65, or male relative (father or brother) diagnosed before age 55, will significantly increase your risk of heart disease.  

Do you have high blood pressure?

High blood pressure makes the heart work harder, contributes to hardening of the arteries, and increases the frequency of angina (chest pain that is the heart's response to a lack of oxygen), as well as the risk of heart attack and stroke.  

Do you have high cholesterol?

High levels of cholesterol in the blood lead to increases in the amount of plaque in the arteries and coronary artery disease. All adults should have a lipid profile performed including a total cholesterol, LDL, HDL, and triglyceride levels. This is done after fasting for eight hours in order to get the most accurate results. The newest guidelines provide targets for your lipids according to your risk factor profile.  

Do you have diabetes?

Diabetes, especially uncontrolled or untreated - can significantly increase your risk of heart disease. A simple blood test can determine how much glucose (sugar) is in your blood. The normal, non-diabetic range for fasting blood glucose is from 70 to 100 mg/dL. If the level is over 126mg/dL, it usually means you have diabetes. If you have diabetes, treating other risk factors for cardiovascular disease - such as hypertension and abnormal cholesterol levels - is particularly important.

Have your menstrual periods stopped?

As women reach menopause, the risks increase with one in 10  women between the ages of 45 and 64 experiencing some form of heart disease. After age 65, that statistic jumps to one in four. Around menopause, estrogen levels start to drop, and heart disease risk starts to rise.

Do you smoke?

If you smoke, kick the habit! Smoking increases your risk for a heart attack by almost five times that of a non-smoker. In addition, it has been found that low-tar cigarettes are not effective in reducing the risk of heart disease in those people who use tobacco.

Are you more than 20 pounds overweight?

Being overweight can more than double your risk of heart disease. Obesity increases the risk of high blood pressure, diabetes and abnormal cholesterol levels.

Do you get little or no regular exercise?

Studies suggest regular exercise can significantly reduce your risk of heart disease. Physical activity lowers your blood pressure, increases the amount of "good" cholesterol in your blood and reduces the tendency of blood to clot. Aerobic exercise - any exercise that makes the heart and lungs work harder to supply the muscles with oxygen - is a great way to strengthen your heart.

What is your body shape?

Depending on your body type, whether you are apple- or pearshaped, you may be more likely to develop heart disease. The Nurses' Health Study at Brigham and Women's Hospital found that middle-aged and older women who are apple-shaped are at greater risk for heart disease. According to the study, women with a 38-inch waist or greater are three times more likely to develop coronary heart disease than women with waistlines of 28 inches or less.

Make a healthy change  

As a woman, it is important for you to understand heart health. Current research studies, such as the Nurses' Health Study at Brigham and Women's Hospital (http://www.brighama ndwomens. org/excellence/ cardiovascular. aspx), are finding significant differences between men and women that extend to the symptoms, prevention and treatment of heart disease. Be heart smart for your good health! 

About The Author: As a woman, it is important for you to understand heart health. Current research studies, such as the Nurses' Health Study at
http://www.brighama ndwomens. org/excellence/ cardiovascular. aspx
Brigham and Women's Hospital, are finding significant differences between men and women that extend to the symptoms,prevention and treatment of heart disease. Be heart smart for your good health!

Please use the HTML version of this article at:
http://www.isnare. com/html. php?aid=289053

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Sunday, March 22, 2009

The Dangers of 'Hidden' Kidney Disease,dialysis,transplant,cleanse


by: Junji Takano


You are taking enough calcium, yet your bone is getting weak. You are taking enough iron supplements, yet you are anemic. What does this mean?

A good friend of mine just rushed to a hospital due to heart attack but died there. He was a healthy-looking man, and he never thought that he was affected from “hidden kidney disease” (a.k.a. hidden kidney failure, hidden renal disease, and hidden renal failure).

Millions of people around the world are fighting against diseases of unknown cause. Some of them might have 'hidden' kidney disease.



When we are fatigued or have a high blood pressure, we never think that it can be caused by kidney trouble. Mostly we think that it is caused by overwork or fatty foods we eat.

Why can't we think that kidney troubles can create low blood pressure, high blood pressure, arteriosclerosis, sudden death, etc.?

Let's take the case of a healthy 40-year-old office worker. When he was examined during a company's medical checkup, he was informed that he had “lack of blood” in the body, but he did not feel anything wrong during his daily work. He took foods that contain more iron, however, his physical condition became worse. He easily gets tired and is unable to concentrate of his work. He became to feel that he is really under the lack of blood. Yes, we now knew that cases of anemia caused by a hidden kidney problem are dramatically increasing.

It may be impossible to detect or compare the difference between normal blood level and anemia. You need to consult your doctor to check it.

Generally, people who are pale and skinny are said to be anemic. That is a wrong perception! Usually, it is caused by poor blood circulation and other kinds of cerebral problems. Or, these appearances might be caused by advanced kidney or renal disease or what we call “hidden kidney disease”. Even if you take iron supplements, you will experience no improvements in your health condition. It is truly because of hidden kidney disease. Hidden kidney disease occurs without any obvious symptoms, signs, or warnings.

Let's take the case of one of our friends, who at the age of 54 was telling us that he lost his focus and energy as well as vitality. He was telling us that it may be because of age. However, most of our friends are still active and energetic even at the age of over 60 years. He was recommended to consult his family doctor, but was diagnosed with deteriorated kidney.

The kidney does send signals to the brain for the production of red blood cells. The kidney also controls the blood volume by communicating with body organs through hormones it secrete into the bloodstream. However, if the kidney function fails, you will be in trouble of lack of blood, usually called iron deficiency or anemia.

Let's take the case of Mr. K. At 40 years old, he was taking foods that contain enough calcium, but he was told that his bone structures are full of hollows. The kidney produces an activated form of vitamin D to promote the absorption of calcium from the blood, making the bones stronger and denser. However, in the case of Mr. K, calcium was calcified within the blood vessels.

Modern medical technology has discovered that calcification of blood vessels may happen even when there's a slight defect in the kidney. This can also damage the capillaries within the kidney. Aside from this occurrence, high blood pressure and hardening of the arteries may worsen the entire physical condition, and it may lead to sudden death, too.

HOW TO DISCOVER OR ANALYZE HIDDEN KIDNEY DISEASE

Let's take the case of Mr. Ueda. At 55 years old, he was suffering from diabetes, and his kidney was only functioning by 50%. But he did not notice any other physical difference until he was informed that he was suffering from hidden kidney disease.

Today, he almost recovered from his hidden kidney disease. He only did meal control suggested by his doctor.

Well, how did he happen to know that he has hidden kidney disease? It was because of protein contents found in a urine test. This shows that metabolic syndrome can lead to various diseases. Controlling your meal is very important. Of course, cigarette smoking, stress accumulation and overwork can cause hidden kidney disease, too.

There are many causes of hypertension, and one of them is kidney disease or renal failure. Several cases of high blood pressure patients are caused by kidney troubles.

At first, why don't you check protein contents in urine? Many patients may find kidney trouble by doing a simple urine test. You can obtain urine testing kits at your nearby drugstores, too.

“Creatinine test” is mostly recommended when checking for hidden kidney disease. Creatinine is entirely excreted by the kidneys. Therefore, it is directly related to the kidney or renal function. The creatinine level should remain constant and normal when the kidneys are functioning normally. Serious renal disorders will cause abnormal elevations.

We know with our decades of experience that the PYRO-ENERGEN helped a lot to those who had hidden kidney diseases!

Whether you look healthy or not, we recommend you to do blood test at your nearest hospital at least once a year. Blood test can detect hundreds of diseases ahead of anything else before your physical condition gets worse.


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About the author:
Junji Takano is a Japanese health researcher involved in
investigating the cause of various diseases. In 1968, he
invented PYRO-ENERGEN, the first electrostatic therapy
device for electromedicine that eradicates viral disease,
cancer, and diseases of unknown cause effectively without
side effects.
------------------------------------------------------------

------------------------------------------------------------
PYRO-ENERGEN. Innovative Treatment for Various Diseases.

Sunday, February 22, 2009

Kalmegh - the wonder herb!

The Flower

Diabetes is one of the Disease that has been hovering among human race since time unknown. Many people have to resort to insulin at a very young age. In my family tree almost every one has this. My father often does take kalmegh once in a day generally in the morning.

Andrographis

Scientific Name(s): Andrographis paniculata (Burm.f.) Wall. Nees. Family: Acanthaceae

Common Name(s): Kalmegh (Hindi), Kalmegha (Snaskrit), Chuanxinlian (Chinese), Kalupnath , Kirayat (Hindi), Mahatita (King of Bitters), Alui , Bhunimba , Bhui-neem , Yavatikta (Sanskrit), Sam biloto (Malay)


The Plant


Clinical Overview

Uses of Andrographis

Kalmegh has been used for liver complaints and fever, and as an anti-inflammatory and immunostimulant. In clinical trials, Andrographis extract has been studied for use as an immunostimulant in upper respiratory tract infections and HIV infection. The potential of andrographolide as an anticancer agent is being investigated. However, clinical evidence to support the use of Kalmegh for any indication is lacking.

Andrographis Dosing

The usual daily dose of andrographolides for common cold, sinusitis, and tonsillitis is 60 mg. Doses of 10 mg/kg resulted in the discontinuation of a clinical trial because of adverse reactions. Clinical trials in children with upper respiratory tract infection reported the use of andrographolide 30 mg daily for 10 days.

Contraindications

Contraindications have not been identified.

Pregnancy/Lactation

Documented adverse reactions. Abortifacient. Avoid use.

Andrographis Interactions

None well documented.


Dried Kalmegh

Andrographis Adverse Reactions

Headache, fatigue, rash, bitter/metallic taste, diarrhea, pruritus, and decreased sex drive were reported in 1 clinical trial. One HIV-positive participant experienced an anaphylactic reaction. Doses used in this trial were 10 mg/kg body weight.

Botany

A. paniculata is an erect annual herb that grows 30 to 110 cm in height and is native to India, China, and Southeast Asia. It is widely cultivated in Asia. The square stem has wings on the angles of new growth and is enlarged at the nodes, while small white flowers with rose-purple spots are borne on a spreading panicle. The plant produces yellowish-brown seeds, and all parts have an extremely bitter taste. The portion of the plant appearing above ground are harvested in the fall. The genetic variability of the species has been examined. 1 , 2

History

A. paniculata has been used for centuries in India, China, Thailand, and other Asian countries and is present in 26 different polyherbal formulations in the Ayurvedic traditional health system. Kalmegh is listed in the 1992 Pharmacopoeia of the Peoples Republic of China as a cold property herb used to rid the body of fevers and dispel toxins. An immunostimulant preparation known as Kan Jang , which contains Kalmegh and eleutherococcushas, been used in Scandinavian countries for 20 years. Kalmegh is also manufactured and marketed in the United States. 3 , 4 , 5

Chemistry

The diterpene lactone andrographolide was first isolated as a major constituent 6 and later characterized as a lactone. 7 , 8 Its full structure was determined in the 1960s, 9 , 10 and x-ray crystallography later confirmed the structure. 11 A number of related minor diterpenes and their glycosides have since been identified. 5 , 12 , 13 , 14 , 15 , 16 , 17 , 18 Methods of analysis, including high-pressure liquid chromatography and nuclear magnetic resonance, 19 have been published. A method for rapid isolation of andrographolide is also available. 20 When callus cultures of the plant were investigated, andrographolide and the other diterpenes were not produced. Instead, the sesquiterpenes paniculides A-C were found. 21 Other constituents of the plant include various flavones. 18 , 22




Andrographis Uses and Pharmacology


Antimicrobial

Extracts of Andrographis and andrographolide derivatives have shown modest activity in vitro against HIV 18 , 23 , 24 , 25 , 26 ; however, a phase 1 study of andrographolide showed no effect on viral replication after 6 weeks, despite increased CD4 counts. 27

Activity in antimalarial screens has also been noted for Andrographis extracts, but clinical trials are lacking. 28 , 29 , 30

The extract of A. paniculata blocked Escherichia coli enterotoxin-induced secretion in rabbit and guinea pig models of diarrhea. 31 Andrographolide and 3 other related diterpenes were responsible for this action. 32 Other in vitro experiments present conflicting results for the action of andrographolide and leaf extracts on E. coli . 33 , 34

Cancer

Animal and in vitro experiments using human cancer cell lines to investigate the potential anticancer effects of A. paniculata have found andrographolide responsible for the observed effects rather than other diterpenes. 5 , 35 , 36 Various mechanisms of action have been proposed, including enhancement of chemokine activity, inhibition of tumor-specific angiogenesis affecting cell cycle progression, and induction of apoptosis. 35 , 36 , 37 , 38 Cancer cell lines investigated include prostate, breast, cervical, colon, hepatoma, melanoma, and lymphocytic leukemia. Researchers are now focusing on synthesizing compounds based on andrographolide to improve selectivity and potency. 35 , 39

The need for caution has been raised by one group of researchers because andrographolide-enhanced SDF-1-chemokine activity might induce tumor cell metastasis. 38 A. paniculata extract has also induced cell differentiation in mouse myeloid leukemia cells. 40



Immunostimulant

Animal data

Both antigen-specific and antigen-nonspecific immune responses in mice were stimulated by andrographolide and an ethanolic extract; the extract was more potent than andrographolide, suggesting that other constituents also were immunostimulants. 41 Inhibition of passive cutaneous anaphylaxis and mast cell stabilization was observed in studies of the purified diterpenes in rats. 42

Clinical data

A systematic review of 4 clinical trials found A. paniculata , either alone or in a fixed combination with A. senticosus ( Kan Jang ), significantly more effective than placebo ( P < p =" 0.0002,">

A small study in patients with familial Mediterranean fever (Nߙ=ߙ24) found a decrease in frequency, duration, and severity of febrile attacks, compared with placebo. 46

Stimulation of the production of key cytokines and immune activation markers has been investigated as potential mechanisms of andrographolide immunomodulation. 4 , 38 , 47



Other uses

Extracts of Andrographis have demonstrated hypoglycemic action in rats with streptozotocin- and alloxan-induced diabetes, supporting a traditional use of Kalmegh. 18 , 48 , 49 Clinical trials are lacking.

Two older trials explored a possible hypotensive effect of andrographolide/Kalmegh, but further investigation has not been conducted. 50 , 51

Animal experiments suggest that the extract of A. paniculata is hepatoprotective, 52 , 53 , 54 but clinical trials are lacking. Hepatic drug-metabolizing enzymes were elevated in 1 animal experiment, 54 however, in a clinical trial, elevated liver enzymes (AST and ALT) were reported. 27

Andrographolide has demonstrated anti-inflammatory effects in several cellular systems, including prevention of phorbol ester-induced reactive oxygen species and N-formyl-methionyl-leucyl-phenylalanine-induced adhesion in rat neutrophils, 55 , 56 inhibition of tumor necrosis factor-induced upregulation of intercellular adhesion molecule expression, and monocyte adhesion 57 and activation of protein kinase pathways. 58

Dosage

Kalmegh dosage in clinical studies has ranged from 3 to 6 g of the crude plant.

The usual daily dose of andrographolides for common cold, sinusitis, and tonsillitis is 60 mg, 59 , 60 but doses up to 1,200 mg have been reported. 61 Andrographolide 48 mg daily was used in a trial of familial Mediterranean fever. 46 Doses of 5 to 10 mg/kg were used in a trial in HIV patients, but adverse reactions at this dosage stopped the trial. 27

Clinical trials in children with upper respiratory tract infection reported the use of andrographolide 30 mg daily for 10 days. 45

Adverse Reactions

Research reveals few adverse reactions reported with the use of A. paniculata . However, adverse reactions (eg, headache, fatigue, rash, bitter/metallic taste, diarrhea, pruritus, decreased sex drive) during a phase 1 study of andrographolide in HIV required interruption of the trial. One HIV-positive participant experienced an anaphylactic reaction. Doses of andrographolide 10 mg/kg body weight were used when the adverse reactions became apparent. 27 In the same trial, elevated liver enzymes were experienced by many of the participants. Two cases of urticaria have been reported in other trials. 43

Toxicology

Toxicology studies are limited, but Kalmegh does not appear to be acutely toxic. Acute lethal doses (median lethal dose) in mice are reported to be more than 40 g/kg for andrographolide. 27



Male reproductive toxicology of Andrographis has been studied. A subchronic 60-day study in male rats showed no changes in testicular weight, histology, or testosterone levels. 63 However, detailed studies in rats given purified andrographolide for 48 days showed decreases in sperm counts and motility that were linked to disruption of spermatogenesis. 64

A small, short-duration, phase 1 clinical trial in healthy men found no negative effects at doses 3 times the usual daily dose of Kan Jang . Instead, a positive trend in the number of spermatozoids, percent active forms, and fertility indexes was found. Limitations of the study included the small number of participants (N = 14), the short duration of the study (10 days), and the low dose tested (3 times the normal dose versus 10-fold in animal studies). 59