Kalmegh

Kalmegh (Andrographis paniculata) is an annual herb of the Acanthaceae family, native to India and Sri Lanka and also grown in China and Southeast Asia. It bears small white or pale purple flowers, and the leaves and aerial parts are used. Its taste is intensely bitter, which is why it is called the King of Bitters (Hossain et al., 2014).

In India, it grows mainly in Andhra Pradesh, Karnataka and Tamil Nadu, and it is widely used in Ayurveda, Siddha and traditional Chinese medicine (Shende et al., 2019).

In Ayurveda, Kalmegh is known as Bhunimba, meaning “neem of the ground”, because its bitterness resembles neem. It is described as bitter in taste (Tikta rasa), cooling in potency (Sheeta virya) and pungent in post-digestive effect (Katu vipaka). It is understood to pacify Kapha and Pitta, and it is traditionally classed as a Deepana and Pachana herb, meaning it is used to kindle digestion.

Kalmegh is known by many names across India and beyond, reflecting its wide use in traditional medicine.

• Botanical name: Andrographis paniculata
• English: King of Bitters, Green Chiretta, Indian Echinacea
• Hindi: Kalmegh
• Sanskrit: Bhunimba, Kirata, Yavatikta
• Bengali: Kalmegh
• Tamil: Nilavembu
• Telugu: Nelavemu
• Malayalam: Nilaveppu
• Kannada: Nelabevu
• Marathi: Oli-kiryata
• Chinese: Chuanxinlian

Kalmegh contains a number of naturally occurring plant compounds. The main ones are listed below (Okhuarobo et al., 2014).

• Andrographolide: The main active compound, a bitter diterpene lactone, and the compound most studied.
• Deoxyandrographolide and Neoandrographolide: Related diterpenes found alongside it.
• 14-deoxy-11, 12-didehydroandrographolide: It is another related diterpene.
• Flavonoids: Including apigenin, luteolin and 7-O-methylwogonin, which show antioxidant activity in laboratory tests.
• Xanthones and Essential Oils: Present in smaller amounts.

Most of the information about these herbs comes from laboratory and animal studies. Good-quality clinical trials in humans are limited.

Kalmegh (Andrographis paniculata) is a well-known Ayurvedic herb mentioned in classical texts and is commonly available as a powder, tablet or extract. It is traditionally used to support liver, digestive and respiratory wellness, and several of its underlying actions have also been studied in modern research, as summarised below.

• Hepatoprotective: may help support healthy liver function, though further research is needed to confirm this in humans.
• Anti-inflammatory: may help ease inflammation in the body.
• Antioxidant: is associated with helping the body counter oxidative stress.
• Antimicrobial: is traditionally believed to help the body resist certain bacteria and other microbes.
• Immunomodulatory: may help support balanced immune function.
• Antipyretic: is traditionally believed to help bring down fever.

Kalmegh is a bitter herb traditionally used to support the liver and digestion. Its traditional benefits are described below. Research in humans is limited, so these are traditional uses rather than proven medical effects. Kalmegh does not treat any disease. See a doctor about any health condition.

Supports Liver Function

Kalmegh is traditionally used in Ayurveda as a liver tonic. Animal studies have looked at its effect on the liver, but this has not been confirmed in humans (Okhuarobo et al., 2014). It is not a treatment for hepatitis, fatty liver or jaundice, and anyone with a liver condition should consult a doctor before taking it.

Supports Digestion and Appetite

Bitter herbs are traditionally used in Ayurveda to kindle digestive fire (Agni). Kalmegh is taken as a bitter tonic to support appetite and comfortable digestion, and it has traditionally been used for bloating and sluggish digestion.

Provides Anti-inflammatory Plant Compounds

Andrographolide, the main compound in Kalmegh, shows anti-inflammatory activity in laboratory studies (Hossain et al., 2014). What this means for health in everyday use has not yet been established in humans.

Traditionally Used During Seasonal Illness

Kalmegh has traditionally been taken during seasonal coughs and colds. Some research has looked at its use in upper respiratory symptoms, but the evidence is limited. It is not a treatment for any infection.

Kalmegh is a traditional bitter tonic, not a treatment. See a doctor for a fever that does not settle, for any liver condition, or for any infection.

Kalmegh is traditionally taken as a bitter tonic, often before food, to support appetite and digestion.

As a Traditional Liver Tonic

In Ayurveda, it is taken as a supportive liver tonic, usually as a powder or decoction, under the guidance of a practitioner.

During Seasonal Illness

It has traditionally been taken during seasonal coughs and colds, though it is not a treatment for infection.

As Part of an Ayurvedic Formulation

Kalmegh is an ingredient in several classical Ayurvedic preparations, and is often taken within a formulation rather than alone.

Note: Ask a qualified Ayurvedic doctor how and how long to take it.

Kalmegh is not suitable for everyone. Read the points below carefully before using it, and consult a doctor first.

• Autoimmune Conditions: Kalmegh may stimulate the immune system. If you have an autoimmune condition such as rheumatoid arthritis, lupus, multiple sclerosis or an autoimmune thyroid condition, do not take it without medical advice.
• Pregnancy: Avoid; Kalmegh may stimulate the uterus and has traditionally been avoided in pregnancy.
• Breastfeeding: Avoid, as safety has not been established.
• Liver Disease: Although Kalmegh is traditionally used as a liver tonic, rare cases of liver injury have been linked to Andrographis supplements. If you have a liver condition, use it only under medical guidance. If you notice yellowing of the skin or eyes, dark urine or persistent nausea, immediately stop taking it and talk to a doctor.
• Low Blood Pressure: Kalmegh may lower blood pressure. Take care if you already have low blood pressure or take medicine for high blood pressure.
• Men Planning a Family: Animal studies suggest high doses may affect sperm count and movement. If you are trying to conceive, consult a doctor before taking it.
• Allergies: Individuals sensitive to the Acanthaceae plant family should avoid Kalmegh.
• Immunosuppressant Medicines: Kalmegh may work against medicines that suppress the immune system, such as those taken after a transplant. Speak to your doctor.
• Children: Do not give it to children without a doctor's advice.
• Before surgery: Stop taking it at least two weeks before planned surgery, and tell your surgeon.

This is general information and not medical advice. Speak to a doctor before starting any herbal medicine.

Kalmegh is available in a few forms, each taken slightly differently. It is very bitter, so many people prefer capsules.

Mixing the Powder Into Warm Water

Stir 1 to 2 g of Kalmegh powder into a cup of warm water and drink it, usually twice a day before food. A little honey can be added to soften the bitterness.

Swallowing the Capsule or Tablet

Capsules and tablets avoid the bitter taste. Follow the dose on the pack or as advised by your practitioner, usually once or twice a day.

Preparing a Decoction

Boil 1 to 2 teaspoons of dried Kalmegh leaves in a cup of water for 5 to 10 minutes. Strain the liquid and drink 50 to 100 ml once a day.

Taking a Standardised Extract

Standardised andrographolide extract is taken in much smaller amounts than the raw powder. Follow the dose on the pack exactly, as extract strength varies between products.

Herbs Traditionally Used With Kalmegh

In Ayurvedic practice, Kalmegh is often given alongside other bitter and liver-supporting herbs. The traditional pairings below are common. Always ask an Ayurvedic doctor before combining herbal products.

The right dose depends on age, health and the form used. The guidance below is a starting point only. Always confirm the dose with a qualified Ayurvedic doctor or a licensed doctor.

• Children: Not recommended without a doctor's advice. There is limited safety information for children.
• Teenagers (13 to 18 years): Only on a doctor's advice, and at a reduced dose.
• Adults, powder: 1 to 2 g daily, taken in warm water, usually split into two doses before food.
• Adults, capsules or tablets: 300 to 600 mg daily, split into one or two doses, as directed on the pack.
• Adults, decoction: 50 to 100 ml once a day, made by boiling 1 to 2 teaspoons of dried leaves.
• Adults, standardised extract: 30 to 60 mg of andrographolide, as directed on the pack. Extract strength varies, so follow the label rather than a general figure.
• Older adults (over 65): Start at the lower end of the adult range, particularly if you take medicine for blood pressure.

Do not take Kalmegh for long periods without medical supervision. 

Kalmegh is well tolerated by many people at normal doses, but side effects can occur. Stop taking it and consult a doctor if any of these trouble you.

Digestive Upset

Higher doses may cause nausea, stomach discomfort, loss of appetite or loose stools. The bitterness itself can also cause nausea in some people.

Allergic Reaction

Some people may develop itching, a rash or swelling. Stop taking it and seek medical help if you develop swelling of the face or difficulty breathing.

Lowered Blood Pressure

Kalmegh may lower blood pressure, which can cause dizziness or lightheadedness, particularly if you already have low blood pressure.

Effects on Male Fertility

Animal studies suggest that high doses may affect sperm count and movement. Men who are trying to conceive should consult a doctor before taking it.

Rare Liver Injury

Although Kalmegh is traditionally used as a liver tonic, rare cases of liver injury have been linked to Andrographis supplements. Stop taking it and see a doctor if you notice yellowing of the skin or eyes, dark urine, itching or persistent nausea.

Headache and Fatigue

Some people report headache or tiredness, particularly at higher doses.

Interaction of Kalmegh With Other Drugs

Discuss with your doctor, you are taking Kalmegh if you use any of the medicines below.

Immunosuppressant Medicines

Kalmegh may stimulate the immune system, which can work against medicines that deliberately suppress it, such as those taken after an organ transplant or for an autoimmune condition. Talk to your doctor before combining them.

Blood Thinning Medicines

Kalmegh may slow blood clotting. Taken with warfarin, aspirin or other blood thinners, it may increase the risk of bruising or bleeding.

Blood Pressure Medicines

Kalmegh may lower blood pressure. Taken with medicine for high blood pressure, it could lower it too far.

Diabetes Medicines

Kalmegh may affect blood sugar. If you take insulin or diabetes tablets, monitor your blood sugar and talk to your doctor.

Medicines Processed by the Liver

If you take regular prescription medicine, particularly anything that affects the liver, check with your doctor before adding Kalmegh.

Note: This is not a complete list. Always tell your doctor about any herbal product you take.

Storage of Kalmegh

Storing Kalmegh properly keeps it effective and stops it from spoiling.

• Keep it in a tightly closed, airtight container.
• Store it in a cool, dry place away from direct sunlight.
• Keep it away from moisture, and always use a dry spoon.
• Keep it out of the reach of children.
• Do not use it after the expiry date printed on the pack.

Buy from a licensed, reputable supplier. Herbal supplement quality varies, and poor quality products are a known cause of safety problems.

The main points to remember about Kalmegh are below.

• Kalmegh (Andrographis paniculata), the King of Bitters, is a bitter Ayurvedic herb known in Sanskrit as Bhunimba.
• It is traditionally used as a bitter tonic to support liver function, digestion and appetite.
• It is a supportive herb, not a treatment, and does not treat hepatitis, fatty liver, malaria, dengue, asthma, diabetes or cancer, and it must never replace prescribed medicine.
• Do not take it if you are pregnant. Avoid it if you have an autoimmune condition, as it may stimulate the immune system.
• Although it is used as a liver tonic, rare cases of liver injury have been linked to Andrographis supplements. If you have liver disease, use it only under medical guidance.
• It may interact with immunosuppressants, blood thinners, and blood pressure and diabetes medicines. Tell your doctor you are taking it.
• The usual adult dose is 1 to 2 g of powder, or 300 to 600 mg of extract, daily.
• See a doctor for a fever that does not settle, or for any liver condition. Do not rely on a herb.

Disclaimer: This information is general and is not medical advice. Kalmegh is a traditional herb and does not treat any disease. Consult a doctor before use, especially if you have a liver or autoimmune condition.