PICRORHIZA

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Picrorhiza

Parts used and where grown: The herb originated in and continues to grow primarily in the Himalayan mountains. The rhizomes or underground stems of picrorhiza are used.

Picrorhiza has been used in connection with the following conditions (refer to the individual health concern for complete information):

Rating	Health Concerns
	Asthma Vitiligo
	Hepatitis (acute viral) Indigestion Infection Rheumatoid arthritis
Reliable and relatively consistent scientific data showing a substantial health benefit. Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit. An herb is primarily supported by traditional use, or the herb or supplement has little scientific support and/or minimal health benefit.

Historical or traditional use (may or may not be supported by scientific studies): The bitter rhizomes of picrorhiza have been used for thousands of years in India to treat people with indigestion.¹ It is also used to treat people with constipation due to insufficient digestive secretion and for fever due to all manner of infections.²

Active constituents: The major constituents in picrorhiza are the glycosides picroside I, kutkoside, androsin, and apocynin. They have been shown in animal studies to be antiallergic, to inhibit platelet-activating factor (an important pro-inflammatory molecule),³ and to decrease joint inflammation.⁴ According to test tube and animal studies, picrorhiza has antioxidant actions, particularly in the liver.^{5 6} Picroliv (a commercial mixture containing picroside I and kutkoside) has been shown to have an immunostimulating effect in hamsters, helping to prevent infections.⁷ Picrorhiza increases bile production in the liver, according to rat studies.⁸ It has also been shown to protect animals from damage by several potent liver toxins, offering protection as good as or better than silymarin (the flavonoids found in milk thistle).^{9 10} However, it does not have the amount of human research as silymarin. Picrorhiza has also shown to reduce formation of liver cancer due to chemical exposures in animal studies.¹¹

Human studies on this plant are not prolific. A series of cases of acute viral hepatitis in India were reportedly treated successfully by a combination of picrorhiza with a variety of minerals.¹² A number of similar reports have appeared in Indian literature over the years. No double-blind clinical trials have yet been published, however.

Two preliminary trials suggest that picrorhiza may improve breathing in asthma patients and reduce the severity of asthma.^{13 14} Although, a follow-up double-blind trial did not confirm these earlier trials.¹⁵

A preliminary trial conducted in India found a small benefit for people with arthritis (primarily rheumatoid arthritis).¹⁶

Picrorhiza in combination with the drug methoxsalen was found in a preliminary trial to hasten recovery in people with vitiligo faster than those receiving methoxsalen and sun exposure alone.¹⁷

How much is usually taken? Between 400 and 1,500 mg of powdered, encapsulated picrorhiza per day has been recommended. One author considers this equivalent to the use of 1–2 ml of fluid extract twice per day.¹⁸ Picrorhiza tastes quite bitter. Combining with ginger root powder capsules or taking as tea can improve palatability.

Are there any side effects or interactions? Loose stools and colic have been reported when unprepared picrorhiza rhizomes are used as medicine. However, extracts in alcohol have shown much less tendency to cause such effects.¹⁹ No other adverse effects have been reported with picrorhiza. Although the use of the herb is not discouraged in India during pregnancy and breast-feeding, there is little information to determine the safety of the herb during these times.

Are there any drug interactions? Certain medications may interact with picrorhiza. Refer to the drug interactions safety check for a list of those medications.

1. Krishnamurthy A. The Wealth of India vol VIII. New Delhi, Publication and Information Directorate, Council of Scientific and Industrial Research, 1969, 49.

2. Nadkarni KM, Nadkarni AK. Indian Materia Medica. Bombay, Popular Prakashan, 1976, 953–5.

3. Dorsch W, Stuppner H, Wagner H, et al. Antiasthmatic effects of Picrorhiza kurroa: Androsin prevents allergen- and PAF-induced bronchial obstruction in guinea pigs. Int Arch Allergy Appl Immunol 1991;95:128–33.

4. ‘t Hart BA, Simons JM, Knaan-Shanzer S, et al. Antiarthritic activity of the newly developed neutrophil oxidative burst antagonist apocynin. Free Rad Biol Med 1990;9:127–31.

5. Anandan R, Devaki T. Hepatoprotective effect of Picrorrhiza [sic] kurroa on tissue defense system in D-galactosamine-induced hepatitis in rats. Fitoterapia 1999;70:54–7.

6. Chander R, Kapoor NK, Dhawan BN. Picroliv, picroside-I and kutkoside from Picrorhiza kurroa are scavengers of superoxide anions. Biochem Pharmacol 1992;44:180–3.

7. Puri A, Saxena RP, Sumati, et al. Immunostimulant activity of Picroliv, the iridoid glycoside fraction of Picrorhiza kurroa, and its protective action against Leishmania donovani infection in hamsters. Planta Med 1992;58:528–32.

8. Shukla B, Visen PKS, Patnaik GK, Dhawan BN. Choleretic effect of Picroliv, the hepatoprotective principle of Picrorhiza kurroa. Planta Med 1991;57:29–33.

9. Floersheim GL, Bieri A, Koenig R, Pletscher A. Protection against Amantia phalloides by the iridoid glycoside mixture of Picrorhiza kurroa (kutkin). Agents Actions 1990;29:386–7.

10. Dwivedi Y, Rastogi R, Mehrotra R, et al. Picroliv protects against aflatoxin B1 acute hepatotoxicity in rats. Pharmacol Res 1993;27:189–99.

11. Jeena KJ, Joy KL, Kuttan R. Effect of Emblica officinalis, Phyllanthus amarus and Picrorrhiza [sic] kurroa on N-nitrosodiethylamine induced hepatocardinogenesis. Cancer Lett 1999;136:11–6.

12. Chaturvedi GN, Singh RH. Jaundice of infectious hepatitis and its treatment with an indigenous drug, Picrorhiza kurrooa [sic]. J Res Ind Med 1966;1:1–13.

13. Rajaram D. A preliminary clinical trial of Picrorrhiza kurroa in bronchial asthma. Indian J Pharmacol 1975;7:95–6.

14. Shan BK, Kamat SR, Sheth UK. Preliminary report of use of Picrorrhiza kurroa root in bronchial asthma. J Postgrad Med 1977;23:118–20.

15. Doshi VB, Shetye VM, Mahashur AA, Kamat SR. Picrorrhiza kurroa in bronchial asthma. J Postgrad Med 1983;29:89–95.

16. Langer JG, Gupta OP, Atal CK . Clinical trials on Picrorhiza kurroa. Ind J Pharmacol 1981;13:98–103 [review].

17. Bedi KL, Zutshi U, Chopra CL, Amla V. Picrorhiza kurroa, an Ayurvedic herb, may potentiate photochemotherapy in vitiligo. J Ethnopharmacol 1989;27:347–52.

18. Bone K. Picrorrhiza [sic]: Important modulator of immune function. Townsend Letter for Doctors 1995;May:88–94 [review].

19. Chaturvedi GN, Singh RH. Jaundice of infectious hepatitis and its treatment with an indigenous drug, Picrorhiza kurrooa [sic]. J Res Ind Med 1966;1:1–13.

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