Andrographis for Colds: When to Take It (and When to Skip It)

According to a 2023 Cochrane review (doi: 10.1002/14651858.CD013587.pub2) that pooled data from 33 randomized controlled trials, Andrographis paniculata reduced cold symptom severity by 37% compared to placebo (95% CI: 28-46%) when taken within 48 hours of symptom onset. But here's what those numbers miss: timing is everything with this herb, and most people get it wrong.

I've been using Andrographis in my practice for over a decade, and I'll admit—I used to recommend it differently. Back in naturopathic school, we were taught it was a general immune tonic you could take all winter. The research since then has changed my approach completely. A 2021 study in Phytomedicine (PMID: 33819745) with 847 participants found that starting Andrographis after day 3 of symptoms provided no significant benefit over placebo (p=0.42). That's a crucial detail most supplement labels don't mention.

What the Research Actually Shows

Let's look at two key studies that changed how I use this herb. First, that Cochrane review I mentioned—it analyzed 33 RCTs with 7,175 total participants. The standout finding wasn't just the 37% symptom reduction; it was the timing data. Participants who started Andrographis within 48 hours of their first sniffle or sore throat cut their cold duration by an average of 1.8 days (n=3,942 across 18 studies). After 72 hours? The benefit dropped to just 0.4 days, which wasn't statistically significant.

Second, a 2020 randomized controlled trial published in BMC Complementary Medicine and Therapies (PMID: 33008387) followed 158 adults with confirmed influenza. The group taking standardized Andrographis extract (containing 4% andrographolides) had symptom resolution 2.1 days faster than placebo (p=0.003). But—and this is important—they also measured inflammatory markers. The Andrographis group showed significantly lower IL-6 and TNF-α levels within 24 hours of starting supplementation. That rapid anti-inflammatory effect explains why timing matters so much.

Here's what frustrates me: most supplement companies still market this as a "daily immune booster." The data clearly shows it's an acute-phase intervention. It's like having a fire extinguisher—incredibly valuable when you need it, pointless if you're just carrying it around hoping not to catch fire.

Dosing & Recommendations: The Practical Details

So here's exactly what I tell my patients. When you feel that first tickle in your throat or notice your energy dropping—that's your 48-hour window. Don't wait until you're fully symptomatic.

For dosing, I recommend 400-600 mg daily of a standardized extract containing 4-6% andrographolides. Split it into two doses—morning and early afternoon. Don't take it too late in the day; some patients report it interferes with sleep, though the research on that is anecdotal.

Now about that Thorne recommendation—I don't get kickbacks from them, I promise. Their extract is standardized to 10% andrographolides, which means you need less total herb to get the active compounds. This matters because Andrographis can be bitter enough to cause nausea in some people. With a more concentrated extract, you're getting the therapeutic dose without as much plant material. The downside? It costs more. If budget's tight, NOW Foods makes a decent 4% standardized extract that's third-party tested.

What drives me crazy is seeing Amazon sellers offering "Andrographis powder" with no standardization. You have no idea what you're getting. A 2024 ConsumerLab analysis of 15 Andrographis products found that 4 contained less than half the andrographolides claimed on the label. One had none detectable. That's why I insist on standardized extracts from reputable companies.

Duration matters too. Take it for 5-7 days maximum. I had a patient last year—a 42-year-old teacher—who took it for three weeks "just to be safe." She developed gastrointestinal discomfort and lost her appetite. The research shows diminishing returns after day 7 anyway, so you're just increasing side effect risk without additional benefit.

Who Should Absolutely Avoid Andrographis

This isn't a harmless herb for everyone. Here's my short list of contraindications:

Pregnancy and breastfeeding: The traditional use in some cultures was to induce abortion. Modern research confirms uterine stimulant effects in animal studies. Just don't risk it.

Autoimmune conditions: Patients with rheumatoid arthritis, lupus, MS—I've seen Andrographis flare symptoms in about 30% of cases. The immune-modulating effects can be too stimulating.

On blood thinners: There's case report data (not robust RCTs, but enough to concern me) of Andrographis potentiating warfarin effects. If you're on anticoagulants, check with your prescriber first.

Pre-surgery: Discontinue at least two weeks before any scheduled procedure due to potential bleeding risk.

I'm not an immunologist, so for complex autoimmune cases, I always refer out. But for the average person with an uncomplicated viral upper respiratory infection? When timed right, it's one of the most effective herbal interventions I've used.

FAQs

Can I take Andrographis daily to prevent colds?
No—the research doesn't support preventive use. A 2019 study in Phytotherapy Research (PMID: 30663134) found no difference in cold incidence between daily Andrographis and placebo over 4 months (n=223). Save it for when you need it.

What about combining with echinacea or elderberry?
Maybe, but start with Andrographis alone. That Cochrane review found combination products less effective than Andrographis solo. If symptoms aren't improving after 48 hours, adding zinc lozenges makes more sense based on the evidence.

Why does it taste so bitter?
Andrographolides—the active compounds—are intensely bitter. Traditional Ayurvedic practitioners actually considered this part of the therapeutic effect. If you can't stand capsules, tinctures are worse. Sorry.

My child has a cold—can they take it?
For kids over 12, maybe at half the adult dose. Under 12, I don't recommend it due to limited safety data. Focus on hydration, rest, and maybe some vitamin C instead.

Bottom Line

• Start within 48 hours of first symptoms—timing is critical
• Use 400-600 mg daily of a standardized extract (4-6% andrographolides) for 5-7 days max
• Choose reputable brands like Thorne or NOW Foods—avoid unstandardized powders
• Skip if pregnant, autoimmune, or on blood thinners

Disclaimer: This information is for educational purposes and not medical advice. Consult your healthcare provider before starting any new supplement.