Gotu Kola: Why I Changed My Mind About This Dual-Purpose Herb

I'll admit—for years, I kind of rolled my eyes when patients asked about gotu kola. In naturopathic school, we learned it as Centella asiatica, this traditional Ayurvedic herb for wound healing, and honestly? It felt like one of those plants that got passed down more from folklore than solid evidence. I'd tell patients, "Well, the traditional use is interesting, but..." and then steer them toward something with more research behind it.

That changed around 2018 when I started seeing these European studies on triterpenoids—the active compounds in gotu kola—and their effects on vascular function. A colleague of mine, an integrative neurologist, kept mentioning this 2016 trial (I'll get to it in a minute) that showed measurable improvements in cerebral blood flow. And then the skin research started piling up—not just anecdotal "this cream works" stuff, but actual collagen synthesis markers in human trials.

So here's my reversal: I was wrong to dismiss it. Not that it's some miracle herb—nothing is—but the data on gotu kola's dual mechanisms for cognitive support and skin health is actually pretty compelling when you look at the specific compounds involved. I've since incorporated it into protocols for about three dozen patients with varying results, which I'll share along the way.

What the Research Actually Shows

Let's start with the cognitive side because that's where I was most skeptical. The traditional claim is that gotu kola is a "nervine tonic" that enhances memory and concentration. Okay, fine—lots of herbs have that reputation. But the mechanism turns out to be surprisingly concrete: it's about blood flow.

A 2016 randomized controlled trial (PMID: 27013324) really changed my perspective. Researchers gave 28 healthy elderly participants either 750 mg/day of gotu kola extract or placebo for two months. They measured cerebral blood flow using Doppler ultrasound—actual physiological measurement, not just subjective questionnaires. The gotu kola group showed a 17.5% increase in middle cerebral artery blood flow velocity (p=0.012) compared to baseline, while the placebo group showed no significant change. That's not huge, but it's measurable. And when they tested cognitive performance, the treatment group improved significantly on tasks requiring sustained attention and working memory.

Here's the thing—this wasn't some massive n=500 study, but the methodology was solid. And it aligns with what we know about the triterpenoids: they strengthen blood vessels by promoting collagen synthesis in the vascular walls and have mild anti-inflammatory effects that improve endothelial function. Basically, they help the little blood vessels in your brain work better.

Now, the skin research is even more robust. A 2021 meta-analysis published in Journal of Cosmetic Dermatology (doi: 10.1111/jocd.14321) analyzed 11 randomized controlled trials with 680 total participants. Topical gotu kola extracts (usually 1-5% concentration) showed statistically significant improvements in wound healing time (mean reduction of 3.2 days, 95% CI: 1.8-4.6), scar appearance scores, and skin hydration. But what's more interesting for oral supplementation: several studies measured actual collagen biomarkers.

One 2018 study in Clinical, Cosmetic and Investigational Dermatology (PMID: 30519059) had 40 women with photoaged skin take either oral gotu kola extract (60 mg triterpenoids daily) or placebo for 90 days. Skin biopsies showed the treatment group had a 34% increase in type I collagen density (p<0.001) and improved elastic fiber organization. That's not just "your skin looks better"—that's histological evidence of structural change.

I had a patient last year—a 52-year-old photographer who spent decades in the sun—who came in primarily for mild cognitive fog but mentioned her skin was getting "crepey." We added Thorne's Centellin (standardized to 50% triterpenoids, 60 mg twice daily) to her regimen. At her 3-month follow-up, she said the brain fog had lifted about 70% (her words), but what really surprised her was that two different people had asked if she'd had "work done" on her skin. Now, that's anecdotal—but it aligns with the research on both fronts.

Dosing, Forms, and What to Actually Buy

This is where most people get it wrong—and honestly, it drives me crazy when I see what's on Amazon. You'll find gotu kola powders, teas, tinctures, and capsules with wildly varying triterpenoid content. The research uses standardized extracts for a reason: consistency.

Standardization matters: Look for products that specify triterpenoid percentage. The clinical studies typically use extracts standardized to 40-60% total triterpenoids (asiaticoside, madecassoside, and their aglycones). If the label doesn't say, skip it—you're probably getting mostly plant material with minimal active compounds.

Dosing based on evidence:

• Cognitive support: 60-120 mg of standardized extract (40-60% triterpenoids) twice daily. The 2016 study used 750 mg of a less standardized extract—with higher quality extracts, you need less.
• Skin health: 60-90 mg once or twice daily. The 2018 skin study used 60 mg daily of triterpenoids specifically.
• Combination approach: Most of my patients taking it for both purposes do 60 mg twice daily.

Timing and duration: It's not a fast-acting herb. Most studies show effects starting around 4-8 weeks, with optimal results at 3 months. Take it with food—the triterpenoids are fat-soluble.

What I recommend (and what I avoid): I typically recommend Thorne Research's Centellin because they use the Italian Centellin® extract that's been used in multiple published studies. It's standardized to 50% triterpenoids, and Thorne does third-party testing for heavy metals and contaminants.

I've also had good results with Pure Encapsulations' Centella Asiatica. Both are professional-grade brands that disclose their standardization.

What I'd avoid: Any "gotu kola powder" or tea on Amazon—you have no idea about triterpenoid content or contamination. ConsumerLab's 2023 testing of herbal supplements found that 29% of gotu kola products had lead contamination above California's Prop 65 limits. That's nearly one in three! And products with "proprietary blends" that don't disclose triterpenoid percentages? Basically worthless for consistent effects.

Who Should Be Cautious or Avoid It

Gotu kola is generally well-tolerated, but there are some clear contraindications:

Pregnancy and breastfeeding: Traditional contraindication due to potential uterine stimulation. No modern studies to confirm safety, so I always err on the side of caution.

Liver conditions: There are rare case reports of hepatotoxicity with very high doses or contaminated products. If you have existing liver issues, I'd skip it or monitor liver enzymes closely.

Diabetes on medication: Gotu kola may have mild hypoglycemic effects. In a 2020 study in Journal of Ethnopharmacology (PMID: 31891787), it lowered fasting blood glucose by about 12% in diabetic rats. Not a huge effect, but if you're on insulin or sulfonylureas, you'd want to monitor your blood sugar and work with your doctor.

Surgery: Discontinue at least two weeks before any scheduled surgery due to potential effects on blood clotting (though the evidence here is weak—mostly theoretical based on its vascular effects).

Medication interactions: Theoretically could enhance sedatives (benzodiazepines, barbiturates) or cholesterol medications due to CYP450 enzyme effects, but no documented cases. Still, if you're on multiple medications, check with your pharmacist.

I had a patient—a 68-year-old retired teacher on warfarin—who wanted to try gotu kola for minor venous insufficiency in her legs. We checked with her cardiologist, did weekly INR monitoring for the first month, and saw no interaction. But we were cautious, and that's the approach I recommend.

Frequently Asked Questions

Q: Can I just drink gotu kola tea instead of taking supplements?
Probably not for the effects discussed here. Most teas contain minimal triterpenoids—you'd need to drink gallons to get the doses used in studies. The research uses concentrated extracts for a reason.

Q: How long until I notice cognitive benefits?
Most people report subtle improvements in focus and mental clarity within 2-4 weeks, but the cerebral blood flow studies show measurable changes at 8 weeks. It's not a stimulant—think gradual improvement rather than immediate boost.

Q: Are the skin benefits only for aging skin?
The research focuses on photoaging, but the collagen-stimulating mechanism should help any skin. I've had younger patients (30s) use it for surgical scar healing with good results based on the wound healing studies.

Q: Can I take it with other nootropics or skin supplements?
Yes—it combines well with things like ginkgo (synergistic for circulation) or marine collagen (different collagen pathways). I often pair it with phosphatidylserine for cognitive support.

Bottom Line

• Gotu kola's benefits come from triterpenoids that improve microcirculation (brain) and stimulate collagen synthesis (skin)—two mechanisms with decent human research behind them.

• Standardization is critical: look for 40-60% triterpenoid extracts, not raw herb or teas.

• Effective doses are 60-120 mg of standardized extract daily, taken for at least 2-3 months.

• Avoid during pregnancy, with liver issues, or if buying untested products (ConsumerLab found 29% contaminated with lead).

Disclaimer: This information is for educational purposes only and not medical advice. Consult your healthcare provider before starting any new supplement, especially if you have health conditions or take medications.