Andrographis: A Potential Health Hazard or a Misunderstood Herbal Remedy?
The Therapeutic Goods Administration (TGA) has proposed removing Andrographis paniculata from its list of permitted ingredients, citing severe allergic reactions and even fatalities associated with its use. This decision comes after years of reports and a growing body of evidence linking the herb to anaphylaxis and other serious health issues. But what is the story behind this controversial herb, and why is it being removed from the market?
The Rise of Traditional Medicines
In recent years, traditional medicines have gained popularity in Western societies, particularly in response to the COVID-19 pandemic. Andrographis paniculata, a herb in the Asterids clade of flowering plants, has been used in Indian and Chinese traditional medicine for its purported benefits in treating and preventing cold and flu symptoms, upper respiratory tract infections, inflammation, and fever. However, despite its popularity, there is a lack of empirical evidence to support these claims.
Anaphylaxis: A Serious Allergic Reaction
Anaphylaxis is a severe allergic reaction that can be life-threatening if not treated immediately. Symptoms include swelling of the tongue and throat, difficulty breathing, and in some cases, death. The TGA has received reports of anaphylaxis and hypersensitivity reactions to Andrographis since 2005, with a particular spike in 2019 and 2020 coinciding with the early months of the COVID-19 pandemic. Despite mandatory labeling changes and product availability restrictions, adverse event reports continued to rise, with significant spikes in 2022, 2023, 2024, and 2025.
Unpredictable and Life-Threatening
What makes the anaphylactic reactions to Andrographis particularly concerning is their unpredictability and potential for rapid progression. Symptoms typically begin within 30 minutes of exposure, and many affected individuals have no history of allergies or asthma. This lack of understanding about why Andrographis causes anaphylaxis further complicates the situation.
The TGA's Response
The TGA's safety review and proposal to remove Andrographis from its list of permitted ingredients are based on the growing body of evidence linking the herb to severe allergic reactions and fatalities. Previous changes to labeling and product availability have not substantially altered the incidence of serious adverse reactions, leading the TGA to take more drastic action. The TGA has opened a consultation with stakeholders, including consumer associations, health professionals, and industry peak bodies, to gather feedback and ensure a thorough evaluation of the situation.
Consumer Safety and Awareness
In the meantime, consumers are advised to read the TGA's updated safety review and supplementary report before taking any medicine containing Andrographis. If an anaphylactic reaction is suspected, emergency medical help should be sought immediately. Additionally, it is crucial to consult with a health professional before taking any medication, including herbal supplements, and to read the label carefully before using any product.
Conclusion: A Cautionary Tale
The story of Andrographis serves as a cautionary tale about the potential risks associated with herbal remedies and the importance of thorough safety reviews and consumer awareness. While traditional medicines can offer valuable benefits, it is essential to approach them with caution and a critical eye, especially when there is a lack of empirical evidence to support their claims. The TGA's decision to remove Andrographis from the market highlights the need for ongoing vigilance and a commitment to public health and safety.
