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Astragalus

Botanical Name: Astragalus membranaceus (Fisch.) Bunge.
Pharmacopoeial Name:Radix astragali.
Common Names:Astragalus, milk vetch root, Huang-Qi.

Summary Table

Drug/Class Interaction Type	Mechanism and Significance	Management
Acyclovir Purine nucleoside analog antivirals	Astragalus promotes T helper cell type 1 (Th1) immunity. Possible additive antiviral activity, against herpes simplex virus type 1 (HSV-1). Experimental support only; interaction not established clinically.	Consider coadministration during drug therapy for HSV family viruses.
Aldesleukin Recombinant interleukin-2 (rIL-2) /	Astragalus may synergistically increase effects of rIL-2. Experimental evidence only; interaction not clinically established.	Theoretically, coadministration may enhance therapeutic outcome of IL-2 treatment.
Cyclophosphamide Myelosuppressive chemotherapy / /	Astragalus promotes myelopoiesis; may protect white blood cell (WBC) counts during chemotherapy with cyclophosphamide, platinum agents, or other myelosuppressive chemotherapies. In nonmalignant disease applications, theoretically an adverse interaction.	Coadminister and continue after myelosuppressive chemotherapy until WBC count normalized; used with related herbs in formula.
Interferon alpha (IFN-α) /	Astragalus increases endogenous IFN; can be used to support IFN therapy or potentiate drug, allowing reduced drug dose and increased tolerability. Empirical clinical support; no trial evidence.	Consider coadministration in chronic viral conditions treated with IFN.
Thrombolytics	Astragalus increases fibrinolytic capacity by promoting tissue-type plasminogen activator (tPA). Astragalus may additively support fibrinolytic drug therapies. Interaction not clinically established.	Consider use in hyperviscosity or high-risk thrombotic patients with appropriate drugs.

herb description

Family

Fabaceae.

Related Species

Astragalus membranaceus var. mongholicus (Bunge).

Habitat and Cultivation

Perennial member of the legume family, native to Northern China, Mongolia, and Siberia and now under organic cultivation in the United States. The genus contains more than 400 species. Wild “locoweeds” (various Astragalus spp.) are a common livestock forage food. Gum tragacanth is derived from a related species, A. gummifer .

Parts Used

Radix (root).

Common Forms

Dried Sliced Root: Often soaked, then pressed or flattened; variant preparation may be honey-roasted in Chinese medicine.

Powdered Root: For decoction, liquid extracts and tablets.

Tincture and Fluid Extracts: 60% to 70% ethanol; usually include a water-extraction phase for polysaccharides, then preserved in ethanol.

Standardized Extracts: Several preparations are available. There is no consensus on marker compounds for standardization at this time; individual manufacturers’ preparations may vary.

herb in clinical practice

Overview

Astragalus has been used for more than 2000 years in Chinese medicine and is one of several important materia medica imports into Western botanical medicine. The herb is primarily used in Western herbalism as an immunomodulating agent and for cardiovascular disease. Interest in the herb as an adjunct to chemotherapy in oncological settings is increasing, but a recent Cochrane review found limited evidence of value for astragalus decoctions in improving adverse effects of chemotherapy in colorectal cancer patients. ¹ Another, more recent meta-analysis reviewed trials in which astragalus was combined with platinum agents in non–small cell lung cancer; evidence showed that the combination may provide increased effectiveness in terms of tumor response, reduced toxicity of the chemotherapy, survival time, or performance status. ²

Most available scientific literature is published in Chinese and has not been directly accessed for this survey. Much of the experimental data on astragalus are based on isolated polysaccharide fractions, either in vitro or by intraperitoneal administration in vivo. Extrapolation from this data to human oral consumption of powdered crude herb or liquid extracts may not be appropriate, particularly with regard to dosage. Chinese clinical trials usually use the herb in combination formulae with other herbs, such as ginseng, dang gui, poria, and rhemannia, because this is the typical manner of clinical administration. The available data have been used to discuss the interactions later.

Astragalus, as with other East Asian herbs incorporated into the Western materia medica relatively recently, is not monographed by the German Commission E, European Scientific Cooperative on Phytotherapy (ESCOP), or World Health Organization (WHO). Astragalus does have an American Herbal Pharmacopoeia monograph, ³ and the literature has been reviewed by McKenna et al. ⁴ and Wagner et al. ⁵ Bensky et al. ⁶ provide an authoritative review, and Chen and Chen ⁷ relate traditional Chinese uses to conventional pharmacology.

Historical/Ethnomedicine Precedent

Chinese uses include spleen (Pi) qi tonification, lung (Fei) qi tonification, and “securing the exterior”; promoting pus discharge and growth of new tissue and providing immune support. These features may contribute to a number of different biomedical pathological conditions. Astragalus is traditionally used in Chinese medicine in combination formulae for a wide range of conditions, from the common cold to chronic renal failure. ⁷

Known or Potential Therapeutic Uses

Cardioprotection (anti-ischemic, fibrinolytic, antioxidant); immunostimulation (reversal of leukopenia, myelosuppression); general prophylaxis of infection, stress, hypertension, certain viral infections (coxsackieviruses B2 and B3, parainfluenza type 1, viral myocarditis, Japanese endocarditis, HSV-1), nephritis, nephropathy, oxidative stress psoriasis, prostatic hypertrophy, and Takayasu arteritis.

Key Constituents

Polysaccharides (astragalans or astragologlucans); triterpene saponins (astragolides I-VII); isoflavones and other flavonoids; amino acids, minerals, essential oils, and phytosterols.

Therapeutic Dosing Range

Dried Root: 10 to 15 g daily; by decoction, maximum 120 g in Chinese medicine.

Hydroethanolic Extracts: 10 to 20 mL daily (based on 1:1 equivalent).

interactions review

Strategic Considerations

Astragalus is used in Western botanical medicine as a tonic, adaptogenic, immunomodulating herb with negligible toxicity. It is myeloprotective, with added cardioprotective, hepatoprotective, and antioxidant properties, which make it a potentially useful adjunct in contexts involving immunosuppression, whether through disease processes, such as human immunodeficiency virus (HIV) and chronic fatigue immune dysfunction syndrome (CFIDS), or drug induced, such as myelosuppressive chemotherapies for the treatment of malignancies and immunosuppression in allograft patients. Recent research on the cardiac properties of the herb may help expand the Western use of astragalus beyond the narrow confines of “immunomodulation.” ^9,10

Astragalus use with pharmaceutical immunosuppression (i.e., allograft patients) may be theoretically problematic, but there are no reports of adverse interactions arising from its use in this context. Combination with immunosuppressants may be regarded as contraindicated in practice. Several interactions described later are based on pharmacodynamic effects of the herb on immune parameters. These interactions are not generally supported by published clinical trials; however, strategic coadministration of the herb in some of the therapeutic contexts described is anecdotally established practice among some practitioners of botanical and integrative medicine.

Effects on Drug Metabolism and Bioavailability

There is currently no evidence of interactions resulting from the effects of astragalus on drug-metabolizing systems. A rodent study examining the hepatoprotective effects of astragalus saponins against acetaminophen-induced toxicity found a significant increase in hepatic cytochrome P450 (CYP) levels after astragalus administration. ¹¹ Although studies are lacking, clinically significant pharmacokinetic interactions have not been reported to date.

herb-drug interactions

Acyclovir and Related Purine Nucleoside Analog Antivirals

Evidence: Acyclovir (Zovirax).

Extrapolated, based on similar properties: Purine nucleoside analog antivirals; famciclovir (Famvir), ganciclovir (Cytovene), valciclovir (Valcivir, Valcyclovir, Valtrex).

Potential or Theoretical Beneficial or Supportive Interaction, with Professional Management

Probability: 4. Plausible
Evidence Base:

Preliminary

Effect and Mechanism of Action

A synergistic pharmacodynamic interaction increases the antiviral efficacy of the drug. Astragalus has established activity against a number of viruses in experimental and in vivo environments. Mechanisms remain to be clarified, but in general, T helper cell type 1 (Th1) cytokines and cell-mediated immune responses are enhanced by astragalus extracts.

Research

Zuo et al. ¹² demonstrated a potentiation of acyclovir against herpes simplex virus type 1 (HSV-1)–infected mice when combined with astragalus that was greater than the effects of either agent alone, when measured by reduced mortality and extended survival time.

Integrative Therapeutics, Clinical Concerns, and Adaptations

Coadministration or pretreatment with astragalus may be useful as a possible adjunct to pharmaceutical antiviral therapies, based on limited available evidence. The interaction remains to be confirmed by clinical studies.

Aldesleukin (IL-2)

Interleukin-2 (IL-2), recombinant interleukin-2 (rIL-2); Proleukin.

	Potential or Theoretical Beneficial or Supportive Interaction, with Professional Management
	Prevention or Reduction of Drug Adverse Effect

Probability: 3. Possible
Evidence Base:

Preliminary

Effect and Mechanism of Action

The coadministration of astragalus and rIL-2 may produce a synergistic pharmacodynamic interaction. Astragalus extracts enhance several aspects of Th1-mediated immunity. Interleukin-2 immunotherapy is used to enhance cell-mediated immunity. Astragalus appears to potentiate IL-2 synergistically, which is one plausible mechanism of its ability to increase Th1 (cell-mediated) over Th2 immune activity.

Research

Co-incubation of lymphokine-activated killer (LAK) cells with astragalus F3 (fractionated extract) polysaccharide (55 µg/mL) achieved the same “tumor cell kill” when combined with 100 units/mL of IL-2, as did untreated LAK combined with 1000 units/mL of IL-2, suggesting a tenfold potentiation. ¹³ In a related study by the same group using LAK cells from patients with acquired immunodeficiency syndrome (AIDS), measured activity against melanoma cell lines increased tenfold when IL-2 was combined with astragalus F3, allowing a 50% reduction in effector/target cell ratio. ^14,15 Similar results of tenfold potentiation with the F3 fraction and IL-2 with murine renal cell carcinoma have been reported. ¹⁶

Integrative Therapeutics, Clinical Concerns, and Adaptations

Patients undergoing low-dose cytokine therapy using IL-2 may benefit from concurrent use of astragalus extracts or combinations, allowing a lower dose of IL-2 to be used and thus reducing potential adverse effects of the immunotherapy. Astragalus tends to favor Th1 over Th2 through additional mechanisms and may be considered a useful synergist in this therapeutic context. Direct clinical evidence for the interaction is not available.

Cyclophosphamide and Related Myelosuppressive Chemotherapy, Especially Alkylating Agents

Evidence: Cyclophosphamide (Cytoxan, Endoxana, Neosar, Procytox).

Extrapolated, based on similar properties: Busulfan (Myleran), carboplatin (Paraplatin), chlorambucil (Leukeran), cisplatin ( cis-diaminedichloroplatinum, CDDP; Platinol, Platinol-AQ), dacarbazine (DIC, DTIC, DTIC-Dome, imidazole carboxamide), ifosfamide (Ifex, Mitoxana), mechlorethamine (Mustargen, nitrogen mustard), melphalan (Alkeran), oxaliplatin (Eloxatin), phenylalanine mustard (Melphalan), pipobroman (Vercyte), streptozocin (Zanosar), temozolomide (Temodar), thiotepa (Thioplex), uracil mustard (uramustine).

	Prevention or Reduction of Drug Adverse Effect
	Beneficial or Supportive Interaction, with Professional Management
/	Bimodal or Variable Interaction, with Professional Management

Probability: 2. Probable
Evidence Base:

Emerging

Effect and Mechanism of Action

Astragalus reduces the effects of cyclophosphamide-induced suppression of cell-mediated immunity, increasing white blood cell (WBC) counts in chemotherapy-induced leukopenia and neutropenia, and is lymphoproliferative at splenic and bone marrow levels. In the context of cyclophosphamide treatment of nonmalignant disease, the interaction is theoretically adverse, although properly speaking, this is a “contraindicated” combination.

Research

Several studies using cells from human cancer and healthy control patients in graft-versus-host (GVH) reaction models suggest that astragalus polysaccharide extracts promote cell-mediated immunity and reverse cyclophosphamide-induced immunosuppression. ^13,17,18 Water extracts increase phagocytosis in carbon clearance tests, stimulate splenic lymphocyte proliferation, and increase tumor necrosis factor alpha (TNF-α) and interleukin-6 (IL-6) production by macrophages. ¹⁹ Proliferative effects on bone marrow stem cells and peripheral WBCs was observed after intraperitoneal (IP) administration of astragalus in mice. ²⁰ Rodent macrophages were activated by astragalus polysaccharide in vitro, partly through nuclear factor kappa B (NF-κB) activation. ²¹ Clinical trials with intravenous (IV) astragalus polysaccharide coadministered with chemotherapy have been reported in the Chinese literature with positive results on outcome, versus chemotherapy alone, in terms of survival as well as quality-of-life measures. ^22,23

Clinical Implications and Adaptations

The astragalus-cyclophosphamide interaction has been classified as adverse by some authorities, presumably in the context of cyclophosphamide used in autoimmune disease treatment rather than cancer therapy. ²⁴ Astragalus extracts may be incorporated into integrative protocols designed to support patients undergoing any myelosuppressive chemotherapies. Combination formulae are typically used in these applications, and experimental evidence indicates that such combinations may be more efficacious than the single herb against cyclophosphamide immunotoxicity. ²⁵ Lymphopenia also occurs frequently in cancer patients, before, during, and after chemotherapeutic interventions, and correlates with decreased immunocompetence. To the degree that astragalus and other botanicals can support lymphocyte counts in such patients, these agents may be of clinical benefit, although controlled trials are required to demonstrate efficacy.

Interferon Alpha (IFN-α)

Interferon Alpha (IFN-α): Alferon N, Intron A, Roferon-A.

	Prevention or Reduction of Drug Adverse Effect
	Potential or Theoretical Beneficial or Supportive Interaction, with Professional Management

Probability: 4. Plausible
Evidence Base:

Preliminary

Effect and Mechanism of Action

Astragalus increases endogenous interferon (IFN) production by leukocytes and thus may potentiate the effects of therapeutic recombinant interferon (rIFN) administration. It is not established whether this is an additive or synergistic effect. Preliminary clinical support is available.

Research

An experimental study compared administration of a combination of recombinant IFN-2α with astragalus in a cell culture model of HSV-1–infected diploid human cells. The combination exhibited greater antiviral activity than the rIFN alone. ²⁶ In a human trial, healthy volunteers were given 8 g/day of astragalus. After 2-week and 2-month periods of administration, blood levels of IFN were significantly elevated compared with controls. ²⁷ The effect of IFN in treatment of 235 patients with chronic viral cervicitis was potentiated by astragalus, the combination being more effective as topical treatment than either IFN or astragalus alone. Interferon and astragalus combinations were superior to either agent alone against the human cold in a human trial using topical nasal spray application. Duration of symptoms was reduced significantly.

Integrative Therapeutics, Clinical Concerns, and Adaptations

Astragalus is known to have antiviral activity and to increase cell-mediated immunity. It is not clear to what extent augmentation of IFN levels underlies these effects; coordinated use of astragalus extracts may potentiate or synergize with IFN treatments (e.g., for viral hepatitis).

Thrombolytic Agents

Effect and Mechanism of Action

Astragalus extracts increase fibrinolysis and improve rheological characteristics of whole blood. Coadministration with various forms of antithrombotic therapy may be supportive, although clinical evidence is unavailable.

Research

Astragaloside IV fractionated extracts increased fibrinolytic potential of human umbilical vein endothelial cells in culture. The effect was mediated by upregulation of tissue-type plasminogen activator (tPA) expression and downregulation of plasminogen activator inhibitor (PA-I). ²⁸ Increased PA-I activity relative to tPA and urokinase-type plasminogen activator (uPA) activity strongly correlates with cardiovascular morbidity and mortality. Reduced fibrinolytic capacity is a major cardiovascular disease risk in younger men. PA-I type 1 (PAI-1) is a risk factor for recurrence of myocardial infarction (MI), and high PAI-1 levels predict a first MI in middle-aged men and women. ^29-31

Integrative Therapeutics, Clinical Concerns, and Adaptations

Astragalus extracts may be supportive of strategies aimed at prophylaxis and treatment of thrombosis in at-risk populations. There are no reports that astragalus extracts adversely interfere with normal hemostasis or interact adversely with typical anticoagulant drugs, which generally do not act through tPA. Combination with natural fibrinolytic agents such as Wobenzyme, nattokinase, and lumbrokinase may be appropriate in integrative protocols targeting hypercoagulable states.

theoretical, speculative, and preliminary interactions research, including overstated interactions claims

Aminoglycoside Antibiotics

Amikacin (Amikin), gentamicin (G-mycin, Garamycin, Jenamicin), kanamycin (Kantrex), neomycin (Mycifradin, Myciguent, Neo-Fradin, NeoTab, Nivemycin), netilmicin (Netromycin), paromomycin (monomycin; Humatin), streptomycin, tobramycin (AKTob, Nebcin, TOBI, TOBI Solution, TobraDex, Tobrex).

A combination of astragalus and Lu Han Cao(Herba Pyrolae) was injected into guinea pigs subsequently administered intraperitoneal (IP) aminoglycosides, and the combination was found to prevent toxicity and nephrotoxicity. ³² Chen and Chen ⁷ overstate this as an interaction. Because the formula included another herb ingredient and parenteral administration, it should not be extrapolated to astragalus alone in oral administration without further supporting data.

Oral Hypoglycemic Agents and Insulin

Buformin (Andromaco Gliporal, Buformina), chlorpropamide (Diabinese), glimepiride (Amaryl), glipizide (Glucotrol; Glucotrol XL), glyburide (Glibenclamide; Diabeta, Glynase, Glynase Prestab, Micronase, Pres Tab), insulin (animal-source insulin: Iletin; human analog insulin: Humanlog; human insulin: Humulin, Novolin, NovoRapid, Oralin), metformin (Dianben, Glucophage, Glucophage XR); combination drugs: glipizide and metformin (Metaglip), glyburide and metformin (Glucovance); tolazamide (Tolinase), phenformin (Debeone, Fenformin), tolbutamide (Orinase, Tol-Tab).

A traditional Chinese use of astragalus combinations includes effects that would be recognized in modern pharmacology as lowering blood glucose. ⁷ There is also some experimental support for this theoretical interaction using streptozocin-induced rodent models of diabetes. It has been suggested that this implies a potential adverse interaction with oral hypoglycemics, a speculation that has no foundation, and if anything is contrary to the known effects and uses of the herb in this context. Data even suggest that insulin sensitivity may be increased by the herb. ³³ Astragalus is also potentially beneficial in preventing diabetic cardiomyopathy. ³⁴

Citations

1.Taixiang W, Munro AJ, Guanjian L. Chinese medical herbs for chemotherapy side effects in colorectal cancer patients. Cochrane Database Syst Rev 2005:CD004540.View Abstract
2.McCulloch M, See C, Shu XJ et al. Astragalus-based Chinese herbs and platinum-based chemotherapy for advanced non-small-cell lung cancer: meta-analysis of randomized trials. J Clin Oncol 2006;24:419-430.View Abstract
3.Upton R. Astragalus root. American Herbal Pharmacopoeia. Santa Cruz, CA; 1999.
4.McKenna DJ, Jones K, Hughes K. Astragalus. Botanical Medicines. 2nd ed. New York: Haworth Press; 2002.
5.Wagner H, Bauer R, Peigen X, Jianming C. Radix Astragali [Huang Qi]. Chinese Drug Monographs and Analysis. Bayer Wald:Verlag für Ganzheitliche Medizin Dr Eric Wühr GmbH; 1997;1(8):18.
6.Bensky D, Clavey S, Stogër E, Gamble A. Ren Shen. Chinese Herbal Medicine: Materia Medica. 3rd ed. Seattle: Eastland Press; 2004:710-714.
7.Chen J, Chen T. Huang Qi (Radix Astragali). Chinese Medical Herbology and Pharmacology. City of Industry, CA: Art of Medicine Press Inc; 2004:847-853.
8.Bruneton J. Toxic Plants Dangerous to Humans and Animals. Hatton CK, Translator. 1st ed. Andover, UK: Intercept Ltd; 1999.
9.Zhang W-D, Chen H, Zhang C et al. Astragaloside IV from Astragalus membranaceus shows cardioprotection during myocardial ischemia in vivo and in vitro. Planta Med 2006;72:4-8.
10.Shen P, Liu MH, Ng TY et al. Differential effects of isoflavones, from Astragalus membranaceus and Pueraria thomsonii, on the activation of PPARalpha, PPARgamma, and adipocyte differentiation in vitro. J Nutr 2006;136:899-905.View Abstract
11.Zhang YD, Shen JP, Zhu SH et al. [Effects of astragalus (ASI, SK) on experimental liver injury]. Yao Xue Xue Bao 1992;27:401-406.View Abstract
12.Zuo L, Dong X, Sun X. The curative effects of Astragalus membranaceous Bunge (A6) in combination with acyclovir on mice infected with HSV-1. Virol Sin 1995.
13.Chu DT, Lepe-Zuniga J, Wong WL et al. Fractionated extract of Astragalus membranaceus, a Chinese medicinal herb, potentiates LAK cell cytotoxicity generated by a low dose of recombinant interleukin-2. J Clin Lab Immunol 1988;26:183-187.View Abstract
14.Chu D, Sun Y, Lin J et al. [F3, a fractionated extract of Astragalus membranaceus, potentiates lymphokine-activated killer cell cytotoxicity generated by low-dose recombinant interleukin-2]. Zhong Xi Yi Jie He Za Zhi 1990;10:34-36, 35.View Abstract
15.Chu DT, Lin JR, Wong W. [The in vitro potentiation of LAK cell cytotoxicity in cancer and aids patients induced by F3, a fractionated extract of Astragalus membranaceus]. Zhonghua Zhong Liu Za Zhi 1994;16:167-171.View Abstract
16.Wang Y, Qian XJ, Hadley HR, Lau BH. Phytochemicals potentiate interleukin-2 generated lymphokine-activated killer cell cytotoxicity against murine renal cell carcinoma. Mol Biother 1992;4:143-146.View Abstract
17.Sun Y, Hersh EM, Talpaz M et al. Immune restoration and/or augmentation of local graft versus host reaction by traditional Chinese medicinal herbs. Cancer 1983;52:70-73.View Abstract
18.Wang DC. [Influence of Astragalus membranaceus (AM) polysaccharide FB on immunologic function of human periphery blood lymphocyte]. Zhonghua Zhong Liu Za Zhi 1989;11:180-183.View Abstract
19.Yoshida Y, Wang MQ, Liu JN et al. Immunomodulating activity of Chinese medicinal herbs and Oldenlandia diffusa in particular. Int J Immunopharmacol 1997;19:359-370.View Abstract
20.Rou M, Renfu X. The effect of Radix Astragali on mouse marrow hemopoiesis. J Tradit Chin Med 1983;3(3):199-204.
21.Lee KY, Jeon YJ. Macrophage activation by polysaccharide isolated from Astragalus membranaceus. Int Immunopharmacol 2005;5:1225-1233.View Abstract
22.Duan P, Wang Z-m. [Clinical study on effect of Astragalus in efficacy enhancing and toxicity reducing of chemotherapy in patients of malignant tumor]. Zhongguo Zhong Xi Yi Jie He Za Zhi 2002;22:515-517.View Abstract
23.Zou Y-h, Liu X-m. [Effect of astragalus injection combined with chemotherapy on quality of life in patients with advanced non–small cell lung cancer]. Zhongguo Zhong Xi Yi Jie He Za Zhi 2003;23:733-735.View Abstract
24.Mills S, Bone K. The Essential Guide to Herbal Safety. St Louis: Churchill Livingstone; 2005.
25.Wei X, Zhang J, Li J, Chen S. Astragalus mongholicus and Polygonum multiflorum’s protective function against cyclophosphamide inhibitory effect on thymus. Am J Chin Med 2004;32:669-680.
26.Zhang L, Liu Y, Yu Z. [Study on the anti–herpes simplex virus activity of a suppository or ointment form of Astragalus membranaceus combined with interferon alpha 2b in human diploid cell culture]. Zhonghua Shi Yan He Lin Chuang Bing Du Xue Za Zhi 1998;12:269-271.View Abstract
27.Hou YD, Ma GL, Wu SH et al. Effect of Radix Astragali seu Hedysari on the interferon system. Chin Med J (Engl) 1981;94:35-40.View Abstract
28.Zhang WJ, Wojta J, Binder BR. Regulation of the fibrinolytic potential of cultured human umbilical vein endothelial cells: astragaloside IV downregulates plasminogen activator inhibitor-1 and upregulates tissue-type plasminogen activator expression. J Vasc Res 1997;34:273-280.View Abstract
29.Meade TW, Ruddock V, Stirling Y et al. Fibrinolytic activity, clotting factors, and long-term incidence of ischaemic heart disease in the Northwick Park Heart Study. Lancet 1993;342:1076-1079.View Abstract
30.Hamsten A, de Faire U, Walldius G et al. Plasminogen activator inhibitor in plasma: risk factor for recurrent myocardial infarction. Lancet 1987;2:3-9.View Abstract
31.Thogersen AM, Jansson JH, Boman K et al. High plasminogen activator inhibitor and tissue plasminogen activator levels in plasma precede a first acute myocardial infarction in both men and women: evidence for the fibrinolytic system as an independent primary risk factor. Circulation 1998;98:2241-2247.View Abstract
32.Xuan W, Dong M. Effects of compound injection of Pyrola rotundifolia L and Astragalus membranaceus Bge on experimental guinea pigs’ gentamicin ototoxicity. Ann Otol Rhinol Laryngol 1995;104:374-380.View Abstract
33.Wu Y, Ou-Yang JP, Wu K et al. Hypoglycemic effect of Astragalus polysaccharide and its effect on PTP1B. Acta Pharmacol Sin 2005;26:345-352.
34.Li C, Cao L, Zeng Q. Astragalus prevents diabetic rats from developing cardiomyopathy by downregulating angiotensin II type 2 receptors’ expression. J Huazhong Univ Sci Technol Med Sci 2004;24:379-384.

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Family

Related Species

Habitat and Cultivation

Parts Used

Common Forms

Overview

Historical/Ethnomedicine Precedent

Known or Potential Therapeutic Uses

Key Constituents

Therapeutic Dosing Range

Strategic Considerations

Effects on Drug Metabolism and Bioavailability

Effect and Mechanism of Action

Research

Integrative Therapeutics, Clinical Concerns, and Adaptations

Effect and Mechanism of Action

Research

Integrative Therapeutics, Clinical Concerns, and Adaptations

Effect and Mechanism of Action

Research

Clinical Implications and Adaptations

Effect and Mechanism of Action

Research

Integrative Therapeutics, Clinical Concerns, and Adaptations

Effect and Mechanism of Action

Research

Integrative Therapeutics, Clinical Concerns, and Adaptations