Andrographis Fights Multiple Sclerosis Fatigue

Of the approximately one million Americans with multiple sclerosis, about 85 percent have relapse-remitting multiple sclerosis (RRMS), in which attacks of symptoms are interspersed with recovery periods. For some, treatment with interferon beta can alleviate issues and help normalize long-term immune responses.

However, regardless of treatment, fatigue is still a major characteristic of RRMS, and researchers have begun turning to integrative practice, including herbal medicines, for an answer. One of those botanicals is andrographis (Andrographis paniculata).

Andrographis is widely known as a cold and flu fighter, reducing symptom severity, and shortening the duration of illnesses. But the adaptogenic traits of the herb show a wide range of abilities, including reducing fatigue in individuals with multiple sclerosis.

Adaptogens are unique botanicals that enhance stress resilience, bolster mental and physical endurance, and enhance cognition. Some of the best known include rhodiola, ashwagandha, and red ginseng. Andrographis appears to share many of the same qualities.

In fact, this pilot clinical study observed that andrographis can improve energy levels even when people feel intensely drained for very serious causes. In this case, it reduced fatigue according to the Fatigue Severity Score by 44 percent in individuals with multiple sclerosis receiving interferon treatment. This is good news to those with the condition, especially if they are dealing with the effects of interferon beta treatment as well.


Bertoglio JC, Baumgartner M, Palma R, et al. Andrographis paniculata decreases fatigue in patients with relapsing-remitting multiple sclerosis: a 12-month double-blind placebo-controlled pilot study. BMC Neurol. 2016;16:77.

Background: Andrographis paniculata (A. paniculata), a medicinal plant, has shown anti-inflammatory, neuroprotective and antifibrotic effects in animal models as well as clinical efficacy in different studies, including an anti-fatigue effect in autoimmune diseases such as rheumatoid arthritis. In multiple sclerosis (MS), fatigue is rated as one of the most common and disabling symptoms. In the present trial, we investigated the effect of A. paniculata on relapse rate and fatigue in relapsing-remitting MS (RRMS) patients receiving interferon beta.

Methods: A randomised double-blind placebo-controlled trial assessed the effects of 170 mg of A. paniculata dried extract tablet b.i.d. p.o. on relapse rate and fatigue using the Fatigue Severity Scores (FSS) over 12 months in RRMS patients receiving interferon. The Expanded Disability Status Scale (EDSS) score, inflammatory parameters and radiological findings were also investigated. Twenty-five patients were enrolled, and twenty-two patients were ultimately analysed and randomised to the active or placebo group.

Results: Patients treated with A. paniculata showed a significant reduction in their FSS score as compared to the placebo, equivalent to a 44 % reduction at 12 months. No statistically significant differences were observed for relapse rate, EDSS or inflammatory parameters, with a trend in reducing new lesions among the A. paniculata group. One patient in the A. paniculata group presented with a mild and transient skin rash, which was alleviated with anti-histamine treatment for three weeks.

Conclusion: A. paniculata was well tolerated in patients and no changes in clinical parameters were observed. A. paniculata significantly reduces fatigue in patients with RRMS receiving interferon beta in comparison to placebo and only interferon beta treatment.

Here is the link to the full text of the study: Andrographis paniculata decreases fatigue in patients with relapsing-remitting multiple sclerosis: a 12-month double-blind placebo-controlled pilot study