Introduction
Jiaogulan (Gynostemma pentaphyllum) is a traditional herbal supplement derived from a climbing vine native to Southeast Asia. Often referred to as "Southern Ginseng" or "Herb of Immortality," it has been used for centuries in Chinese and Ayurvedic medicine. While not an FDA-approved pharmaceutical drug, it is widely available as a dietary supplement with purported adaptogenic, cardioprotective, and metabolic benefits.
Mechanism of Action
Jiaogulan contains bioactive compounds called gypenosides, which share structural similarities with ginsenosides from Panax ginseng. Its proposed mechanisms include:
- AMPK activation leading to improved glucose metabolism
- Modulation of nitric oxide production resulting in vasodilation
- Antioxidant activity through increased superoxide dismutase (SOD) and glutathione peroxidase
- HMG-CoA reductase inhibition contributing to cholesterol reduction
- Adaptogenic effects via hypothalamic-pituitary-adrenal axis modulation
Indications
Note: These are traditional and supplement uses, not FDA-approved indications- Adjunctive support for cardiovascular health
- Glucose metabolism support in prediabetes
- Adaptogenic support for stress response
- Lipid management support
- General tonic for fatigue and vitality
Dosage and Administration
Standard dosing: 100-450 mg standardized extract daily (typically containing 20-98% gypenosides) Traditional preparations: 2-4 cups of tea daily (using 2-3 grams dried herb per cup) Divided dosing: Typically administered 2-3 times daily with meals Special populations: No established dosing recommendations for pediatric, geriatric, or hepatic/renal impairment patientsPharmacokinetics
Absorption: Poorly characterized; gypenosides appear to have moderate bioavailability Distribution: Limited data; components distribute to various tissues with particular affinity for cardiovascular system Metabolism: Hepatic metabolism via CYP450 enzymes (primarily CYP3A4) Elimination: Primarily renal excretion with some biliary elimination Half-life: Not established in human studiesContraindications
- Known hypersensitivity to Gynostemma pentaphyllum or related plants
- Pregnancy and breastfeeding (due to insufficient safety data)
- Patients awaiting surgery (theoretical risk of bleeding)
- Severe hepatic impairment
Warnings and Precautions
- May potentiate hypoglycemic medications
- Theoretical risk of bleeding due to antiplatelet effects
- May interact with antihypertensive medications
- Quality control issues with commercial preparations (variable gypenoside content)
- Limited long-term safety data beyond 6 months of continuous use
Drug Interactions
Significant interactions:- Antidiabetic agents (insulin, sulfonylureas, metformin) - increased hypoglycemia risk
- Antihypertensives - additive blood pressure lowering effects
- Anticoagulants/antiplatelets (warfarin, aspirin, clopidogrel) - potential increased bleeding risk
- CYP3A4 substrates (statins, calcium channel blockers) - possible altered metabolism
- Immunosuppressants (due to potential immunomodulatory effects)
- Thyroid medications (limited evidence of thyroid modulation)
Adverse Effects
Common (≥1/100):- Gastrointestinal discomfort
- Nausea
- Increased bowel movements
- Headache
- Dizziness
- Dry mouth
- Severe allergic reactions
- Significant hypoglycemia
- Hepatotoxicity (case reports)
Monitoring Parameters
- Blood glucose levels (especially in diabetics)
- Blood pressure
- Liver function tests (baseline and periodic)
- Coagulation parameters if on anticoagulant therapy
- Lipid profile if used for cholesterol management
- Signs of bleeding or bruising
Patient Education
- Inform healthcare providers about jiaogulan use, especially before surgery
- Monitor for signs of hypoglycemia if diabetic
- Discontinue 2 weeks before elective surgery
- Purchase from reputable sources with third-party verification
- Report any unusual side effects or symptoms promptly
- Do not use during pregnancy or breastfeeding without medical supervision
- Understand that herbal supplements are not FDA-approved for treating specific diseases
References
1. Blumert M, Liu J. Jiaogulan: China's "Immortality" Herb. Badger, CA: Torchlight Publishing; 2003. 2. Chen JC, Zhang GH, Zhang ZQ, et al. Effect of Gynostemma pentaphyllum on the cardiovascular system. Acta Pharmacol Sin. 1990;11(5):426-429. 3. Huyen VT, Phan DV, Thang P, et al. Antidiabetic effect of Gynostemma pentaphyllum tea in randomly assigned type 2 diabetic patients. Horm Metab Res. 2010;42(5):353-357. 4. Megalli S, Davies NM, Roufogalis BD. Anti-hyperlipidemic and hypoglycemic effects of Gynostemma pentaphyllum in the Zucker diabetic fatty rat. J Pharm Pharm Sci. 2006;9(3):281-291. 5. World Health Organization. WHO Monographs on Selected Medicinal Plants. Volume 2. Geneva: World Health Organization; 2002. 6. Natural Medicines Database. Gynostemma Professional Monograph. Therapeutic Research Center. 2023.
Note: This monograph is for educational purposes only. Jiaogulan is not an FDA-approved drug and should not be used as a substitute for prescribed medications. Consult healthcare providers before starting any new supplement regimen.