Andrographis paniculata (HMPL-004)
Also known as: HMPL-004 · Andrographolide · Kalmegh · King of bitters
The “king of bitters” — the only botanical taken into a Phase III IBD programme, with results comparable to mesalazine in ulcerative colitis.
Clinically studied. Well-studied in ulcerative colitis, including a head-to-head comparison with mesalazine and a 224-patient placebo-controlled trial. Not yet studied specifically in Crohn’s.
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How it works
Andrographolide, the plant’s signature compound, helps regulate NF-κB by binding its p50 subunit, which moderates production of TNF-α, IL-1β and IL-6. It is one of very few botanicals developed as a standardised, pharmaceutical-grade extract (HMPL-004) and taken through a full clinical development programme — a rare vote of confidence for a plant medicine.
Traditional use
Known as kalmegh in Ayurveda and chuan xin lian in traditional Chinese medicine, andrographis has been used for centuries for digestive complaints, dysentery and fever. Its extreme bitterness earned it the name “king of bitters”.
Highlights
- In a head-to-head trial, remission was 21% with andrographis versus 16% with full-dose mesalazine.
- In a 224-person placebo-controlled trial, 60% responded at the higher dose versus 40% on placebo.
- The first botanical to reach a Phase III inflammatory bowel disease programme.
- Research so far has been in ulcerative colitis — community data from people with Crohn’s will be especially valuable.
- The researched extract (HMPL-004) is standardised; retail products vary in andrographolide content.
What the research shows
Every study below links to its original publication so you can read it yourself. Many natural compounds have only been studied in small trials. That isn’t a verdict on them; it reflects how little funding exists for compounds that can’t be patented.
| Study | Design & population | Outcome |
|---|---|---|
| Tang 2011 Positive result | Randomised, double-blind, multicentre, active-comparator trial, 8 weeks 120 patients · Mild-to-moderately active ulcerative colitis | Clinical remission 21% with HMPL-004 1,200 mg/day versus 16% with mesalazine 4,500 mg/day; response 76% versus 82%. |
| Sandborn 2013 Positive result | Randomised, double-blind, placebo-controlled dose-ranging trial, 8 weeks 224 patients · Mild-to-moderately active ulcerative colitis | Clinical response at week 8 in 60% on 1,800 mg/day and 45% on 1,200 mg/day versus 40% on placebo. |
Randomised, double-blind, multicentre, active-comparator trial, 8 weeks · 120 patients · Mild-to-moderately active ulcerative colitis
Clinical remission 21% with HMPL-004 1,200 mg/day versus 16% with mesalazine 4,500 mg/day; response 76% versus 82%.
Randomised, double-blind, placebo-controlled dose-ranging trial, 8 weeks · 224 patients · Mild-to-moderately active ulcerative colitis
Clinical response at week 8 in 60% on 1,800 mg/day and 45% on 1,200 mg/day versus 40% on placebo.
Using it alongside conventional care
Andrographis is one of the strongest examples of a botanical holding its own against a conventional medication: it matched full-dose Mesalamine in a head-to-head trial. That research was in ulcerative colitis, and people with Crohn’s are increasingly exploring it too. It is one of the natural options we most want to track in our community data. Because andrographis has immune-modulating activity, discuss it with your care team if you are on Humira, Remicade, Entyvio or other immune-targeted therapy.
Medications mentioned
Humira (adalimumab)
Anti-TNF biologic
Neutralises tumour necrosis factor alpha (TNF-α), a master cytokine driving intestinal inflammation.
Remicade (infliximab)
Anti-TNF biologic
Chimeric monoclonal antibody against TNF-α, delivered by infusion.
Entyvio (vedolizumab)
Gut-selective integrin blocker
Blocks α4β7 integrin, preventing lymphocyte trafficking into gut tissue.
Mesalamine (mesalazine / 5-ASA)
Aminosalicylate
Topically acting anti-inflammatory at the mucosal surface.
Never stop or change a prescribed medication without your gastroenterologist. Many people use natural support alongside conventional care, and your care team can help you do that safely.
Recommended sourcing
Where to buyWhat to look for in Andrographis paniculata
- Standardised andrographolide content stated on the label
- Extract rather than raw herb powder
- Third-party tested for purity
- Reputable herbal manufacturer with GMP certification
The trials used 1,200–1,800 mg/day of the HMPL-004 extract. Not for use during pregnancy.
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Amounts used in research
HMPL-004 at 1,200 mg/day and 1,800 mg/day for 8 weeks in ulcerative colitis. Generic andrographis products are not standardised to the same andrographolide content.
Good to know
- Generally well tolerated over 8-week trial exposures; headache and rash were the more common adverse events.
- Immunostimulant activity in vitro makes its interaction with immunosuppressive Crohn’s therapy theoretically unpredictable.
- Reports of anaphylaxis and severe allergic reaction, uncommon but documented.
- Traditional use as an abortifacient; avoid in pregnancy.
- May potentiate antihypertensive and anticoagulant drugs.
Community experiences
Reported benefit
Typical dose
Time to notice
Common pairings
Real-world data for Andrographis paniculata is coming. When our Community Symptom Tracker launches, this section will show anonymised, aggregated experiences from people with Crohn’s who have tried Andrographis paniculata: how many noticed a difference, what they took, and what they paired it with.
Community data will always be labelled as self-reported, and it won’t replace the published research above.
Coming soon
Tried Andrographis paniculata? Your experience matters.
Our Community Symptom Tracker will let you log what you take and how you feel — and see what’s working for people like you. Alongside it, our wellness store will offer curated, third-party-tested protocols.
Sources
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Tang T, Targan SR, Li ZS, Xu C, Byers VS, Sandborn WJ. · Alimentary Pharmacology & Therapeutics · 2011 · PMID 21114791
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Andrographis paniculata extract (HMPL-004) for active ulcerative colitis
Sandborn WJ, Targan SR, Byers VS, et al. · American Journal of Gastroenterology · 2013 · PMID 23044768
Phase 2 — in development
Where traditional research stops, our community begins
Natural compounds can’t be patented, so they rarely get the multi-million-dollar trials that drugs receive. That leaves people with Crohn’s without answers to the questions that matter most: what actually helps, at what dose, and for whom? Our Community Symptom Tracker will crowdsource those answers from real people living with Crohn’s, and our upcoming wellness store will make it easy to find quality, third-party-tested products.
- Log your symptoms, supplements and doses in a private daily tracker
- See what’s working for people with the same disease location and medications
- Contribute to the largest real-world dataset on natural Crohn’s support
- Shop curated, third-party-tested protocols from our upcoming store
Be one of the first to join
Early access is opening soon. Bookmark this page and check back — we’ll announce sign-ups here first.