Caveats and Contraindications Regarding the Use of Astragalus

Of the scores of anti-aging herbs available in the Materia Medica of Traditional Chinese Medicine, Astragalus membranaceous has recently fallen under the spotlight.  Aside from the newest research that shows its ability to lengthen telomeres, there are multiple studies going back 15-20 years demonstrating its ability to reduce inflammation, enhance the immune system and improve fatigue.  Much of this information can be found in this wonderful post discussing some of its benefits.

Although generally safe, there are some caveats to the use of astragalus and some potential side effects.  These are described in the Traditional Chinese Medical literature.  Having used astragalus on at least 1000 patients, I can say with certainty that these concerns are legitimate.  There are two major contraindications in the Traditional Chinese Medical literature regarding the use of astragalus.  One is in the case of acute infections, flus and colds.  The other relates to a condition known as “dampness” that affects the digestive system, nervous system and lymphatic system.

One of the many benefits described in the traditional texts is that astragalus strengthens the “Wei Qi”.  This translates as the protective energy or the immune system.  For thousands of years, astragalus was touted as a way to prevent or “lock out invasion of wind-heat or wind-cold” aka infection by various viruses and bacteria.  It is one of the most effective herbs on the planet for strengthening the immune system.  However, they were very clear that it also had the ability to “lock in” these invaders, prolong acute febrile diseases and potentially drive them to deeper parts of the body.  There are written observations that discuss post-viral fatigue type symptoms and prolonged illness caused by the inappropriate use of astragalus and other similar herbs.  More research is needed for a full explanation.  I suspect this has to do with some of the lectins present in the herb http://www.ncbi.nlm.nih.gov/pubmed/22172162.  For a weakened or deranged immune system these can be of great benefit.  However, in the presence of an active infection, astragalus likely acts like a cloaking device and allows some pathogens to proliferate more effectively while masking symptoms.  As a general rule, astragalus should be avoided or discontinued during acute infections of the respiratory tract, digestive tract and urinary tract.  It should also be avoided during yeast infections and acute prostatitis.  There are circumstances where astragalus can be used as an adjunctive herb in these situations, especially in weak or elderly patients.  However, it would always be combined with other herbs that deal directly with infection and inflammation.  In the cases of chronic diseases, astragalus can work miracles when combined with other herbs that address the specific condition.

Currently, it is not possible to determine if the extract contained in TA-65 ™ or other related products have cause for any of these concerns.  It contains very specific chemical compounds from astragalus, which may not be involved in this mechanism.  Several of my patients are taking TA-65 ™ and they all report fewer colds.  However, to be on the safe side, I recommend that they temporarily discontinue it if they feel any symptoms coming on.

The second potential contraindication with astragalus concerns a mysterious concept called “dampness”.  This is very common in today’s society.   When “dampness” is present, the interconnected mechanisms within the digestive, nervous and lymphatic systems become “clogged”.  It leads to and arrays of symptoms including fatigue, mental fog, digestive disturbances and disruption of neurotransmitter balance.  This complex subject illuminates entire aspects of disease, especially the beginnings of autoimmune conditions.  Although parts of our scientific knowledge can fill in some of the pieces, it is not sufficiently advanced enough to effectively explain this very real condition.  The concept of dampness repeatedly appears throughout the Traditional Chinese Medicine literature spanning hundreds of years.  Ayurveda, an even older medicine, also recognized this disease pathology.  It is considered one of the primary “seeds” of many chronic diseases.  The appropriate use of astragalus with this condition will be discussed in a future post.

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