Gotu Kola (Centella Asiatica) and Pycnogenol for Calcium Score
Thanks and credit goes to Joel Kahn MD and Kirk Hamilton for alerting me to the combination of two plant extracts, French maritime pine bark (Pycnogenol) and Centella asiatica (Goto Cola) for Reversing Calcium Score, Atherosclerosis and preventing in-stent stenosis. Most of the recent studies have been done by Dr. Gianni Belcaro’s group in Italy showing impressive efficacy and safety of this combination in preventing progression of cardiovascular disease and in-stent stenosis. Dr. Joel Kahn uses this combination in his cardiology practice and has written an excellent summary of the research studies reprinted in Life Extension Magazine. (1)
The 2019 study by Dr Hu showed reversal of arterial calcifications. Control subjects had a 34.88% increase while treated subjects has a decrease of -9.95%. However, this was not a calcium score study which would be the preferred technique. I would like to see this repeated using actual calcium scores. I would assume this efficacy would be translated to calcium scores. It would be nice to actually see this. (2)
There may also other uses for skin, obesity etc. Combinations with Aloe Vera and Nattokinase are aslo9 useful as antiseptic and anti-thrombotic. (1-11)
Pycnogenol from Pure Encapsulations
Life Extension has the combination product available on Amazon: Combination Gotu Kola and Pycnogenol: Click Link Here to Buy on Amazon
Rhamnan- Marine Algae Supplement Reverses Atherosclerotic Plaque in Apo-E Mice
Patil, Nikita P., et al. “Rhamnan sulfate reduces atherosclerotic plaque formation and vascular inflammation.” Biomaterials 291 (2022): 121865.
rhamnan sulfate was a potent inhibitor of NF-κB pathway activation in endothelial cells by TNF-α. We treated ApoE -/- mice with a high fat diet for 4 weeks and then an addition 9 weeks of high fat diet with or without rhamnan sulfate. Rhamnan sulfate reduced vascular inflammation and atherosclerosis in both sexes of ApoE -/- mice but had a stronger therapeutic effect in female mice. Oral consumption of rhamnan sulfate induced a significant decrease in cholesterol plasma levels in female mice but not in male mice. Conclusions Rhamnan sulfate has beneficial effects in reducing inflammation, binding growth factors and NF-κB, enhancing endothelial barrier function and reducing atherosclerotic plaque formation in ApoE -/- mice.
Link to buy product on Amazon:
Calroy Arterosil HP Rhamnan Sulfate – Monostroma Nitidum
Articles with Related Content
Above Left header image: Low magnification micrograph of the distal right coronary artery with complex atherosclerosis and luminal narrowing. Masson’s trichrome. Courtesy of wikimedia commons
Jeffrey Dach MD
7450 Griffin Road Suite 180/190
Dave, Florida 33314
954 792 4663
Links and References
1) Reversal of Calcification and Atherosclerosis. two plant extracts.
French maritime pine bark and Centella asiatica Goto Cola. November 2022. Written by: Joel Kahn, MD.
arterial/cardiac calcifications in subjects with asymptomatic atherosclerosis.
2) Hu, Shu, et al. “Central cardiovascular calcifications: supplementation with Pycnogenol® and Centellicum®: variations over 12 months.” Minerva Cardioangiologica 68.1 (2019): 22-26.
BACKGROUND: This ‘concept’ registry study evaluated the efficacy of Pycnogenol® and the combination Pycnogenol® and Centella Asiatica (Centellicum®) in controlling over 12 months the increasing number of arterial/cardiac calcifications in subjects with asymptomatic atherosclerosis.
METHODS: The study included 3 groups of 30 males with asymptomatic coronary calcifications. Group one was followed with standard management (SM); group 2 used SM and Pycnogenol® (150 mg/day); group 3 used the combination Pycnogenol® (150 mg/day) + Centellicum® (450 mg/day). All subjects took cardioaspirin (Bayer, 100 mg/day).
RESULTS: No dropouts, no clinical events were observed in 12 months. The 3 groups had comparable demographic and medical characteristics at baseline. No tolerability problems and no side effects from supplementation were reported. After 12 months, oxidative stress was significantly decreased (P<0.05) in both groups taking Pycnogenol®. The evaluation of the number of calcifications >1 mm indicated a trend in controls using SM towards a progressive increase in calcifications. At 12 months the decrease in the number of calcifications with the combined supplements (Pycnogenol® and Centellicum®) (group 3) was -9.952% and thus significantly better that in the other two groups (P<0.05). Pycnogenol® alone was more effective than SM alone in controlling the variation in calcifications (P<0.05). Considering a 34.88% increase in SM subjects, the total absolute difference between SM (34.8%) and the decrease observed in group 3 (-9.95%) was 44.75% (P<0.02). This indicates that supplementation with the combined supplements blocks the increase in calcified areas and, possibly, in time may decrease the number of calcified spots.
CONCLUSIONS: This study shows that there is a significant activity of the complex Pycnogenol®+ Centellicum® in reducing the progressive diffusion of central cardiovascular calcifications-associated with advanced plaques – in a relatively short period of time. Longer studies – focusing also on events – may better evaluate the efficacy of these standardized supplements combination on the evolution of atherosclerosis.
3) Belcaro, Gianni, et al. “Delayed progression of atherosclerosis and cardiovascular events in asymptomatic patients with atherosclerotic plaques: 3-year prevention with the supplementation with Pycnogenol®+ Centellicum®.” Minerva cardioangiologica 68.1 (2020): 15-21.
Background: The aim of this study was the evaluation of the progression of atherosclerosis and the occurrence of cardiovascular events in asymptomatic patients with atherosclerotic plaques (Class IV and V) and arterial wall atherosclerotic lesions and intima-media thickening (IMT).
Methods: Progression of atherosclerotic lesions, oxidative stress and IMT were measured in a 3-year concept, pilot registry study. All subjects were followed with standard management (SM) – including diet and exercise – to control cardiovascular risk factors.The target measurements were: the rate of progression of the atherosclerotic lesions (the passage of subjects from one atherosclerotic class to the next class); the occurrence of “hard” cardiovascular events (i.e. myocardial infarction or strokes; angina was not considered a “hard” event). The study included 3 groups: 1) SM): 2) subjects using cardioaspirin (100 mg/day) and SM; 3) subjects following SM, taking cardioaspirin and supplemented with Pycnogenol® (150 mg/day)+Centellicum® (450 mg/day).
Results: The groups were comparable for age and baseline evaluations. 54 subjects completed the 3 year study with standard management only, 74 with aspirin and 56 with aspirin and Pycnogenol®+Centellicum®. The BMI of all subjects was <26. No side effects and no tolerability problems were observed with the supplements. Progression was defined by the passage of the atherosclerotic lesions from one class to the next more advanced class. Progression in the supplement group was observed in 5.3% of the subjects in comparison with a progression >20% in the other groups (P<0.05).
In comparison with the SM group and the cardioaspirin group the rate of ‘hard’ cardiovascular events, requiring hospital admissions were <4% with the combined supplement in comparison with a value >12% in the other two groups (22.22% event rate in the SM group).
The reduction produced by the aspirin only was significantly lower (P<0.05) in comparison with supplemented patients. Antiplatelet management appears to reduce a significant number of events (P<0.05) without a real effect on progression of atherosclerotic lesions. The additional parameters of carotid IMT and oxidative stress were also lower (P<0.05) with the supplements.
Conclusions: In conclusion, this study indicates that the combined supplementation with Pycnogenol®+Centelicum® appears to control both the progression of atherosclerosis and the occurrence of cardiovascular events in this 3 year study. Larger studies, in a wider population with more complex and less standardized conditions may be needed.
prevent asymptomatic atherosclerosis progression
4) Belcaro, G., M. Dugall, E. Ippolito, M. Hosoi, U. Cornelli, A. Ledda, M. Scoccianti, M. R. Cesarone, L. Pellegrini, R. Luzzi, M. Corsi and B. Feragalli (2017). “Pycnogenol® and Centella asiatica to prevent asymptomatic atherosclerosis progression in clinical events.” Minerva Cardioangiol 65(1): 24-31.
BACKGROUND: The aim of this study was to evaluate the effect of the nutritional supplements Pycnogenol® and Centella asiatica (CA) on atherosclerosis progression in low-risk, asymptomatic subjects with carotid or femoral stenosing plaques. METHODS: The study included subjects aged 45-60 with stenosing atherosclerotic plaques (50-60%) in at least one carotid or common femoral bifurcation. Subjects were allocated into 3 groups. In Group 1 (controls), management was based on education, exercise, diet and lifestyle changes. This same management plan was used in the other two groups: Group 2 used Pycnogenol® (100 mg/day), while Group 3 used Pycnogenol® 100 mg/day plus CA(100 mg/day). The follow-up lasted 4 years. Plaque progression was assessed using the ultrasonic arterial score based on arterial wall morphology, considering plaque characteristics and the number of subjects that had cardiovascular events. Oxidative stress was also measured.
RESULTS: Of the 413 individuals that were admitted, 391 individuals completed 4 years. Group distribution was comparable. The rate of progression of ultrasound arterial score was significantly lower in the two supplement groups (P<0.05) in comparison with controls suggesting a beneficial effect of Pycnogenol® with a significant difference in favor of the combination (P<0.05). There was a reduction in plaques progression in the supplement groups with the best effects obtained by the combination, considering maximum plaque thickness and length and echogenicity (grey scale median) (P<0.05). Plaques became generally dense (more echogenic) achieving a mixed echogenicity. The occurrence of anginal events was less than 3% in the two supplement groups (in comparison with 6.25% in controls) (P<0.05) with the best results obtained by the combination (P<0.05). The occurrence in myocardial infarctions was significantly lower for the combination (P<0.05). Minor transient ischemic attacks were also less frequent with the supplements with the best results observed with the combination (P<0.05). Events in controls – requiring hospital admission – were globally seen in 16.4% of subjects (minor events) in comparison with 8.9% of subjects using Pycnogenol® and only 3.3% of patients using the combination. At 4 years, oxidative stress in the supplement groups was lower than in controls (P<0.05, with no significant difference between groups 2 and 3). CONCLUSIONS: Pycnogenol® and the combination of Pycnogenol® plus CAreduce the progression of arterial plaques and the progression to clinical stages. The reduction in plaques and clinical progression was associated with a reduction in oxidative stress. The results justify a larger study to define the efficacy of the combination of Pycnogenol® plus CAas a prophylaxis in preclinical atherosclerosis.
post-stent prevention of neointima and plaque re-growth.
5) Belcaro, Gianni, et al. “Pycnogenol®+ Centellicum®, post-stent evaluation: prevention of neointima and plaque re-growth.” Minerva cardioangiologica 67.6 (2019): 450-455.
Background: The aim of this study was to evaluate the regrowth and progression of within-stent neointima after stenting as a model of accelerated atherosclerosis and the potential effects of the combination Pycnogenol® and Centellicum® in 12 months’ follow-up.
Methods: Progression was defined as the passage from one arterial risk class to next, more advanced risk class in 12 months of follow-up. Each class corresponds to a different risk of cardiovascular events and progression. Three management groups were formed, treated with either standard management (SM), Pycnogenol® 150 mg/day, or a combination of Pycnogenol® 150 mg/day and Centellicum® 450 mg/day.
Results: No side effects or tolerability problems were observed. 82 subjects with stented arteries in class 2 were evaluated for the passage into class 3 over 12 months. This group included 82 subjects; there were no dropouts. The management subgroups were comparable at baseline. At 12 months 66.7% of subjects in the SM subgroup progressed to class 3, versus 10.7% in the Pycnogenol® group; progression was seen in 6.7% (P<0.05) of subjects supplemented with the combination. In the second section of the registry study (78 subjects with stented arteries in class 3) we evaluated the percentage of patients passing into class 4. At 12 months 53.6% of subjects using the SM progressed versus 26.9% in the subgroup using Pycnogenol® (P<0.05) and 11.5% in the Pycnogenol®+Centellicum® group (P<0.05). Across all 160 subjects in the three management groups, progression of the stented artery at 12 months was seen in 59.6% of subjects in the SM group versus 18.5% (P<0.05) in the group managed with Pycnogenol® only. The Pycnogenol®+Centellicum® combination further decreased progression down to 8.9% (P<0.05). Oxidative stress was significantly reduced (P<0.05) in the two supplement groups.
Conclusions: In conclusion, the combination Pycnogenol®+Centellicum® appears to reduce the rate of progression of the neointima after stenting.
6) Pycnogenol-Nattokinase Combo Prevents In-Flight Venous Thrombosis
Thursday, 15 April 2004 0:38 By Erik Goldman | Editor in Chief – Vol. 5, No. 1. , 2004
Flite Tabs formula contains 150 mg of “Pinokinase,” a proprietary combination of pycnogenol and nattokinase.
7) Belcaro, G., et al. “Pycnogenol® and Centella asiatica in the management of asymptomatic atherosclerosis progression.” International Angiology: a Journal of the International Union of Angiology 34.2 (2014): 150-157.
8) Belcaro, Gianni, et al. “Pycnogenol® and Centella asiatica to prevent asymptomatic atherosclerosis progression in clinical events.” Minerva Cardioangiologica 65.1 (2015): 24-31.
Gotu Kola (Centella Asiatica (L.) Urban) and Aloe Vera Herb Extracts
9) Mayefis, Delladari, et al. “Effectiveness of Combination of Gotu Kola (Centella Asiatica (L.) Urban) and Aloe Vera Herb Extracts as a Natural Disinfectant.” Jurnal EduHealth 14.01 (2023): 182-193.
10) Sun, Boju, et al. “Therapeutic potential of Centella asiatica and its triterpenes: A review.” Frontiers in pharmacology 11 (2020): 568032.
Centella asiatica (also known as Centella asiatica (L.) Urb. or Gotu kola) is a traditional Chinese medicine with extensive medicinal value, which is commonly used in Southeast Asian countries. This study aimed to summarize the effects of C. asiatica and its main components on neurological diseases, endocrine diseases, skin diseases, cardiovascular diseases, gastrointestinal diseases, immune diseases, and gynecological diseases, as well as potential molecular mechanisms, to study the pathological mechanism of these diseases based on the changes at the molecular level. The results showed that C. asiatica and its triterpenoids had extensive beneficial effects on neurological and skin diseases, which were confirmed through clinical studies. They exhibited anti-inflammatory, anti-oxidative stress, anti-apoptotic effects, and improvement in mitochondrial function. However, further clinical studies are urgently required due to the low level of evidence and lack of patients.
Among the 109 studies included, 58 were in vivo experiments, 36 in vitro experiments, 11 in vivo and in vitro experiments, and 4 clinical trials (Figure 2).
Previous studies found that C. asiatica and its triterpenoids could effectively increase SOD and GPX activities, activate nuclear factor erythroid-2-related factor 2, improve the cognitive impairment of animals, and then alleviate the symptoms of related diseases (Gray et al., 2017a; Chintapanti et al., 2018; Welbat et al., 2018).
C. asiatica extract, asiatic acid, and asiaticoside could effectively increase the content of brain-derived neurotrophic factor (BDNF)
C. asiatica extracts are promising in treating endocrine diseases, especially type 2 diabetes and obesity (Table 3). As for specific compounds, asiatic acid was effective in obesity (Rameshreddy et al., 2018) and madecassoside might be a potential candidate for treating osteolytic bone diseases (Wang et al., 2019).
First, the C. asiatica extract seemed to improve the oxidative stress. Both the diabetic animal model and the obesity animal model demonstrated that the C. asiatica extract increased the GSH, CAT, and SOD activities, thereby improving the enzyme antioxidant system (Kumari et al., 2016; Masola et al., 2018; Rameshreddy et al., 2018). Second, the results of animal experiments showed that the C. asiatica extract could effectively decrease related inflammation factors (TNF-α, IL-1β, and IL-4). At the same time, it also reduced blood glucose and blood lipid levels (Oyenihi et al., 2017; Masola et al., 2018). Besides, the results showed that the extracts of C. asiatica lowered food and water intake and body weight, which suggested that C. asiatica extract may affect obesity by influencing the feeding center controlled by central nervous system (Halpern et al., 2008; Blanco et al., 2011).
Moreover, the potential of asiatic acid as an anti-obesity agent can be proved from the facts that it suppresses weight gain, and enhance the sensitivity of leptin and insulin. At the molecular level, asiatic acid can increase the level of enzymatic antioxidants (CAT, GPx and SOD), reverse the expression of CPT-1 and UCP-2 that are suppressed by high-fat diet. Therefore, it can be deduced that asiatic acid can repair oxidative stress damage caused by obesity, and can also suppress weight gain by promoting fatty acid oxidation (Rameshreddy et al., 2018).
treatment of osteoporosis
The results of madecassoside intervention in a mouse model of osteoporosis, caused by estrogen deficiency and bone marrow monocytes showed that it can inhibit the expression of related genes by affecting the NF-κB and MAPK signaling pathways (NFATc1, c-Fos, Acp5, CTSK, VATPase-d2), inhibits the generation of osteoclasts, weaken the absorption activity of osteoclasts. It can be inferred that made cassoside can be a potential candidate for the treatment of osteoporosis (Wang et al., 2019).
EFFECTS ON SKIN DISEASES
The C. asiatica extract and its triterpenoids had certain therapeutic and relieving effects on acne, baldness, vitiligo, atopic dermatitis, and wounds
Effects on Cardiovascular Diseases
A clinical prospective, placebo-controlled, randomized, dose range trial found that after 4 weeks of treatment with C. asiatica total triterpenes (TTFCA), the capillary filtration rate, ankle circumference and ankle edema of patients with venous hypertension were improved, and the dose range showed that 180 mg/day was most effective in symptoms improvement (De Sanctis et al., 2001).
Clinical studies have shown that after 4 years of intervention in patients with Pycnogenol® 100 mg/day plus C. asiatica (100 mg/day), the combined treatment group has reduced plaque progression, reduced oxidative stress, and mild transient brain deficiency as compared to the control group. The incidence of angina events in combined treatment group was less than 3%, while the control group it was 6.25%. Therefore, it can be established that C. asiatica may have a role in preventing preclinical atherosclerosis (Belcaro et al., 2015; Belcaro et al., 2017).
https://www.centellicum.com/ References 2
S. Hu, G. Belcaro, M.R. Cesarone, B. Feragalli, R. Cotellese, M. Dugall, C. Scipione , V. Scipione , C. Maione (2020). Central cardiovascular calcifications: supplementation with Pycnogenol® and Centellicum®: variations over 12 months. Minerva Cardioangiologica 68(1):22-6
G. Belcaro, M.R. Cesarone, S. Hu, B. Feragalli, P. Peterzan, M. Corsi, R. Luzzi, M. Hosoi, R. Cotellese, M. Dugall, C. Scipione , V. Scipione , (2020). Delayed progression of atherosclerosis and cardiovascular events in asymptomatic patients with atherosclerotic plaques: 3-year prevention with the supplementation with Pycnogenol®+Centellicum®
Belcaro, G. and M. Cornelli (2017). “Variations in Echogenicity in Carotid and Femoral Atherosclerotic Plaques with Pycnogenol®+ Centella Asiatica Supplementation.” Int J Angiol 26: 95-101.
Cotellese, R., S. Hu, G. Belcaro, A. Ledda, B. Feragalli, M. Dugall, M. Hosoi and E. Ippolito (2018). “Centella asiatica (Centellicum®) facilitates the regular healing of surgical scars in subjects at high risk of keloids.” Minerva Chir 73(2): 151-156.
Hosoi, M., G. Belcaro, A. Ledda, U. Cornelli, M. Dugall, B. Feragalli, R. Luzzi, R. Cotellese, S. Hu and F. Fano (2018). “Effects of collagen remodulation with Centella asiatica (Centellicum®) in Dupuytren palmar fibromatosis: a pilot supplement study.” Minerva Ortopedica e Traumatologica 69(3): 78-83.
Hu, S., G. Belcaro, M. Hosoi, B. Feragalli, R. Luzzi and M. Dugall (2018). “Postpartum stretchmarks: repairing activity of an oral Centella asiatica supplementation (Centellicum®).” Minerva Ginecol 70(5): 629-634.
Luzzi, R., G. Belcaro and E. Ippolito (2016). “Carotid plaque stabilization induced by the supplement association Pycnogenol® and centella asiatica (Centellicum®).” Minerva Cardioangiol 64(6): 603-609.
Belcaro, G., M. Dugall, M. Hosoi, E. Ippolito, M. Cesarone, R. Luzzi, U. Cornelli and A. Ledda (2014). “Pycnogenol® and Centella Asiatica for asymptomatic atherosclerosis progression.” Int Angiol 33(1): 20-26.
Belcaro, G., M. Dugall, E. Ippolito, M. Hosoi, U. Cornelli, A. Ledda, M. Scoccianti, M. R. Cesarone, L. Pellegrini, R. Luzzi, M. Corsi and B. Feragalli (2017). “Pycnogenol® and Centella asiatica to prevent asymptomatic atherosclerosis progression in clinical events.” Minerva Cardioangiol 65(1): 24-31.
Belcaro, G., E. Ippolito, M. Dugall, M. Hosoi, U. Cornelli, A. Ledda, M. Scoccianti, R. D. Steigerwalt, M. R. Cesarone, L. Pellegrini, R. Luzzi and M. Corsi (2015). “Pycnogenol® and Centella asiatica in the management of asymptomatic atherosclerosis progression.” Int Angiol 34(2): 150-157.
Luzzi, R., G. Belcaro and E. Ippolito (2016). “Carotid plaque stabilization induced by the supplement association Pycnogenol® and centella asiatica (Centellicum®).” Minerva Cardioangiol 64(6): 603-609.
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