Astragalus (Astragalus membranaceus) is a flowering herb that was popularized in Traditional Chinese Medicine (TCM) before being introduced to the Western world. Recent evidence suggests it may help protect kidney function in sepsis.1
According to the Sepsis Alliance,2 sepsis can trigger kidney damage and kidney damage can trigger the onset of sepsis. Kidney damage is among the first organs to be affected during sepsis. Up to 48% of all acute kidney injury is triggered by sepsis.3
During treatment for sepsis, doctors may use dialysis to help filter the blood if the kidneys are not working efficiently. How long a person may require dialysis will depend on the damage to the kidneys and the extent of the infection. In some cases, sepsis survivors will continue to need dialysis to treat lasting damage.
Sepsis is an extreme response to an infection that is present in the body.4 According to the Centers for Disease Control and Prevention,5 1 in every 3 people who die in the hospital has sepsis. The symptoms of sepsis may look like something else. It is vital that you recognize the potential symptoms and seek immediate medical attention as sepsis is life-threatening.
Conditions that raise your risk include diabetes, advanced age, chronic illness, cancer and chemotherapy and HIV infections.6,7 New evidence from animal studies suggests astragalus may play a role in preventing kidney damage from sepsis.8
Astragalus May Help Protect Kidney Function in Sepsis
The astragalus plant is native to China and has different names depending on the region where it’s harvested. A direct translation of the Chinese names is “yellow leader,” which the plant earned because of the distinctive yellow color of the roots, the most important part harvested for medicinal purposes.9
Astragalus is a popular herbal medication in Chinese medicine. However, there are several species of astragalus, some of which have a toxin that is linked to livestock poisoning.10 These species are not commonly used in human supplements, but it is wise to have your astragalus plant expertly identified before using the root at home.
Astragalus polysaccharide (APS) is a bioactive water-soluble compound extracted from the dried roots.11 Recently, researchers used APS in an animal model12 to test whether it was protective on induced acute renal injury like that seen with sepsis.
In lab studies, lipopolysaccharide-induced cell injury was used to establish a baseline model for sepsis-induced acute renal injury. Subsequently, experiments in mice found APS was able to reverse the induced kidney damage, which the researchers demonstrated by improvements in serum BUN and measurements of inflammatory and immune function mediators, such as tumor necrosis alpha and IL-1beta.
The results of the study supported past research evaluating APS after polymicrobial sepsis in an animal study.13 Herbal preparations have also been used for the treatment of chronic kidney disease. One study published in the Hong Kong Journal of Nephrology14 evaluated the use of astragalus in 35 patients with Stage 4 and 5 chronic kidney disease (CKD).
The researchers estimated the glomerular filtration rate (eGFR) before starting treatment and again after treatment with astragalus. Three months of supplementation benefited those who were at Stage 4. The researchers found that it was able to “maintain stable levels of eGFR and delay the initiation of renal replacement therapy in patients with progressive CKD Stage 4.”15
Astragalus Supports Kidney Function
A unique medical complication of diabetes is diabetic nephropathy. This microvascular damage of the kidneys is characterized by high blood pressure, protein in the urine and edema.16 TCM practitioners have used astragalus membranaceus (AM) for the treatment of diabetic nephropathy (DN).
One study in the Journal of Diabetes Research17 sought to understand the pharmacological mechanisms involved. The analysis of the active ingredients found potential therapeutic targets including quercetin, calycosin, formononetin and 7-O-methylisomucronulatol.
The researchers concluded the multiple components and characteristics of astragalus may provide “a novel approach for further research of the mechanism of AM in the treatment of DN.”18
Scientists have been reporting19 and studying20 the positive effect astragalus has on diabetic kidney function to understand the mechanism of action, including improvement in glucose levels and renal function in diabetic animal studies.21
In a study22 of individuals undergoing continuous ambulatory peritoneal dialysis (CAPD), physicians had prescribed AM initially to support their general well-being and vitality. In a retrospective look at the data, it was discovered that those taking astragalus improve their residual renal function, which is important to the survival of those undergoing CAPD.
Patients undergoing chemotherapy may experience acute kidney injury from the chemotherapeutic drugs. Cisplatin is a commonly used chemotherapeutic agent for solid tumors, which can induce acute kidney injury. One study23 published in Biomed Research International found astragalus polysaccharide had a protective effect against the cisplatin-induced injury in the lab and in an animal study.
Astragalus Reduces Inflammation and May Help Shrink Tumors
In TCM, astragalus is prescribed for general weakness and to improve overall vitality. In addition, the root compound has demonstrated antidiabetic activity, antiviral actions, immune modulation and anti-inflammatory properties.24
One study25 sought to understand the anti-inflammatory mechanisms of APS on intestinal health, using lab based cellular studies and an animal study. Lipopolysaccharides (LPS) were used to stimulate intestinal epithelial cells. They found APS inhibited inflammatory markers and chemokines by activating an inflammatory pathway that was induced by LPS stimulation.
Prefeeding the experimental animals with APS alleviated inflammatory factors and improved the intestinal morphology. Astragalus has been actively investigated for clinical applications in the treatment of inflammatory diseases and cancers. Another of the major constituents of AM are saponins extracted from the herb.26
They have a protective effect against gastrointestinal inflammation without major systemic side effects that experts suggest may help “in the battle against inflammatory diseases and cancers of the gut.”27 Traditional cancer therapies may be accompanied by immune suppression, which in turn raises the risk of metastasis.
The active ingredients in AM may help enhance shrinking or stabilization of solid tumors through a pro apoptosis effect, while avoiding side effects induced by chemotherapy. It also ameliorates immunosuppression and improves systemic immunity, which may make it a strong candidate for adjunctive therapy in cancer treatment.28
Health and Beauty Benefits of Astragalus
Yet, there are more benefits from this unassuming herb belonging to the legume family. Because it is rich in antioxidants, there are several studies that have suggested astragalus has cardiovascular benefits. One study29 found the flavonoid concentration in astragalus had a positive impact on the formation of atherosclerotic plaques.
Intravenous injections demonstrated the ability to improve heart function and reduce the symptoms of congestive heart failure.30,31 In one study32 of 92 people with ischemic heart disease, astragalus reduced symptoms of angina and improved heart rate. In an animal study,33 evidence suggested astragalus could improve the function of the heart and blood vessels.
In addition to reducing the inflammatory response, astragalus has a direct impact on the immune system. When astragalus extract was given to healthy adults it increased blood levels of IGM, IGE and cAMP.34
An herbal tincture demonstrated the ability to stimulate CD4 and CD8 T-cells35 and patients with viral myocarditis36 showed enhanced T3 and T4, suggesting to the researchers there was an improved immune response.
Each of the mechanisms affecting anti-inflammatory response may contribute to the antiaging properties attributed to astragalus.37 The herb is also known as an adaptogen,38 which means it helps reduce physical, mental and emotional stress. This may help contribute to improving your sleep quality.39
Contraindications for Use
Astragalus reduces inflammation and has a direct impact on your immune system. While this is beneficial for most people, those taking corticosteroids or medications to minimize organ transplant rejection should refrain from taking astragalus, since it interferes with the way these medications work.40
Since the herb makes the immune system more active, it is best to avoid it if you have an autoimmune disease, like multiple sclerosis, rheumatoid arthritis, lupus and other immune system conditions. The same is true for people taking immunosuppressant drugs since astragalus may decrease the effectiveness of the medication.
Astragalus has a diuretic effect, increasing the excretion of urine. This can have an impact on how the body excretes lithium, increasing the amount of the drug in the body with serious side effects. Not enough is known about the mechanism of action, although some animal studies have suggested it could be toxic to pregnant women and their baby. It is wise to avoid using while pregnant or breastfeeding.
Astragalus may increase the risk of bleeding in people taking blood thinners, like warfarin.41 It may also lower blood pressure. Taken with high blood pressure medication, your blood pressure may get too low.
Although not an entirely popular choice in modern medicine, mounting scientific evidence suggests a lab generated variation may soon have a place within the pharmaceutical industry in the treatment of sepsis, diabetes and cardiovascular disease.
Astragalus has been used for decades in traditional medicine. If you don’t have any contraindications, it may be worth considering incorporating astragalus to help maintain or improve your overall health.