Articles

Makandi (C. forskholii): A Pharmacopaea in a Single Root 

William A. Courson 

From "Light on Ayurveda Journal" (Winter 2005/6)


One of the most broadly useful herbs of Ayurveda but among the less well-known in the West is Makandi (Coleus forskholii). So wide-ranging are its therapeutic applications that it seems to deserve the accolade accorded to the beloved Lotus and to the Neem tree, in that it functions as an entire pharmacy stock that makes its home in a single plant. (1)

Also known as Mainmul, Sughandabalu and Karpuravali (Hindi: Patharchur; Kannada: Makandiberu; and Gujarati: Garmalu), Makandi is a member of the mint family (Lamiaceae) growing wild on the Indian plains and the lower Himalayas on sun-exposed arid and semi-arid hill slopes of Uttar Pradesh (India) where it thrives from Simla eastward to Sikkim and Bhutan, the Deccan Plateau, the Eastern Ghats, the Eastern Plateau and the rainshadow regions of the Western Ghats in India. It has also been cultivated as an ornamental plant around the world and its root is used as a spice in Thailand, Myanmar and throughout Southeastern Asia. Makandi is one of 150 Coleus species commonly cultivated, but among a very few of these the roots (and to a lesser extent, the stems) of C. forskohlii are used for therapeutic purposes. In 1973, researchers first isolated the diterpene Forskolin from its roots, making it the only plant source thus far known for the substance. (2)

Botanical identification

Coleus is a member of the Lamiaceae (mint) family, a perennial, branched, aromatic herb. The entire plant is aromatic (whether fresh or dried). Members of the genus have square stems, branched, and the nodes are often hairy. The pale blue corolla is bilabiate, the lower lobes are elongated and concave, and it grows to a height of 30 cm to 62 cm. The roots are thick, tuberous, fasiculated, up to 20 cm long and 0.5-2.5 cm thick, and are conical, fusiform, straight and strongly aromatic. Leaves appear when the plant becomes pubescent, and are narrowed into petioles. Flowers vary from a very showy bluish to pale lavender. Racemes are perfect, the calyx is fine toothed and deflexed in the front. The plant possesses four parted ovaries. The leaves and tubers have quite different odors, the latter being reminiscent of ginger. (3)

Close relatives of C. forskholii, C. vettiveroides (Sanskriut: Iruveli) and C. Zeylanica (Sanskrit: Hrivera) are used therapeutically for its antimicrobial, cooling and deodorant properties. (4) Coleus aromaticus (Sanskrit: Pashanbheda, or “Stone-breaker”) has been used in cases of renal calculi, conjunctivits, and spastic colon (5) Another species of coleus, C. kilimandschari, is found in parts of East Africa and has been used in Rwandan folk medicine to treat infections and autoimmune diseases. (6) In Egypt and northern Africa, leaves and roots of the related C. barbatus are used as an expectorant, emmenagogue, antidepressant and diuretic. (7) According to one correspondent, it has been used successfully in the treatment of CVA (stroke). (8)

As recorded in a variety of Ayurvedic texts, Makandi was used principally to treat heart and lung diseases, intestinal spasms, insomnia, and convulsions, inter alia. More recently, a number of research studies indicate that Makandi showed positive effects against a wide range of conditions such as asthma, glaucoma, hypertension, cancer, heart disease, diabetes, infertility, sports injuries, painful urination and obesity. It has also demonstrated inhibition of platelet activating factor and stimulation of thyroid functioning ordinarily free of side-effects (e.g. tachycardia, hypertension, anorexia, agitation, etc.) (9)(10)(11) Practitioners of folk medicine in the Himalaya region use the root as well to treat constipation. (12)(13)(14)

In the West, it is of current interest principally owing to its potential application in the realms of weight management (as a substitute for Ephedra, now banned from sale in many jurisdictions), hypertension, hypothyroidism, and in the treatment of mood disorders. One possible mechanism for this action in controlling weight may be its effect on blood glucose levels, according to research conducted at the Central Drug Research Institute of Lucknow, India.(15) Additionally, research has shown Makandi may be an effective natural therapy for glaucoma. Researchers at Thorne Research Inc. in Dover, Idaho, conducted a research review of natural therapies for ocular disorder, noting that it has been used successfully as a topical agent to lower intraocular pressure, a characteristic of glaucoma. (16)

Ayurvedic Energetics


Makandi has been classified as possessing a pungent taste, a heating energy, and a Pungent post-digestive effect. Its gunas are light and dry, and it is tridoshic, possessing a pacifying-diminishing effect of all three doshas (KPV-). It enters Rasa and Rakta dhatus, and respiratory and circulatory srotamsi. Historically, it is deemed as Chakushaya (benefiting the eyes) and Kasaswasahara (alleviating coughing and benefiting breathing).(17) Makandi has been used as noted supra for its anti-glaucoma, anti-platelet, bronchospasmolyltic, cardiotonic, and hypotensive properties as well as its reported anti-allergenic properties in eczema, asthma and hay-fever. (18)

Mechanism


Makandi is known to be a rich source of biologically active compounds including a diterpene molecule known as Forskolin. The mechanism of action of Forskolin is the potentiation and activation of the enzyme adenylate cyclase, which increases the amount of cyclic adenosine monophosphate (cAMP) in cells. Cyclic AMP is among the most important cytoregulatory compounds. Once formed cAMP activates many other enzymes involved in cellular metabolism. This enzyme is the critical catalyst in the production and conversion of magnesium-mediated adenosine triphosphate (ATP) to cyclic adenosine monophosphate (cAMP). The effects of heightened cAMP include the inhibition of mast cell degranulation and histamine release, inhibition of platelet activation and degranulation, an increased force of contraction of the heart muscle, relaxation of the arteries and other smooth muscles (e.g. bronchial passages, the gastrointestinal tract, and the uterus, bladder and arteries), increased insulin secretion, increased thyroid function, and increased lypolysis.

Therapeutic Actions and Applications


1.Anti-Allergenic / Anti-Asthmatic: Conditions such as eczema and asthma are characterised by a relative decrease in cAMP in the skin and bronchial smooth muscle, respectively. The effect of this causes mast cell degranulation and smooth muscle contraction along with excessive levels of platelet activating factor (PAF). PAF plays a central role in many inflammatory and allergic responses including bronchoconstriction and reduced coronary blood flow. Most modern drugs for allergic symptoms are designed to increase cAMP levels. Makandi elaborates an identical effect through augmenting enzyme activity without negative side effects. Studies have shown that relaxation of bronchial smooth muscle tissue is dependent on intra-cellular cAMP production. Since Forskolin is not a sympathomimetic amine or central nervous system stimulant (such as Ephedrine and Theophylline), its mechanism of action is free of the side-effects (e.g. tachycardia, hypertension, anorexia, etc.) common to sympathetic agents generally prescribed. (19)

2. Obesity / Hypothyroidism: Makandi may offer benefits through regulating lypolysis and increasing thyroid hormone production and release. Typically, an increase in cyclic AMP leads to subsequent activation of protein kinase. Protein kinase has been shown to activate the hormone sensitive lipase which is involved in the breakdown of triglycerides, known as building blocks of fatty tissue. (19)
Another factor relevant to the weight loss mechanism of Forskolin involves its thyroid stimulating action, comparable in strength to thyrotropin or TSH2. The thyroid stimulating action of Forskolin may also contribute to the increase in the metabolic rate and thermogenesis. Forskolin may also be involved in regulating insulin secretion. Insulin, although well recognized for its metabolism of carbohydrates, is also involved in the metabolism of fats and proteins that are major contributors to body composition (20)(21)(22)

3. Skin Cell Rejuvenation: Psoriasis is a common skin disorder believed to be caused by a decrease in cAMP in relation to another cytoregulatory chemical, cyclic guanine monophosphate (cGMP). The result of this is a dramatic increase in cell division of as much as 1,000 times the normal rate. Studies have indicated that Makandi may be very useful in the treatment of psoriasis owing to its balancing effect on cAMP and cGMP. (23) When mixed with mustard oil, the root is applied to eczema and skin infections. (24)

4. Cardiovascular Support: One of the most beneficial aspects of Makandi appears to be relating to its use in conditions such as hypertension, congestive heart failure, and angina pectoris. Makandi has been shown to reduce blood pressure along with improving the contractility of the heart muscle, mainly due to an increase in cAMP. Makandi is also noted for its effects on reducing platelet aggregation and acting as a direct cerebral vasodilator.

5. Digestive Insufficiency and Malabsorption Syndromes: Makandi stimulates digestive secretions (i.e. hydrochloric acid, pepsin, amylase and pancreatic enzymes) and has also demonstrated effects in improving nutrient absorption in the small intestine as well as improving the release of salivary amylase in cases of dry mouth. (25) It is also used to treat constipation. (26)

6. Glaucoma: Lowering of intraocular pressure has been reported coincident with the use of Makandi. According to one possibly anecdotal report, the effect of lowered IOP seems to lessen after six months. (27) (28). The herb can be used both internally or as topically as an eye-bath, although some users report it irritating.


Suggested Formulations

Makandi can be used in concert with other herbal medicines, of which the following formulae are suggested:

(a) Blood conditions: Manjista (Rubia cordifolia), Neem leaf (Azadirachta indica), Turmeric (Curcuma longa), Guduchi (Tinospora cordifolia); for anti-platelet action, combined with Ginger (Zingiber officinale) and Turmeric (Curcuma longa);

(b) Cerebrovascular disease: combine with Brahmi (Hydrocotyle asiatica) to promote cerebral vasodilation;

(c) Congestive heart failure: combined with Arjuna (Terminalia arjuna), Punarnava (Boerhaavia diffusa), Guduchi (Tinospora cordifolia),Brahmi (Hydrocotyle asiatica), Jatamansi (Nardostachys jatamansi), Tulsi (Ocimum sanctum), Guggulu (Commiphora mukul), Amalaki (Emblica officinalis), Bibhitaki (Terminalia belerica), Haritaki (Terminalia chebula), Pippali (Piper longum), Cardamom (Elettaria cardamomum), or Ginger (Zingiber officinale);

(d) Hypertension: combined with Ban-sangli (Craetagus oxyacanthoides);

(e) Ischemic heart disease: combined with Ban-sangli (Craetagus oxyacanthoides) and/or Salvia miltiorrhiza;

(f) Digestive insufficiency: combined Erand-karkati (Carica papaya); with Gentian stimulates upper digestive function;

(g) Obesity: combined with Naranja (Citrus aurantium). (29)


Dosage


Makandi’s root contains but a minute amount of Forskolin and thus may not be sufficient for a therapeutic result. A typical dosage consists of 6 to 12 grams of dried Makandi root daily, or 6-12ml daily of 1:1 fluid extract. (30)


Contraindications & Potential Interactions

Although very few serious adverse effects have been noted, Makandi should be avoided by individuals suffering from gastric ulcer or from hypotension. Owing to its ability to potentiate the effects of some medications, particularly anticoagulants (Coumadiun/warfarin, Heparin, Trental/pentoxyfylline, Plavix/clopidogrel, and Ticlid/ticlopidine), antiasthmatics and antihypertensives (Beta-blockers, Clonidine or Hydralazine), it should be avoided or used with care by individuals on such a regimen, in whom rare cases of tachycardia and sudden hypotension have been reported. There are theoretical grounds to believe that coleus could increase the effect of anti-platelet medicines such as aspirin, possibly leading to spontaneous bleeding. However, this has never been documented to occur. A few individuals have reported burning, itching or tearing when Makandi is applied topically in an eye-bath.

On July 20, 2005, the Irish Medicines Board (a governmental regulatory body) acting on the advice of Italian public health authorities issued a caution regarding the safety of certain imported products containing C. forskholii. In both countries, adverse reactions following the use of such products were noted, and included four reports of atropine-like acute poisoning (agitation, confusion, hallucination, tachycardia, mydriasis and past amnesia), and two reports of tremor, asthenia, visual disturbances and confusion. These reactions, however, were the result of contaminants present in the products of five foreign producers and in no way related to the effects of C. forskholii. Practitioners and consumers should thus takes steps to assure themselves of the standards of quality of their Makandi supplier(s). (31)

Makandi is not recommended for use by pregnant or nursing mothers, or those with severe liver or kidney disease.


Notes

(1) Ammon H.P.T. et al.: "Forskolin: From Ayruvedic Remedy to a Modern Agent,” Planta Medica (1985) Vol. 51, pp. 473-477

(2) Reddy, C.S., R.B. Desireddy & V. Ciddi: “A Review on Forskolin: A Cyclic AMP Modulator from Tissue Cultures of Coleus Forskholii,” Pharmacognosy Magazine, (July-October 2005) V. 1, No. 3, p. 85

(3) “Coleus forskholii: Origin and Botanical Traits,” Online at http://www.tnsmpb.tn.gov.in/images/COLEUS%20FORSKOHLII.pdf (September 29, 2005),
Tamil Nadu State Medicinal Plant Board, State Government of Tamil Nadu (India)

(4) Himalaya Health Care Products, Online at himalayahealthcare.com/aboutayurveda/cahc.htm (September 29, 2005)

(5) “Medicinal Plants: Ayurvedic Herbal Medicines,” National Institute of Ayurvedic Medicine, Online at www.niam.com/corp-web/mediplnt.htm (September 29, 2005)

(6) Families.com, Online at www.encyclopedias.families.com/coleus-509-510-gea2 (September 29, 2005)

(7) Loc.cit., Note 3

(8) October 3, 2005: Personal correspondence from Dr. Kenneth Lakuma Opiro of Uganda, in the author’s possession

(9) Saleem, A.M., P.B. Dhasan & M.R.M. Rafiullah: “Isolation of Forskolin from Stem of Coleus Forskholli,” Pharmacognosy Magazine, (July-October 2005) V. 1, No. 3, p. 89

(10) Chavez, M: Research Perspectives in Asthma: A Rationale for the Therapeutic Application of Magnesium, Pyridoxine, Coleus forskholii and Ginkgo biloba in the Treatment of Adult and Pediatric Asthma,” The Internist (September 1998) V.5, No.3, pp.14–16

(11) Dubey MP, R.C. Srimal, S. Nityanand S, & B.N. Dhawan: Pharmacological studies on coleonol, a hypotensive diterpene from Coleus forskohli, Journal of Ethnopharmacology (1981) Vol. 3, pp. 1–13.

(12) Agrawal, D.P.: “The Himalayan Medicine System and its Materia Medica,” Online at www.indianscience.org/essays/20-%20E-Himalayan%20Medicine%20System%20fine12.pdf, p. 14 (September 29, 2005)

(13) Duke, J.A.: The Green Pharmacy Herbal Handbook (Saint Martin’s Press, 2000) p. 109

(14) Loc.cit., Note 12

(15) Ahmad, F. et al.: “Insulin and Glucagon Releasing Activity of Coleonol (Forskolin) and its Effect on Blood Glucose Level in Normal and Alloxan Diabetic Rats,” Acta Diabetologica (1991) pp.71-77

(16) Head, K.A.: “Natural Therapies for Ocular Disorders, Part Two: Cataracts and Glaucoma,” Alternative Medicine Review (2001) pp. 141-66

(17) Pole, Sebastian, Lic. OHM, Ayur.H.C., “Herbal Ayurveda,” (online on August 20, 2005 at http://www.herbalayurveda.com/herbdetail.asp?ID=49)

(18) Ibid.

(19) Thallon, Cheryl: “Coleus Forskholii,” (Online on August 20, 2005 at http://www.organicfood.co.uk/vms/coleusforskholii.html)

(20) Allen, D.O. et al.: “Relationships Between Cyclic AMP Levels and Lipolysis in Fat Cells After Isoproterenol and Forskolin Stimulation,” The Journal of Pharmacology and Experimental Therapeutics (1986) Vol. 238(2) pp. 659-664

(21) Haye, B. et al.: “Chronic and Acute Effects of Forskolin on Isolated Thyroid Cell Metabolism,” Molecular and Cellular Endocrinology (1985) Vol. 43, pp. 41-50

(22) Yajima H. et al.: “cAMP Enhances Insulin Secretion by an Action on the ATP-Sensitive K+ Channel-Independent Pathway of Glucose Signaling in Rat Pancreatic Islets,” Diabetes (1999) Vol. 48, No. 5, pp.1006-12

(23) Loc.cit., Note 19
(24) Loc.cit., Note 3
(25) Loc.cit., Note 19
(26) Loc.cit., Note 12
(27) Loc.cit., Note 16

(28) Abel,R: The Eye Care Revolution (Kensington Health, 1999) quoted in Meyers, Stephen: “Natural Healing for Aging Vision,” HSR: Health Supplement Retailer (online Sept. 17, 2005 at www.hsrmagazine.com/articles/231feat2.html)

(29) Coleus forskholii, website of Global Herbal Supplies, Inc., (Queensland, Australia); Online at www.globalherbalsupplies.com/herb_information/coleus_forskohlii.htm (September 29, 2005)

(30) Loc.cit., Note 13

(31) “Statement concerning the safety of products containing the Ayurvedic Herb Coleus Forskolii (July 20, 2005),” Irish Medicines Board, Government of Ireland; Online at http://www.imb.ie/safety.asp?nav=2,37&action=view&safety_item_id=44 (October 1, 2005)

Biographical Note:

William Courson is on the staff of the Starseed Center for Yoga & Wellness in Montclair, New Jersey (USA). He is administrative director of Starseed’s New Jersey Institute of Ayurveda and is a practitioner and student of both traditional Western as well as ayurvedic herbal medicine. 

Posted By Sai Ayurvedic College of Miami  on Feb 3rd, 2006 

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