Astragalus
Astragalus membranaceus · Huáng Qí 黄芪
A foundational Qi-tonifying herb of Chinese medicine.
Evidence tier
Preliminary
Research weight
Citations
18 verified / 18
Classification
TCM Herb
❝
What the evidence says. Early or small human trials; promising but not yet conclusive.
What is Astragalus?
Astragalus (Astragalus membranaceus · Huáng Qí 黄芪) is a traditional Chinese medicine herb used for immune modulation. NutriDex grades the human evidence as Preliminary. Astragalus (Huáng Qí) is one of the most important 'Qi tonics' in Traditional Chinese Medicine, used to strengthen vitality and resistance. Modern studies — largely Chinese and often of modest quality — point to immunomodulating, antioxidant, and anti-inflammatory activity. It is most studied as an adjunct to chemotherapy (possibly easing side effects) and in chronic kidney disease and heart failure, with positive but methodologically limited results. Its astragalosides have been explored for telomere biology, though human longevity evidence is weak.
Purported Benefits
✓Immune modulation
✓Anti-fatigue / adaptogenic
✓Adjunct in chemo & kidney care
✓Antioxidant
Evidence by outcome
The same supplement can be well-proven for one use and unproven for another — here is the human evidence graded outcome by outcome.
| Outcome | Evidence | Effect | Studies |
|---|---|---|---|
| Chemotherapy adjunct (response/tolerability)MAs suggest improved response and reduced side effects, but trials are largely low-quality and Chinese-language. | Mixed | ↑ benefit · moderate | 4 |
| Diabetic / chronic kidney disease markersLarge MAs (32 RCTs) show reduced proteinuria and creatinine as ACEI/ARB adjunct; methodology limited. | Moderate | ↑ benefit · moderate | 4 |
| Immune modulation (T-cell/cytokines)19-study MA found raised CD3+/CD4-CD8 ratio and cytokine modulation, but with substantial heterogeneity. | Moderate | ↑ benefit · moderate | 2 |
| Cancer-related fatigueAn 8-RCT MA showed large fatigue reduction (SMD -1.63) but a phase-2 RCT found no change in global fatigue score. | Mixed | ↑ benefit · moderate | 2 |
| Heart failure (LVEF)19-RCT MA found improved LVEF (+5.8%) as adjunct, but Chinese trials with quality limitations. | Moderate | ↑ benefit · moderate | 1 |
Dosing & Compounds
Typical Dose
9–30 g dried root as decoction (traditional); 500–1,000 mg standardized extract.
Active Compounds
Safety & Cautions
Generally well tolerated. May over-stimulate immunity — caution with autoimmune disease and immunosuppressants. Possible anticoagulant interaction. Educational only — always check with your doctor or pharmacist before combining Astragalus with any medicine.
Astragalus drug interactions
Known or theoretical interactions between Astragalus and common medications — educational, not exhaustive. Always check with your doctor or pharmacist before combining Astragalus with any medicine.
Caution
Immunosuppressants
Immunostimulant activity may counteract immunosuppressant therapy in transplant/autoimmune patients.
Astragalus enhances T-cell, macrophage and cytokine activity, opposing immunosuppressive drugs. MSKCC — Astragalus
Key Studies ★ 18 studies
meta-analysis
Lin 2024 meta-analysis (DN + RAAS blockers)
✓ PubMed
In 32 RCTs (n=2462) with stage III diabetic nephropathy, astragalus added to ACEI/ARB blockers raised the total effective rate and significantly reduced urinary protein excretion, serum creatinine, BUN and HbA1c versus blockers alone.
systematic review/meta-analysis
Sun 2025 systematic review/meta-analysis (cervical cancer)
✓ Full text
Across 9 RCTs (n=776), astragalus polysaccharides added to chemoradiotherapy improved objective response and disease control rates, Karnofsky performance status, and CD4+/CD8+ immune ratios versus chemoradiotherapy alone.
systematic review/meta-analysis
Astragalus polysaccharides in malignant tumors 2025 (SR/MA)
✓ Full text
Systematic review and meta-analysis in cancer patients found astragalus polysaccharides improved clinical efficacy and immune indices as adjunct to standard antitumor therapy with a favorable safety profile.
meta-analysis
Ye 2024 meta-analysis (Astragalus injection + chemotherapy)
✓ Full text
Pooled clinical meta-analysis concluded that Astragalus injection resensitized tumors to chemotherapy drugs and improved patient quality of life across cancer patients receiving chemotherapy.
systematic review/meta-analysis
Sheng 2025 SR/MA (cancer-related fatigue)
✓ PubMed
Across 8 RCTs of cancer patients, adding Astragalus membranaceus to control treatment significantly reduced cancer-related fatigue (SMD -1.63, 95% CI -1.90 to -1.36) and improved quality of life (SMD 0.86), though authors caution the trials were small and low quality.
meta-analysis
Liu 2023 meta-analysis (idiopathic membranous nephropathy)
✓ PubMed
In 50 RCTs (n=3423) of moderate-to-high-risk idiopathic membranous nephropathy, adjunctive Astragalus membranaceus formulas added to supportive care or immunosuppression improved complete and partial remission rates and serum albumin and reduced proteinuria and serum creatinine versus standard therapy alone.
systematic review/meta-analysis
Li 2024 SR/MA (lupus nephritis)
✓ Full text
Across 14 RCTs (n=800) of lupus nephritis, astragalus-containing Chinese herbal medicine added to Western medicine improved SLEDAI scores, 24-hour proteinuria, serum creatinine and BUN, raised overall response 21% (RR 1.21), and showed lower adverse-event rates (RR 0.56) than Western medicine alone.
systematic review/meta-analysis
Hong 2024 SR/MA (type 2 diabetes)
✓ Full text
In 20 studies (n=953) of type 2 diabetes, astragalus as an adjuvant to conventional antidiabetic drugs significantly reduced fasting and postprandial plasma glucose and HbA1c versus drugs alone, while astragalus monotherapy did not significantly lower HbA1c.
Meta-analysis
Karger / Complementary Medicine Research 2023
✓ PubMed
Meta-analysis of 19 human studies (n=1,094) found Astragalus significantly increased CD3+ T cells and the CD4/CD8 ratio and modulated cytokines (IL-2, IL-4, IL-6, IL-10, TNF-alpha, IFN-gamma), supporting immunomodulatory effects, though with substantial heterogeneity.
Meta-analysis
Frontiers Pharmacol 2024 (HFrEF)
✓ PubMed
Meta-analysis of 19 RCTs (n=1,565) found Astragalus membranaceus plus conventional therapy improved LVEF (MD=5.82, 95% CI 4.61-7.03) and reduced LVEDD (MD=-4.05, 95% CI -6.09 to -2.01) without increasing adverse events (RR=0.86, 95% CI 0.25-2.96).
Meta-analysis
Frontiers Pharmacol 2024 (lupus nephritis)
✓ Source
Systematic review and meta-analysis of RCTs found Astragalus-containing Chinese herbal medicine added to Western medicine may improve outcomes in lupus nephritis, with authors noting methodological limitations of included trials.
systematic review/meta-analysis
Zhang 2019 updated SR/MA (diabetic kidney disease)
✓ PubMed
Updated systematic review of RCTs found adjunctive astragalus preparations added to conventional therapy may reduce albuminuria, proteinuria and serum creatinine short-term in diabetic kidney disease, with adverse-event rates similar to standard care.
Meta-analysis
McCulloch 2006 (meta-analysis)
✓ PubMed
Astragalus-based formulas may improve platinum-chemotherapy response and tolerability; trials low quality.
RCT
Shen 2024 (PG2 in breast cancer, phase 2 RCT)
✓ PubMed
Randomized, placebo-controlled phase 2 trial (66 stage II/III breast cancer patients on adjuvant anthracycline chemotherapy): Astragalus polysaccharide (PG2) did not significantly change the overall fatigue global score vs placebo, but reduced chemotherapy-induced fatigue, insomnia, and improved global health status particularly in the premenopausal subgroup.
Agency / regulator
NCCIH (NIH)
✓ Source
US NIH National Center for Complementary and Integrative Health states there is not enough rigorous human evidence to determine whether astragalus is effective for any health condition, and notes possible herb-drug and immunosuppressant interactions.
safety review
LiverTox: Astragalus (NIH/NIDDK)
✓ Full text
Authoritative NIH safety review reports astragalus is generally well tolerated with no convincing reports of serum enzyme elevations or clinically apparent liver injury in published human studies.
Review
Li 2011 review (CKD)
✓ PubMed
Possible benefit in chronic kidney disease; rigorous trials still needed.
Study
Heart-failure trials
✓ Full text
Adjunctive symptom improvement in small/short studies.