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Scientific Name(s): Astragalus membranaceus (Moench), Astragalus mongholicus Bunge.
Common Name(s): Astragalus, Huáng chí, Huáng qí, Hwanggi, Jin Fu Kang, Membranous milk-vetch, Meng gu huang qi, Ogi, Ougi, Radix Astragali

Medically reviewed by Last updated on Mar 22, 2022.

Clinical Overview


Most evidence suggests that astragalus root may modulate immune function and reported benefits are derived from this action, although studies are older and of limited quality. Evidence in the literature for other purported therapeutic uses is lacking.


There is no recent clinical evidence to guide dosage of astragalus products; however, recommendations of 2 to 6 g daily of the powdered root are typical.


Contraindications have not yet been identified.


Information regarding safety and efficacy in pregnancy and lactation is lacking.


None well documented.

Adverse Reactions

Allergy has been reported. A case report exists of increased carbohydrate antigen 19-9 and induction of reversible liver and kidney cysts in a woman consuming A. membranaceus daily for 1 month.


Evidence is equivocal; however, mutagenicity has been shown in the Ames test.

Scientific Family

  • Fabaceae (pea)
  • Leguminosae (bean)


The genus Astragalus, commonly known as milk vetches, comprises more than 2,000 species distributed worldwide. The perennial herbs grow to approximately 1 m high, are native to the northern provinces of China, and are cultivated in China, Korea, and Japan. The plants bear tubular yellowish flowers and small (3 to 6 cm) leaves. The dried root harvested from mature plants 4 to 7 years old is used medicinally and sold as 15 to 20 cm pieces with a tough, fibrous skin and a light interior.1, 2, 3, 4


Astragalus root is well known in traditional Chinese medicine and is listed in the Pharmacopoeia of the People's Republic of China. It is an important component of Chinese Fu Zheng herbal therapy, in which the goal is to restore immune system function by reinforcing the body’s Qi, and is principally used as a tonic and for treatment of diabetes and nephritis. There is extensive Chinese-language literature on the herb/plant. It is sold as shredded roots and in powder, tincture, and encapsulated form. Some products are produced by frying the roots with honey and the untreated root has a sweet, licorice-like taste of its own. Astragalus root is used in the United States as an immunostimulant to counteract the immune suppression associated with cancer chemotherapy.1, 2, 3, 4


Compounds identified in astragalus include polysaccharides, saponins, flavonoids, isoflavonoids, sterols, amino acids (including gamma-aminobutyric acid), volatile oils, and other mineral elements (eg, zinc, iron, copper, manganese, vanadium, tin).

The polysaccharides include the astragalans and astraglucans and are of primary interest along with the triterpene saponin astragalosides. The flavones kaempferol and quercetin and isoflavones, isoflavonones, and pterocarpans are also of interest. The saponin astragaloside intravenous (IV) has been used as a marker for quality assurance of astragalus products.3, 5, 6, 7

Uses and Pharmacology


Clinical data

Astragalus root as adjunctive therapy in cancer has been studied in limited Chinese trials, including a combination preparation (Jin Fu Kang) used in China for the treatment of non–small cell lung cancer, and IV astragalus in malignant tumor.8, 9, 10 An IV extract (PG2) from A. membranaceus has been studied for cancer-related fatigue in an open-label study, which found improvements in subjective outcomes.11

A systematic review of herbal medicines as adjuvants to the leucovorin calcium (folinic acid), fluorouracil, and oxaliplatin (FOLFOX-4) regimen used for treating colorectal cancer was conducted to identify evidence of safety and efficacy of treatment, as well as management of chemotherapy adverse reactions. A total of 13 randomized Chinese clinical trials involving 940 patients compared herbal medicines plus the FOLFOX-4 combination with the FOLFOX-4 regimen alone in patients with advanced (stage IV) colorectal cancer. Although 58 different herbs and/or extracts were used in 7 studies, A. membranaceus was the most common herb found in treatment preparations. Tumor response rate, overall survival at 1 year, time to progression, quality of life, body weight, nausea/vomiting symptoms, and neutropenia improved significantly (P values from P < 0.00001 to P = 0.01) with herbal adjuvants. Astragalus was included in each of the studies contributing to these results.12


Animal data

Contractility improved in isolated frog and toad hearts, and extracts produced hypotension in cats, dogs, and rabbits. Saponins from astragalus exerted positive inotropic activity in isolated rat heart tissue.3 Astragalosides also increased fibrinolytic potential in human umbilical vein tissue with effects on plasminogen expression.13

Clinical data

No clinical reports of interference with hemostasis have been published.13 Astragalus has been studied in Chinese clinical trials using patients with cardiopulmonary bypass, ischemic heart disease, angina pectoris, and chronic heart failure with positive effect.14, 15, 16, 17 No effect of astragalus has been found in improving clinical outcomes in viral myocarditis, and the quality of those studies included in the Cochrane review was reported to be poor.18

Immune effects

In vitro and animal data

Several studies on immune function have been conducted in rodents and in vitro using human cells.19, 20, 21, 22, 23, 24, 25, 26

Clinical data

A number of clinical trials have been conducted in Chinese populations with immune-related conditions including systemic lupus erythematosus, myasthenia gravis, and herpes simplex keratitis. Although the studies were small and published in Chinese, findings were generally supportive of enhanced immune function as demonstrated by indices of cytokines or other relevant measures.27, 28, 29, 30, 31 Other clinical studies have been published reporting effects of the extract on long-term fatigue (astragalus in combination), and cancer-related fatigue with improvements in subjective outcomes, but not cytokine expression.11, 32 T cell activation by A. membranaceus has been reported in healthy volunteers given the extract orally.33

Astragalus has been studied in viral diseases including HIV, herpes simplex, and coxsackie-B infections as adjunctive therapy, most likely due to immune effects rather than direct action on a virus itself. T cell responses to A. membranaceus in patients with viral myocarditis reflected an enhanced immune response; however, no reduction in deaths due to cardiac failure was shown.18 Initial interest in the extract for a therapeutic role in HIV treatment34, 35, 36 has not persisted, with no further clinical trials reported.

Other uses


Studies in rodents suggest potential applications of A. membranaceus in diabetes. A small clinical study in type 2 diabetes showed improvements in glucose metabolism, but not other glycemic indices.6, 37

Renal effects

Natriuretic activity of oral Radix Astragali has been demonstrated in healthy adult men.38 Chinese studies have demonstrated effects on kidney function, including reducing proteinuria in chronic kidney disease; however, methodologies have varied, and solid evidence for efficacy has not been determined.7, 39


Astragaloside IV has been shown to promote the repair of sciatic nerve injury in a rodent study.40 Although astragalus is often recommended for prevention of the common cold, there are no published English-language clinical trials that support this use. Antioxidant properties and a wide range of other effects have been demonstrated in limited studies.


There is no recent clinical evidence to guide dosage of astragalus products; however, recommendations of 2 to 6 g daily of the powdered root are typical.3, 41

The saponin astragaloside IV has been used as a marker for quality assurance of astragalus products, but is not considered a major bioactive constituent.7

Pregnancy / Lactation

Information regarding safety and efficacy in pregnancy and lactation is lacking.


Although clinically important case reports are lacking, potentiation of acyclovir and related compounds of interleukin and interferon and suppression of immunosuppressant medicines could occur. Potentiation of thrombolytics may also be possible.13

Adverse Reactions

Allergy has been reported.7 A case report exists of increased carbohydrate antigen 19-9 and induction of reversible liver and kidney cysts in a woman consuming A. membranaceus daily for 1 month.42


An astragalus hot water extract was mutagenic in the Ames test in Salmonella typhimurium TA98 when activated by S9 rat liver fractions. The same preparations given by intraperitoneal injection at 1 to 10 g/kg produced chromosomal aberrations in the bone marrow of mice and increased the incidence of micronucleated cells in bone marrow. No attempt was made to isolate the mutagenic compounds responsible for these effects.43 Other tests suggest astragalus to be antimutagenic.3 At doses 100 times higher than effective oral doses in humans, no adverse effects were observed in mice, while a median lethal dose for intraperitoneal administration of 40 g/kg in mice has been reported.3


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3. Radix Astragali. In: WHO Monographs on Selected Medicinal Plants. Vol 1. Geneva, Switzerland: World Health Organization; 1999.
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11. Chen HW, Lin IH, Chen YJ, et al. A novel infusible botanically-derived drug, PG2, for cancer-related fatigue: a phase II double-blind, randomized placebo-controlled study. Clin Invest Med. 2012;35(1):E1-11.22309959
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14. Qu ZL, Dong H, Wang SD. Effects of astragalus injection on renal function in patients after cardiac valve replacement with cardiopulmonary bypass [in Chinese]. Zhongguo Zhong Xi Yi Jie He Za Zhi. 2009;29(4):313-316.19526755
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18. Liu ZL, Liu ZJ, Liu JP, Kwong JS. Herbal medicines for viral myocarditis. Cochrane Database Syst Rev. 2013;8:CD003711.23986406
19. Chen SM, Tsai YS, Lee SW, et al. Astragalus membranaceus modulates Th1/2 immune balance and activates PPARγ in a murine asthma model. Biochem Cell Biol. 2014;92(5):397-405.25264079
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22. Tomoda M, Shimizu N, Ōhara N, Gonda R, Ishii S, Ōtsuki H. A reticuloendothelial system-activating glycan from the roots of Astragalus membranaceus. Phytochemistry. 1991;31:63-66.
23. Shimizu N, Tomoda M, Kanari M, Gonda R. An acidic polysaccharide having activity on the reticuloendothelial system from the root of Astragalus mongholicus. Chem Pharm Bull (Tokyo). 1991;39(11):2969-2972.1799943
24. Sun Y, Hersh E, Lee SL, McLaughlin M, Loo T, Mavligit G. Preliminary observations on the effects of the Chinese medicinal herbs Astragalus membranaceus and Ligustrum lucidum on lymphocyte blastogenic responses. J Biol Response Mod. 1983;2(3):227-237.6644339
25. Lau BH, Ong P, Tosk J. Macrophage chemiluminescence modulated by Chinese medicinal herbs Astragalus membranaceus and Ligustrum lucidum. Phytother Res. 1989;3:148.
26. Sun Y, Hersh E, Talpaz M, et al. Immune restoration and/or augmentation of local graft versus host reaction by traditional Chinese medicinal herbs. Cancer. 1983;52(1):70-73.6336578
27. Cai XY, Xu YL, Lin XJ. Effects of radix Astragali injection on apoptosis of lymphocytes and immune function in patients with systemic lupus erythematosus [in Chinese]. Zhongguo Zhong Xi Yi Jie He Za Zhi. 2006;26(5):443-445.16883914
28. Mao SP, Cheng KL, Zhou YF. Modulatory effect of Astragalus membranaceus on Th1/Th2 cytokine in patients with herpes simplex keratitis [in Chinese]. Zhongguo Zhong Xi Yi Jie He Za Zhi. 2004;24(2):121-123.15015443
29. Niu GH, Sun X, Zhang CM. Effect of compound astragalus recipe on lymphocyte subset, immunoglobulin and complements in patients with myasthenia gravia [in Chinese]. Zhongguo Zhong Xi Yi Jie He Za Zhi. 2009;29(4):305-308.19526753
30. Su L, Mao JC, Gu JH. Effect of intravenous drip infusion of cyclophosphamide with high-dose Astragalus injection in treating lupus nephritis [in Chinese]. Zhong Xi Yi Jie He Xue Bao. 2007;5(3):272-275.
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