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Gotu kola and global cognition: grade C

Limited evidence. Direction: No effect.

C LimitedShort-term only

Educational guidance, not medical advice

Why this grade

Rubric condition met: Clinical-population evidence only; the one randomized comparison found no added effect

In a 12-week randomized trial in 60 older adults with mild cognitive impairment, adding 500 mg of gotu kola twice a day to exercise gave no additional cognitive benefit over exercise alone. A 6-week quasi-experimental study after stroke found no difference from folic acid in overall scores and had no placebo group. A 2026 systematic review called the clinical evidence limited and inconsistent. All of this is clinical evidence, so the grade is capped at C.

How we grade evidence

Studies this grade rests on

EffectMixedNo effectSize shows participants (n)2015202020252030Meta-analysisSystematic reviewRCTQuasi-experimenta…Phoemsapthawee 2022, 2022: RCT, n = 60, result not recordedFarhana 2016, 2016: quasi-experimental comparison with folic acid, 6 weeks (no placebo), n = 48, result not recordedYuwadee 2026, 2026: systematic review, n not recorded, result not recordedPuttarak 2017, 2017: meta-analysis, n not recorded, result not recorded
each study this grade rests on, by publication year and design. Solid: effect versus the comparator; half-filled: mixed; hollow: no effect; dashed: result not recorded yet. Larger marks had more participants.
Show the numbers
StudyYearDesignParticipantsResult
Farhana 20162016quasi-experimental comparison with folic acid, 6 weeks (no placebo)48result not recorded
Puttarak 20172017meta-analysisnot recordedresult not recorded
Phoemsapthawee 20222022RCT60result not recorded
Yuwadee 20262026systematic reviewnot recordedresult not recorded

Pharmacological Activities of Centella asiatica: A Systematic Review of Preclinical and Clinical Evidence on Cardiovascular, Neurological, Antioxidant, and Anti-inflammatory Effects.

Yuwadee A, Boonprasert K, Na-Bangchang K. Pharmacological Activities of Centella asiatica: A Systematic Review of Preclinical and Clinical Evidence on Cardiovascular, Neurological, Antioxidant, and Anti-inflammatory Effects Planta Med, 2026. PMID 42906579

Result not recorded
Design
Systematic review of 62 studies (54 preclinical, 8 clinical trials)
Population
Preclinical models and clinical trials
Funding
National Research Council of Thailand; Thailand Science Research and Innovation Fundamental Fund; Thammasat University

Effectiveness of Gotu Kola Extract 750 mg and 1000 mg Compared with Folic Acid 3 mg in Improving Vascular Cognitive Impairment after Stroke.

Farhana KM, Malueka RG, Wibowo S. Effectiveness of Gotu Kola Extract 750 mg and 1000 mg Compared with Folic Acid 3 mg in Improving Vascular Cognitive Impairment after Stroke Evid Based Complement Alternat Med, 2016. PMID 27340413

Result not recorded
Design
Quasi-experimental comparison with folic acid, 6 weeks (no placebo)
Sample
n = 48
Population
Patients with cognitive impairment after stroke (clinical population, Indonesia)
Funding
Funding: not stated in the PubMed or Crossref record; full text not read.

Does Gotu kola supplementation improve cognitive function, inflammation, and oxidative stress more than multicomponent exercise alone? - a randomized controlled study.

Phoemsapthawee J, Ammawat W, Prasertsri P. Does Gotu kola supplementation improve cognitive function, inflammation, and oxidative stress more than multicomponent exercise alone? - a randomized controlled study J Exerc Rehabil, 2022. PMID 36420467

Result not recorded
Design
Randomized controlled trial, 3 arms, 12 weeks
Sample
n = 60
Population
Older adults with mild cognitive impairment (clinical population)
Funding
Kasetsart University Research and Development Institute

Effects of Centella asiatica (L.) Urb. on cognitive function and mood related outcomes: A Systematic Review and Meta-analysis.

Puttarak P, Dilokthornsakul P, Saokaew S. Effects of Centella asiatica (L.) Urb. on cognitive function and mood related outcomes: A Systematic Review and Meta-analysis Sci Rep, 2017. PMID 28878245

Result not recorded
Design
Systematic review and meta-analysis of 11 RCTs (5 of C. asiatica alone, 6 of combination products)
Population
Mostly healthy volunteers (91% of studies); one trial in children with a diagnosis
Funding
Thai Traditional Medical Knowledge Fund

Search and history

Search (): (centella[tiab] OR gotu kola[tiab]) AND (stroke[tiab] OR cognitive impairment[tiab]) AND (trial[tiab] OR randomized[tiab])

  • Graded C (proposed): Proposed in the monograph draft
  • C to C (approved): Editor sign-off November 13, 2026: grade matches the editor-approved final page