Astragalus is a root used in Chinese medicine as a tonic and given in China as an injection alongside chemotherapy. Many studies, mostly of poor design, report less fatigue, nausea and gut toxicity, which is not yet proof. It lowered levels of the transplant drug tacrolimus in one patient and may interact with hormone and blood-thinning treatments.
Astragalus membranaceus root is a traditional Chinese tonic for stamina and immunity, sold as a supplement and used in China as an injectable. Memorial Sloan Kettering's About Herbs summary cites limited clinical data that it may help cancer-related and chemotherapy-related fatigue, and meta-analyses associating it with less chemotherapy nausea and vomiting, less gastrointestinal toxicity, less radiation lung injury and better quality of life in liver cancer, while noting that most of the included studies had poor methodology. Injectable forms were reported to improve outcomes in liver cancer and quality of life in advanced cancers. MSK reports fatigue, headache and lower blood pressure as side effects. Interactions it lists: a nearly 50 per cent fall in tacrolimus concentration in one patient taking astragalus granules; possible interference with hormonal therapies because of oestrogenic activity; possible added bleeding with anticoagulants; additive effects with diuretics and blood-pressure drugs; and laboratory effects on P-glycoprotein and on gemcitabine handling whose clinical relevance is unknown.
Polysaccharides and saponins such as astragaloside IV have immune, antioxidant and oestrogenic effects in laboratory models.
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