Gotu kola (Centella asiatica) has a history of use in traditional medicine systems, particularly in Ayurveda and Traditional Chinese Medicine, for improving venous circulation and reducing swelling. In modern herbal medicine, its use for edema—especially chronic venous insufficiency (CVI)-related edema—has been investigated in several human clinical studies. Gotu kola contains triterpenoid saponins, mainly asiaticoside and madecassoside, which are thought to strengthen capillaries and improve microcirculation.

Several randomized controlled trials (RCTs) have evaluated gotu kola extracts (often standardized to triterpenoid content) for the treatment of venous insufficiency and related lower limb edema. In these studies, participants using gotu kola extract demonstrated significant reductions in ankle swelling, improved microcirculatory parameters, and decreased feelings of heaviness and discomfort compared to placebo groups. Notable studies include Cospite et al. (1991) and Cesarone et al. (2001), which showed measurable improvements in edema and capillary filtration rate in patients with CVI using standardized gotu kola extracts.

While the evidence is stronger for venous insufficiency-related edema than for other causes (such as heart failure or kidney disease), these results suggest that gotu kola may provide benefit for edema associated with vascular dysfunction. The overall quality of evidence is moderate, and more large-scale, high-quality RCTs would be beneficial. Nonetheless, gotu kola’s use for edema has both traditional roots and moderate scientific backing, particularly for conditions involving poor venous return.