Self-Heal
LamiaceaePrunella vulgaris
Also known as: Heal-All, Xia Ku Cao, Heart-of-the-Earth
clinical_notes Clinical Summary
Self-heal (Prunella vulgaris / Xia Ku Cao) is a low-growing mint-family perennial used across Chinese, European, and Japanese traditions.
In TCM it is the primary herb for clumps and nodules of the neck (goiter, thyroid nodules, scrofula) by clearing liver fire and softening hardness.
Modern research demonstrates antiviral activity (especially against HSV-1/2 and HIV), immunomodulation in experimental autoimmune thyroiditis, and antihypertensive effects.
A 2022 meta-analysis showed adjunctive benefit for thyroiditis/nodular goiter (OR 3.96).
Pregnancy Safety
Traditionally avoided in pregnancy in TCM. Limited safety data; not recommended outside practitioner guidance.
Lactation Safety
Limited safety data. Generally avoided outside practitioner guidance.
warning Contraindications
- Spleen and Stomach Deficiency (TCM) (caution)Theoretical
- Pregnancy and lactation (avoid)Theoretical
- Hypotension (caution)Theoretical
vital_signs Clinical Profile
Primary Indications
- check_circle thyroid nodules
- check_circle swollen lymph nodes
- check_circle HSV outbreaks
- check_circle hypertension (with heat signs)
- check_circle acute conjunctivitis
- check_circle mastitis
- check_circle sore throat
Therapeutic Actions
System Affinities
- check_circle liver
- check_circle gallbladder
- check_circle thyroid
- check_circle lymphatic system
- check_circle eyes
labs Active Constituents
rosmarinic acid
ursolic acid
oleanolic acid
betulinic acid
triterpenoid saponins
rutin
hyperoside
prunellin
vitamins B1, C, K
history_edu Traditional Use
Traditional Chinese Medicine (TCM)
夏枯草 (Xia Ku Cao)
Nature: cold
- clears Liver fire
- brightens the eyes
- disperses nodules and clumps
- resolves constrained heat
Name literally means summer-dry herb because the aerial parts dry and turn brown in summer when Liver Yang is at its peak. Classical use for scrofula (luo li / lymph nodules), goiter, and red eyes.
Traditional Uses Across Healing Systems
While many herbs lack controlled clinical trials, centuries of traditional practice across cultures provide valuable insight into their therapeutic applications.
Clears liver heat for red swollen painful eyes, photophobia, headaches; disperses nodules including goiter, scrofula, breast masses; lowers blood pressure.
A cooling herb representing the waning yang of summer; harvested at summer solstice.
Wound healing (hence self-heal), sore throat, mouth ulcers, gargle for gingivitis, topical for skin injuries.
English name self-heal and heal-all reflect its reputation as a first-aid plant.
Kagoso — used for similar liver/thyroid conditions as in TCM.
Modern Japanese interest especially in antiviral effects against HSV.
spa Parts Used
fruiting spike
- thyroid nodules
- hypertension
- liver heat
Dried brown fruiting spikes harvested in summer when partially dried on plant. The classical TCM material (Spica Prunellae).
aerial parts (whole flowering plant)
- wound healing (topical)
- sore throat
- skin conditions
Entire flowering plant used in Western herbalism; typically fresh or recently dried.
shield Safety
Contraindications — Evidence Basis
Spleen and Stomach Deficiency (TCM)
Cold, draining herb that can further weaken digestion in those with cold/deficiency patterns (loose stools, low appetite, fatigue, cold extremities).
Pregnancy and lactation
Insufficient safety data; traditional TCM practice avoids during pregnancy and nursing.
Hypotension
Has clinical antihypertensive effects; may exacerbate hypotension or enhance effect of antihypertensive drugs.
Monitoring Parameters
Monitor during use, especially with prolonged or high-dose therapy.
TSH, free T4, free T3, thyroid ultrasound
Baseline and every 3-6 months if used for thyroid nodulesPrimary clinical TCM use is thyroid nodule/goiter; monitor efficacy via labs and imaging
flagThreshold: New or enlarging nodule, TSH outside reference: refer for endocrine evaluation
Blood pressure
Weekly during initiation, then monthlyClinical antihypertensive effect; monitor for additive effects with prescription antihypertensives
flagThreshold: SBP <100 mmHg or symptomatic hypotension: reduce dose
Toxicity
Low toxicity at traditional doses. Rat LD50 >36 g/kg aqueous extract.
Diarrhea, abdominal cramping, transient hypotension at high doses.
Discontinue; supportive care; rehydration.
Adverse Effects
CYP Metabolism
In vitro inhibition of HIV integrase by prunellin polysaccharide. Limited human CYP interaction data. Potential additive effects with antihypertensives.
swap_horiz Interactions
Lisinopril
Class: ACE inhibitor / antihypertensive
Prunella vulgaris aqueous and ethanol extracts have documented antihypertensive activity mediated by ursolic and oleanolic acid vasodilation and mild diuresis; additive BP lowering with ACEIs, ARBs, calcium-channel blockers or beta-blockers is plausible.
Monitor home blood pressure when initiating self-heal alongside antihypertensives; dose-adjust antihypertensive drugs to avoid symptomatic hypotension, particularly in elderly patients.
Cyclosporine
Class: Immunosuppressant
Spica Prunellae ethanol extract (triterpenoids, flavonoids, polysaccharides) produces dose-dependent immunosuppression of Con-A and LPS-stimulated splenocyte proliferation and reduces splenocyte/thymocyte mass, potentially additive with calcineurin inhibitors.
Avoid high-dose self-heal in transplant patients to prevent over-immunosuppression. Monitor cyclosporine trough levels and white-cell count if co-administered.
Metformin
Class: Biguanide antidiabetic
Prunella vulgaris polysaccharides and rosmarinic acid improve insulin sensitivity and inhibit aldose reductase, lowering fasting and post-prandial glucose in diabetic models; additive hypoglycemia with metformin, sulfonylureas, or insulin is possible.
Advise patients with type-2 diabetes to monitor fingerstick glucose closely when starting self-heal; anticipate possible reductions in oral hypoglycemic or insulin requirements.
Levothyroxine
Class: Thyroid hormone
Self-heal is traditionally used for goiter and thyroid hyperfunction; PV polysaccharides inhibit orbital fibroblast proliferation in thyroid-associated ophthalmopathy and may reduce TSH responsiveness/T4 release in hyperthyroid models, potentially opposing exogenous levothyroxine.
Avoid therapeutic self-heal extracts in patients on levothyroxine replacement; if unavoidable, re-check TSH/fT4 after 6–8 weeks and adjust levothyroxine dose.
Zidovudine (AZT)
Class: NRTI antiretroviral
Aqueous Prunella vulgaris extracts inhibit HIV-1 entry and integrase activity (prunellin polysaccharide) and show synergistic antiretroviral activity with AZT, ddI and ddC in vitro.
Not a substitute for ART; however, co-administration appears safe and may theoretically enhance antiretroviral activity. Monitor CD4 and viral load on standard schedule.
hub Combinations
Synergistic pairings can enhance therapeutic outcomes, while knowing suitable substitutes helps when specific herbs are unavailable or contraindicated.
Synergistic Combinations
4Bladderwrack
Limited EvidenceBladderwrack provides iodine substrate for thyroid hormone synthesis while self-heal disperses thyroid nodules — cross-tradition pairing.
Integrative thyroid formulas.
Bupleurum
Traditional UseBupleurum soothes Liver Qi while Xia Ku Cao clears Liver fire — complementary for liver depression with heat.
Classical TCM pairing.
Chinese Skullcap
Traditional UseBoth clear Liver heat; common TCM pairing for hypertension with red eyes, irritability, headaches.
Classical TCM pairing.
Dan Shen
Limited EvidenceDan Shen invigorates blood while Xia Ku Cao disperses nodules — combination for thyroid nodules with blood stasis.
Modern TCM thyroid formulas.
science Studies
Safety and efficacy of Prunella vulgaris preparation in adjuvant treatment of thyroid nodules: A meta-analysis
Meta-AnalysisThis meta-analysis of RCTs searched eight databases to evaluate the effect of Prunella vulgaris (PV) preparations as adjuvant therapy for thyroid nodules. PV combined with levothyroxine sodium or thyroxin tablets showed more clinical benefit than thyroid hormone therapy alone, including improved overall clinical efficacy rates and greater reductions in nodule diameter, with a lower incidence of adverse reactions. However, the authors note uncertainty in study quality and recommend higher-quality trials. The analysis supports P. vulgaris as a potentially useful adjunct for shrinking thyroid nodules in combination with standard thyroid hormone treatment.
Initial treatment combined with Prunella vulgaris reduced prednisolone consumption for patients with subacute thyroiditis
ObservationalThis retrospective cohort study analysed 87 patients with subacute thyroiditis (SAT) treated at the First Affiliated Hospital of Zhejiang University between 2013 and 2016. Patients received either prednisolone (PSL) alone or PSL combined with Prunella vulgaris. Both groups showed similar remission rates, but patients treated with PSL and PV tended toward lower recurrence rates (4.4% vs. 9.5%) and lower incidence of transient hypothyroidism (2.2% vs. 4.8%), though these differences did not reach statistical significance. This observational study suggests PV as an adjunct may allow a lower-dose steroid approach and reduce relapse risk in SAT, and that the combination was safe.
medication Dosing
decoction
9-15 g dried spike
daily, divided
Classical TCM range. Simmer 20-30 minutes. Higher doses (up to 30g) used short-term for acute conditions.
tincture
2-4 mL (1:5 in 40% ethanol)
TID
Western herbal dose. Higher doses for acute viral conditions.
tea
3-6 g dried aerial parts in 240 mL water
2-3x/day
Gentle infusion. Can be used as gargle/mouth rinse for oral inflammation.
topical
Compress or poultice of fresh aerial parts, or 10% tincture wash
2-3x/day
For wounds, minor skin infections, cold sores (HSV).
Disclaimer: This information is largely AI-generated and reviewed by human experts at Evara Health. It is intended for educational and clinical reference purposes only and should not replace professional medical advice.
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