Tinospora cordifolia (guduchi)
Summary
Tinospora cordifolia, or giloy, is an Ayurvedic herb promoted for immunity. Small Indian trials reported fewer allergic-rhinitis symptoms (75 people, 8 weeks) and fewer HIV-related symptoms (68 people, 6 months). Since 2021, case series and a 43-patient multicentre study have linked giloy to autoimmune-like hepatitis; 4 of the 43 (9.3%), all with existing liver disease, died within 2 months.
Key facts
- A climbing shrub native to India and South Asia used widely in Ayurveda; stem extracts are the usual supplement form[7][2]
- 75 patients, 8 weeks: complete relief from sneezing in 83% on Tinospora versus little relief on placebo[1]
- In 43 patients with giloy-associated liver injury across 13 Indian centres, 4 (9.3%) died within 2 months, all of whom had pre-existing chronic liver disease, and 2 needed a liver transplant; causality was rated probable in 67.4%[6]
- Botanical, chemical and DNA testing of the plant samples in one case series confirmed Tinospora cordifolia, not the look-alike Tinospora crispa[2]
- NIH LiverTox records clinically apparent liver injury with long-term use[7]
- 3 graded human outcomes on this page
- October 13, 2026
How it works
ProposedTinospora extracts are described as immune stimulants: in trials, white-cell counts and neutrophil phagocytosis rose. Hepatologists propose that the same immune stimulation explains the autoimmune-like hepatitis seen in case series. The active constituents and their targets in people are not established.[1][4][5]
What the human research says
Human trials only, one row per outcome. The form column shows what each trial actually tested. Grades follow our evidence-grading policy.
At a glance: strongest evidence per outcome
| Outcome | Grade | Effect | Strongest evidence | Rows |
|---|---|---|---|---|
| Allergy | Grade D | Improved | RCT · n = 75 · 2005 | 1 row |
| Immune markers | Grade D | Mixed | RCT · n = 68 · 2008 | 1 row |
| Wound care | Grade D | Mixed | RCT · n = 45 · 2007 | 1 row |
Every graded row
| Outcome | Effect | Grade | Best evidence | PMID |
|---|---|---|---|---|
| Sneezing, nasal discharge, obstruction and itch in allergic rhinitis | Improved | Grade D | RCT · n = 75 · 2005 Adults with allergic rhinitis (India) Form: Tinospora cordifolia extract · Dose: Not stated in the abstract · Duration: 8 weeks 83% had complete relief from sneezing, 69% from nasal discharge, 61% from obstruction and 71% from itch with Tinospora; most placebo patients had no relief. Nasal eosinophils and neutrophils fell. | 15619563 (opens PubMed)Source [1] |
| Symptoms and blood markers in HIV-positive adults | Mixed | Grade D | RCT · n = 68 · 2008 HIV-positive adults (India) Form: Standardised water extract of Tinospora stem (Tinofend) · Dose: 300 mg three times daily (900 mg/day) · Duration: 6 months 60% on the extract versus 20% on placebo reported fewer HIV-related symptoms, but most objective measures did not back this up; eosinophils and haemoglobin fell. Anorexia, nausea, vomiting and weakness were reported. | 20040936 (opens PubMed)Source [3] |
| Diabetic foot ulcer size and debridements added to surgical care | Mixed | Grade D | RCT · n = 45 · 2007 Adults with diabetic foot ulcers (India); 50 enrolled, 45 completed Form: Tinospora cordifolia · Dose: Not stated in the abstract · Duration: 4 weeks (phagocytosis at 3 months) Overall improvement (73.9% vs 59.1%) and ulcer area, perimeter and depth did not differ significantly; fewer debridements and better neutrophil phagocytosis were significant. | 17558098 (opens PubMed)Source [4] |
Forms
| Form | Elemental % | Absorption (human data) | GI tolerance | Studied for |
|---|---|---|---|---|
| Tinospora stem water extract (tablets, capsules, satva, juice) | Varies[3] | No human absorption data were found in the cited sources.[3] | Anorexia, nausea, vomiting and weakness in the 6-month HIV trial; liver injury reported with self-medication, median 90 days of use in one series.[3][5] | Allergic rhinitis, HIV and diabetic-foot trials |
Studied doses
Doses studied in human trials ranged from the 900 mg/day standardised stem extract (300 mg three times daily for 6 months) in the HIV trial to unstated amounts over 4–8 weeks in the allergic-rhinitis and diabetic-foot trials.[3][1][4]
Interactions
Published interactions only: each row cites a source. No row means none was found in our sources, not that a combination is safe.
Medicines
- ImmunosuppressantsCase reportTinospora is described as an immunostimulant and has been linked to autoimmune-like hepatitis; it could oppose immune-suppressing therapy. No interaction studies exist.[3][5][6]
- Medicines that can harm the liverCase reportGiloy has caused clinically apparent liver injury; combining it with other liver-toxic drugs could add to the risk. Not studied directly.[6][7]
- Diabetes medicinesReviewTinospora preparations raised insulin and lowered insulin resistance in diabetic mice, so additive glucose lowering is possible; not tested in people on these drugs.[8]
Who should be careful
- Liver disease or autoimmune conditions
- Case series found giloy can trigger autoimmune-like hepatitis or unmask silent autoimmune liver disease; all 4 deaths in the 43-patient cohort were in people with existing chronic liver disease. Hepatologists advise caution, especially in people prone to autoimmune disorders.[5][6]
- Transplant recipients and people on immunosuppressants
- Immune-stimulating effects could work against anti-rejection or autoimmune treatment.[3][5]
- Pregnancy and breastfeeding
- No human safety data were found; the only pregnancy data are from mice.[8]
- Anyone with symptoms of liver trouble
- Jaundice, dark urine or fatigue while using giloy warrant stopping it and seeing a clinician; recovery took a median of 86.5 days after stopping in one series.[5]
Talk to your pharmacist or clinician before starting a supplement, especially if you take prescription medicines.
Liver injury
Giloy is now a recognised cause of herb-induced liver injury.
- Case series (2021)
- Six patients developed acute hepatitis after a median 90 days of use; liver biopsy showed an autoimmune pattern, and one decompensated on steroid tapering.[5]
- Multicentre study (2022)
- 43 patients from 13 Indian centres; acute worsening of chronic liver disease was the most common presentation, probable causality in 67.4%, and close to 10% died within 2 months.[6]
- Plant identity confirmed
- Botanical, chemical and DNA testing confirmed that the plant samples patients consumed were Tinospora cordifolia, not a look-alike species.[2]
How to read the label
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Frequently asked questions
What is giloy?
Tinospora cordifolia, an Ayurvedic climbing shrub also called guduchi, widely sold as an immune booster.[7]
Does giloy help allergies?
One 8-week Indian trial in 75 people with allergic rhinitis reported much more symptom relief than placebo. It has not been repeated.[1]
Can giloy damage the liver?
Yes. Case series and a 43-patient multicentre study link it to autoimmune-like hepatitis; 4 of the 43 died within 2 months, all of whom already had chronic liver disease, and 2 needed a transplant.[5][6]
Sources
- [1]Efficacy of Tinospora cordifolia in allergic rhinitis.. J Ethnopharmacol, 2005. RCT
- [2]Herb-induced Liver Injury-A Guide to Approach. Lessons from the Tinospora cordifolia (Giloy) Case Series Story.. J Clin Exp Hepatol, 2023. observational
- [3]Immunomodulatory effect of Tinospora cordifolia extract in human immuno-deficiency virus positive patients.. Indian J Pharmacol, 2008. RCT
- [4]Immunomodulatory role of Tinospora cordifolia as an adjuvant in surgical treatment of diabetic foot ulcers: a prospective randomized controlled study.. Indian J Med Sci, 2007. RCT
- [5]Herbal Immune Booster-Induced Liver Injury in the COVID-19 Pandemic - A Case Series.. J Clin Exp Hepatol, 2021. observational
- [6]Tinospora Cordifolia (Giloy)-Induced Liver Injury During the COVID-19 Pandemic-Multicenter Nationwide Study From India.. Hepatol Commun, 2022. observational
- [7]Tinospora.. LiverTox: Clinical and Research Information on Drug-Induced Liver Injury, 2012. database
- [8]Effect of Tinospora cordifolia on gestational diabetes mellitus and its complications.. Women Health, 2023. animal-study
What changed
- Independent adversarial review: liver-injury mortality restated precisely from the full text (4 of 43, 9.3%, all with pre-existing chronic liver disease; 2 transplants; causality probable in 67.4%) instead of "close to 10%"; added the species-confirmation finding (T. cordifolia, not T. crispa) so the liver signal cannot be dismissed as misidentification; mechanism sources corrected (neutrophil phagocytosis is from the diabetic-foot trial, not the HIV trial).
- Second-pass self-review: every PMID re-checked against NCBI esummary (title, year, no retraction or expression-of-concern flag), every dose, n and duration re-read against the PubMed abstract or PMC full text, grades held conservative, and interactions limited to what a cited source supports.
- First draft. Source titles and years taken from NCBI E-utilities esummary; abstracts read for every evidence row.