What is Bacopa monnieri?
Bacopa monnieri, or water hyssop, is a creeping marsh plant commonly used in Ayurvedic medicine. It is often taken to improve cognitive function and memory, relieve stress and anxiety, and enhance general mood and vitality.[6] Bacopa monnieri likely interacts with the dopamine, serotonin, and cholinergic systems, and it may promote neuronal communication by increasing the growth of dendrites (branches off of neurons). Bacopa monnieri also has antioxidant and anti-inflammatory properties.[7]
What are Bacopa monnieri’s main benefits?
Bacopa monnieri may produce a small improvement in memory, but the effect is inconsistent across different tests, scenarios, and populations, making it difficult to ascertain specifically when and for whom it’s most beneficial. A 2014 meta-analysis of randomized controlled trials reported that Bacopa monnieri has the potential to improve cognition, especially speed of attention.[1] However, a 2021 meta-analysis of randomized controlled trials did not find clinically meaningful differences for any nootropic, neuroprotective, or mood-related outcomes in participants who took Bacopa monnieri compared to participants who did not. The study population included adults with and without memory loss (analyzed separately). Any positive effects that were noted in the included trials were small, and no two trials found significant changes across the same neuropsychological tests.[8] A 2022 systematic review on the use of Bacopa for Alzheimer’s disease also reported no clinically meaningful differences with Bacopa monnieri treatment.[7] Moreover, many of the trials that do report cognitive benefits from Bacopa monnieri fail to adjust for multiple comparisons despite measuring a number of different outcomes,[9] and the cognitive tests that are used are not always appropriate for the population being studied.[10]
There is some preliminary research suggesting that Bacopa monnieri could have antidepressant and anxiolytic effects, possibly by reducing cortisol secretion and the depletion of dopamine and serotonin during chronic stress, but more research is needed to confirm this effect.[8][7]
Overall, the evidence for Bacopa monnieri is too heterogeneous to come to a firm conclusion about efficacy. It might improve some aspects of memory, cognition, and mood in certain people, but it could also have no substantial effects on any aspects of health.
What are Bacopa monnieri’s main drawbacks?
The most common adverse effects of Bacopa monnieri are gastrointestinal issues like nausea, cramping, bloating, and diarrhea, as well as dry mouth.[1][8] This could be related to Bacopa monnieri’s cholinergic properties, or gastric irritation from the bacoside compounds.[11] There are also reports of flu-like symptoms occurring after taking Bacopa, as well as a reduction in the number of dreams.[1] Not all studies report adverse events, so other negative reactions are possible. Anecdotally, some people experience a lack of motivation after taking Bacopa, likely due to its anxiolytic (anxiety reducing) effects.[12] A rat study reported a reversible decrease in sperm count, motility, and viability at a dose of 250 mg/kg/day, but there are no human studies on Bacopa and fertility.[13]
How does Bacopa monnieri work?
The exact mechanisms by which Bacopa monnieri confers any potential benefits are not fully understood, but they are likely a byproduct of the main active components of Bacopa monnieri, particularly saponins (e.g., bacoside-A and bacoside-B), alkaloids, and polyphenols.[14] In vitro studies find that bacosides could be neuroprotective and may actually enhance neurotransmission and synaptic activity, partly by stimulating the proliferation of branches (dendrites) off of neurons. Bacosides may also modulate stress hormones within the brain and positively interact with the serotonin, dopamine, and cholinergic systems, which helps to explain Bacopa’s possible mood-related effects.[15][7] Furthermore, Bacopa monnieri has antioxidant and anti-inflammatory properties.[16]
What are other names for Bacopa Monnieri
- Brahmi
- Aindri
- Lysimachia Monnieri L. Cent.
- Graticola Monnieri L.
- Herpestis Monniera L. Kunth.
- Water Hyssop
- Thyme-leafed Gratiola
- Indian Pennywort
- Jalabrahmi
- Cnidium Monnieri (Unrelated herb)
Dosage information
The most common dose for Bacopa monnieri is 300 mg per day, assuming that the total bacoside content (the active compound) is approximately 55% of the extract by weight. Doses of up to 600 mg per day have been used in some studies.[1] A phase I study found doses of 300 mg and 450 mg per day to be safe in healthy adults.[2] Higher doses don’t necessarily equate with greater effects.[3]
Bacopa monnieri is fat soluble and requires a lipid transporter to be absorbed, so it should be supplemented alongside a meal. Historically, Bacopa monnieri was consumed with ghee, a clarified butter that originated in India.[4]
Bacopa monnieri should be stored at 30℃ (86℉) or lower, with a relative humidity of 65% or less. The bacopaside content of the supplement will decrease if it is kept at higher temperatures.[5]
Frequently asked questions
Bacopa monnieri, or water hyssop, is a creeping marsh plant commonly used in Ayurvedic medicine. It is often taken to improve cognitive function and memory, relieve stress and anxiety, and enhance general mood and vitality.[6] Bacopa monnieri likely interacts with the dopamine, serotonin, and cholinergic systems, and it may promote neuronal communication by increasing the growth of dendrites (branches off of neurons). Bacopa monnieri also has antioxidant and anti-inflammatory properties.[7]
Bacopa monnieri may produce a small improvement in memory, but the effect is inconsistent across different tests, scenarios, and populations, making it difficult to ascertain specifically when and for whom it’s most beneficial. A 2014 meta-analysis of randomized controlled trials reported that Bacopa monnieri has the potential to improve cognition, especially speed of attention.[1] However, a 2021 meta-analysis of randomized controlled trials did not find clinically meaningful differences for any nootropic, neuroprotective, or mood-related outcomes in participants who took Bacopa monnieri compared to participants who did not. The study population included adults with and without memory loss (analyzed separately). Any positive effects that were noted in the included trials were small, and no two trials found significant changes across the same neuropsychological tests.[8] A 2022 systematic review on the use of Bacopa for Alzheimer’s disease also reported no clinically meaningful differences with Bacopa monnieri treatment.[7] Moreover, many of the trials that do report cognitive benefits from Bacopa monnieri fail to adjust for multiple comparisons despite measuring a number of different outcomes,[9] and the cognitive tests that are used are not always appropriate for the population being studied.[10]
There is some preliminary research suggesting that Bacopa monnieri could have antidepressant and anxiolytic effects, possibly by reducing cortisol secretion and the depletion of dopamine and serotonin during chronic stress, but more research is needed to confirm this effect.[8][7]
Overall, the evidence for Bacopa monnieri is too heterogeneous to come to a firm conclusion about efficacy. It might improve some aspects of memory, cognition, and mood in certain people, but it could also have no substantial effects on any aspects of health.
A 2016 systematic review of 5 studies using Bacopa monnieri in child and adolescent participants found that supplementation may improve behavioral and cognitive outcomes.[23] However, two of the studies had no control group. More robust study designs are needed to determine the efficacy of Bacopa in children and adolescents. There was also a 2022 randomized controlled trial investigating the efficacy of Bacopa monnieri’s ability to reduce attention and hyperactivity in male children ages 6 to 14.[24] No differences were noted for behavioral outcomes, but there were some improvements in the Bacopa group for certain cognitive outcomes, such as cognitive flexibility and processing speed. It is essential for parents to discuss supplements with a clinician before administering them to a child, as children can have different reactions to supplements than adults.
Although Bacopa monnieri is mainly viewed as a nootropic and adaptogen, it is also purported to be useful for a variety of health conditions, such as fevers,[25] constipation, cough, seizures,[26] infections/wounds,[27] cancer,[28] and general pain.[29] None of these purported effects have been studied in human randomized controlled trials, and some have not even been studied in animal models. Consequently, there is not enough evidence to support the use of Bacopa for these conditions. There was also a small pilot trial that found Bacopa might improve emotional function in people with Parkinson’s disease, but more research is needed to confirm this effect.[30]
The most common adverse effects of Bacopa monnieri are gastrointestinal issues like nausea, cramping, bloating, and diarrhea, as well as dry mouth.[1][8] This could be related to Bacopa monnieri’s cholinergic properties, or gastric irritation from the bacoside compounds.[11] There are also reports of flu-like symptoms occurring after taking Bacopa, as well as a reduction in the number of dreams.[1] Not all studies report adverse events, so other negative reactions are possible. Anecdotally, some people experience a lack of motivation after taking Bacopa, likely due to its anxiolytic (anxiety reducing) effects.[12] A rat study reported a reversible decrease in sperm count, motility, and viability at a dose of 250 mg/kg/day, but there are no human studies on Bacopa and fertility.[13]
Bacopa monnieri may interact with certain medications, including those commonly used for neurodegenerative and psychiatric conditions, although research in this area is limited. Because Bacopa monnieri may affect the serotonin, dopamine, and cholinergic systems, it is possible it could interact with pharmaceuticals that act on these systems. This includes anticholinergic medications, like those used to treat glaucoma and Alzheimer’s disease. Additionally, an in vitro study found that Bacopa monnieri inhibited the activity of certain cytochrome P450 enzymes (e.g., CYP3A4, CYP2C9, CYP2C19) and could therefore cause significant adverse reactions when taken alongside drugs that are metabolized by these enzymes, like clozapine, haloperidol, fluoxetine, and phenytoin.[31] In a case study, a patient taking cevimeline (a cholinergic agonist that stimulates saliva production and is metabolized by P450 enzymes) experienced malaise, nausea, and tachycardia after taking a supplement containing Bacopa monnieri. The clinicians suspected cholinergic toxicity due to the herb-drug interaction. Symptoms resolved once the supplement was discontinued.[32]
There is also rat research that found Bacopa could substantially increase thyroxine levels (T4), meaning it could interact with thyroid medications.[33] Other possible interactions that have not yet been documented could also exist. This is why it is very important to speak with a clinician before taking Bacopa monnieri, especially when it will be used in combination with prescription medications.
The exact mechanisms by which Bacopa monnieri confers any potential benefits are not fully understood, but they are likely a byproduct of the main active components of Bacopa monnieri, particularly saponins (e.g., bacoside-A and bacoside-B), alkaloids, and polyphenols.[14] In vitro studies find that bacosides could be neuroprotective and may actually enhance neurotransmission and synaptic activity, partly by stimulating the proliferation of branches (dendrites) off of neurons. Bacosides may also modulate stress hormones within the brain and positively interact with the serotonin, dopamine, and cholinergic systems, which helps to explain Bacopa’s possible mood-related effects.[15][7] Furthermore, Bacopa monnieri has antioxidant and anti-inflammatory properties.[16]
In some trials, Bacopa monnieri was studied as a combination supplement, with the goal of enhanced therapeutic benefits. Bacopa monnieri has been used alongside a number of other herbs and vitamins, with mixed results. For example, a 4-week trial combining 300 mg of bacopa monnieri with 120 mg of ginkgo biloba found no improvements in any cognitive outcomes when compared to placebo, but the study was relatively short in duration and may not have used an optimal dose of ginkgo biloba.[17] Conversely, a 2-month pilot study examining a nutraceutical containing 320 mg of Bacopa monnieri, 100 mg of L-theanine, 30 mg of saffron, 2 mg of copper, and some vitamins (9.5 mg of vitamin B6, 450 mcg of biotin, 400 mcg of folic acid, 33 mcg of vitamin B12, and 25 mcg of vitamin D), reported cognitive improvements with supplementation in participants with cognitive impairment.[18]
Bacopa monnieri is also used in two polyherbal formulations. Protandim is combination supplement made up of ashwagandha, Bacopa extract, green tea extract, silymarin, and curcumin.[19] Perment is a combination supplement made up of Bacopa monnieri, ashwagandha, butterfly pea, and Asparagus racemosus.[20] There is little research on either of these polyherbal supplements. It is possible they provide more benefit than Bacopa on its own, but, without well-designed human trials, it is difficult to determine their clinical efficacy.
Bacopa monnieri may also work synergistically with rosemary. One in vitro study found that Bacopa monnieri in combination with rosemary (Rosmarinus officinalis) had stronger antioxidant effects than either supplement on its own.[21] Similarly, a study using a rat model of Alzheimer’s disease found that oral administration of Bacopa monnieri and Rosmarinus officinalis could have neuroprotective effects.[22] There is no human evidence to support these findings.
Keep in mind that although there is nothing inherently wrong with combination supplements, it is a challenge to deduce which components of these supplements are actually causing any beneficial effects. Thus, any benefits cannot be directly attributed to Bacopa monnieri.
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