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Research · Supplements

Astragalus

In diabetic kidney disease, a meta-analysis of 66 low-quality trials reports less urine protein and lower creatinine when astragalus is added to standard care. A 118-patient trial found slower eGFR decline. Blood sugar and fatigue trials are low quality, and polysaccharide trials in cancer report higher T cell counts. Adverse events matched control groups in kidney trials.

Add to Bio HackChecked 2026-11-09
Status
Dietary supplement in the US. Not approved by the FDA as a drug for any use.
Also called
Astragalus membranaceus, Astragalus mongholicus, Astragali Radix, Radix Astragali, huang qi, huangqi, milkvetch root, Astragalus injection
Taken for
kidney health, chronic kidney disease, diabetic kidney disease, blood sugar, immunity, colds, energy, fatigue, allergies

Strong several reviews agree · Moderate one review or consistent trials · Limited one or a few small studies · Untested no study in people, listed with what it rests on

Shown to help8

Reported risks0

No risks sourced yet.

What people take it for, and what was found

Shown to help8

Moderate

Immune cell counts during cancer treatment

Shown to raise CD3 and CD4 T cell counts when astragalus polysaccharides were added to cancer treatment, across 31 trials of mixed cancers.

The numbers and sources
Effect
In 31 RCTs, astragalus polysaccharides added to cancer treatment raised CD3+ T cell counts (MD 8.79, 95% CI 6.15 to 11.43), CD4+ counts (MD 7.94, 95% CI 5.27 to 10.61) and the CD4+/CD8+ ratio (MD 0.40, 95% CI 0.28 to 0.52). CD8+ counts did not differ (MD -1.74, 95% CI -4.66 to 1.17). Response to treatment was more frequent (RR 1.30, 95% CI 1.21 to 1.39) [1].
Population
2,648 people with various cancers in trials published 2010 to 2024 [1].
Sources
[1]
Caveats
The trials mixed cancer types. Polysaccharides are an isolated component, and the abstract does not give the route of administration. T cell counts are lab markers, not infection outcomes [1].
Limited

Chronic kidney disease in diabetes

Limited evidence: astragalus, mostly by injection, lowered urine protein in diabetic kidney disease in low-quality trials. One oral trial slowed kidney function decline but not albuminuria.

The numbers and sources
Effect
In a meta-analysis of 66 RCTs (4,785 people with diabetic kidney disease), astragalus injection added to conventional treatment lowered albuminuria (32 RCTs, SMD -2.05, 95% CI -2.49 to -1.61), proteinuria (26 RCTs, SMD -1.85) and serum creatinine (32 RCTs, -14.78 µmol/L, 95% CI -19.22 to -10.33). Oral astragalus lowered albuminuria in 4 RCTs (236 people, SMD -1.27) [2]. In 118 people with type 2 diabetes, stage 2 to 3 CKD and macroalbuminuria, oral astragalus granules added to standard care for 48 weeks slowed eGFR decline by 4.6 mL/min/1.73 m² per year (95% CI 1.5 to 7.6) and lowered systolic blood pressure by 7.9 mmHg. Albuminuria did not differ [3].
Population
Adults with diabetic kidney disease [2]. Adults with type 2 diabetes and CKD in Hong Kong [3].
Sources
[2], [3]
Caveats
Study quality was low, heterogeneity was 94% to 97%, and the authors report publication bias [2]. Most pooled trials used an injection, not an oral product [2]. Trial [3] was assessor-blind with standard care as the control, not placebo.
Limited

Blood sugar in type 2 diabetes

Limited evidence: astragalus added to treatment lowered fasting glucose in type 2 diabetes, and the decoction lowered HbA1c, in studies of limited quality.

The numbers and sources
Effect
In a meta-analysis of 13 studies (1,054 people), astragalus added to treatment lowered fasting glucose by 0.28 mmol/L as an injection and 0.83 mmol/L as a decoction. The decoction lowered HbA1c by 1.77 points (95% CI -3.06 to -0.47, I² 90.8%), and the injection did not change it significantly [4].
Population
Adults with type 2 diabetes [4].
Sources
[4]
Caveats
The authors call the analysis preliminary and the studies of limited quality. The search included Chinese databases [4].
Limited

Fatigue after COVID-19

One small trial in 64 nurses found less chronic fatigue after COVID-19 on astragalus root extract than on placebo.

The numbers and sources
Effect
In nurses with chronic fatigue syndrome after COVID-19, chronic fatigue prevalence on 500 mg of root extract twice a day fell to 13.8% at the end of treatment and 17.2% a month later. Being in the placebo group was associated with higher odds of chronic fatigue (OR 12.36, p = 0.01) [6].
Population
64 nurses in Iran, 32 per group, triple-blind [6].
Sources
[6]
Caveats
One small trial. The abstract does not give treatment length or baseline prevalence [6].
Limited

Seasonal allergies

One trial found a combination product containing astragalus reduced runny nose more than placebo in 48 adults. Other symptoms did not differ.

The numbers and sources
Effect
In 48 adults with moderate to severe seasonal allergic rhinitis, a herbal and mineral complex containing astragalus for 6 weeks reduced runny nose more than placebo. Other primary symptom measures did not differ between groups [7].
Population
48 adults with seasonal allergic rhinitis [7].
Sources
[7]
Caveats
One small trial of a combination product, not astragalus alone [7].
Limited

Kidney damage from high blood pressure

Limited evidence: astragalus injection lowered kidney damage markers more than placebo in 5 low-quality trials in people with hypertension.

The numbers and sources
Effect
In a systematic review of 5 RCTs (429 patients), astragalus injection lowered beta-2 microglobulin and microalbuminuria more than placebo, and lowered blood urea nitrogen more than prostaglandin. No adverse effects were reported [8].
Population
Patients with kidney damage from hypertension [8].
Sources
[8]
Caveats
Trial quality was generally low, and the search relied mostly on Chinese databases [8]. All trials used an injection, not an oral product.
LimitedStudied in children

Colds

Limited evidence: in children with nephrotic syndrome, astragalus granules were tied to fewer upper respiratory infections. A Cochrane review found no placebo-controlled trial for preventing them in children.

The numbers and sources
Effect
A Cochrane review screened 120 full-text papers on oral astragalus to prevent frequent respiratory infections in children and found no randomized trial comparing astragalus alone with placebo, so it could not assess benefit or safety. 44 studies were excluded for having no placebo [10]. In two studies pooled for children with nephrotic syndrome, upper respiratory tract infections occurred in 23.9% given astragalus granules with prednisone against 42.9% on prednisone alone (RR 0.56, 95% CI 0.33 to 0.93), with evidence quality rated low [11].
Population
Children up to 14 years in community settings [10]. Children with nephrotic syndrome taking prednisone [11].
Sources
[10], [11]
Caveats
Evidence quality was low, and the comparison was against prednisone alone with no placebo [11]. No trial in adults with colds was located.

Doses studied

The Hong Kong kidney trial used oral granules equivalent to 15 g of raw herb a day for 48 weeks [3]. The post-COVID fatigue trial used 500 mg of root extract twice a day [6]. The interaction study used 4 g of extract granules twice a day for 7 days [9]. Most trials in the diabetic kidney disease meta-analysis gave astragalus by injection [2].

Risks

Checked, no increase found2

Limited

Adverse events in trials

Limited evidence: adverse events were about as common with added astragalus as with standard treatment in diabetic kidney disease trials.

The numbers and sources
Effect
Across the diabetic kidney disease trials, adverse events were similar with added astragalus and with conventional treatment alone [2]. In the 48-week trial, 117 adverse events were recorded, in 31 patients on astragalus and 41 on standard care [3].
Population
Adults with diabetic kidney disease [2][3].
Sources
[2], [3]
Caveats
Most pooled trials were low quality, so harms may be under-reported [2].
Limited

Drug interactions

One small study found 7 days of astragalus did not significantly change fexofenadine levels in 14 healthy volunteers. Other drug pathways were not tested.

The numbers and sources
Effect
In 14 healthy volunteers, 7 days of astragalus extract did not significantly change blood levels of fexofenadine, a probe for the P-glycoprotein drug transporter. The authors reported a possible effect on elimination in people with one ABCB1 gene variant [9].
Population
14 healthy Chinese volunteers [9].
Sources
[9]
Caveats
One short crossover study of one transporter. Other drug pathways were not tested.

Sources

  1. Li Q, Li J, Wang Y, et al. Efficacy and safety of astragalus polysaccharides in patients with malignant tumors: A systematic review and meta-analysis. Naunyn-Schmiedeberg's Archives of Pharmacology. 2025. https://doi.org/10.1007/s00210-025-04074-2
  2. Zhang L, Shergis JL, Yang L, et al. Astragalus membranaceus (Huang Qi) as adjunctive therapy for diabetic kidney disease: An updated systematic review and meta-analysis. Journal of Ethnopharmacology. 2019. https://doi.org/10.1016/j.jep.2019.111921
  3. Chan KW, Kwong ASK, Tsui PN, et al. Add-on astragalus in type 2 diabetes and chronic kidney disease: A multi-center, assessor-blind, randomized controlled trial. Phytomedicine. 2024. https://doi.org/10.1016/j.phymed.2024.155457
  4. Tian H, Lu J, He H, et al. The effect of Astragalus as an adjuvant treatment in type 2 diabetes mellitus: A (preliminary) meta-analysis. Journal of Ethnopharmacology. 2016. https://doi.org/10.1016/j.jep.2016.05.062
  5. Sheng X, Yang L, Huang B, et al. Efficacy of Astragalus Membranaceus (Huang Qi) for Cancer-Related Fatigue: A Systematic Review and Meta-Analysis of Randomized Controlled Studies. Integrative Cancer Therapies. 2025. https://doi.org/10.1177/15347354241313344
  6. Banihashemi ZS, Azizi-Fini I, Rajabi M, et al. Chronic fatigue syndrome post-COVID-19: triple-blind randomised clinical trial of Astragalus root extract. BMJ Supportive & Palliative Care. 2024. https://doi.org/10.1136/spcare-2023-004595
  7. Matkovic Z, Zivkovic V, Korica M, et al. Efficacy and safety of Astragalus membranaceus in the treatment of patients with seasonal allergic rhinitis. Phytotherapy Research. 2010. https://doi.org/10.1002/ptr.2877
  8. Sun T, Xu H, Xu F. Astragalus injection for hypertensive renal damage: a systematic review. Evidence-Based Complementary and Alternative Medicine. 2012. https://doi.org/10.1155/2012/929025
  9. Zhou Q, Ye Z, Ruan Z, et al. Investigation on modulation of human P-gp by multiple doses of Radix Astragali extract granules using fexofenadine as a phenotyping probe. Journal of Ethnopharmacology. 2013. https://doi.org/10.1016/j.jep.2013.01.037
  10. Su G, Chen X, Liu Z, et al. Oral Astragalus (Huang qi) for preventing frequent episodes of acute respiratory tract infection in children. Cochrane Database of Systematic Reviews. 2016. https://doi.org/10.1002/14651858.cd011958.pub2
  11. Zou C, Su G, Wu Y, et al. Astragalus in the prevention of upper respiratory tract infection in children with nephrotic syndrome: evidence-based clinical practice. Evidence-Based Complementary and Alternative Medicine. 2013. https://doi.org/10.1155/2013/352130

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