A promising development in the fight against Covid – Bangkok Post

After five days of treatment, more than 300 Covid-19 patients have been cured by fah talai jone (andrographis paniculata) or green chireta.

"We are confident that fah talai jone can cure Covid-19 patients who have mild symptoms and are asymptomatic," said Dr Kwanchai Wisitthanon, deputy director-general of the Department of Thai Traditional and Alternative Medicine. The figures above are from a recent study by the department.

"The medicine is safe to treat patients with," he added.

Known as the King of Bitters, fah talai jone has been in the spotlight following the surge in Covid-19 infection cases across Thailand. High in andrographolide that can kill some viruses, the Thai herb has been used to cure sicknesses like the flu, sore throat and infection in Asian countries such as China, India and Thailand for centuries.

Last April, a research team at the Institute of Biological Products of the Department of Medical Sciences under the Ministry of Public Health found that the medicinal herb can kill and inhibit the coronavirus disease, or Covid-19, in test-tube experiments.

Fah talai jone (andrographis paniculata) or green chireta capsules have options of ground leaves and extract. Karnjana Karnjanatawe

To test its effectiveness for curing patients, six volunteers participated in the first clinical test during the second half of last year. The research was conducted by the Thai Traditional Medicine Research Institute of the Department of Thai Traditional and Alternative Medicine.

The patients had mild symptoms such as sore throats, headaches, cough or runny nose. Each participant received 60mg of andrographolide at 6am, 2pm and 10pm, or a total of 180mg andrographolide a day for five days. The amount of andrographolide is three times higher a dose than the treatment of the common flu.

The research team took blood samples of each patient on the first, third and fifth dates to check the amount of the virus copies.

The fah talai jone plants. Vichien Keeratinijakul

The results were impressive.

"Within three days of using fah talai jone, every patient's condition improved. The symptoms were gone within five days," said Dr Kulthanit Wanaratna, director of the Thai Traditional Medicine Research.

"No side effects were found," he said.

However, the result from only six patients was not enough. The Institute wanted more proof to eliminate bias or any doubts about herbal therapy.

"We needed to conduct a Randomised Controlled Trial (RCT) because such research is the most rigorous method to determine the effectiveness of fah talai jone," he said.

An RCT is a standard in clinical research in controlled conditions with random patients. The study needs two groups of volunteers. The patients must not have severe symptoms or are infected but have not developed any symptoms. Each group needs 30 patients. One group will receive a total of 180mg andrographolide a day for five days while the other group will receive placebos for five days.

A field hospital facility for patients who have mild symptoms or are asymptomatic. Pattarapong Chatpattarasill

Each volunteer will not know if they receive the real medicine or placebo. Their condition will be monitored daily. The results will be compared to reaffirm if the medicine can treat Covid-19 patients with mild symptoms or they can get better without the treatment.

While the RCT has been carried out since last year among returnees in state quarantine facilities, the country was hit by a second wave of Covid-19 last December.

In response to the emergency and to prepare for another hit this month, the Department of Thai Traditional Medicine worked with nine hospitals in Samut Sakhon, Ratchaburi, Nakhon Pathom, Rayong and Tak to provide fah talai jone to more than 300 patients.

"We are certain about the effectiveness of the medicine and that it can kill the virus so we rolled out the project with patients," he said.

Disinfection is another way to mitigate the Covid-19 pandemic. Apichit Jinakul

According to the present protocol of the Department of Medical Services, those who test positive for the Covid-19 will be admitted to the hospital and treated according to their symptoms. Those who have mild illness and are asymptomatic will not receive antiviral medicines like Favipiravir which is used for Covid-19 treatment. Instead, they will receive drugs to cure their symptoms such as cough medicine or fever reducer.

"This is an opportunity for us so we introduced fah talai jone to patients," he said.

After three days of treatment, the patients' conditions improved.

"All sickness conditions including sore throat, cough, loss of smell and taste, runny nose, headache and fever gradually cured within three to five days. None of the patients developed severe illness such as a high breathing rate or lung infection," he noted.

Although the treatment by the herbal medicine went well, the credibility was not high because it lacked scientific proof. The patients did not pass another Covid-19 test after the treatment. Dr Kwanchai explained that they followed a new protocol recommended by the Infectious Disease Association of Thailand that if patients did not show any symptoms after the quarantine period, they can be discharged without taking a second Covid-19 test.

"It is because there is no further indication relating to the sickness, it means the level of disease is too low to transmit to others," he said.

Wearing a face mask and washing hands with alcohol gel is a common practice to prevent infection. Somchai Poomlard

Another reason is to save costs.

"Our research budget is quite limited so we only have a Google form for doctors to evaluate each patient's conditions during Covid-19 treatment with fah talai jone. But if we could have RT-PCR test results after the treatment, the research would have more credibility," he said.

For those who are anxious and worry if they get the infection during the present outbreak, Dr Kulthanit advised taking fah talai jone only when they have fever-like symptoms.

"Fah talai jone cannot be used for prevention of Covid-19. If you cough, have a fever, sore throat or runny nose, take a normal prescription which is 60mg of andrographolide a day," he said. (The amount of andrographolide per capsule indicates on each prescription bottle).

"The condition should improve within one or two days. If you do not feel better within three days, you should stop using fah talai jone. You should see a doctor."

Fah talai jone is a cooling herb. It should not be consumed for more than five to seven days otherwise it may cause numbness in the hands and feet, lowering blood pressure and also impact the kidneys, he added.

Not everyone can take fah talai jone. Those who should avoid the medicine are pregnant women, breastfeeding mothers, those who have kidney and liver problems and people who regularly take high blood pressure pills and blood thinners.

In addition to fah talai jone, the Department of Thai Traditional and Alternative Medicine will partner with Mahidol University to conduct a clinical trial for a herbal extract from finger roots or krachai, which is normally used as a herbal ingredient in Thai cooking. The lab research of the university recently found that Pinostrobin and Pandulatin A, which are extracted from krachai can kill and inhibit the Covid-19 virus. Testing on real patients is due to begin soon.

Besides this, the Department of Thai Traditional and Alternative Medicine will also expand its focus to cover herbal remedies that can cure inflammatory diseases such as benjalokawichien or ya ha rak, chantaleela, which consists of eight herbs and ya khao, which is mixed with rice water for drinking.

"The research on Thai traditional remedies will take time but it will benefit people in the long run. The knowledge will not only help with Covid-19 treatment but also other pandemics in the future," he said.

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A promising development in the fight against Covid - Bangkok Post