The key point is that direct evidence for andrographolide against these three tick-borne pathogens is very limited. Much of the available evidence concerns general antimicrobial, anti-inflammatory, antimalarial, or antiviral activity—not proven treatment of human Lyme disease, babesiosis, or bartonellosis.
1. Botanical medicines tested against Borrelia burgdorferi
Feng J, Leone J, Schweig S, Zhang Y. Evaluation of natural and botanical medicines for activity against Borrelia burgdorferi. Frontiers in Medicine. 2020;7:6.
doi: 10.3389/fmed.2020.00006
Full text: https://www.frontiersin.org/articles/10.3389/fmed.2020.00006/full (opens in new tab)
This laboratory study tested several botanical medicines against growing and stationary-phase B. burgdorferi. It reported activity for some botanical preparations, including Japanese knotweed, cat’s claw, Chinese skullcap, cryptolepis, and others. It did not establish that andrographolide treats Lyme disease in humans, and andrographolide itself should not automatically be equated with the activity of a whole-plant extract.
A related study often cited in discussions of persistent Borrelia forms is:
Goc A, Niedzwiecki A, Rath M. In vitro evaluation of the anti-Borrelia burgdorferi activity of selected organic compounds. Phytomedicine. 2017;31:1–7.
This type of study provides laboratory evidence only; results from test-tube concentrations cannot be directly converted into human dosing or clinical effectiveness.
2. Andrographolide: general antibacterial evidence
Reddy VL, Reddy SM, Ravindranath A, et al. Andrographolide: antibacterial activity against common bacteria of human health concern and possible mechanism of action. Indian Journal of Microbiology. 2017;57?
The search result commonly associated with this work is indexed under:
“Andrographolide: antibacterial activity against common bacteria of human health concern and possible mechanism of action.”
Publisher link: https://link.springer.com/article/10.1007/s12223-017-0496-9 (opens in new tab)
This research evaluated andrographolide against selected conventional bacterial species. It does not demonstrate activity against B. burgdorferi, Bartonella henselae, or Babesia species, nor does it establish clinical efficacy.
Because bibliographic records for this article should be checked against the publisher or PubMed before formal citation, use the DOI and complete journal details from the final publisher record rather than relying on an informal webpage citation.
3. Reviews of andrographolide’s anti-infective properties
Andrographolide and Its Derivatives: A Comprehensive Review of Anti-Infective Properties and Clinical Potential. Molecules. 2025;30(21):4273.
Article link: https://www.mdpi.com/1420-3049/30/21/4273 (opens in new tab)
This review discusses reported antiviral, antibacterial, antiparasitic, and anti-inflammatory effects of andrographolide and its derivatives. It is useful for understanding proposed mechanisms and the broader pharmacology, but it is a review of preclinical and clinical literature—not proof that andrographolide treats Lyme disease, babesiosis, or bartonellosis.
Jarukamjorn K, Nemoto N. Pharmacological aspects of Andrographis paniculata on health and its major constituent andrographolide. Journal of Health Science. 2008;54(4):370–381.
doi: 10.1248/jhs.54.370
This review summarizes pharmacological and anti-inflammatory research on Andrographis paniculata and andrographolide. It is not a pathogen-specific clinical treatment study.
Hossain MS, Urbi Z, Sule A, Rahman KMH. Andrographis paniculata (Burm. f.) Wall. ex Nees: a review of ethnobotany, phytochemistry, and pharmacology. The Scientific World Journal. 2014;2014:274905.
doi: 10.1155/2014/274905
This is a broad review of the plant and its constituents. It should not be interpreted as evidence that the herb eradicates Borrelia, Babesia, or Bartonella in people.
4. Evidence relating to Bartonella
A frequently cited laboratory study is:
Zhang Y, et al. Botanical medicines with activity against stationary phase Bartonella henselae. bioRxiv. 2020.
doi: 10.1101/2020.08.19.256768
Full text: https://www.biorxiv.org/content/10.1101/2020.08.19.256768v1.full (opens in new tab)
Important limitations:
- This is a preprint, not necessarily peer-reviewed final evidence.
- It examined botanical medicines in laboratory assays.
- Activity of a plant extract does not prove that andrographolide was the active constituent.
- It does not establish a safe or effective human treatment regimen.
A related essential-oil study is:
Ma X, et al. Essential oils with high activity against stationary phase Bartonella henselae. Antibiotics. 2019;8(4):205.
doi: 10.3390/antibiotics8040205
Full text: https://pmc.ncbi.nlm.nih.gov/articles/PMC6963529/ (opens in new tab)
This study reported activity from certain essential oils and constituents, including compounds such as carvacrol. Carvacrol is not andrographolide, and oregano oil should not be presented as evidence for andrographolide treatment.
5. Evidence relating to Babesia
At present, there is no strong clinical evidence establishing andrographolide as a treatment for human babesiosis. Some laboratory and pharmacological literature describes Andrographis paniculata or andrographolide as having antimalarial or antiparasitic activity, but:
- Babesia is an apicomplexan parasite, not a malaria parasite.
- Activity against Plasmodium cannot be assumed to equal activity against Babesia.
- Antimalarial activity in cell or animal models does not establish efficacy against human babesiosis.
- Established babesiosis treatment depends on the species, disease severity, immune status, and medical assessment.
For general babesiosis treatment and clinical guidance, consult:
Centers for Disease Control and Prevention. Clinical Care of Babesiosis.
https://www.cdc.gov/babesiosis/hcp/clinical-care/index.html (opens in new tab)
The CDC describes prescription treatment approaches such as atovaquone plus azithromycin or clindamycin plus quinine in selected circumstances. These should not be replaced by andrographolide without qualified medical supervision.
6. Clinical guidance for Lyme disease
Lantos PM, Rumbaugh J, Bockenstedt LK, et al. Lyme disease. Clinical Infectious Diseases. 2021;72(1):e1–e48.
doi: 10.1093/cid/ciaa1215
Full text: https://academic.oup.com/cid/article/72/1/e1/6010652 (opens in new tab)
This guideline provides evidence-based recommendations for diagnosis and treatment of Lyme disease. It does not recommend andrographolide as an established treatment.
7. Clinical guidance for Lyme disease and tick-borne coinfections
Theel ES, Aguero-Rosenfeld ME, Pritt BS. Testing for tick-borne diseases: a review of current and emerging diagnostic methods. Clinical Microbiology Reviews. 2021;34(1):e00018-19.
doi: 10.1128/CMR.00018-19
This review discusses diagnostic challenges and the importance of distinguishing Lyme disease from other tick-borne infections. Overlapping symptoms do not prove coinfection, and positive or negative tests require clinical interpretation.
8. Safety and clinical-trial limitations
A review of andrographolide clinical evidence is:
Cáceres DD, Hancke JL, Burgos RA, Wikman GK. Use of visual analogue scale measurements to assess the effectiveness of standardized Andrographis paniculata extract SHA-10 in reducing the symptoms of common cold. Phytomedicine. 1999;6(4):217–223.
doi: 10.1016/S0944-7113(99)80001-5
This illustrates that human studies of andrographis have mainly involved respiratory symptoms and other general conditions—not confirmed Borrelia, Babesia, or Bartonella infection.
Potential concerns include gastrointestinal effects, allergic reactions, blood-pressure or glucose effects, interactions with medicines, and possible effects on drug-metabolizing enzymes or immune function. Pregnancy, autoimmune disease, bleeding risk, and concurrent prescription treatment warrant particular caution.
Bottom line
The accurate interpretation of the evidence from a traditional allopathic position is:
- Borrelia: Some botanical extracts have shown in-vitro or lab activity, but there is no adequate clinical evidence that andrographolide alone cures Lyme disease.
- Bartonella: Some botanical extracts and essential oils have shown laboratory activity, but direct evidence for andrographolide is insufficient.
- Babesia: Evidence for andrographolide as a human babesiosis treatment is inadequate; antimalarial activity cannot be assumed to be anti-Babesia activity.
- Human treatment: Andrographolide should be regarded as an experimental or supportive supplement, not a proven replacement for diagnosis and pathogen-specific medical treatment.