IngredientsSaussurea costus (Falc.) Lipsch., commonly known as costus, is a perennial herb that has been traditionally used in various indigenous medicinal systems across Asia. It carries several synonyms, including Aucklandia costus Falc., Aplotaxis lappa Decne., Saussurea costus (Falc.) Sch.-Bip., Aucklandia lappa Decne., Saussurea lappa (Decne.) C. B. Clarke, and Theodorea costus O. Kuntz. Saussurea costus (Falc.) Lipsch. syn. Saussurea lappa C. B. Clarke belongs to the family Asteraceae and is a critically endangered plant that is monetarily very vital as a therapeutic herb of North-West Himalaya. More recently, a further reclassification has been proposed: the Saussurea genus, particularly Dolomiaea costus (formerly Saussurea lappa), is a globally distributed perennial plant with significant medicinal usage, due to its unique biochemical composition.
The name "costus" can also refer to other species, for example Costus speciosus or Costus igneus, which are different plants with different chemical profiles. These unrelated plants should not be confused with Saussurea costus when evaluating traditional uses or scientific evidence.
Saussurea costus, often referred to as Indian costus or kuth, predominantly thrives in the Himalayan region, especially in India and Pakistan, flourishing at elevations between 2,600 and 4,000 meters. Geographically, it is constrained to parts of the Himalaya (Jammu & Kashmir, Himachal Pradesh and Uttarakhand) at an elevation of 3,200–3,800 meters above mean sea level. The herb is native to China and India.
Costus carries diverse vernacular names in India: Kuth (Hindi), Postkhai (Kashmiri), Kostum (Tamil), Kot (Punjabi), Kut (Gujrati), Kur (Bengali), Sepuddy (Malayalam), Kushtha (Sanskrit), Kustam (Telugu), Kushtha (Marathi), and Koshta (Kannada). It is also generally known as costus root and as Kust or Qist Hindi in Arabia.
The root and essential oil are the parts used in traditional medicine systems such as Ayurveda and Unani. Dried four- to five-year-old roots of Saussurea lappa, known as costus root, have a reputation for their usage in traditional medicine systems in India, China, Japan, and Pakistan. Preparations documented in traditional and modern contexts include powder (churna), decoction (kwath), herbal oil, capsules, and tinctures. Root and powder are used orally with warm water to treat gastric problems, while root paste is applied to inflamed areas to relieve pain or on the skin to address boils, blisters, and leprosy. The oil of S. costus is very expensive and has a very strong aroma; therefore it is also used in high-grade perfumes and in preparations of hair oils, insecticides, and insect repellents.
S. costus is endemic to a geographically restricted part of the Himalayas and is a critically endangered species enlisted in Appendix I of CITES. Most of the natural populations of the species are either under destructive harvesting or have been extirpated due to immense demand in the pharmaceutical industry. According to a workshop organized at Shimla, Himachal Pradesh, India in 2003, it was concluded that 80% of the wild population in the Himalayan region of India declined over ten years. Therefore, the plant species was assessed as critically endangered; consequently, its collection from the wild was banned, and the species was listed in the CITES appendix of 214 endangered plants. Authentication is an important practical matter: there is a need for authentication of A. costus root with phytochemical analysis for conservation and prohibition of adulteration and misuse. The internal transcribed spacer (ITS) region and 5S rRNA intergenic spacer provide a reliable and effective way for differentiation of S. lappa from its adulterants and substitutes.
In Ayurveda, S. costus is referred to as Kushtha and is regarded as one of the most potent herbs for treating respiratory disorders (asthma and bronchitis), skin diseases, rheumatism, and ulcers due to its antimicrobial, anti-inflammatory, and expectorant properties. Ayurvedic texts like the Sushruta Samhita and Charaka Samhita described the importance of S. costus in formulations used for detoxification, digestive disorders, and respiratory diseases. Its roots are used mainly as an antispasmodic in asthma, cough, and also in treatment of cholera, chronic skin diseases, and rheumatism. Different preparations are also used by Ayurvedic physicians for the treatment of various ailments including cough and cold, quartan malaria, leprosy, persistent hiccups, rheumatism, hair-wash, stomachache, toothache, and typhoid fever. It is also an important medicine for gout and erysipelas and is traditionally said to promote spermatogenesis. A. costus roots have been known since the 13th century for use in ancient Ayurvedic products.
In Unani medicine, the root is valued for its ability to stimulate brain activity and improve liver and kidney functions, and is commonly prescribed for anemia, hyperglycemia, hyperlipidemia, ulcer, and chronic cough. According to Ayurveda, Unani, Siddha, and Traditional Chinese Medicine, costus roots are recommended for leukoderma, liver, kidney, blood disorders, Qi stagnation, and tridosha.
Saussurea costus (syn. Saussurea lappa, Asteraceae) is considered one of the most important traditional Chinese medicinal plants. In the Chinese Pharmacopoeia, it is recommended for managing abdominal pain, bloating, and dysentery by alleviating gastrointestinal stagnation. Saussurea costus is frequently used in Korean traditional prescriptions for inflammatory diseases.
S. costus possesses a lengthy historical background in Ayurveda, Tibetan, and Chinese medicine, valued for its therapeutic benefits. Saussurea costus is widely used in different traditional medicinal systems, particularly those of India, China, Tibet, and Korea. Across systems, it has been traditionally used to treat a variety of ailments including conditions requiring carminative, expectorant, antiarthritic, antiseptic, aphrodisiac, anodyne, and vermifuge properties, without any noticeable adverse effects in the historical record.
In perfumery, costus was a fixative of extraordinary tenacity. Used at trace levels, often below 0.1% of concentrate, it imparted a primal, skin-warm intimacy to compositions. IFRA Standard 124 (Amendment 40, 2006) prohibits costus root oil, absolute, and concrete as fragrance ingredients due to severe contact sensitisation risk from its sesquiterpene lactones.
Sesquiterpene lactones have been reported as the major phytoconstituents of this species. Among sesquiterpenes, dehydrocostus lactone, dihydrocostunolide, costunolide, and lappadilactone have been isolated as the main chemical constituents. Costunolide, dehydrocostus lactone, and cynaropicrin, isolated from this plant, have been identified as having the potential to be developed as bioactive molecules.
A new crystalline lactone—saussurea lactone (C₁₅H₂₀O₂) and costunolide were isolated from costus (Saussurea lappa) root oil in the 1950s–60s. Additional identified compounds include dehydrocostus lactone, costic acid, palmitic acid, linoleic acid, β-sitosterol, α-cyclocostunolide, alantolactone, β-cyclocostunolide, and isoalantolactone.
Sesquiterpenoids are the major constituents of the essential oil of S. costus roots, representing about 79.80% of its content. The main compounds in Saussurea lappa essential oil were identified as dehydrocostus lactone, costunolide, 8-cedren-13-ol, and α-curcumene. Quantitative HPLC studies demonstrated that the concentrations of costunolide and dehydrocostus lactone increased by 105–159% at higher altitudes.
Phytochemical surveys of Saussurea lappa have revealed various metabolites including sesquiterpenes, flavonoids, phytosterols, lignans, and terpenes. UPLC/T-TOF–MS/MS analysis of a methanol extract identified flavones including apigenin, acacetin, baicalein, luteolin, and diosmetin, and the flavonol aglycones quercetin, kaempferol, isorhamnetin, gossypetin, and myricetin and/or their glycosides and glucuronic derivatives as major compounds. Phytochemical studies showed that water extracts contained the most phenols (19.36 mg/g) and flavonoids (2.41 mg/g), followed by ethanol extracts.
Saussurea species contain sesquiterpene lactones, triterpenes, steroids, lignans, flavonoids, and some of these compounds possess interesting biological activities. Quantitative and qualitative analysis of aqueous and ethanol extracts of S. lappa roots performed using GC-MS showed that the ethanol extract contained 37 compounds whereas the aqueous extract contained 18 compounds. In cultivated Uttarakhand root material, a total of 35 aroma compounds representing about 92.81% of the total composition were identified; aldehyde (7Z,10Z,13Z)-7,10,13-hexadecatetrienal (25.5%) was the major compound, with dehydrocostus lactone (16.7%), elemol (5.84%), γ-costol (1.80%), vulgarol B (3.14%), valerenol (4.20%), and terpinen-4-ol (1.60%) also present.
Costunolide is one of the naturally occurring sesquiterpene lactones that has been extensively investigated for a wide range of biological activities. Multiple lines of preclinical studies have reported that the compound possesses antioxidative, anti-inflammatory, antiallergic, bone remodeling, neuroprotective, hair growth promoting, anticancer, and antidiabetic properties.
Studies have shown that costunolide inhibits LPS-induced inflammatory response through the IKK/NF-κB signaling pathway in macrophages. Dehydrocostus lactone (DCL) is a major sesquiterpene lactone isolated from Aucklandia lappa Decne., a traditional Chinese herbal medicine used to treat gastrointestinal diseases. Oral administration of DCL (5–15 mg/kg) not only ameliorated symptoms of colitis and colonic barrier injury, but also inhibited the expression of proinflammatory cytokines and myeloperoxidase in colon tissues in DSS-challenged mice. DCL treatment results in inhibition of the NF-κB pathway and activation of Nrf2 signalling; DCL interacts with IKKα/β and Keap1 to inhibit NF-κB pathway and activate Nrf2 signalling.
Cynaropicrin shows dose-dependent inhibition of TNF-alpha. A total methanol extract at 0.1 mg/ml as a final concentration exhibited more than 50% inhibition on the cytokine-induced neutrophil chemotactic factor (CINC) induction.
Costunolide and dehydrocostus lactone have been reported for their wide spectrum of biological effects including anti-inflammatory, anticancer, antiviral, antimicrobial, antifungal, antioxidant, antidiabetic, antiulcer, and anthelmintic activities. In recent years they have attracted extensive research interest due to their potential anti-cancer activities for various types of cancer, with mechanisms including cell cycle arrest, induction of apoptosis and differentiation, promotion of microtubule protein aggregation, inhibition of telomerase activity, inhibition of metastasis and invasion, reversal of multidrug resistance, and restraint of angiogenesis.
Extensive investigation of the anticancer effects of costunolide have shown that the compound induces apoptosis and inhibits proliferation of various cancer cells in vitro, and suppresses angiogenesis and metastasis. Studies have revealed that costunolide increased Bax/Bcl-2 ratio, decreased mitochondrial transmembrane potential, and enhanced cytoplasmic levels of cytochrome c, and activation of caspase-9, caspase-3, and cleaved PARP, resulting in cell apoptosis. In colorectal cancer models, costunolide inhibited CRC cell proliferation in vitro and in vivo by targeting AKT.
Hepatoprotective activity of S. costus methanol extract has been investigated by measuring the expression of miRNA-34A, miRNA-23, catalase, HNF-1α, sirtuin-1, C/ebpα in the liver as well as the plasma level of caspase 2, CK18, TNF-α, and IL-6. S. costus was proved to be a potent inducer of apoptosis because of the presence of costunolide.
A high dose of S. costus revealed the best downregulated expression for the IKBKB, IKBKG, NfkB1, IL-17A, IL-6, IL-17F, IL-1β, TNF-α, TRAF6, and MAPK genes in diabetic rat models. The downregulation of IKBKB by S. costus could be attributed to dehydrocostus lactone as an active compound with proposed antidiabetic activity. Research assessed the inhibition of α-amylase using crude extracts from Saussurea costus, a medicinal plant traditionally used for treating diabetes and its complications. Two novel potent proteinaceous amylase inhibitors (ScAI-R and ScAI-L) were purified and characterized from S. costus roots and leaves.
A fundamental limitation characterizes the entire evidence base: the quality of evidence for costus is limited; active constituents, bioavailability, pharmacokinetics, physiological pathways, and importance to human health are not known with sufficient detail or confidence. Modern evidence on costus root is still limited, and most studies are laboratory or animal-based. The following sections distinguish between preclinical findings (in vitro and animal studies) and the very sparse human clinical data.
Preclinical evidence (in vitro and animal): Different pharmacological experiments in a number of in vitro and in vivo models have convincingly demonstrated the ability of Saussurea costus to exhibit anti-inflammatory, anti-ulcer, anticancer, and hepatoprotective activities, lending support to the rationale behind several of its traditional uses. In animal models, treatment with dehydrocostus lactone significantly reduced pathological injury and fibrosis, the secretion of pro-fibrotic mediators TGF-β and α-SMA, and components of the extracellular matrix in a bleomycin-induced pulmonary model. DHL administration also inhibited the infiltration of inflammatory cells and downregulated the expression of TGF-β, TNF-α, and IL-6 in a dose-dependent manner.
Human clinical evidence: People use costus for parasite infections in the intestines and other conditions, but there is no good scientific evidence to support these uses. No large randomized controlled trials in human subjects have been retrieved from peer-reviewed databases specifically for the anti-inflammatory use of costus root as a whole preparation. The anti-inflammatory evidence remains predominantly preclinical.
Preclinical evidence: In Ayurvedic medicine, S. costus was utilized to treat asthma, inflammatory diseases, ulcers, and stomach disorders. At the molecular level, studies using animal models of ulcerative colitis have shown that costunolide and dehydrocostus lactone exert therapeutic effects in ulcerative colitis based on network pharmacology, molecular docking, and animal experiments. Specifically, these compounds regulate TLR4, NF-κB, and PI3K expression pathways. A. costus has been noted to have remarkable effects on gastric, hepatic, inflammatory, respiratory, cancer, and skin problems; however, several errors in the selection of plant material, authentication, selection of dose, assessment methodology, selection of standard, and controls have been identified in published studies.
Human clinical evidence: No adequately powered randomized controlled clinical trials in humans specifically evaluating costus root for gastrointestinal conditions were identified in peer-reviewed literature. The evidence base for this indication consists exclusively of traditional use records and preclinical (in vitro/animal) studies.
Preclinical evidence (in vitro and animal): Studies have found that costunolide possesses anti-cancer effects against human gastric adenocarcinoma, prostate cancer, liver cancer, bladder cancer, and esophageal cancer, and promotes apoptosis of a variety of cancer cells. Costunolide significantly suppressed renal carcinoma cell growth via stimulation of apoptosis and autophagy in a concentration-dependent manner in human cancer cell lines. Costunolide induced autophagy and apoptosis via the ROS/JNK signaling pathway. In colorectal cancer models, costunolide activates and induces p53 stability by inhibiting MDM2 ubiquitination via the suppression of AKT phosphorylation in vitro; the compound also suppresses cell growth in a p53-independent fashion and p53 activation may contribute to anticancer activity via AKT. Dehydrocostus lactone and costunolide isolated from S. costus roots showed antiviral activity towards HBV by significantly suppressing the expression of HBsAg with IC₅₀ (1.0 and 2.0 µM) in a dose-dependent manner in human hepatoma Hep3B cells.
Human clinical evidence: All anticancer evidence for costunolide and dehydrocostus lactone currently derives from in vitro cell lines and xenograft animal models. Despite advancements, comprehensive studies on its bioactivity remain limited. No human clinical trials specifically testing costus root or its isolated constituents as anticancer agents have been identified in this review. This area is considered early-stage preclinical research.
Preclinical evidence: S. costus is traditionally used for treating asthma, gastric ulcer, inflammation, and liver diseases. An aqueous extract of S. costus was found to be hypolipidemic. In a PMC-indexed rat study, researchers evaluated hepatoprotective activity of a methanol extract by measuring catalase activity, inflammatory cytokines, apoptotic markers, and genetic markers including miRNA-34a and miRNA-223 expression. Histological studies revealed decreased micro- and macrovesicular steatosis in hepatocytes and reduced inflammatory infiltrates and connective tissue between hepatic lobules compared to diabetic control rats.
Human clinical evidence: No human randomized controlled trials specifically examining hepatoprotective effects of costus root were identified. The hepatoprotective evidence base is preclinical.
Preclinical evidence: In Indian folklore, costus was used as an antidiabetic plant; recently, efforts have been devoted to assessing its potential against diabetes. In an alloxan-induced diabetic rat model, the plant Saussurea costus demonstrated preventive power against diabetes in a comparative study with lactic acid bacteria. Inhibition assays for human salivary and pancreatic α-amylase were performed to assess the effectiveness of S. costus inhibitors in regulating postprandial blood glucose levels, suggesting potential applications in managing hyperglycemia in diabetes.
Human clinical evidence: No well-designed human clinical trials on costus for diabetes were identified. Evidence is restricted to animal and in vitro models.
Scientific evidence suggests the use of costus as an antimicrobial and antiparasitic. Antioxidant assays (ABTS, FRAP, DPPH) indicated the highest antioxidant ability within the water extracts, suggesting its use in oxidative stress-related disease treatment, while antimicrobial testing showed strong activity. A field trial citation appears in a 2007 review noting a study (Akhtar and Riffat, 1991) evaluating Saussurea lappa roots against nematodes in children, but full clinical data were not retrievable in these search results.
A methanol extract of the plant showed cardiotonic effects in preclinical studies. In an animal model of atherosclerosis, dehydrocostus lactone, a natural sesquiterpene lactone, has significant anti-inflammatory effects and has the potential to inhibit ox-LDL-induced atherosclerosis in laboratory settings. These findings are exclusively preclinical.
A petroleum ether extract showed potent anticonvulsant activity against picrotoxin-induced convulsions in mice. Many authors have reported that the bitter roots of S. costus have anxiolytic, anti-inflammatory, and antirheumatic activities in preclinical settings. All neurological evidence is preclinical.
Extracts and molecules from this plant have been investigated for various biological activities including anti-inflammatory, wound healing, immunostimulatory, antioxidant, hepatoprotective and choleretic, antiulcerogenic, anti-bacterial, anti-viral, larvicidal, anti-angiogenesis, gastro-protective, cardiotonic, anticancer, cytotoxicity, PTP1B inhibitory, anticonvulsant, antidiarrheal, anti-epileptic, antihyperlipidemic, and anti-aging activities.
Based on the peer-reviewed literature retrieved, the body systems associated with costus research include:
The following dosages are drawn exclusively from identified source documents and represent experimental or traditional use values, not clinical recommendations.
No standardized human clinical dosage has been established through controlled trials for any indication. The quality of the evidence for costus is limited; active constituents, bioavailability, pharmacokinetics, physiological pathways, and importance to human health are not known with sufficient detail or confidence.
The most significant documented safety concern for costus products is contamination with aristolochic acid. Costus often contains a contaminant called aristolochic acid. Aristolochic acid damages the kidneys and causes cancer. Costus products that contain aristolochic acid are unsafe. Aristolochia plants were widely used to prepare herbal remedies until aristolochic acids were observed to be highly nephrotoxic and carcinogenic to humans. In general, the root of D. costus is safe to consume; however, it may contain aristolochic acid that has nephrotoxic and carcinogenic properties.
Regulatory action has followed from this risk: in China, since 2003, the CFDA cancelled the drug standards for three medicinal materials containing aristolochic acids — Caulis Aristolochiae Manshuriensis, Radix Aristolochiae Fangchi, and Saussurea costus. Under US law, the FDA can confiscate any plant product that it believes contains aristolochic acid, and the product will not be released until the maker proves it is aristolochic acid-free.
Costus oil, isolated from Saussurea lappa C. and used in perfumery, is responsible for numerous cases of allergic contact dermatitis (ACD). The haptens implicated are the sesquiterpene lactones costunolide and dehydrocostus lactone. The International Fragrance Association in 1982 advised against the use of costus root oil as a fragrance raw material due to its content of the allergenic sesquiterpene lactones costunolide and dehydrocostus lactone. IFRA Standard 124 (Amendment 40, 2006) subsequently prohibited costus root oil, absolute, and concrete as fragrance ingredients.
The sesquiterpene lactone mix used in standard patch testing contains alantolactone, dehydrocostus lactone, and costunolide. Patients allergic to sesquiterpene lactone mix may react to the plant or pollen, as well as cosmetics, ointments, creams, lotions, and topical medicaments that use these plant extracts. Cross-sensitivity studies found that thirteen costus-sensitive patients patch tested with 38 sesquiterpene lactones of five different classes over a two-year period showed cross-reactions falling into two chemical categories: those that resembled the primary sensitizer, and those belonging to different skeletal classes.
When applied to the skin, there is not enough reliable information to know if costus is safe or what the side effects might be. About the toxicity and safety of D. costus, little information is available. A study suggests that ethephon-induced renal toxicity can be reduced through consumption of D. costus root extract. In addition, by improving sperm abnormalities, testicular tissue damage and DNA damage, as well as P53 protein expression, D. costus has shown protective effects against ethephon-induced reproductive toxicity in rats. These findings are from animal studies only.
Several errors in the selection of plant material, authentication, selection of dose, assessment, selection of standard, and control have been identified across published studies, highlighting the practical importance of source verification for any product purporting to contain costus root. There is a need for authentication of A. costus root with phytochemical analysis for conservation and prohibition of adulteration and misuse.
There is not enough reliable information about the safety of taking costus if you are pregnant or breast-feeding.
Across all investigated applications, the evidence for costus (Saussurea costus) is preliminary and predominantly preclinical. The pharmacological studies have demonstrated its anti-inflammatory, antioxidant, anti-cancer, hepatoprotective, and immunomodulatory effects in laboratory settings, and ethnobotanical data showcase its extensive use in treating ailments like asthma, digestive disorders, and skin conditions; some clinical trials also underscore its efficacy in certain health conditions, though these require further validation. A schematic drug development and research strategy exploiting the potential of plant extract, fraction, products, and probable constituents — costunolide, dehydrocostus lactone, cynaropicrin, and saussureamine — assuring dose-response relationship and safety may be determined under pre-clinical study which could then be extrapolated to the clinical level. The major safety concerns are well-established: aristolochic acid contamination poses documented renal and carcinogenic risk, and the sesquiterpene lactones in the essential oil are established contact sensitizers banned from fragrance use by IFRA. No approved clinical indication exists in any major regulatory jurisdiction based on the retrieved evidence.
Health conditions that Costus may help support.
Body systems that Costus may help support.
Go back