My Kidney Garden : Tulsi Tea is Holy Basil! a Gift to the Mind Body Soul

by Robin Rose MD June11, 2025

What’s in your tea cup? With CKD (really with everything else as well) there is reason to bring an attitude of supportive precision to what we drink.

This adaptogenic herb is revered in Ayurveda and has anti-inflammatory, antioxidant, and nephroprotective properties. For people with CKD, Tulsi offers many benefits (with some precautions, especially in advanced stages - see below). It’s many renal protection abilities include decreasing creatinine/BUN and improving histology.

It’s formal name is Ocimum sanctum Lamiaceae.

I used to buy Organic India tulsi teabags - lovely blends with mint or ginger. Now Tulsi grows like a weed in my garden - volunteering and offering her gifts all year long. She tastes really good too!

This fragrant tropical plant — also called Holy Basil — is known as The Incomparable One, the Mother Medicine of Nature, the Queen of Herbs, and the Elixir of Life.

Poetically it has been described as giving luster to the complexion, sweetness to the voice, fostering beauty and intelligence, and offering a calm emotional disposition.

🍃Tulsi has an array of skills that enliven our lives - as an adaptogen, it offers organ and tissue protection, with resistance to chemical stresses from pollutants and heavy metals, from prolonged physical exertion, from ischemia, cold exposure, and noise pollution. Among many other things.

It’s pharmacological actions also include metabolic balancing, immune modulation, chemoprevention, anti inflammation, antioxidation, hepatoprotection, radioprotection, antimicrobial, neuroprotection, and antidiabetic actions. There is mention of antibacterial, antiviral, antifungal as well as antimalarial and antihelminthic uses in the literature.

🍃Anti-inflammatory benefits include suppression of unfriendly molecules like NF-kB, COX-2, IL-6, TNF - which contribute to slowing progression of kidney decline.

🍃Antioxidant benefits involve increased levels of GSH, SOD, catalase —::> decreasing the dread oxidative kidney damage that promotes progressive kidney decline.

🍃Blood sugar regulation assistance in CKD is a daily need. Tulsi improves insulin resistance and sensitivity - clearly important in CKD for prevention as well as in diabetics with CKD - offering protection to vulnerable blood vessels.

To elaborate on this most important aspect of tulsi benefits — it contributes to lowering blood glucose, aids in correcting lipid profiles, protecting kidney and liver from the metabolic damage of elevated blood sugar. It can protect against the negative effects of a high fat diet.

Symptoms of diabetes are decreased with regular enjoyment of tulsi tea. This includes polydipsia, polyphagia, polyuria, itching, sweating, fatigue, and burning feet. Improvements have been reported with fasting blood sugar, postprandial blood sugar, and even decreased HgA1c has been noted.

🍃Mild diuretic effect offers assistance with fluid regulation in earlier stages.

🍃Anti-fibrotic effects are also a daily necessity- and tulsi contributes to reducing TGF-B1-mediated fibrosis, enhancing long term protection.

Reviews confirm that O. sanctum contains ursolic acid, eugenol, rosmarinic acid, and flavonoids with potent free-radical scavenging and NF‑κB/COX-2/TNF‑α inhibition properties .

These compounds reduce MDA (malondialdehyde), a marker of lipid peroxidation in renal tubules.

🍃Protection from nephrotoxins is so important to stymie kidney damage. Tulsi is known to protect against gentamicin, heavy metals, and oxidative nephrotoxins.

The detox benefits of tulsi reflects its high phenolic compound content. With its antioxidant boosting, it enables the body to transform and eliminate toxins by enhancing activity of the liver detox enzymes (cytochrome p450), and it is able to deactivate toxin chemicals and facilitate safe excretion.

This protection is against pesticides, pollutants, pharmaceuticals, heavy metals (lead, arsenic, cadmium, mercury), radiation, industrial toxicants. It offers protection against genetic and immune cell damage caused by these offenders. Even common place toxins like alcohol and Tylenol can cause damage - and can be diminished with tulsi.

🍃Coagulation effects (note: CKD patients often have uremia-induced platelet dysfunction]

•••Anti-platelet activity: inhibition of platelet aggregation via eugenol and ursolic acid.

Eugenol, a major volatile oil in Tulsi, has shown inhibition of arachidonic acid-induced platelet aggregation, [comparable to aspirin at high concentrations]. Aqueous extracts inhibited clot retraction and delayed thrombosis in carrageenan-induced rodent studies.

•••COX inhibition: mild COX-1 and COX-2 inhibition → ↓ thromboxane A2.

•••Modulation of fibrinolysis: flavonoids may enhance fibrinolytic activity.

•••Reduction in clotting tendency - slowed clot formation has been seen in lab assays

🍃Uric acid lowering: useful in stages 1-3

(especially if uric acid > 6.5 mg/dL) — including tulsi offers benefits. Uric acid levels often rise in chronic kidney disease due to impaired renal clearance and complex metabolic shifts. This hyperuricemia may contribute to CKD progression and cardiovascular comorbidities.

Serum uric acid accumulates as GFR drops below ~60 mL/min/1.73 m².

But the serum uric acid can also be elevated already as early as Stage 2, even though glomerular filtration rate (GFR) is still relatively preserved (GFR 60–89 mL/min/1.73 m²). This is especially true in the presence of metabolic syndrome, hypertension, insulin resistance, or dietary excess of purines/fructose.

Keep it in mind that: Tubular Dysfunction Precedes GFR Decline!! Early CKD can involve subtle tubular injury (ie. from oxidative stress, toxins, inflammation). Since urate handling is tubular, not glomerular, you can see hyperuricemia before significant GFR loss.

👉🏿Tulsi mechanisms with uric acid:

•••Inhibition of xanthine oxidase (XO)—::> the eugenol, rosmarinic acid, and apigenin contained in tulsi have been shown to inhibit XO [enzyme responsible for converting xanthine → uric acid]. This is the same target as allopurinol and febuxostat, though Tulsi is much milder.

•••Uric acid excretion/Uricosuric Activity—::>

Tulsi exhibits mild effects for enhancing excretion of Uric acid in the urine — likely due to enhanced renal clearance of urate via OAT1/OAT3 pathways (this is limited or altered in advanced CKD when tubular excretion is notably impaired). It is however helpful in early CKD.

•••Antioxidant protection:

Uric acid can induce oxidative stress, mitochondrial dysfunction, and inflammation in renal tubular cells. Tulsi’s polyphenols counteract this by: reducing reacting oxygen species, inhibiting NF- kB, and supporting mitochondrial function. This benefit may reduce tubular inflammation and fibrosis in urate nephropathy.

KIDNEY TUBULES ARE WHERE THE ACTION IS

Tulsi has promising protective effects on kidney tubules [especially in models of nephrotoxicity, oxidative stress, and inflammation]. Its actions are mainly antioxidant, anti-inflammatory, and mitochondria-protective —::> preserving tubular structure and function in early and toxic CKD conditions.

Some details —::>

👉🏿Antioxidant protection

Reduces lipid peroxidation and oxidative damage in tubular epithelial cells.

👉🏿Anti-inflammatory

Suppresses NF-kB and COX-2 -reduced tubular injury in toxin-induced nephritis.

👉🏿Mitochondrial support

Preserves ATP levels and mitochondrial integrity in proximal tubules.

👉🏿Anti-fibrotic

Downregulates TGF-B1, preventing interstitial fibrosis in chronic tubular injury.

👉🏿Diuretic effect

Increases urine output and clearance, which may relieve tubular workload.

⚡️CAUTION and AWARENESS⚡️

Although there have been no liver/kidney histological changes found in studies, later stage CKD patients just need to be aware of the following effects when function has declined.

👉🏿Stage 4–5 CKD or ESKD requires caution: moderate use of tea/extract only.

👉🏿Even though tulsi leaves are not high in potassium, the tea should still be moderated in Stage 4–5 CKD [monitor levels]. Estimated potassium content: 12–25 mg per 8 oz cup.  This is considered very low potassium, far below concerning levels for CKD stages 3–5.

👉🏿OF NOTE: Tulsi tea is considered low oxalate.

Estimated oxalate content: 0.3–2.5 mg per 8 oz cup (depending on leaf concentration, brewing time, and whether fresh or dried tulsi is used). This puts Tulsi tea in the low-oxalate category - safe for most patients with CKD or with oxalate nephropathy — especially if it is brewed as a weak tea (1 tsp dry leaf per 8 oz).

👉🏿Blood-thinning effects (see above):

Caution with warfarin or antiplatelet medications including aspirin - be aware and monitor.

👉🏿Lowering blood sugar/BP (these are benefits of course but mindful monitoring helps eliminate unanticipated problems). Tulsi may enhance effects of hypoglycemic or antihypertensive drugs

👉🏿Essential oil extracts

For those in moderate-to-severe CKD with renal clearance burden, this can be unsafe without a botanically educated clinician to manage.

HAVE A DELICIOUS STEAMY CUP OF TULSI TEA

This is a family favorite - kids like it, combining it with other herbs like mint or ginger can bring a smile to all who enjoy this delectable treat. Knowing it offers benefits to kidney is rewarding and pleasing.

Tulsi tea is another treasure in the kidney success toolkit.

REFERENCES

1. Vohra P, Arora S. Protective effect of Ocimum sanctum on gentamicin-induced nephrotoxicity in rats. Indian J Physiol Pharmacol. 2014;58(2):175-179.

2. Chattopadhyay RR. Possible mechanism of hepatoprotective activity of Ocimum sanctum Linn., leaf extract: part II. Indian J Pharmacol. 2003;35(6):437-440.

3. Sharma A, Chandola HM, Singh G, Basisht G. Role of antioxidant therapy in diabetic nephropathy: A review. AYU. 2012;33(2):183-187.

4. Mondal S, Mirdha BR, Mahapatra SC. The science behind sacredness of Tulsi (Ocimum sanctum Linn.). Indian J Physiol Pharmacol. 2009;53(4):291-306.

5. Jamshidi N, Cohen MM. The clinical efficacy and safety of Tulsi in humans: A systematic review of the literature. Evid Based Complement Alternat Med. 2017;2017:9217567. doi:10.1155/2017/9217567

6. Rai G, Rai NP, Pandey DN, Rai AK. Ocimum sanctum as a phytomedicine for protection against nephrotoxicity and oxidative stress. Pharmacogn Rev. 2020;14(28):45-50.

7. Suanarunsawat T, Devakul Na Ayutthaya W, Songsak T, Thirawarapan S. Antioxidant activity and protective effect of Ocimum sanctum on lipid peroxidation in kidney of rats treated with cadmium. Acta Pharmacol Sin. 2011;32(9):1120-1126.

8. Uma Devi P, Ganasoundari A, Vrinda B, Srinivasan KK, Unnikrishnan MK. Radioprotective effect of leaf extract of Indian medicinal plant Ocimum sanctum. Indian J Exp Biol. 2000;38(3):253-255.

9. Pattanayak P, Behera P, Das D, Panda SK. Ocimum sanctum Linn. A reservoir plant for therapeutic applications: An overview. Pharmacogn Rev. 2010;4(7):95-105

10. Cohen MM. J Ayurveda Integ Med 2014: 5(4): 251-9.