Supplement
Padma Basic (Tibetan multi-herb formula)
Circulation / vascular support; moderate human evidence for improving pain-free and maximum walking distance in intermittent claudication (peripheral arterial disease).
Grade C: human trials exist, but they are small, mixed or not yet repeated. This is not a finding that it does not work. How to read a grade →
This is a Tibetan blend of herbs sold for blood flow. It was tested in people whose legs cramp and hurt when they walk because of narrowed arteries. In five small studies, people could walk farther before the pain started. A careful review found that the studies were small and not well run. So the result is hopeful but not certain.
A letter describes the human evidence, not the product, the manufacturer, or the ingredient's worth.
See the full evidence record →Pain-free and maximum walking distance in intermittent claudication (peripheral artery disease).
Why this gradeGrade C, small or unreplicated trials. The reasoning, and what the grade does not cover.
Grade C on walking distance in intermittent claudication. Five small placebo-controlled trials report longer walking distance, and the Cochrane review pools two of them to a 96 m gain in maximum walking distance (Stewart et al., 2016; PMID PubMed ID: the permanent number the US National Library of Medicine gives a published paper. Each one links to that paper's record on PubMed. 27021597), but rates every result very low quality: small samples, little between-group statistics, withdrawals tied to the outcome and evidence of publication bias. Under the written definitions, B needs at least one well-designed trial supported by others; small trials of very low quality are C. Moved from B in October 2026 by applying the written grade definitions.
WHAT THIS GRADE DOES NOT COVERlonger-term use beyond about four months, which no trial followed; quality of life, which no trial reported; and ankle brachial index, which did not change in the one trial that measured it.
A grade describes the human evidence for a named use. It is not advice, and it is not a judgment on any individual prescription. How the letters are decided →
Who responds: this record's trial reading reports no subgroup that identifies who responds.
How this letter has changed · latest: October 2026 · Downgraded
The B rested on a Cochrane review that rates its five small placebo-controlled trials very low quality, with withdrawals tied to the outcome and evidence of publication bias (Stewart et al., Cochrane Database Syst Rev, 2016; PMID 27021597). The written definition of B requires at least one well-designed trial supported by others; small trials of very low quality are C. Walking distance gains are unchanged as findings. Applied by the written grade definitions, October 2026.PMID 27021597
Every change to a letter on this site is dated and published. The full evidence log →
Commercial disclosure
EBL earns no commission on any supplement it grades. A purchase made through the dispensary link below pays EBL nothing, the practitioner discount goes to you in full. The dispensary is Fullscript, a practitioner dispensary, and many of the professional-grade brands in it are sold mainly through practitioners rather than in health food stores. Grades are assigned by published rubric before any commercial relationship exists and are never influenced by one. Full disclosure.
2 capsules, 2-3× daily (standard study dose; ~760–1140 mg/day of the multi-herb formula).
Complex multi-herb Tibetan formula (Padma 28 / Padma 28N is the studied original; Padma Basic is a related US-market product). Because of the multi-botanical composition, third-party heavy-metal and microbial contamination testing is essential. Herbal medicines broadly carry documented contamination risk.
The cited reviews pool trials of the formula and do not report when doses were taken (PMID 27021597, PMID 16600251).
Checked against the published summaries; the full papers could not be read. What the cited trials did, not a schedule. Every supplement, by trial timing →
How to buy this: quality criteria, not a brand
2 capsules 2–3×/day (~760–1,140mg/day of the multi-herb formula).
Padma 28 / 28N is the studied original; Padma Basic is the related US product. Complex multi-botanical.
Third-party heavy-metal AND microbial contamination testing, essential for multi-herb formulas.
No contamination testing; unverified “Tibetan formula” knockoffs.
The grade and these criteria are set only from human trials. Any purchase link is convenience and does not affect the grade.
Pregnancy and lactation. Known allergy to any constituent, and the formula contains more than twenty, including myrobalan, calendula, costus and valerian, so an allergy history has more surface than usual here. The multi-herb composition is itself the caution: the interaction profile is the union of every constituent's, and nobody has characterized it.
Anticoagulants and antiplatelets, on possible additive bleeding risk. Immunosuppressants. Sedatives, on the valerian content. All of these are mechanistic cautions inferred from the constituents; no interaction study has been done on the formula as a whole, and that absence is the honest headline.
Mechanism-based, no human interaction study located. The drug interactions described for Padma Basic (Tibetan multi-herb formula) are mechanism-based. A PubMed search for human interaction, pharmacokinetic or co-administration studies pairing it with anticoagulant, antiplatelet, immunosuppress, sedative returned no results in August 2026. The caution stands on pharmacology, not on a trial, and is labeled as such. Basis: pharmacological mechanism, not a human study. Searched PubMed in August 2026: 4 queries, 0 human results.
Pain-free walking distance and maximum walking distance (6-minute walk test or treadmill). Walking distance is re-measured at 8 to 16 weeks. Ankle-brachial index annually if PAD is documented.
Primary evidenceTwo papers, each linked to its PubMed record.
Stewart et al. (Cochrane Database Syst Rev, 2016; PMID 27021597): five placebo-controlled randomized trials, 365 participants, at least 16 weeks; walking distance rose within the Padma 28 groups, and two trials (193 participants) pooled showed maximum walking distance 96 m higher than placebo An inactive substitute made to look like the real treatment, so participants cannot tell which one they received., rated very low quality evidence; small trials, limited between-group statistics, withdrawal linked to the outcome and evidence of publication bias; no effect on ankle brachial index. Melzer et al. (Atherosclerosis, 2006; PMID 16600251): earlier pooled analysis of the same trials, positive. Grade C: the trials are small and the Cochrane review rates the evidence very low quality and asks for well-designed research.
EBL grade range: B- (vascular / circulation support, intermittent claudication) shading to C / 'insufficient' for general longevity. The Cochrane review confirmed signal but flagged very low overall evidence quality. Because this is a complex multi-herb Tibetan formula, third-party quality testing is especially relevant (heavy metals, microbial, identity) and medical supervision, especially for anyone on antiplatelet or anticoagulant therapy.
Educational use only · Not medical advice · Starting, stopping or changing any supplement or medication is a decision for your physician
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. The grade on this page describes the strength of published human trial evidence in the populations studied. It is not a recommendation for any individual and is not medical advice. Starting, stopping or changing any supplement or medication is a decision for your physician.
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How EBL searched for the trials (1 search)
The search that was run, what it returned, and what was left out and why, so the absence of evidence can be checked as well as its presence.
("Padma 28"[tiab] OR "Padma Basic"[tiab] OR padma[ti]) AND (claudication[tiab] OR "arterial occlusive"[tiab] OR "peripheral arterial"[tiab]) AND (randomized controlled trial[pt] OR meta-analysis[pt] OR systematic review[pt])Grades move when new trials publish. A free monthly email lists every grade EBL moved, with the reason and the trial behind it: the sign-up is on the Evidence Log →