Innovation sometimes means approaching an old concept with new eyes. The ancient healing system native to India called Ayurveda proved an ideal opportunity for AOR to test this theory, optimizing ancient knowledge for modern health.

According to many scholars, Ayurvedic medicine (also called Ayurveda) is one of the world’s oldest healing systems. The term “Ayurveda” combines the Sanskrit words ayur (life) and veda (science or knowledge). It originated in India more than 3,000 years ago and remains one of the country’s traditional health care systems. Ayurveda is also practiced in varying forms in Southeast Asia and in other parts of the world¹. In Ayurveda, health is viewed as much more than the absence of disease and a greater emphasis is placed on prevention. Key concepts of Ayurvedic medicine include universal interconnectedness, the body’s constitution (prakriti), and life forces (dosha). Its fundamental tenet is that we must reach our unique state of balance in our whole being—body, mind, and consciousness.

Prakriti, Vikruti, and Doshas

According to Ayurveda, each person has a constitution or prakriti, that is specific to them. Prakriti relates to genetically inherited physical and emotional qualities. It is determined at the time of conception by the combination of three constitutional principles or doshas present in the individual at that time¹. Ayurveda’s three constitutional principles – vata, pitta, and kapha – can be compared to the biologic ‘humors’ of the ancient Greek system. They are loosely translated as air, fire and earth, respectively¹.Our prakriti is fixed throughout our lifetime but it is influenced by the constant interaction with our environment as the body tries to maintain a state of balance. This dynamic equilibrium between our different doshas results in an adaptive condition called vikruti. The vikruti reflects one’s ability to adjust to life’s influences, but it should match the prakriti as closely as possible. If the life forces do not match the constitution, the resulting imbalance can lead to illness.

Ayurvedic Constitutions

Each person has all three doshas present in their constitution in various proportion.

Restoring Balance

Based on these concepts, Ayurvedic physicians prescribe individualized treatments to restore and maintain the balance between vikruti (current state) and prakriti (basic constitution) taking into account the season, the geography, and so on.

The first line of defense in combating imbalances is to remove the root cause of the problem in order for the body to begin to heal itself. The remaining imbalances can be rectified by using opposites. For example, excess heat or acidity in the digestive system would require the ingestion of cooling and soothing herbs like shallaki (boswellia). Ayurveda emphasizes the importance of supporting the digestive fire for optimal nutrient absorption and proper elimination of waste materials.

Ayurvedic recommendations draw on a number of modalities including diet modifications, lifestyle adjustments, herbal compounds, cleansing processes (panchakarma), meditation, yoga and breathing techniques (pranayama), and energetic pressure points (marma)².

“The first line of defense in combating imbalances is to remove the root cause of the problem in order for the body to begin to heal itself.”

Medicinal Herbs in Ayurveda

Unlike the Western pharmacological understanding of herbs based on their chemical constituents, Ayurveda approaches them through their energetic qualities. Besides their energetic action (virya), herbs and plants are classified according to their taste (rasa) – sweet, bitter, sour, salty, pungent and astringent – post-digestive effect (vipaka), their action on the doshas, their affinity for the different bodily systems, and to other special properties (prabhava) they may exhibit.

Herbs can be taken separately to address specific health issues, but well-balanced constitutional formulas are often more effective. Ayurvedic physicians usually prepare personalized herbal formulas in which herbs are combined synergistically in a holistic and individualized manner and adjust them accordingly to their patient’s needs.

Below is a brief list of Ayurvedic herbs and some of their common indications in non-Ayurvedic terms.

Is Ayurvedic Medicine Effective?

In spite of the thousands of years of existence and application of Ayurvedic medicine, the National Center for Complementary and Integrative Health (NCCIH), a division of the National Institutes of Health (NIH) in the U.S., concludes that there aren’t enough well-controlled clinical trials and systematic research reviews to prove that these approaches are beneficial³. However, we must bear in mind that Ayurveda is a holistic and highly individualized medicine for which the so-called ‘well-controlled clinical trials’ model —the gold standard for Western medical research— is poorly suited.

Problems in Clinical Trials of Ayurvedic Medicine

As mentioned previously, prakriti determines the effectiveness of particular herbal medicines and would have to be a major factor to consider as an inclusion/exclusion criterion in clinical studies. The administration of an herb or herbal compound to a subject population of various constitutions may not yield uniform outcomes. Ayurveda also proposes different interventions at different stages of disease, providing another variable difficult to control in a clinical trial³.Another factor to consider is the cost of such clinical trials. The universal standard for pharmaceutical testing is repeated, large-scale, randomized double-blind tests. In order to recuperate the considerable costs of testing to the regulatory standards, pharmaceutical companies have to patent the substances tested and sell them with a substantial profit. Plants cannot be patented, and very few research institutions are willing to fully invest the time and money necessary to satisfy the regulatory requirements. With the increased popularity and demand for safe and effective natural remedies, it has become imperative to examine some of the challenging issues that are being faced by clinical research trials with herbal medicines. Some initiatives in that direction are encouraging. For example, statistical analysis reveals that curcumin – derived from Curcuma longa – is the most widely-studied plant-derived medicinal chemical in modern science. A preliminary clinical trial funded in part by NCCIH in 2011 found that conventional and Ayurvedic treatments for rheumatoid arthritis had similar effectiveness. The conventional drug tested was methotrexate and the Ayurvedic treatment included 40 herbal compounds. Another preliminary clinical trial found that osteoarthritis patients receiving a compound derived from Boswellia serrata gum resin had greater decreases in pain compared to patients receiving a placebo⁵.

Conclusion

Although more clinical trials to assess the safety and efficacy of Ayurvedic herbal remedies and interventions would be desirable, we must remember that Ayurveda has been passed down through the centuries as a complete healing system, evolving to meet the needs of the time, and yet remaining committed to its core principles. Various cultures have drawn upon the ideas of Ayurvedic medicine, and it continues to thrive in both the East and the West.While science works to catch up on proving the scientific basis for treatments, Ayurveda’s long standing tradition and increasing popularity is a testament to its efficacy and innocuity. Further, new technologies are being developed to exploit these benefits. The most notorious example of this is the improvement in curcumin’s bioavailability using nanotechnology.

References

1. Chopra A, Doiphode VV. Ayurvedic medicine. Core concept, therapeutic principles, and current relevance. Medical Clinics of North America. 2002;86(1):75–89.

2. Conboy L, Edshteyn I, Garivaltis H. Ayurveda and Panchakarma: measuring the effects of a holistic health intervention. Scientific World Journal. 2009;9:272–280.

3. Ashish K Sharma*,I; Rajesh KumarII; Anurag MishraIII; Rajiv GuptaIII Problems associated with clinical trials of Ayurvedic medicines. Problemas associados com ensaios clínicos de medicamentos Ayurvédicos. Revista Brasileira de Farmacognosia. Rev. bras. farmacogn. vol.20 no.2 Curitiba Apr./May 2010

4. Vishal AA, Mishra A, Raychaudhuri SP. A double blind, randomized, placebo controlled clinical study evaluates the early efficacy of aflapin in subjects with osteoarthritis of knee. International Journal of Medical Sciences. 2011;8(7):615-622.