Ayurveda
***Disclaimer: This blog is not meant to be used as legal or medical advice. It is written as my person perspective on how medical professionals could blend western medicine with other modalities***
Ayurveda is the tradition of medicine that stems from ancient India. As I mentioned in a previous post, there is an emphasis on one's dosha which is determined by body shape, activity, personality, and attitude. Interventions are often tailored to the patient's dosha. The tradition covers many aspects of medicine including surgery, but upholds the value of preventative medicine, and views strength as the ability to endure extremes. Yoga is another big part of Ayurveda worth it's own blog post. In this post, I'm going to focus on the herbs associated with Ayurvedic medicine.
Because this is such a broad sweeping modality, it is difficult to define everything it should or should not be used for. Like my recent post on aromatherapy, this is a subject worth coming back to regularly. On that note, more data comes out all the time and most of it is positive!
Unfortunately for now, there is not a lot of strong evidence we can base recommendations on. I'd like to talk about why that is for a minute. Like many other complementary and alternative medicine (CAM), it's difficult to produce a strong clinical trial. In Ayurveda, they use very unique and specific herbs to treat the individual patient. What would a placebo look like? How do you find patients similar enough that they all would get the same herbs as treatment? Like my post on Applied Kinesiology, there is a diagnostic part of Ayurveda that makes things difficult to test against traditional western medicine. How do we account or adjust for dosha?
Nevertheless, doctors who are passionate about Ayurveda press forward as best they can. I found two studies that have the traditional herbs formed into single dose capsules. This allows for the possibility of a placebo and blinding. However, both trials are small and conducted in India, so it's difficult to extend results to other populations. But like I said before, the success of these trials is promising. I hope the researchers continue with their work in a way that opens doors here in the US.
Sharma et al studied pre-diabetic patients. They were careful to select patients of the same dosha, so they all were to receive the same specific treatment. Another remarkable feature of this trial is that of the 50 participants, they had 100% completion of the trial by all patients. One of the reasons they attribute this to is that the herbal remedy had no reported side effects. This may sound miraculous for patients who have suffered the stomach upset of metformin. The trial was careful to stratify the randomized groups to be as evenly matched as they could. With such small numbers to work with, it's difficult to say that the one or two patient differences had an influence on the results. Although both arms of the study showed improvement in signs and symptoms, there was statistic difference in favor of the Ayurvedic intervention. This deserves a stronger trial - if one can be afforded.
Suresh et al found similar results with urolithiasis patients. Again, it was a small trial, but they had a capsule product. This allows for placebo and blinding. There was no mention of dosha in this trial. I don't know if that means it is irrelevant or simply implied by the regimen. There was also no mention of stratification, so it's possible that some other patient factor played a role in the results. They did find that the kidney stones (4-9mm size) shrank significantly in the treatment arm as compared to the placebo arm. Reported symptoms decreased more significantly, and expelled stones were greater in the treatment arm as well. This demonstrates significant promise and should be looked at further.
As for my recommendation, there is still not enough solid evidence to suggest Ayurveda will work for all patients. However, there is a lot of promising data out there. I think if a patient is looking for more ideas to maintain good health and they're willing to try Ayurvedic medicine, it might be worth recommending. Ayurvedic practitioners in your area might be more easily found through your local yoga centers.
References:
Sharma RK, Patki PS. Double-blind, placebo-controlled clinical evaluation of an Ayurvedic formulation (GlucoCare capsules) in non-insulin dependent diabetes mellitus. J Ayurveda Integr Med. 2010;1(1):45–51. doi:10.4103/0975-9476.59827
Because this is such a broad sweeping modality, it is difficult to define everything it should or should not be used for. Like my recent post on aromatherapy, this is a subject worth coming back to regularly. On that note, more data comes out all the time and most of it is positive!
Unfortunately for now, there is not a lot of strong evidence we can base recommendations on. I'd like to talk about why that is for a minute. Like many other complementary and alternative medicine (CAM), it's difficult to produce a strong clinical trial. In Ayurveda, they use very unique and specific herbs to treat the individual patient. What would a placebo look like? How do you find patients similar enough that they all would get the same herbs as treatment? Like my post on Applied Kinesiology, there is a diagnostic part of Ayurveda that makes things difficult to test against traditional western medicine. How do we account or adjust for dosha?Nevertheless, doctors who are passionate about Ayurveda press forward as best they can. I found two studies that have the traditional herbs formed into single dose capsules. This allows for the possibility of a placebo and blinding. However, both trials are small and conducted in India, so it's difficult to extend results to other populations. But like I said before, the success of these trials is promising. I hope the researchers continue with their work in a way that opens doors here in the US.
Sharma et al studied pre-diabetic patients. They were careful to select patients of the same dosha, so they all were to receive the same specific treatment. Another remarkable feature of this trial is that of the 50 participants, they had 100% completion of the trial by all patients. One of the reasons they attribute this to is that the herbal remedy had no reported side effects. This may sound miraculous for patients who have suffered the stomach upset of metformin. The trial was careful to stratify the randomized groups to be as evenly matched as they could. With such small numbers to work with, it's difficult to say that the one or two patient differences had an influence on the results. Although both arms of the study showed improvement in signs and symptoms, there was statistic difference in favor of the Ayurvedic intervention. This deserves a stronger trial - if one can be afforded.
As for my recommendation, there is still not enough solid evidence to suggest Ayurveda will work for all patients. However, there is a lot of promising data out there. I think if a patient is looking for more ideas to maintain good health and they're willing to try Ayurvedic medicine, it might be worth recommending. Ayurvedic practitioners in your area might be more easily found through your local yoga centers.
References:
Sharma RK, Patki PS. Double-blind, placebo-controlled clinical evaluation of an Ayurvedic formulation (GlucoCare capsules) in non-insulin dependent diabetes mellitus. J Ayurveda Integr Med. 2010;1(1):45–51. doi:10.4103/0975-9476.59827
Suresh B. Patankar, A.M. Mujumdar, Fanthome Bernard, Phadke Supriya,
A 28 week, randomized, double-blind, placebo-controlled, parallel group study to evaluate the safety and efficacy of an herbal formulation in patients with renal calculi,
Journal of Ayurveda and Integrative Medicine, 2019, ISSN 0975-9476,
https://doi.org/10.1016/j.jaim.2018.08.001.
A 28 week, randomized, double-blind, placebo-controlled, parallel group study to evaluate the safety and efficacy of an herbal formulation in patients with renal calculi,
Journal of Ayurveda and Integrative Medicine, 2019, ISSN 0975-9476,
https://doi.org/10.1016/j.jaim.2018.08.001.
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