| Ayurveda December 18, 2005 |
What is Ayurveda?
Ayurveda is a system of medicine that originated in India several thousand years
ago. The term Ayurveda combines two Sanskrit words--ayur, which means life, and
veda, which means science or knowledge. Ayurveda means "the science of life."
Ayurveda is considered a type of CAM and a whole medical system. Ayurveda is
based on theories of health and illness and on ways to prevent, manage, or treat
health problems. Ayurveda aims to integrate and balance the body, mind, and
spirit (thus, some view it as "holistic"). This balance is believed to lead to
contentment and health, and to help prevent illness. However, Ayurveda also
proposes treatments for specific health problems, whether they are physical or
mental. A chief aim of Ayurveda is to cleanse the body of substances that can
cause disease to help reestablish harmony and balance.
Ayurveda is based on ideas from Hinduism. Some Ayurvedic ideas also evolved
from ancient Persian thoughts about health and healing. Many Ayurvedic practices
were handed down by word of mouth and were used before there were written
records. Two ancient books, written in Sanskrit on palm leaves more than 2,000
years ago, are thought to be the first texts on Ayurveda--Caraka Samhita and
Susruta Samhita. They cover many topics, including: pathology (the causes of
illness), diagnosis, treatment, lifestyle, ethics and philosophy.
What major beliefs underlie Ayurveda?
Two major beliefs in Ayurveda that pertain to health and disease:
Interconnectedness-Ideas about the relationships among people, their health,
and the universe form the basis for how Ayurvedic practitioners think about
problems that affect health. (1) All things in the universe (both living and nonliving)
are joined together. (2) Every human being contains elements that can be found
in the universe. (3) All people are born in a state of balance within themselves and
in relation to the universe. (4) This state of balance is disrupted by the processes
of life. Disruptions can be physical, emotional, spiritual, or a combination.
Imbalances weaken the body and make the person susceptible to disease. (5)
Health will be good if one's interaction with the immediate environment is effective
and wholesome. (6) Disease arises when a person is out of harmony with the
universe.
Constitution and Health-Ayurveda also has some basic beliefs about the body's
constitution. "Constitution" refers to a person's general health, how likely he is to
become out of balance, and his ability to resist and recover from disease or other
health problems.: (1) The constitution is called the prakriti. The prakriti is thought
to be a unique combination of physical and psychological characteristics and the
way the body functions. It is influenced by such factors as digestion and how the
body deals with waste products. The prakriti is believed to be unchanged over a
person's lifetime. (2) Three qualities called doshas form important characteristics of
the constitution, and control the activities of the body. Practitioners of Ayurveda
call the doshas by their original Sanskrit names: vata, pitta, and kapha. It is also
believed that: Each dosha is made up of one or two of the five basic elements:
space, air, fire, water, and earth. Each dosha has a particular relationship to body
functions and can be upset for different reasons. A person has her own balance of
the three doshas, although one dosha usually is prominent. Doshas are constantly
being formed and reformed by food, activity, and bodily processes. Each dosha is
associated with a certain body type, a certain personality type, and a greater
chance of certain types of health problems. An imbalance in a dosha will produce
symptoms that are related to that dosha and are different from symptoms of an
imbalance in another dosha. Imbalances may be caused by an unhealthy lifestyle
or diet; too much or too little mental and physical exertion; or not being properly
protected from the weather, chemicals, or germs.
In summary, it is believed that a person's chances of developing certain types of
diseases are related to the way doshas are balanced, the state of the physical
body, and mental or lifestyle factors.
What is each dosha like?
Here are some important beliefs about the three doshas:
* The vata dosha is thought to be a combination of the elements space and air. It
is considered the most powerful dosha because it controls very basic body
processes such as cell division, the heart, breathing, and the mind. Vata can be
thrown out of balance by, for example, staying up late at night, eating dry fruit, or
eating before the previous meal is digested. People with vata as their main dosha
are thought to be especially susceptible to skin, neurological, and mental diseases.
* The pitta dosha represents the elements fire and water. Pitta is said to control
hormones and the digestive system. When pitta is out of balance, a person may
experience negative emotions (such as hostility and jealousy) and have physical
symptoms (such as heartburn within 2 or 3 hours of eating). Pitta is upset by, for
example, eating spicy or sour food; being angry, tired, or fearful; or spending too
much time in the sun. People with a predominantly pitta constitution are thought
to be susceptible to heart disease and arthritis.
* The kapha dosha combines the elements water and earth. Kapha is thought to
help keep up strength and immunity and to control growth. An imbalance in the
kapha dosha may cause nausea immediately after eating. Kapha is aggravated by,
for example, sleeping during the daytime, eating too many sweet foods, eating
after one is full, and eating and drinking foods and beverages with too much salt
and water (especially in the springtime). Those with a predominant kapha dosha
are thought to be vulnerable to diabetes, gallbladder problems, stomach ulcers,
and respiratory illnesses such as asthma.
How does an Ayurvedic practitioner decide on a person's dosha balance?
Practitioners seek to determine the primary dosha and the balance of doshas
through questions that allow them to become very familiar with the patient. Not all
questions have to do with particular symptoms. The practitioner will:
* Ask about diet, behavior, lifestyle practices, and the reasons for the most recent
illness and symptoms the patient had
* Carefully observe such physical characteristics as teeth, skin, eyes, and weight
* Take a person's pulse, because each dosha is thought to make a particular kind
of pulse
How else does an Ayurvedic practitioner work with the patient at first?
In addition to questioning, Ayurvedic practitioners use observation, touch,
therapies, and advising. During an examination, the practitioner checks the
patient's urine, stool, tongue, bodily sounds, eyes, skin, and overall appearance.
He will also consider the person's digestion, diet, personal habits, and resilience
(ability to recover quickly from illness or setbacks). As part of the effort to find out
what is wrong, the practitioner may prescribe some type of treatment. The
treatment is generally intended to restore the balance of one particular dosha. If
the patient seems to improve as a result, the practitioner will provide additional
treatments intended to help balance that dosha.
How does an Ayurvedic practitioner treat health problems?
The practitioner will develop a treatment plan and may work with people who
know the patient well and can help. This helps the patient feel emotionally
supported and comforted, which is considered important.
Practitioners expect patients to be active participants in their treatment, because
many Ayurvedic treatments require changes in diet, lifestyle, and habits. In
general, treatments use several approaches, often more than one at a time. The
goals of treatment are to:
* Eliminate impurities. A process called panchakarma is intended to be cleansing; it
focuses on the digestive tract and the respiratory system. For the digestive tract,
cleansing may be done through enemas, fasting, or special diets. Some patients
receive medicated oils through a nasal spray or inhaler. This part of treatment is
believed to eliminate worms or other agents thought to cause disease.
* Reduce symptoms. The practitioner may suggest various options, including yoga
exercises, stretching, breathing exercises, meditation, and lying in the sun. The
patient may take herbs (usually several), often with honey, with the intent to
improve digestion, reduce fever, and treat diarrhea. Sometimes foods such as
lentil beans or special diets are also prescribed. Very small amounts of metal and
mineral preparations also may be given, such as gold or iron. Careful control of
these materials is intended to protect the patient from harm.
* Reduce worry and increase harmony in the patient's life. The patient may be
advised to seek nurturing and peacefulness through yoga, meditation, exercise, or
other techniques.
* Help eliminate both physical and psychological problems. Vital points therapy
and/or massage may be used to reduce pain, lessen fatigue, or improve
circulation. Ayurveda proposes that there are 107 "vital points" in the body where
life energy is stored, and that these points may be massaged to improve health.
Other types of Ayurvedic massage use medicinal oils.
How are plant products used in Ayurvedic treatment?
In Ayurveda, the distinction between food and medicine is not as clear as in
Western medicine. Food and diet are important components of Ayurvedic practice,
and so there is a heavy reliance on treatments based on herbs and plants, oils
(such as sesame oil), common spices (such as turmeric), and other naturally
occurring substances.
Currently, some 5,000 products are included in the "pharmacy" of Ayurvedic
treatments. In recent years, the Indian government has collected and published
safety information on a small number of them. Historically, plant compounds have
been grouped into categories according to their effects. For example, some
compounds are thought to heal, promote vitality, or relieve pain. The compounds
are described in many texts prepared through national medical agencies in India.
Below are a few examples of how some botanicals (plants and their products)
have been or are currently used in treatment. In some cases, these may be mixed
with metals.
* The spice turmeric has been used for various diseases and conditions, including
rheumatoid arthritis, Alzheimer's disease, and wound healing.
* A mixture (Arogyawardhini) of sulfur, iron, powdered dried fruits, tree root, and
other substances has been used to treat problems of the liver.
* An extract from the resin from a tropical shrub (Commiphora mukul, or guggul)
has been used for a variety of illnesses. In recent years, there has been research
interest in its use to possibly lower cholesterol.
In the United States, how are Ayurvedic practitioners trained and certified?
Practitioners of Ayurveda in the United States have various types of training. Some
are trained in the Western medical tradition (such as medical or nursing school)
and then study Ayurveda. Others may have training in naturopathic medicine, a
whole medical system, either before or after their Ayurvedic training. Many study in
India, where there are more than 150 undergraduate and more than 30
postgraduate colleges for Ayurveda. This training can take up to 5 years.
Students who receive all of their Ayurvedic training in India can earn either a
bachelor's or doctoral degree. After graduation, they may go to the United States
or other countries to practice. Some practitioners are trained in a particular aspect
of Ayurvedic practice--for example, massage or meditation--but not in others, such
as preparing botanical treatments.
The United States has no national standard for certifying or training Ayurvedic
practitioners, although a few states have approved Ayurvedic schools. Some
Ayurvedic professional organizations are collaborating to develop licensing
requirements.
Consumers interested in Ayurveda should be aware that not every practitioner
offering services or treatments called "Ayurvedic" has been trained in an Ayurvedic
medical school. Services offered at spas and salons, for example, often fall into
this category. If you are seeking Ayurvedic medical treatment, it is important to
ask about the practitioner's training and experience (see the NCCAM fact sheet
"Selecting a CAM Practitioner").
Does Ayurveda work?
Ayurveda includes many types of therapies and is used for many health issues.
However, very few rigorous, controlled scientific studies have been carried out on
Ayurvedic practices. In India, the government began systematic research in 1969,
and the work continues.
Are there concerns about Ayurvedic medicine?
Health officials in India and other countries have expressed concerns about certain
Ayurvedic practices, especially those involving herbs, metals, minerals, or other
materials. Here are some of those concerns:
* Ayurvedic medications have the potential to be toxic. Many materials used in
them have not been thoroughly studied in either Western or Indian research. In
the United States, Ayurvedic medications are regulated as dietary supplements. As
such, they are not required to meet the rigorous standards for conventional
medicines. An American study published in 2004 found that of 70 Ayurvedic
remedies purchased over-the-counter (all had been manufactured in South Asia),
14 (one-fifth) contained lead, mercury, and/or arsenic at levels that could be
harmful. Also in 2004, the Centers for Disease Control and Prevention received 12
reports of lead poisoning linked to the use of Ayurvedic medications.
* Most Ayurvedic medications consist of combinations of herbs and other
medicines, so it can be challenging to know which ones are having an effect and
why.
* Whenever two or more medications are used, there is the potential for them to
interact with each other. As a result, the effectiveness of at least one may
increase or decrease in the body. For example, it is known that guggul lipid (an
extract of guggul) may increase the activity of aspirin, which could lead to bleeding
problems.
* Most clinical trials of Ayurvedic approaches have been small, had problems with
research designs, lacked appropriate control groups, or had other issues that
affected how meaningful the results were.
Here are some of the herbs used in Ayurvedic medicine: Ashwagandha,
Boswellia, Coleus, Ginger, Gotu Kola, Guggul, Gymnema, Licorice, Myrrh,
Phyllanthus, Picrorhiza, Turmeric and Tylophora.
Is NCCAM supporting any studies on Ayurveda?
Yes, NCCAM supports studies in this area. For example:
* Researchers at the University of Pennsylvania School of Medicine tested the
effects of guggul lipid on high cholesterol. Over the 6-month period of this study,
they did not find that adults with high cholesterol showed any improvement in
cholesterol levels. In fact, the levels of low-density lipoproteins (the "bad"
cholesterol) increased slightly in some people in the group taking guggul. In
addition, some in the guggul lipid group developed a skin rash. This team is
conducting further studies on herbal therapies used in Ayurveda for cardiovascular
conditions, including curcuminoids (substances found in the root of the plant
turmeric).
* At the NCCAM-supported Center for Phytomedicine Research at the University of
Arizona, scientists are investigating three botanicals (ginger, turmeric, and
boswellia) used in Ayurvedic medicine to treat inflammatory disorders. They are
seeking to better understand these botanicals and determine whether they might
be useful in treating arthritis and asthma.
* A compound from a plant called Mucuna pruriens, also known as cowhage, is
being studied at the Cleveland Clinic Foundation. The research team is
investigating the compound's potential to prevent or lessen the severe, often
disabling side effects that people with Parkinson's disease experience from
prolonged treatment with conventional drugs.
References
Sources were drawn primarily from the peer-reviewed medical and scientific literature in
English indexed in the National Library of Medicine's PubMed database.
Barnes PM, Powell-Griner E, McFann K, Nahin RL. Complementary and alternative medicine
use among adults: United States, 2002. CDC Advance Data Report #343. 2004.
Bhatt AD. Clinical research on Ayurvedic therapies: myths, realities, and challenges. Journal
of the Associated Physicians of India. 2001;49:558-562.
Centers for Disease Control and Prevention. Lead poisoning associated with Ayurvedic
medications--five states, 2000-2003. Morbidity and Mortality Weekly Report.
2004;53(26):582-584.
Centers for Disease Control and Prevention. Agency for Toxic Substances and Disease
Registry. Lead Toxicity: Physiologic Effects. Agency for Toxic Substances and Disease
Registry Web site. Accessed on September 1, 2005.
Chopra A, Doiphode VV. Ayurvedic medicine--core-concept, therapeutic principles, and current
relevance. Medical Clinics of North America. 2002;86(1):75-88.
Courson WA. State licensure and Ayurvedic practice: planning for the future, managing the
present. Newsletter of the National Ayurvedic Medical Association [online journal]. Autumn
2003. Accessed on February 22, 2005.
Dodds JA. Know your CAM provider. Bulletin of the American Academy of Orthopaedic
Surgeons/American Association of Orthopaedic Surgeons [online journal]. December 2002.
Accessed on September 12, 2005.
Fugh-Berman A. Herb-drug interactions. Lancet. 2000;355(9198):134-138.
Gogtay NJ, Bhatt HA, Dalvi SS, et al. The use and safety of non-allopathic Indian medicines.
Drug Safety. 2002;25(14):1005-1019.
Lodha R, Bagga A. Traditional Indian systems of medicine. Annals of the Academy of
Medicine, Singapore. 2000;29(1):37-41.
Mishra L, Singh BB, Dagenais S. Healthcare and disease management in Ayurveda.
Alternative Therapies in Health and Medicine. 2001;7(2):44-50.
Saper RB, Kales SN, Paquin J, et al. Heavy metal content of Ayurvedic herbal medicine
products. Journal of the American Medical Association. 2004;292(23):2868-2873.
Shankar K, Liao LP. Traditional systems of medicine. Physical Medicine and Rehabilitation
Clinics of North America. 2004;15:725-747.
Subbarayappa BV. The roots of ancient medicine: an historical outline. Journal of Bioscience.
2001;26(2):135-144.
Szapary PO, Wolfe ML, Bloedon LT, et al. Guggulipid for the treatment of
hypercholesterolemia: a randomized controlled trial. Journal of the American Medical
Association. 2003;290(6):765-772.
Thompson Coon J, Ernst E. Herbs for serum cholesterol reduction: a systematic review.
Journal of Family Practice. 2003;52(6):468-478.
World Health Organization Regional Office for South-East Asia. Health and Behaviours Facts
and Figures--Conquering Depression. World Health Organization Regional Office for
South-East Asia Web site. Accessed on February 16, 2005.
Ayurveda is a system of medicine that originated in India several thousand years
ago. The term Ayurveda combines two Sanskrit words--ayur, which means life, and
veda, which means science or knowledge. Ayurveda means "the science of life."
Ayurveda is considered a type of CAM and a whole medical system. Ayurveda is
based on theories of health and illness and on ways to prevent, manage, or treat
health problems. Ayurveda aims to integrate and balance the body, mind, and
spirit (thus, some view it as "holistic"). This balance is believed to lead to
contentment and health, and to help prevent illness. However, Ayurveda also
proposes treatments for specific health problems, whether they are physical or
mental. A chief aim of Ayurveda is to cleanse the body of substances that can
cause disease to help reestablish harmony and balance.
Ayurveda is based on ideas from Hinduism. Some Ayurvedic ideas also evolved
from ancient Persian thoughts about health and healing. Many Ayurvedic practices
were handed down by word of mouth and were used before there were written
records. Two ancient books, written in Sanskrit on palm leaves more than 2,000
years ago, are thought to be the first texts on Ayurveda--Caraka Samhita and
Susruta Samhita. They cover many topics, including: pathology (the causes of
illness), diagnosis, treatment, lifestyle, ethics and philosophy.
What major beliefs underlie Ayurveda?
Two major beliefs in Ayurveda that pertain to health and disease:
Interconnectedness-Ideas about the relationships among people, their health,
and the universe form the basis for how Ayurvedic practitioners think about
problems that affect health. (1) All things in the universe (both living and nonliving)
are joined together. (2) Every human being contains elements that can be found
in the universe. (3) All people are born in a state of balance within themselves and
in relation to the universe. (4) This state of balance is disrupted by the processes
of life. Disruptions can be physical, emotional, spiritual, or a combination.
Imbalances weaken the body and make the person susceptible to disease. (5)
Health will be good if one's interaction with the immediate environment is effective
and wholesome. (6) Disease arises when a person is out of harmony with the
universe.
Constitution and Health-Ayurveda also has some basic beliefs about the body's
constitution. "Constitution" refers to a person's general health, how likely he is to
become out of balance, and his ability to resist and recover from disease or other
health problems.: (1) The constitution is called the prakriti. The prakriti is thought
to be a unique combination of physical and psychological characteristics and the
way the body functions. It is influenced by such factors as digestion and how the
body deals with waste products. The prakriti is believed to be unchanged over a
person's lifetime. (2) Three qualities called doshas form important characteristics of
the constitution, and control the activities of the body. Practitioners of Ayurveda
call the doshas by their original Sanskrit names: vata, pitta, and kapha. It is also
believed that: Each dosha is made up of one or two of the five basic elements:
space, air, fire, water, and earth. Each dosha has a particular relationship to body
functions and can be upset for different reasons. A person has her own balance of
the three doshas, although one dosha usually is prominent. Doshas are constantly
being formed and reformed by food, activity, and bodily processes. Each dosha is
associated with a certain body type, a certain personality type, and a greater
chance of certain types of health problems. An imbalance in a dosha will produce
symptoms that are related to that dosha and are different from symptoms of an
imbalance in another dosha. Imbalances may be caused by an unhealthy lifestyle
or diet; too much or too little mental and physical exertion; or not being properly
protected from the weather, chemicals, or germs.
In summary, it is believed that a person's chances of developing certain types of
diseases are related to the way doshas are balanced, the state of the physical
body, and mental or lifestyle factors.
What is each dosha like?
Here are some important beliefs about the three doshas:
* The vata dosha is thought to be a combination of the elements space and air. It
is considered the most powerful dosha because it controls very basic body
processes such as cell division, the heart, breathing, and the mind. Vata can be
thrown out of balance by, for example, staying up late at night, eating dry fruit, or
eating before the previous meal is digested. People with vata as their main dosha
are thought to be especially susceptible to skin, neurological, and mental diseases.
* The pitta dosha represents the elements fire and water. Pitta is said to control
hormones and the digestive system. When pitta is out of balance, a person may
experience negative emotions (such as hostility and jealousy) and have physical
symptoms (such as heartburn within 2 or 3 hours of eating). Pitta is upset by, for
example, eating spicy or sour food; being angry, tired, or fearful; or spending too
much time in the sun. People with a predominantly pitta constitution are thought
to be susceptible to heart disease and arthritis.
* The kapha dosha combines the elements water and earth. Kapha is thought to
help keep up strength and immunity and to control growth. An imbalance in the
kapha dosha may cause nausea immediately after eating. Kapha is aggravated by,
for example, sleeping during the daytime, eating too many sweet foods, eating
after one is full, and eating and drinking foods and beverages with too much salt
and water (especially in the springtime). Those with a predominant kapha dosha
are thought to be vulnerable to diabetes, gallbladder problems, stomach ulcers,
and respiratory illnesses such as asthma.
How does an Ayurvedic practitioner decide on a person's dosha balance?
Practitioners seek to determine the primary dosha and the balance of doshas
through questions that allow them to become very familiar with the patient. Not all
questions have to do with particular symptoms. The practitioner will:
* Ask about diet, behavior, lifestyle practices, and the reasons for the most recent
illness and symptoms the patient had
* Carefully observe such physical characteristics as teeth, skin, eyes, and weight
* Take a person's pulse, because each dosha is thought to make a particular kind
of pulse
How else does an Ayurvedic practitioner work with the patient at first?
In addition to questioning, Ayurvedic practitioners use observation, touch,
therapies, and advising. During an examination, the practitioner checks the
patient's urine, stool, tongue, bodily sounds, eyes, skin, and overall appearance.
He will also consider the person's digestion, diet, personal habits, and resilience
(ability to recover quickly from illness or setbacks). As part of the effort to find out
what is wrong, the practitioner may prescribe some type of treatment. The
treatment is generally intended to restore the balance of one particular dosha. If
the patient seems to improve as a result, the practitioner will provide additional
treatments intended to help balance that dosha.
How does an Ayurvedic practitioner treat health problems?
The practitioner will develop a treatment plan and may work with people who
know the patient well and can help. This helps the patient feel emotionally
supported and comforted, which is considered important.
Practitioners expect patients to be active participants in their treatment, because
many Ayurvedic treatments require changes in diet, lifestyle, and habits. In
general, treatments use several approaches, often more than one at a time. The
goals of treatment are to:
* Eliminate impurities. A process called panchakarma is intended to be cleansing; it
focuses on the digestive tract and the respiratory system. For the digestive tract,
cleansing may be done through enemas, fasting, or special diets. Some patients
receive medicated oils through a nasal spray or inhaler. This part of treatment is
believed to eliminate worms or other agents thought to cause disease.
* Reduce symptoms. The practitioner may suggest various options, including yoga
exercises, stretching, breathing exercises, meditation, and lying in the sun. The
patient may take herbs (usually several), often with honey, with the intent to
improve digestion, reduce fever, and treat diarrhea. Sometimes foods such as
lentil beans or special diets are also prescribed. Very small amounts of metal and
mineral preparations also may be given, such as gold or iron. Careful control of
these materials is intended to protect the patient from harm.
* Reduce worry and increase harmony in the patient's life. The patient may be
advised to seek nurturing and peacefulness through yoga, meditation, exercise, or
other techniques.
* Help eliminate both physical and psychological problems. Vital points therapy
and/or massage may be used to reduce pain, lessen fatigue, or improve
circulation. Ayurveda proposes that there are 107 "vital points" in the body where
life energy is stored, and that these points may be massaged to improve health.
Other types of Ayurvedic massage use medicinal oils.
How are plant products used in Ayurvedic treatment?
In Ayurveda, the distinction between food and medicine is not as clear as in
Western medicine. Food and diet are important components of Ayurvedic practice,
and so there is a heavy reliance on treatments based on herbs and plants, oils
(such as sesame oil), common spices (such as turmeric), and other naturally
occurring substances.
Currently, some 5,000 products are included in the "pharmacy" of Ayurvedic
treatments. In recent years, the Indian government has collected and published
safety information on a small number of them. Historically, plant compounds have
been grouped into categories according to their effects. For example, some
compounds are thought to heal, promote vitality, or relieve pain. The compounds
are described in many texts prepared through national medical agencies in India.
Below are a few examples of how some botanicals (plants and their products)
have been or are currently used in treatment. In some cases, these may be mixed
with metals.
* The spice turmeric has been used for various diseases and conditions, including
rheumatoid arthritis, Alzheimer's disease, and wound healing.
* A mixture (Arogyawardhini) of sulfur, iron, powdered dried fruits, tree root, and
other substances has been used to treat problems of the liver.
* An extract from the resin from a tropical shrub (Commiphora mukul, or guggul)
has been used for a variety of illnesses. In recent years, there has been research
interest in its use to possibly lower cholesterol.
In the United States, how are Ayurvedic practitioners trained and certified?
Practitioners of Ayurveda in the United States have various types of training. Some
are trained in the Western medical tradition (such as medical or nursing school)
and then study Ayurveda. Others may have training in naturopathic medicine, a
whole medical system, either before or after their Ayurvedic training. Many study in
India, where there are more than 150 undergraduate and more than 30
postgraduate colleges for Ayurveda. This training can take up to 5 years.
Students who receive all of their Ayurvedic training in India can earn either a
bachelor's or doctoral degree. After graduation, they may go to the United States
or other countries to practice. Some practitioners are trained in a particular aspect
of Ayurvedic practice--for example, massage or meditation--but not in others, such
as preparing botanical treatments.
The United States has no national standard for certifying or training Ayurvedic
practitioners, although a few states have approved Ayurvedic schools. Some
Ayurvedic professional organizations are collaborating to develop licensing
requirements.
Consumers interested in Ayurveda should be aware that not every practitioner
offering services or treatments called "Ayurvedic" has been trained in an Ayurvedic
medical school. Services offered at spas and salons, for example, often fall into
this category. If you are seeking Ayurvedic medical treatment, it is important to
ask about the practitioner's training and experience (see the NCCAM fact sheet
"Selecting a CAM Practitioner").
Does Ayurveda work?
Ayurveda includes many types of therapies and is used for many health issues.
However, very few rigorous, controlled scientific studies have been carried out on
Ayurvedic practices. In India, the government began systematic research in 1969,
and the work continues.
Are there concerns about Ayurvedic medicine?
Health officials in India and other countries have expressed concerns about certain
Ayurvedic practices, especially those involving herbs, metals, minerals, or other
materials. Here are some of those concerns:
* Ayurvedic medications have the potential to be toxic. Many materials used in
them have not been thoroughly studied in either Western or Indian research. In
the United States, Ayurvedic medications are regulated as dietary supplements. As
such, they are not required to meet the rigorous standards for conventional
medicines. An American study published in 2004 found that of 70 Ayurvedic
remedies purchased over-the-counter (all had been manufactured in South Asia),
14 (one-fifth) contained lead, mercury, and/or arsenic at levels that could be
harmful. Also in 2004, the Centers for Disease Control and Prevention received 12
reports of lead poisoning linked to the use of Ayurvedic medications.
* Most Ayurvedic medications consist of combinations of herbs and other
medicines, so it can be challenging to know which ones are having an effect and
why.
* Whenever two or more medications are used, there is the potential for them to
interact with each other. As a result, the effectiveness of at least one may
increase or decrease in the body. For example, it is known that guggul lipid (an
extract of guggul) may increase the activity of aspirin, which could lead to bleeding
problems.
* Most clinical trials of Ayurvedic approaches have been small, had problems with
research designs, lacked appropriate control groups, or had other issues that
affected how meaningful the results were.
Here are some of the herbs used in Ayurvedic medicine: Ashwagandha,
Boswellia, Coleus, Ginger, Gotu Kola, Guggul, Gymnema, Licorice, Myrrh,
Phyllanthus, Picrorhiza, Turmeric and Tylophora.
Is NCCAM supporting any studies on Ayurveda?
Yes, NCCAM supports studies in this area. For example:
* Researchers at the University of Pennsylvania School of Medicine tested the
effects of guggul lipid on high cholesterol. Over the 6-month period of this study,
they did not find that adults with high cholesterol showed any improvement in
cholesterol levels. In fact, the levels of low-density lipoproteins (the "bad"
cholesterol) increased slightly in some people in the group taking guggul. In
addition, some in the guggul lipid group developed a skin rash. This team is
conducting further studies on herbal therapies used in Ayurveda for cardiovascular
conditions, including curcuminoids (substances found in the root of the plant
turmeric).
* At the NCCAM-supported Center for Phytomedicine Research at the University of
Arizona, scientists are investigating three botanicals (ginger, turmeric, and
boswellia) used in Ayurvedic medicine to treat inflammatory disorders. They are
seeking to better understand these botanicals and determine whether they might
be useful in treating arthritis and asthma.
* A compound from a plant called Mucuna pruriens, also known as cowhage, is
being studied at the Cleveland Clinic Foundation. The research team is
investigating the compound's potential to prevent or lessen the severe, often
disabling side effects that people with Parkinson's disease experience from
prolonged treatment with conventional drugs.
References
Sources were drawn primarily from the peer-reviewed medical and scientific literature in
English indexed in the National Library of Medicine's PubMed database.
Barnes PM, Powell-Griner E, McFann K, Nahin RL. Complementary and alternative medicine
use among adults: United States, 2002. CDC Advance Data Report #343. 2004.
Bhatt AD. Clinical research on Ayurvedic therapies: myths, realities, and challenges. Journal
of the Associated Physicians of India. 2001;49:558-562.
Centers for Disease Control and Prevention. Lead poisoning associated with Ayurvedic
medications--five states, 2000-2003. Morbidity and Mortality Weekly Report.
2004;53(26):582-584.
Centers for Disease Control and Prevention. Agency for Toxic Substances and Disease
Registry. Lead Toxicity: Physiologic Effects. Agency for Toxic Substances and Disease
Registry Web site. Accessed on September 1, 2005.
Chopra A, Doiphode VV. Ayurvedic medicine--core-concept, therapeutic principles, and current
relevance. Medical Clinics of North America. 2002;86(1):75-88.
Courson WA. State licensure and Ayurvedic practice: planning for the future, managing the
present. Newsletter of the National Ayurvedic Medical Association [online journal]. Autumn
2003. Accessed on February 22, 2005.
Dodds JA. Know your CAM provider. Bulletin of the American Academy of Orthopaedic
Surgeons/American Association of Orthopaedic Surgeons [online journal]. December 2002.
Accessed on September 12, 2005.
Fugh-Berman A. Herb-drug interactions. Lancet. 2000;355(9198):134-138.
Gogtay NJ, Bhatt HA, Dalvi SS, et al. The use and safety of non-allopathic Indian medicines.
Drug Safety. 2002;25(14):1005-1019.
Lodha R, Bagga A. Traditional Indian systems of medicine. Annals of the Academy of
Medicine, Singapore. 2000;29(1):37-41.
Mishra L, Singh BB, Dagenais S. Healthcare and disease management in Ayurveda.
Alternative Therapies in Health and Medicine. 2001;7(2):44-50.
Saper RB, Kales SN, Paquin J, et al. Heavy metal content of Ayurvedic herbal medicine
products. Journal of the American Medical Association. 2004;292(23):2868-2873.
Shankar K, Liao LP. Traditional systems of medicine. Physical Medicine and Rehabilitation
Clinics of North America. 2004;15:725-747.
Subbarayappa BV. The roots of ancient medicine: an historical outline. Journal of Bioscience.
2001;26(2):135-144.
Szapary PO, Wolfe ML, Bloedon LT, et al. Guggulipid for the treatment of
hypercholesterolemia: a randomized controlled trial. Journal of the American Medical
Association. 2003;290(6):765-772.
Thompson Coon J, Ernst E. Herbs for serum cholesterol reduction: a systematic review.
Journal of Family Practice. 2003;52(6):468-478.
World Health Organization Regional Office for South-East Asia. Health and Behaviours Facts
and Figures--Conquering Depression. World Health Organization Regional Office for
South-East Asia Web site. Accessed on February 16, 2005.
Popular
Supplements
Acetyl-L Carnitine
Acidophilus
Bladderwrack
Bilberry
Chromium
CLA
Cod Liver Oil
Coenzyme Q
Colostrum
Dandelion
EGCG
Echinacea
Eleuthero
Ellagic Acid
Eve. Primrose Oil
Fish Oil
Flaxseed
Garlic
Ginger
Ginseng
Ginkgo Biloba
Glucosamine
Gotu Kola
Guar Gum
Hyaluronic acid
Lecithin
Lycopene
Milk Thistle
Nattokinase
Passion Flower
Probiotics
Policosanol /
Polycosanol
Pycnogenol
Reishi / Lingzhi
Resveratrol
Rhodiola
Royal Jelly
Stevia
Whey
Xylitol
Supplements
Acetyl-L Carnitine
Acidophilus
Bladderwrack
Bilberry
Chromium
CLA
Cod Liver Oil
Coenzyme Q
Colostrum
Dandelion
EGCG
Echinacea
Eleuthero
Ellagic Acid
Eve. Primrose Oil
Fish Oil
Flaxseed
Garlic
Ginger
Ginseng
Ginkgo Biloba
Glucosamine
Gotu Kola
Guar Gum
Hyaluronic acid
Lecithin
Lycopene
Milk Thistle
Nattokinase
Passion Flower
Probiotics
Policosanol /
Polycosanol
Pycnogenol
Reishi / Lingzhi
Resveratrol
Rhodiola
Royal Jelly
Stevia
Whey
Xylitol