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Ayurveda:Voodoo or real medicine?. Amit Pahwa, MS-4 Tinsley Harrison Society University of Alabama School of Medicine October 11, 2005. Ayurvedic Medicine. “Ayus” = life, “Veda” = knowledge Evolved in India among Brahmin sages Focuses on life energies rather than symptoms Three doshas

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Ayurveda:Voodoo or real medicine?

Amit Pahwa, MS-4

Tinsley Harrison Society

University of Alabama School of Medicine

October 11, 2005


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Ayurvedic Medicine

  • “Ayus” = life, “Veda” = knowledge

  • Evolved in India among Brahmin sages

  • Focuses on life energies rather than symptoms

  • Three doshas

    • Vata

    • Pitta

    • Kapha


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Vata

  • “Vaayu” = to move things

  • Most influential dosha

  • Cell membrane transport, electrolyte balance, waste elimination, and cell division

  • Aggravated by dryness

  • Reduced by foods with building blocks


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Pitta

  • “Pinj” = to shine

  • Metabolism and molecules of energy

  • Body temperature maintenance, optic nerve impulses, feelings of hunger and thirst

  • Aggravated by heat

  • Reduced by “cooling it”


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Kapha

  • “Shlish” = that which holds things together

  • Provides structure and lubrication

  • Carbohydrates and polysaccharides, mucous, spinal fluid, and synovial fluid

  • Aggravated by sweet and fatty foods

  • Reduced by hot, dry, and light things


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Pathway to Imbalance

1. Accumulation

2. Aggravation

3. Spreading

4. Localization

5. Manifestation

6. Bursting


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Emblica officinalis

Terminalia chebula

Terminalia bellerica

Triphala


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Triphala

  • Kaur et al. examined in vitro cytotoxic and apoptotic activity of triphala

  • Studies were performed on various cell lines including mouse and human breast cancer as well as human prostrate cancer

  • NMR studies showed major component of Triphala is gallic acid



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Apoptotic Effects

Triphala concentration

Phase Contrast

Hoescht DNA


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Triphala

  • Sandhya et al compared effects of Triphala on normal versus cancer lines

  • Also looked at activity in vivo

  • Showed similar cytotoxic and apoptotic activity on cancer cell lines but insignificant effects on normal cells

  • Elucidated possible mechanism with quantification of ROS


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Normal

Cancer

Triphala

Dose dependent cytotoxicity of normal versus cancer cells

Apoptosis of normal versus human breast cancer after Triphala


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Triphala

Tumor growth volume of mouse thymic lymphoma after 40 mg/kg of Triphala

Apoptosis percentage in control versus treated excised thymic lymphoma


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Salacia reticulata

  • Belongs to family of plants used by Ayurvedics for diabetes

  • Diabetics drank water left overnight in a mug made from the plants root

  • Studies have shown that S. reticulata has two compounds (salacinol and kotalanol) which both inhibit alpha-glucosidase



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Salacia reticulata RCT

  • Jayawardena et al conducted cross over double blind RCT

  • Recruited diabetics using the combination of sulfonylurea/metformin

  • Study population was split into two groups. Each group received placebo for 3 months and S. reticulata tea for 3 months in addition to normal treatment


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Salacia reticulta RCT

  • Mean HgbA1c was lower during three month treatment period compared to the placebo period

  • Mean dose of sulfonylurea lower in treatment period

  • Adverse effect rates similar in both groups

  • No changes in liver enzymes, serum creatinine, or hematological indices



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CAM: Economic Impact

  • 1990: 427 million CAM visits

  • 1997: 629 million CAM visits

  • Exceeded visits to U.S. physicians

  • 1997: $27 billion out-of-pocket expense


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CAM: Participants

  • Commonly used therapies

    • Spiritual healing or prayer (14%)

    • Herbal medicine (10%)

    • Chiropractic therapies (8%)


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CAM: Economic Impact

  • NCCAM research budget

    • 1992: $2 million

    • 1999: $50 million

    • 2003: $114 million


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Summary

  • Ayurvedic herbs have physiological effects

  • More patients using CAM in addition to traditional Western therapy without their doctors’ knowledge

  • As future PCP, we need to understand the effects of CAM in combination with Western therapy


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References

  • Hankey, Ayurvedic Physiology and Etiology: Ayurvedo Ameritnaam. The Doshas and Their Functioning in Terms of Contemporary Biology and Physical Chemistry. The Journal of Alternative and Complementary Medicine. 2001, 7: 567-574.

  • History of Traditional Indian Medicine. http://www.mic.ki.se/India.html

  • The National Institute of Ayurvedic Medicine. http://niam.com/corp-web/index.htm

  • The Wonders of Triphala:Ayurvedic Formula for Internal Purification. http://www.planetherbs.com/articles/triphala.html

  • R.K. Mishra Triphala – Renowned Ayurvedic Remed. http://www.naturalhealthweb.com/articles/mishra14.html

  • S. Kaur, H. Michael. S. Arora, P.L. Harkonen, Subodh Kumar. The in vitro cytotoxic and apoptotic activity of Triphala – an Indian herbal drug. Journal of Ethnopharmacology. 2005 Feb 10;97(1):15-20

  • T. Sandya, K.M. Lathika, B.N. Pandey, K.P. Mishra. Potential of traditional ayurvedic formulation, Triphala, as a novel anticancer drug. Cancer Letters. 2005 May 14.

  • A. Ghavami, B.D. Johnston, and B.M. Pinto. A New Class of Glycosidase Inhibitor: Synthesis of Salacinol and its Stereoisomers. J. Org. Chem. 2001 Apr 6;66(7):2312-7

  • M.H.S. Jayawardena. N.M.W. de Alwis, V. Hettigoda, D.J.S. Fernando. A Double Blind Randomized Placebo Controlled Cross Over Study of a Herbal Preparation Containing Salacia reticulata in the Treatment of Type 2 Diabetes. Journal of Ethnopharmacology. 2005 Feb 28;97(2):215-8.


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Acknowledgements

Dr. Sharmila Makhija

Dr. Jason Hartig

Dr. Akhil Maheshwari


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