Ayurveda:Voodoo or real medicine?

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AyurvedaVoodoo 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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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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Triphala toxcitity
Plant extract Cell line 40 µg/ml 80 µg/ml 400 µg/ml
Terminalia bellerica S115 (mouse breast CA)
  MCF-7 (human breast CA)
  PC-3 (human prostrate CA)
  DU-145 (human prostrate CA)
         
Emblica officinalis S115
  MCF-7
  PC-3
  DU-145
       
         
Triphala S115
  MCF-7
  PC-3
  DU-145
         
Terminalia        
chebula S115
  MCF-7
  PC-3
  DU-145
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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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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
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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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WHY SHOULD I CARE?
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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 TriphalaAyurvedic 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
  1097(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 666(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
  2897(2)215-8.

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Acknowledgements
Dr. Sharmila Makhija
Dr. Jason Hartig
Dr. Akhil Maheshwari
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