Ayurvedic Medicine: An Introduction

Intr= oduction=20
= Key=20 Points=20
Background=20
Ayur= vedic=20 Medicine in India=20
Use = in the United States=20
U= nderlying=20 Concepts=20
= Treatment=20
Practitioner=20 Training and Certification=20
C= oncerns=20 About Ayurvedic Medications=20
Oth= er=20 Points To Consider About Using Ayurvedic Medicine=20
N= CCAM-Funded=20 Research=20
References=20
S= elected=20 References=20
Acknowledgments=20

Introduction

Ayurvedic medicine (also called Ayurveda) is one of the world's = oldest=20 medical systems. It originated in India and has evolved there over = thousands of=20 years. In the United States, Ayurvedic medicine is considered complementary and alternative medicineA = group of=20 diverse medical and health care systems, practices, and products that = are not=20 presently considered to be part of conventional medicine. Complementary = medicine=20 is used together with conventional medicine, and alternative medicine is = used in=20 place of conventional medicine. (CAM)=97more specifically, a = CAM whole medical systemA = complete system of=20 theory and practice that has evolved over time in different cultures and = apart=20 from conventional medicine. Examples of whole medical systems include=20 traditional Chinese medicine, Ayurvedic medicine, homeopathy, and=20 naturopathy.. Many therapies used in Ayurvedic medicine are = also used=20 on their own as CAM=97for example, herbs, massagePressing, rubbing, and moving muscles = and other=20 soft tissues of the body, primarily by using the hands and fingers. The = aim is=20 to increase the flow of blood and oxygen to the massaged = area., and=20 specialized diets. This fact sheet provides a general overview of = Ayurvedic=20 medicine and suggests sources for additional information.

Key Points

The aim of Ayurvedic medicine is to integrate and balance the = body, mind,=20 and spirit. This is believed to help prevent illness and promote = wellness.=20
Ayurvedic medicine uses a variety of products and techniques to = cleanse=20 the body and restore balance. Some of these products may be harmful if = used=20 improperly or without the direction of a trained practitioner. for = example,=20 some herbs can cause side effects or interact with conventional = medicines.=20
Before using Ayurvedic treatment, ask about the practitioner's = training=20 and experience.=20
Tell your health care providers about any complementary and = alternative=20 practices you use. Give them a full picture of what you do to manage = your=20 health. This will help ensure coordinated and safe care.

Background

Ayurvedic medicine, also called Ayurveda, originated in India several = thousand years ago. The term "Ayurveda" combines the Sanskrit words=20 ayur (life) and veda (science or knowledge). Thus, = Ayurveda=20 means "the science of life."

In the United States, Ayurvedic medicine is considered a type of CAM = and a=20 whole medical system. As with other such systems, it is based on = theories of=20 health and illness and on ways to prevent, manage, or treat health = problems.

Ayurvedic medicine aims to integrate and balance the body, mind, and = spirit;=20 thus, some view it as "holistic." This balance is believed to lead to = happiness=20 and health, and to help prevent illness. Ayurvedic medicine also treats = specific=20 physical and mental health problems. A chief aim of Ayurvedic practices = is to=20 cleanse the body of substances that can cause disease, thus helping to=20 reestablish harmony and balance.

Ayurvedic Medicine in India

Ayurvedic medicine, as practiced in India, is one of the oldest = systems of=20 medicine in the world. Many Ayurvedic practices predate written records = and were=20 handed down by word of mouth. Two ancient books, written in Sanskrit = more than=20 2,000 years ago, are considered the main texts on Ayurvedic = medicine=97Caraka=20 Samhita and Sushruta Samhita. The texts describe eight = branches of=20 Ayurvedic medicine:

Internal medicine=20
Surgery=20
Treatment of head and neck disease=20
Gynecology, obstetrics, and pediatrics=20
Toxicology=20
Psychiatry=20
Care of the elderly and rejuvenation=20
Sexual vitality.

Ayurvedic medicine continues to be practiced in India, where nearly = 80=20 percent of the population uses it exclusively or combined with = conventional=20 (Western) medicine. It is also practiced in Bangladesh, Sri Lanka, = Nepal, and=20 Pakistan.

Most major cities in India have an Ayurvedic college and hospital. = The Indian=20 government began systematic research on Ayurvedic practices in 1969, and = that=20 work continues.

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=A9 Maartje van Caspel

Use in the United States

According to the 2007 National Health Interview Survey, which = included a=20 comprehensive survey of CAM use by Americans, more than 200,000 U.S. = adults had=20 used Ayurvedic medicine in the previous year.

Underlying Concepts

Ayurvedic medicine has several key foundations that pertain to health = and=20 disease. These concepts have to do with universal interconnectedness, = the body's=20 constitution (prakriti), and life forces (doshas).

Interconnectedness. Ideas about the relationships = among=20 people, their health, and the universe form the basis for how Ayurvedic=20 practitioners think about problems that affect health. Ayurvedic = medicine holds=20 that:

All things in the universe (both living and nonliving) are joined=20 together.=20
Every human being contains elements that can be found in the = universe.=20
Health will be good if one's mind and body are in harmony, and = one's=20 interaction with the universe is natural and wholesome.=20
Disease arises when a person is out of harmony with the universe.=20 Disruptions can be physical, emotional, spiritual, or a combination of = these.=20

Constitution (prakriti). Ayurvedic medicine = also=20 has specific beliefs about the body's constitution. Constitution refers = to a=20 person's general health, the likelihood of becoming out of balance, and = the=20 ability to resist and recover from disease or other health problems.

The constitution is called the prakriti. The = prakriti is a=20 person's unique combination of physical and psychological = characteristics and=20 the way the body functions to maintain health. It is influenced by such = factors=20 as digestion and how the body deals with waste products. The = prakriti=20 is believed to be unchanged over a person's lifetime.

Life forces (doshas). Important = characteristics of=20 the prakriti are the three life forces or energies called=20 doshas, which control the activities of the body. A person's = chances of=20 developing certain types of diseases are thought to be related to the = way=20 doshas are balanced, the state of the physical body, and mental = or=20 lifestyle factors.

Ayurvedic medicine holds the following beliefs about the three=20 doshas:

Each dosha is made up of two of five basic elements: = ether (the=20 upper regions of space), air, fire, water, and earth.=20
Each dosha has a particular relationship to bodily = functions and=20 can be upset for different reasons.=20
Each person has a unique combination of the three doshas, = although one dosha is usually prominent. Doshas are=20 constantly being formed and reformed by food, activity, and bodily = processes.=20
Each dosha has its own physical and psychological=20 characteristics.=20
An imbalance of a dosha will produce symptoms that are = unique to=20 that dosha. Imbalances may be caused by a person's age, = unhealthy=20 lifestyle, or diet; too much or too little mental and physical = exertion; the=20 seasons; or inadequate protection from the weather, chemicals, or = germs.=20

The doshas are known by their original Sanskrit names: = vata,=20 pitta, and kapha.

The vata dosha combines the elements ether = and air.=20 It is considered the most powerful dosha because it controls = very basic=20 body processes such as cell division, the heart, breathing, discharge of = waste,=20 and the mind. Vata can be aggravated by, for example, fear, grief, = staying up=20 late at night, eating dry fruit, or eating before the previous meal is = digested.=20 People with vata as their main dosha are thought to be = especially susceptible to skin and neurological conditions, rheumatoid=20 arthritis, heart disease, anxiety, and insomnia.

The pitta dosha represents the elements = fire and=20 water. Pitta controls hormones and the digestive system. A person with a = pitta imbalance may experience negative emotions such as anger = and may=20 have physical symptoms such as heartburn within 2 or 3 hours of eating.=20 Pitta is upset by, for example, eating spicy or sour food, = fatigue, or=20 spending too much time in the sun. People with a predominantly = pitta=20 constitution are thought to be susceptible to hypertension, heart = disease,=20 infectious diseases, and digestive conditions such as Crohn's = disease.

The kapha dosha combines the elements water = and=20 earth. Kapha helps to maintain strength and immunity and to = control=20 growth. An imbalance of the kapha dosha may cause nausea = immediately=20 after eating. Kapha is aggravated by, for example, greed, = sleeping=20 during the daytime, eating too many sweet foods, eating after one is = full, and=20 eating and drinking foods and beverages with too much salt and water = (especially=20 in the springtime). Those with a predominant kapha dosha are = thought to=20 be vulnerable to diabetes, cancer, obesity, and respiratory illnesses = such as=20 asthma.

Treatment

Ayurvedic treatment is tailored to each person's constitution. = Practitioners=20 expect patients to be active participants because many Ayurvedic = treatments=20 require changes in diet, lifestyle, and habits.

The patient's dosha balance. Ayurvedic=20 practitioners first determine the patient's primary dosha and = the=20 balance among the three doshas by:

Asking about diet, behavior, lifestyle practices, recent illnesses = (including reasons and symptoms), and resilience (ability to recover = quickly=20 from illness or setbacks)=20
Observing such physical characteristics as teeth and tongue, skin, = eyes,=20 weight, and overall appearance=20
Checking the patient's urine, stool, speech and voice, and pulse = (each=20 dosha is thought to make a particular kind of pulse). =

Treatment practices. Ayurvedic treatment goals = include=20 eliminating impurities, reducing symptoms, increasing resistance to = disease, and=20 reducing worry and increasing harmony in the patient's life. The = practitioner=20 uses a variety of methods to achieve these goals:

Eliminating impurities. A process called=20 panchakarma is intended to cleanse the body by eliminating = ama.=20 Ama is described as an undigested food that sticks to tissues, = interferes=20 with normal functioning of the body, and leads to disease.=20 Panchakarma focuses on eliminating ama through the digestive = tract=20 and the respiratory system. Enemas, massage, medical oils administered = in a=20 nasal spray, and other methods may be used.=20
Reducing symptoms. The practitioner may suggest = various=20 options, including physical exercises, stretching, breathing = exercises, meditationA conscious = mental process=20 using certain techniques=97such as focusing attention or maintaining a = specific=20 posture=97to suspend the stream of thoughts and relax the body and=20 mind., massage, lying in the sun, and changing the diet. = The=20 patient may take certain herbs=97often with honey, to make them easier = to=20 digest. Sometimes diets are restricted to certain foods. Very small = amounts of=20 metal and mineral preparations, such as gold or iron, also may be = given.=20
Increasing resistance to disease. The = practitioner may=20 combine several herbs, proteins, minerals, and vitamins in tonics to = improve=20 digestion and increase appetite and immunity. These tonics are based = on=20 formulas from ancient texts.=20
Reducing worry and increasing harmony. Ayurvedic = medicine=20 emphasizes mental nurturing and spiritual healing. Practitioners may = recommend=20 avoiding situations that cause worry and using techniques that promote = release=20 of negative emotions.

Use of plants. Ayurvedic treatments rely heavily on = herbs=20 and other plants=97including oils and common spices. Currently, more = than 600=20 herbal formulas and 250 single plant drugs are included in the = "pharmacy" of=20 Ayurvedic treatments. Historically, Ayurvedic medicine has grouped plant = compounds into categories according to their effects (for example, = healing,=20 promoting vitality, or relieving pain). The compounds are described in = texts=20 issued by national medical agencies in India. Sometimes, botanicals are = mixed=20 with metals or other naturally occurring substances to make formulas = prepared=20 according to specific Ayurvedic text procedures; such preparations = involve=20 several herbs and herbal extracts and precise heat treatment.

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=A9 Falko Matte

Practitioner Training and Certification

Many practitioners study in India, where there are more than 150=20 undergraduate and 30 postgraduate colleges for Ayurvedic medicine. = Training can=20 take 5 years or longer. Students who receive their Ayurvedic training in = India=20 can earn either a bachelor's degree (Bachelor of Ayurvedic Medicine and = Surgery,=20 BAMS) or doctoral degree (Doctor of Ayurvedic Medicine and Surgery, = DAMS) there.=20 After graduation, some Ayurvedic practitioners choose to provide = services in the=20 United States or other countries.

The United States has no national standard for training or certifying = Ayurvedic practitioners, although a few states have approved Ayurvedic = schools=20 as educational institutions.

Concerns About Ayurvedic Medications

Ayurvedic practice involves the use of medications that typically = contain=20 herbs, metals, minerals, or other materials. Health officials in India = and other=20 countries have taken steps to address some concerns about these = medications.=20 Concerns relate to toxicity, formulations, interactions, and scientific=20 evidence.

Toxicity. Ayurvedic medications have the potential = to be=20 toxic. Many materials used in them have not been thoroughly studied in = either=20 Western or Indian research. In the United States, Ayurvedic medications = are=20 regulated as dietary supplements. As such, they are not required to meet = the=20 safety and efficacy standards for conventional medicines. An = NCCAM-funded study=20 published in 2004 found that of 70 Ayurvedic remedies purchased = over-the-counter=20 (all manufactured in South Asia), 14 contained lead, mercury, and/or = arsenic at=20 levels that could be harmful. Also in 2004, the Centers for Disease = Control and=20 Prevention reported that 12 cases of lead poisoning occurring over a = recent=20 3-year period were linked to the use of Ayurvedic medications.

Formulations. Most Ayurvedic medications consist of=20 combinations of herbs and other medicines. It can be challenging to know = which=20 components are having an effect and why.

Interactions. Whenever two or more medications are = used,=20 there is the potential for them to interact with each other. As a = result, the=20 effectiveness of at least one may increase or decrease in the body.

Scientific evidence. Most clinical trials (i.e., = studies in=20 people) of Ayurvedic approaches have been small, had problems with = research=20 designs, lacked appropriate control groups, or had other issues that = affected=20 how meaningful the results were. Therefore, scientific evidence for the=20 effectiveness of Ayurvedic practices varies, and more rigorous research = is=20 needed to determine which practices are safe and effective.

Other Points To Consider About Using Ayurvedic = Medicine

Tell your health care providers about any complementary and = alternative=20 practices you use, including Ayurvedic medicine. Give them a full = picture of=20 what you do to manage your health. This will help to ensure = coordinated and=20 safe care. for tips about talking with your health care providers = about CAM,=20 see NCCAM's Time to Talk=20 campaign.=20
Women who are pregnant or nursing, or people who are thinking of = using=20 Ayurvedic therapy to treat a child, should be especially sure to = consult their=20 health care provider.=20
It is important to make sure that any diagnosis of a disease or = condition=20 has been made by a provider who has substantial conventional medical = training=20 and experience with managing that disease or condition.=20
Proven conventional treatments should not be replaced with an = unproven CAM=20 treatment.=20
It is better to use Ayurvedic remedies under the supervision of an = Ayurvedic medicine practitioner than to try to treat yourself.=20
Before using Ayurvedic treatment, ask about the practitioner's = training=20 and experience.=20
Find out whether any rigorous scientific studies have been done on = the=20 therapies in which you are interested.

NCCAM-Funded Research

Examples of NCCAM-supported research on therapies used in Ayurvedic = medicine=20 include studies of:

Herbal therapies, including curcuminoids (substances found in = turmeric),=20 used for cardiovascular conditions=20
A compound from the cowhage plant (Mucuna pruriens), used = to=20 prevent or lessen side effects from Parkinson's disease drugs=20
Three botanicals (ginger, turmeric, and boswellia) used to treat=20 inflammatory disorders such as arthritis and asthma=20
Gotu kola (Centella asiatica), an herbA plant or part of a plant used for = its flavor,=20 scent, or potential therapeutic properties. Includes flowers, leaves, = bark,=20 fruit, seeds, stems, and roots. used to treat Alzheimer's = disease.=20

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Selected References

Barnes PM, Bloom B, Nahin R. Complementary and alternative = medicine use=20 among adults and children: United States, 2007. CDC National = Health=20 Statistics Report #12. 2008.=20
Chopra A, Doiphode VV. A= yurvedic=20 medicine-core concept, therapeutic principles, and current = relevance.=20 Medical Clinics of North America. 2002;86(1):75=9688.=20
Courson WA. State licensure and Ayurvedic practice: planning for = the=20 future, managing the present. Newsletter of the National = Ayurvedic=20 Medical Association [online journal]. Autumn 2003. Accessed on = February=20 14, 2008.=20
Dodds JA. Know your CAM provider. Bulletin of the American = Academy=20 of Orthopaedic Surgeons/American Association of Orthopaedic = Surgeons=20 [online journal]. December 2002. Accessed on February 14, 2008.=20
Gogtay NJ, Bhatt HA, Dalvi SS, et al. The=20 use and safety of non-allopathic Indian medicines. Drug=20 Safety. 2002;25(14):1005=961019.=20
Lead poisoning associated with Ayurvedic medications=97five = states,=20 2000=962003. Morbidity and Mortality Weekly Report. = Centers for=20 Disease Control and Prevention Web site. Accessed on February 14, = 2008.=20
Lodha R, Bagga A. T= raditional=20 Indian systems of medicine. Annals of the Academy of = Medicine,=20 Singapore. 2000;29(1):37=9641.=20
Mishra L, Singh BB, Dagenais S. Ayurveda:=20 A historical perspective and principles of the traditional healthcare = system=20 in India. Alternative Therapies in Health and = Medicine.=20 2001;7(2):36=9642.=20
Mishra L, Singh BB, Dagenais S. H= ealthcare=20 and disease management in Ayurveda. Alternative Therapies in = Health=20 and Medicine. 2001;7(2):44=9650.=20
Saper RB, Kales SN, Paquin J, et al. Heavy=20 metal content of Ayurvedic herbal medicine products. Journal = of the=20 American Medical Association. 2004;292(23):2868=962873.=20
Shankar K, Liao LP. T= raditional=20 systems of medicine. Physical Medicine and Rehabilitation = Clinics of=20 North America. 2004;15(4):725=96747.=20
Singh BB, Vinjamury SP, Der-Martirosian C, et al. A= yurvedic=20 and collateral herbal treatments for hyperlipidemia: a systematic = review of=20 randomized controlled trials and quasi-experimental designs.=20 Alternative Therapies in Health and Medicine. = 2007;13(4):22=9628.=20
Subbarayappa BV. T= he=20 roots of ancient medicine: an historical outline. Journal of = Bioscience. 2001;26(2):135=96144.

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For More Information

NCCAM Clearinghouse

The NCCAM Clearinghouse provides information on CAM and NCCAM, = including=20 publications and searches of Federal databases of scientific and medical = literature. The Clearinghouse does not provide medical advice, treatment = recommendations, or referrals to practitioners.

Toll-free in the U.S.: 1-888-644-6226
TTY (for deaf and = hard-of-hearing=20 callers): 1-866-464-3615
Web site: nccam.nih.gov
= E-mail:

PubMed^=AE

A service of the National Library of Medicine (NLM), = PubMed^=AE=20 contains publication information and (in most cases) brief summaries of = articles=20 from scientific and medical journals. CAM on PubMed^=AE, = developed=20 jointly by NCCAM and NLM, is a subset of the PubMed^=AE system = and=20 focuses on the topic of CAM.

Web site: www.ncbi.nlm.nih.gov/si= tes/entrez
CAM=20 on PubMed^=AE: nccam.nih.gov/researc= h/camonpubmed/

ClinicalTrials.gov

ClinicalTrials.gov is a database of information on federally and = privately=20 supported clinical trials (research studies in people) for a wide range = of=20 diseases and conditions. It is sponsored by the National Institutes of = Health=20 and the U.S. Food and Drug Administration.

Web site: http://www.clinicaltrials.gov/

Research Portfolio Online Reporting Tool (RePORT)

RePORTER is a database of information on federally funded = scientific=20 and medical research projects being conducted at research = institutions.

Web site: projectreporter.nih.= gov

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Acknowledgments

NCCAM thanks the following people for their technical expertise and = review of=20 the content update of this publication: Bala Manyam, M.D., Texas A&M = University System Health Science Center College of Medicine; and Partap = Khalsa,=20 D.C., Ph.D., NCCAM.

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This publication is not copyrighted and is in the public = domain.=20 Duplication is encouraged.

NCCAM has provided this material for your = information. It=20 is not intended to substitute for the medical expertise and advice of = your=20 primary health care provider. We encourage you to discuss any decisions = about=20 treatment or care with your health care provider. The mention of any = product,=20 service, or therapy is not an endorsement by NCCAM.

NCCAM Publication No. D287
Created=20 October 2005
Updated July 2009

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