Featured

Minimize effects of wildfire pollution with Yoga – Ayurveda

It’s a heart-wrenching time with all the natural catastrophes and man made disasters we are witnessing. These times unite us too, so let the light and hope remain kindled!

For starters, let’s stay safe and keep our respiratory system proactively healthy. Here are some suggestions:

1. Unabashedly wear masks and distribute them to friends and family while outside.

2. Apply a mechanical oil barrier in the nasal and paranasal sinuses with a neutral oil like sesame/ avocado/olive, in that order of preference. The oil should be warm and enough to layer the nasal and large paranasal sinuses which bear the immediate impact of the particulate matter.(recommend 2-3 drops in each nostril). If you have access to an Ayurvedic oil – anu tailam, use that instead.

Two things will occur because of this:
a. Preliminary trapping of the particulate matter which can be removed as sputum before it goes in the deeper to the bronchi and deeper recesses of the lungs.
b. The immune/allergic response to the particulate matter can be reduced to decent extent.

3. For people prone to allergic reactions and mucosal senstiivity, please preventatively do a six minute respiration refining practice called the three step rhythmic breathing. It has allowed even hypersensitive asthmatics to survive in highly polluted cities like mumbai. It can be done by anyone and the benefits of the practice are beyond physical. If interested, you may learn more here.

4. Of course, use turmeric freely. Saute 3/4 tsp in 1/2 tsp ghee or olive oil, add 1/4 inch of lean ginger and boil in water. Squeeze half a lemon and gently sip. Repeat upto two to three times if symptomatic.

5. For all other mainstream care nuances, this article by the Children’s hospital summarizes them well. Reach out to your healthcare providers if any workup is needed.

If you need any other Ayurvedic support and herbal formulations, feel free to reach me, Dr.Namyata Pathak at drnamyata@ayurvedaacademy.com or call 1-888-275-9103 for an appointment at Fremont,CA or over a video consult. We are able to ship herbs from Mon-Friday. Stay well indoors or choose south from the bay during the weekend. Not as far as LA though! 

Advertisements

Resources: Ayurveda research

a. Pubmed Indexed journals on Ayurveda
Pubmed is an archive of scientific publications of a certain standard maintained by the National Institute of Health’s National Library of Medicine.

i. Journal of Ayurveda and Integrative Medicine
published by Institute of Ayurveda and Integrative Medicine, Bengaluru

ii. Ayu
published by Gujarat Ayurveda University, Jamnagar

iii. International Journal of Ayurvedic Research
Published by the Department of AYUSH, Government of India
(discontinued due to lack of funds)

b. Ayurveda research database

DHARADigital Helpline for Ayurveda Research Articles
Other Ayurveda journals not indexed with Pubmed, are indexed by DHARA
AVP Research Foundation,Coimbatore develops and maintains this while it is funded by CCRAS, Dept of AYUSH, Govt of India

c. International resources

Ayurveda Journal of Health, a USA based quarterly publication

More links & resources to follow! Recommendations welcome.

Resources: Scratching beneath the surface

a. Original Charak Samhita with verse by verse translation

Agnivesha, Charaka Samhita, revised by Charaka and Dhridabala. English translation by P. M. Mehta, vol 1-5,
Published by Gulabkuverba Ayurved Society, Jamnagar.

b. For technical logic of medicinal interventions in Ayurveda

Gogte V.M. Ayurvedic pharmacology and therapeutic use of medicinal plants. Bhavan’s Swami Prakashananda Ayurvedic Research Centre; Mumbai: 2000.
Available from Chaukhambha publication, 2009

c. For bridging Ayurveda and modern medicine

Lele RD. Ayurveda and Modern medicine. 2nd edition, Bhartiya Vidya Bhavan, 2001

Resources: An Introduction to Ayurveda

Self healing experiences are the best introductions to Ayurveda. The list below comes second.

a. An insightful book to understand the heart of Ayurveda for personal choices
Prakruti – Robert Svoboda is warm, insightful read inspired from his personal experiences and uncommon insights

b. A comprehensive, well structured, detailed view of the entire field: Ayurveda encyclopedia

c. An overview of the classical core texts

Written by a cardiac surgeon, Dr.M.S.Valiathan, it represents short summaries of each chapter of every section in these classical treatises.
Legacy of Charak
Legacy of Sushruta
Legacy of Vagbhatta

We will selectively expand this list. Do share more inspiring introductions that you may have come across!

Genesis of Reverse Pharmacology in India: Akin to Dr.Youyou Tu’s Nobel for an anti-malarial

youyou tu strathclyde

Pathak N. A slide in Roots of modern medicine in Reverse Pharmacology, Presentation made to visiting Faculty, Strathclyde University, Kasturba Health Society, Mumbai, India.2012 (Click to enlarge)

An organized effort to discover an anti-malarial bioactive from Traditional Chinese Medicine experience, led to a Nobel Prize for Dr.Youyou Tu in Oct 2015. Motivated by the Vietnamese war, it was an orchestrated effort to streamline those organic, spontaneous processes which have often led to discovering modern drugs from traditional medicine/plants.

I share below one such tale is of Reserpine discovered from Sarpagandha. In India too, an organized effort to discover drugs from medicinal plants had ensued in the last three decades led by Dr.Ashok Vaidya, Dr.RA Mashelkar, Dr. Bhushan Patwardhan and many other interdisciplinary experts. Unlike Dr.Youyou Tu’s mission it was not on a ‘war’-footing. I do hope that the newly formed AYUSH ministry is willing to examine this case to invest its energies in meaningful directions!

Reserpine story in brief

In 1930, an ace Ayurvedic physician, Vd.Gananath Sen found that a medicinal plant, Sarpagandha (Rauwolfia serpentina Linn.) reduces raised blood pressure. As anti-hypertensives were not available as yet, patients flocked to get that herb from him. Intrigued, a renowned cardiologist Dr.Rustom Jal Vakil decided to test in his patients while chemists like Ajmal Khan began isolating potential actives from the plant. Eventually at CIBA-Geigy, Reserpine, the catecholamine depletor (which reduces the tone of the sympathetic nervous system) was identified as an active and one of the first anti-hypertensives was developed. Studying Sarpagandha and reserpine had also helped understand mechanisms of depression, schizophrenia and Parkinson’s disease. For more details, click here.

Genesis of Reverse Pharmacology

Why couldn’t we replicate this with some many other clinical observations in a vaidya’s clinic today, questioned Dr.Ashok Vaidya. For over three decades, he and his team relentlessly pursued a path of scientific documentation and investigation of Ayurvedic products. There had to be a new path of medicinal product development which documented the existing clinical experience, asked relevant questions to create standardized products of value. The path came to be christened ‘Reverse Pharmacology’, eventually nurtured by many other academic and industry leaders. In the last decade, the Government of India orchestrated a nationwide team effort, called CSIR-NMTILI to develop global products (for malaria, arthritis and diabetes) using this path. It is now being increasingly used by industry to spur innovation in light of the increasingly dry drug pipelines.

Reverse pharmacology is now defined as the trans-discipline that initiates drug discovery and development from traditional knowledge/practices at the bedside through robust and objective clinical documentation.

Key conceptual publications are found here:

i) Vaidya ADB. Reverse Pharmacological correlates of Ayurvedic drug actions. Indian J Pharmac. 2006; 38(5), 311-15

ii) Patwardhan B, Mashelkar RA. Traditional medicine inspired approaches to drug discovery. Can Ayurveda show the way forward? Drug discovery today 2009; 14, 804 – 5

I will share more stories of Science in Ayurveda (both contemporary and fundamental) which I am fortunate to belong to. I also invite people to share more of these lesser known stories of India’s efforts in the last couple of centuries.

Surrender: A prayer of Swami Ramakrishna to the Mother

Surrender

Swami Ramkrishna, the self realized teacher of Swami Vivekanand

I surrender, O Mother, all of myself at your feet,
May in my heart eternally play your remembrance sweet.
I crave not for indulgences, nor fame, nor accomplishments
I pray only that my heart flow incessantly in your love .
May a renewed, greedless, untainted, pure love kindle,
O Mother of the Universe! Let my heart just chant in that love.

I have witnessed the illusion of this dazzling golden world,
O! please be watchful that this ignorant child of yours does not lose its way.
That he doesn’t forget you! O Mother, guard him closely
May no lust and greed, ever poison him as he lives on.
He knows not that without you, there is no support
You alone are the Mother, make me fearless with your gentle watch.

I know not how to chant your pure and sweet name,
I Have neither devotion nor intellect to guide me to your Lotus feet!
Nor do I possess a deep, true love that fills all of my being,
An incomplete me, is lost in playing to some random tunes.
Embrace me now, with your heart-filling love
In the radiance of your grace, may endless blessings flow!

Translated from Bengali to Gujarati by Sri.Makrand Dave, a poet seer
Translated from Gujarati to English by Namyata Pathak-Gandhi, an amateur

(PS. The path of Surrender forms the backbone of many Eastern philosophies. Reminds me of an anecdote: A man was traveling on a train and decided to carry his suitcase on the head. A fellow passenger asked him what he was upto. He said he was trying to reduce the burden on the train!

Surrender is an attitudinal choice which enables a happy and healthy life for some individuals.)

When is it a good time to eat?

tea time

Meal timings are being debated a great deal − ‘Breakfast like a king’ or ‘Eat every two hours’ are the many schools of thought.

Ayurveda suggests to follow the cue of appetite. ‘Eat when you are hungry’ and each time, satiate only 2/3rd of your appetite.

Our appetite is the culmination of the state of our ‘agni’ – the multilevel internal fire which keeps us functioning as biological systems. Protecting and restoring health are revolved around the fulcrum of agni in Ayurveda. It gets easily influenced by foods, seasons, behaviour, exercise, emotional states, personal constitution. Just like fire, if we feed it too much it can ‘douse’ off, and if we donot feed it can consume what it can find and emaciate us. If we feed it just right, it nourishes us, replenishes us and becomes an enabler for our life and works.

This is the critical difference between conventional nutrition guidelines and Ayurveda. The gastro-intestinal tract is not just a food processing unit. Its ‘current state’ must be respected for healthy meal decisions.

In general, the larger meals are proposed in the first half of the day when agni is naturally high, particularly between 10 am to 2 pm.

Herb drug interactions

Herb drug interactions can and do occur, and must be actively taken care of by you and your physician. Although extensive literature is not available on this topic, here are possible interactions with Ayurveda and herbal supplements.  These are based on some observations and plausible confounding mechanisms. The list is not exhaustive and will be expanded.

In general, it is a good practice to leave a gap of atleast an hour between plant based supplements and conventional medicines.

Common in Ayurvedic medicine

1. Warfarin is combined with ginkgo (Ginkgo biloba), garlic (Allium sativum), dong quai (Angelica sinensis), or danshen (Salvia miltiorrhiza) may cause bleeding.

2.Liquorice (Glycyrrhiza glabra, yashtimadhu, jethimadh) may cause a potentiation of oral and topical corticosteroids.

3. Anthranoid-containing plants (including senna [Cassia senna] and cascara [Rhamnus purshiana]) and soluble fibres (including guar gum and psyllium) can decrease the absorption of drugs. Senna is the main ingredient of a common laxative – Kayam churna and avipattikar churna.

4.Indian gooseberry and turmeric (Amla- haldi), very commonly used by diabetics,  may reduce the bioavailability of metformin when used together in diabetes.(Ref 2)

5.Ayurvedic syrup shankhapushpi may decrease concentrations of anti-epileptic phenytoin.(Ref 3)

Common in Traditional Chinese medicine and Herbal medicine

1.Panax ginseng and antidepressants causes an induction of mania in depressed patients.

2.St John’s wort (Hypericum perforatum) with serotonin-reuptake inhibitors may cause mild serotonin syndrome. It may also decrease bioavailability of digoxin, theophylline, cyclosporin, and phenprocoumon.

3.Yohimbine (Pausinystalia yohimbe) and tricyclic antidepressants may lead to increased risk of hypertension.

4. Xaio chai hu tang (sho-salko-to) by decreased blood concentrations of prednisolone when taken with the Chinese herbal product.

References
1.Windrum P, Hull DR, Morris TC. Herb-drug interactions. Lancet. 2000 Mar 18;355(9208):1019-20.

2.Puranik A, Nabar N, Joshi J et al. Single dose metformin kinetics after co-adminstration of nisha-amalaki powder or mamejawa gahnwati, ayurvedic anti-diabetic formulations: A randomized crossover study in healthy volunteers. J Obes Metab Res 2014;1:99-104

3.Dandekar UP et al.Analysis of a clinically important interaction between phenytoin and Shankhapushpi, an Ayurvedic preparation.J Ethnopharmacol. 1992 Jan;35(3):285-8.

 

Other good resources on herb drug interaction

1.http://www.itmonline.org/arts/herbdrug.htm

2.https://nccih.nih.gov/training/videolectures/clinically-relevant-herb-drug-interactions

3.University of Maryland interactio checker: http://umm.edu/health/medical/altmed

Featured

Health to disease. Are you are at the tipping point?

CARDS BALANCEKnow when are about to tip towards disease

In the second week of September 2015, the National Heart Blood Lung Institute released partial results of a clinical trial name SPRINT. They found that adults who had controlled their systolic blood pressure below 120mmHg had fewer than one-third of the cardiovascular events than those who maintained it below 140 mmHg. As of now, the practice guidelines recommend to maintain systolic blood pressure under 140 mmHg. Because of the new information, there are speculations that these guidelines might drop this cutoff to 120 mmHg. It means that a 60 year old person who maintained his systolic blood pressure at 130mmHg, might not be doing enough. On the other hand, some experts may exert caution for this drop. There would be concerns that in persons with aged, poorly elastic arteries, blood may not circulate well to the brain if the systolic blood pressure dropped too low. There may also be debates whether this is a conspiracy of Big Pharma to sell more drugs.

Health indicators or disease indicators?

Studies like these and other community based studies are well intended, as they strive to update the quantitative ‘cut-offs’ (QC) associated with diseases later. Examples of QCs are body weight, body mass index, blood pressure, pulse rate, blood work. These QCs first became popular with the Framingham Heart Study in which a large community of people was assessed and followed up for many years to see who developed which diseases, when and when they died. Such retrospective information, is analysed to help predict future diseases. The emergent QCs are assumed to be indicators of health, falsely so, as they actually indicate current and future disease.

QCs give us a sense of certainty and the healthcare systems a manageable working module. However, the experience of being in health is much more subjective and QCs may not grasp the whole picture. You may have normal blood work, but may be prone to infections. You may be lean, but feel constipated and uneasy frequently. You might have all the perfect numbers, but just can’t sleep well and are increasingly fatigued. These are the real day-to-day health issues which represent the grey areas between health and disease. These ‘fuzzy’ symptoms are sometimes strong enough to trigger the change from physiology (normal functioning) to pathology (abnormal functioning). For example: Sleep deprivation is known to increase insulin resistance which leads to diabetes. In a Honolulu aging study, it was found that men with constipation had 2.7 times the risk of developing Parkinson’s Disease than those who had atleast one bowel movement per day.

A ‘health indicator’ worth adopting

Do we have an assessment for health that values the experience of health today and also considers the future risk of diseases? Here is a Checklist for Health that can also signal if you might be on a downhill road towards disease. It reminds us of things to address in the immediate and near future, to take care of long term health. It helps us know ourselves and our environment better.

  1.  I feel hungry regularly.
    (It is not too poor or uncontrollable)
  2.   My food digests in time.
    (I donot have abdominal heaviness for long hours post meals, no thick, stubborn, white coating on my tongue)
  3. My poop is regular and happens daily.
    (Not sticky, or dry or hard or loose stools, or difficult to evacuate)
  4. I’m peeing well.
    (Adequate, pale yellow — transparent, with no discomfort)
  5. I sleep sound, on time, wake up fresh!
    (No daytime sleepiness or laziness post meals)
  6. I feel light and energetic.
  7. I can see, smell, taste, feel, hear well.
    (No altered tastes, intolerance to normally bearable noises, distorted skin sensations, snubbed sense of smell, hazy vision)
  8. I have adequate strength for daily activities and some exercise.
  9. I can think clearly and feel emotionally tuned with the world.
  10. I do not fall victim to diseases easily.
  11. I can tolerate extremes of heat and cold well.
  12. I have adequate muscle strength and a built with strong enough bones (Body composition, BMI, Muscle and bone mass tests are helpful here)

Questions one to six relate to how your internal physiology affects the experience of health. Questions seven to nine indicate how you engage with the world outside. The remaining indicate longterm physical health.

Advantages of adopting the health indicator

It is one that is used by the oldest system of organized medicine — Ayurveda (Traditional Indian Medicine). People who add it to their health radar find themselves comparing notes with it often. They understand themselves and their environment better, get empowered to make healthful choices. They feel healthier and happier and are not bogged down by the fear of disease. This checklist is an enabler of all other descriptions of health and should be used in conjunction with the updated QCs.

Much needed contemporary biomedical evidence for these suggestions is currently on its way. One such example is the increasing interest in gut health. The friendly bacteria living on us outnumber our cells by a ratio of 10:1. Consequently, their genomic sequences are thought to play an active role in our health. Hence, projects like American Gut (crowd funded) and µbiome, are requesting people for their stool samples to study the bacterial genomes and draw insights for health and disease. Among the mainstream medical fraternity too, symptoms like gas and constipation are slowly being discussed more openly, without being belittled.

There is another debate is about daily required water intake. Eight cups has been suggested for adults, but a static number has drawn much controversy because hydration depends on many factors like exercise, body weight, ambient temperature among others. So the recent dynamic recommendations are similar to those suggested in this checklist — drink till your urine is pale yellow or lighter.

Contemporary biomedical evidence for the other suggestions may emerge in the next few years and trickle down into health and medical practices. Until we expand our knowledge about them, we can plunge in some safe, effective practices for our own selves and our families.

So, what can you do if you are at the tipping point?
Initiate self-education for health — Eastern and Western health approaches, and watch out for my posts!

For those who may be interested, here is the original Sanskrit text of the checklist:
सममांसप्रमाणस्तु समसंहननो नरः|
दृढेन्द्रियो विकाराणां [१] न बलेनाभिभूयते||18||
क्षुत्पिपासातपसहः शीतव्यायामसंसहः|
समपक्ता समजरः सममांसचयो मतः||19||
Agnivesha. Charaka Samhita. Sutra sthana. Chapter 21. Sutra 18–19