Ayurvedic Medicine: An Introduction
Introduction
Ayurvedic medicine (also called Ayurveda) is one of the world's oldest
medical systems. It originated in India and has evolved there over thousands of years. In the United States,
Ayurvedic medicine is considered complementary and alternative medicine (CAM)—more specifically, a CAM whole medical system. Many therapies
used in Ayurvedic medicine are also used on their own as CAM—for example, herbs, massage, and specialized diets. This fact sheet
provides a general overview of Ayurvedic medicine and suggests sources for additional
information.
Key Points
- The aim of Ayurvedic medicine is to integrate and balance the body, mind, and spirit. This is believed to
help prevent illness and promote wellness.
- Ayurvedic medicine uses a variety of products and techniques to cleanse the body and restore balance. Some
of these products may be harmful if used improperly or without the direction of a trained practitioner. For
example, some herbs can cause side effects or interact with conventional medicines.
- Before using Ayurvedic treatment, ask about the practitioner's training and experience.
- Tell your health care providers about any complementary and alternative practices you use. Give them a full
picture of what you do to manage your health. This will help ensure coordinated and safe care.
© José Carlos Pires Pereira
Background
Ayurvedic medicine, also called Ayurveda, originated in India several thousand years ago. The term "Ayurveda"
combines the Sanskrit words ayur (life) and veda (science or knowledge). Thus, Ayurveda means "the science of
life."
In the United States, Ayurvedic medicine is considered a type of CAM and a whole medical system. As with other such
systems, it is based on theories of 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; thus, some view it as "holistic." This
balance is believed to lead to happiness and health, and to help prevent illness. Ayurvedic medicine also treats
specific physical and mental health problems. A chief aim of Ayurvedic practices is to cleanse the body of
substances that can cause disease, thus helping to reestablish harmony and balance.
Ayurvedic Medicine in India
Ayurvedic medicine, as practiced in India, is one of the oldest systems of medicine in the world. Many Ayurvedic
practices predate written records and were handed down by word of mouth. Two ancient books, written in Sanskrit
more than 2,000 years ago, are considered the main texts on Ayurvedic medicine—Caraka Samhita and Sushruta Samhita.
The texts describe eight branches of Ayurvedic medicine:
- Internal medicine
- Surgery
- Treatment of head and neck disease
- Gynecology, obstetrics, and pediatrics
- Toxicology
- Psychiatry
- Care of the elderly and rejuvenation
- Sexual vitality
Ayurvedic medicine continues to be practiced in India, where nearly 80 percent of the population uses it
exclusively or combined with conventional (Western) medicine. It is also practiced in Bangladesh, Sri Lanka, Nepal,
and Pakistan.
Most major cities in India have an Ayurvedic college and hospital. The Indian government began systematic research
on Ayurvedic practices in 1969, and that work continues.
Use in the United States
According to the 2007 National Health Interview Survey, which included a comprehensive survey of CAM use by
Americans, more than 200,000 U.S. adults had used Ayurvedic medicine in the previous year.
Underlying Concepts
Ayurvedic medicine has several key foundations that pertain to health and disease. These concepts have to do
with universal interconnectedness, the body's constitution (prakriti), and life forces (doshas).
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. Ayurvedic medicine holds that:
- All things in the universe (both living and nonliving) are joined together.
- Every human being contains elements that can be found in the universe.
- Health will be good if one's mind and body are in harmony, and one's interaction with the universe is
natural and wholesome.
- Disease arises when a person is out of harmony with the universe. Disruptions can be physical, emotional,
spiritual, or a combination of these.
Constitution (prakriti). Ayurvedic medicine also has specific beliefs about the body's
constitution. Constitution refers to a person's general health, the likelihood of becoming out of balance, and the
ability to resist and recover from disease or other health problems.
The constitution is called the prakriti. The prakriti is a person's unique combination of physical and
psychological characteristics and the way the body functions to maintain health. 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.
Life forces (doshas). Important characteristics of the prakriti are the three life forces or
energies called doshas, which control the activities of the body. A person's chances of developing certain types of
diseases are thought to be related to the way doshas are balanced, the state of the physical body, and mental or
lifestyle factors.
Ayurvedic medicine holds the following beliefs about the three doshas:
- Each dosha is made up of two of five basic elements: ether (the upper regions of space), air, fire, water,
and earth.
- Each dosha has a particular relationship to bodily functions and can be upset for different reasons.
- Each person has a unique combination of the three doshas, although one dosha is usually prominent. Doshas
are constantly being formed and reformed by food, activity, and bodily processes.
- Each dosha has its own physical and psychological characteristics.
- An imbalance of a dosha will produce symptoms that are unique to that dosha. Imbalances may be caused by a
person's age, unhealthy lifestyle, or diet; too much or too little mental and physical exertion; the seasons;
or inadequate protection from the weather, chemicals, or germs.
The doshas are known by their original Sanskrit names: vata, pitta, and kapha.
The vata dosha combines the elements ether and air. It is considered the most powerful dosha
because it controls very basic body processes such as cell division, the heart, breathing, discharge of waste, and
the mind. Vata can be aggravated by, for example, fear, grief, 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 and neurological conditions, rheumatoid arthritis, heart disease, anxiety, and insomnia.
The pitta dosha represents the elements fire and water. Pitta controls hormones and the
digestive system. A person with a pitta imbalance may experience negative emotions such as anger and may have
physical symptoms such as heartburn within 2 or 3 hours of eating. Pitta is upset by, for example, eating spicy or
sour food, fatigue, or spending too much time in the sun. People with a predominantly pitta constitution are
thought to be susceptible to hypertension, heart disease, infectious diseases, and digestive conditions such as
Crohn's disease.
The kapha dosha combines the elements water and earth. Kapha helps to maintain strength and
immunity and to control growth. An imbalance of the kapha dosha may cause nausea immediately after eating. Kapha is
aggravated by, for example, greed, 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, cancer, obesity, and respiratory
illnesses such as asthma.
Treatment
Ayurvedic treatment is tailored to each person's constitution. Practitioners expect patients to be active
participants because many Ayurvedic treatments require changes in diet, lifestyle, and habits.
The patient's dosha balance. Ayurvedic practitioners first determine the patient's primary dosha and the balance
among the three doshas by:
- Asking about diet, behavior, lifestyle practices, recent illnesses (including reasons and symptoms), and
resilience (ability to recover quickly from illness or setbacks)
- Observing such physical characteristics as teeth and tongue, skin, eyes, weight, and overall
appearance
- Checking the patient's urine, stool, speech and voice, and pulse (each dosha is thought to make a
particular kind of pulse).
Treatment practices. Ayurvedic treatment goals include eliminating impurities, reducing symptoms, increasing
resistance to disease, and reducing worry and increasing harmony in the patient's life. The practitioner uses a
variety of methods to achieve these goals:
- Eliminating impurities. A process called panchakarma is intended to cleanse the body by eliminating ama.
Ama is described as an undigested food that sticks to tissues, interferes with normal functioning of the body,
and leads to disease. Panchakarma focuses on eliminating ama through the digestive tract and the respiratory
system. Enemas, massage, medical oils administered in a nasal spray, and other methods may be used.
- Reducing symptoms. The practitioner may suggest various options, including physical exercises, stretching,
breathing exercises, meditation, massage, lying in the sun, and changing the diet. The patient may take certain
herbs—often with honey, to make them easier to digest. Sometimes diets are restricted to certain foods. Very
small amounts of metal and mineral preparations, such as gold or iron, also may be given.
- Increasing resistance to disease. The practitioner may combine several herbs, proteins, minerals, and
vitamins in tonics to improve digestion and increase appetite and immunity. These tonics are based on formulas
from ancient texts.
- Reducing worry and increasing harmony. Ayurvedic medicine emphasizes mental nurturing and spiritual
healing. Practitioners may recommend avoiding situations that cause worry and using techniques that promote
release of negative emotions.
Use of plants. Ayurvedic treatments rely heavily on herbs and other plants—including oils and common spices.
Currently, more than 600 herbal formulas and 250 single plant drugs are included in the "pharmacy" of Ayurvedic
treatments. Historically, Ayurvedic medicine has grouped plant compounds into categories according to their effects
(for example, healing, promoting vitality, or relieving pain). The compounds are described in texts issued by
national medical agencies in India. Sometimes, botanicals are mixed with metals or other naturally occurring
substances to make formulas prepared according to specific Ayurvedic text procedures; such preparations involve
several herbs and herbal extracts and precise heat treatment.
© Falko Matte
Practitioner Training and Certification
Many practitioners study in India, where there are more than 150 undergraduate and 30 postgraduate colleges for
Ayurvedic medicine. Training can take 5 years or longer. Students who receive their Ayurvedic training in India can
earn either a bachelor's degree (Bachelor of Ayurvedic Medicine and Surgery, BAMS) or doctoral degree (Doctor of
Ayurvedic Medicine and Surgery, DAMS) there. After graduation, some Ayurvedic practitioners choose to provide
services in the 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 as educational institutions.
Concerns About Ayurvedic Medications
Ayurvedic practice involves the use of medications that typically contain herbs, metals, minerals, or other
materials. Health officials in India and other countries have taken steps to address some concerns about these
medications. Concerns relate to toxicity, formulations, interactions, and scientific evidence.
Toxicity. 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 safety and efficacy standards for
conventional medicines. An NCCAM-funded study published in 2004 found that of 70 Ayurvedic remedies purchased
over-the-counter (all manufactured in South Asia), 14 contained lead, mercury, and/or arsenic at levels that could
be harmful. Also in 2004, the Centers for Disease Control and Prevention reported that 12 cases of lead poisoning
occurring over a recent 3-year period were linked to the use of Ayurvedic medications.
Formulations. Most Ayurvedic medications consist of combinations of herbs and other medicines. It
can be challenging to know which components are having an effect and why.
Interactions. 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.
Scientific evidence. Most clinical trials (i.e., studies in people) 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. Therefore, scientific evidence for the effectiveness of Ayurvedic practices varies, and more
rigorous research is needed to determine which practices are safe and effective.
© Maartje van Caspel
Other Points To Consider About Using Ayurvedic Medicine
- Tell your health care providers about any complementary and alternative practices you use, including
Ayurvedic medicine. Give them a full picture of what you do to manage your health. This will help to ensure
coordinated and safe care. For tips about talking with your health care providers about CAM, see NCCAM's Time
to Talk campaign.
- Women who are pregnant or nursing, or people who are thinking of using Ayurvedic therapy to treat a child,
should be especially sure to consult their health care provider.
- It is important to make sure that any diagnosis of a disease or condition has been made by a provider who
has substantial conventional medical training and experience with managing that disease or condition.
- Proven conventional treatments should not be replaced with an unproven CAM treatment.
- It is better to use Ayurvedic remedies under the supervision of an Ayurvedic medicine practitioner than to
try to treat yourself.
- Before using Ayurvedic treatment, ask about the practitioner's training and experience.
- Find out whether any rigorous scientific studies have been done on the therapies in which you are
interested.
NCCAM-Funded Research
Examples of NCCAM-supported research on therapies used in Ayurvedic medicine include studies of:
- Herbal therapies, including curcuminoids (substances found in turmeric), used for cardiovascular
conditions
- A compound from the cowhage plant (Mucuna pruriens), used to prevent or lessen side effects from
Parkinson's disease drugs
- Three botanicals (ginger, turmeric, and boswellia) used to treat inflammatory disorders such as arthritis
and asthma
- Gotu kola (Centella asiatica), an herb used to treat Alzheimer's disease.
© Marje Cannon
Selected References
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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 14, 2008.
- 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 February 14, 2008.
- Gogtay NJ, Bhatt HA, Dalvi SS, et al.
The use and safety of non-allopathic Indian
medicines. Drug Safety.
2002;25(14):1005–1019.
- Lead poisoning associated with Ayurvedic
medications—five states, 2000–2003. Morbidity and Mortality
Weekly Report. Centers for Disease Control and Prevention Web
site. Accessed on February 14, 2008.
- Lodha R, Bagga A.
Traditional Indian systems of
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2000;29(1):37–41.
- Mishra L, Singh BB, Dagenais
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- Mishra L, Singh BB, Dagenais
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- 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(4):725–747.
- Singh BB, Vinjamury SP, Der-Martirosian C,
et al.
Ayurvedic and collateral herbal treatments for hyperlipidemia: a
systematic review of randomized controlled trials and quasi-experimental
designs. Alternative Therapies in Health and Medicine. 2007;13(4):22–28.
- Subbarayappa BV.
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