More study on ayurvedic medications is necessary

The Supreme Court has taken Patanjali Ayurved to task for deceptive claims made about its own ayurvedic medications and for running commercials against allopathy. Previously, the court had banned Patanjali from marketing its goods as “permanent relief” for conditions including heart disease, asthma, and hypertension.

Ads for 54 such ailments are banned under the Drugs and Magic Remedies (Objectionable Advertisements) Act of 1954. Regarding coronil, a medication that was marketed as a treatment for COVID-19, Patanjali has also come under fire for its claims.

This debate raises two points of contention. The first consists of unverified statements on Ayurvedic medications. Research on these medications has been scant. The standards for previous medical systems are loose, in contrast to the strict requirements of clinical trials for contemporary medications overseen by the Drug Controller General of India. The second is the possibility of side effects brought on by ayurvedic medications. The reporting of adverse events is already included in scientific clinical trials (Phases 1, 2, and 3) and post-marketing monitoring if done correctly.

It’s critical to distinguish complementary and alternative medicine (CAM) from herbal and nutritional supplements. The US Food and Drug Administration (FDA) defines the former as “products taken by mouth that contain a dietary ingredient intended to supplement the diet,” such as vitamins, minerals, and herbal remedies. On the other side, complementary and alternative medicine (CAM) treatments, such Chinese, Ayurvedic, and Unani medicines, are founded on traditional beliefs and ancient writings.

An age-old medical system called Ayurveda has its roots in India. It is described in depth in the Sushruta Samhita and Charaka Samhita and is attributed to the Hindu deity Dhanvantari. The foundation of Ayurveda is the belief that imbalances in doshas, vata, pitta, and kapha lead to illness. Most ayurvedic medications are made from plants or herbs. Rasastra is the practice of incorporating metals or minerals, such as gold, arsenic, lead, and sulfur, into herbal remedies.

Conversely, the World Health Organization defines allopathic medicine as “the general category of medical practice that is known as Western medicine, evidence-based medicine, or modern medicine.”

Ayurveda places more emphasis on treating symptoms than contemporary medicine does on diagnosing and treating patients initially. There has been significant scientific investment in the study of illness origin and treatment due to the extensive use of allopathic medications in the Western world. As a result, we are aware of every medication’s chemical makeup, precise mechanism of action, and adverse effects. This isn’t true with ayurvedic medications, however.

The majority of medications used worldwide up to the turn of the century were natural or plant-based goods. Heavy metals like silver, mercury, and gold were used extensively. The use of antibiotics in medicine began during World War II and has continued for the last 80–90 years. But since then, the search for novel therapies has advanced quickly. Novel medications that target certain disease-causing pathways or operate at particular receptors are being developed. Nowadays, gene editing may be used to cure some hereditary illnesses. Huge financial support and the necessary infrastructure are needed for this.

But the field of ayurvedic knowledge has not advanced at the same rate. The benefits of arjuna bark for heart disease, high blood pressure, and cholesterol are well established; nevertheless, sufficient scientific data is lacking about the precise mechanism of action, dosage, and length of therapy.

An alkaloid called serpine, which comes from the Rauwolfia serpentina plant, was formerly employed in allopathy to treat hypertension. Due to adverse consequences, it is no longer used in allopathy; nevertheless, Ayurveda still uses it. In a similar vein, other herbal remedies such as tulsi and ashwagandha have been extensively utilized without thorough research, testing, or certification. Additionally, there are promising ayurvedic medications for diabetes mellitus. The active component, method of action, medication interactions, and side effects of ayurvedic medicines need to be investigated using contemporary technologies. Regulations pertaining to quality assurance, standardization, and sound manufacturing procedures are equally crucial.

With the creation of an Ayush (ayurveda, yoga, naturopathy, unani, siddha, and homoeopathy) section on all new AIIMS campuses, the government has lately pushed alternative medicine. However, much more work has to be done.

One Chinese-made anti-malarial medication serves as an example of what may be done. For more than 2,000 years, qinghao, also known as sweet wormwood or Artemisia annua, was a traditional Chinese herb used to treat malaria-related fever. Chinese scientist Tu Youyou developed qinghaosu, its anti-malarial basis, in 1971. In 1976, its chemical structure was discovered, which paved the way for the creation of its more potent derivatives. Artesunate is being used to treat falciparum malaria everywhere in the globe.

The adverse effects of several ayurvedic medications have drawn attention to them and made them less reliable. The general consensus is that since they are made of natural substances, they are harmless.

Their formulas could include contaminants and are not standardized. A PGIMER research on 43 popular ayurvedic over-the-counter medications was published in the journal Toxicology Research (Cambridge). The study indicated that metal concentration exceeded allowable levels for zinc, mercury, arsenic, and lead in the majority of the formulations.

In a previous research conducted in Boston, Massachusetts, the incidence of metals in 230 ayurvedic medicines was found to be the same in medications made in India and the US (around 20% of each). Lead and mercury were the most often found metals, and rasashastra remedies had more metal than non-rasashastra medicines did. Ayurvedic medications, like complementary and alternative medicine (CAM), are increasingly linked to serious adverse effects include skin rashes, renal damage, and liver illness.

It is necessary to do study on the components, active ingredients, effectiveness, and side effects of popular ayurvedic medications. It is necessary to use a multidisciplinary strategy that incorporates the tools of contemporary science. We need well-founded clinical trials with objective outcome measures and sound hypotheses from comprehensive pre-clinical research. Additionally, regulations should be strictly enforced and strengthened.