by Manju Kolli
Before I had the joy of becoming an Ayurvedic Practitioner, I trained and served as a clinical pharmacist. My experience in pharmacy, spanning more than 15 years, has both informed and enriched my perspective on the Ayurvedic practice I have built.
As a pharmacist, one of the most alarming and challenging trends I have witnessed is the surge in sales of over-the-counter (OTC) drugs, particularly those designed to alleviate symptoms of a range of increasingly common chronic illnesses. The growing use of OTC medications has been further fueled by their affordability, as well as by a rise in the number of prescription drugs that are now available over the counter.
Abuse and overuse of OTC medications can have serious consequences. The dangers from misuse of certain OTC painkillers, cough medicines, antihistamines, antacids, and laxatives, for example, are well documented within the medical community, and there is growing public awareness of the perils as well.
We are now seeing rising sales of herbal supplements, the market for which is currently valued in the multibillion dollar range and continuing to grow as increasing numbers of consumers seek natural remedies, both to prevent disease and to address chronic conditions. Additionally, the COVID-19 crisis is prompting many wellness consumers to look to supplements, including herbs, to boost their immune system.
Given my overlapping backgrounds in pharmacy and Ayurveda, I am acutely aware of the dangers of potential misuse of herbal supplements by consumers who may be self-medicating. This concern is shared by Ayurvedic and allopathic doctors alike. A friend who is a nephrologist even made a personal appeal to me to help save people’s kidneys by warning them of the dangers that lie in the misuse of herbal supplements.
The Science of Herbs
Although those of Indian origin tend to see Ayurveda as grandma’s wisdom-infused medicine, the reality is that Ayurveda is highly scientific in its approach to health and wellness. The well-developed rationales and principles underlying this approach and the logical treatment protocols it comprises have withstood the test of time.
Foundational to Ayurveda is the understanding that we all have a distinct blueprint at birth. As we mature, age, and go through life’s varied experiences and challenges, the natural balance of our original constitution (prakruti) changes and can be pushed out of balance. This imbalanced state (vikruti) is heavily influenced by our dietary and lifestyle choices.
Since a person responds to external triggers according to their particular prakruti, one person’s medicine can be another’s poison. This insight is true for most herbs just as it is true for most drugs.
Also essential to the proper use of herbs is a clear understanding of the Ayurvedic principle Karya Karana Bhava, which holds that no event occurs in creation without a cause. Simply put, there is a cause behind each and every disease. Ayurveda’s wisdom is used to address that cause in order to maintain health, prevent disease, and restore balance.
Let us look at the common problem of indigestion. One study cited by the National Institute of Health estimates that one in four Americans suffers from it.
There are many causes of indigestion. I have grouped together some common causes according to the dosha they can aggravate:
Excessive or high-impact physical activity or insufficient food consumption, aggravating vata
Spicy, salty, or sour foods, or excessive anger, aggravating pitta
An extremely sedentary lifestyle or consumption of too many sweet and heavy foods, aggravating kapha
Trikatu (which comprises dry ginger, black pepper, and pippali) can be very helpful in curing indigestion, as well as the bloating it can cause; however, it is only truly applicable to one of the three scenarios listed above.
In the first scenario, indigestion is likely to have resulted from insufficient digestive fire because of a loss of tissue strength, with the influence of vata’s predominantly dry and light properties. Trikatu will increase these depleting qualities, due to its own inherent dry and light properties, which, in turn, will aggravate the indigestion.
In the second scenario, indigestion results from excessive pitta, and trikatu will likewise aggravate indigestion and pitta due to its hot potency.
In the third scenario, however, trikatu is indicated as an appropriate pacifying remedy.
Here are some other examples of commonly available herbs that are subject to misuse:
Tulsi is known for helping with cold and cough symptoms. If, however, a cough is due to depletion, and it is dry, tulsi will increase the dryness and depletion and could aggravate the cough.
Ashwagandha is frequently used to treat depression, help with fertility, and increase muscle mass. If a client’s symptoms are due to excess accumulation of ama (undigested food in the body), however, ashwagandha will only worsen the condition.
Triphala is definitely an amazingly versatile herbal medicine that can help in many scenarios, but long-term use of it can create a harmful dryness in mucosal linings.
Neem can help with diabetes by removing excess accumulation of mucus. Yet if neem is overused after it achieves the desired action, vata gets aggravated, creating an imbalance.
Even ghee, one of the most widely advocated superfoods in Ayurveda, can be misused. If a person is suffering from insufficient digestive fire (mandagni) and excessive mucus, ghee can further dampen digestion and exacerbate the problem.
These are but a few examples of why it is essential to understand the nature of both the prakruti and the vikruti of clients, as well as the pathological road map of their disease manifestation, before prescribing herbal treatments. It is also important to use the optimal delivery method, including the Karya Karana Bhava, that will efficiently and effectively deliver the right herb to the right site and body system.
As these examples illustrate, well-meaning friends can naively advocate for an herb that has worked very well for them but can be harmful for someone else. In contrast, a knowledgeable Ayurvedic Practitioner can help clients find and correctly use herbal supplements that are right for them.
Our Role in Educating the Public
As Ayurvedic Practitioners, we play a critical role in protecting public health. Here are three suggestions for increasing awareness of the benefits of herbal supplements and the dangers of self-medicating:
Ask your clients to reach out to you with any questions rather than try to self-medicate based on advice from friends or information they find on the internet.
Offer free talks in public venues, such as virtual or live forums hosted by local libraries.
Author articles for local newspapers to educate your community.
The increasing popularity of herbal supplements and remedies represents a potential turning point in public awareness and medical community acceptance of Ayurveda as a credible pathway to health and wellness. It is up to us as practitioners and students of Ayurveda to help people understand that herbs and herbal supplements must be used appropriately.
About the Author
Manju Kolli is an Ayurvedic Practitioner based in California’s Bay Area, where she is the founding director of Ayurhitam, an Ayurvedic wellness clinic. Manju has more than 15 years of experience serving as an allopathic clinical pharmacist at the long-term care pharmacy PharMerica. A NAMA-recognized Ayurvedic Practitioner, she also teaches Ayurveda and has expertise in women’s and children’s health, gut problems, skin conditions, mental health, and allergies.