Ayurvedic Herbal Treatment of Rheumatoid Arthritis

 Rheumatoid arthritis is a medical condition characterised by inflammation, swelling, and pain in symmetrical joints, usually involving the smaller joints. This disease typically runs a chronic course, while having a varied long-term outlook. About half of those affected may have mild symptoms, which are usually well controlled with conventional treatment,  one-fourth may have a chronic but limited course, while the remaining one-forth have an aggressive form of the disease, with severe pain and joint disfigurement.

The modern treatment of rheumatoid arthritis is usually with standard, oral anti-inflammatory and pain-killing medications, as well as local applications having the same mode of action. People affected with refractory rheumatoid arthritis are usually put on steroids and immune-suppressant drugs. The response to these medications is usually good to start with; however, the long term benefits are usually limited, while the side effects are substantial and serious. Ayurvedic medicines have a major edge in treating such refractory patients, while limiting the potential side effects.

The aim of Ayurvedic treatment is to reduce the chronic inflammation process related to rheumatoid arthritis, as well as to regulate and regularise the immune system of the body, so that it helps positively in combating the disease. Herbal medicines act on the joint to reduce pain as well as swelling, and work on the joints to help repair the joint structure. Deformities in joints can either be prevented or reduced with the long term use of Ayurvedic medicines. Active Ayurvedic treatment for about 8-18 months is usually sufficient to significantly reduce all associated symptoms even in patients with severe forms of rheumatoid arthritis. Most such patients also have concurrent symptoms related to other auto-immune disorders, especially of the skin and mucous membranes. These symptoms too need to be treated aggressively, in order to bring about a remission of arthritis.

To sum up, Ayurvedic medicines have a major role to play in the treatment of aggressive and refractory types of rheumatoid arthritis.

Dr A A Mundewadi is available as an Ayurvedic Consultant at https://www.mundewadiayurvedicclinic.com and http://www.ayurvedaphysician.com  For treatment of RA, kindly click on this link https://www.mundewadiayurvedicclinic.com/product-page/rheumatoid-arthritis-ra 

Ayurvedic Herbal Treatment of Osteoarthritis (OA)

 Osteoarthritis (OA) involves degeneration of the smooth cartilage which lines the long bones and forms joints. This can cause pain, swelling, stiffness and limitation of movement. The knee, hip, spine and hands are most commonly affected. OA is most commonly due to old age, obesity, trauma, occupational hazards, and genetic influences; it is more common in women. Treatment is with pain killers, physical activity, weight loss measures, local injections, and surgery to correct bone deformity or joint replacement. Most affected people do well with conservative treatment. Regular physical activity is important to maintain stability of the joint, strengthen supporting muscles, and reduce pain.

People usually try alternative treatment when they do not get satisfactory relief or get only temporary relief with modern medicines and conservative measures to treat OA. With moderate or advanced OA, the damage to cartilage as well as the associated symptoms keeps progressing. Ayurvedic herbal treatment is very effective in treating both moderate as well as advanced OA. Depending upon the severity of the condition, Ayurvedic medicines need to be given in high doses for about 3 to 6 months to get complete relief from pain, swelling and other symptoms related to OA.

Ayurvedic herbal treatment is also very effective in treating advanced OA, especially for those people who have been advised complete joint replacement. Aggressive treatment with herbal medicines, combined with local pain relief ointments, graded exercises, and weight loss measures have resulted in stabilizing affected individuals to such an extent that joint replacement is no longer required. Treatment duration for such patients is usually about 6 to 12 months. Side effects or unwanted effects of Ayurvedic medicines used for such patients are virtually nonexistent, even though high doses are required to effectively treat advanced OA.

Ayurvedic herbal treatment thus has a very important role to play in the treatment and management of OA.

The writer, Dr A A Mundewadi, is available as an Ayurvedic Consultant  at https://www.mundewadiayurvedicclinic.com  and  http://www.ayurvedaphysician.com

For treatment of OA, kindly click on this link https://www.mundewadiayurvedicclinic.com/product-page/osteoarthritis-oa

Ayurvedic Herbal Treatment of Avascular Necrosis (AVN)

 Loss of blood supply to the end part of long bones results in a gradual cellular death and collapse of bone, causing pain, limitation of movement, and destruction of the joint. This condition is known as avascular necrosis (AVN), and mostly involves the hip joint, though other long bones and even small bones may also be affected. Trauma and drugs like corticosteroids can cause AVN; organ transplant recipients are also more susceptible.

Modern treatment options for AVN bring about limited results. Reduction in weight bearing by restricting activity and using crutches; pain relieving drugs; medicines like biphosphonates and vasodilator drugs; and heat therapy, bring about some degree of improvement. Surgical options include core decompression, bone grafting, and total hip arthroplasty. Poor prognostic factors include age over 50 years, stage 3 or more disease progression  at the time of diagnosis, death of more than a third of the weight bearing area of the joint, and lateral involvement of the joint.

Ayurvedic herbal medicines can be judiciously used to bring about significant relief or even a complete cure in patients suffering from AVN. Herbs increase blood circulation to the affected bone, increase micro-circulation, reduce swelling, flush out dead tissue, and even help in bone remodeling. In the early stages of the disease, treatment of about 4 months is sufficient, while those having an advanced condition require treatment with high doses of herbs for about 6-8 months. Highly refractory patients also need medicated enemas in addition to the oral treatment.

Ayurvedic treatment can also be given in concurrence with surgical procedures to provide maximum benefit; it can also be offered as a treatment option for patients with failed surgeries.

Ayurvedic herbal treatment thus has a definite role to play in the treatment and management of AVN.

The writer, Dr A A Mundewadi, is available as an Ayurvedic Consultant at https://www.mundewadiayurvedicclinic.com and www.ayurvedaphysician.com For treatment of AVN, kindly click on this link https://www.mundewadiayurvedicclinic.com/product-page/i-ayurvedic-herbal-treatment-of-avascular-necrosis-avn-m-a-product

Ayurvedic Herbal Treatment in the Management of Alzheimer Disease

Alzheimer disease (AD) is a chronic, progressive, neurodegenerative disorder involving cognitive and behavioral impairment which severely impairs day to day activities, as well as social and occupational functioning. This condition causes dysfunction and atrophy of the hippocampus, a part deep within the brain which helps to encode memories, as well as parts of the cerebral cortex which are involved in thinking and making decisions. Structural changes may begin to appear in the brain several decades before actual appearance of signs and symptoms.

AD usually goes through 4 clinical stages. The first stage is preclinical, in which the hippocampus and nearby brain areas get affected and start shrinking; however, patients are usually clinically unaffected. In the next stage which is termed as mild AD, the cerebral cortex too gets affected, giving rise to symptoms such as memory loss; getting lost; difficulty in doing daily activities, handling finances, making judgments; loss of spontaneity and initiative; and mood and personality changes. The subsequent stage is moderate AD, in which brain parts are involved which control language, reasoning, sensory processing and conscious thought. This causes symptoms such as increased memory loss and confusion; shortened attention span; difficulty with language, learning, logical thinking, recognizing people and organized movement; increased mood and personality changes; and repetitive actions and statements. The last stage is severe AD, in which there is significant atrophy of affected brain parts, because of which patients fail to recognize close or family members; become completely dependent; and lose all communication and sense of self. There may be additional symptoms like weight loss, difficulty in swallowing, incontinence, skin infections, convulsions, and increased sleeping.

Senile plaques (SPs) and neurofibrillary tangles (NFTs) are the hallmark of AD pathology. Plaques are formed by the accumulation of dense, mostly insoluble deposits of a protein known as beta-amyloid (Ab) as well as some cellular material surrounding neurons. Ab is a part of a larger protein known as amyloid precursor protein (APP), which is associated with the neuron cell membrane. Degenerative processes speed up the formation of Ab fragments, which come together outside the cell and form clumps known as SPs. It is currently unclear whether SPs are the cause or byproduct of the AD disease process.

Healthy neurons have an internal communication system partly made up of structures known as microtubules, which allow to and fro movement of nutrients and molecules. A special kind of protein known as tau binds to the microtubules and stabilizes them. AD causes chemical changes in tau which in turn bind together and cause tangling, disintegration and collapse of the microtubular system, leading to disorganized structures known as NFTs. These cause disruption in the communication between neurons, gradually leading to cellular death.

The anatomic pathology of AD thus includes SPs and NFTs at the microscopic level, and cerebro-cortical atrophy at the macroscopic level, which can be visualized in MRI plates. Clinical onset of AD is primarily preceded by accumulation of SPs; while NFTs, loss of neurons and their synaptic connections are associated with progressive cognitive decline. AD thus affects the communication, metabolism and repair of brain cells; progressive neuron cell death causes the clinical features of the disease. The presence of a sufficient number of SPs and NFTs along with a characteristic distribution in the brain is required for a definitive diagnosis of AD, since these may be present in other neurodegenerative diseases, and may also be a part of aging. In addition to SPs and NFTs, other pathological changes may also contribute to the disease process. These include granulovacuolar degeneration (in the hippocampus); formation of neuropil threads (in the brain cortex); cholinergic (neurotransmitter) deficiency; oxidative stress and damage (in the brain); chronic inflammation; clusterin (protein) alterations; increased presenilin (gene) expressions; and estrogen (hormone) loss.

Currently, modern medicine can only offer symptomatic treatment for AD, with most medications modulating neurotransmitters, either acetylcholine, or glutamate. Behavioral symptoms like depression, agitation, aggression, hallucinations, delusions, and sleep disorders can be treated using antidepressants, anxiolytics, antiparkinson medications, beta blockers, antiepileptic drugs and neuroleptics. Graded and interactive mental activities are known to improve cognition and slow down deterioration. Diets which reduce carbohydrate consumption and allow for increased consumption of fruits, vegetables, and non-farmed fish have been known to reverse mild to moderate cognitive decline. Such interventions also include a graded exercise program, stress reduction techniques, and supplementation with vitamin D3, fish oil, coenzyme Q-10, melatonin, and methylcobalamin. Physical activity, exercise, cardiorespiratory fitness, and a Mediterranean diet may have a preventive effect.

In the absence of any specific treatment or cure for AD, Ayurvedic herbal treatment can be utilized judiciously with significant results. AD is treated as a mix of autoimmune and degenerative disorder, and treated using some common treatment principles utilized for such diseases. This includes detoxification, treatment of chronic infection and inflammation, providing specific nutrition for degenerating tissues, opening up of damaged and blocked nutritional pathways, modulating metabolism at the general level as well as cellular level, and repair of reversible damage. These actions are usually performed concurrently, and may need to be tailor-made as per the history, clinical presentation and specific requirements of each individual.

Epigenetics is a change in gene expression that results from gene-environment interactions; this may be brought about by chemical or functional changes in RNA and DNA without actually changing the gene sequence. Epigenetic elements are possible in the causation of AD since the occurrence of AD in the majority of patients is sporadic, without a family history, and presents late in life. Exposure to chemicals, aluminium and lead; chronic oxidative and environmental stress; and chronic inflammation, are known factors which may present using this mechanism. While these are causative factors, the information pertaining to epigenetics can be used in Ayurvedic treatment to reverse the pathology as well as symptoms of AD.

Ayurvedic herbomineral combinations need to be given for several months to reverse AD pathology. The dosage depends upon the severity of symptoms; patients with moderate and severe AD require high doses. These are supplemented with herbs to continue mild detoxification, treat inflammation and provide nutrition. While these medicines are administered orally, there are other treatment modalities also in use. Courses of medicated enemas and medicated nasal drops can bring about significant improvement. A special procedure known as “Shiro-Basti” is used, in which warm Ayurvedic medicated oils are poured onto the scalp within special, elongated skull caps for specific durations. Generalized skin massage and fomentation with medicated steam also provide good results. Exposure to sunlight (known in Ayurvedic terminology as “aatap sevan”) helps AD people to remain active in the day time and sleep well at night. The consumption of various medicated oils, ghee (clarified butter) and bone marrow is also known to provide benefit.

Most of these procedures, as well as oral treatments, require some degree of cooperation from people affected with AD; hence it is advisable to commence Ayurvedic treatment as early as possible, preferably at the time of diagnosis. This can ensure that patients get the maximum possible therapeutic benefit in the form of decreased symptoms, better quality of life, and reduction in morbidity and mortality.

The writer, Dr A A Mundewadi, is available as an Ayurvedic consultant at https://www.mundewadiayurvedicclinic.com and http://www.ayurvedaphysician.com

Bullous Pemphigoid – Ayurvedic Herbal Treatment

Bullous Pemphigoid (BP) is a rare, autoimmune disease featuring inflammatory blisters in the sub-epidermal part of the skin. It is chronic in nature and can persist for months or years, with a tendency to spontaneous remissions and exacerbations.

It is not to be confused with another similar sounding disease, Pemphigus vulgaris (PV). While both are autoimmune diseases targeting the skin, PV is comparatively more common, is limited to the upper epidermis, involves the mucous membrane more often, blisters rupture easily, and it has a higher fatality rate. In comparison, BP is located between the dermis and epidermis, the tense blisters do not break easily, mucous membrane involvement is much lesser, and it is more amenable to treatment, though it too can be fatal in the elderly or debilitated people. The diagnosis can be confirmed in both diseases using skin biopsy for Direct Immunoflourescence test (DIF) and Indirect Immunoflourescence test (IDIF) using serum. While autoantibodies desmoglein 1 and 3 denote PV disease, the presence of anti-BPA 1 and 2 confirm a diagnosis of BP.

The standard treatment of BP includes the use of anti-inflammatory drugs and immune suppressants, to reduce and heal blisters and erosions and to prevent recurrence with continued use of the minimum possible dosage of medicines. Anti-inflammatory drugs include corticosteroids, tetracycline and dapsone, while immune suppressant drugs include azathioprine, methotrexate, mycophenolate mofetil and cyclophosphamide. Doxycycline has been found to be more effective and with lesser adverse effects as compared to prednisone. Most patients experience long term remission with about 6-60 months of treatment.

Most of the mortality associated with BP is due to the adverse effects of long term use of drugs used for treatment. Steroids can aggravate hypertension, heart disease, diabetes, peptic ulcer, and bone thinning. Since BP primarily affects elderly people, most patients already have such diseases as comorbidities. Localized skin involvement can be treated using potent topical corticosteroid ointments along with anti-inflammatory medicines so as to avoid the side effects of oral steroid therapy. Refractory patients may benefit from biological treatment with Rituximab.

Ayurvedic herbal medicines have a definite role to play in the management of BP since the treatment is safe for long term use, and can effectively provide prolonged or permanent remission from the disease. While it has been discussed above that BP is completely different from PV, since the part of skin involvement is different in both diseases, the Ayurvedic treatment guidelines and protocol for both diseases is more or less the same. This is because, till date, there is no different treatment approach based upon the different layers of affected skin.

Ayurvedic herbal treatment for BP involves the use of herbal medicines which have a direct action on skin, subcutaneous tissue, capillaries, blood, and blood vessels. Since this is an autoimmune disorder, treatment is aimed at managing inflammation, allergy, chronic infection, detoxification, strengthening and rejuvenation of faulty or dysfunctional tissue, and gradual modulation of immunity. As the disease gradually moves into a remission phase, follow up treatment includes the use of generalized rejuvenation of the full body, also known as Rasayana therapy. For better prevention, those herbomineral formulations are used which not only activate healthy body metabolism, but also simultaneously provide control for inflammation, allergy, and help gradually build up true body immunity.

Patients who do not respond adequately to simple oral herbal therapy, or those with severe involvement at presentation, are subjected to systematic detoxification plans known in Ayurveda as Panchkarma. These may be given singly or in combination, as per the discretion of the attending physicians. Caution needs to be exercised while doing detoxification procedures, since BP is mainly found in the elderly population. For recurrent, localized skin involvement, simple blood-letting from a vein near the affected parts, or leech application in several sittings may provide dramatic results at almost no risk.

Local application of herbal ointments along with a few oral herbs may provide benefit to most patients affected with BP. Ayurvedic herbal treatment for about 6-8 months is usually sufficient in providing long term remission to most patients who approach physicians for Ayurvedic treatment. Severe autoimmune involvement may require aggressive treatment for nearly 18- 24 months. The presence of comorbidities may additionally prolong treatment. Most affected people with BP usually get significant relief and lasting remission with Ayurvedic herbal treatment.

The writer, Dr A A Mundewadi is available as an Ayurvedic Consultant at https://www.mundewadiayurvedicclinic.com and http://www.ayurvedaphysician.com

Pemphigus Vulgaris (PV) – Ayurvedic Herbal Treatment

Pemphigus vulgaris (PV) is a rare autoimmune disease involving the formation of blisters on the skin and mucous membranes. This disease is quite significant since it is potentially life-threatening, with a high mortality rate of 5-15%, even though affecting only the skin and mucous membranes. Circulating antibodies are directed against the keratinocyte cell surfaces in the skin; this causes a loss of cell-to-cell adhesion, resulting in a breach of the skin epidermis, thereby causing blisters. These blisters are of varying size, and may appear on normal or inflamed skin. The blisters are fragile and rupture easily; these are painful and heal slowly, usually without scarring. Almost all patients present with oral cavity involvement; other mucous membranes which may be involved include the conjunctiva, esophagus, labia, vagina, cervix, vulva, penis, urethra, nasal mucosa, and anus.

Diagnosis is usually made by skin biopsy from the edge of a blister; direct immunoflourescence (DIF) on normal-appearing skin surrounding the blister or plucked hair sheaths; and indirect immunoflourescence (IDIF) using the patient’s serum. ELISA tests can detect the presence of antibodies and these titers correlate well with disease activity. While antidesmoglein 3 antibodies are present in patients having only mucosal involvement, the course of the disease correlates well to antidesmoglein 1 antibody levels. Reversion of DIF test to negative can be used as an indicator of remission and for monitoring while tapering medicines.

Treatment of PV is mainly with corticosteroids to reduce and stop the inflammation process. Immune suppressing medicines are sometimes used early on in the course of the disease as steroid-sparing medication. Fatalities are more common in the first 5 years of the disease, and are related to susceptibility to infection, as well as fluid and electrolyte imbalance. Morbidity and mortality is related to the severity and extent of the disease, the dosage of steroids required to induce remission, as well as the presence of co-morbidities. Elderly patients and patients with extensive disease have a more serious prognosis. The long term use of steroids and immune suppressants also contributes to the overall morbidity and mortality. Rituximab, sulfasalazine, pentoxyphylline, methotrexate and dapsone have been used as steroid-sparing drugs. Intravenous immunoglobin therapy and plasmapheresis have been used with some degree of success in refractory patients.

Because of the high mortality of this disease as well as the contributing toxicity of steroids and immune suppressants drugs, Ayurvedic herbal medicines have a significant role to play in the overall long term treatment and management of PV. This being an autoimmune disorder, the treatment protocol includes a multipronged approach of detoxification, proper nutrition, rejuvenation of body systems, immune modulation, as well as specific treatment for the actual systems or organs affected.

Special attention is focused on strengthening the integrity of the skin and mucous membranes. This involves the use of medicines which act specifically on the skin and mucous membranes as well as on blood vessels. Herbal medicines which have immune modulating properties as well as act specifically on skin and mucous membranes are very useful in this scenario. Medicines also need to be given to help in healing of ulcers, and for the prevention of secondary infection in the sores.

Detoxification for each patient needs to be tailor-made according to the severity and chronicity of PV lesions. While some patients may require just a few additional medicines to boost kidney and liver function, yet others may require an elaborate detoxification plan for induced emesis, induced purgation, and blood-letting. Known in Ayurveda as Panch-karma, these procedures may be used as standalone or as combination-procedures. These detoxification procedures may provide rapid remission of PV symptoms; however, patients need to be selected carefully, since most affected with PV are old or have concurrent comorbid conditions.

Depending upon the severity of the condition as well as the response of patients to treatment, Ayurvedic herbal medicines may need to be given for periods ranging from about 6 to 10 months. With regular treatment, most patients affected with PV respond well to Ayurvedic herbal treatment and more than 80 % achieve full remission. Gradual tapering of medicines, as well as suitable modifications in diet and lifestyle, can help prevent recurrence of the condition. Aggravating factors like stress and certain medications also need to be avoided. A judicious utilization of Ayurvedic herbal treatment can thus bring about significant improvement in PV and considerably minimize the mortality due to this condition.

The writer Dr A A Mundewadi is available as an Ayurvedic Consultant at https://www.mundewadiayurvedicclinic.com and  www.ayurvedaphysician.com For Ayurvedic herbal treatment of PV, kindly click here

Chronic Urticaria – Ayurvedic Herbal Treatment

Urticaria, also known commonly as hives, is an allergic reaction of the skin with characteristic red, itchy patches of various size and shape. The individual patches usually subside within 24 hours, without any pigmentation or scaling. This condition is known as chronic urticaria if lesions recur for more than 6 weeks. A more serious variant of this condition is known as angioedema, in which the swelling goes much deeper and involves the mucous membrane, usually in areas like the eyelids, lips and tongue.

Chronic urticaria is usually diagnosed clinically with the help of a detailed medical history and physical examination. Further investigations may be required in case of a concurrent history of parasitic infection, thyroid disorder, or autoimmune disorder. Rarely, a skin biopsy may be required if the lesions persist for more than 24 hours at a time, or there are accompanying features of skin bleeds, autoimmunity, fever or arthritis.

Chronic urticaria is usually divided into three subsets: 1) Physical or inducible urticaria, also known as symptomatic dermatographism, cholinergic urticaria, and pressure urticaria. About 20 % of patients present with this subtype, in which the trigger is some consistent, identifiable factor such as mechanical stimuli (pressure, vibration), temperature changes, sweating, stress, sun exposure, and water contact.2) Chronic urticaria secondary to some underlying medical condition; however, this is very rare. 3) The largest subtype is known as chronic idiopathic urticaria or chronic spontaneous urticaria. No definite causative factor can be attributed to this subtype; however, in about 20-45 % of such patients, there may be an underlying autoimmune process driving the disease.

The standard management of chronic urticaria includes the use of anti-histamines to reduce the rash as well as itching. Most people with mild symptoms can be managed well with these medicines itself. For those with moderately severe symptoms, additional medicines like colchicine, dapsone, and steroids are given for a limited time period. Those with an autoimmune process may require immune modulating drugs, while a small percentage may require anti-thyroid medications.

It is equally important to avoid triggers like mental stress, overtiredness, tight fitting clothes, alcohol, aspirin and other non-steroidal anti-inflammatory drugs. Application of soothing ointments can help relieve itching; night time pruritis can be alleviated by lukewarm baths. Chronic urticaria may last from months to years; however, about 50 % patients experience remission within a year with proper treatment. With the exception of angioedema, this disease is not life threatening; however, it can significantly affect the quality of life.

Ayurvedic herbal medicines can be used with very good results in the treatment of chronic urticaria, especially in those patients who do not respond to conventional therapy. Herbal medicines can be used to reverse the basic pathology of the disease. Medicines which strengthen the skin tissue, treat allergy, and prevent recurrence, are used to reduce symptoms. Medicines useful in this condition are those which act on the skin, subcutaneous tissue, mucus membranes, capillaries, and blood.

Ayurveda also differentiates the treatment protocol for chronic urticaria based on the symptoms and specific causes. Urticaria with predominantly ‘Vata’ dosha symptoms is known as ‘Sheeta-pitta’;  with dominant ‘Pitta’ symptoms, it is known as “Utkotha”; while with dominant ‘Kapha’ symptoms, it is known as ‘Udarda’. Each of these types of urticaria is treated differently, according to the clinical presentation, causative factors, and severity. For patients with refractory symptoms, purification Panchkarma procedures like induced emesis, induced purgation, and bloodletting are utilized, either as stand-alone procedures, or as combinations, or even as repeat combination-procedures, if indicated.

Ayurvedic herbal medicines also need to be given to treat chronic gastro-intestinal symptoms, repeated worm infestations, thyroid disorders, chronic stress, latent infections, and chronic inflammation. For patients with an underlying autoimmune process driving chronic urticaria, an elaborate treatment needs to be planned, which includes detoxification; treatment of chronic inflammation; healing of damaged organs, tissues and body systems; rejuvenation using tonifying medicines; provision of specific nourishment; gradual immune modulation; and providing treatment for the specific type of chronic urticaria.

With proper and regular treatment, most patients having chronic urticaria can be fully treated in about 4-8 months. Before commencing treatment, it is important to do a thorough examination and accurate diagnosis, in order to achieve a quick remission. Depending upon the severity, patients with autoimmune disease may require treatment for longer periods. It is equally important to adopt suitable lifestyle modifications and avoid know triggers.

The writer, Dr A A Mundewadi, is available as an Ayurvedic Consultant at https://www.mundewadiayurvedicclinic.com  and  www.ayurvedaphysician.com  For Ayurvedic herbal treatment of chronic urticaria, kindly click on this link https://www.mundewadiayurvedicclinic.com/product-page/urticaria-chronic