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 

Multiple Myeloma – Ayurvedic Herbal Treatment

Multiple myeloma, also known as myeloma or Kahler’s disease, is a cancer of the plasma cells in the bone marrow. Plasma cells are responsible for producing different antibodies against infections to which the body is exposed. Myeloma features an abnormal proliferation of plasma cells in the bone marrow, causing destructive bone lesions, and producing an abnormal protein known as monoclonal antibody or M protein. Common symptoms include anemia, fatigue, weight loss and weakness, unexplained fever, bleeding, bone pain and bone tenderness, hypercalcemia, fractures, kidney disease, nerve pains, enlarged tongue, skin lesions, and an increased susceptibility to infections.

The exact cause of multiple myeloma is as yet unknown; however, it is believed that exposure to chemicals, radiation, and viruses; immune disorders; and a family or genetic history, may cause or trigger the disease. This condition is usually seen in middle and old age. A detailed medical history and clinical examination, coupled with multiple blood and urine tests, along with x-ray and bone marrow tests may be required for a confirmed diagnosis of myeloma.

Based upon the severity, the disease is usually divided into three stages and has a median survival of about three years; however, there may be wide variations, depending upon the disease severity, immune status of the patient, and the response to treatment. Although there is presently no cure for this disease, a combination of treatments can help achieve a prolonged remission. Treatment includes immune-modulators, radiation, chemotherapy, surgery, stem cell transplant, blood transfusions, and plasmapheresis.

Ayurvedic herbal treatment can be used concurrently with modern treatment in order to bring about a complete remission of the disease and prevent a relapse. In order to reverse the basic pathophysiology of the disease, herbal medicines are given to neutralize and remove the malignant plasma cells and help the bone marrow produce normal blood precursors. The deposition of abnormal protein causes damage in various organs, and this needs to be treated separately. Kidney damage can be reversed completely if treated with herbs at early detection. Nerve damage and neuropathy has to be treated with herbal medicines which act on the central nervous system as well as on peripheral nerve endings. Medicines which act on the blood tissue need to be given on order to treat anemia, abnormal bleeding, and skin rashes.

Other herbs are added to help treat bone pain, reduce crowding of plasma cells in bone, prevent fractures, and bring about healing of bone lesions. Severe bone pain is a typical feature of advanced disease. Highly aggressive treatment is required in order to provide relief from bone pain, bone tenderness and prevent fractures. Sometimes, a special Ayurvedic Panchkarma procedure known as Tikta-Ksheer basti is needed. In this procedure, several courses of enemas of medicated oils and medicated milk are given to help ease off bone lesions.

Immune modulation is an important part of treatment to help prevent severe infections. For multiple myeloma, Ayurvedic herbo-mineral drugs, known as Rasayanas, are used judiciously with maximum impact in reversing most of the symptoms and signs of this condition. It is important to choose one or several Rasayanas which regulate blood and bone marrow metabolism, modulate immunity, reverse weakness and weight loss, and also treat anemia and low grade fever. At the same time, these medicines should be well tolerated by the patient and should not have any adverse effects on important body organs like the kidneys, liver and heart.

Once a patient achieves remission, it is important to gradually taper off the treatment while continuing a few important medicines so as to prevent a relapse. Blood and urine tests are used to monitor for a relapse. With a combination of modern and Ayurvedic treatment, most patients having multiple myeloma achieve remission within 12 to 18 months. In order to prevent a relapse, they need low dose medications and monitoring for at least 5 years.

Ayurvedic herbal treatment can thus be judiciously used in combination with modern treatment to successfully manage and treat multiple myeloma.

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

Tinnitus – Ayurvedic Herbal Treatment

Abnormal sounds in the ear are known as tinnitus; these can be of varying types such as ringing, buzzing, hissing, chirping or whistling. The sounds may be continuous or intermittent; and may vary in intensity from being mild – which may be just a nuisance – to severe or very severe, and may adversely affect interpersonal relations and quality of life. It may or may not be associated with hearing loss.

Tinnitus can be caused by excess accumulation of wax in ears; ear or sinus infections; sudden or prolonged exposure to loud sounds; Meniere disease (a disease of the inner ear), otosclerosis (hardening of the middle ear bones); neck and jaw problems; neck and head injury; certain diseases like high blood pressure, cardiovascular disease, allergies, anemia, underactive thyroid and diabetes; natural aging (due to hardening of arteries and degeneration of sensory hair in the inner ear); and drugs like aspirin, certain antibiotics, anti-inflammatory drugs, antidepressants, quinine medications, and some diuretics. Tinnitus may be aggravated by fatigue, stress, smoking, and consumption of alcohol or caffeinated drinks.

The standard management of tinnitus involves looking for and treating any known causes for the condition. This includes - as the case may be – wax removal; antibiotic drops and oral medication for infection; medical and surgical treatment for trauma, tumors and otosclerosis; specific treatment of unrelated medical issues which may be the cause for tinnitus; and avoidance of drugs which may be causing or aggravating this condition. Anti-anxiety and anti-depressant drugs in low doses are helpful in some people. Sound masking devices may be used to reduce exposure to loud sounds. Tinnitus training therapy, cognitive therapy and biofeedback may also be used to mitigate the effects of tinnitus. While tinnitus may resolve spontaneously in a few individuals, yet, in other affected people, it may not get eliminated or reduced in spite of removing all known causes as well as taking adequate treatment.

Ayurvedic herbal treatment can be given to those affected individuals who have tinnitus refractory to standard treatments and with poor quality of life due to its severity. The primary pathophysiology of tinnitus relates to degeneration and dysfunction of the sensory hair in the inner ears, and distorted auditory input being conveyed to the brain. Treatment is given to reverse or reduce this pathology by using herbal medicines which strengthen and tonify the inner ear components as well as modulate auditory nerve impulses. Most of these herbs also serve to reduce stress and fatigue, which are known to aggravate or amplify the effects of tinnitus.

Additional Ayurvedic treatment is also given to treat specific causes of tinnitus. For otosclerosis, herbal medicines are used which reduce calcification, and make the middle ear bones more pliable and responsive to sound waves. In the case of Meniere’s disease, Ayurvedic medicines are used which reduce the pressure and fluid overload in the inner ears. People with a known history of high blood pressure and cardiovascular disease are given herbal medicines which reduce atherosclerosis and stiffening of arteries, and make blood vessels more elastic. Some people with severe tinnitus have a history of serious allergies, and herbal treatment for this brings about significant amelioration of tinnitus symptoms.

Ayurvedic tonics known as Rasayanas are useful in several people with tinnitus; it is believed that these medicines improve digestion and tonify the metabolism of the body at the tissue level as well as at the cellular level. While the use of medicated oils as ear drops in tinnitus treatment is controversial – and especially contraindicated in people with perforated ear drums – this treatment does have a place in softening impacted wax; treating  hardened and over-sensitive eardrums; and as additional therapy in aged people. Some medicated oils are mild and have a soothing and strengthening effect, while others are strong and have an irritating or stimulant effect; these have to be selected and used on a case-to-case basis.

Depending upon the severity and cause of tinnitus, most affected people get significant relief or a cure from this condition with about 4 to 6 months of treatment. Ayurvedic herbal treatment can thus be judiciously utilized in the management and treatment of tinnitus.

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 tinnitus, kindly click here

Ayurvedic Herbal Treatment – Acute Intermittent Porphyria

Acute Intermittent Porphyria (AIP) is a medical condition which forms part of a rare group of hereditary conditions known as Porphyrias, which involve defects in heme metabolism, resulting in excessive secretion of porphyrins.  This causes intermittent episodes of acute abdominal pain, neuropathies, and constipation.  Heme is the iron part of hemoglobin in blood. Other porphyrias include skin and central nervous system involvement. Diagnosis is confirmed by elevated levels of urine porphobilinogen, and conservative treatment is with intravenous glucose infusion, which inhibits heme synthesis and helps reduce abdominal pain.  Patients having attacks of severe pain and those with neurological involvement usually require treatment with Hematin.

All individuals having this genetic defect have increased levels of porphyrins secretion, but all do not experience symptoms. It is stipulated that systemic inflammation brings about a reduction in kidney function as well as neurological damage, which in turn causes peripheral and autonomic neuropathies and psychiatric symptoms. AIP usually occurs in the age from 18 to 40, with women being more affected than men. Attacks of abdominal pain usually last from 3 to 7 days. Precipitating factors include unknown causes, fasting, alcohol, prolonged exposure to sun, stress, heavy exercises, and drugs like Phenobarbital, estrogens, and sulphonamides.

Individuals having AIP who have recurring attacks, severe incapacitating neuropathies, and those having severe neuropsychiatric manifestations are suitable candidates for Ayurvedic herbal treatment. Ayurvedic treatment not only provides good symptomatic relief, it also significantly reduces inflammation, which is the hallmark of severe symptoms and recurrence. Involvement of the skin and central nervous system has to be treated separately.

With the commencement of Ayurvedic treatment, most patients get relief from severe pain within 1 to 5 days. Further treatment is aimed at preventing a recurrence, and ensuring a good bowel movement. Patients need to be treated regularly for about 3 to 5 months in order to get lasting relief and freedom from recurrence of the symptoms. Treatment is then tapered off and stopped completely. For day to day medical issues, short courses of simple Ayurvedic medicines are given to treat symptoms. Ayurvedic medicines are tolerated quite well and have not been known to aggravate or precipitate AIP; however, patients should avoid self-medication, and take treatment from a qualified Ayurvedic practitioner. It is equally important to avoid all known precipitating factors.

Patients having skin involvement usually present with severe itching; this can be controlled very well with Ayurvedic herbs within a few weeks. Patients having neuropsychiatric symptoms or motor neuropathy need specialized treatment for longer periods – nearly 6 to 9 months. Along with oral medication, Ayurvedic Panchkarma procedures like full body massage, fomentations, medicated enemas and Shiro-bastis may be required. A few patients with severe involvement of the nervous system may even require medications for up to 2 years for a full remission of symptoms.

Ayurvedic herbal medicines can thus be judiciously utilized in the successful management and treatment of AIP as well as all porphyrias.

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