Lesson The Maharishi AyurVeda Approach to Diabetes and High Cholesterol
Maharishi Ayurveda Health Professional Training Program Diabetes Mellitus Madhumeha There are 20 types of Prameha (diabetes) described in the classical Ayurvedic texts. These are divided into 3 main categories or stages, according to Vata, Pitta, and Kapha. First stage: Second stage: Third stage: Kapha: easy to manage. Pitta: more challenging, but manageable. Vata: difficult to manage. During the first stage, Kapha becomes vitiated together with Medo Dhatu, resulting in Mutra Atisara (excessive flow of urination). Causes Familial predisposition. Inadequate physical activity. Irregular meals. Inadequate diet: Kapha aggravating: too sweet, too sour, too salty. Stressful or toxic environment; pollution. Mental stress and tension. Symptoms (traditionally described) Excessive sweating. Excessive urination. Lethargy, laziness. Change of color and smell of urine; "urine like honey" Copyright 2012, Maharishi Ayurveda Association of America 4.1
Diet and Regimen Diet: In general, follow Kapha Pacifying Diet. Special foods to favor: Fresh and warm foods Grains: old rice, mung dahl, whole wheat, barley, rye. Vegetables: bitter gourd, Indian drumstick, asparagus, artichoke, spinach, fenugreek leaves, broccoli, zucchini, louki (bottle gourd), snake gourd. Spices: turmeric, cumin, hing (asafetida), fenugreek seeds, mustard seeds, black pepper, ginger. Dairy: takra (Ayurvedic buttermilk), milk in small quantities. Fruits: astringent fruits such as unripe pomegranate. Foods to avoid: heavy foods; sugar, new grains, fish, eggs, red meat; sweet foods; ice cream; chocolate, cakes, alcohol, carbonated drinks, urad dahl. Regimen: Behaviors to follow: maintain regular daily routine: regular exercise without straining (such as long walks, brisk walks), Yoga Asanas, Pranayama and regular Transcendental Meditation program; regular mealtimes; light breakfast and dinner; lunch as main meal of day. Behaviors to avoid: excess travelling; excess heat causing sweating; snacking; eating late at night; eating while watching TV; suppression of natural urges; lack of activity, laziness, mental tension; smoking. Copyright 2012, Maharishi Ayurveda Association of America 4.2
Traditional Ayurvedic Herbal Preparations for imbalances associated with Diabetes Mellitus, Type 2 Note: Always begin with treatment to normalize digestion and eliminate Ama, as indicated (e.g., see Obesity protocol). In general, herbs used in managing diabetes are predominant in the Kapha-reducing tastes, especially bitter and astringent. Turmeric powder, especially in the initial stages. Take 1-3g, 2-3x times a day with little aloe vera gel or juice. Also use it in cooking. Gurmar/Sharndunika (Gymnema sylvestre): "destroyer of sweet." Counters sugar craving as well as having documented hypoglycemic effect. It usually is included as a principal ingredient in a compound containing other herbs such as amla, turmeric, and neem. Traditionally, the leaves are chewed several times a day. Alternatively, powdered gurmar extract is given in a dose of 400-600 mg daily. Fenugreek: soak 1 tsp. of seeds overnight and eat in morning. Can repeat in afternoon. Use in cooking. Neem: 500 to 1000 mg once or twice daily. Usually included in a compound with other herbs (see Gurmar, above). Shilajit (Mineral Pitch): Usually included in an herbal compound. If used singly, take 300 to 600 mg once or twice daily. Karela (Bitter Melon/Bitter Gourd): especially the juice, 2-4 ounces per day. Can also be included in the diet as a food item. Jambul fruit or seeds: Take 1-2 grams of dry powdered herb per day. It is considered to be synergistic with okra. Other useful bitter herbs and spices include: tulsi, aloe vera, kutki, ginger, cardamom, guggul, and myrrh (the latter two are used for obesity, but are often included in compounds to help decrease blood sugar. Copyright 2012, Maharishi Ayurveda Association of America 4.3
MAPI Herbal Preparations for imbalances associated with Diabetes Mellitus, Type 2 Note: Always begin with treatment to normalize digestion and eliminate Ama, as indicated (e.g., see Obesity protocol). Glucostat or MA 471: 1-2 tabs at 8 a.m. and 5 p.m. MA 347: 1-2 tabs before lunch and dinner MA 408 or MA 631: 1-2 tabs after lunch and dinner Digest Tone: 2 to 4 tabs at bedtime Be Trim Tea (main ingredient: Gurmar): 1 cup after meals 3 times a day Herbal Preparations Ingredients: Glucostat (MA 471/MA 140): Ingredients: Punarnava, Ashwagandha, Jambul, Bael Tree, Mineral Pitch, Enicostema, Phyllanthus, Neem, Arjuna, Bitter Melon, Salsaradigan. Note: both Enicostema littorale and Jambul (Eugenia jambolanum) have documented anti-hyperglycemic activity (e.g., see http://www.ncbi.nlm.nih.gov/pubmed/15235149 ). Other ingredients are bitter alterative herbs used to reduce Kapha in the blood and are thereby used in Diabetes (e,g, Neem, Bitter Melon). Be Trim Tea: Principal ingredient is Gurmar (Gymnema silvestre), which has documented anti-hyperglycemic effect. MA 347: Gmelina asiatica (Gopabhandra), Ginger, Horse radish, Pluchea lanceolata, Three-leaved caper, Garlic, Dried catkins, White leadwort, Castor oil root, Himalayan cedar, Nutgrass. MA 408: Jaggery, Ghee, Castor oil, Spreading hogweed, Gmelina asiatica, Bael fruit, Sterospermum chelonoides, Indian trumpet flower, Aerua lanata, Egg plant, Uraria lagopoides, Pseudarthria viscida, Clerodendrum serratum. Note: several of these ingredients have documented anti-hyperglycemic effect, e.g., Gmelina asiatica (Gopabhandra). Copyright 2012, Maharishi Ayurveda Association of America 4.4
MA 631: Ghee, Three-Leaved Caper, Castor Oil Root, Country Mallow, Chebulic Myrobalan, Ceylon Leadwort, Long Pepper (Catkins), Ginger, Himalayan Cedar, Muskroot/Spikenard, Black Pepper, Major Catkins Multi-Modality Approaches Vedic Physiological Purification Program (Panchakarma) is indicated in most chronic conditions, including diabetes Meditation/stress reduction (Transcendental Meditation program), to address the stress-related components of this condition Maharishi Vedic Vibration Technology (MVVT) Gandharva Veda: Vedic Music Therapy using the melodies and frequencies of nature Veda Aromatherapy Maharishi Light Therapy with Gems Creating environmental balance through: o the near environment: Maharishi Sthåpatya Veda--Vastu vidya--vedic architecture in accord with Natural Law; creating balance through proper orientation, layout and proportion of homes and buildings o the distant environment: Maharishi Jyotish and Yagya: Vedic science for prediction and neutralization of negative influences on health from the distant environment Copyright 2012, Maharishi Ayurveda Association of America 4.5
Maharishi Ayurveda Health Professional Training Program High Cholesterol Pathogenesis: According to Maharishi Ayurveda, high cholesterol is caused by Kapha vitiation and Ama. It is generally associated with disturbed digestion and metabolism. Causes Imbalanced digestion and metabolism. Sedentary lifestyle. Irregular diet and routine. Overeating, eating in between meals. Kapha aggravating diet. Diet: Diet and Regimen In general: Kapha pacifying, Ama reducing diet (e.g., Kapha Comprehensive Purification Diet, Vata-Kapha Comprehensive Purification Diet, or Pitta-Kapha Comprehensive Purification Diet). Favor a light, warm and fresh breakfast; lunch as main meal (balanced vegetarian diet is best); light supper. Special foods to favor : Warm soups, onions, garlic, orange, lemon, bitter, astringent and spicy foods. Take just before lunch: 1 teaspoon of ginger juice + 1 teaspoon lemon juice + 1 pinch of rock salt + a dab of honey. Drink at lunch time and in the late afternoon : Takra (lassi with the cream removed, diluted 1:6 parts yogurt to water), with 1-2 pinches of salt, plus 2 pinches cumin or ginger. It increases Agni and reduces Ama and Kapha. Copyright 2012, Maharishi Ayurveda Association of America 4.6
Special foods to avoid : Heavy and fatty food Sweet and salty food. Alcohol, red meat, fish, cheese, yogurt Oily, cold, or leftover food Cold water, carbonated drinks Heavy meal at night. Regimen: Behaviors to favor: Maintain regular daily routine; avoid anger. Pursue regular physical exercise, such as brisk walking. Abhyanga (oil massage) is not recommended; substitute dry massage (Garshan) in the daily routine. Daily Yoga Asanas Transcendental Meditation Life-supporting behaviors that give happiness (Behavioral Rasayana). Listen to Gandharva Veda music. Spend time with loved ones and children. Behaviors to avoid: Daytime sleep and/or night vigil. Time urgency with inadequate time for self, meals, rest, or time with family and friends. Working in a stressful job long-term. Long-term stressful family situation. Suppression or forceful evacuation of natural urges. Excessive sexual activity. Excessive physical or mental work. Copyright 2012, Maharishi Ayurveda Association of America 4.7
Traditional Ayurvedic Herbal Preparations for imbalances associated with High Cholesterol Note: Always begin with treatment to normalize digestion and eliminate Ama, as indicated. In general, herbs used in managing high cholesterol are predominant in the Kaphareducing tastes, especially bitter and astringent. Many, such as Guggulu, also have a lekhana (scraping) action. The following herbs are traditionally used to normalize the imbalances associated with high cholesterol. Triphala guggulu, 250 to 500 mg 3 times a day. Garlic: mix one finely chopped clove, 1/2 teaspoon fresh grated ginger root, and 1/2 teaspoon lime juice. Eat before each meal. Trikatu 1/2 teaspoon with honey 1 teaspoon 2-3times a day. Alternatively, take Trikatu-Cinnamon Tea: mix 1 teaspoon cinnamon and 1/4 teaspoon Trikatu. Steep for 10 minutes in cup of hot water, Add 1 teaspoon honey. Drink twice daily. Turmeric: take 1 to 3 grams daily with food. Homemade herbal mixture: kutki 3 parts, chitrak 3 parts, shilajit 1/4 part. Take 1/2 teaspoon twice a day with honey and warm water. Lemon-honey water in a.m.: to 1 cup warm water, add 1 teaspoon honey plus a squeeze of lemon or lime juice. Copyright 2012, Maharishi Ayurveda Association of America 4.8
MAPI Herbal Preparations for imbalances associated with High Cholesterol Note: Always begin with treatment to normalize digestion and eliminate Ama, as indicated. Cholesterol Protection or MA 1596: 2 tablets, 2 to 3 times day MA 344: 1-2 tablets around 8 a.m. and 5 p.m., taken after food MA 631: 1 to 2 tablets twice a day after meals Digest Tone: 2-4 tablets at bedtime Note on Guggulu (Commiphora Mukul): Classical Ayurvedic Kapha-Vata pacifying herb (a resin), traditionally used in treating the imbalances associated with high cholesterol. It is a penetrating herb that promotes detoxification and rejuvenation by scraping (lekhana) Ama as well as excess Meda Dhatu and Kapha from the bodily channels (srotas). It is often combined with other herbs to create a targeted effect toward specific doshas and tissues; e.g., Triphala Guggulu is commonly used for high cholesterol. Recent studies on the efficacy of Guggulu in normalizing cholesterol have had mixed results, with some showing significant effect and others no significant effect. Herbal Preparations Ingredients: Cholesterol Protection: Guggulu, Turmeric, Amlaki-Haritaki-Bibhitaki (Triphala), Parijatha, Phyllanthus, Guduchi, Indian Sarsparilla, Manjistha, Shilajit, Licorice, Ginger, Pippali, Black Pepper, Zinc. MA 344 (Triphala Guggulu): Guggulu, Amlaki-Haritaki-Bibhitaki (Triphala) MA 631 (Shivagutika): Shilajit, Guggulu, Ginger, Kutki, Bharda, Black pepper, Cinnamon, Cardamom, Saffron Digest Tone: Amlaki-Haritaki-Bibhitaki (Triphala) + Cabbage Rose Copyright 2012, Maharishi Ayurveda Association of America 4.9
Multi-Modality Approach Vedic Physiological Purification Program (Pancha Karma) is indicated in most chronic conditions Meditation/stress reduction (Transcendental Meditation program), to address the stress-related components of this condition Maharishi Vedic Vibration Technology (MVVT) Gandharva Veda: Vedic Music Therapy using the melodies and frequencies of nature Veda Aromatherapy Maharishi Light Therapy with Gems Creating environmental balance through: o the near environment: Maharishi Sthåpatya Veda--Vastu vidya--vedic architecture in accord with Natural Law; creating balance through proper orientation, layout and proportion of homes and buildings o the distant environment: Maharishi Jyotish and Yagya: Vedic science for prediction and neutralization of negative influences on health from the distant environment Copyright 2012, Maharishi Ayurveda Association of America 4.10
Red Yeast Rice (RYR) Dosing Protocol Scripps Center for Integrative Medicine Available in 600 mg tablets or capsules. Begin with 600 mg daily, taken with a meal. Titrate upward by 600 mg every 2-4 weeks, to maximum dose of 2400 mg daily, taken in two divided doses of 1200 mg each. Additional points: Take CoQ 10, 200mg. daily, while taking RYR In four weeks, get a fasting blood test (test in morning after 12 hours overnight fast of water only) for both liver function (liver function panel) and cholesterol level (full lipid panel.) Choose a commercial brand with documented RYR content (some contain little or no actual RYR) and with no detectable citrinin (a mycotoxin). Recommended resource: Consumer Lab at www.consumerlab.com. Excellent review article on RYR and product selection. Recent studies: o Halbert SC et al. Tolerability of Red Yeast Rice versus Pravastatin. American Journal of Cardiology 2010; 105(2):198-204. o Gordon RY et al. Marked Variability of Monacolin Levels in Commercial Red Yeast Rice Products: Buyer Beware! Arch Intern Med. 2010;170(19):1722-1727. Copyright 2012, Maharishi Ayurveda Association of America 4.11
Possible side effects: A sensation of flushing or redness of the skin may occur. This usually last for 15-20 minutes then improves. After 3-4 weeks of drug use this side effect usually goes away. If you stop the niacin for several days and then resume its use, the flushing effect returns. Although uncommon, a rash may develop. If it does, stop the Niacin and call your doctor who prescribed the Niacin. Very rarely inflammation of the liver can occur. This is more common if used in combination with other lipid lowering drugs. This is a reversible phenomenon when the Niacin dose is decreased or discontinued. Lab Tests: Lab tests of your blood should be checked four weeks after starting niacin and every 3 months thereafter. Blood test to include Fasting Lipid Panel and Hepatic Function Panel. Some patients may require more monitoring; for example, if you are a diabetic a HgbA1C should also be done. If you have elevated Homocysteine levels, they should be treated and monitored. Tips for taking niacin: Take with meals. This slows the rate of absorption and can decrease side effects. If taking the drug with a large meal is not possible, take with Metamucil or other fiber supplement or 6 oz non-fat yogurt. Do not use niacin in conjunction with anything else that causes flushing. No alcoholic beverages or spicy foods for one hour before or hour after taking niacin A children s strength aspirin (81 mg) taken 20 minutes before will blunt the flushing. After 2 months you may find you no longer need the aspirin. If aspirin is prescribed for you anyway, continue taking and do not stop until you have spoken with your doctor. Re: Product Selection Non-flush (e.g., with inositol) and slow-acting Niacins are not effective. (Avoid them.) Several inexpensive, effective brands: Rugby, Bartell's, Natural Factors Copyright 2012, Maharishi Ayurveda Association of America 4.12