An overview of thyroid diseases The thyroid is an endocrine gland situated in the neck at the level of the cricoid cartilage at the base of the larynx and extending from the level of the fifth cervical vertebra down to the first thoracic. It is butterfly shaped with 2 elongated lateral lobes with superior and inferior poles connected by a median isthmus. The gland contains two hormones, L-thyroxine (tetraiodothyronine, T4) and L-triiodothyronine (T3). Affecting between one and two percent of the population worldwide, thyroid disease is among the most common endocrine disorders. Thyroid disorders and thyroid cancer disproportionately affect women.
Skin inflammations are quite common conditions, with atopic dermatitis or eczema affecting 10-20% of all children and 1-3% of adults (1) and psoriasis affecting between 2 and 2.6% of the US population. The prevalence of atopic dermatitis has doubled or tripled in industrialized countries during the past three decades. The visible and often disfiguring nature of skin inflammations leads to far greater levels of distress and depression than would be experienced with a more severe but less disfiguring condition. (2) Because a number of patients are suspicious of cortisone creams prescribed for them by their family practitioner or dermatologist, they may frequently present for Ayurvedic care as an alternative.
According to Ayurveda, skin has seven layers, corresponding to the seven dhatus. Similarly, in modern physiology, skin has been found to have seven layers, stratum corneum, on the surface, stratum lucidum, stratum granulosum, stratum spinosum, stratum basale, the basement membrane and the dermis. (For a diagram of the seven layers of the skin, click here.) At the same time, the epidermis of the skin, as whole, is seen as an upadhatu of rasa dhatu, and the dermis as part of mamsa dhatu. Skin belongs to bahya marga, the external pathway of disease, and as such is very vulnerable to toxins carried by rasa and rakta dhatus during the prasara stage of disease, accounting for the relatively common nature of skin inflammations.
In the Ayurvedic approach to sinusitis, exposure to an infective agent such as pathogenic bacteria is just one factor in the development of the illness. Of far greater significance is the build up of excess doshas in the body, due to incorrect diet and lifestyle. Once excess doshas have built up and become prevalent due to repeated errors in daily regimen, they are readily carried by vata upwards to the head, where they lodge in any weak spot, creating acute illness. Unfortunately, due to today's polluted environment, the integrity of the mucus membranes of the nasal sinuses is under constant attack. Thus weakened, the sinuses are particularly vulnerable to invasion by provoked doshas. It is the unwholesome situation created by a combination of weakened sinuses, accumulation of doshas and build-up of ama or toxins in the body that provides a fertile ground for the multiplication of pathogens.
Sinusitis, as an inflammatory condition, always involves some component of pitta, the fiery humour. However, provocation of either vata or kapha within the sinuses can give rise to pitta irritation of the mucous membranes. Sinus infections thus can be regarded as either vata, pitta or kapha in nature, each type having specific causative factors and symptoms.
Silent bladder infections, also known as asymptomatic bacteruria, may result in generalized ill health or may lead to acute cystitis or to pyelonephritis, a potentially life-threatening kidney infection. Hence it is important to appreciate the groups affected by silent bladder infection, as well as how to make an Ayurvedic diagnosis of this condition and give appropriate chikitsa.
Addiction to sugar is a significant cause of overweight, obesity, diabetes, dental caries, candidiasis and adrenal deficiency. In addition, by lowering immunity, white sugar may contribute to the incidence of cancer and acute and chronic infections. Although white sugar as an addiction of choice affects all ages from infancy on, individuals born in the 1950s are particularly susceptible, due to the prevalence of sweetened infant formula at that period. All types of agni may be involved in sugar cravings, but the nature, consequences and management of sugar addiction differs depending upon the agni type.
In this article, we will consider candidiasis as a condition of kapha ama, reviewing the epidemiology, diagnosis and Ayurvedic management of this common condition.
Candida is a unicellular yeast whose cells reproduce by budding. A normal flora which can under certain circumstances become an invasive pathogen, it can flourish in most environments. Candida species frequently colonize the oropharynx, skin, mucous membranes, pranavahasrotas (lower respiratory tree), annavahasrotas (gastrointestinal tract) and mutravahasrotas (genitourinary tract). Candida can be found on foods, countertops, air-conditioning vents, and floors (6).
A discussion of candidiasis leads us to larger look at considerations of the ways in which epidemiology has changed from classical times until now. Many factors pertinent to the development of Candida overgrowths are relevant to modern industrial society and were not in effect in ancient times. These factors include a diet high in refined sugar and refined flour products, antibiotic therapy, environmental stresses that weaken immunity including EMFs (1), ELF radiation (2), chemical toxins and increased background radiation; sedentary lifestyles (3), epidemic obesity (4), development of immunodeficiency diseases such as HIV, and medical use of immunosuppressant therapies including inhaled corticosteroids. All these factors play a part in the frequency with which candidal conditions are seen in a typical Ayurvedic practice setting. Patients with endocrine disorders including diabetes, hypothyroidism and adrenal insufficiency are at increased risk for Candida overgrowth (6).
April - Average sunrise - 6:30am, average sunset - 7:45pm; Temperature range 62-34, average 53.
May - Average sunrise - 5:45am, average sunset - 8:00pm; Temperature range 71-44, average 61
Weather - Wide range of weather patterns, and large temperature changes. Can be very warm and sunny, or cold. April and May are often some of the wettest months in the year, with snow storms or thunderstorms. May experience windy periods as well.
Kapha - during late spring Kapha has accumulated is liquefied by the increasing heat, which can disturb the digestive system. Kapha can become provoked during precipitation, snowy days and cloudy rainy days
To minimize Kapha:
warming, drying, and activating foods
Pungent, bitter, and astringent tastes
Honey and hot herbal teas
Vegetarian, low-fat diet
Limit oils - Sesame oil and flax seed oil can be used minimally
Vegetables, grains, and beans, cooked and well-spiced
One salad per day
Whole grain crackers and toasted breads of millet, quinoa, and corn
Sweet fruits (e.g. figs, grapes and raisins, dates, blueberries, red raspberries, Babcock peaches, apples, pears, mango, and coconut.)
Bitter and astringent herbal teas and nonalcoholic beers and wines
Reduce or avoid:
Excessive sour, oily, salty, and fried foods
Red meat, shellfish fish
Alcohol, caffeine, and soda pop
Excessively hot spices, such as cloves, mustard, onion, garlic, chilies, radish, and cayenne.
Frequent use of acidic fruits, juices, and vegetables: tomatoes, beets, eggplant, corn, carrots, hot leafy greens, papayas, pineapple, citrus (except limes), and vinegar.
Vata - During late spring Vata can be aggravated by the highly changeable conditions and dry windy days
To minimize Vata:
Cooked, warm, soupy, moderate to heavy foods, soothing and satisfying
Plenty of healthy oils (monounsaturates, sesame oil, ghee, butter, nut butters, and EFAs) - avoid hydrogenated oils, other saturated and polyunsaturated oils
Natural sweet, sour, and salty tastes and flavorful sauces
Carminative spices such as basil, oregano, ginger, cardamom, cinnamon, cumin, pippali, coriander, and dill.
Protein-rich diet of animal products: ghee, warm milk, yogurt, cooked cheese, buttermilk, kefir, eggs, etc, as well as the grains like quinoa, corn, and basmati rice, and easily digested nuts and sesame seeds
Best fruits and juices: tomato, pomegranate, carrot, fresh-squeezed orange and grapefruit, apricot, peach, strawberry, raspberry, and vegetable juices
Lots of fresh veggies (cooked are easier to digest for Vata): pumpkin, carrots, beets, green leafy veggies, avocado, broccoli, baked potato, winter squash, tomatoes, etc.
Reduce or Avoid:
Caffeine, white sugar, and soda
Excessive use of beans and heavy grains (prepare them with ghee and spices)
Dry foods taken alone, large amounts of raw vegetables
Taking foods and drinks colder than room temperature
Late spring is a time of changing weather and release of accumulated kapha in the body, so digestion can be especially delicate, it can be especially important to follow agni rules at this time
Follow agni rules
Proper food combining
Drink ginger tea in the morning (fresh for vata and pitta, dry for kapha)
Take Agni kindler before meals
Drink CCF tea after meals
Movement: vigorous exercise daily (ex. jogging, aerobics etc), strength training, engage in new activities and mental challenges
Do not skip meals, and do not fast. The Kapha digestive agni tends to be low, as does appetite, and not eating on time slows down the metabolism even more. Start your day with a light breakfast. Eat a sustaining meal at lunch, and a lighter meal for dinner.
Vigorous oil massage with warming oil
Protect yourself from the damp and cold. Drink lots of warm water, infused with warming spices such as turmeric, dried ginger and black pepper. At-home steam therapy can help open clogged channels.
Go to bed early and wake up really early in the morning, 90 minutes before sunrise, do not indulge in daytime snoozes.
Stay cool--both physically and emotionally. Avoid going out in the heat of the day, especially on an empty stomach or after you have eaten tangy or spicy foods. Avoid exercising when it's hot. Walk away from situations that make you see red.
Do not skip meals, do not fast and do not wait to eat until you are ravenously hungry. You want to keep the fire burning at a moderate temperature, you don't want to put the fire out or to stoke it too high.
Daily oil massage with moderate to cooling oil
Water-based activities are ideal exercise for Pitta-dominant people. Try swimming or aqua-aerobics to stay fit but cool. Strolling after sunset, especially along a waterfront, is also a soothing way to fit some leisurely activity into your day.
Go to bed early, rise 60 minutes. Make sure to turn off the computer or TV by 10pm and turn the lights out. A cup of warm milk, with some cardamom, can be helpful before bedtime.
Balance work and play. Set aside some time for R&R everyday, and do not get so absorbed in a project that you are unable to detach from it.
Establish a daily routine. Go to bed and rise at same time (30 min before sunrise). Regulate meal times, eat even if not hungry to establish routine. Don't skip meals.
Foods and drinks that nourish
Daily oil massage with warming oil such as sesame
Light to moderate daily activity (don't over do and exhaust self) - slow classical vinyasa, swimming, dancing, bike riding
Keep warm, stay out of wind.
Flatirons with Spring flowers (Photo credit: Wikipedia)
Addiction to sugar is a significant
cause of overweight, obesity, diabetes, dental caries, candidiasis and adrenal
deficiency. In addition, by lowering immunity, white sugar may contribute to
the incidence of cancer and acute and chronic infections. Although white sugar
as an addiction of choice affects all ages from infancy on, individuals born in
the 1950s are particularly susceptible, due to the prevalence of sweetened
infant formula at that period. All
types of agni may be involved in
sugar cravings, but the nature, consequences and management of sugar addiction
differs depending upon the agni type.
VishamAgni and Sugar
The individual with visham
agni has cravings for sweet, salty, sour, spicy and oily foods. They are
just as likely to indulge in tortilla chips and salsa, potato chips, French
fries and ketchup, salted peanuts or crackers as in sugar. To complicate
matters, manufacturers frequently include sugar in savory items such as crackers,
chips or peanut butter. Often, such individuals may realize that sweet baked goods
such as cookies upset their digestion. Instead, they will use M&Ms or
chocolate peanuts, seeking the combination of sweet, fat and crunch.
The impact of
white sugar on such an individual can be devastating to the adrenals. Vata-provoked clients with visham agni are prone to under-eating
and random meal plans. Breakfast could be a few Twinkies or a Power Bar in the
car on the way to work. Feeling hungry while at work, they may snack on chips,
crackers, doughnuts or whatever is in the office or the vending machine. After
a salad for lunch, they are hungry again by mid afternoon and begin consuming
chocolate and other munchies. By dinner time, they have no appetite left, having
wasted their available agni on junk
foods. Each time sugar is eaten, it stimulates an adrenal-type energy rush,
gradually leading to adrenal exhaustion, especially if combined with caffeine.
As the adrenals become increasingly exhausted, the urge to eat sugar grows
stronger, in response to the need to "get some energy". As much as sugar may be
a cause of overweight in other agni types,
itcan contribute to chronic
underweight in the person with visham
agni. Yet despite being underweight, the junk-food junkie may have more
toxic hard fat in the system than the pitta
with a chubby little belly.
A young woman with this agni condition
worked at a residential elder care facility. When at home, she followed a
strict diet of brown rice, steamed vegetables and carrot juice. At work, she
indulged in big portions of lasagna and stacks of Oreo Cookies. After
explaining to her that there was in fact nothing wrong with lasagna for her
constitution, we encouraged her to stash healthy treats at the elder care
facility, so that Oreo Cookies would not tempt her.This strategy works well for both visham agni and tikshnagni. Creating a stash of suitable treats made
with whole sugars or other natural sweeteners gives an outlet for the desire
stimulated by the presence of poor quality sweets.
A good remedy to balance sweet cravings for vata can be prepared using Ashwagandha. Roast an ounce of
Ashwagandha in ghee and add a tablespoon of date sugar. Store in a screw top
glass jar in the refrigerator.This can be eaten in the morning about twenty minutes before breakfast,
in the mid afternoon-- if sweet cravings arise-- and at bed time with a cup of
hot milk. To help reduce the stress
levels that exacerbate sweet cravings, tulsi tea can be used as a general
beverage or Tranquil Mind formula
can be taken three times daily. For adrenal exhaustion, Stress Ease can also be taken.
with tikshnagni craves sweet, bitter
and astringent foods. A sugary cup of black tea satisfies the desire for a
mixture of sweet with astringent, a cup of sweet latte or a rich dark chocolate
meets the need for a mixture of sweet and bitter. Unfortunately, caffeine and
white sugar provoke pitta, intensifying
tikshnagni. Thus, the more the pitta individual indulges in white
sugar, coffee, tea and supermarket chocolate, the worse their tikshnagni becomes and the more strongly
they crave sweets. Next, they begin to crave yeasted breads and sweet baked
goods in an attempt to diminish their raging inner fire. Yeast, being sour, further
provokes pitta, worsening tikshnagni.People with tikshnagni
need extra protein, a slower burning fuel. Thus the empty calories of muffins,
cookies, cupcakes and brownies only serve to make them hungrier. Soon they are
twenty to thirty pounds overweight while being essentially malnourished.
A fifty year
old real estate agent with a pitta prakruti
presented with a lifelong history of tikshnagni
and compulsive overeating. She came from an alcoholic family and had been an
active alcoholic herself for ten years, a typical finding with tikshnagni and sugar addiction. She had
a set of very strict diet guidelines that inevitably fell apart each evening.
Until that point each day she perceived herself as a person who ate healthily
and avoided dairy and processed flours. She took fruit for breakfast and
typically ate a business lunch with her clients. Feeling remorseful about the
size of her stressful lunch, she took only fish and salad for dinner. Like most
stressed out individuals with tikshnagni,
she began craving chocolate around four in the afternoon, but held back,
determined to be 'good.' By the end of her austere dinner she was ready to
spend the rest of the evening consuming chocolate, ice cream and cookies. She
was about forty pounds overweight.
each day began with her fruit breakfast. Although this may be a good strategy
for a healthy pitta with a tranquil
life, fruit was not advisable for breakfast given her tikshnagni and the competitive nature of her job, with its
stressful lunches. Instead of starting the day with the sweet taste, she could
begin with bitter.A half teaspoon
of Mahasudarshan in a teaspoon of honey works well for most people to diminish
cravings for breads and sweets. This can be followed, twenty minutes later, by
a breakfast containing protein. It is better to avoid a sweet breakfast
altogether in this situation and to start the day with a small but complete meal
such as a bowl of kitcheri and a whole wheat chapatti.
To regulate tikshnagni she could prepare Shatavari
Kalpa.Roast an ounce of Shatavari
with ghee and add a tablespoon of sucanat or turbinado sugar. This can be taken
mid-morning and mid-afternoon to prevent hypoglycemia and to regulate tikshnagni. For stress and addictive
tendencies she should drink Brahmi tea three times daily. She could also take Stress Ease three times daily.
Mandagni and sugar.
For the kapha individual
with mandagni, sugar addiction is
truly alife or death
situation. Waking sluggish and dull, kapha
seeks energy from a donut or sugary cereal with cold milk. Although this gives
a short burst of adrenal energy, these foods, to which a majority of
individuals with mandagni are
allergic, serve only tomake him more
sluggish and sleepy. Worse still, in kapha
individuals, the insulin response is easily over stimulated. Whereas
vata will burn all the sugar they
consume in a frenetic rush of adrenal energy, kapha's body will immediately respond by storing sugar as fat.
Gradually, the pancreas becomes more and more oversensitive, leading to a
peri-diabetic condition of obesity, low energy and constant cravings for sweets
and refined flours. White sugar and refined flour do not contain enough
chromium for their own metabolism and thus deplete the body of chromium,
essential to metabolism and to the functioning of the pancreas. Continued over-consumption
of such refined foods will tip the kapha individual
from peri-diabetes to diabetes proper, complete with retinopathy, neuropathy,
arterial disease and diabetic ulcers. This is truly a high price to pay for a
bowl of cereal and a Snickers Bar a day.
A forty year
old financial planner had reached a level of mandagni so severethat not only wheat, dairy and sugar but even brown rice
made him nauseated, tired, heavy and dull. He was sixty pounds overweight and
lived on an energy roller-coaster, consuming caffeinated soda and sugar to get
a burst of energy and then breads and cereal to calm him down. The breads made
him tired and lethargic, so then he needed sugar and caffeine, which wired him,
after which he needed more bread. In a few short years, if he did not change
his ways, he would be diabetic.
He could be helped by taking a teaspoon of Shardunika after
each meal or Sweet Ease formula
three times daily. This would help balance his insulin secretion and reduce his
craving for sweets. As with tikshnagni,
a morning dose of Mahasudarshan would help with his craving for breads. Ten
minutes before each meal he could take a half teaspoon of organic turmeric
powder to aid in balancing the blood sugar load from that meal. To help reduce
weight and kindle agni, he could use
Trikatu. For stress he could take Bacopa tea three times daily or Mental Clarity formula, which would
help with the sluggishness and lethargy that drove him to drink Pepsi-Cola.
In accordance with the basic principles of Ayurveda,
although white sugar is a poison for all three doshas, its use must be handled very differently depending upon agni type. It is essential, as we have
seen, to provide dietary counseling and to offer appropriate stress- reduction
strategies, as sugar consumption is a manifestation of mental stress and a
cause of physiological stress. Because of the importance of stress in the
overall picture, it may often be wise to begin the treatment program with the
appropriate stress-reducing herbs and to hold the other suggestions for a later
In working with addicted patients, the practitioner must
be clear not to be an enabler, helping the addict to have an easier time while
he or she continues to pursue a self destructive lifestyle. In the next few
editions of the Vine, we will offer a series on working with addictions.
acceptance has for long dogged efforts to reduce the incidence of smoking.
Today, with an appreciation of the harmful effects of second hand smoke, social
acceptance of smoking is finally giving way to widespread efforts to limit
smoking, with even such unlikely venues as restaurants in Italy and pubs in
Ireland banning smoking.
smoke leaves tarry deposits on the lungs. The pink, elastic lung tissue becomes
stiff and blackened, losing its elasticity and oxygen exchange potential,
eventually leading to obstructive airway disease. Vata individuals are particularly prone to dry cough, raspy throat,
poor circulation and peripheral vascular disease as a result of smoking.
Smoking also reduces their appetite leading to visham agni and underweight. In the worst case, smoking can lead
to gastric ulcers. Pitta individuals
are the most likely to suffer from smoking-induced heart disease and
hypertension, while sinus problems, post-nasal drip, chronic bronchitis and
emphysema will affect kapha
smokers.Lung cancer or increased
incidence of bladder cancer may affect all doshas.
working with a smoker, it is essential to address the underlying cause of the
addiction. Vata smokes out of nervousness and pitta out of self-hate and self-destruction, but it is kapha who is the most vulnerable to the
emotionally suppressive effect of smoking. Kapha
uses smoking as a strategy to suppress deep-seated grief, which is held in the
lungs. Other doshas may also adopt
this strategy if they have been subjected to great grief, such as bereavement.
Hence in seeing a smoker it is important to take a full emotional history
including all childhood traumas as well as more recent events.
of the enabling issue, it is often best to offer minimal herbal support to the
smoker initially. The best tactic is to explain to the smoker all the ways in
which their habit is causing their current health concerns. As well as direct
effects of smoking listed above, this also includes the indirect effects that
result from provocation of the doshas
as a result of the smoking habit, which falls into the category of prajnaparadh or crimes against innate
wisdom.The smoker should then be
offered herbs such as Brahmi to help address the underlying grief, depression
or anxiety. In addition, appropriate counseling should be recommended to deal
with childhood or recent traumas.
Vata must be spoken to very
gently, as if one were trying to coax a child. Discourage vata from quitting smoking suddenly, as this will lead to immense vata provocation. Also, smoking is a
habit that is all too easy to quit--again and again. Slow steady, sustainable
changes are best. It is wise to follow the Ayurvedic tobacco withdrawal
protocol outlined below. Pitta should
be reasoned with. It can be helpful to have materials in your office showing
the difference between a smoker's lungs and a non-smoker's lungs. Encourage pitta to get online, do the research and
appreciate the immense risk they are running. Appeal to their pride,
encouraging them to access their will power and help them to see how quitting
smoking will help them succeed in their goals in life. As for kapha, threaten them with the dire
consequences of continuing to smoke. Point out how their lung pulse looked. If
there are two doshas present in the
lungs it is imperative to tell them that they are already developing
obstructive airway disease.All
too often, kapha will quit smoking
only after a life-threatening bout of pneumonia.
is the greatest tool in dealing with smoking. Conscious smoking is the first
step in quitting. In conscious smoking, the patient agrees to smoke only when
they are not doing anything else at the same time. Instruct them to smoke as a
meditation, bringing awareness to their thoughts, feelings and body sensations
before, during and after smoking. This can result in some amazing discoveries.
One patient reported that she realized she was trying to kill herself by
smoking, another said that he became aware of the grief over his mother's death
that he was suppressing by smoking.
soon as the individual is ready to begin the process of releasing their habit,
they can begin the tobacco withdrawal protocol. A typical Ayurvedic smoking mix
and client handout is shown below.
root--ground, not powdered
10-15% marshmallow root
root--broken up well
"If you are trying to cut out tobacco, start out with 60%
herbal mixture, 40% tobacco, then gradually cut down the amount of tobacco
You need to buy rolling paper and roll your own
This mixture is rejuvenating for the lungs and clears the
mind and sharpens concentration."
It is important to explain to the client from the outset
that herbs can be given to rejuvenate the lungs, balance the doshas and address their current health
concerns, but that these herbs will not be effective as long as the smoking
habit is continued. In particular, lung rejuvenatives should not be given until
tobacco smoking has stopped. Healthy lung tissue cannot be built until smoking
is discontinued. Once the client has stopped smoking, lung rejuvenatives are
essential. Liquorice is a good choice to help with lung rejuvenation as well as
raspy throat and pre-ulcerative conditions of the stomach or duodenum.
Punarnava helps strengthen the lungs and is also anti-cancer in traditional
usage. Ideally, first carry out the tobacco withdrawal, then give some shamanam herbs to begin to balance the doshas. Next give cleansing herbs in
preparation for pancha karma and
carry out a thorough cleanse.Although vaman, therapeutic
emesis, is a far from popular process, it will be invaluable for kapha in the process of recovering from
smoking. Once pancha karma has been
done, there is the optimum situation to rejuvenate the lungs using Chyavanprash
as well as the herbs discussed above. It takes as year or so of not smoking to
return the lungs to the pink, clean condition of a non-smoker. Hopefully,
pancha karma and rasayana could greatly accelerate this process.
another beneficial process that should be commenced only after quitting
smoking. Especially when someone is healing from pneumonia, asthma or
obstructive airway disease, it is imperative for them to learn to breathe
properly, filling the lung bases and bringing air all the way into the upper
lungs. In addition, surya namaskar
and chest-opening asanas such as
cobra and camel pose will be of great benefit in healing the lungs and
restoring a normal breathing pattern.Finally, the root cause of the smoking habit can be best
addressed by a meditation practice, with a focus on basic mindfulness and
breath awareness. A practice such as the Empty Bowl Mediation taught by Dr
Vasant Lad is ideal in bringing in a more refined awareness of the breath and
That which lies beyond breath.
In previous issues of The Vine, we have discussed working
with smokers and with pot smokers. In this issue, we will look at the much more
difficult issue of working with alcoholics. In a typical Ayurvedic practice, we
are unlikely to see the flagrant, rock-bottom alcoholic--unless one of our
clients relapses after being sober for some time. Alcoholism is difficult to
work with because it is so often covert. For purposes of this discussion, we
will consider anyone who uses alcohol on a regular, daily basis as, at the very
least, a mild alcoholic. Try a simple test--tell them that their Ayurvedic herbs
will not be effective a long as they are using alcohol on a regular basis. The
defensiveness and denial with which your suggestion that they give up alcohol
is met will soon tell you of the hold the substance has over them.
When a patient
fails to improve despite appropriate treatment, if may be worthwhile to
consider whether they are a closet alcoholic and are hiding this obstacle to their
healing from you. One client we saw insisted that he has stopped his daily wine
habit, yet failed to make progress with his complaints of hyperacidity and
indigestion. Growing impatient with his lack of improvement, he sought out
other practitioners, with no greater success. It was his wife, also a client,
who alerted us to the fact that both of them were still drinking on a daily
basis. Another patient failed to improve on her Ayurvedic regimen and had not
admitted to any substance issues. The only indication of her alcoholism was a persistent
habit of being late for her appointments or canceling at the last minute as
well as a tendency to be sometimes warm and sometimes extremely cold and
Another tricky group of alcoholics are the sporadic users or
binge alcoholics. These individuals may be sober during the week and drunk on
the weekend or refrain from alcohol for extended periods of time, punctuated by
bouts of intense binging. In this group of users, denial runs rampant, since
they are always "sober" between binges. Yet, difficult as it may be, it is
essential for the individual to admit their addiction, to themselves and to
you, in order to start on the road to recovery.
Alcoholics who are on Antabuse offer a particular challenge
to the Ayurvedic practitioner. We recommend that Ayurvedic herbal regimens be
given to such individuals only by an Ayurvedic physician with a good grounding
in Allopathic pharmacology or an Ayurvedic practitioner who is also a medical
doctor. Herb-drug interactions are extremely complex and understanding them
requires a knowledge of Pharmacodynamics--the science of how drugs and herbs are
transported, distributed, metabolized and excreted. However, such clients can
be helped by ancillary therapies such as diet and lifestyle counseling, abhyanga, shirodhara,marma point massage using Sandalwood
oil, and herbal dusting.
The people most likely to be drawn to alcoholism are of
course pitta individuals, although kapha may be strongly attracted to beer.
Pitta seeks out alcohol to alleviate
stress and tension. It is the quest of the mood altering effect that marks the
difference between a harmless use and an addiction. It is particularly
important to appreciate that pitta individuals
suffering from depression or manic depressive disorder may self-medicate with
Ayurvedic therapies will not be successful until the client is sober, as
attempts to balance the doshas cannot
be effective when a prajnaparadh, or
crime against Ayurvedic wisdom, continues. Thus, as a rule, it is important to
emphasize that sobriety is a precondition for Ayurvedic treatment. "You want to
be rid of your allergies? Please return when you are ready to quit alcohol, and
than we can definitely deal with your allergies."
The patient in question waited three months before returning
to announce, "I'm sober. Now let's work on the allergies." However, in the case
of the person self-medicating for depression or manic depressive disorder, it
is usually necessary to institute treatment for depression prior to withdrawal
of alcohol. This can be approached by giving Brahmi tea one teaspoon per cup
three times daily or by using Mental
Clarity Formula. This formula lends itself well to work with alcoholics
since it contains not only Brahmi and Bacopa but also Shankhapushpi, an
important liver herb which is also effective for depression.
For anyone who has used alcohol to the point of being blind
drunk or having blackouts, the esoteric aspect of Ayurveda points to the danger
of bhutas or elementals which may
have attached to the aura ofduring the episode of near-unconsciousness. Such energies may impact the
individual's ability to reform and engage in genuine recovery, since it is in
the interests of the energy for the alcoholism to continue. A simple way to
remove bhutas from the aura is to mix
Shankhapushpi in ghee and burn it in the presence of the affected individual.
If the client concerned might think that talk of bhutas is hocus-pocus, they can be told, accurately enough, that
Shankhapushpi smoke is a good remedy for depression and addictions.
As soon as the client has embarked on a course of sobriety,
an Ayurvedic detoxification program should be instituted. For two weeks, the
client should eat kitcheri for lunch and dinner, accompanied by a sabji(cooked vegetable dish) of carrots,
beets, daikons and bitter greens, seasoned with cumin, turmeric and cilantro.
Abundant cilantro should be used to balance the dish for pitta. For breakfast
and mid-afternoon snack they should have juice of carrot, beet, daikon,
cucumber and cilantro. The amount of beet and daikon used in the juice should
be small relative to the other ingredients, to avoid provoking pitta. Each morning, they should take a
half teaspoon of Mahasudarshan mixed in honey, followed by warm water, or, if
preferred, Mahasudarshan tablets. This should be taken at least twenty minutes before
breakfast. At bed time they should take half a teaspoon of Triphala steeped for
ten minutes in boiling water and strained. If Triphala tea is not well
tolerated, Amlaki tea or tablets can be substituted. This detoxification program is not only effective in
cleansing the liver; it is also dramatic enough to signify a passage to a new,
Following the detoxification program, it is essential to
rebuild the liver. Liver Formula,
which includes cleansing herbs such as Musta and Manjista, hepato-protectives
such as Kutki and liver rejuvenatives such as Bhringaraj, is an ideal choice
for this situation. An excellent anupan to
ensure the optimum effectiveness of Liver Formula is Aloe Vera, two tablespoons
with each dose of Liver Formula. Mahasudarshan can be continued for up to a
month after the detoxification program. If the client has a "beer belly" or has
gained excess weight as a result of the alcohol habit, Trim Support could be used after a six week course of Liver
Formula.For those who have been
heavy users of alcohol, a peri-diabetic condition may be observed, including
weight gain, blood sugar swings and sweet cravings. In this case, Sweet Ease can be used along with Trim
Support, or an individualized formula can be prepared using herbs such as
Shardunika to regenerate the pancreas, Turmeric to balance blood sugar and
Chitrak to kindle agni and improve
metabolism. Brahmi tea or Mental Clarity formula can be continued for some
months if mood swings or depression are an issue. In some cases, alcoholism may have led to periodontal
disease. This can be managed with organic sesame oil mouthwash.
Pancha Karma will
be of great value for the recovering alcoholic, but timing is an important
consideration. Unless the alcoholism was extremely mild, it is often wise to
wait at least six months before initiating pancha
karma. This gives the individual time to become stable in their sobriety.
Nothing is more dangerous than an alcohol relapse during or immediately
following pancha karma. Typically, Pitta Massage Oil could be used for abhyanga in this situation. If alcoholic liver damage is an issue,
the client will not be able to do internal oleation. In this case, Panchamrit
can be substituted for the usual internal oleation. Amlaki is the best
substance for virechan and Guduchi
for basti in this case.
½ bowl fresh homemade yogurt
tsp turbinado sugar
tsp tulsi power
Tbsp lukewarm milk
1 tsp ghee
Alcoholism arises from a state of depression, emptiness,
meaninglessness or stress. Hence it is important to introduce stress-reducing
practices such as yoga and pranayama
and to encourage pursuit of meaning through meditation and selfless service. Nurturing
lifestyle practices are necessary to fill the empty space left by the alcohol.
For example, marma point aromatherapy
can be done using Champa or Jasmine attar, while for diffusion aromatherapy Sandalwood
oil can be used. A bed-time foot massage with
Bhringaraj oil or coconut Brahmi oil, a cup of warm milk
with cardamom and cinnamon or a dose of Stress
Ease with some soothing rose and coriander tea can replace an alcoholic
"nightcap". The former weekend alcoholic can substitute a weekend
self-nurturing routine such as abhyanga and
Continuous support from the Ayurvedic practitioner is
essential in the process of recovery. This should be supplemented by attendance
at Alcoholics Anonymous or by individual counseling. Through herbal therapies
and pancha karma the physical and
mental aspects of detoxification and recovery can be effectively addressed,
while through subtle therapies and rejuvenation practices, the client can be
helped to fill the inner void and find new meaning in life.