Introduction
Ayurvedic medicine is one of the traditional systems of medicine from the Indian Sub-continent; others include Unani tibb and the Siddha tradition. Homeopathy is also widely used. The goal of Ayurveda is to prevent disease through proper balance of the three irreducible principles at work in the body. It is a complete system of medicine based on its own medical philosophy, system of diagnosis and treatment methods.
Background Information
Ayurveda is based on the Vedic hypothesis that there are common principles underlying the microcosm (individual) and macrocosm (universe) and man and the universe are composed of the same basic elements. Disease occurs if there is an imbalance. Although use is not as widespread as Chinese medicine in the UK, popularity has been steadily increasing over the last 5 years. It is used to maintain and promote health as well at treating chronic and acute conditions.
Treatment
Diagnosis is based on examination of the pulse, tongue, voice, skin, vision, general appearance urine and stools. General treatment is used to eliminate toxic substances from the body and re-establish the natural balance of the doshas. A combination of treatments is used; these include herbal medicine, massage, manipulation, dietary and lifestyle advice, yoga, as well as purifying techniques for cleansing and detoxifying the body. Individualised combinations of herbs, minerals and metals are used. Many different methods and forms of herbal preparation are used, including fresh juice, infusions, decoctions, powders, pills, poultices, oils and liniments.
Side Effects and Interactions
As with any medicine, Ayurvedic medicine may have side effects. Those commonly reported are nausea, abdominal discomfort and diarrhoea. Herbs with potential for cardiac, renal and hepatic toxicity are included in the materia medica. Heavy metals, such as lead, are used as therapeutic agents, and it is argued that if products are correctly formulated they do not cause toxic effects. However there have been a number of reports of lead poisoning resulting from the use of medicines from the Indian Sub-continent. Herbal combinations are used, so it may not be possible to associate an adverse effect with a specific herb.
Interactions between Ayurvedic medicine and orthodox drugs are possible, though there are few published studies. Interactions cannot be predicted as complex herbal combinations are used and the final chemical composition of any prescription and its metabolism are not known. Health care providers should be aware of this, as closer monitoring may be required.
Regulation
At present in the UK there are no minimum training requirements for herbal practitioners. There is no single organisation representing Ayurvedic practitioners, and it is difficult to identify trained practitioners. A system of statutory registration has been proposed and it is hoped that this will be introduced in the next few years. Most of the herbal products available in the UK are unlicensed, with no evidence of quality, safety or efficacy. The EU Directive on Traditional Herbal Medicinal Products introduced a registration scheme for over-the-counter herbal medicines, suitable for use without the intervention of a medical practitioner. Registered products will meet standards of safety and quality and labelling will be improved.
Herbal medicines assessed by the Medicines & Healthcare products Regulatory Agency (MHRA) have a PL (product licence) or THR (Traditional Herbal Registration) number on the label. These products are accompanied by clear comprehensive information about the safe use of the product. However the quality of unlicensed herbal medicines is not assessed by the MHRA and information provided may be incomplete or unreliable.
Labelling Issues and Safety Concerns
The majority of Ayurvedic medicines in the UK are manufactured and imported from the Indian Subcontinent. Some products have full labels with details of all ingredients and instructions for use, but the labelling of many is inadequate. Many products are not labelled in English or do not include any list of ingredients. Some have been shown to contain potentially harmful ingredients such as lead, mercury and arsenic. Combination products containing herbs and pharmaceuticals have also been identified.