This Backgrounder will introduce you to Ayurveda's major ideas and practices and provide sources for
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Ayurvedic medicine (also called Ayurveda) is one of the world's oldest medical systems. It originated in India and has evolved there over thousands of years. In the United States, Ayurveda is considered complementary and alternative medicine (CAM)--more specifically, a CAM whole medical system.a Many therapies used in Ayurveda are also used on their own as CAM--for example, herbs, massage, and yoga. This Backgrounder will introduce you to Ayurveda's major ideas and practices and provide sources for more information on these or other CAM therapies.
aCAM is a group of diverse medical and health care systems, practices, and products that are not currently considered part of conventional medicine. Complementary medicine is used together with conventional medicine. Alternative medicine is practiced in place of conventional medicine. Conventional medicine is medicine as practiced by holders of M.D. (medical doctor) or D.O. (doctor of osteopathy) degrees and by their allied health professionals. Some conventional medical practitioners also practice CAM. Whole medical systems are healing systems and beliefs that have evolved over time in different cultures and parts of the world.
1. What is Ayurvedic medicine?
Ayurvedic medicine is also called Ayurveda. It is a system of medicine that originated in India several thousand years ago. The term Ayurveda combines two Sanskrit words--ayur, which means life, and veda, which means science or knowledge. Ayurveda means "the science of life."
In the United States, Ayurveda is considered a type of CAM and a whole medical system. As with other such systems, it is based on theories of health and illness and on ways to prevent, manage, or treat health problems. Ayurveda aims to integrate and balance the body, mind, and spirit (thus, some view it as "holistic"). This balance is believed to lead to contentment and health, and to help prevent illness. However, Ayurveda also proposes treatments for specific health problems, whether they are physical or mental. A chief aim of Ayurvedic practices is to cleanse the body of substances that can cause disease, and this is believed to help reestablish harmony and balance.
2. What is the history of Ayurvedic medicine?
Ayurveda is based on ideas from Hinduism, one of the world's oldest and largest religions. Some Ayurvedic ideas also evolved from ancient Persian thoughts about health and healing.
Many Ayurvedic practices were handed down by word of mouth and were used before there were written records. Two ancient books, written in Sanskrit on palm leaves more than 2,000 years ago, are thought to be the first texts on Ayurveda--Caraka Samhita and Susruta Samhita. They cover many topics, including:
Ayurveda has long been the main system of health care in India, although conventional (Western) medicine is becoming more widespread there, especially in urban areas. About 70 percent of India's population lives in rural areas; about two-thirds of rural people still use Ayurveda and medicinal plants to meet their primary health care needs. In addition, most major cities have an Ayurvedic college and hospital. Ayurveda and variations of it have also been practiced for centuries in Pakistan, Nepal, Bangladesh, Sri Lanka, and Tibet. The professional practice of Ayurveda in the United States began to grow and became more visible in the late 20th century.
3. How common is the use of Ayurveda in the United States?
The first national data to answer this question are from a survey released in May 2004 by the National Center for Health Statistics and the National Center for Complementary and Alternative Medicine (NCCAM). More than 31,000 adult Americans were surveyed about their use of CAM, including specific CAM therapies such as Ayurveda. Among the respondents, four-tenths of 1 percent had ever used Ayurveda, and one-tenth of 1 percent had used it in the past 12 months. When these percentages are adjusted to nationally representative numbers, about 751,000 people in the United States had ever used Ayurveda, and 154,000 people had used it within the past 12 months.
4. What major beliefs underlie Ayurveda?
Here is a summary of major beliefs in Ayurveda that pertain to health and disease.
Ideas about the relationships among people, their health, and the universe form the basis for how Ayurvedic practitioners think about problems that affect health. Ayurveda holds that:
Constitution and Health
Ayurveda also has some basic beliefs about the body's constitution. "Constitution" refers to a person's general health, how likely he is to become out of balance, and his ability to resist and recover from disease or other health problems. An overview of these beliefs follows.
In summary, it is believed that a person's chances of developing certain types of diseases are related to the way doshas are balanced, the state of the physical body, and mental or lifestyle factors.
5. What is each dosha like?
Here are some important beliefs about the three doshas:
6. How does an Ayurvedic practitioner decide on a person's dosha balance?
Practitioners seek to determine the primary dosha and the balance of doshas through questions that allow them to become very familiar with the patient. Not all questions have to do with particular symptoms. The practitioner will:
7. How else does an Ayurvedic practitioner work with the patient at first?In addition to questioning, Ayurvedic practitioners use observation, touch, therapies, and advising. During an examination, the practitioner checks the patient's urine, stool, tongue, bodily sounds, eyes, skin, and overall appearance. He will also consider the person's digestion, diet, personal habits, and resilience (ability to recover quickly from illness or setbacks). As part of the effort to find out what is wrong, the practitioner may prescribe some type of treatment. The treatment is generally intended to restore the balance of one particular dosha. If the patient seems to improve as a result, the practitioner will provide additional treatments intended to help balance that dosha.
8. How does an Ayurvedic practitioner treat health problems?
The practitioner will develop a treatment plan and may work with people who know the patient well and can help. This helps the patient feel emotionally supported and comforted, which is considered important.
Practitioners expect patients to be active participants in their treatment, because many Ayurvedic treatments require changes in diet, lifestyle, and habits. In general, treatments use several approaches, often more than one at a time. The goals of treatment are to:
9. How are plant products used in Ayurvedic treatment?
In Ayurveda, the distinction between food and medicine is not as clear as in Western medicine. Food and diet are important components of Ayurvedic practice, and so there is a heavy reliance on treatments based on herbs and plants, oils (such as sesame oil), common spices (such as turmeric), and other naturally occurring substances.
Currently, some 5,000 products are included in the "pharmacy" of Ayurvedic treatments. In recent years, the Indian government has collected and published safety information on a small number of them. Historically, plant compounds have been grouped into categories according to their effects. For example, some compounds are thought to heal, promote vitality, or relieve pain. The compounds are described in many texts prepared through national medical agencies in India.
Below are a few examples of how some botanicals (plants and their products) have been or are currently used in treatment. In some cases, these may be mixed with metals.
10. In the United States, how are Ayurvedic practitioners trained and certified?
Practitioners of Ayurveda in the United States have various types of training. Some are trained in the Western medical tradition (such as medical or nursing school) and then study Ayurveda. Others may have training in naturopathic medicine, a whole medical system, either before or after their Ayurvedic training. Many study in India, where there are more than 150 undergraduate and more than 30 postgraduate colleges for Ayurveda. This training can take up to 5 years.
Students who receive all of their Ayurvedic training in India can earn either a bachelor's or doctoral degree. After graduation, they may go to the United States or other countries to practice. Some practitioners are trained in a particular aspect of Ayurvedic practice--for example, massage or meditation--but not in others, such as preparing botanical treatments.
The United States has no national standard for certifying or training Ayurvedic practitioners, although a few states have approved Ayurvedic schools. Some Ayurvedic professional organizations are collaborating to develop licensing requirements.
Consumers interested in Ayurveda should be aware that not every practitioner offering services or treatments called "Ayurvedic" has been trained in an Ayurvedic medical school. Services offered at spas and salons, for example, often fall into this category. If you are seeking Ayurvedic medical treatment, it is important to ask about the practitioner's training and experience (see the NCCAM fact sheet "Selecting a CAM Practitioner").
11. Does Ayurveda work?
Ayurveda includes many types of therapies and is used for many health issues. A summary of the scientific evidence is beyond the scope of this Backgrounder. You can consult the PubMed database on the Internet or contact the NCCAM Clearinghouse (for both resources, see "For More Information") for any research results available on a disease or condition. However, very few rigorous, controlled scientific studies have been carried out on Ayurvedic practices. In India, the government began systematic research in 1969, and the work continues.
12. Are there concerns about Ayurvedic medicine?
Health officials in India and other countries have expressed concerns about certain Ayurvedic practices, especially those involving herbs, metals, minerals, or other materials. Here are some of those concerns:
13. In sum, what should people do if they are considering or using Ayurveda?
14. Is NCCAM supporting any studies on Ayurveda?
Yes, NCCAM supports studies in this area. For example:
Sources were drawn primarily from the peer-reviewed medical and scientific literature in English indexed in the National Library of Medicine's PubMed database.
Barnes PM, Powell-Griner E, McFann K, Nahin RL. Complementary and alternative medicine use among adults: United States, 2002. CDC Advance Data Report #343. 2004.
Bhatt AD. Clinical research on Ayurvedic therapies: myths, realities, and challenges. Journal of the Associated Physicians of India. 2001;49:558-562.
Centers for Disease Control and Prevention. Lead poisoning associated with Ayurvedic medications--five states, 2000-2003. Morbidity and Mortality Weekly Report. 2004;53(26):582-584.
Centers for Disease Control and Prevention. Agency for Toxic Substances and Disease Registry. Lead Toxicity: Physiologic Effects. Agency for Toxic Substances and Disease Registry Web site. Accessed on September 1, 2005.
Chopra A, Doiphode VV. Ayurvedic medicine--core-concept, therapeutic principles, and current relevance. Medical Clinics of North America. 2002;86(1):75-88.
Courson WA. State licensure and Ayurvedic practice: planning for the future, managing the present. Newsletter of the National Ayurvedic Medical Association [online journal]. Autumn 2003. Accessed on February 22, 2005.
Dodds JA. Know your CAM provider. Bulletin of the American Academy of Orthopaedic Surgeons/American Association of Orthopaedic Surgeons [online journal]. December 2002. Accessed on September 12, 2005.
Fugh-Berman A. Herb-drug interactions. Lancet. 2000;355(9198):134-138.
Gogtay NJ, Bhatt HA, Dalvi SS, et al. The use and safety of non-allopathic Indian medicines. Drug Safety. 2002;25(14):1005-1019.
Lodha R, Bagga A. Traditional Indian systems of medicine. Annals of the Academy of Medicine, Singapore. 2000;29(1):37-41.
Mishra L, Singh BB, Dagenais S. Healthcare and disease management in Ayurveda. Alternative Therapies in Health and Medicine. 2001;7(2):44-50.
Saper RB, Kales SN, Paquin J, et al. Heavy metal content of Ayurvedic herbal medicine products. Journal of the American Medical Association. 2004;292(23):2868-2873.
Shankar K, Liao LP. Traditional systems of medicine. Physical Medicine and Rehabilitation Clinics of North America. 2004;15:725-747.
Subbarayappa BV. The roots of ancient medicine: an historical outline. Journal of Bioscience. 2001;26(2):135-144.
Szapary PO, Wolfe ML, Bloedon LT, et al. Guggulipid for the treatment of hypercholesterolemia: a randomized controlled trial. Journal of the American Medical Association. 2003;290(6):765-772.
Thompson Coon J, Ernst E. Herbs for serum cholesterol reduction: a systematic review. Journal of Family Practice. 2003;52(6):468-478.
World Health Organization Regional Office for South-East Asia. Health and Behaviours Facts and Figures--Conquering Depression. World Health Organization Regional Office for South-East Asia Web site. Accessed on February 16, 2005.
For More Information
The NCCAM Clearinghouse provides information on CAM and on NCCAM, including publications and database searches. Among its publications are "Herbal Supplements: Consider Safety, Too" and "Selecting a CAM Practitioner." The Clearinghouse does not provide medical advice, treatment recommendations, or referrals to practitioners.
A service of the National Library of Medicine (NLM), PubMed contains publication information and (in most cases) abstracts of articles from biomedical journals. CAM on PubMed, developed jointly by NCCAM and NLM, is a subset of NLM's PubMed system and focuses on the topic of CAM.
A National Library of Medicine Web site, MedlinePlus provides extensive information about drugs, an illustrated medical encyclopedia, patient tutorials, and the latest health news.
Web site: www.medlineplus.gov
CRISP (Computer Retrieval of Information on Scientific Projects)
CRISP is a database of federally funded biomedical research projects. It is one source (in addition to ClinicalTrials.gov) for finding out about NIH-sponsored studies on therapies that are part of Ayurveda.
Web site: www.crisp.cit.nih.gov
ClinicalTrials.gov is a federally supported database of information on clinical trials, primarily in the United States and Canada.
Web site: www.clinicaltrials.gov
NCCAM thanks the following people for their technical expertise and review of this publication: Bala Manyam, M.D., Texas A&M University System Health Science Center College of Medicine; Cathryn Booth-LaForce, Ph.D., F.A.P.S., R.Y.T., University of Washington School of Nursing; and Jack Killen, M.D., and Craig Carlson, M.P.H., NCCAM.
This publication is not copyrighted and is in the public domain. Duplication is encouraged.
NCCAM Publication No. D287
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Article Reviewed: July 5, 2012
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