The Nirmukta Freethought Community

This thread serves two broad purposes:

1. Creating a comprehensive resource for Ayurveda on our forums, allowing for a proper scientific analysis of Ayurveda from a skeptical perspective. Here 'skeptical' refers to Scientific Skepticism, not the colloquial sense of the term.
2. Compiling links to the various other threads that deal with Ayurveda on these forums.

There are many different threads on Ayurveda here, many of them overlapping in their content. If you wish to discuss some specific aspect of Ayurveda, please first check to see if it can be covered in any one of the other threads.

1. Absurd claims of Ayurveda
2. NATURAL MEDICINE : Ayurveda helps woman beat a mysterious disease
3. Tata Trust funds 20 crore for Ayurveda "Healthcentre"
4. iitb conducting research on homeopathy & ayurveda
5. Govt. of India promoting Ayurveda, Unani, etc.
6. Apollo hospitals has a Ayurveda section!! *headdesk*

If you wish to discuss Ayurveda in general from a skeptical perspective, please use this thread, adding your comments and arguments.

(This is just a copypaste of an email, with minimal copyediting. Please treat as such).
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I spoke with a gentleman yesterday on Ayurveda. This is a person with bachelors and masters in Ayurveda, and clearly a skeptical attitude. I could not detect much hint of bullshit when he spoke (something that I smell in bucketloads, on previous occasions I spoke with supporters of any form of alternative medicine.).

Anyway, this gentleman works in the pharma field (in drug discovery, creation, specifically with any required scientific instumentation). He has personally tested/created drugs currently approved by FDA. These are herbal in nature, and took about 5 years of review, and passed clinical trials.

Starting a conversation as a skeptic, and eventually talking for about an hour, he made several points, which I outline below. What surprized me was the incumbent opinion of Ayurveda amongst freethinkers was way off from the arguments he was making.

* Ayurveda does not claim "no side effects". It never mentions "cure" any place.
* It only refers to treatment.
* Ayurveda and herbal remedies are not one and the same.
* Claims of use of heavy metals are both valid and invalid.
- Ayurveda has 2 main classifications - herb based, mineral based.
- The former is the majority prescribed concoction, and does not contain heavy metal.
- The latter if it contains heavy metal is usually in it's calcified/oxidized form, which is not absorbed by the body. It is thus not to be considered as dangerous as virgin heavy metal, if at all.
* From his knowledge of reading many papers, peer-reviewed in mainstream &respected medical journal (including JHAMA), ayurveda has demonstrable efficacy.

This man is clearly a skeptic, and though I didn't ask directly, I think he's pretty much a tacit atheist. More importantly he seemed very honest, and there was no reaon to suggest he didn't know what he was talking about.

I had no real take on Ayurveda itself, largely because it is not written about as much as say Homeopathy, in skeptic circles. The articles I found on nirmukta were largely opinion pieces, and not dealing with the theory/aruryvedic treatments itself. Infact, this gentleman brought forward points about the theory: Ayurveda was largely an empirical study at it's time.. they had no idea about micro-organisms, but when they found A was helpful in condition B, it was noted as such, and the
treatise thus evolved.

Which is all to say this is I think a fantastic topic for Nirmukta to cover. This gentleman was a little miffed with the freethinker community as he said he had experiences of being hand-waved away just for making points that would seem in favor of Ayurveda. I have observed this behavior as well, and we'd be doing a disservice to freethinking if someone with this level of understanding, and interest
of pharma is turned away from our community.

I'll be speaking with him soon. Meanwhile, if you have anything to add, somethings that I should perhaps bring up, let me know.
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I have since learned about Meera Nanda's book (Ayurveda Today, a critical look) on the subject, and I intend to pick it up in the near future.

Thanks Anil for presenting a view from someone who works with ayurveda.

Looking at the points he is making, I think it is important to take into consideration how Ayurveda is marketed and what freethinkers usually criticize about Ayurveda.

• Theory of Ayurveda - This is pretty much bunk (as far as etiology is concerned). It talks about matter being made of five elements and uses tri-doshas to explain illnesses. Despite that, money and effort are wasted in trying to pin scientific validity to it.
• Appeals to antiquity - Ayurveda is ancient. So by definition it has to be good. That is a pretty common argument.
• Some people tout ayurveda as an alternative to SBM not because of its efficacy (if any) but because of nationalistic and religious sentiments.
• Ayurveda is all natural and has no side effects - This is a key pitch in the marketing of ayurveda.
  

The people who advocate ayurveda and are most visible in the media and to the population in general make claims like those listed above, but rarely put forth the kind of points the gentleman gave.

Another question that pops-up is, if a particular ayurvedic treatment is proven to be efficacious for a condition, how does mainstream medicine fare for the same condition? If it is better or the same, why should ayurveda be preferred? And what are the conditions that ayurveda can actually treat?

However, I agree that it is a problem if good evidence is presented that some treatments work and people still wave them away just because they come from ayurveda.

(01-08-2011 05:13 PM)Lije Wrote:  

• Theory of Ayurveda - This is pretty much bunk (as far as etiology is concerned). It talks about matter being made of five elements and uses tri-doshas to explain illnesses. Despite that, money and effort are wasted in trying to pin scientific validity to it.
• Appeals to antiquity - Ayurveda is ancient. So by definition it has to be good. That is a pretty common argument.
• Some people tout ayurveda as an alternative to SBM not because of its efficacy (if any) but because of nationalistic and religious sentiments.
• Ayurveda is all natural and has no side effects - This is a key pitch in the marketing of ayurveda.
  

Absolutely. I made several of these points myself. But that's not what this thread is about. (FYI.. my reply above was a private discussion with Ajita, and he suggested it might be better made in public).

I get that the marketing is "shady" at best. I do not want to discuss that here. What I'd like (and I'm sure most freethinkers would too) to see is a discussion on the efficacy of theoretical Ayurveda. As in does ayurveda, as it's experts (and not marketers and corporates) understand it can actually provide benefits visible for eg. in a double blind test. The gentleman I spoke to said "vehemently yes!", and also stated that these are studies in respected/peer reviewed medical journals.

Once we have a better understanding of this, we can perhaps poke the marketing/etc aspects to a bigger degree. And since the experts seemingly believe that no promise of "0 side effetcs" or "cure" has been provided for, we can make this case to all the rampanty bad practice.

Quote: As in does ayurveda, as it's experts (and not marketers and corporates) understand it can actually provide benefits visible for eg. in a double blind test. The gentleman I spoke to said "vehemently yes!", and also stated that these are studies in respected/peer reviewed medical journals.

Ayurvedic medicines, usually are herbal (and in rare cases, animal) extracts. Of course, you can expect these extracts to have certain pharmacological properties. And I don't doubt that a double blind test might actually prove the efficacy of some of these treatments. The problem, however, IMO are the following:

1. An 'extract' is just that-it's a mixture of many many different compounds,without any real effort made to purify it. Now, I don't deny that there may be an active ingredient(s) in this mixture. But, there are also a large number of other things in there that have no significance to the treatment. Ayurveda makes no attempt to distinguish between the active molecules and the unnecessary garbage in this crude extract. Which, of course, is a throwback to its ancient origins. There are a number of scientifically validated "modern medicine" drugs that are derived from plant or animal sources as well. The best and most well-known example that comes to mind is Quinine, taken from the bark of the Cinchona tree. The difference is that these drugs, once extracted from the plant, undergo a process of purification, so that the end product is a single active compound. It's not cinchona extract any more, it's quinine, and nothing else. (Quinine, by the way, is synthesized chemically now. There still are other examples of drugs that are herbally derived, like Taxol and Vincristine )

2. Any drug, before being used to treat a condition, has to pass through a set of clinical trials. This can be a long-winded process, but it ensures that the drug is efficacious and safe to use. Ayurvedic drugs do not undergo this procedure. We do not know of any side effects that the treatment may have. We do not even know if the medicines actually work, except for the very few that have been tested using double-blind control studies. And even in these few cases, we're not sure of how exactly the treatment works. Obviously not through the Vata-Pitta-Kapha balancing theory.

(02-08-2011 11:52 AM)Pratibha Wrote:  Ayurvedic medicines, usually are herbal (and in rare cases, animal) extracts.

The explanation I got was a bit broader and detailed .. it is mainly classified in 2 forms: Herb-based and Mineral-based. The former, as you've started is based on extracts/etc of a list of trees/shrubs. There is an exact list of this (in the text that make up Ayurveda).

For a concoction to be officially "Ayurvedic", it has to :
* Be mentioned in these texts.
* Be used in the exact prescribed manner.

I was quoted an exmple of "Tulsi" .. while largely called an Ayurvedic boon from anything from shampoos to masala ingredients, there is seemingly a specific manner in which it is to be extracted/used. So most of the marketed claims are not specifically ayurvedic.

Quote:Ayurveda makes no attempt to distinguish between the active molecules and the unnecessary garbage in this crude extract. Which, of course, is a throwback to its ancient origins. There are a number of scientifically validated "modern medicine" drugs that are derived from plant or animal sources as well. The best and most well-known example that comes to mind is Quinine, taken from the bark of the Cinchona tree. The difference is that these drugs, once extracted from the plant, undergo a process of purification, so that the end product is a single active compound. It's not cinchona extract any more, it's quinine, and nothing else. (Quinine, by the way, is synthesized chemically now. There still are other examples of drugs that are herbally derived, like Taxol and Vincristine )

In essence I brought these up as well. As far as regulatory bodies are concerned (FDA what was this gentleman has worked with, and is very well versed with), they are not concerned with efficacy. They are only worried about toxicity. The rationale seems to be that anything approved as a drug should have no harm, first and foremost. Then the market decides which drub sells better. And modern medicine has largely won this.

Indian regulatory bodies, while having similar policies, are far more lenient in how they work with Ayurvedic medicine. They seemingly are not put to the same stringent standard as the FDA.

This market based approach seems curious to me. As long as a drug is not toxic, and is shown to have the affect it states on the label, it is allowed. Today many get away with having wishy-washy claims ("can help with maintaining low stress", "can assist loss of weight", etc), and it is largely through this loophole that many Arurvedic drugs make it into the market. But perhaps this is the right approach? Making these more stringent will only push this into the grey market, as there is a huge demand for these.

Quote:Ayurvedic drugs do not undergo this procedure.

Are you sure? My understanding from the aforementioned conversation is that there are regulations for these drugs (perhaps not as stringent as we may like, but they definitely are present). FDA, for sure, has policies for Ayurvedic drugs.

Quote:The explanation I got was a bit broader and detailed .. it is mainly classified in 2 forms: Herb-based and Mineral-based. The former, as you've started is based on extracts/etc of a list of trees/shrubs. There is an exact list of this (in the text that make up Ayurveda).

I don't know much about these mineral based Ayurvedic medicines. I'm more aware of the herbal stuff, and I think that is what makes up the bulk of Ayurvedic remedies. The 'mineral medicines' are probably the ones that have been found to cause all the lead, mercury, and arsenic poisonings (1, 2, 3)

Quote:In essence I brought these up as well. As far as regulatory bodies are concerned (FDA what was this gentleman has worked with, and is very well versed with), they are not concerned with efficacy. They are only worried about toxicity. The rationale seems to be that anything approved as a drug should have no harm, first and foremost. Then the market decides which drub sells better. And modern medicine has largely won this.

Somebody correct me if I'm wrong here, but the way I understand it, all drugs approved by FDA need to undergo certain studies, which include pharmacokinetic analysis, bioaviability, and drug interaction studies. How can these tests be performed on extracts? You need to get some details on these FDA approved Ayurvedic medicines that your friend was talking about. My hunch is they were released as nutritional supplements, rather than medicines, in which case, toxicity would be the only issue they'd study.

Quote:Are you sure? My understanding from the aforementioned conversation is that there are regulations for these drugs (perhaps not as stringent as we may like, but they definitely are present). FDA, for sure, has policies for Ayurvedic drugs.

See above for FDA. In India, of course, things are very different. It seems you can sell anything under the name of traditional medicine. AYUSH, the government department that deals with regulation of alternative medidcine, has loads of regulations in place. Enforcement, however, is a completely different thing. Sticklers for Ayurveda go for treatment to families that have been practicing Ayurveda since generations. I don't even know if these guys hold offical degrees in Ayurveda (doesn't really matter either way, just saying). You can get ayurvedic concoctions from these places, without even a list of ingredients, which is completely against the official regulations. As for clinical trials for Ayurvedic drugs in India, I've never heard of them. The basic premise, again, as I understand it, is that the drugs and the process to manufacture them are inscribed in the text, and they're perfectly safe and efficacious. So, there's no need now to do trials on a system that has been in place for such a long time. The only time clinical trials are required is when a new formulation is tried out, or some kind of change is made in the formulation.

None of this negates the fact, as I've mentioned before, that some Ayurvedic medicines might actually work. But, was is really needed, I think, is to try and identify the active components in such cases, subject them to all the relevant pharmacological studies, and then release as a drug. But, I doubt it would be Ayurvedic any more.

There is a very thin line of difference between a 'drug' and 'food' in FDA regulations and ayurvedic medicine producers often pass the products as 'food supplement' and not as a drug. This study clearly consider Ayurvedic medicines as 'dietary supplement' and therefore it is treated as food.

The only way to know whether the product has been approved as a drug is to look at the approval papers from FDA. Needless to say that FDA depends on manufacturers to comply with the regulations and conducts very little verification due to the volume of products they regulate. In food, they just inspect 1% of all foods imported to US!!

They do respond well in case they come across any discrepancy.
Example of US FDA response: http://www.fda.gov/ICECI/EnforcementActi...168454.htm

I just read meera nanda's
The State of Ayurveda Examining the Evidence.pdf

This essay tackles a lot of what we've disucssed, and a worthwhile read.

~Anil

(09-08-2011 06:17 PM)anilg Wrote:  I just read meera nanda's
The State of Ayurveda Examining the Evidence.pdf

This essay tackles a lot of what we've disucssed, and a worthwhile read.

~Anil

Anil, the link is missing...

Bobby

Quote:Anil, the link is missing...

I managed to fish it out

Thanks Anil

Ayurveda's popularity is partly due to the misconception that synthetic chemicals are bad and anything herbal is good. Take rotenone for example, http://en.wikipedia.org/wiki/Rotenone . It is a herbal "insecticide" making it "organic" ("everything has Carbon, yo!" to whoever coined this word to refer to herbal stuff). But it can cause Parkinson's disease in human. Then there's obvious stuff like hemlock. But what makes rotenone dangerous is that it is a particular chemical that is used with the belief that being organic, it is somehow safer. [This is where I first read about it: http://blogs.scientificamerican.com/scie...iculture/]

Does anyone have such examples for Ayurvedic medicine, other than heavy metals?

Also, here is an interesting graphic about scientific evidence and various "health" supplements: http://www.informationisbeautiful.net/pl...pplements/