Personalization of medicine has been a goal in allopathic medicine in recent years. The idea is that the one size fits all method of dosing, adjusted perhaps in some medications for sex or body size, misses the target for many patients. It’s using buckshot where a bullet might do better. Figuring out via genetic testing how patients respond to medications and what their individual nutritional needs might be is one of the cutting edges of recent research.
Ayurveda is at its core a personalized system, experts contacted by NutraIngredients-USA have said, and developed that way throughout its several thousand-year history in India. Based on their observations of the patients and their symptoms, traditional practioners would formulate herbal tonics and other preparations for individual needs.
The attraction of the single component model
Many of those preparations were variants on standard themes, using some main ingredients, such as brahmi, ashwagandha, turmeric, tulsi and others. In the Western, reductionist model, researchers started to tease out the individual active components of many of these ingredients, most notably with turmeric, to pin down their specific health effects and modes of action. There is a tension within the modern research on Ayurveda, said Jennifer Rioux, a registered Ayurvedic clinician and yoga practitioner with 15 years experience in Tucson, AZ. Rioux, who holds a PhD in medical anthropology, is a research University of Arizona.
“In the West, research on Ayurveda has focused on lab based studies investigating the uses and actions of traditional herbs, as well as pilot studies and small clinical trials. More funding is needed for Ayurvedic research," Rioux said.
“Research in India has been ongoing for some time. Training in research differs from the West and sometimes methodologies are not comparable. However, there has been more international exchange and collaboration between Western and Indian researchres in the past 20 years, which is enhancing the quality of research on Ayurveda overall,” she said.
Dhaval Dhru, MD, is chair of the Department of Ayurvedic Sciences in the School of Traditional World Medicines at Bastyr University in Kenmore, WA. Dhru agrees with Rioux that the scientific tide for Ayurveda is rising.
“I tell my students the Ayurvedic concepts come from a concise, longstanding, ancient tradition that is still being upheld in the modern world. There is more and more research being done in the West, but we still don’t have what I would call a large scale clinical trial,” he said.
Studies to support specific ingredients
The small scale nature of the research in the West has to do with both market conditions and scientific and even political biases, Rioux and Dhru said. Much research is funded by companies developing dietary ingredients, and that economic underpinning can’t come close to being able to fund the large scale trials of the sort necessary to bring new drugs to market, which have their patent-protected pot of gold at the end of the rainbow. So without a huge commitment of public funds which is very unlikely to be forthcoming, pining for those big trials on Ayurvedic ingredients or therapies is like wishing pigs could fly.
Even in the smaller scale studies with more modest goals, tensions exist. Ingredient suppliers fund research not from a desire to expand human knowledge but rather to support the efficaciousness and uniqueness of their ingredients. Thus, a study on whole turmeric could just as well boost sales of the cheaper, more generic ingredient down the road. Precise specifications for the ingredient and specific dosages are what help to tell the story for a specific product. And it’s the kind of specificity that attracts what public research support that’s available from clinics and medical centers.
“It is usually a reductionist approach, or what you might call a more precise approach. We look at what we believe to be the active compound and see its effect first at the cellular level or in an animal model. The prime example of that would be the curcumin research,” said Dhru.
Rioux said that approach may do a significant disservice to the development of Ayurveda in the West. It’s akin to rejecting the ballet as a whole and focusing on the series of ten steps that can be repeated precisely over and over.
“One of the issues with the current research is that the conventional research paradigm is not appropriate for Ayurveda. They are trying to separate out one component or one mechanism and that is not the way that Ayurveda works. What would be more appropriate would be a model based on complex systems research. Pulling out one compound and looking at that doesn’t really reflect the experience of a patient receiving Ayurvedic therapy in a clinical setting,” she said.
A return to synergy?
But Dhru believes that establishing that foundation via the mechanistic studies will one day lead Western trained scientists back to Ayurveda’s synergistic core. Already, for example, piperine has significant clinical backing for its ability to boost the activity of curminoids.
“I think these single ingredient studies are just going to increase the interest and I think pretty soon there will be a little shift that if there are these effects, what would happen if you combine two or three of these ingredients?” he said.
Both Rioux and Dhru said adhering to the Ayurvedic, synergistic approach would help boost one the of tradition’s great selling points, the muting of potential side effects and promotion of overall balance.
“Plants are intelligent, they have their own way of interacting with one another, their own way of mitigating negative effects. That is not present when the entire plant is not used,” Rioux said.
“If you use just one one compound you are using it just like a laser knife. It’s precise, but you can also do some collateral damage,” Dhru said.