From spiritual gurus, ministers to even Prime Minister Narendra Modi, everyone has an opinion on the efficacy of Ayurveda and other ancient therapies (alternative medicine). Rashtriya Swayamsevak Sangh chief Mohan Bhagwat has described Ayurveda as India’s soft power. The economic and cultural push towards accepting alternative medicine in public healthcare is growing.
Despite very limited human research, Ayurveda is deemed effective due to its ancient nature or its association with the Indian culture. From severe chronic diseases, to general well-being, Ayurveda claims to have a solution to every health concern.
Herbs like turmeric have a medicinal and religious connotation that go back several thousand years. Predating 250 BC, Susruta’s compendium of Ayurveda suggests turmeric ointment can relieve the effects of food poisoning.
Subsequently, curcumin, an anti-inflammatory, and an active ingredient in turmeric (Cucurma longa), was extracted. Using modern techniques, researchers have shown that curcumin induces apoptosis (cell death) in cells, inhibits angiogenesis (growth of new blood vessels) and has been implicated in inhibiting plaque formation in brains of Alzheimer’s animal models.
However, human research has not been able to show robust efficacy. In a six-month longitudinal human study, curcumin failed to alter mental state examination scores of Alzheimer’s patients. Besides, if consuming turmeric everyday were effective, then South Asian population should have had fewer cases of Alzheimer’s. But, according to a dementia report (2010), India has the second highest number of dementia patients, with its most common type being Alzheimer’s disease.
This disparity in facts comes from the inconsistent understanding of Ayurveda research vis-à-vis advances in physiology, pharmacology and molecular biology.
While curcumin may inhibit Alzheimer’s plaque at high doses in mice, it is not consumed in the same quantity in Indian diet. Pure turmeric contains an average of 3.14% curcumin by weight. Consuming a teaspoon of turmeric daily would give only about 135 mg of curcumin against a recommended dose of 400-2,000 mg. Moreover, in such high quantities, curcumin is known to cause nausea, headache and rashes.
While many modern drugs are derived from herbs, which are then synthesised in laboratories, after years of research, drugs are carefully developed to maximise efficacy with minimal side effects. Despite that, it is mythical to assume that a treatment would be devoid of any side effects.
Ayurveda researchers who argue that it shouldn’t be interpreted from a Western perspective use the very same modern laboratory techniques to study herbal drug pharmacology.
Further, in creating the divide between the two sciences, they fashion a niche, where an expert of one cannot comprehend the other, allowing no critique from modern physiologists. But evidence shows that the laws of biology, chemistry and physics are universal and constantly subjected to scientific scrutiny.
In the majority of clinical trials conducted by the Ayurvedic research institutes under the AYUSH ministry, appropriate measures are seldom taken to design trials within the framework of scientific methodology such as randomisation, placebo control, condition matching, or double blinding.
A recent big-data study is an example of data manipulation to show a biased result that exaggerates Ayurveda efficacy. The study, in collaboration with six organisations such as AIIMS and CSIR, analysed data from 3,53,000 patients treated with Ayurveda. A news portal reported these results concluding that 75%of the patients got relief from Ayurveda, as compared to 0.9% whose condition was aggravated.
A close study of the results found that the patients had chronic but not life-threatening diseases, where one requires immediate treatment.
These 75% “relieved” patients were a cumulative figure that included little improvement (58.4%) and significant improvement (13.8%) while only 3.6% patients reported as “condition relieved”.
Apart from the 0.9% that reported aggravated condition, a significant 23.2% reported no relief. Moreover, the study did not entail any double blinding, suggesting that the result may include an experimental bias due to drug expectation.
As a chronic disease progresses over a period of two-three years, it is highly likely for the patients to feel better, or worse, without any interventions. The data gave no comparisons with other treatment groups.
Mitali Mukherjee, a scientist with the Delhi-based Institute of Genomics and Integrative Biology, suggested that systematic big-data analysis can provide an unbiased look, but this study is neither unbiased nor accurate in establishing whether Ayurveda is certainly effective in 75% of patients.
On November 5, the Ayurveda Day, the AYUSH ministry organised marches, seminars and social media campaigns. However, medical research and big data suggest that despite pro-Ayurveda evidence in preclinical models, research under AYUSH has largely produced ill-researched and ineffective drugs for humans.
Dr Sumaiya Shaikh is the editor for Alt News Science and works as a neuroscientist in Sweden. She advocates for evidence based medicine & critiques misinformation in public health policies.