Abstract

Ayurvedic medicine, a traditional system of medicine practiced in the Indian subcontinent is considered to be devoid of adverse events. We report three cases which highlight the possibility of adverse events related with the use of ayurvedic products. A 35 year old woman with hepatitis took ayurvedic powder medicine and swarnabhasma (gold salt) and had her liver injury worsened, possibly due to alkaloids, and developed nephrotic syndrome, possibly due to gold salt. A 57 year old hypertensive man was taking ayurvedic medicine containing reserpine which had long been withdrawn from the allopathic system of medicine due to wide range of side effects. A 47 year old woman with rheumatoid arthritis was taking an unknown tablet containing steroid as an adulterant for 2 years and developed side effects typical of steroid excess. We would like to highlight the fact that ayurvedic medicines do have propensity to cause adverse events due to adulteration or inherent constituents like alkaloids, and hence may not always be completely safe.

Highlights

  • Ayurveda is one of the most renowned traditional systems of medicine, and has been widely practiced in the Indian subcontinent, including Nepal, since the 2nd century BC1

  • We report three cases which highlight the possibility of adverse events related with the use of ayurvedic products

  • It has been proven that certain constituents of ayurvedic products, like heavy metals and alkaloids, can have adverse events, and the possibility of these adverse events needs to be highlighted so that both the practitioners and consumers will become cautious in their use, as with allopathic medicines4,5

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Summary

Background

Ayurveda is one of the most renowned traditional systems of medicine, and has been widely practiced in the Indian subcontinent, including Nepal, since the 2nd century BC1. Case 2 A 57 year old gentleman from Kathmandu, a teacher by occupation had come for a blood pressure check-up at the medical outpatient department (OPD) of Patan Hospital, Lalitpur, Nepal in June, 2018 He told the doctor that he had been taking an ayurvedic medicine called “Tensarin” for high blood pressure for the past 3 years. Soon after we stopped the unlabeled medicine, she started to have more pain and swelling in the small joints of both hands and symptoms suggestive of steroid withdrawal were noted She was subsequently diagnosed as rheumatoid arthritis based on clinical features and laboratory parameters: C- reactive protein- 25 mg/L (normal < 5 mg/L), Rheumatoid factor- 30 IU/mL (normal < 25 IU/mL). When last seen 3 months ago (October, 2018), her arthritis was well-controlled with DMARDs without steroid preparations or unlabeled medicines

Discussion
Conclusion
Zastrow M
Bigazzi PE
Lobay D
11. Saseen JJ
The 2nd case
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