WDS 51: Ayurveda adjuvant therapy in ATT Toxicity by Dr. D.C. Katoch, Prof. R.K. Chulet, Prof. Deep Narayan Pandey, Vd. Pratibha Navani, Dr. Ashwini kumar Sood, Dr. Ankur Sharma, Dr. Yatinder Sharma & others.

[4/9, 9:12 AM] Prof. Deep Narayan Pandey: 

*An important question*

Anti-tuberculosis treatment of allopathy is said to be effective in treating the disease but brings toxicity of various kinds.

Are there specific drugs (single herbs or a combination) within Vrahattrayee that can counter the side effects of ATT ?

Reference from Samhitas, Science and Experience ?

[4/9, 9:28 AM] Dr Harish Verma Verma Canada: 

Combination of Guduchi & Amla is proven for this purpose. If you want I an post scientific article. 

[4/9, 9:30 AM] Prof. Deep Narayan Pandey:

 Thank you indeed. Yes please.

[4/9, 9:31 AM] Prof. Deep Narayan Pandey: 

Meanwhile, I have scanned the literature and the latest review is this - - -

Baskaran, U. L. and E. P. Sabina (2017). "Clinical and experimental research in antituberculosis drug-induced hepatotoxicity: a review." Journal of Integrative Medicine 15(1): 27-36.

[4/9, 9:37 AM] Ashwini Kumar Sood Dr: 

Drugs used for kochs are quite toxic. Used in combination or singly they have some side effects which can be moderate to life threatening  . Streptomycin for example may immediately cause anaphylactic shock or in long term may damage chochlea resulting in life long disability . 

From skin to cns to git every orgsn may be involved . Treatment depends upon the system involved . It can not usually generalised . Treatment will cause hepatotoxicity is so well recognised that pts by themself start OTC products like liv 52 to combat liver disorder symptoms .

[4/9, 9:40 AM] Anita Gaytri Dr. DG:

Pippali enhances the bio availability of rifampicin...proven studies. 

Also, liver supplements as ATT takes a toll on liver.

[4/9, 9:44 AM] Prof. Deep Narayan Pandey: 

This paper is comprehensive, cites all the major research published up to 2017.

Experience of colleagues here would be very useful. Kindly do share as and when your schedule permits.

[4/9, 9:48 AM] Vd Subhash Joshi:

 Dr. SOODji. Right. Explained.  CONGRATS. !!!!

[4/9, 9:56 AM] Vd Pratibha Navani: 

Along with it Rudanti given in 2 gms doses twice daily reduces the virulence of the Tuberculosis.

[4/9, 9:59 AM] Dr B K Mishra Ji: 

लगभग 20 वर्ष पहले एलोपेथिक ट्रीटमेंट के साथ प्रतिदिन सायंकाल निम्नांकित आयुर्वेदीय योजना करने पर रोगी को किसी प्रकार के उपद्रव से रहित त्वरित स्वास्थ्यलाभ  का मैंने अनुभव किया है। 

 सितोपलादि/ तालिशादी चूर्ण + श्रृंगाराभ्र + प्रवालपिष्टी + श्रृंग भस्म + च्यवनप्राश 

दुग्ध अनुपान

ऐलादि वटी

पूर्व रोगी वर्तमान में पूर्ण स्वस्थ हैं..

अन्य उर्जास्कर योग भी निश्चित रूप से लाभप्रद रहेंगे..

[4/9, 10:02 AM] Prof. Deep Narayan Pandey: 

Meanwhile, I have compiled a filed of published research on this. Enclosed as above. 

[4/9, 10:03 AM] Prof. Deep Narayan Pandey: 

Of the 96 papers, a few are only marginally relevant.

[4/9, 10:06 AM] Vd Pratibha Navani:

 Excellent articles sir worth for   ATT Programme as adjuvent therapy.

[4/9, 10:17 AM] Prof. Deep Narayan Pandey: 

It would be great if colleagues here can design a standard protocol for *countering the toxicity and immuno-compromized state due to antituberculosis treatment, with Ayurveda.*

This would be helpful for a relative, 81 years, who is being suggested ATT to address the problem of lower spinal vertibral pain.

[4/9, 10:33 AM] Ankur Sharma Dr Delhi: 

Prior to counter the side effects of att we should know the main side effects of each att drug

And select ayurveda medicine accordingly. 

Rifamcin~~ hepatotoxic 

isoniazid~~peripheral neuropathy+ hepatotoxicity

pyrazinamide~~hyperuricemia

ethambutol~~~ocular toxicity~optic neuritis

Hence ayurveda tonic should be advised while keeping in mind concern of 

Hepato,neuro nephro protective ayurvedic tonics.

There are lots of medicine for that....

Kalmegh

Rohitak

Kasni

Paatijaat

Nirgundi

Goghirt

Sahijan

Ksheerbala preparations

Shatavari

Kesar

Punarnava

Varun shigru

Makoy

In nutshell Decoction of Patanjali.....

sarvkalp kwaath

Paarijat kwaath

Nirgundi kwaath

Vrikkdoshharkwaath  Each 2.5gm

Saptamrit lauh

Mahatriphala ghirt

[4/9, 11:08 AM] Prof. Deep Narayan Pandey: 

Could we articulate the impact you so well described in terms of Ayurveda (impact on दोष, अग्नि, धातु, मलक्रिया, आत्मा, इंद्रिय and मन) so that these can be maintained in a state of equilibrium during ATT, with the help of Ayurveda? That would be very helpful.

[4/9, 11:08 AM] Sanjay Chhajed Dr. Mumbai: 

Respected sir and 1990 my name study was published in JRIM based on my dessertition "role of rasayan in the management of Rajyakshma, pulmonary tuberculosis", this study was further done at BJMedical College, Pune. I continue to work for my PhD "Biochemical study of hepatoprotective effects of piper longum against the hepatotoxicity induced antitubercular drugs".

[4/9, 11:12 AM] Dr Bhadresh Nayak, Surat: 

Piper longum is biihansher is proved by the reshecher

Some of company launch medicine which prescribed with anti the drugs.

[4/9, 11:45 AM] Prof. Deep Narayan Pandey: 

Thank you indeed for sharing your valuable insights doctor saheb !

[4/9, 12:15 PM] Prof. Deep Narayan Pandey:

भूयश्चैषां बलाधानं कार्यं स्वरसभावनैः| सुभावितं ह्यल्पमपि द्रव्यं स्याद्बहुकर्मकृत्|| 

स्वरसैस्तुल्यवीर्यैर्वा तस्माद्द्रव्याणि भावयेत्| अल्पस्यापि महार्थत्वं प्रभूतस्याल्पकर्मताम्|| 

कुर्यात् संयोगविश्लेषकालसंस्कारयुक्तिभिः| ---

ch.kalp.12.47-49 (poorvardh)

The quality and action of drugs can be enhanced by the proper triturating with either swarasa (juice) or kvatha (decoction) of the same drug or of the other drugs with similar qualities and action. This method also potentiates the multidimensional action of the preparation. 

By the combination and separation of drugs, kala (time), sanskara (processings), and yukti (proper planning) one can modify the potency of medicaments. There by minute dose can produce greater benefits and vice versa.

[4/9, 12:19 PM] Prof. Deep Narayan Pandey: 

Interesting fact is that Acharya Charaka has  gone on to suggest that even विरुद्ध वीर्य can join hands in certain circumstances

इष्टवर्णरसस्पर्शगन्धार्थं प्रति चामयम्| अतो विरुद्धवीर्याणां प्रयोग इति निश्चितम्||

------ch.kalp.12.46

The rationality for using viruddha virya (opposite quality drugs or antagonistic) drugs along with main drug are to impart pleasant color, good taste, agreeable smell and touch and relation to the specific disorders.

[4/9, 12:20 PM] Prof. Deep Narayan Pandey:

 *... and in relation to the specific disorders.* is pathbreaking insight.

[4/9, 12:37 PM] Sanjay Chhajed Dr. Mumbai:

 There are no direct references as reducing att.

[4/9, 1:22 PM] Dr Surendra A Soni:

Plenty of formulations available to reduce toxicity.

Various ghrita formulations....

Chyavan prasth

Draksha avaleha

Vasavaleha

Amalaki rasayan

Almost all rasayan are helpful to reduce toxicity.

If gold preparations like S V malati etc vasant kalpas are added,  all kind of toxicity are covered.

[4/9, 1:32 PM] Prof. Deep Narayan Pandey: 

Great! Thank you indeed. Very useful insight.

*I have a question.* While reducing toxicity is one aspect, necessary as well, yet the mental agony too is often manifested. Would you like to suggest something for that as well so that मन is also addressed (although i am aware that Rasayanas do address the मन issue as well).

[4/9, 1:36 PM] Dr Surendra A Soni:

Siddha ksheer pak or Shuddha Go- Ghritapan/ drakshadi/vasadi/triphala Ghrita as per status of Agni may be best choice for sattvadhan.

Yasti, shankhapushpi etc are other choice.

[4/9, 8:22 PM] Dr. D C Katoch sir:

Panchagavya can not be left out from the list of formulations recommended for ATT induced or TB induced toxic state.

[4/9, 8:40 PM] Vd Pratibha Navani: 

Sir in Tuberculosis which would be much beneficial for pt after att Aja dugdh or gau dugdh.

[4/9, 8:42 PM] Dr. D C Katoch sir: 

Gomutra

 CSIR studies have proven the antitoxic and immunity enhancing value of Gomutra.

[4/9, 8:46 PM] Dr Harish Canada: 

Interesting !!!!

 But Dhatu Paushtic Action of Gomutra is ?

[4/9, 8:52 PM] Dr. D C Katoch sir:

 Because Gomutra promotes tissue integrity by improving Dhatwagni action.

 In TB toxic states, trikatu and Pippali rasayan are  best for aamaj vish; agastya rasayan for chronic toxic inflammatory reaction in lungs; madiphala rasayan for ras-rakta dushti and yashtimadhu for degenerative state.

 And Suvarn or Suvarnmakshik  Yoga in all toxic conditions of TB.

[4/9, 9:19 PM] Dr Harish Canada: 

Whether Gomutra is Lekhan or Brihangan ?

In TB, usually Brihangan Chikista is required.

[4/9, 9:26 PM] Dr. D C Katoch sir: 

Because Gomutra promotes tissue integrity by improving Dhatwagni action. Brihangan does not mean Immunity Promotion nor Lekhan means immunosuppresion.

[4/9, 9:32 PM] Ankur Sharma Dr Delhi:

 Lekhan  scrapping the microchannels to keep patency.

Gomuta has kafshoshak....property.

But definitely tb patient require brihangan chiktsha to  nourish body.

[4/9, 9:33 PM] Ankur Sharma Dr Delhi: 

As antiinfective agent gomutra may be utilized for short time span but prolonged use may not be beneficial for emaciated  patients.

[4/9, 9:39 PM] Dr Surendra A Soni: 

Brinhan needs specific diet schedule in the form of Pathya. Gomutra is not a dietary substance.

[4/9, 9:40 PM] Dr Surendra A Soni:

 Perfect !

Well said respected Katoch Sir !

[4/9, 9:44 PM] yatinder sharma Dr:

 Gomutra has bioanhancing properties also... for rifampicin and has us patent for that....

[4/9, 10:03 PM] Ankur Sharma Dr Delhi: 

Yes sir 

I agree

[4/9, 10:05 PM] Dr. D C Katoch sir:

 Aahar Vyavastha, not Pathya I think.

Pathya term is used in the context of management of a patient, not for healthy person or for bringhan karm.

[4/9, 10:17 PM] Dr Surendra A Soni:

 Yes Sir !

I mean to same in context to TB.

[4/10, 8:54 AM] Shantanu Das Prof KC: 

Sir normally I use...Rudanti cap...nd krishna chaturmukha ...rasa....in chronic treated TB cases....

I hv gotten gd results....

[4/10, 1:53 PM] yatinder sharma Dr: 

I gave vasant malti ras 

Abhraka bhasma sahastra puti shringarabhra rasa  

Tankan bhasma

With rudravanti rasayan syrup

Shakti rasayan 

Cruel capsules

In multi drug resistant T.B 

patient age was 65 

He recovered completely in 6 months got afb negative without giving any anti tuberculer drugs....

[4/10, 1:55 PM] Shantanu Das Prof KC: 

Yes...swarna malati also a ...choise.....

[4/10, 3:19 PM] Ankur Sharma Dr Delhi:

 @⁨yatinder sharma Dr⁩

Sir

 Please tell pharma company of Rudravanti rasayan syrup, shakti rasayan, cruel capsules. 

[4/10, 3:20 PM] yatinder sharma Dr: 

Rudravanti syrup is of maharshi badri,

And cruel capsule is of unjha pharma.

[4/10, 3:20 PM] yatinder sharma Dr:

 Shakti rasayan is also of maharshi badri.

[4/10, 3:29 PM] Ankur Sharma Dr Delhi:

 Thanks sir for ur valuable reply.

[4/10, 7:13 PM] Prof. Deep Narayan Pandey:

 *This is a great achievement*. Actually, to my knowledge a rare case where TB has been cured without the use of standard ATT.

It would be great if you kindly share more details for our benefit, doctor saheb.

[4/10, 7:16 PM] Prof. Deep Narayan Pandey: 

My question was to help counter the side effects of ATT in patients who are undergoing ATT, but this case you shared has much wider scope and needs to be taken seriously. Thank you for sharing your valuable insights.

[4/10, 8:07 PM] Dr Harish Canada:

 Sometimes patients give false information that they have fully recovered. 

There should be thorough investigations before declaring TB cured. 

If only AFB in sputum has become negative that does not mean TB has been cured.

[4/10, 8:17 PM] Prof. Deep Narayan Pandey: 

Agree, and I hope the conclusions drawn in this case were evidence-based (meaning thereby that multiple tests were done by sufficiently rigorous lab).

[4/10, 8:33 PM] yatinder sharma Dr: 

Thank you sir.

[4/10, 8:41 PM] yatinder sharma Dr: 

Surely sir... I adviced him to do test from 3 different labs... all came clear and the patient improved systematically also....

[4/10, 9:23 PM] Prof. Ramakant Chulet Sir: 

Sir , Dr SM Chulet remain incharge of TB hospital for a long period at jaipur . He told me ATT is success only pt takes 3 peepa of chyawanprash means near about 45 kg during entire period of treatment with ATT.

What is significance I don't know but it's true.

[4/10, 9:31 PM] Ashwini Kumar Sood Dr: 

 remarkable observation.

[4/10, 9:31 PM] yatinder sharma Dr: Thanks.

[4/10, 9:51 PM] Prof. Deep Narayan Pandey: 

Prof. Ramakant ji !

बड़ा जबर्दस्त रास्ता दिखाया आपने आचार्य श्रेष्ठ !

कल की चर्चा में भी च्यवनप्राश की मुख्य भूमिका उभर कर सामने आई थी।

[4/10, 9:54 PM] Prof. Ramakant Chulet Sir: 

वो अपने हर रोगी को ३ पीपा advice करते थे रोगी खाते थे बनवाकर की चुलेट जी ने कहा है जब २-३ बार जानकारी मिली तो मैं उनसे मिलने गया फिर तो ५-७ बार मिला मैं ज़बरदस्त चिकित्सक क्षय का क्षय करके ही छोड़ता था !

[4/10, 10:00 PM] Prof. Deep Narayan Pandey: 

वाह ! 

[4/11, 9:11 AM] Sanjay Chhajed Dr. Mumbai: 

MDR tuberculosis has been SUCCESSFULLY  treated by non AKT. many times it can be adjucted by Ayurveda.

There was one Mr kapur at vajreshwari who was known to treat tuberculosis successfully with the drug called Rudanti. I have treated few patients with good success without AKT. But more useful is the combination and increased bioavailability & there by the faster and more efficient treatment without complications.

[4/10, 10:00 PM] Prof. Deep Narayan Pandey: Thanks to all.

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Above discussion held on 'Kaysampraday" a Famous WhatsApp-discussion-group  of  well known Vaidyas from all over the India. 

Compiled & edited by

Dr.Surendra A. Soni

M.D.,PhD (KC)

Associate Professor

Dept. of Kaya-chikitsa

Govt. Ayurveda College

Vadodara Gujarat, India.

Email: surendraasoni@gmail.com

Mobile No. +91 9408441150