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Ayurvedic Guidelines for Daily Routine: Living in Sync with Nature’s intelligence 

Ayurveda recommends a healthy, consistent daily routine (Dinacharya) based on the 3 pillars of health, (including proper digestion and elimination, proper rest and sleep, and moderation/discipline in lifestyle) which is Synched with the cycles of Nature, including the daily circadian rhythm cycle, seasonal cycles or cycles of Aging.

A regular practice like above which is synced with the Intelligence of Nature, is more potent and helpful than medicine, by bringing the body, mind, emotions, and spiritual elements back to balance. It also helps rest the nervous system by decreasing decision fatigue by following a grounding, soothing, healing, personalized routine which is in contrast with present hectic and unsettling lifestyle.

The Ayurvedic routine creates a series of comforting reference points throughout the day which are very reassuring and rejuvenating to the cellular intelligence and the nervous system, a much needed, welcome break.

So, all of us are welcome to start living with some more self-care, filled with love and compassion towards ourselves, as much as we offer it to the outside world.

You can start practicing couple of these tiny habits gradually and make it manageable for yourself, rather than overwhelming. You can pick up the habits which you feel comfortable doing on a regular basis, or just try them for fun.

Stay committed and relaxed, add things realistically, be predictable and well-paced.

Remember to have self-compassion all through the process!

Here are the brief recommendations below:

-Morning:

  • Wake up before Sunrise, which is the perfect time for the nature’s quietude, light and peaceful energies.
  • Eliminate in the morning to help with early detoxification (bowels and urination)
  • Wash face and eyes with a cool splash of water to drive away the remnant drowsiness and induce freshness.
  • Drink a glass of pure warm water with lemon juice on rising to promote detoxification.
  • Sit down to meditate, enjoy the stillness outside and within, say a prayer, or focus on your breath for a few minutes.
  • Be grateful, reflecting on the blessings in your life.

Cleansing:

  • Clean tongue by scraping 3-5 times, back to front to help detoxify
  • Oil pulling for 2-5 minutes after or before brushing your teeth. Massage gums.
  • Nasya, lubricate nasal passages, or practice nasal rinsing.
  • Practice Yoga, or Stretch and flex your body, to 50% of your capacity.
  • Self-massage with the right kind of oils, try to massage all body parts
  • Take a nice warm shower to rinse off excess oils, with minimal soap use

Food:

  • Eat 3 consistent timed meals a day, or as per your true hunger.
  • Eat foods which are seasonally appropriate and as per your body type and imbalance.
  • Try to include all 6 tastes into your meals
  • Try to minimize snacking in between meals.
  • Eat mindfully, in a pleasant state of mind , with loved ones
  • Eat while sitting comfortably
  • Try to eat when truly hungry
  • Avoid eating when angry or upset
  • Largest meal preferably at noon, medium breakfast and earlier, lighter dinner.

-Afternoon:

  • Establish a consistent, predictable work and rest schedule.
  • Focus on cleaning and decluttering your work and home environment to facilitate good energetic flow.
  • Develop mutually nurturing relations in your interaction with others during the day
  • Be of service to others when possible.

-Evening and bedtime

  • Allow time for proper rest and winding down as needed.
  • Perform the evening routine of brushing, cleaning face and massaging feet etc.
  • Sit down to meditate, say a prayer, do body scanning, progressive muscle relaxation or focus on your breath for a few minutes.
  • Be grateful, reflecting on the blessings during your day.
  • Try to establish a consistent bedtime, preferably by 10 pm, to honor the cyclical energies of nature.

Circadian Rhythm: Nature’s Intelligent clock cycle

  • Embedded deep within the brain is a master clock, Suprachiasmatic Nucleus (SCN Weaver, 1998) inside the hypothalamus that regulates the timing of many of the biological, hormonal, and behavioral processes that occur in the human body, playing a critical role in sleep, metabolism, aging and overall health and maintaining homeostatic .
  • Circadian Rhythms (CRs) are biological temporal processes that display endogenous, entrainable free-running periods that last approximately 24 h. They are driven by molecular internal clocks which can be reset by environmental light-dark cycles on a feedback loop (Edery, 2000).
  • Researchers have shown over the past few years that cellular and regional, peripheral clocks can be found in the liver, kidneys, pancreas, heart, fat and other organs and tissues that are synchronized with the sleep-wake cycle (Zylka et al., 1998). These cellular clocks regulate the activity of 3 to 10 percent (and up to 50 percent) of genes in various tissues and other parts of the body as well, by regulating the expression of clock-controlled genes (Ccg).
  • The first clock gene was isolated, or cloned, from fruit flies in 1984. Now, we have identified dozens of genes in cyanobacteria, plants, and mammals (Reppert and Weaver, 2002) that help the body keep time, including those going by such names as Clock, Per (for period) and Tim (for timeless).
  • Important genes are involved in CRs including Clock (Circadian locomotor output cycles kaput), Bmal1 (brain and muscle aryl-hydrocarbon receptor nuclear translocator-like 1), Cry1 (cryptochrome 1), Cry2 (cryptochrome 2), Per1 (Period 1), Per2 (Period 2), Per3 (Period 3), and Ccg. They organize transcription/translation autoregulatory feedback loops comprising both activating and inhibiting pathways (Reppert and Weaver, 2002; Schibler and Sassone-Corsi, 2002) forming a complex network.
  • In mammals, sleep-awake and feeding patterns, hormone secretion, heart rate, blood pressure, energy metabolism, and body temperature exhibit CRs.
  • Zeitgebers like light and food (rhythmically occurring phenomena that have primary control over circadian rhythm) for e.g. Routinely eating or sleeping at the wrong times may throw these peripheral clocks out of sync with the master clock in the brain, seen often in people with shift working, frequent trans meridian air flight, exposure to artificial light.
  • There is sufficient evidence to suggest that these chronobiological disruptions predispose individuals to the development of obesity, diabetes, cardiovascular diseases, sympathetic/parasympathetic dysfunction, hypertension, ailments of the heart and stomach, as well as various cancers, neurological and neurodegenerative diseases, and psychiatric illnesses including depression and other disorders.
  • Resynchronizing the body’s many clocks may help to restore health and proper functioning and prevention of Many chronic illnesses.
  • In the presence of light, particularly of blue wavelengths, the hormone melanopsin is produced, inhibiting the release of melatonin. at night, in the absence of light and melanopsin, melatonin is released and contributes to sleep onset.
  • During the light period, particularly in the morning, larger amounts of cortisol and insulin are released. Notably, insulin secretion and insulin sensitivity are both controlled by circadian rhythms. Insulin production diminishes and remains low throughout the day unless foods requiring insulin are consumed. During the morning, we are particularly sensitive to the action of insulin. as the day progresses, we become more resistant to insulin, and during sleep we are most insulin resistant.
  • Disruption in the circadian function leads to abnormal levels of insulin, leptin, and ghrelin, hormones affecting appetite, satiety, metabolic rate, and fat storage—a key hormone mitigating this function is melatonin.
  • Night shift workers have among the highest rates of obesity due to the presence of light at night and disordered sleep and eating rhythms.
  • Circadian disruptors related to the second zeitgeber, food, include frequent snacking, high-fat foods, late-night eating, and medications that alter sleep-wake patterns. These disruptions lead to altered melatonin production, a potent hormone that, when dysregulated, leads to insulin resistance, glucose insensitivity, and sleep disturbance. Interestingly, because food is also a driver of the circadian clock, intermittent fasting mitigates circadian dysfunction and, if performed appropriately, resets a dysregulated circadian clock.
  • CR dysfunctions in blood pressure and heart rate, are involved in arrhythmias which may lead to sudden cardiac death, myocardial infarction or stroke, often occurring at the early morning during the surge in blood pressure.
  • CRs are dissipative structures due to a negative feedback produced by a protein on the expression of its own gene (Goodwin, 1965; Hardin et al., 1990). They operate far-from- equilibrium and generate order spontaneously by exchanging energy with their external environment (Prigogine et al., 1974; Goldbeter, 2002; Lecarpentier et al., 2010).

Benefits of Fasting

Fasting affects not just are physical and mental well-being, but also are emotional and spiritual aspects of health.

Many wise ancient cultures have recommended fasting to help with achieving optimal physical, mental, emotional, spiritual health and longevity, and also freedom from disease utilizing intermittent, periodic or seasonal fasting.

Yogic philosophy recommends and encourages to keep a fast on a particular day of the week or month based on your spiritual intentions. (for e.g. Monday or Thursday, or on a full moon day and 11th night of the lunar cycle). It is recommended not only to practice food abstinence on the spiritual fasting day, but also cultivate mindfulness and a positive attitude to help with spiritual progression. Sadhana is the discipline of routine spiritual practice and the surrendering of the ego to the higher self.

The Benefits of Fasting

Fasting, when done correctly, positively affects our physical, energetic, mental, emotional, and spiritual aspects, since we are much more than just the body and mind.

Fasting has shown to have the following health benefits, and more:

  1. Helps with weight loss, leading to physical Lightness, and increasing energy level. Fasting allows the body to use fat as it’s primary source of energy instead of sugar, enabling many athletes to hit low body fat percentages for competitions.
  2. Improving mental clarity, alertness and moods, decrease in depression and anxiety and improves subjective feelings of wellbeing.
  3. Resetting the metabolic button, improving metabolism of sugars and fats.
  4. Resting and healing the digestive system, helping with GI symptoms including IBS, food intolerances, constipation, acidity, gas, bloating.
  5. Revitalizing the immune system, helping with stabilizing many autoimmune diseases, Arthritis, IBD, Parkinson’s, Alzheimer’s dementia etc.
  6. Facilitating the natural detoxification and cleansing of the body, including the liver and the GI tract.
  7. Helps prevent and reverse several medical conditions like hypertension, hyperlipidemia, obesity, diabetes type 2, autoimmune diseases, clarifying skin problems. (More on detailed medical benefits, and the reasoning behind them.)
  8. It helps improve self-discipline and form long-term good eating habits and patterns.
  9. Creates mindfulness in eating patterns, controlling overindulgences of senses.
  10. It helps with emotional eating and food cravings too, since it enables one to rise above and beyond the set emotional patterns strengthens will power and self-confidence.
  11. It helps promote an inner stillness, and better alignment with out spiritual purpose in life.

 

Read here for the Scientific evidence of benefits of Fasting

A few more common alternative health myths I come across! (for Part I, click here)

Myth: I do not need to take any supplements, since I am eating good food.

Truth: I come across this very frequently in Pacific Northwest, regarding Vitamin D, and Vit B12 in Vegans.

Recent analysis of nutrient intakes of the U.S. population shows that a large percentage of people fall short of the average requirements of many nutrients. Almost everyone falls short of the average requirements for vitamin D and vitamin E, and more than one-third fall short of the average requirements for calcium, magnesium and vitamin A.

Resource:
Top 15 Foods Rich In Essential Minerals – https://www.healthambition.com/food-rich-minerals/

Myth: Since I am so healthy, I will be fine if I take herbs for my chest pain (…manage my fractures naturally, control a bad infection using natural herbals, not need gall bladder surgery etc….)

Truth: In a single word, NO!

Herbal and complementary medicine and techniques have a major role in preventive and chronic disease management, but in acute or emergency cases like chest pain (probably due to heart attack), severe abdominal pain (gall bladder infection/stone impaction, acute stomach ulcer or pancreatitis) accident, injury or fracture, you should still go to get urgent care from your medical provider rather than try to cure-it-yourself!

On the other hand, we have pushed the limits on prolonging life at all cost, not considering the quality of life as our time on this wonderful planet draws closer to its end.

Myth: I have to choose between either conventional or alternative medicine.

Truth: You can do both!

This is true even for cancer treatment. Integrative approaches research for symptom management in cancer patients and survivors have had promising results.

Cancer treatment centers with integrative health care programs may offer services such as acupuncture and meditation to help manage symptoms and side effects for patients who are receiving conventional cancer treatment. NCCIH-funded research has suggested that:

  1. Cancer patients who receive integrative therapies while in the hospital have less pain and anxiety.
  2. Massage therapy may lead to short-term improvements in pain and mood in patients with advanced cancer.
  3. Yoga may relieve the persistent fatigue that some women experience after breast cancer treatment.

Myth: Natural medicine has nothing in common with conventional medicine

Truth: Nature has been providing medicines to treat our diseases and relieve our suffering for many thousands of years.

Pharmacognosy is the study of medicinal drugs derived from plants or other natural sources. Many of our modern drugs were originally derived from either plant, animals, or fungi.

Examples are morphine from the opium poppy, aspirin from the white willow tree, anticoagulant coumadin from spoiled sweet clover. Periwinkle has yielded vinblastine (successful treatment of Hodgkin’s lymphoma, turning a disease that was once uniformly fatal into one that can now be totally cured in many patients) and vincristine (used for treating acute childhood leukemia).

Ethnobotany, the study of traditional human uses of plants, is recognized as an effective way to discover future medicines. In 2001, researchers identified 122 compounds used in modern medicine which were derived from “ethnomedical” plant sources; 80% of these have had an ethnomedical use identical or related to the current use of the active elements of the plant.

Myth: I can go for my surgery without discussing my herbs/vitamins/supplements with my doctor.

Truth: Certain supplements may increase the risk of bleeding, decrease your blood pressure or heart rate, affect the response to anesthesia, or adversely affect the outcome of your surgery….

It is very important to inform your doctor about the vitamins, herbals, OTC supplements etc you are taking. These might need to be stopped up to 2 weeks ahead of an elective surgery.

Here is a link for you to do a self-check on herbals.

Myth: Yoga can’t help serious diseases/it’s just for fun and flexibility

Truth: A Big YES!

There have been numerous studies proving the benefits of Yoga on several diseases, including cancers.

Myth: Alternative health websites just aren’t trustworthy.

Truth: There are fallible websites out there. But there are some good ones. You simply have to follow some rules so you can identify which are right.

If you’re visiting a health website for the first time, these five quick questions can help you decide whether the site is a helpful resource:

  1. Who? Who runs the Web site? Can you trust them?
    Be skeptical about anecdotal information from persons who have no formal training in nutrition or botanicals, or from personal testimonials (e.g. from store employees, friends, or online chat rooms and message boards) about incredible benefits or results obtained from using a product. Question these people on their training and knowledge in nutrition or medicine.
  2. What? What does the site say? Do the claims for the product seem exaggerated or unrealistic? Do its claims seem too good to be true? (Then probably they are not True!)
  3. When? When was the information posted or reviewed? Is it up to date?
  4. Where? Where did the information come from? Is it based on scientific research? Learn to distinguish hype from evidence-based science. Reputable websites will have real links at the bottom of websites, linking to scientific research. Check for university studies.
  5. Why? Why does the site exist? Is it selling something? Beware of such phrases such as: This is not a hoax or Send this to everyone you know.

Myth: Acupuncture, yoga, meditation, massage, all these have no scientific proof of action, so they must be woo-woo!

Truth: Many more insurance companies are approving the use of alternative therapies like yoga, acupuncture, massage therapy, chiropractic care, physical therapy etc. for acute or chronic pain, injuries, depression/anxiety and a variety of other mind-body conditions.

Meditation, yoga, and relaxation with imagery are recommended for routine use for common conditions, including anxiety and mood disorders. Stress management, yoga, massage, music therapy, energy conservation, and meditation are recommended for stress reduction, anxiety, depression, fatigue, and quality of life.

Preliminary studies of the effects of a single session of Swedish massage on hypothalamic-pituitary-adrenal and immune function in normal individuals.

Want to know how you can find truthful information?

To find reliable sources of scientifically sound information about vitamin/mineral supplements:

Look for scientific research findings on the dietary supplements. The National Center for Complementary and Integrative Health (NCCIH) and the National Institutes of Health (NIH) Office of Dietary Supplements (ODS), as well as other Federal agencies, have free publications, clearinghouses, and information on their Web sites.

The NIH Office of Dietary Supplements has a series of Vitamin and Mineral Fact Sheets that provide scientifically-based overviews of a number of vitamins and minerals. They can provide a good basis for a discussion with your doctor about whether or not you should take a vitamin/mineral supplement.

MedlinePlus is another good source of information on vitamins and minerals.

The Food and Drug Administration (FDA) has a variety of articles and consumer advisories to help consumers inform themselves about dietary supplements, including warnings and safety information, labeling, evaluation information, and FDA’s role in regulating dietary supplements.

For those interested in looking directly at scientific studies, the PubMed Dietary Supplement Subset is a good database to search: here, here, or here.

The Linus Pauling Institute’s Micronutrient Information Center is a source for scientifically accurate and peer-reviewed information regarding the roles of vitamins, minerals, phytochemicals (plant chemicals that may affect health), and other dietary factors, including some food and beverages, in preventing disease and promoting health. You can look here, here, and here. The subset is designed to limit search results to citations from a broad spectrum of dietary supplement literature including vitamin, mineral, phytochemical, ergogenic, botanical, and herbal supplements in human nutrition and animal models.

Some more helpful tips:
6 Things To Know When Selecting a Complementary Health Practitioner – https://nccih.nih.gov/health/tips/selecting
Steps in advising patients who are interested in complementary and alternative therapies – http://www.nature.com/nrclinonc/journal/v10/n11/fig_tab/nrclinonc.2013.125_F2.html
Talking about Complementary and Alternative Medicine with Health Care Providers: A Workbook and Tips – http://cam.cancer.gov/attachments/workbook/talking_about_cam_workbook.pdf

Sources:
http://www.crnusa.org/pdfs/CRNFactSheetNutrientShortfalls.pdf
Quantity is not necessarily better than Quality: What should medicine do when it can’t save your life?
http://www.newyorker.com/magazine/2010/08/02/letting-go-2
https://www.nlm.nih.gov/medlineplus/canceralternativetherapies.html
Heart rate variability and treatment outcome in major depression: a pilot study.
http://www.ncbi.nlm.nih.gov/pubmed/24769434
Insular cortex mediates increased pain tolerance in yoga practitioners.
http://www.ncbi.nlm.nih.gov/pubmed/23696275
Effect of Mindfulness-Based Stress Reduction on Anxiety, Depression and Stress in Women With Multiple Sclerosis.
http://www.ncbi.nlm.nih.gov/pubmed/26835467

I have been practicing Integrative medicine for the last 20+ yrs. in the USA. The spectrum of the practice of Medicine has shifted dramatically in the last few decades due to multiple factors, including the cost, effectiveness, morbidity and mortality, and others, too many to list. The use of CAM (Complementary and Alternative medicine) in the USA has nearly tripled in the last 4 decades due to these factors.

Most complementary health approaches fall into one of two subgroups—natural products or mind and body practices. I have noticed patterns of beliefs and frequent confusion in my patients and the general population, so this article might help to clarify a few of these common alternative health myths.

Complimentary, Alternative, or Integrative Health: What’s the difference?

Integrative medicine combines Alternative medicine with evidence-based medicine. Practitioners claim that it treats the “whole person,” focuses on wellness and health rather than on treating disease and emphasizes the patient-physician relationship. The Academic Consortium for Integrative Medicine and Health has developed the following definition: “Integrative medicine and health reaffirms the importance of the relationship between practitioner and patient, focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic and lifestyle approaches, healthcare and disciplines to achieve optimal health and healing.”

Integrative medicine is not the same as complementary and alternative medicine (CAM) nor is it simply the combination of conventional medicine with complementary and alternative medicine. Instead it “emphasizes wellness and healing of the entire person as primary goals, drawing on both conventional and CAM approaches in the context of a supportive and effective physician-patient relationship”.

Myth: The assumed “safety” of natural herbs and medicines.
Truth: Just because it is “Natural” does not automatically mean it is “safe”

There are many herbs (all are natural) that have several side effects and interactions with different other herbs, supplements, or prescription drugs you might be taking. It is always better to consult with your health care provider before you start on any new herb/supplement regimen to make sure it is safe and appropriate for you.

If you have a special condition, like pregnancy, breastfeeding, slow functioning of liver, kidney, heart, or other vital organs, it is crucial that you discuss starting the herbals with your provider first. There have been incidences of liver, kidney, or heart failure when people have taken herbs without discussing the potential side effects with their providers.

The herbal products themselves can be contaminated or using cheap, inferior products or substitutions. In a recently published study, DNA barcoding was used to conduct a blind test of the authenticity for 44 herbal products representing 12 companies and 30 different species of herbs. Most (59%) of the products tested contained DNA barcodes from plant species not listed on the labels. One-third of these also contained contaminants and or fillers not listed on the label. Product substitution occurred in nearly 70% of the products tested and only 2/12 companies had products without any substitution, contamination or fillers. Some of the contaminants posed serious health risks to consumers.

The FDA keeps a tight watch on the products in the market. Here is a good link to keep abreast of the safety warnings/ list of recalled products from the market.

Myth: It’s cheaper than a doctor and medications
Truth: It is not “cheap” as one might think. Not in the short term.

Many Integrative health providers do not accept insurance, thus costing us more out of pocket in the short term. Herbs and supplements are likely not reimbursed by your insurance company. Your HSA/FSA might help save you some tax dollar amount. However, engaging in healthier practices and nutrition may help reduce our need for more drastic and chronic medical care in the long run. With its focus on long-term preventative care, it might save us money in the long run and achieve better and optimal health.

According to statistics released in July 2009 from a nationwide government survey, 83 million U.S. adults spent $33.9 billion out-of-pocket on visits to complementary and alternative medicine (CAM) practitioners and purchases of CAM products, classes, and materials.

Myth: Taking megadose of good supplements should be OK
Truth: More is not better all the time! Note: This advice is particularly important for pregnant or breastfeeding mothers!

Fat-soluble vitamins like Vitamin A, D, and E can be dangerous in high or mega doses, since they are stored in the fat and Liver, leading to different toxicities over time.

Most water-soluble vitamins, like the B complex vitamins, are usually safe to take in a little higher amount than RDA, (recommended dietary allowance), since most of them are flushed out in the urine. Exceeding 2,000 milligrams of vitamin C per day can cause diarrhea and kidney stones.

It’s nearly impossible for your regular diet to provide an overdose of vitamins D, E, K, C, and all the B vitamins.

Vitamin A is an exception. Liver and fish liver oils are concentrated sources of preformed vitamin A (retinol).  Cases of vitamin A toxicity also have been reported among children given daily servings of chicken liver or any animal liver, like seal or whale liver in the north and south poles.Similarly, if you are taking a higher/prescription dose of Vitamin D due to deficiency, your provider might monitor the levels periodically to make sure it is in the safe range.

Only a qualified provider might recommend high doses for a specific condition such as large doses of niacin (vitamin B3) for helping reduce cholesterol or prescription dose Vitamin D for deficient patients with MS etc.

Exceptions: This is usually discussed case by case, but Older adults may benefit from taking more calcium, vitamins B-12, and vitamin D since the body does not absorb these as well as it ages. Iron supplementation can be beneficial for young women, who need 18 milligrams of iron a day. Vegans may need extra calcium and B-12 and could benefit from taking supplements of iron and zinc.

Myth: I will be safe since I am just taking food, supplements, and natural herbs!
Truth: This holds true for regular prescription medications also since people fail to consider these facts:

Everything you put in your mouth has the potential to interact with food, herbs, and prescriptions taken orally by altering the way the body metabolizes each of them. some herbs and foods can lessen or increase the impact of a drug by working as a catalyst or an enzyme booster or inhibitor or interfere with the body’s ability to absorb micronutrients.

Good examples of food that interact with drugs are: Alcohol, acting on brain and liver metabolism; Grapefruit juice which interacts with Blood pressure medications, Hormones, OCP, statins and cholesterol-lowering medications;
Orange Juice interacts with antacids with aluminum, and several antibiotics; High fiber food can interfere with absorption of few drugs, like Digoxin and Tylenol; Large amounts of broccoli, spinach, and other green leafy vegetables high in vitamin K, which promotes the formation of blood clots, can counteract the effects of heparin, warfarin, and other drugs given to prevent clotting; caffeinated drugs with asthma drugs and some antibiotics like Cipro and so on.

Myth: I do not need to talk with my Health care provider before starting any herbal formulas.
Truth: Mixing multiple herbs and drugs, can be an accident waiting to happen!

Herbal interactions with prescriptions can interfere with how the drug is metabolized by the body, increase side effects or toxicity of prescription medications, or block the intended beneficial effect of a drug. Always check with your doctor to check for an herb Drug interaction before you start taking those. Your pharmacist is your big ally also when it comes to discussing herbal-drug interactions. Interactions between herbs and conventional drugs: overview of the clinical data.

“While many of the interactions reported are of limited clinical significance and many herbal products (e.g. black cohosh, saw palmetto, echinacea, hawthorn and valerian) seem to expose patients to minor risk under conventional pharmacotherapy, a few herbs, notably St. John’s wort, may provoke adverse events sufficiently serious to endanger the patients’ health. Healthcare professionals should remain vigilant for potential interactions between herbal medicines and prescribed drugs, especially when drugs with a narrow therapeutic index are used.

High-risk patients, such as the elderly, patients taking three or more medications for chronic conditions, patients suffering from diabetes, hypertension, depression, high cholesterol or congestive heart failure, should be especially on the lookout for such side reactions.

Coumadin/Warfarin, a blood thinner given to patients to prevent blood clots, is a nightmare for herbalists, doctors, and pharmacists to manage the INR, since it is so easily affected by food, the Vitamin K from green veggies and the liver metabolism makes it susceptible to have hundreds of food/herb/drug interactions. Some of the food supplements which might make the blood thinner, would be High dose fish oil, aspirin, feverfew, Gingko Biloba etc.

Ginger, garlic, turmeric should be OK to take as food with Coumadin, but if you are taking it in a capsule or supplement form, you might need to watch the INR closely when you start these supplements (check here and here).

Myth: Natural medicines and Food supplements must be regulated similar to prescription drugs.
Truth: Close, but not exactly!

FDA states that dietary supplements are regulated under a “different set of regulations from those covering ‘conventional food’ and drug products” but this does not mean they are unregulated. In fact, with over 150 million Americans using dietary supplements annually with little problem, it is clear that supplements are held to strict requirements, ensuring their safety and efficacy.

Prescription and over-the-counter drugs are regulated by the United States Food and Drug Administration (FDA), which requires evidence of effectiveness, safety, and quality control in manufacturing. Dietary/Food supplements (such as vitamins, minerals, and many herbal products) are governed by the Dietary Supplement Health and Education Act (DSHEA) of 1994.

Consumers may look for marks of certification by groups like the United States Pharmacopeia (USP) on product labels, certifying independent testing and verification to contain the ingredients on the label, meeting requirements for purity and good manufacturing practices (GMP). Other third-party testers like NSF, Consumer Labs, and Consumer Reports are also available.

If you’re wondering how to read a label and ensuring the safety of the product I really like looking at this chart to make sure I am reading the labels of supplements correctly.

Myth: All supplements in the market must be the same as long as the active ingredient is there!
Truth: Buying Cheap Quality, bulk /discount, poorly formulated herbs, with toxic fillers and additives, which have not been tested independently, will never be up to par with well-formulated, minimal fillers, hypoallergenic, Thoroughly checked, and tested by the third party, though slightly expensive formulations from reputable companies.

There are several good companies and brands available in the market. Discuss with your Integrative health provider to see what will work the best for you.
If I see too many chemically enhanced supplements, with a big inactive ingredient list, including fillers, colorants, “natural flavors”, xanthan or carrageenan gums, HFCS, or soy lecithin (Unless it says Organic for the last 2 ingredients) I cross those products off my list to choose from.

 

My General advice:

FAQ about Dietary supplements

Be an informed consumer:
https://nccih.nih.gov/health/decisions
How to go about selecting a CIH practitioner:
https://nccih.nih.gov/health/tips/selecting