Tuesday, December 20, 2016

Management of skin patches with #ayurveda: (Dark to Normal)

Views shared by several ayurveda professionals and non-ayurveda people in discussion group:

Disclaimer:
All views shared here are only for knowledge. This information doesn’t have any scientific validation. Various doctors and non-medicos have shared their views and experiences in this discussion. Please do not try any of the suggestions described here, without prior consult from your regular, qualified doctor. Dr. Prerak Shah and no other person is responsible for any unwanted effects, side effects or contra-indications in your health. Thank you.

File with all photos / pictures are available on flinnt.com

Next topic for discussion:  Management of skin patches with #ayurveda: dark pigmentation / patches of skin --> to normal skin colour (opposite of vitiligo).....
Ayulink: Please mention the herbs used for, processes used for and other informaiton.
Dr. Supratim Bir: Difference of 1 week.It was a case with C/o itching for many yrs.
I missed the next week pic. It was better. Procedure adopted was only Agnikarma N lippu/castor oil for local application only.
Dr. J. T. Contractor: Malkangni oil+ olive oil+ castor oil + cod liver oil After massage exposure to tender sun light get the silky skin in just 6 weeks,avoid oily, spicy,sour & baker products in diet
Dr. Bhadresh Naik: Before strat dipigmention of skin we must know anatomy and melanin for choice of treatment.
Upper and lower extremities muscular rash Cooper colour multiple skin rash go for leprosy.
Make clinical and examination to sure diagnosis.
That's make prognosis better.
Due to heamtological skinrash must make dd.
USA Gary Yuen: What would be the cause of such skin?
Vd. Binal Jagani: In Hyperpigmentation yashtimadhu taila local application regularly gives good results.
Vd. Manhar Prajapati: How's agnikarm work or where to apply in skin disease ??nice result
Mostly hyper pigmentation occurs after preg in female on upper cheeks.. Pandu also consider for this
Dr. Supratim Bir: Shyav varna n kandu indicated the doshik involvement, which I considered as vata kafa- so did select the Agnikarma.  In vata, kafa n vata-kafa condition Agnikarma can be opted.
Dr. Dayanand Bothre: Which shalaka did you use? Gold or panchadhatu?
Anand Javeri: Topical application / massage of aloe vera gel combined with saffron works good on patches / pigmentation. And based on our earlier discussion, i think massaging triphala powder on skin should work.
Dr. Supratim Bir: Saptadhatu
Vd. Dhruti Nirav Bhatt: Vacha, Dhanyak, Lodhra, Raktchandan, Masurdal powder, rose Patel's powder mix it and make paste with Rose water or Milk and apply .it has very good result in Pigmentation or discoloration.
Kumkumadi tail is also good.
USA Gary Yuen: Any reason manjistha isn't used in perhaps all skin conditions?
Dr. Madhuri Patil Chaudhari: Manishtha is used where Bhrajak pitta needs to be corrected. i think its only Herb best 1 to work on Bhrajak pitta.
Shri Minoo parabia: Ingorio, Balanites aegyptiaca  fruit is abraded with  water and applied on Vyang.
Vd. Dhruti Nirav Bhatt: Ayurvedic medicine s like Kaishor Guggul,Arogyavardhini tab and Mahamanjisthadi kwath
Dr. Madhuri Patil Chaudhari: Dr Ravindra Ji's shared post about water and its effect on human body :
As Skin  or tvacha is updhatu of Ras dhatu. Ras dhatu is directly affcted by Udakvah strotas.. Avrodh, grnthi etc. So Skin Manifestation of ras dhatu-udakvah strotas dushti -signs, and water imbalance or Ras dhatvagni vishamata are related. Thats why Arogya vardhini or Gandhak Rasayan  is 1st choice as correctional measure of internal imbalance.
Main point of that article is too much water in food producess a state that favours biodegradation by germs thriving state for that food over a period of Time..so lesser the water,, lessar the bio degradation.
Likewise.. (yatha brmhande tatha pinde) too much water in human body is detrimental to Immune system s to fight agantuj entities or germs that may harm- biidegradation speeding up because of More amount of water than is needed for normal sustenance.
Udakvah strotas Dushti..Ras dhatu dushti.. Skin problems- the relationship between Water or udak imbalance and skin diseases.  One more.. In all skin problems Vaman is best shodhan kriya. Udan vayu correlation with udakvah strotas..
Dr. Suyog Kulkarni: I have good experience with Kumkumadi oil. Also , for dark circles under the eyes , local application of Kumkumadi with netratarpan of Triphala ghrita and shirodhara with brahmi oil helps.
Dr. Madhuri Patil Chaudhari: Kumkuadi Ghrut  for dark circles  - Nasya.
Croatia Branko Markovic:
I am also curious. If the goal is hair regrowth, there are many herbs such as amalaki brahmi mandukaparni bhringaraj curry leaves hibiscus jatamamsi and others but would like to know more.
More about dark patches in this case.. But also while you are mention hair regrowth is interesting subject :) Didnt saw some good hair regrowth treatment - results in ayurveda although many doctors claim it.
Dark green vegetables such as karela leaves, gobi leaves, moringa, methi leaves etc might be enough to fix but certainly there are herbs to complement.
Ayulink: Are the skin patches from any disorder or just natural?
Croatia Branko Markovic: There wore not any history od disorder. It could be from the sun.
USA Gary Yuen: seems there might have been some mild previous disorder.
Croatia Branko Markovic: Probably it was but not noticed.. There was history of IBS but except that there wore not some sings or he didnt notice..
USA Gary Yuen: Balding is Indralupta, Rujya and Khálitya? is this covered somewhere?
Vd. Dhruti Kagrana:
Stimulants that cause Hyperpigmentation:
- Over exposure to sunlight
- Environmental pollutants
- Cosmetics and creams that are unauthenticated
- Excessive usage of antibiotics and hormone treatments
- Viral infections on the skin that is caused through the virus-acne vulgaris
Croatia Branko Markovic: Think in this case was simply: Pitta prakruti + pitta vrudhi + sun
Vd. Dhruti Kagrana: On account of pigmentation, a bargained digestive system prompts an expansion of pitta dosha into rasa dhatu. Pitta dosha is an ayurvedic guideline of physiology speaking to the vigor of conversion in the body. The blood which is influenced by vata and kapha unfavorably impacts recuperating process.
Dr. Jyoti Ashok: So what is the solution for that? In vyanga , bangu no matter whatever v give including shodhana & lepana , some days pigmentation is markedly more some days less.
Croatia Branko Markovic: How to then get rid of pigmentation from picture? External and internal medicine?
Dr. Madhuri Patil Chaudhari: Pigmentation  or skin patches corelated to weak liver function.  all medicines that enhance functioning of liver internally. i prefer Aloe Vera,  haridra, triphala. and punarnavashtak kashay. manjishthadi kashay. Exrernally Dashang lep, haridra, ambehaldi,  mixed with manjisthadi oil or yashtimadhu oil or ghrut  for lepan. some pigmentation resolve on their own with Time.
Dr. Uday H. Hanagal:
Vruddhastu kurute anilaha karshyakarshnya-------------denataha. (A.H.Sutrasthana 11th char. Doshadivijnyaneya adhyaya)
Here Karshnya means Blackish colour on  the skin.
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Compiled by : Dr.Dhruti Kagrana

Saturday, December 17, 2016

Interpretation of LH, FSH and AMH according to #Ayurveda and its management.

Views shared by several ayurveda professionals and non-ayurveda people in discussion group:

Disclaimer:
All views shared here are only for knowledge. This information doesn’t have any scientific validation. Various doctors and non-medicos have shared their views and experiences in this discussion. Please do not try any of the suggestions described here, without prior consult from your regular, qualified doctor. Dr. Prerak Shah and no other person is responsible for any unwanted effects, side effects or contra-indications in your health. Thank you.

File with all photos / pictures are available on flinnt.com

Next topic for discussion:  Interpretation of  LH, FSH and AMH according to #Ayurveda and its management.

Ayulink: Very high value of LH, and FSH at young age and forcefully acceptance of menopause at very young age is becoming major issue these days.
Anartav, nashtartava, rasa dhatu dushti, vata disturbance are commonly used terms by vaidyas.
But it is very difficult to understand all hormone system and / or endocrine system according to Ayurveda.
USA Gary Yuen: Agree psychology and hormones have a large effect. An ancient Greek gynaecogist says sex should begin when menopause begins. Our changes in sexual morality also has large effects on hormone balance, just like teenage acne and other skin problems also due to pitta from forced morality and customs.
Dr. Ronak Rathod: In kids In central precocious puberty LH AND FSH levels are too raised that affects whole body's growth system ....  generally hypothalamic hematoma is the etiology factor of it . Such cases are missed in early diagnosis.
USA Gary Yuen: It may be difficult to prescribe antidotes for larger societal changes but likely pitta rasayanas such as amalaki shatavari and jatamamsi could help. In Greek medicine, herbs such as flax are used as sort of an abhyanga interernally in the uterus. I don't know if ayurveda does such things but sounds good.
Ayulink: Yes. May be you are mentioning about Uttarbasti treatment mentioned in Ayurvedic texts, where medicine are introduced directly in uterus.
USA Gary Yuen: Yes. I am curious where that is discussed. Maybe there are no studies of how they effects hormone studies but it seems like it should have effect and might even be good to maintain health just like abhyanga.
Dr. Bhadresh Naik: According to ayurved hormones correlate is difficult. Consider the dhatu and strotas we can correlate something different.
Example - Pcod is artvav xay, Sign and symptoms relleted with
Ras, Sukra or stribeej, Artvahvah strotas. As morden fsh and lh thyroid poor function, High insulin production. We treat according to Ayurveda we consider as above etiology patients get benefit. Even hormones profile are change that's suggests it's indirectly effects on hormone. Shatavari, Gudhchi, Krina jirak, Suva nasya- Uttter basti- Nakstra puspantakras- Puspadhavaras in female- Vasarista- Brugrajarist Is best line of treatment.
USA Gary Yuen: Yes. Direct observation of all external parts such as skin eye tongue hair and pulse are enough. No need to follow modern medicine methods of measurement without knowing etiology.
Dr. Bhadresh Naik: Not even lifestyle, Stress, Anxiety, Poor hygiene, Poor nutrients intake. Important  not to follow the rule of during menstrual period according to ayurved is majjor cause of irregular menstrual period. Lack of excercise is major causative factor.
USA Gary Yuen: Our modern way of life is very harmful for everyone. Here is a study of ayurvedic treatment of PCOS with successful changes in LH & FSH. After 1 year, 85-90+ percent cured, 85% successful conception and healthy babies. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3215317/
Dr. Bhavesh Modh: Overall effect of the therapy
In allopathic medicine oral contraceptives, progestin’s, anti androgens and ovulation induction agents remain standard therapies.
Aartava-kshaya, which can be correlated with PCOS has been described as deficiency or loss of artava, artava dose not appears in time or is delayed, is scanty and dose not last for three days. Pain in vagina also can be seen. According to Ayurveda, Aartava-kshaya is a disorder involving Pitta and Kapha doshas, Medas, Ambu/Rasa, Shukra/Artava Dhatu and Rasa, Rakta, Artava Vaha Srotas Therefore Poly Cystic Ovarian Syndrome can also be described with same involvement of Dosha, Dhatu and Upadhatu Kapha predominance manifests as increased weight, subfertility, hirsutium, diabetic tendencies and coldness. Pitta predominance manifests as hair loss, acne, painful menses, clots and heart problems. Vata predominance manifests with painful menses, scanty or less menstrual blood and severe menstrual irregularity. The pathology is an obstruction in the pelvic cavity (Apana Kshetra) causing disorders in the flow of Vata. This in turn leads to an accumulation of Kapha and Pitta. The treatment principle is to clear obstruction in the pelvis, normalize metabolism and regulate the menstrual system (Aartava Dhatu). Kapha reducing, insulin enhancing and hormone rebalancing drugs help to the relieve symptoms of Poly Cystic Ovarian Syndrome.
Triphala Kwatha, Chandraprabha Vati and Manibhadra Choorna help to clear obstruction and normalize the srotas. Especially Triphala and Guggulu are very useful for reducing excess weight. Powder of A. racemosus brings balance and strength to the menstrual system and it helps to regulate Aartva Dhatu. Properties of Powder of seeds of P. graveloens, oil of Krishna Jeeraka (Nigella sativa) and oil of Sahachara (Barleria prionits) were helped to destroy cysts on ovaries and stimulate the follicular maturity. Properties of Deepana and Pachana of above drugs they elevate the Jatharagni, Dhatvagni as well as Aartavagni. Powder of Guduchchadiya enhances the overall immunity and powder of Atibala has properties of Prajasthapana, Garbhasya DaurbalyAhara, Balya, Brunhanaand Ojo Vardhana. Therefore it helps to get conceived and avoid miscarriage.
Uttara Vasti is the most effective treatment in gynaecological disorders. It helps to purification and clears the Aartava Vaha Srotas, pacifies vitiated Apana Vayu and improve follicular maturity.
Due to Samprapti Vighatana Kriya of this Ayurveda treatment regimen the symptoms of Poly Cystic Ovarian Syndrome get reduced. The effect of therapy show highly significant result on all above symptoms of Poly Cystic Ovarian Syndrome. When considering irregular menstruation most of the patients had 2 - 4 months duration. At the end of the treatment .
USA Gary Yuen: Looking at a book on chinese medicine and infertility, it recommends these acupuncture points. Finding where they match with marma and abhyanga could prove helpful.
KI-13 Qixue, KI-3 Taixi, BL-23 Shenshu, BL-52 Zhishi, Ren-4 Guanyuan, Du-4 Mingmen, LU-7 Lieque (on the right) and KI-6 Zhaohai (on the left), Ren-8 Shenque-Baomen, Zihu..
Dr. Bhavesh Modh: In  mammals, AMH prevents the development of the Müllerian ducts into the uterus and other Müllerian structures. The effect is ipsilateral, that is each testis suppresses Müllerian development only on its own side. In humans, this action takes place during the first 8 weeks of gestation.( Responsible  for. पिंड, पेशी, अर्बुदIf no hormone is produced from the gonads, the Müllerian ducts automatically develop, while the Wolffian ducts, which are responsible for male reproductive parts, automatically die.
Its ability to inhibit growth of tissue derived from the Müllerian ducts has raised hopes of usefulness in the treatment of a variety of medical conditions including endometriosis, adenomyosis, and uterine cancer. Research is underway in several laboratories. If there were more standardized AMH assays, it could potentially be used as a biomarker of polycystic ovary syndrome.
USA Gary Yuen: Is there yet info about cause of hormone levels?
Vd.  Mahavir Vora: Manibhadra churna is it of manibhadra leha or some other combination.
USA Irene CCA: A Patient had her last period one year and a half and after that she had her period again But it was two month having shatavari/guduchi and aswhagandha. she wonder if that is something to do with having  period again? She is waiting if next month come again. Doctor told her than after one year without period should not come again.
Dr. Bhadresh Naik: Consider age.
USA Irene CCA: 49
Dr. Supratim Bir: The 45-55 yrs are considered to have menopause. she had a long gap, so I would suggest her an USG of lower abdomen to screen out her uterus n adnexa.
USA Irene CCA: USG?
Slovenia Anoop S. Anand: Ultra Sound
Dr. Bhadresh Naik: Is she undergone menopausal stage she might have a perspiration, Hot flashes, Dry vaginal, Depression, Pain in breast. Occ menstrual cycle I advised usg, Pep smear. If painless vaginal bleeding y must aware about it. It's common Don't frusted Take it easy normal..
USA Irene CCA: pep smear?
Dr. Bhadresh Naik: Continue Shatavari granules, Pit shamak drugs. Pep smear test is performed by gynecologist. Smear taken from ext vaginal To rule out ca uterus It's common test but very important.
Dr. Supratim Bir: Yes Indicated for screening.
Dr. Gaurav Makan: Irene, the foremost step to go with will be USG Pelvis. After its results and keeping in mind the clinical picture.
USA Gary Yuen: If we are discussing what is the best possible health if one strictly studies and follows the original texts of Ayurveda, I think one should be able to still have regular menstruations and give birth long after age 50. likely after age 80 or more. but it would take great knowledge of diet and rasayanas. and effort to reach samadhi and not have the sexual moraltiies of our age, and become comfortable in ones body.
Dr. Bhadresh Naik: In western countries menarche and menopausal age are different from Indian so it's possible in western countries.
USA Gary Yuen: Possible in India and Asia, possible everywhere. We are very very far from the health, beliefs, customs, diet, spirtual health and practices, etc from ancient times. So now it is very difficult but not impossible.
Dr. Gaurav Makan: I agree sir! Environmental factors and dietary factors being the main cause.
USA Gary Yuen: Comparing the diet recommended in Caraka and astanga hrdyam, and strictly following rasayanas in Caraka, few people try. The vegetables recommended in astanga are far better than most people know of but still eaten and used in some parts of India. That is one of many factors that could help avoid all modern diseases including PCOS. Plus all hominid relatives such as chimps, they do not get menopause til past age 90. They live a natural life like we did long long ago, around maybe even before Vedic age.
Dr. Madhuri Patil Chaudhari: Menopause is cessation of menses as well as fullstop of  ovulation. A woman i know, never had menstruation, still gave birth 2 normal  kids. (Inspite of Extreme Ras and Aartav kshay).  Its not always necessary that Shukra dhatu is also dushit in such cases. PCOS is not entirely reproductive system disorder.. but also overall Ras dhatu and med dhatu dushti, not of shukravah strotas, but may b affected ultimately , if left untreated. Menstruation and ovulation are not always co-dependent. Without ovulation, there is no LH. facotrs to b kept in mind while dd of female hormonal disorders. Ayurved  says Rajodarshan or Rajonivrutii. Rajodarshan  is menstruation and Artav is ovulation. Artav khay is not same as Rajonivrutii.  Menopause is rajonivrutii. Artav khay is Relative term , never came across Artavnivrutti. or cessasion of ovulation.
Shri Minoo parabia: Pause - cessation - of menstruation. May I say?
Dr. Madhuri Patil Chaudhari: yes thats popular meaning.There is nothing like cessation of ovulation  only artav kshay,  not artav nivrutti.
Croatia Branko Markovic: Food causing hormonal changes is biggest problem then life style. Food products are stuffed with hormones, allergens etc. Yes in Vedic time a lot of things wore possible and people wore mostly conscious about them self and environment and people today live and they are not aware that they are living even.. With investigation what average people in the west eat they could be happy they are still alive.
Dr. Madhuri Patil Chaudhari: yes , Endocrine disruptors. food additives.
Vd. Dhruti Nirav Bhatt: According to Ayurved Apan Vayu has main role in Genitourinary system and also Vayu has main role on Nervous system and Endocrine system so We should Control Vayu. Constipation cause Apan Vayu dusti and it may cause menstrual disturbance. Stress cause Endocrine disturbance and effect on Pituitary gland and also Ovary. sometimes Obesity ,High Insulin level cause PCOD. Now a days Lifestyle,Food habits,Stress are main causative factors for Menstrual disturbance.
Dr. Madhuri Patil Chaudhari: HPO axis, hypothalamus- pitutary- ovary axis, goes out of tune because abnormal or nomal but induced (like in medicinal ovulation suppression)  negative feedback. Mechanism main cause of Hormonal disturbances.
USA Gary Yuen: There is a also a study of using multiple grains together becomes a better prebiotics. In the study, they use barley and rice, the same as recommended in Sutrashana I.5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3744518/
Eating a variety of dal and grains, such as panchranga increases gut diversity and reduces CRP. Higher CRP is also liked with obesity and changes in LH/FSH levels.
For infertility treatment, I found bhringaraj is used. There is a review of common Chinese formulas in Taiwan, and the 2nd most popular treatment is bhringaraj combined with a member of the olive family: Ligustrum lucidum. It seems that except for the common olive, there might not be any historical use of the family.
Dr. Ravindra Upadhyay:
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Compiled by : Dr. Dhruti Kagrana

Friday, December 9, 2016

"Triphala an #ayurvedic preparation and tennin…"

Views shared by several ayurveda professionals and non-ayurveda people in discussion group:

Disclaimer:
All views shared here are only for knowledge. This information doesn’t have any scientific validation. Various doctors and non-medicos have shared their views and experiences in this discussion. Please do not try any of the suggestions described here, without prior consult from your regular, qualified doctor. Dr. Prerak Shah and no other person is responsible for any unwanted effects, side effects or contra-indications in your health. Thank you.

File with all photos / pictures are available on flinnt.com

Next topic for discussion: "Triphala an #ayurvedic preparation and tennin…"

Ayulink: I have a question. Triphala contains tennins. There is no standard criterion for tennins in Triphala. Does anybody know how much tennins should be in Triphala?
According to modern labs tennins are toxins and should be less in amount. My personal interpretation of tennins was bitterness.I think Haritaki and Bibhitaki - both are full of tennins. So tennins contains in Triphala can be higher then normal.
If tennin is toxic, how Triphala helps to detoxify the body?
Anand Javeri: What is tennins? I have heard about tannins.
Ayulink: I heard that tennin is good for anti-microbial activity. I wish to check anti-microbial activity of Triphala. Does it help us to prove Triphala as Rasayana?
USA Gary Yuen: I don't know much about tannins but they are found in numerous plant foods, and as far as I know considered healthy. https://www.ncbi.nlm.nih.gov/pubmed/9759559
I can't find anything yet on haritaki, but on relatives:
The tannin components of T. catappa extract exhibited their ability to prevent lipid peroxidation, superoxide formation and their free radical scavenging activity punicalagin, the major tannin component of the leaves exhibited chemopreventive effect against H-ras induced transformation which could have resulted from inhibition of the intracellular redox status and JNK-1/p38 (stress activated protein kinases) activation.
Two compounds, punicalin and punicacortein C, inhibited purified HIV reverse transcriptase with ID50 of 8 and 5 mM, respectively. All tannins appeared to inhibit virus-cell interactions.
Ayulink: Does it mean, we call tennins as Rasayana action supportive?
USA Gary Yuen: I think so, it is maybe one of the main compontents of rasayanas. Another study of tannins and flavonoids in 5 foods (fruits?) showed amla to be among the highest: Kusirisin et al. (2009) found that five plants namely Phyllanthus emblica, Terminalia chebula, Morinda citrifolia, Kaempferia parviflora and Houttuynia cordata, traditionally used in diabetic patients, exhibited strong antioxidant activity. P. emblica showed stronger antioxidative activity assayed by the 2,2¢-azinobis-(3-ethylbenzothiaz- oline-6-sulfonic acid) diammonium salt (ABTS) method as well as inhibition of TBARS and anti-glycation activity than the other plants. The investigation showed that total polyphenol and tannin content of Phyllanthus emblica and the flavonoid content of Houttuynia cordata were the highest.
Shri Minoo parabia: Tannins are basically polyphenols. They are astringent. Tannins actively bind proteins, aminoacids and alkaloids. Therefore, tannins can defunct all enzymes. This property makes it anticeptic against bacteria and fungus.  Tanning industry therefore uses different tannin sources. Another such compound is tri hydroxy benzoic acid or gallic acid present in Ambla.
USA Gary Yuen: In the Astanga Hrdyam, it's said the only animals that can be eaten regularly are from the desert. any reason why? their diet?
Anand Javeri: I think tannin is found in tea also.
Dr.Yogesh Gorakhnath Patil: Yes
Croatia Branko Markovic: Black and green tea are full of tannins. Some consider them as healthy and other consider them as strong acidic agent and advise to avoid them especially in patient with cancer or strong inflamation. But if Amalaki is full of them and still reduce inflamation then there should be other qualities which work together with tannins..
Dr.Yogesh Gorakhnath Patil: I think "कषाय रस = tanin content"
Anand Javeri: Does tannin mean tannic acid?
Croatia Branko Markovic: Tannins found in tea have both positive and negative impacts on health. A positive impact comes from the fact that tannins are antioxidants. A negative effect is tannins are also anti-nutrients which can make it difficult for the body to absorb nutrients. It is said that tannic acid is not found in tea.. Tannin is not tannic acid.. Tannin acid is component in some tannin substances like in apricot...
Dr. Sachinkumar Jinture: Trifala grt combination made by our acharya
Ayulink: Still several doubts are not clear:  Do we consider efficacy of Triphala from tennin?
How much tennin should be present in Triphala for better effect? Higher amount of tennin in Triphala is good or lower amount is good? Any standard data available?  If tennin is toxic, how Triphala helps to detoxify the body?
The main point is to find out efficacy and quality standard of Triphala considering tennin contains.
Vd. Sachin Kadlag: If haritaki  and bibhitak  both are full of tennins ,   Both are  kashaya  rasa pradhana dravya.  But what about aamalaki , does it have tennin or  is it free of tennnin.
Vd. Pankaj Chhayani: Amalaki also have Kashaya rasa.
Vd. Sachin Kadlag: In Sharangdhar samhita , madhyama khanda , churna adhyaya , there is triphala churna , combination is given as 1 haritaki , 2 bibhitak and 4 aamalaki ,  does aamalaki in triphala combination , neutralises  unwanted effects of tennins in haritaki and bibhitak. ?..
USA Gary Yuen: Another study of tannins and flavonoids in 5 foods (fruits?) showed amla to be among the highest:
Vd. Sachin Kadlag: Haritaki and aamalaki , both are pancharasa (except lavana) , but haritaki is having kashaya pradhana and aamalaki is amla rasa pradhana.
Another speciality of aamalaki and haritaki is both are exception (अपवाद) dravyas in respectively amla skandha and kashaya skandha , does this exception has something to do different.  Both are individually rasayan.
Croatia Branko Markovic: First thing should be clear are tannins rejuvenator or they are slightly toxic? Other thing is how other substances work in correlation with tannins in triphala?
Ayulink: Majority of Ayurveda doctors- including post graduate scholars, describe Triphala as laxative to their patient. For me this is improper. Using Triphala as only laxative is using space rocket / shuttle to fly to next city. The strength of Triphala is much more strong then a simple laxative.
Croatia Branko Markovic: So what are main actions of triphala according to your experience?
Vd. Sachin Kadlag: Triphala is descibed as  best in netra roga in ashtnga hrudaya uttartantra adhyaya 40.
Triphala is very well practised as netrya rasayana , in form of triphala ghruta orally and also for netra tarpan vidhi
Ayulink: Sir, if tennin are good as antiseptic or antioxidant and good to fight against bacteria etc. why they call toxic?
Cellular rejuvenation And detoxification.
Vd. Sachin Kadlag:
Yes,  rasayana means rejuvenation of new high quality (प्रशस्त)dhatus.
त्रिफला मधुसर्पिभ्यां निशि नेत्रबलाय।  reference ashtanga hrudaya.
Croatia Branko Markovic: Yes.. from my personal experience from prolonged use of triphala like 3-6 months slowly all system are getting corrected..
What is your usual prescription of triphala? Dose, anupan and when?
Vd. Sachin Kadlag: Triphala guggula is also indicated in vrana , where it definitely acts as disinfectant. Triphala systematically as well as locally acts as disinfectant.
Ayulink: Sweet taste / Madhur rasa substances are considered good for kapha or immunity promotion and are good to believe as Rasayana.  Astringent taste is considered as Vata aggravating and diminishing immunity/ kapha.  But Haritaki / Bibhitaki or Triphala are kashaya rasa (astringent) Pradhan and still they are considered as best Rasayana.
Vd. Sachin Kadlag: Using triphala as rasayana best time is empty stomach early morning.  Best Anupaan  will be cow ghee.  But for different seasons (ऋतू) , anupana can be chosen different , as given in rutu haritaki .
Ayulink: Early morning between  5 to 5.30 am. This is my personal opinion.
Vd. Sandeep J. Prasad: There is also controversy in formation of trifala. What we should follow?? Equal amount of all.
Ayulink: 1:1:1 or 1:2:4 ?
Vd. Sandeep J. Prasad: Yes sir,Which is more scientific?
Ayulink: ??? No answer of this question
Vd. Sandeep J. Prasad: Why???
Ayulink: The whole dissuasion started from a simple question:
How can we check the quality of Triphala? There are hundreds of manufacturers selling Triphala in market. Being a practitioner, how can I know the good quality of it?
Dr. Sachinkumar Jinture: all ref are same acharya   sharangdhar ref is for whole fruits (fal) and other gives Only "fal twak " ...weight are same…. personal experience.
Vd. Sachin Kadlag: Its believed that ideal 1 fruit of haritaki 20 gm,  1 bibhitak 10 gm and aamalki 5 gm,  which is too much contradictory to what we get in market.
Ayulink: There is no way to check wether it is 1:1:1 or 1:2:4, no way to find out is it only bark or pulp used, many of them grinds seeds also to make it cheaper. So there must be some criterion to identify good quality Triphala by its efficacy.
USA Irene CCA: My personal experience with triphala is I started used as a laxant but I realize that it was to dry for me eventually. Then I started taking it as a powder and I left it all day in water and drink it at night . I have triphala for 9 weeks and rest for 4 weeks
Ayulink: I approached one analytical lab for it and there comes tennin in the picture. Triphala is full of tennin and it's the main active component - that's our understanding.
Vd. Sachin Kadlag: But in some forests still some person get a small sized aamalki.
USA Irene CCA: Now after starting study ayurveda I know that triphala is more than a laxative - the powder I buy is equal amount of three fruits but I reforced with a little more amount of amalaki
Dr. Bhaskar B Nymathi: In Triphala Hareetaki & Vibēthaki is having  is having kashayya pradhāna rasa also have remaining 4 Rasa as anurasa. Triphala has its *Rasāyana* effect by its *Madhura vipakata* . Karma of combined effect *Synergism* }of Triphala is differs from using single drug.
Dr. Sachinkumar Jinture: trifala causes Nausea if its combination with seeds ...personal experince.
USA Irene CCA: some one said better taking it first thing in the mornig. I have it at night?
Croatia Branko Markovic: For rasayana better early morning..I give early morning bigger dose and before bed smaller dose.. While in India I tried from several companies triphala and in every triphala taste was different..more kashaya or amla or even sweet kashaya in different proportion..so what taste is right?Why vibhitaka men's fearless? How bibhitaki act on mind or nervous system? Nobody today use it in that manner..
Dr. Sachinkumar Jinture:
त्रिफला कफपित्तघ्नी मेहकुष्ठहरा सरा
चक्षुष्या दीपनी रुच्या विषमज्वरनाशिनी ।।
ref of Bhavprakash nighantu . for some idea . Kashaya ras and  Madhur anuras with water.
Vd. Pankaj Chhayani: Vibhitaki works on problems of Rasa, Rakta, Mansa, and Meda Dhatu...Triphala is given in Jvarhara Dashemani and further its also given in Chikitsa of Vishama Jvara in Charaka samhita. I think Triphala is also given in one or two place (Kushtha Chikitsa) in Charaka chikitsa sthan except Rasayana chapter, so I think only Triphala alone is given at very few places in chikitsa. Its given with/in various combination, so it may be possible that it increase bioavailability of any given formulation
Dr. Jyoti Ashok: In netraroga the combination if haritaki:vibheetaki: amalaki is 1:2:3.
In rest of the diseases it is 1:1:1
But in market v get only 1:1:1. . So v usually add more amalaki to it in netrarogas.
Vd. Pankaj Chhayani: Haritaki-1, vibhitaki-2 Amalaki-4
Dr. Jyoti Ashok: Yes. Its 1:2:4
Vd. Pankaj Chhayani:
Though its not in combination
I think more clarification of proportion is given by Acharya Bhela.
Croatia Branko Markovic: Yes..but I know that is working amazing for mano roga... today nobody know to use it in this way is it?
Vd. Pankaj Chhayani: If you see various ailments caused by Rasa/Rakta/Mansa/Meda vitiation, there are someano doshas.
Some mano dosha.
Croatia Branko Markovic: There is yes.. but there is direct possibility to work on Mano dosha without working on body..
Vd. Pankaj Chhayani: Its Majja is Madakarak, so it works on brain too.
Croatia Branko Markovic: Yes! It can work on fears also.
Vd. Pankaj Chhayani: its fruit majja
USA Gary Yuen: Testing for tannins might be a partial way to determine quaity. There are scientific tests that people use to find new plants, but I do not know if any are easy to do. Radial diffusion method for determining tannin in plant extracts.
https://www.ncbi.nlm.nih.gov/pubmed/24301886
https://www.ncbi.nlm.nih.gov/pubmed/3536314
some info of determining tannin content, the book Dietary Tannins: Consequences and Remedies.
https://books.google.com/books?id=_E9yNLJNW0kC&pg=PA84&lpg=PA84
Ayulink: Does it mean that we can allow manufacturers to grind fruit Majja too? Will it be more useful on mano roga? Mental diseases or psychology conditions?
USA Gary Yuen: do you mean fruit seeds?
Vd. Pankaj Chhayani: Yes seeds
USA Gary Yuen: Here is one study comparing fruit, seed, and seed coat powder. i haven't looked through the whole thing. i think there is benefit. I now consume amla with seeds. http://scialert.net/fulltext/?doi=ajft.2014.151.161
Vd. Pankaj Chhayani: Actually I don't know about this and I never used, this is written in text. Hypothetically it may have effect on brain.
USA Gary Yuen: Is it said somewhere? there's rasayanas that include amla that work on the brain, but one also includes brahmi
Vd. Pankaj Chhayani: Yes, Sour taste enlighten mind(mano bodhayati), and strengthen the sense organs(indriyani dradhikaroti).
Dr. Suyog Kulkarni: Triphala when used as Rasayan is prescribed in 1:2:4 proportion & its called yogawahi Triphala. I usually use this proportion to prepare Triphala ghrita for netratarpan .
Ayulink: how to check quality of Triphala? Physical and chemical tests? How we select supplier or manufacturer? Does Price is the only. Criterion to buy it?
Vd. Sachin Kadlag: In haritaki , mainly two varieties available.  Bala hirda and survari hirada , some vaidyas use them for different indications.
Dr. Sachinkumar Jinture: vaidya's self manufacturing is toooo good.
Vd. Sachin Kadlag: In aamalaki , as well we can get dongari aavala which is small in size but rare in quantity , is said to be best for rasayana .
Dr. J. T. Contractor: ndian gooseberry toxicity likely to be less than 20 PPM.
Dr. Bhavesh Modh: Quality  of HARITAKI  depends  on some nob.per 400gm . eg. 20 no. Of  Haritaki  in 400gm  it's  super quality. Best Amalaki  collect  in *Jeshth mahina* (May-Jun)
In this month  very  rare  availability  but full  of Ras gun & virya . Acc to Rajvaidhy Rasiklal Parikh.
Dr. P. A. Deshpande: My glowing face with use of triphala massage  before bath.  I use for entire body too and it shines young ones . Just a experience to share  in triphala topic.
Anand Javeri: Is triphala to be used in finely ground form?
Dr. P. A. Deshpande: Not necessary  rough  particles slips away while doing massage.
Dr. Ravindra Upadhyay: Depends. Sometimes  kwatha, & at times finely ground powder.
Anand Javeri: Wouldn't rough particles scratch the skin particularly face skin.
Dr. P. A. Deshpande: No . Its a very light massage. Just to absorb in skin.
Vd. Rupa Raval: Yes use of trifala for udvartan gives best result.
Anand Javeri: What is udvartan?
Vd. Rupa Raval: Use of powder made of herbs in body massage is called Udvartana(Udwarthanam/powder massage).
USA Gary Yuen: my previous links show multiple test methods for tannins. that could be one of multiple needed tests. It would need to be sent to a lab.
Colombia Enrique Jorge Galindo Bogota: What is the result to use triphala powder in udvartana.
Ayulink: It's good as scrub or exfoliation. Also skin luster improves.
Dr. Gaurav Makan: Triphla kwath is used as coagulant too.
External application.
Dr Feroz Khan: It remves dead cells from skin while scrubing gently.
Dr. Anup Torane: Trifala kwath hav best antiseptic antimicrobial property when used as to wash infected wound n also in yonidhavan also.
Dr. Ronak Rathod: There is preliminary evidence that Triphala contains compounds with antioxidant properties in isolated cells and rats, but this has not yet been demonstrated in people. Triphala has significant immunostimulatory effects on cellular immune response, especially cytotoxic T cells and natural killer cells.Triphala extract significantly prevents selenite-induced experimental cataractogenesis in vitro and in vivo for rats
Dr. Manju Mishra: Types of triphla  kashaya  ,madhur , swalp,,sugandhit  ..4  types. Here   we  r  discussing  about mahti  or  kashaya. It is  laxative n  rejuinative.
USA Gary Yuen: In a test of the antioxidants of 3,100 foods, triphala was #2. only a tree sap from the amazon was higher. #3 was amla powder. #4 lavangaha.
https://nutritionj.biomedcentral.com/articles/10.1186/1475-2891-9-3
one study shows amla powder is as effective as diabetic medicine. I don't know how triphala compares, but it should have an effect as well. https://www.ncbi.nlm.nih.gov/pubmed/21495900
Dr. Ravindra Upadhyay: Amla acts on liver and pancreas , corrects metabolism, increases insulin secretion, &  controls  sugar.
Shri Minoo parabia: Dhatri-Nisha is famous anti diabetic regimen
Dr. Ravindra Upadhyay: These drugs might be reducing insulin resistance, increasing insulin secretion, or decreasing the absorption of glucose from the intestine.
Shri Minoo parabia: Mostly mimetic. Needs research.
USA Gary Yuen: there are also studies of alma and triphala being very effective against cancer. For cancer, I think there are no studies of haritaki, but that might be the best
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Vd. Dhruti Kagrana

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