Ayurvedic medicine and remedies for Fatty Liver

According to Ayurvedic texts, kapha medo dushti (vitiation of kapha and meda) occurs during the initial stages of non-alcoholic fatty liver disease (NAFLD). Inflammatory conditions occur with the involvement of pitta, which might ultimately lead to steatohepatitis; when vata gets involved in the pathogenesis, it manifests in the form of fibrosis, which might eventually lead to cirrhosis. Reducing agnivaigunya (abnormalities in the digestive functions), balancing of kapha and meda, and correcting strotorodha (obstruction in the circulatory channels) can aid in better management of this condition.

The exact cause of NAFLD is not yet understood though it may be due to excessive- intake of macronutrients, specifically fats and its pathogenesis and aetiological factors are similar to that of sthaulya (obesity). The initial symptoms of NAFLD are similar to ajirna (indigestion). This includes abdominal distention, heaviness, decreased or increased appetite, diarrhoea, belching, constipation and malaise. As the disease progresses to the next stage, amlapitta (acidity)-related symptoms like loss of sensation of taste, burning sensation in the chest and abdomen, sour eructations, abdominal distention and loose stools are experienced.

Progression to cirrhosis or fibrosis manifests in the form of severe liver disorders like pandu (anaemia), raktapitta (haemorrhage in the nose and mouth) and kamala (jaundice).

According to Ayurveda, an imbalance between an individual and ecosystem due to faulty lifestyle and dietary habits is one of the major causes of metabolic conditions like NAFLD. Therefore, practising yoga, pranayama, and along with a healthy diet and lifestyle can help manage and prevent fatty liver disease.

• Virechana
  • Virechana is a purgation procedure, which is specifically performed to eliminate excess pitta. Along with pitta, it also leads to elimination of excess vata and kapha.
  • It is indicated in the treatment of many health conditions including asthma, disorders of the large intestine, disorders caused by vitiation of the rakta dhatu, insanity, gastrointestinal disturbances and pitta-related conditions.
  • Hot liquids or solid foods, meat soups and foods containing fatty materials are given to the patient before virechana.
  • Herbs used for this procedure are decided according to the patient’s condition.
  • After undergoing virechana, people experience lightness in the body and an improvement in appetite.
  • Virechana is known as the shodhana karma for treating liver conditions. Therefore, it can be useful in treating kamala and fatty liver.
• Vamana (medical emesis)
  • In the vamana procedure, excess pitta and kapha doshas are eliminated from the body via the oral route.
  • Vamana is indicated for anorexia, asthma, peptic ulcers, sinusitis and kapha-related diseases.
  • Milk, oily foods, animal meat and fatty foods are given to increase kapha in the body before performing this procedure.
  • Vamana is beneficial in reducing weight, total cholesterol levels and total triglycerides. Therefore, it can help treat fatty liver caused due to obesity.
  • This procedure reduces urea levels, serum creatinine and also help improve liver function.

Ayurvedic herbs for fatty liver

• Guduchi
  • Guduchi acts on the digestive and circulatory systems.
  • It is a bitter herb with tonic properties that helps in strengthening the overall body system. Giloy also promotes tissue regeneration.
  • It stimulates the natural immune responses in body and is used in the treatment of malarial fever, piles, skin conditions, jaundice, dysentery, constipation and gout.
  • Guduchi is known as the best dosha pacifying herb for NAFLD management.
  • You can take it in the form of powder, extract or as per your physician’s direction.
• Bhumiamalaki
  • Bhumiamalaki acts on the urinary, digestive and reproductive systems.
  • It is used in the treatment of jaundice, urogenital diseases, gonorrhoea, dyspepsia, colitis, dysentery, ulcers, skin conditions, tonsillitis and bleeding gums.
  • Bhumiamalaki has astringent and stomachic properties that make it useful for treating health conditions.
  • It is especially recommended for the treatment of liver conditions like jaundice and NAFLD.
  • You can take bhumiamalaki in the form of a pill, infusion, powder, poultice or as per your physician’s direction.
• Katuki (kutki)
  • Katuki has laxative, cholagogue (promotes expulsion of bile) and stomachic properties, and it acts on the excretory, digestive, nervous, female reproductive and circulatory systems.
  • This herb helps treat skin conditions, metal toxicity, bilious fevers, paralysis and constipation arising from the small intestine and malaria.
  • It also has hepatoprotective properties that make it useful in the treatment of liver conditions like jaundice, viral hepatitis and NAFLD.
  • You can take katuki in the form of a pill, powder, extract, tincture or as per your physician’s direction.
• Haritaki (chebulic myrobalan)
  • Haritaki acts on the female reproductive, digestive, respiratory and excretory systems.
  • It has laxative, rejuvenating, nervine, tonic and astringent properties and is known for improving longevity, memory, intellect and digestion.
  • Haritaki is used to treat abdominal distention, jaundice, tumours, rheumatism, asthma, colic, piles, ulcerated gums, itching, diarrhoea, spleen conditions and paralysis.
  • It is also effective in the management of liver conditions like NAFLD.
  • Haritaki shows therapeutic effects in people with obesity as well. Therefore, it is useful to treat fatty liver caused due to obesity.
  • You can take haritaki in the form of powder, gargle, paste, decoction or as per your physician’s direction.
• Pippali (long pepper)
  • Pippali has aphrodisiac and pain-relieving properties, and it acts on the respiratory, digestive and reproductive systems.
  • The herb is used for treating cough, kapha disorders, sciatica, paralysis, asthma, epilepsy and worm infestations.
  • Pippali makes an important component of various ayurvedic formulations due to its hepatoprotective properties. It contains alkaloids like piperine, which promotes regeneration of liver cells. It is also effective against many liver conditions like hepatobiliary disorders, liver cirrhosis and fatty liver.
  • You can take pippali in the form of oil, infusion, powder or as per your physician’s direction.

Ayurvedic medicines for fatty liver

• Vasaguduchyadi kashaya
  • Vasaguduchyadi kashaya is an Ayurvedic formulation that is prepared using triphala (a combination of amalaki [Indian gooseberry], vibhitaki [belleric myrobalan], and haritaki), neem, guduchi and eight other herbal ingredients.
  • This medicine is used to treat jaundice and anaemia.
  • It has hypolipidaemic, haematinic and hepatoprotective properties that make it useful in the management of liver conditions like NAFLD as well.
• Pippalyasava
  • This formulation is prepared from 26 herbs including ela (cardamom), vidanga (false black pepper), turmeric, pippali, maricha (black pepper), jaggery, jatamansi (muskroot) and amalaki.
  • It is indicated in the treatment of piles, spleen disorders, pthiasis, sprue, anorexia, general fatigue and flatulence and also helps to increase appetite.
  • The hepatoprotective properties of this herb, which makes it useful in the treatment of liver diseases like NAFLD.
• Arogyavardhini rasa
  • Arogyavardhini rasa, as the name suggests, is used to promote the overall arogya (health).
  • It brings about a balance between the three doshas and is mentioned in the context of kushtha (skin diseases) and yakrut (liver) conditions.
  • This herbo-mineral formulation includes parad (mercury), gandhak (brimstone), shilajatu (asphaltum), tamra bhasma (calcined preparation of copper), chitraka (leadwort), katuki, abhraka bhasma (calcined preparation of mica), guggulu and some other ingredients.
    
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  • This medicine is indicated in the treatment of worm infections, agnimandya (weakened digestive fire), pleehadosha (spleen conditions), medoroga (disease of the meda dhatu) and prameha (diabetes).
  • Arogyavardhini rasa has antioxidant properties, which helps improve liver function and aids in the management of conditions like jaundice and NAFLD.

As treatments vary based on numerous factors and an individual’s prakriti (constitution), consult a qualified Ayurvedic doctor for the appropriate medications and treatments for your specific complaints.

Do’s

• Include curry leaves, red rice, green gram, pomegranate, dry fruits, garlic, snake gourd, coriander, bitter gourd, ginger, buttermilk, barley, orange, raisins, drumstick and a gruel prepared from panchakola (5 spices) and trikatu (a combination of the three acrids – pippali, shunthi [dried ginger] and maricha) in your diet
• Eat freshly prepared foods
• Take your meals on time
• Consume a low-fat and high-fibre diet
• Drink at least eight glasses of lukewarm water per da.
• Exercising regularly, e.g., brisk walking for half an hour in fresh air
• Practice pranayamas and yoga asanas like gomukhasana and dhanuraasana

Don’ts

• Do not consume cauliflower, black gram, curd, potatoes, pickles, milk, yellow gram, meat preparations, full-fat milk, fish, basmati rice, artificial sweeteners, chocolates, jams and ice creams
• Avoid aerated drinks, bakery food items, excessively spicy or fatty foods
• Avoid eating sour, salty, sour foods
• Do not eat canned and preserved foods and junk food
• Do not follow a sedentary lifestyle
• Do not drink alcohol
• Do not smoke
• Do not overeat
• Do not sleep during the day

In a randomised trial, 32 patients diagnosed with NAFLD were divided into two groups – group A received arogyavardhini vati and triphala guggulu along with a physical and dietary regimen and group B received only dietary and physical regimen instructions. The study results indicated that group A showed more improvements in the lipid profile test, body mass index, and liver function tests compared to group B. It was concluded that a combination of medicines and dietary and physical regimen is effective in the management of NAFLD.

• Excessive purgation during virechana can cause bloody discharge through the anus, weakness, abdominal pain, drowsiness and syncope.
• Vamana is not advisable in children, old people and people with heart diseases, hematemesis and cachexia. Pregnant women and people with weakness should also not undergo vamana.
• Pippali may aggravate pitta in the body.
• Haritaki might cause severe exhaustion, dehydration and emaciation if taken in excess.

Liver is one of the major organs of the body. Diseases that affect liver function also has a major impact on overall body functions and health. Ayurvedic herbs and formulations used for the treatment of fatty liver possess hepatoprotective properties, which not only aid in preventing and managing liver diseases but also promote the normal functioning of liver 

The panchakarma therapy of virechana helps eliminate vitiated doshas in the body, which is the primary cause for fatty liver. Following dietary restrictions and exercising regularly helps in better management of the disease as well as in improving the overall health.