AYUSH Ministry’s COVID ‘Remedies’ Lack Evidence, Add To Confusion

New Delhi: A 65-year-old man in Mumbai was taking ayurvedic remedies for weeks prior to testing positive for COVID-19. Even when his symptoms worsened and he had trouble breathing, he was reluctant to go to a hospital. He died of COVID-19 in September.

“Essentially, he had trust in traditional ayurvedic medicine and did not trust the system of modern medicine. He said that modern medicine would not be as effective and private hospitals would be expensive,” said his niece, Rutuja Havaldar, explaining her uncle’s decision. Havaldar said that her uncle followed the advice of a family member who presents videos propagating AYUSH for COVID-19 on Marathi TV channels.

In April, when Charles, the prince of Wales, recovered from COVID-19, Union minister of state for AYUSH (ayurveda, yoga and naturopathy, unani, siddha and homeopathy), Sripad Naik, claimed that the former had used ayurvedic medicine. The British royal’s office issued a statement refuting the claim. A few months later, Naik himself contracted COVID-19 as did Union home minister Amit Shah. Both turned to modern medicine: Shah was first admitted to Medanta Hospital in Gurugram and then to the All India Institute of Medical Sciences, New Delhi, while Naik was in the care of doctors at Manipal Hospital in Goa.

Yet, the AYUSH ministry in October released recommendations to integrate “Ayurveda and Yoga interventions” into India’s national clinical management protocol for COVID-19. Among other things, it recommends tackling COVID-19 with warm water gargles, applying medicated ghee in nostrils, steam inhalation, drinking “golden milk” (hot milk with turmeric) and kadha/kashayam/kwath (hot infusion with ayurvedic herbs) combined with good diet, sleep and exercise. The clinical protocol recommends patients take ayurvedic formulations such as Ayush-64, Guduchi Ghana Vati, Guduchi with Pipalli and Asvagandha even while suffering from hypoxia (loss of oxygen in the body) and breathlessness due to COVID-19. India had recorded 8.2 million cases and over 122,000 deaths by November 2.

The Ministry of Health and Family Welfare already has a clinical protocol for COVID-19 based on modern medicine and science and the document has been updated multiple times to add or drop new medicines and therapies whenever new evidence has come in. The new AYUSH ministry recommendations -- based on little scientific evidence and some in contradiction with the current clinical protocol -- have lent legitimacy to home remedies and added to confusion over COVID-19.

These AYUSH recommendations have upset some doctors and made frontline workers’ jobs more difficult, we found. Doctors we spoke to narrated instances of COVID-19 patients reporting late to hospitals as they were relying on ayurvedic home remedies instead. Doctors said they noticed low platelet counts and excessive bleeding during surgeries among their patients as a result of unmonitored use of herbal remedies.

IndiaSpend studied AYUSH ministry’s COVID-19 recommendations and government documents that claim traditional ayurvedic remedies could prevent, manage and treat COVID-19, and noticed serious discrepancies between the protocols for modern and ayurvedic medicine.

How robust is the evidence for the AYUSH protocol for COVID-19?

One glaring discrepancy between the government’s allopathic and AYUSH protocols was on treating COVID-19 symptoms: The government’s modern medicine clinical management protocol say that moderate COVID-19 symptoms include hypoxia (loss of blood-oxygen) and breathlessness, and such patients should immediately get medical attention and remain at a dedicated COVID-19 centre, not at home. However, the AYUSH protocol suggests that hypoxia and breathlessness pertain to mild COVID-19, and as such, could be treated by consuming herbs mixed in water.

Source: National Clinical Management Protocol based on Ayurveda and Yoga for management of Covid-19

IndiaSpend also studied the 253 citations referenced in the AYUSH recommendations and found deficiencies in the studies cited. For example, the committee cited a 1981 article about a clinical trial for Ayush-64’s efficacy on malaria, which is not available online. AltNews found a copy of this paper, which apparently claimed that patients on AYUSH64 showed an “80% response with the drug”, without specifying what this means. However, newer research by government agencies found this drug to not be effective against malaria and this was not considered by AYUSH ministry in this recent protocol. This research, for example, published in2000, found that Ayush-64 showed only 50% efficacy compared to chloroquine, after which the researchers discontinued further research.

Many of the 253 citations were not related to studies conducted for COVID-19 at all but for breast cancer, HIV, diabetes, malaria--diseases with pathologies very different from SARS-CoV-2, the virus that causes COVID-19. Yet the AYUSH protocol has made extrapolations from these diseases, to COVID-19.

Many of these studies had not been carried out on humans yet; they were very nascent pre-clinical research involving just mice or chicks. Still others had not even reached the animal testing phase and were merely carried out on computer software. Yet, these studies made definitive conclusions about the usefulness of these herbs to manage COVID-19. The document also repeatedly referred to “trends”, but from incomplete and unpublished studies.

Source: Report and recommendations of the Interdisciplinary Committee for integration of Ayurveda and Yoga Interventions in the 'National Clinical Management Protocol: COVID-19'

Some citations were from the 1960s, which researchers said was too old to cite as evidence in a clinical protocol for a newly-emerged disease. Several citations had been repeated, many were incomplete and some URLs mentioned opened to pages where no paper had been uploaded. Many of the articles cited were opinion pieces, commentaries and reviews of literature. Some of the articles cited were written by people who were on the same government committee that had recommended the AYUSH treatments, and hence not entirely independent in their assessments.

IndiaSpend emailed questions to the Ministry of AYUSH and also contacted its office-holders by phone about the evidence cited in their protocol. Both the email and phone calls went unanswered. We will update this story when they reply.

Abby Philips, a hepatologist based in Kerala, studied the citations mentioned by the AYUSH ministry and found them lacking in many ways. “There is deception on the part of the AYUSH ministry,” he said.

For example, the AYUSH recommendation had cited references to show the adverse effects, contraindications and limitations of modern medicine for COVID-19 but had not cited any articles to show its positive indications, he said. “Likewise, the document has only cited articles that show positive effects of AYUSH formulations without considering any valid literature which shows its benefits as well as harms or which is critical of the same,” he said.

A number of the journals in which AYUSH research had been published seem dubious, said Philips. Some, such as the Indian Journal of Pure and Applied Biosciences (IJPAB), had been cited wrongly--in this case as “International Journal of Pure Applied Sciences”. Some journals--such as the International Journal of Pharmacy and Biological Sciences (IJPBS) and the International Journal of Current Microbiology and Applied Sciences (IJCMS)--were not indexed or affiliated to credible databases such as Medline or Scopus, found Philips.

“There is not a single study, cited in the AYUSH ministry document, that was done on human beings to test efficacy of AYUSH drugs on COVID-19,” said Philips.

Public sold on AYUSH, doctors have it hard

The new AYUSH protocol had upset India’s largest body of modern medicine doctors, the Indian Medical Association (IMA). In a letter to the government in October, the IMA asked: How many ministers in the Indian government have chosen AYUSH treatment for COVID-19? Further, the IMA challenged the government and asked it to hand over India’s entire COVID-19 care to the AYUSH ministry if its proposals were truly scientific and effective.

Doctors treating COVID-19 have had the challenges stacked against them right from the beginning (as IndiaSpend reported here and here on staff shortages, lack of equipment and other problems). Apart from the few scientifically proven options available to them, they also have to contend with pseudoscience.

For example, recipes of “Corona Kashayam” circulating on WhatsApp call for boiling water with household ingredients--turmeric, cloves, lemon and ginger--to “cure” COVID-19. A fact check by BoomLive debunked the kashayam cure. State governments in Tamil Nadu and Kerala, for example, officially distributed packets of AYUSH medicines for COVID-19.

Raghuraj Hegde, an ophthalmic plastic surgeon in Bengaluru, was performing a surgery in September and the patient suffered excessive and unexplained bleeding. “The patient had done a range of tests before the surgery and there was no reason for him to have had so much bleeding. He was not on any blood thinners either. We couldn’t explain the situation,” said Hegde.

Hegde struggled but safely concluded the surgery. Afterwards, Hegde found out that the patient had been taking a herbal concoction of ginger, garlic, turmeric and asafoetida thrice daily to ward off COVID-19. Studies document that commonplace ingredients such as garlic, ginger and turmeric when consumed in certain quantities can affect platelet function and blood coagulation.

“The surgery I performed was an elective surgery and is not generally one where there could be heavy bleeding. So, we did not have blood on stand-by,” said Hegde. Had he known beforehand that the patient was taking herbal remedies that could cause blood-thinning, Hegde said, he would have delayed the surgery and asked the patient to stop the home remedies for a few days first. But this would not be an option in case of emergency surgeries or pregnancies.

“Often when we ask patients before surgery if they are on any medication, it does not occur to them to tell us they are eating raw ginger, raw turmeric or drinking kashayam,” he said. “They see this as a ‘herbal home remedy', not as a chemical or medicine. I think it is time that we doctors ask patients directly if they are taking any herbal or ayurvedic medicines before any surgery to eliminate the risk of things like excessive bleeding… more so because of people’s anxiety over the pandemic and them taking herbal medicines to prevent COVID-19,” said Hegde, adding that his department at Manipal Hospital, Bengaluru, had now asked surgeons to make this a part of pre-surgery protocol.

Philips, the Kerala-based hepatologist, had also consulted patients with various ailments, who had been taking AYUSH formulations to keep away COVID-19. The Kerala government was distributing some homoeopathic medicines as a preventive for COVID-19 and Philips tested some of them in a government approved lab.

“The lab results showed that these so-called medicines were anything from placebos to potentially harmful,” said Philips, the Kerala-based hepatologist, who has published a number of scientific articles on the impacts of AYUSH drugs on the body. “One sample of homeopathic pills had nothing in it, not even sugar. Another sample had arsenic and other industrial solvents such as palmitate. The biopsy of one of my patients showed drug-induced liver injury, which they probably suffered after consuming these homeopathic medicines.” This points to the clear risk involved in taking these medicines and moreover, their supply is not highly regulated and they are often consumed without a physician’s supervision, added Philips.

AYUSH challenges modern science

Ten months into the pandemic, drug after drug promoted as potential treatment for COVID-19 has fallen through. In the last few weeks, major trials have shown that none of the currently prescribed drugs and interventions--remdesivir, lopinavir/ritonavir, hydroxychloroquine, interferon β1, plasma therapy--are successful at treating COVID-19.

And on this very basis, the AYUSH system of medicine has thrown a challenge to modern medicine. In the government’s report, the expert committee that recommended the AYUSH protocol made exactly this argument.

Hydroxychloroquine, tocilizumab, remdesivir, paracetamol, anti-tussives, enoxaparin sodium, heparin, methylprednisolone or dexamethasone and convalescent plasma have all been recommended in the clinical protocol based on “experiences with limited number of subjects mainly for preventing/ managing systemic pathological effects of COVID-19”, they argued. Likewise, the AYUSH Ministry was also recommending four AYUSH medicines--Ayush-64, Guduchi Ghana Vati, Pipalli and Asvagandha--for COVID-19.

“At present, modern medicine does not offer a cure for COVID-19 and its treatment is mostly empirical and symptomatic. Moreover, modern medicine does not offer any specific measure to boost immunity and also has limitations for managing mental health,” argued the expert committee in the document.

While this is true, where things are different is that modern science has put various drug candidates through hundreds of clinical trials all over the world and, that too, on large sample sizes, as IndiaSpend reported. In the 10 months of this pandemic, their results have been peer-reviewed and hundreds of papers have been published in journals, becoming take-off points for further research. Clinical trials have also been conducted on humans and some are in advanced phases. And in this process of rigorous testing, many of the initial drug candidates for COVID-19, have, in fact, been junked.

“However, in case of the AYUSH ministry-recommended drugs, the trials were facing difficulties in enrolling volunteers as patients were being courted by several trials at the same time,” said Sanjeev Sharma, director of National Institute of Ayurveda, Rajasthan. “We have not published any new studies on ayurvedic drugs for COVID-19 so far,” he confirmed, adding, “Many studies are being completed and the papers will be published soon.”

AYUSH vs Science
AYUSH Medicine Recommended for Science’s warning
Ayush-64
There are four plant extracts in Ayush-64: Alstonia sholaris, Picrrorhiza kurroa, Swetia chirata and Caesalpinia crista
Therapeutic intervention (add-on to standard care as per Ministry of Health and Family Welfare guidelines) Alstonia sholaris has been shown to have toxic effects on blood cells in animal studies. No proper human studies undertaken yet.
No major safety studies conducted for Picrrorhiza kurroa. It is considered a potentially toxic plant as it is suspected to worsen autoimmune diseases and also lower blood sugar levels.
Swetia chirata’s safety in humans still unknown. Only in vitro and in vivo studies in small animals exist.
Guduchi Ghana Vati
Tinospora cordifolia Willd. It’s a stem aqueous extract
Prophylactic care and as add-on to standard care T. cordifolia is very similar to T.crispa, a plant of the same family. Both contain diterpenoids and furans that are potentially toxic. Sometimes wrong identification and inclusion of T. cordifolia as T. crispa in herbal products has resulted in liver failure in humans.
Pipalli
Piper longum L.
It’s a fruit
Therapeutic intervention (add-on to standard care as per Ministry of Health and Family Welfare guidelines) Piperine, a major content of Piper longum, has been found to be extremely toxic in animals, even causing death. No major human studies performed on this aspect.
Asvagandha
Withania somnifera Dunal.-
It’s a root aqueous extract
Prophylactic care Asvagandha has been shown to be a possible cause for severe liver injury by the United States DILI Network. It is featured on the LiverTox database.

(Bhuyan is a special correspondent at IndiaSpend.)

We welcome feedback. Please write to respond@indiaspend.org. We reserve the right to edit responses for language and grammar.

New Delhi: A 65-year-old man in Mumbai was taking ayurvedic remedies for weeks prior to testing positive for COVID-19. Even when his symptoms worsened and he had trouble breathing, he was reluctant to go to a hospital. He died of COVID-19 in September.

“Essentially, he had trust in traditional ayurvedic medicine and did not trust the system of modern medicine. He said that modern medicine would not be as effective and private hospitals would be expensive,” said his niece, Rutuja Havaldar, explaining her uncle’s decision. Havaldar said that her uncle followed the advice of a family member who presents videos propagating AYUSH for COVID-19 on Marathi TV channels.

In April, when Charles, the prince of Wales, recovered from COVID-19, Union minister of state for AYUSH (ayurveda, yoga and naturopathy, unani, siddha and homeopathy), Sripad Naik, claimed that the former had used ayurvedic medicine. The British royal’s office issued a statement refuting the claim. A few months later, Naik himself contracted COVID-19 as did Union home minister Amit Shah. Both turned to modern medicine: Shah was first admitted to Medanta Hospital in Gurugram and then to the All India Institute of Medical Sciences, New Delhi, while Naik was in the care of doctors at Manipal Hospital in Goa.

Yet, the AYUSH ministry in October released recommendations to integrate “Ayurveda and Yoga interventions” into India’s national clinical management protocol for COVID-19. Among other things, it recommends tackling COVID-19 with warm water gargles, applying medicated ghee in nostrils, steam inhalation, drinking “golden milk” (hot milk with turmeric) and kadha/kashayam/kwath (hot infusion with ayurvedic herbs) combined with good diet, sleep and exercise. The clinical protocol recommends patients take ayurvedic formulations such as Ayush-64, Guduchi Ghana Vati, Guduchi with Pipalli and Asvagandha even while suffering from hypoxia (loss of oxygen in the body) and breathlessness due to COVID-19. India had recorded 8.2 million cases and over 122,000 deaths by November 2.

The Ministry of Health and Family Welfare already has a clinical protocol for COVID-19 based on modern medicine and science and the document has been updated multiple times to add or drop new medicines and therapies whenever new evidence has come in. The new AYUSH ministry recommendations -- based on little scientific evidence and some in contradiction with the current clinical protocol -- have lent legitimacy to home remedies and added to confusion over COVID-19.

These AYUSH recommendations have upset some doctors and made frontline workers’ jobs more difficult, we found. Doctors we spoke to narrated instances of COVID-19 patients reporting late to hospitals as they were relying on ayurvedic home remedies instead. Doctors said they noticed low platelet counts and excessive bleeding during surgeries among their patients as a result of unmonitored use of herbal remedies.

IndiaSpend studied AYUSH ministry’s COVID-19 recommendations and government documents that claim traditional ayurvedic remedies could prevent, manage and treat COVID-19, and noticed serious discrepancies between the protocols for modern and ayurvedic medicine.

How robust is the evidence for the AYUSH protocol for COVID-19?

One glaring discrepancy between the government’s allopathic and AYUSH protocols was on treating COVID-19 symptoms: The government’s modern medicine clinical management protocol say that moderate COVID-19 symptoms include hypoxia (loss of blood-oxygen) and breathlessness, and such patients should immediately get medical attention and remain at a dedicated COVID-19 centre, not at home. However, the AYUSH protocol suggests that hypoxia and breathlessness pertain to mild COVID-19, and as such, could be treated by consuming herbs mixed in water.

Source: National Clinical Management Protocol based on Ayurveda and Yoga for management of Covid-19

IndiaSpend also studied the 253 citations referenced in the AYUSH recommendations and found deficiencies in the studies cited. For example, the committee cited a 1981 article about a clinical trial for Ayush-64’s efficacy on malaria, which is not available online. AltNews found a copy of this paper, which apparently claimed that patients on AYUSH64 showed an “80% response with the drug”, without specifying what this means. However, newer research by government agencies found this drug to not be effective against malaria and this was not considered by AYUSH ministry in this recent protocol. This research, for example, published in2000, found that Ayush-64 showed only 50% efficacy compared to chloroquine, after which the researchers discontinued further research.

Many of the 253 citations were not related to studies conducted for COVID-19 at all but for breast cancer, HIV, diabetes, malaria--diseases with pathologies very different from SARS-CoV-2, the virus that causes COVID-19. Yet the AYUSH protocol has made extrapolations from these diseases, to COVID-19.

Many of these studies had not been carried out on humans yet; they were very nascent pre-clinical research involving just mice or chicks. Still others had not even reached the animal testing phase and were merely carried out on computer software. Yet, these studies made definitive conclusions about the usefulness of these herbs to manage COVID-19. The document also repeatedly referred to “trends”, but from incomplete and unpublished studies.

Source: Report and recommendations of the Interdisciplinary Committee for integration of Ayurveda and Yoga Interventions in the 'National Clinical Management Protocol: COVID-19'

Some citations were from the 1960s, which researchers said was too old to cite as evidence in a clinical protocol for a newly-emerged disease. Several citations had been repeated, many were incomplete and some URLs mentioned opened to pages where no paper had been uploaded. Many of the articles cited were opinion pieces, commentaries and reviews of literature. Some of the articles cited were written by people who were on the same government committee that had recommended the AYUSH treatments, and hence not entirely independent in their assessments.

IndiaSpend emailed questions to the Ministry of AYUSH and also contacted its office-holders by phone about the evidence cited in their protocol. Both the email and phone calls went unanswered. We will update this story when they reply.

Abby Philips, a hepatologist based in Kerala, studied the citations mentioned by the AYUSH ministry and found them lacking in many ways. “There is deception on the part of the AYUSH ministry,” he said.

For example, the AYUSH recommendation had cited references to show the adverse effects, contraindications and limitations of modern medicine for COVID-19 but had not cited any articles to show its positive indications, he said. “Likewise, the document has only cited articles that show positive effects of AYUSH formulations without considering any valid literature which shows its benefits as well as harms or which is critical of the same,” he said.

A number of the journals in which AYUSH research had been published seem dubious, said Philips. Some, such as the Indian Journal of Pure and Applied Biosciences (IJPAB), had been cited wrongly--in this case as “International Journal of Pure Applied Sciences”. Some journals--such as the International Journal of Pharmacy and Biological Sciences (IJPBS) and the International Journal of Current Microbiology and Applied Sciences (IJCMS)--were not indexed or affiliated to credible databases such as Medline or Scopus, found Philips.

“There is not a single study, cited in the AYUSH ministry document, that was done on human beings to test efficacy of AYUSH drugs on COVID-19,” said Philips.

Public sold on AYUSH, doctors have it hard

The new AYUSH protocol had upset India’s largest body of modern medicine doctors, the Indian Medical Association (IMA). In a letter to the government in October, the IMA asked: How many ministers in the Indian government have chosen AYUSH treatment for COVID-19? Further, the IMA challenged the government and asked it to hand over India’s entire COVID-19 care to the AYUSH ministry if its proposals were truly scientific and effective.

Doctors treating COVID-19 have had the challenges stacked against them right from the beginning (as IndiaSpend reported here and here on staff shortages, lack of equipment and other problems). Apart from the few scientifically proven options available to them, they also have to contend with pseudoscience.

For example, recipes of “Corona Kashayam” circulating on WhatsApp call for boiling water with household ingredients--turmeric, cloves, lemon and ginger--to “cure” COVID-19. A fact check by BoomLive debunked the kashayam cure. State governments in Tamil Nadu and Kerala, for example, officially distributed packets of AYUSH medicines for COVID-19.

Raghuraj Hegde, an ophthalmic plastic surgeon in Bengaluru, was performing a surgery in September and the patient suffered excessive and unexplained bleeding. “The patient had done a range of tests before the surgery and there was no reason for him to have had so much bleeding. He was not on any blood thinners either. We couldn’t explain the situation,” said Hegde.

Hegde struggled but safely concluded the surgery. Afterwards, Hegde found out that the patient had been taking a herbal concoction of ginger, garlic, turmeric and asafoetida thrice daily to ward off COVID-19. Studies document that commonplace ingredients such as garlic, ginger and turmeric when consumed in certain quantities can affect platelet function and blood coagulation.

“The surgery I performed was an elective surgery and is not generally one where there could be heavy bleeding. So, we did not have blood on stand-by,” said Hegde. Had he known beforehand that the patient was taking herbal remedies that could cause blood-thinning, Hegde said, he would have delayed the surgery and asked the patient to stop the home remedies for a few days first. But this would not be an option in case of emergency surgeries or pregnancies.

“Often when we ask patients before surgery if they are on any medication, it does not occur to them to tell us they are eating raw ginger, raw turmeric or drinking kashayam,” he said. “They see this as a ‘herbal home remedy', not as a chemical or medicine. I think it is time that we doctors ask patients directly if they are taking any herbal or ayurvedic medicines before any surgery to eliminate the risk of things like excessive bleeding… more so because of people’s anxiety over the pandemic and them taking herbal medicines to prevent COVID-19,” said Hegde, adding that his department at Manipal Hospital, Bengaluru, had now asked surgeons to make this a part of pre-surgery protocol.

Philips, the Kerala-based hepatologist, had also consulted patients with various ailments, who had been taking AYUSH formulations to keep away COVID-19. The Kerala government was distributing some homoeopathic medicines as a preventive for COVID-19 and Philips tested some of them in a government approved lab.

“The lab results showed that these so-called medicines were anything from placebos to potentially harmful,” said Philips, the Kerala-based hepatologist, who has published a number of scientific articles on the impacts of AYUSH drugs on the body. “One sample of homeopathic pills had nothing in it, not even sugar. Another sample had arsenic and other industrial solvents such as palmitate. The biopsy of one of my patients showed drug-induced liver injury, which they probably suffered after consuming these homeopathic medicines.” This points to the clear risk involved in taking these medicines and moreover, their supply is not highly regulated and they are often consumed without a physician’s supervision, added Philips.

AYUSH challenges modern science

Ten months into the pandemic, drug after drug promoted as potential treatment for COVID-19 has fallen through. In the last few weeks, major trials have shown that none of the currently prescribed drugs and interventions--remdesivir, lopinavir/ritonavir, hydroxychloroquine, interferon β1, plasma therapy--are successful at treating COVID-19.

And on this very basis, the AYUSH system of medicine has thrown a challenge to modern medicine. In the government’s report, the expert committee that recommended the AYUSH protocol made exactly this argument.

Hydroxychloroquine, tocilizumab, remdesivir, paracetamol, anti-tussives, enoxaparin sodium, heparin, methylprednisolone or dexamethasone and convalescent plasma have all been recommended in the clinical protocol based on “experiences with limited number of subjects mainly for preventing/ managing systemic pathological effects of COVID-19”, they argued. Likewise, the AYUSH Ministry was also recommending four AYUSH medicines--Ayush-64, Guduchi Ghana Vati, Pipalli and Asvagandha--for COVID-19.

“At present, modern medicine does not offer a cure for COVID-19 and its treatment is mostly empirical and symptomatic. Moreover, modern medicine does not offer any specific measure to boost immunity and also has limitations for managing mental health,” argued the expert committee in the document.

While this is true, where things are different is that modern science has put various drug candidates through hundreds of clinical trials all over the world and, that too, on large sample sizes, as IndiaSpend reported. In the 10 months of this pandemic, their results have been peer-reviewed and hundreds of papers have been published in journals, becoming take-off points for further research. Clinical trials have also been conducted on humans and some are in advanced phases. And in this process of rigorous testing, many of the initial drug candidates for COVID-19, have, in fact, been junked.

“However, in case of the AYUSH ministry-recommended drugs, the trials were facing difficulties in enrolling volunteers as patients were being courted by several trials at the same time,” said Sanjeev Sharma, director of National Institute of Ayurveda, Rajasthan. “We have not published any new studies on ayurvedic drugs for COVID-19 so far,” he confirmed, adding, “Many studies are being completed and the papers will be published soon.”

AYUSH vs Science
AYUSH Medicine Recommended for Science’s warning
Ayush-64
There are four plant extracts in Ayush-64: Alstonia sholaris, Picrrorhiza kurroa, Swetia chirata and Caesalpinia crista
Therapeutic intervention (add-on to standard care as per Ministry of Health and Family Welfare guidelines) Alstonia sholaris has been shown to have toxic effects on blood cells in animal studies. No proper human studies undertaken yet.
No major safety studies conducted for Picrrorhiza kurroa. It is considered a potentially toxic plant as it is suspected to worsen autoimmune diseases and also lower blood sugar levels.
Swetia chirata’s safety in humans still unknown. Only in vitro and in vivo studies in small animals exist.
Guduchi Ghana Vati
Tinospora cordifolia Willd. It’s a stem aqueous extract
Prophylactic care and as add-on to standard care T. cordifolia is very similar to T.crispa, a plant of the same family. Both contain diterpenoids and furans that are potentially toxic. Sometimes wrong identification and inclusion of T. cordifolia as T. crispa in herbal products has resulted in liver failure in humans.
Pipalli
Piper longum L.
It’s a fruit
Therapeutic intervention (add-on to standard care as per Ministry of Health and Family Welfare guidelines) Piperine, a major content of Piper longum, has been found to be extremely toxic in animals, even causing death. No major human studies performed on this aspect.
Asvagandha
Withania somnifera Dunal.-
It’s a root aqueous extract
Prophylactic care Asvagandha has been shown to be a possible cause for severe liver injury by the United States DILI Network. It is featured on the LiverTox database.

(Bhuyan is a special correspondent at IndiaSpend.)

We welcome feedback. Please write to respond@indiaspend.org. We reserve the right to edit responses for language and grammar.


41 responses to “AYUSH Ministry’s COVID ‘Remedies’ Lack Evidence, Add To Confusion”

  1. Loving the clarity in this comments section, the neutral perspective of many who have commented before me here, and the respect/trust that people have for our systems of medicine as well.

    I’m not even close to an expert in any system of medicine, be it ayurveda, homeopathy or allopathy or any other which is not mentioned in this article. I’m not trying to demean/defame allopathy; just pointing out certain things based on some claims in this article. And I don’t mean ancient systems don’t have drawbacks at all in today’s conditions, or that modern system of medicine is totally inefficient/wrong (although it majorly is, more so considering the worldwide malpractices/fundings that happen due to misleading propagations by the medical community; not all but many.)

    But firstly, if someone genuinely starts to list and brood over the potential side-effects of even a very simple modern medicine like a paracetamol/pain killers, many paediatric drugs or the so-called vaccines recommended for babies by modern scientific system of medicine (leave alone highly harmful ones like steroids or remdesivir), a serious threat to the permanent functioning of many internal organs or the very critical immune system of our body, it is impractical for modern system of medicine to even survive. Numerous disclaimers mentioned are so scary even to read in most medicines; nevertheless, we hardly even care about those, considering and acknowledging the positives of allopathy. Many have to admit to this fact openly.

    So it is highly foolish to write an exhaustive story, pointing out such trivial examples like this article mentions and counter other systems of medicine, just because one system is not working out well. It’s not fair to:

    1. Merely consider one or two who have been claimed to be affected due to potential side-effects of AYUSH protocols, against the lakhs who have been affected or even many successfully treated by traditional systems.
    2. Mention citations of just the AYUSH ministry seems like targeting someone, rather than genuinely researching entirely and aiming for the larger good.
    2. Totally condemn and defame an age-old system of medication, without deep research into it and to superficially mention few things to support invalid claims.

    Moreover, for hugely established medical treatments in which allopathy has advanced/succeeded like complex fractures, transplant of organs, transfusions, advanced modern treatment methods like for cancer, child birth issues, etc, simplified methods of treatments /surgeries for things like cataract or common eye surgeries, dental problems, hernia surgeries, simplified C-section advancements (a few common ones to mention), no one has stopped from resorting to such allopathic treatments or kept defaming it, despite their major/ long-term side effects, considering that it ultimately helps in survival and makes life easier.

    So if something is established and successful, people are not going to baselessly keep condemning/go against any system of medicine. I’d like to highlight to the people who do such writings for the field of medicine that such articles are highly misleading and kindly request people to refrain from such writings, in case it’s aimed at merely condemning something rather than truly finding better ways to live. If AYUSH protocols are overclaimed/wrong /inefficient, it’d be appropriate to approach concerned people/talk to them and try to change things, rather than do such politically aimed writings which mislead the public.

  2. Basically, you are ignorant of the principles of homoeopathy. Many people in my place got cured with homoeopathy. What clarity do you have with allopathy? They changed every possible medicine and all the people, including doctors, followed every instruction like sheep and finally were fooled. Stop propagating your opinions and ignorance in this way. Do some quality research with open eyes and ears.

  3. Facts written about guduchi, pipli and ashwagandha are false and baseless. Ayurveda is a thousand-year-old science which is based on proper scientific evidences. There is no sure treatment for the coronavirus in modern medicine, and this article portrays modern medicine as if these are only based on scientific evidences.

    If modern medicine doctors don’t have any concrete treatment, they start criticising other systems of medicine. These people test ayurvedic system by their own frame of testing things, which is absolutely wrong.

  4. First, do more research on ayurveda and then write an article. You are just defaming Indian medicine without proper knowledge by telling baseless stories of patients taking doses without precautions and prescription of ayurvedic doctor. Secondly, why are the side effects of only herbal medicine listed? Tell people about the side effects of allopathy too if you are worried about all of this.

  5. Glad to see that your admission on the modern chemical concoctions: “In the last few weeks, major trials have shown that none of the currently prescribed drugs and interventions–remdesivir, lopinavir/ritonavir, hydroxychloroquine, interferon β1, plasma therapy–are successful at treating COVID-19.”

    Please give citations for the various findings given in the table, Ayush vs Science. All the observations will be found hollow without a scientific, peer -reviewed, double-blind studies.

    Ayurveda and Siddha are being practiced for thousands of years in our country. Mere slandering will not justify your arguments.

  6. So many deaths have occurred and are still occurring due to COVID-19 in hospitals, treated by modern medicine. Why have you not mentioned them? Only a few cases of natural system are a big deal for you. Every science has its pros and cons.

  7. So many patients die daily in hospitals under allopathic treatment. Why you have not concluded that allopathic treatment is not effective? Your complete writeup is baseless.

  8. I wish funds were available for a randomised double-blind trial of genuine proposals of repurposed AYUSH drugs or formulations for which pharmacokinetic analytical data is already available.

    Many drugs and treatments have a proven history of efficacy and have undergone such detailed studies in the past that they can readily move directly to Phase 3, applying the same regulations and protocol as other conventional drugs.

    A survey of such research papers already awaiting funding must be undertaken.

  9. This is absolutely brilliant and an eye-opener for the general public.

    I had several severe hunches about the dubious and misleading efficiency of the so-called COVID medicine as purported by our “respected government”.

    I urge you to please share the article in social media accounts. I am doing my part to do it. Please keep such articles coming. I loved reading it.

  10. Don’t just go blindly with home remedies continuously. Approach an experienced ayurvedic doctor. Go for authentic classical ayurvedic medicines, which will be effective for COVID-19, which has been proved by CCRAS, All India Institute of Ayurveda and NIA.

  11. Can you please tell me about any five allopathy medicines that have no side-effects at all? Also, can you please provide us the research paper on the herbs you mentioned, so that we can know for how long taking ashwagandha or katuki causes side-effects?

  12. Both my sons had tested positive for COVID-19. They lost the sense of taste and smell, and recovered using ayurvedic medicine. My wife and I too continued with the same authentic medication and had no symptoms, or recovered without symptoms.

    I don’t think talking ayurvedic medicine would prevent you from getting infected, but I am sure most can recover. You have quoted one case of causality consuming ayurvedic medicine. How many do you have with conventional modern medicine?

  13. I think the way you have presented this article is dishonouring the prestige of ayurveda.

    First, if some patients self-medicate without consulting ayurvedic specialists, then it’s on their own risk. It’s a trend nowadays–if you don’t find the cause of something, blame another system.

    Let me give you an example. Recently, an old woman suffered from pemphigus vulgaris and was severely affected and admitted to ICU. After all brain-storming, they couldn’t find any cause; besides, she had a history of psoriasis. They emphasised that she took heavy metals like ayurvedic drugs and this caused her disease, but surprisingly, she was not on any ayurvedic drug ever in her life. Now, she is no more. Who will take the responsibility? AYUSH system or something else? It’s not a blame game.

    Nothing is constant in modern medicine. You never know which protocol will change. This doesn’t mean that the previous one was baseless. There are so many things in modern medicine which have no correlation; still they work.

    Also if you read, there are levels of hypoxia and various causes for breathlessness, and AYUSH is not forcing you that you should only take this. You should consult an ayurvedic specialist before taking any ayurvedic medicine. And on talking various concoctions, excess of anything is harmful, as stated in ayurveda. And Indians have been taking this since our society existed.

    IndiaSpend is very specifically pointing out on a single case, and that patient already belonged to high-risk category. So, be liberal in terms of your views about any medicine system. As graduate of Ayurveda have modern and ayurvedic basis, they know better than any reporter. Kindly consult ayurvedic physician. Also u did not wish to seek the other party’s views, which shows that kind of your writing.

  14. Why we should believe you?

    All the medicines are good for the disease for which it is made for, but it has its side effects. Hence, ayurvedic medicine may have side-effects.

    Lots of people have benefited from naturopathic and ayurvedic treatment against COVID. Some unfortunate incidents may occur, in any type of medicine.

    Do you have any data or research about failure percentage for allopathic treatment vs ayurvedic and naturopathic treatment to correlate? If not, please don’t tarnish the ayurvedic and naturopathic treatment. You may become a puppet in the hand of big sharks.

  15. A large force/union/lobby/mafia has been dragging ayurveda and homeopathy down right from 1857. That lobby is even against chelation therapy, chemo, which are very effective allopathy approaches. This lobby/mafia group promotes mostly expensive medicines, and unwanted major surgeries. Kottakkal ayurvedic system has treated lakhs from major parts of the world, and created shocking wonders. This is the reality.

  16. What about the lakhs of deaths that happened after taking modern medicines, despite making false claim of clinical evidence? When one mortality case is reported after taking ayurvedic medicines, we should not forget those several thousand cases of death by modern medicine’s treatment.

  17. When COVID-19 lacks proper treatment, why can’t you try and take a chance with ayurveda? The arguments related to the drugs shown above are inappropriate. We all know the side-effects of paracetamol and people are still using it.

  18. The problem with allopathy is that it wants no other system to survive.

    AYUSH practitioners tell you to use their recommendations for mild cases, and when symptoms become severe, the patient can shift to allopathy.

    In allopathy also, some patients see severe aggravation of disease. If the same aggravation happens in any other methods of medicine, the allopathy guys will say it’s a failed system.

    On the other hand, other systems say that both have their advantages, and that if things don’t improve with our system, then go for allopathy.

    Allopathy is an intolerant system.

  19. Please, this is not 1980 and 1990s. People are more educated and can read for themselves. Person reading newspapers daily know the so-called effectiveness of remdesivir-like medicines and misdirection, even by someone as important like the USA president.

    The growth of allopathy is primarily due to burgeoning support for its research in pharmas and hospitals of USA, while systems like ayurveda and siddha don’t share the same and were almost wiped out by the British. They did not simply have the base support and political goodwill to grow and flourish. Unlike allopathy, the traditional systems are only getting their due import in recent days.

    Most people know that modern medicinal system, as you say, is driven by host of factors of which big pharmas play a huge role–be it financial or marketing support. And it’s plainly true that their considerations affect a lot of people in different ways.

    Need I remind you that surgery as a practice started in India by Susruta who used surgical tools when allopathy as a system was nonexistent? Allopathy is a science that derives its major sources from all traditional systems of the world.

    Yes, I respectfully decline what u purport. And if you are a journalist, know that a single example for matter like this is not enough.

    I am not saying Indian medicines are the best; they have glaring deficiencies, but so does allopathy. A joint venture by both in tackling pandemic–ie, modern for emergency and tractional meds for recuperation and recovery–is ideal. What I abhor is people shunning a system like ayurveda and siddha due to wrong assumption due to reports like yours.

  20. As an aware citizen of India, we know there is always a fight between allopathy and AYUSH, and the media took the profit of this fight.

    However, allopathy is unable to treat many diseases that ayurveda/AYUSH can do, and with all side-effects of allopathy, it will always be on the losing side. And media cannot hide the sun, the moon and the truth for long.

  21. Some of the information is helpful. However, you have mentioned that asvagandha has been shown to be a possible cause for severe liver injury by the United States DILI Network. It is featured on the LiverTox database As per NCBI, it is very rare, but you didn’t write that it is a considerably rare side-effect.

  22. The herbs in above table whose side-effects are listed may show the adverse effects when used in large quantity. Secondly, the blood-thinning property of the kadha is an adverse effect when used for such a long period.

    The panic of the pandemic caused much more anxiety, and people resorted to many remedies without proper guidance and supervision, but that cannot be a yardstick to judge the efficacy of ayurvedic drugs in different conditions.

  23. In a running race, even though the person in the first position is the winner, it doesn’t mean that those in the second and third positions are unfit.

    We all agree that allopathy is now a worldwide language in medical science, spread in all continents and countries. But even today, traditional medicine is present in many countries and helping humans as an alternative system.

    First of all, IndiaSpend should respect ayurveda and yoga and accept it as a science helping mankind since centuries. I am a modern doctor, but I am not against AYUSH, and I have also seen positive responses from patients using AYUSH medications. The only problem is the lack of evidence and research.

    I hope IndiaSpend also supports AYUSH to help conduct more research and effective medicines. At the end of the day, allopathy or ayurveda both are for the healthy living of mankind–no need to discriminate further.

  24. Your first paragraph itself seems intentional, as if there is zero mortality of COVID-19 patients under allopathic treatment.

  25. This is a fake article to spread misinformation about ayurvedic treatment. Such tricks won’t help reduce dependence on and usage of ayurvedic treatment in all health issues. In fact, such articles help trigger discussions and increase confidence with ayurvedic treatment.

  26. A proper ayurveda vaidya would have saved that patient unlike helpless allopaths. Self-medication based on brochure is dangerous, more so in ayurveda.

  27. Thousands of COVID-19 patients have been completely cured with traditional Siddha medicines in Tamil Nadu government care centres. Do some proper research before scaremongering around traditional medicine. While the modern toxic drug remdesivir has killed thousands, not a single mortality has been recorded in Siddha care centres.

    • Yes, you are right. There is no mortality in siddha centres. But, that is because any patient with symptoms is sent to higher centres (read hospitals with real doctors ). “Treating” asymptomatic patients and sending away anyone with a complication to modern medicine is actually a very nice way to manipulate data. You need to do some “research” before commenting. I’m not here to discredit alternative medicine. Just pointing out your incorrectness and the audacity to belittle the actual efforts put up by the frontline warriors.

      And also, you know that remdesivir has toxicity if taken in higher dosage because scientists have studied it and documented it with extensive research unlike alternative medicine.

  28. As a reputed ayurvedic practitioner from Bangalore, I wanted to share my opinion about your article.
    As you have stated in the article, no modern medicine like antivirals or steroids has proven it efficacy in treating COVID-19 till date, after doing so much research across the globe. All modern medicines like antivirals are derived from chemicals, which damage vital organs like the heart, liver and kidney–this is also proved by the modern science.

    What’s the use of treating mild to moderate cases of COVID-19 patients with these toxic chemicals? Severely ill patients of COVID-19 with other co-morbidities like cancer, heart or kidney problems, uncontrolled diabetes or hypertension cannot be treated with either AYUSH or modern medicine. For the quick fix, these patients are treated in the ICU with life-support machines like ventilators only to increase hospital bills. In this situation, allopathy is helpless.

    In the process of treating the symptoms rather than dealing with the underlying and primary causes, allopathy has often resulted in creating greater problems than it has attempted to solve, creating side-effects more dangerous than the disease.

    Mild to moderate cases of COVID-19 are well managed with authentic ayurvedic medications. Many formulations are prepared by qualified ayurvedic doctors with due knowledge of every aspect–starting from the selection of herbs, its purification if indicated, standard preparing methods, its dosage etc.

    Ayurvedic doctors study more than 500 herbs with their properties, actions, side-effects, and their accurate dosages in detail. Ayurveda is an age-old, time-tested, ancient Indian system of medicine in which the treatment principles told by our acharyas like Charaka, Sushrutha, Vagbhata etc 5,000 years ago hold good even today and forever. Western people are now getting attracted to ancient Indian wisdom and a lot of research is going on there. India lacks research in ayurveda because ayurveda is not getting sufficient funds for research. Also, the allopathic drug mafia is not allowing it to happen.

    The spread of false information about ayurveda as placebo, not scientific, potentially harmful, damages liver etc by allopathic doctors is baseless. How can they access an ancient medical science without knowing or studying it?

    Now, the nation is awake. People are getting acquainted with knowledge and are conscious. They cannot be fooled by these allegations. The ancient medical science which has withstood thousands of years, and will never be forgotten or allowed to perish.

    Ayurveda is the future healthcare system across the globe.

  29. I have been fighting a lonely battle against the unscientific things going on in our country, which may be killing several thousand people and causing suffering to crores. I am in Hyderabad.

  30. I am ready to challenge you for treatment of COVID in ayurveda. You are writing this article as if no one is dying when taking modern medicine.

  31. Excellent job and an unbiased approach. The efforts are laudable. Truth will enlighten and enrich our medical science. A truthful and holistic approach will make ayurveda practitioners proud, but arrogance and false claims can misguide physician and patients. There is no place for ambiguity and assumptions and non-scientific approach.

  32. You are writing about modern medicine and AYUSH medicine. What about AYUSH doctors/manpower who are used to do the job of MBBS doctors, and use modern medicines to treat COVID-19?

    AYUSH doctors were used by all state governments all over India to work as frontline COVID warriors, with less pay and facilities, compared to MBBS doctors. They should have been spared from such duties of allopathic medicine so that they could focus on AYUSH medicine only, and that might have shown the path to evidence-based AYUSH medicines to cure COVID-19.

    You should write about AYUSH manpower forcefully used to provide modern treatment to COVID-19 patients.

  33. I think the author should make some efforts to talk to ayurveda physicians who have treated thousands of cases. Anyone taking any medicine (including in ayurveda) without a physician is wrong. How can you blame a system of medicine for it ? Also, talk with the researchers who were involved in integrated research.

    The problem is, we are asking fish to climb trees. Asking for medicine or protocol in ayurveda is impossible, because it is individualised medicine. Every prescription is different from the previous one. People talk about evidence; where is evidence for remidisivir or hydroxychloroquine or anything else? In fact, the ICMR says they are not effective, whereas the US FDA approves remidisivir.

    So in allopathy, a drug can be given as treatment without evidence, whereas when it comes to ayurveda, we want evidence. At the same time, the lobby will oppose the conduct of any clinical trial with ayurveda. Can anyone justify this?

  34. With one case of death of a senior citizen, we can not refute AYUSH/ayurveda system of medicine, which should be used as prophylactic against various diseases caused by attack of viruses including COVID-19, as it is an ancient Indian system of medicine.

    But when it seems that the patient is developing acute symptoms, then he/she should immediately approach modern medicine and get treated with antivirals, antibiotics, NSAIDs, steroids and other supplements as well as better medical set-up and diet based on symptoms.

    Last but not the least, follow instructions and guidelines by ministry of health to avoid contracting coronavirus and other viruses.

  35. Certain facts emphasise proper guidance and implementation of AYUSH drugs only by a practiced AYUSH professional and not by quacks.

    With reference to the case of the elective surgery, the doctor himself clarifies the basis of blood thinners and that is what every AYUSH doctor tries to explain. but the modern association of doctors are calling them placebos.

    The opinion of hepatologist who himself proclaims his studies as markers in scientific journal is finding it hard to explain his studies to the AYUSH ministry query over his controversial study and giving advice not to use AYUSH medicines in his letterhead, listing huge packs of AYUSH drugs randomly, and knowingly ignoring the effects of pesticides.

    So if you really want to know in detail, please contact the concerned authority rather than doing PR for certain associations.

  36. What about the 195 patients who died after treatment in allopathic hospitals in Manipur? In this state, no one had turned to Ayurveda but all of them sought allopathic treatment right from the beginning, but they die. Then, which one causes more confusion?

    Almost 99% of COVID-19 deaths in the world are in allopathic hospitals. Why weren’t they saved? Is that not leading to more confusion? Singling out very few cases of ayurvedic treatment for COVID-19 and blaming will not prove anything.

  37. Western medicine could not make a vaccine, and you blame Ayurveda. People were testing negative and then positive for COVID, and you blame Ayurveda. Across the country, thousands have died after testing negative, and the cause of their death was COVID.

    You are scared of Ayurveda. Despite seeking treatment using modern medicine, people are dying. With Ayurveda, at least people are content.

  38. What a ridiculous article by IndiaSpend. Instead of promoting AYUSH as a complementary system of medicine, you are criticising it just because billions of people across the globe believe in traditional systems of medicine. Why should western medicine doctors feel insecure? In fact, AYUSH never claims to cure COVID, but it always talks about helping boost immunity etc. It’s a shame that you don’t take pride in our tradition and wisdom.

    I request IndiaSpend to remove such articles, as you will only find support in a few handful of western medicine doctors. People in general would hate such posts. I think people like me from now on wouldn’t even want to read any articles from IndiaSpend.

Leave a Reply

Your email address will not be published.

*

code