PARKINSON’S DISEASE & AYURVEDA
by Dr Suneet Arora, Ayurveda Physician.

Ayurvedic medicine has a great deal of practical experience in treating kampavata, the ancient correlate of Parkinson’s Disease.
While the use of the l-DOPA-containing herb Kapikacchu (Mucuna pruriens) has received much attention, comprehensive treatment of this condition requires a much more holistic approach.

Parkinson’s is an incredibly complex disease with several motor & nonmotor features.
That is why Parkinson’s medication even 3-4 times daily do not work after a while.

Ayurvedic treatment for this condition is not simple. The real effect of Ayurveda lies in its ability to reform and re-constitute the subtle energetic body which is the foundation of health and the cause of disease. Treatment mandates complete purification through one or several courses of panchakarma chikitsa, carefully selected herbs, mineral, and metal derived medicines, a proper diet, and a healthy lifestyle which includes regular asana, pranayama, and meditation practice. Following these recommendations, however, will not only improve the physical symptoms but may eventually give insight as to the psychological factors contributing to the disease. Living in disharmony with one’s unique nature (prakriti) is the root cause of disease and re-aligning oneself at the physical, emotional, intellectual, and pranic levels is essential for true healing to take place.

The Ayurvedic approach to Parkinson’s Disease goes far beyond the effect of our herbal medicines on brain chemistry. The approach outlined above is based on healthy lifestyle changes, refinement of the mind through Yogic practices, and living in harmony with Nature.

Diagnosis of Parkinson’s Disease in Ayurveda
In classical texts, Nanatmaja Vyadhis are mentioned (endogenous diseases caused by a single dosha), Ayurveda lists the 80 most common ones caused by Vata dosha. One of these 80 Vata-caused diseases is called “Vepathu,” meaning shaking or trembling. This term is derived from the Sanskrit root vip meaning “to tremble, shake, vibrate, shiver, or quiver.” Another Sanskrit word for tremble or shake is kampa and the condition originally known as vepathu came to be commonly known as kampavata. Ayurveda described vepathu as being characterized by sarvang-kampa (feeling of whole body tremor) and shiro-kampa (head tremor). Later, the term “kampavata” appeared in Ayurveda texts, describing kampavata as a condition whose symptoms more closely resembles modern day Parkinson’s disease, i.e., karpadatale kampa (tremor in the hands and legs), nidrabhanga (sleep distrubance), kshinmati (slowness of utterance and thought).

If we study the all available literature of Ayurveda the following are the key observed symptoms of kampavata
Kampa (Tremor), Sthambha (Rigidity), Chestasanga (Slowness Of Movement), Vak Vikriti (Speech Disorder), Avanamana (Flexion Posture ), Kshinamati (Dementia), Smritihani (Loss Of Memory) and Vivandha (Constipation)

Kampa (tremor) is described to occur many parts of body including Shirakampa (tremor of the head), Oshtakampa (lip tremor), Hastakampa (tremor of the hands), Padakampa (tremor of the legs).

Parkinson’s Disease (PD) is a chronic, progressive neurodegenerative disease characterized by both motor and nonmotor features. The motor symptoms of PD [resting tremor, bradykinesia (slow movements), and muscular rigidity] are attributed to the loss of nigrostriatal dopaminergic neurons, although the presence of non-motor symptoms (sleep disorders, depression, and cognitive changes) which almost always precede the classical motor symptoms supports neuronal loss in non-dopaminergic areas as well.

CAUSE OF PD AS PER AYURVEDA
Etio-pathogenesis means knowledge of how a disease process begins and then proceeds. Ayurveda has a sophisticated method of understanding how every disease forms and identifies the six stages of advancement of any disease. This method is known as samprapti (from samyak, proper, correct and prapta, to deduce through observation). Sometimes samprapti is alluded to as the Six Stages of Disease.
The samprapti of kampavata (PD), the recurring theme will be vata vitiation, although the other two doshas—particularly Kapha dosha—play important roles.

When Vata begins to accumulate due to diet, lifestyle or just getting older, it is in the colon that this process begins. If no measures are taken to reduce it, it will continue to accumulate and become aggravated to the point of overflow and spread into the gross (blood) and/or subtle (nadis) circulations. This mixing of excess Vata dosha with the blood (dosha-dushya sammurchana) disturbs vyana Vata subdosha leading to signs of Vata vitiation anywhere in the body (coldness, dryness, roughness, irregularity, lightness, quickness, loss of density, loss of structure). If Vata relocates (sthana-samsraya) into Majja Dhatu it can cause dysfunction of the sensitive homeostatic centers in the brain and brainstem. In Parkinson’s disease we know that there is damage to the extrapyramidal nerve tracts whose neurons originate in the medulla and pontine regions and regulate fine motor movements. This damage is the result of Vata dosha which initially accumulated in the pakvashaya (colon) entering and relocating to this brainstem region (majja dhatu).

While predominantly a Vata disease, kampavata (PD) also involves varying degree of Pitta and Kapha dosha vitiation as well in different individuals. Pitta vitiation represents an inflammatory response--possibly to toxic protein affecting neurons. This same protein later forms intracellular clumps known as Lewy Bodies—a manifestation of dysregulated Kapha dosha.

Ayurveda teaches that dushyas are the tissues which are made dysfunctional by contact with the vitiated doshas. In kampavata, the vitiated doshas are apana Vata, vyana Vata, Tarpaka Kapha, and shleshaka Kapha. These vitiated doshas combine with majja dhatu which becomes the pradhana dushya (main disrupted tissue).

Signs & Symptoms of Parkinson’s Disease:
Tremor at rest; rigidity on passive movement (“cogwheel rigidity” of the limbs); slowness of movement (bradykinesia); shuffling feet when walking; decreased bodily movement (hypokinesia); arms don’t swing normally when walking; postural instability; festinating gait; mask facies, the face appears to be fixed and without expression
These features are unilateral at onset, but become bilateral as the condition progresses. Later, postural instability (and falls), orthostatic hypotension, and dementia can develop.
The cardinal motor symptoms (experienced by the patient) of Parkinson's disease are: shaking (lips, arms, legs); stiffness; difficulty getting up from a chair; slowness; feet feel “stuck to the floor” when walking or changing directions; restriction of movement; difficult to initiate movements; postural instability

Common non-motor symptoms include: Cognitive impairment, especially with concentration; Sleep disorders, such as excessive daytime sleeping, insomnia, or REM Sleep Disorder; Depression; Anxiety; Postural hypotension (low blood pressure when standing); Constipation; Frequent urination; Impaired speech (slurred or low volume) and swallowing; Drooling; Anosmia (loss of sense of smell)

Treatment of Parkinson’s Disease:
The Neurologist starts with conventional symptomatic anti-Parkinson disease medications that can provide good control of motor signs of Parkinson disease for 3-5 years. After this, disability often progresses despite increasing the dosages, and many patients develop long-term motor complications, including fluctuations and dyskinesias, balance difficulty, and dementia.

AYURVEDIC TREATMENT OF PARKINSON’S
Before explaining the details of Ayurvedic treatment, you need to know that kampavata is a vatavyadhi condition (diseases caused by spread of vitiated Vata dosha throughout the mind-body).
Vatavyadhi diseases are divided into two types i.e. Dhatukshayajanya and Margavrodhjanya. Dhatukshayajanya diseases are caused by the destruction or loss of vital tissues; Margavrodhjanya diseases are caused by blockages to the proper flow of energies and nutrients through their channels.

The precise treatment of the patient with kampavata will depend on the physicians understanding of which type of vatavyadhi is present, the patients unique prakriti, vikriti, lakshanas, samprapti, satmya, and several other factors. Here, I can outline the general principles that I have found effective for many of my patients.

In dhatukshayajanya vatavyadhi the weakening and reduction in majja dhatu results in the srotamsi (channels) composing that tissue to become empty. That vacuum is filled up by Vata dosha leading to Vatavyadhi. The treatment of any dhatukshayajanya vatavyadhi, including kampavata boils down to three approaches which can be implemented concurrently or in sequence, based on the characteristics of both the patient and the disease.

1. Complete purification and removal of toxic substances from all of the dhatus (tissues) by Panchkarma, that exists and is designed expressly for this purpose.
2. Controlling vitiation of Vata dosha
3. Correcting the destruction of involved dhatus

Panchkarma remains the main line treatment of Parkinson’s Disease.
It starts with preparing the patient for Panchkarma (Purvakarma), Then snehana (internal and external oleation) with swedana (sudation), and the Pradhan karma (major part) of Virechan (purgation), followed by post procedure treatment (sansarjan karma).
After this, the main therapy starts of BASTI Karma (therapeutic retention enema) of oils (anuvasan basti) and decoctions (niruh basti) for 8/15/21 days.

Common Ayurvedic medicines used in PD

Single herbs: Amalaki, Guduchi, Ashwagandha, Kapikacchu, Kushta, Rasna, Shankhapushpi, Mandukaparni, Yastimadhu.
Compound Medicines: Shatavaradi Guggulu, Amritadi Guggulu, Arogyavardhini etc. with Mashabaladi kwatha, Dashmoolrasnadi kwatha, Atmaguptaharitakadi kwath, Gambharipippiladi kwatha
Ayurvedic Ghees (Ghritas): Narasimha rasayana, Dashmooladi ghrita, Apatyakara ghrita, Brahmi ghrita, Saraswata ghrita, Mahatriphaladi ghrita, Ashwagandha ghrita, etc.
Mineral and metal substances (Rasaushadhis): Brihat Vatachintamani Ras, Rasaraja Ras, Smritisagar Ras, Abhrak bhasma, Suvarna bhasma

In west, researches on CBD oil is being conducted and has been found beneficial in PD.

Pathyapatha (Diet): A well-balanced, nutritious diet with sufficient fiber and healthy fats is the recommendation. Foods should be as much as possible organic. In truth, the most beneficial diet is a Vata-reducing Ayurvedic diet because it would support the actions of the medicines prescribed which also in most cases seek to reduce Vata dosha.

Asana/Pranayama/Dhyana (Yoga postures/Breathing Exercise/Meditation) are useful adjuvants in the treatment: The aspect of health involving subtle energies are addressed by these practices which are considered as essential as the physical therapies and herbal medications described above.

The treatment of Parkinson's Disease is not an easy walk, and both the patients and the attendents get impatient and frustated, NEVERTHELESS AYURVEDA SURE GIVE HOPE OF A BETTER QUALITY OF LIFE (QOL) FOR A PD PATIENT. 

About the question mostly asked at our clinic, thet can ayurveda treatments be taken along with allopathy/ western medicine, the answer is YES, both can be taken together; and aometimes one treatment can be supportive of the other.

Note:
Treatment kit for parkinsons can be delivered to your doorstep after online consultation.
For online consultation,
Call 0161-5028269; Whatsapp +91 7589001373; e mail: [email protected]