Triphala

How It Works

BOTTOM LINE :The anticancer effect of Triphala has not been confirmed in humans.

Triphala is an herbal formulation used in the Indian medicinal system of Ayurveda for the treatment of various ailments. It consists of three medicinal plants: Emblica officinalis, Terminalia chebula, and Terminalia belerica. It is used for anemia, jaundice, constipation, asthma, fever, chronic ulcers, inflammation, obesity and to strengthen the immune system against infections such as pneumonia, tuberculosis, and AIDS. Triphala was shown to have beneficial effects in studies done in laboratory and in animals. However human data are lacking.

Purported Uses

To treat Infections

Studies done in mice showed that Triphala can reduce infections. No studies have been done in humans.

To decrease high levels of cholesterol

Triphala was shown to reduce cholesterol levels in rats with high cholesterol. However, this has not been studied in humans.

To strengthen the immune system

Studies in rats have shown that Triphala can improve immune function but human data are lacking.

Research Evidence

Several laboratory studies have shown that Triphala has beneficial effects. However, it has not been studied in humans.

Side Effects

Intestinal gas Stomach upset Diarrhea.

Clinical Summary

Triphala is an herbal formulation that is widely used in Ayurveda for the treatment of various ailments. It consists of equal portions of dried and powdered fruits of three medicinal plants: Emblica officinalis, Terminalia chebula, and Terminalia belerica. It is used for anemia, jaundice, constipation, asthma, fever, chronic ulcers, inflammation, obesity and to promote immunity against infections such as pneumonia, tuberculosis, and AIDS. Triphala has been shown to have antioxidant, anti-inflammatory, antibacterial, immunomodulatory, chondroprotective, and anticancer properties in vitro. Triphala's effects are due to the polyphenols and flavonoids present in its constituents. It also demonstrated hypolipidemic effects in hypercholesterolemic rats. However, these effects have not been tested in clinical trials. Triphala may cause gastrointestinal side effects.

Purported uses

Anemia Jaundice Constipation Asthma Infections Chronic ulcers Inflammation Obesity Hypercholesterolemia Cancer

Constituents

Amla (Emblica officinalis) Myrobalan (Terminalia chebula) Belleric Myrobalan (Terminalia belerica).

Mechanism of Action

The exact mechanism of action is not known although the polyphenols and flavonoids are thought to be responsible for many of Triphala's effects. Gallic acid, a major polyphenol in Triphala, has antioxidant property. Triphala also increased the reactive oxygen species (ROS) in breast cancer cells (MCF-7 and T-47D), resulting in apoptosis. Terminalia chebula, one of the components of Triphala, was shown to be a potent hyaluronidase and collagenase inhibitor that prevented degradation of cartilage. Triphala also protected mice from radiation-induced mortality. Oral administration of Triphala enhanced the immune functions in rats.

Adverse Reactions

Intestinal gas, stomach upset, diarrhea.

References

1. Sandhya T, Lathika KM, Pandey BN, Mishra KP. Potential of traditional ayurvedic formulation, Triphala, as a novel anticancer drug. Cancer Lett 2006;231(2):206-14.

2. Naik GH, Priyadarsini KI, Bhagirathi RG, et al. In vitro antioxidant studies and free radical reactions of triphala, an ayurvedic formulation and its constituents. Phytother Res 2005;19(7):582-6.

3. Jagetia GC, Malagi KJ, Baliga MS, et al. Triphala, an ayurvedic rasayana drug, protects mice against radiation-induced lethality by free-radical scavenging. J Altern Complement Med 2004;10(6):971-8.

4. Rasool M, Sabina EP. Antiinflammatory effect of the Indian Ayurvedic herbal formulation Triphala on adjuvant-induced arthritis in mice. Phytother Res 2007;21(9):889-94.

5. Kumar MS, Kirubanandan S, Sripriya R. Triphala Promotes Healing of Infected Full-Thickness Dermal Wound. J Surg Res 2007.

6. Srikumar R, Parthasarathy NJ, Devi SR. Immunomodulatory activity of triphala on neutrophil functions. Biol Pharm Bull 2005;28(8):1398-403.

7. Sumantran VN, Kulkarni AA, Harsulkar A, et al. Hyaluronidase and collagenase inhibitory activities of the herbal formulation Triphala guggulu. J Biosci 2007;32(4):755-61.

8. Sandhya T, Mishra KP. Cytotoxic response of breast cancer cell lines, MCF 7 and T 47 D to triphala and its modification by antioxidants. Cancer Lett 2006;238(2):304-13.

9. Deep G, Dhiman M, Rao AR, Kale RK. Chemopreventive potential of Triphala (a composite Indian drug) on benzo(a)pyrene induced forestomach tumorigenesis in murine tumor model system. J Exp Clin Cancer Res 2005;24(4):555-63.

10. Saravanan S, Srikumar R, Manikandan S. Hypolipidemic effect of triphala in experimentally induced hypercholesteremic rats. Yakugaku Zasshi 2007;127(2):385-8.

11. Kaur S, Michael H, Arora S, et al. The in vitro cytotoxic and apoptotic activity of Triphala--an Indian herbal drug. J Ethnopharmacol 2005;97(1):15-20.

Ashwagandha

How It Works

BOTTOM LINE :While ashwagandha has shown an ability to hinder the growth of cancer cells in laboratory tests and enhance radiation therapy in animals, it is unknown if these effects can be replicated in humans.

A popular Ayurvedic medicinal substance derived from the root and berry of the plant. Ashwagandha contains numerous biologically active components. It is thought that some of these components can influence potent hormone-like substances that cause arthritis inflammation. Extracts of the root also increase the number of red and white blood cells and platelets in the blood. Ashwagandha has been shown to relax the central nervous system in animals. Studies in laboratories have shown that extracts of ashwagandha kill some cancer cells and enhance some immune cells. It is thought that the structure of ashwagandha extracts may damage the cancer cells ability to generate the energy it needs to reproduce. Ashwagandha also reduces the level of glutathione, an antioxidant, in tumor cells which may enhance the effects of radiation therapy against those cells. Studies in animals have demonstrated possible toxicity, however comparable effects have not been observed in humans.

Purported Uses

To treat cancer While ashwagandha has shown promise in animal and laboratory studies, few trials have demonstrated an effect in humans.

To treat diabetes No scientific evidence supports this use.

To treat epilepsy No scientific evidence supports this use.

To reduce fatigue Ashwagandha has been shown to increase blood cell counts in the lab, however it is unclear if this will reduce fatigue in humans.

To treat digestive disorders No scientific evidence supports this use.

To maintain health Ashwagandha has antioxidant properties in lab tests, however it is unclear if it will have any effect on humans.

To reduce pain Ashwagandha has been shown to have a tranquilizing effect in animals. It is unclear if this will reduce pain in humans.

To treat rheumatoid arthritis A clinical trial showed effectiveness of a herbomineral formula containing ashwagandha. To what extent ashwagandha played a role in the reduction in pain severity and disability is unclear.

As a sedative Ashwagandha has been shown to have a tranquilizing effect in animals. It is unclear if it has a similar effect in humans.

To treat skin infections No scientific evidence supports this use.

To relieve stress Ashwagandha has been shown to have a tranquilizing effect in animals. It is unclear if it has a similar effect in humans.

Research Evidence

Arthritis Pain : Forty-two volunteers with osteoarthritis participated in a trial of a herbomineral formula containing ashwagandha. Volunteers were randomly assigned to receive either a combination of herbs and minerals or placebo for three months. After a fifteen-day washout period, treatments were reversed. Volunteers in the treatment group reported significant drops in pain severity and disability score with few side effects. Because a combination of herbs was used, it is unclear if ashwagandha played an important role in the results.

Warnings

Do Not Take If

• You are pregnant. (Ashwagandha may induce abortion.)
• You are taking sedatives. (Ashwagandha may increase sedative effects.)

Scientific Name

Withania somnifera. Family :Solanaceae

Clinical Summary

A popular Ayurvedic medicinal substance derived from the root and berry of the plant. This herb is often used as a component in formulations prescribed for stress, strain, fatigue, pain, skin diseases, diabetes, gastrointestinal disease, rheumatoid arthritis, and epilepsy. It is also used as a general tonic, to increase energy and improve health and longevity. Externally, it can be applied as a local analgesic. In vitro, Ashwagandha is effective against breast, central nervous system, colon and lung cancer cell lines. Animal studies suggested ashwagandha have anti-inflammatory, anti-tumor, immunomodulatory, antioxidant and anti-stress properties. Other studies have shown cytotoxic, chemo preventative, immunomodulating, and radio sensitizing effects.The herb may also help prevent chemotherapy induced neutropenia. Small scale human study suggest Ashwagandha may promote growth in children and improve hemoglobin concentration, red blood cell count and sexual performance in adults. A herbomineral formula containing ashwagandha was shown to benefit osteoarthritis in a clinical trial. Ashwagandha has also been found to be rich in iron. This herb may induce abortion. Pregnant women should avoid this herb.

Purported uses

• Cancer treatment
• Diabetes
• Epilepsy
• Fatigue
• GI disorders
• Health maintenance
• Pain
• Rheumatoid arthritis
• Sedation
• Skin infections
• Stress

Constituents

• Alkanoids: isopelletierine, anaferine
• Steroidal lactones: withanolides, withaferins
• Saponins: sitoindoside VII and VIII Iron

Mechanism of Action

Alkaloids, steroidal lactones, saponins and withanolides are thought to be the biologically active components. Studies have pointed to cyclooxygenase inhibition as the cause of the herb's anti-arthritis properties. Ashwagandha's anti-inflammatory effects were comparable to hydrocortisone sodium succinate in rats. The root extract of the herb produced significant increases in hemoglobin concentration, red blood cell count, white blood cell count and platelet count. Ashwagandha has been shown to exhibit antioxidant effects in the brain and to have a tranquilizing effect on the central nervous system in animals. In vitro, isolates from the root of the plant have cytotoxic properties against H-460, HCT-116, SF-268 and MCF-7 cell lines. Ashwagandha increase cytotoxic T lymphocyte production. Other studies show ashwagandha's cytotoxicity is related to its structure and that it enhances ATPase and inhibits succinate dehydrogenase activity, impairing oxidative phosphorylation. In animal studies, ashwagandha can increase the effects of radiation therapy and inhibits tumor growth. The herb also reduces tumor GSH levels which may contribute to the enhancement of radiation response. Ashwagandha can reverse paclitaxel induced neutropenia in mice. Significant toxicity was observed at high doses in animal studies, however, toxicity studies in humans are limited.