Ayurvedic Herbal Medicine

Place within Ayurveda

The US National Center for Complementary and Integrative Health (NCCIH) describes Ayurveda as an ancient Indian medical system based on writings that take a natural and holistic approach to physical and mental health. It states that Ayurvedic treatment combines products, which are mainly plant-derived but sometimes animal, metal or mineral, with diet, exercise and lifestyle. Herbal medicine is therefore one component of the wider system described on the Machipedia page Ayurveda, which is the place to read about the system as a whole.

Relation to herbo-mineral preparations

A 2008 study of Ayurvedic medicines sold over the Internet notes that metals may be present in some products because of the practice of rasa shastra, described there as combining herbs with metals, minerals and gems. Preparations of that kind are covered on the Machipedia page Rasa Shastra and are not the subject of this page, although the safety literature on contamination often mixes the two groups of products, as discussed under Safety and Suitability.

Limits of the sources reviewed

The sources reviewed for this page do not give a dated, text-based history of the herbal materia medica, for example when particular compendia were composed or when specific formulations were first recorded. This page therefore makes no claims about the dating of individual herbs or formulations. Readers who want that history need a scholarly source from Indology or the history of medicine.

Dravyaguna and pharmacological descriptors

Dravyaguna is the department or field concerned with the properties of substances (dravya) in Ayurvedic pharmacology. A paper from an Ayurvedic postgraduate institute states that rasa, a concept corresponding to taste, is the only perceivable parameter for drug identification in Ayurveda, and that guna (quality), virya (potency) and vipaka (effect of biotransformation) are inferred from the identified rasa. A review of taste receptors lists taste, post-digestive effect, qualities and energetic nature as descriptors used in Ayurvedic pharmacology.

These are concepts internal to the tradition. The taste-receptor review explores whether modern findings on taste receptors and transient receptor potential channels shed new light on them, which is an interpretive proposal rather than a demonstration that the concepts predict clinical effects.

Single herbs, combinations and branded products

The research literature uses several different kinds of product under the Ayurvedic label. A Cochrane review of diabetes studies identified trials of proprietary herbal mixtures, named in the review as Diabecon, Inolter, Cogent DB, Pancreas tonic and Hyponidd, and one trial of whole-system Ayurvedic treatment. Reviews of osteoarthritis trials include named compound preparations such as Rumalaya, and a review of Maharishi Amrit Kalash covers a branded herbal supplement. A result for one product therefore says little about another.

Related Machipedia pages

The term overlaps with several other Machipedia pages. Herbal Medicine covers plant-based remedies across traditions, Rasa Shastra covers herbo-mineral preparations, Rasayana Therapy and Panchakarma cover other Ayurvedic approaches, and Ayurvedic Diet and Naturopathy are separate pages. The sources reviewed for this page do not define the boundaries between these topics, so the divisions here follow Machipedia page structure rather than a published standard.

Forms of product in the literature

Published trials and reviews describe Ayurvedic herbal products in several forms. These include oral herbal mixtures tested for type 2 diabetes, compound preparations tested for osteoarthritis, a triphala mouthrinse compared with chlorhexidine mouthwash for plaque-induced gingivitis, and oral supplements such as Ashwagandha (Withania somnifera) and Maharishi Amrit Kalash. Reviews note that products differ in composition, dosing and processing, which is one reason pooled results are limited. This page does not describe formulas or preparation methods.

Practitioners and training

NCCIH reports that there is no significant regulation of Ayurvedic practice or education in the United States and that no state requires practitioners to be licensed. The World Health Organization (WHO) publishes a 2010 document titled Benchmarks for training in Ayurveda, intended as a reference for training standards. The sources reviewed do not allow a comparison of the content or length of training across countries, and the WHO document was not summarized beyond its title and publication details.

Uses described in the sources

NCCIH presents Ayurveda as an approach to physical and mental health. Individual product reviews describe specific uses. A meta-analysis states that Ashwagandha is widely used in Ayurvedic medicine for stress management, and a review of Maharishi Amrit Kalash states that its two supplements are believed to have beneficial effects on overall health and wellbeing. Trials have also been run on conditions such as type 2 diabetes, osteoarthritis, gingivitis and side effects of chemotherapy.

Care boundary

These are uses that practitioners, manufacturers and trial authors describe. They are not established treatments for the conditions listed, and a use that has been studied in a trial is not the same as a use supported by good evidence. NCCIH advises telling all health care providers about any complementary approaches in use, which applies to herbal products taken alongside prescribed medicines.

Reviews by condition

A Cochrane review of Ayurvedic treatments for diabetes mellitus (searches to 2011) included seven randomized trials with 354 participants, all adults with type 2 diabetes and lasting three to six months: six of proprietary herbal mixtures and one of whole-system Ayurvedic treatment. Diabecon, Inolter and Cogent DB were associated with reductions in HbA1c, fasting blood sugar or both compared with placebo or no additional treatment, while Pancreas tonic and Hyponidd showed no significant glucose-lowering response. The authors concluded that, because of methodological deficiencies and small samples, they could not draw definite conclusions and that evidence was insufficient to recommend these products in routine practice.

A 2014 systematic review and meta-analysis of Ayurvedic interventions for osteoarthritis included 19 randomized and 14 non-randomized controlled trials with 2,952 patients. It reported large effects beyond placebo for the compound preparation Rumalaya on pain and global improvement and effects comparable to glucosamine for Shunti-Guduchi on pain and function, with positive findings for several other preparations based on single trials. The authors call for well-planned trials.

Named herbs and formulations

A 2021 systematic review of triphala included 12 randomized trials with 749 patients. It reported lower LDL cholesterol, total cholesterol and triglycerides in 6 studies, and lower body weight, body mass index and waist circumference in 5 trials in obese patients. Fasting blood glucose fell in people with diabetes but not in those without it, and the authors state that large, well-designed trials are required. A separate meta-analysis of seven trials of triphala mouthrinse against chlorhexidine in plaque-induced gingivitis found a statistically significant mean difference in gingival and plaque indices, with very high heterogeneity (I-squared of 91.76 percent and 96.10 percent).

A 2025 meta-analysis of randomized trials of Ashwagandha found a reduction in cortisol (seven studies) of 1.16 micrograms per deciliter but no significant effect on perceived stress (six studies; 488 participants in total). A 2024 systematic review of Maharishi Amrit Kalash found three randomized trials with 418 participants and mixed risk of bias; two in breast cancer patients reported benefits on performance status, anorexia, vomiting and body weight, and none recorded adverse events. The authors state that the small number of trials makes effects difficult to verify.

State of the evidence

NCCIH states that a few well-designed trials and systematic reviews suggest Ayurvedic approaches are effective, but that most trials are small or poorly designed. It describes a 2013 trial of 440 people with knee osteoarthritis in which two Ayurvedic plant-extract formulations, glucosamine sulfate and celecoxib produced similar pain relief and functional improvement. It concludes that little evidence exists for Ayurveda for other conditions.

Metals in some products

A 2004 study bought Ayurvedic herbal products made in South Asia from Boston-area stores and found that 14 of 70 (20 percent) contained lead, mercury or arsenic, and that each of the 14 could result in intakes above published regulatory standards if taken as recommended by the manufacturer. A 2008 study of 193 Ayurvedic medicines sold over the Internet found detectable metals in 20.7 percent of products, with similar prevalence in US-made and Indian-made products. Rasa shastra products had a higher prevalence (40.6 percent against 17.1 percent), and all metal-containing products exceeded at least one standard for acceptable daily intake.

A report from New York City covering 2010 to 2019 analyzed 584 health remedies collected during poisoning investigations and store surveys, and found a significant association between blood lead levels and estimated cumulative lead exposure among adult users of Ayurvedic medications, with higher average blood lead than users of other remedies. NCCIH states that some preparations may contain toxic levels of lead, mercury or arsenic and that arsenic poisoning from Ayurvedic products is rare. These findings concern products sampled, not every product.

Liver injury

A case series of five patients from Iceland and the US Drug-Induced Liver Injury Network described liver injury attributed to Ashwagandha-containing supplements, typically cholestatic or mixed with jaundice and itching after two to 12 weeks, with liver tests normalizing within one to five months in four patients. A 2026 scoping review of 13 publications covering 25 patients reported that most recovered after stopping the product, but included one case of acute liver failure requiring transplantation and three deaths among patients with pre-existing cirrhosis. The authors advise that people with advanced chronic liver disease avoid Ashwagandha.

A case report describes severe liver injury requiring listing for transplantation after use of a metallic-mineral Ayurvedic preparation, called a bhasma, and its authors call it the first documented case with toxicology analysis. That product belongs to the herbo-mineral group covered on the Machipedia page Rasa Shastra.

Quality, regulation, interactions and pregnancy

NCCIH states that there is no significant regulation of Ayurvedic practice or education in the United States. Trials in the reviews above mostly reported few adverse events: the osteoarthritis review observed no severe adverse events and the triphala review reported no serious adverse event, but these were small trials, and the Maharishi Amrit Kalash trials did not record adverse events. The sources reviewed do not report systematic data on herb-drug interactions, so this page makes no statement about them.

NCCIH advises anyone who is pregnant or nursing to consult a health care provider, because some Ayurvedic products may contain ingredients that could be harmful. Herbal products are not a substitute for diagnosis or necessary conventional care.