Ayurveda for Covid-19: A conversation with Dr. Ramya Bhat

स्वस्थस्य स्वास्थ्य रक्षणम्

आतुरस्य विकार प्रशमनम् च

– (Ch.Sh.Su. 30/26)

The guiding principal and aim of the science of Ayurveda is what is written above. The first line svasthasya svāsthya rakṣaṇaṃ means “to enable an already healthy person to protect his good health”. The second line āturasya vikāra praśamanaṃ ca means to “and to cure any disease that might arise”. These are not only references to the principles of prevention and treatment which Ayurveda encompasses, but also to the way in which one must deal with the patient, even while attempting to treat a disease. Treating one condition should not lead to hampering the patient’s overall health or causing another disease. These high standards of Ayurveda seem very strange when we think of how in Allopathy, it is understood and accepted that treatment for one problem will always lead to other problems. Covid-19 treatment in Allopathy is the classic case of this.

This write-up is a detailed interaction with Ayurveda Physician Dr. Ramya Bhat, whose modest clinic in Bengaluru has been treating Covid-19 patients since the pandemic started. In this interview, she talks about how Ayurveda medicines work with the examples of patients she has treated, including helping patients with complications arising out of prolonged steroid use.

Dr. Ramya Bhat completed B.A.M.S from A.L.N Rao Memorial Ayurvedic Medical College in Koppa, Karnataka. She then completed her M.S from Government Ayurveda college in Bangalore and practiced as a surgical intern at K.C. General Hospital in Bengaluru. She also trained exclusively in Nādi Pariksha under a Vaidya in Trivandrum, Kerala. She comes from a family where several of her mother’s brothers are Ayurveda physicians and her father is a well-respected Vaidya in Mangalore, Karnataka. She is among the few who can understand and explain medicine in the language of Ayurveda and Allopathy.

The language of this interaction has been kept simple and largely non-medical for the benefit of common readers. The write-up has two broad sections focussing on Prevention and Treatment options for Covid-19 through Ayurveda.

I. Prevention – Understanding the mechanism of Vaccines and Immunity Boosters of Ayurveda

For people to make an informed decision, it is necessary to understand the fundamental way in which vaccines work as well as how immunity boosters of Ayurveda work. In this light, Dr. Ramya Bhat answers relevant questions in this section of the interview.

Q: In Ayurveda, is there a parallel for vaccination?

Dr. Ramya: Yes, of course. We give immunity boosters internally, not through intra-muscular, that is, not through injection.

Q: What is the difference in the two methods?

Dr. Ramya: Whenever you give a vaccination, it contains directly the virus or mRNA. So we already have some antibodies in our body and we are adding to it (through vaccine). Whereas, when we take Ayurveda based medicine, we stimulate the liver, pancreas and spleen to produce more and more immunoglobulins (antibodies such as IgG and IgM). These are naturally produced by the liver, and our medicines enable the liver to produce more and more of these.

Q: Would you say one method is better than the other for any particular reason?

Dr. Ramya: Ayurveda is better because it is natural. In a simple language, if we have to understand, vaccine is a method where we are importing something foreign into our body, since we have a shortage of it (antibodies). Whereas in Ayurveda, we are producing antibodies in our own body. So always, what we produce naturally and continuously is better, isn’t it?

Whatever you are importing, what is the guarantee that your body will accept it? For ex., for Covishield they might be taking the mRNA of a chimpanzee³ or something else. What is the guarantee that our body will accept it completely? If our body does not accept it, obviously we will have side effects. And for how many days will it remain in our body and what is its efficacy – these are also not known. A vaccine’s effect may differ in cold countries; in hot countries it may act differently; it will differ from person to person and also with environmental changes. So when we take the vaccine, there is no guarantee that our body will produce all the needed antibodies to fight against the virus. Our body may not accept some of them because they are foreign. That is when we see allergic reactions to vaccines because the body is rejecting the vaccine. The vaccine is common for all, but every human body is different and so the same vaccine may not have the same impact on every body.

In Ayurveda, we stress on keeping desha, guna, kaala, ritu and divas also in mind while prescribing medicines. So when we give immunity boosters based on the these factors, each individual’s body will naturally produce antibodies through their own organs. These antibodies will be there for a longer duration, and there is no question of whether or not our body will adjust to it. Moreover, when our body produces antibodies naturally it will be exactly suitable to our food habits, our environment, our body constitution and will match us perfectly. Whereas with vaccines, such customization to an individual is not possible – it may or may not work. For example, I’ve had patients for whom other problems were resolved after the vaccine. So there was one patient who felt that their joint aches suddenly reduced after the vaccine. I have also had patients who developed newer problems after the vaccine. Personally, I am not against the vaccine; it is each individual’s choice.

Q: How is it that some people develop the infection even after the vaccine?

Dr. Ramya: When that happens it means that the person’s immune level was very low even previously.

Q: So even with vaccine, are you finding that it works better for those who already have a stronger immune system?

Dr. Ramya: Yes, definitely.

Q: The government has officially announced few medicines like Ayush 64 and Sidda’s Kabasura Kudineer as immunity boosters. I have personally tried the Sidda medicine but found it to increase pitta (body heat) and hence discontinued it since I am of a pitta dominant prakriti. What is your take on these medicines? Is it advisable to prescribe one type of medicine for all, regardless of prakriti?

Dr. Ramya: I always treat patients based on their prakriti. However, I have given amrita sattva, which irrespective of prakriti, works well and did not cause any side effect. This is an existing medicine in Ayurveda, also known as guduchi sattva.¹ Whereas, many people have taken turmeric or haridra. But haridra churna did not work for people with pitta prakriti – it increased their body heat. You might have heard about Ayush Kwatha (also certified by Ministry of Ayush). It contains cinnamon and has caused some side effects to people with pitta prakriti like dry cough, ulcers in the mouth and burning sensation in stomach as well as constipation.

So Ayurveda always concentrates on body prakriti and one medicine will not act (in the same way) on all people. Just like food – for some people brinjal is fine but for others it is not suitable. So it is the same with medicines.

Q: Actually, I have noticed that most of the medicines that they are generally prescribing under Ayurveda by AYUSH Ministry are ones that are acting by increasing pitta. Is this in order to counter the respiratory problems which are usually kapha induced?

Dr. Ramya: Yes, that is probably why they are doing it. But actually, we are not supposed to concentrate only on the respiratory system and give the medicine. We need to concentrate on our body’s overall immune system . See, when the virus enters the body, it is not that it will enter only the lungs and cause some problems there. When the virus enters the body, the whole body’s system becomes active and fights against it.

Q: You mean to say that it does not happen in isolation, as in, only in the lungs or some other part, right?

Dr. Ramya: Yes, it does not happen that way. If you have a weak stomach, it will affect your stomach. If you have a weak lung, it will affect your lung. That is how it happens.

Q. This probably explains why there are a wide range of symptoms for people testing positive. I have come across cases where it started off as a dental (gum infection) or a ear infection or sore throat and then they were found to be Covid positive. What are the other cases that you have come across (other than respiratory issues)?

Dr. Ramya: Digestive issues have been seen in many Covid patients. For a lot of people, the reason they developed cough is not because of a respiratory issue. It is because of increased acid secretion causing throat irritation, leading to loss of smell and taste. You might have heard that in many of the indigestion cases, the patient loses the sense of taste and smell. In many cases, loose motions or vomiting has been there. Sometimes, it looks like symptoms of typhoid but Covid was found to be positive. Some may have fever as a step-ladder pattern – sudden shooting up and then no fever at all, without any respiratory symptoms. In one of my patients, his CT scan was absolutely normal but he had all sorts of digestion issues. And another patient of mine came to me with skin rashes all over the body with fever (he was not yet vaccinated and was aged 32).

This is how viral activity happens – it does not go looking for the lungs. It may affect any part of the body because it travels through the blood and affects whichever part of our body is weakest. Just because majority of the people might have had respiratory issues, they concluded that corona means it will affect the lungs. But that is not how it is to be understood and may vary from person to person.

Q: As you’ve said before, ideally, you must see the prakriti and only then prescribe medicines. But not everyone might have access to Ayurveda Physicians who can do that. So is there an existing medicine in Ayurveda which is safe enough for all to take, regardless of prakriti?

Dr. Ramya: Dasamoolarishtam can be safely given for up to 80% people. Amruta Sattva (also called Guduchi Sattva) is safe for everyone. These are all immunity boosters. And of course, Bhoomi Amalaka also. But the dose has to be fixed for each person – that is the only criteria. That means, for example, I cannot withstand 500mg of Bhoomi Amalaka, but I can withstand 250 mg of it. So dose is also important. So whenever we are treating the patient, we must look into prakriti, body weight, agni bala and kaala. Regarding kaala – whenever there is a cloudy weather, medicine has to be given in a small quantity, because large quantity will not be digested.

Q: So again, you feel that it is better to take the advice of an Ayurveda physician and then follow the treatment?

Dr. Ramya: Yes, because not all medicines are suitable for all.

Q: So if Ayurveda medicines are not prescribed according to prakriti, it could lead to some side-effects. How severe could these side-effects be, especially when we compare to side-effects of allopathy?

Dr. Ramya: Usually with Ayurveda’s immunity boosters, if at all there are side effects, it would be problems like gastritis, constipation or symptoms due to pitta aggravation. But it would never lead to problems like kidney failure, liver failure, etc.

(Author’s Note: If you develop side-effects due to Ayurveda remedies, do consult with an ayurveda physician for simple home remedies which can resolve the issue easily.)

Q. So I’m just thinking out loud and wondering if the AYUSH Ministry had to promote immunity boosters in the correct way, how can it be done? Would it help if they had a helpline of Ayurveda practitioners who can be called for online consultation?

Dr. Ramya: Firstly, there should be at least 4 types of immunity boosters, suitable for different prakriti. For ex., for pitta prakriti people, they should have medicines which do not contain cinnamon or other heat generating ingredients. Or else, there is something called anupan (adjuvant). For ex., for Dhanavantari Vati, we advise people to take it with jeera water, so that it does not create trouble. For some people, we advise them to take it with honey. So the adjuvant is also very important.

Then it must be mentioned that the medicine must be taken after consultation with an Ayurveda physician. So the patient must consult an Ayurveda physician and take the immunity booster medicine which is suitable for their specific prakriti. These days every Primary Healthcare Centre (PHC) has an AYUSH practitioner. So they can be consulted for this purpose. And yes, doctors like me can guide patients over the phone also.

Author’s Note:

Recent studies such as the two studies conducted by AIIMS and NCDC show that “About 60 per cent of people who had two jabs of either Covishield or Covaxin and 77 per cent of those who received one jab showed signs of the Delta variant.”

The reason for this is that the corona virus is mutating more than any virus in recent times. Updating vaccines accordingly is going to be a production nightmare. This is further complicated by the fact that for a vaccine to be effective, we need to administer it at least for 70% of the population simultaneously.  Moreover, there are many for whom the vaccines are contraindicated (as mentioned in Health Ministry website) such as for pregnant and lactating women, people with immune issues or coagulation disorder, those on blood thinners, those having cardiac disorders, etc.

Compared to this, building one’s immunity which works irrespective of the mutation of the virus, is a much more effective method. So, even if one intends to or has already taken the vaccine, it is always better to also have traditional immunity boosters and not rely only on vaccines alone. Just make sure that you take the advice of an AYUSH doctors so that the immunity booster medicine prescribed will be suitable to your body constitution.

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II. Treatment – Understanding the action of drugs in Allopathy and Ayurveda

Q: Suppose someone comes to you with the very first sign of symptoms of Covid-19. And you put them on Ayurveda treatment. As the disease progresses, can you explain how Ayurveda works in comparison to how allopathy works (I don’t mean vaccination, but regular allopathy treatment).

Dr. Ramya: Whenever we give Ayurveda treatment in the beginning stage, immediately our body starts acting against the virus and our body starts killing the virus. Whereas in allopathic system, it works by suppressing the activity of the virus. All allopathic medicines work in this way – whether it is an antibiotic, steroid or whatever else, they are suppressing the action of the virus.

So that’s why they have a specific duration for antibiotics – it needs that much time to suppress the virus. But some people may be allergic to certain antibiotics. Sometimes, even after taking antibiotics for longer duration, it may not work, and that’s when they shift to steroids.

For ex., it is like you are keeping some viruses in a room and you have locked the room. After one week, either it will die or some of the virus maybe active and they come out and produce symptoms again and again. Whereas in Ayurveda, we are not blocking the activity of the virus. Instead, we are making our body soldiers fight against them and kill the virus.

Q: You mean, a natural mechanism which will kill the virus?

Dr. Ramya: Yes. For ex., if we consider liver stimulants as per Ayurveda. When the patient is given these liver stimulants, the liver produces more and more immunoglobulins (antibodies). The body also has a lymphatic system with lymphatic glands all over the body. This is the immune system of the body. When the liver is stimulated, the lymph glands also get stimulated. The liver starts with capillaries and ends with capillaries. So every minute level of blood circulation takes place with the help of the liver. It is directly connected with the heart, lungs and other organs. As the liver starts working more actively, and since it is the powerhouse of the body, cellular oxidation increases and each cell starts getting nourished. So every cell in your body becomes capable of fighting against the foreign body. Whereas, in allopathy, most of the medicines are hepatotoxic (damaging to liver cells).

Q: Have you been treating people who are Covid positive? Were these initial stages or did they come to you after complications? How long does it take for recovery through Ayurveda?

Dr. Ramya: We were treating quite a few Covid-19 patients because they feared going to the hospital, especially during the first week of May. They would say “No, if we go to the hospital, only the dead body will be back.” This is mainly due to the side effects of steroids. Not all the deaths are because of Covid-19. Many people were not able to withstand the steroids given and it led to multiple organ failure.

Many people are taking Ayurveda medicines which are working wonderfully for them. And I have seen cases where even after Fabiflu and other steroid medications, after they are discharged from the hospital, they still got fever and breathlessness. After that, they came to me for Ayurveda and we have been able to treat them with Ayurvedic medicines, and they recovered within 5 days or within a week.

One of my patients had fever for almost 15 days before he came to me. He took homeopathy medicine for 5 days and because his fever did not come down, he approached allopathy doctors who prescribed an antibiotic called cefixime. He developed severe tiredness and cough. He was afraid of getting an RT-PCR done. So I advised him to get CRP (to detect inflammation) and D-Dimer tests (to detect blood clots) and both were on the higher side. Then I started giving him treatment as per Ayurveda. He recovered within 5 days. All his breathing difficulties and cough reduced.

Another patient was a lady who was 85 years old and came to me. She too was afraid to get the test done. She was not even ready to get admitted to a hospital. She had high fever and joint pain. Anyway, within 5 days with Ayurveda treatment, I was able to help her recover.

Q: Why are some people developing conditions like diabetes after allopathy treatment?

Dr. Ramya: That is due to steroids. See, steroids are immune-suppressants. They work by suppressing the body’s immune system as well as the viral activity. So whenever you take immuno-suppressants, they have a huge amount of side-effects. When you take steroids, it suppresses all your body functions. And if your body organs are weak, they are not able to come back to the normal situation.

Q: Have people come to you after taking steroids, with pneumonia or other complications?

Dr. Ramya: Yes, yes. I am treating patients with pneumonia, with diabetes, with all sorts of skin rashes and skin diseases, severe hair fall, pigmentation, palpitation – all this after fabiflu or remdesivir were given to these patients. And one of my patients was given steroids for almost 20 days. He now has diabetes, thyroid problem, increased blood cholesterol level, increased liver function tests, and he has protein leakage in the kidney.

Regarding protein leakage advice, I don’t know if the allopathy system is like that or if it is the doctor’s lack of understanding. If there is a protein leakage, it means that the person’s body is not able to digest the protein. But in allopathy, if there is a protein leakage, they ask the patient to take heavy protein supplements. It again increased his (patient’s) albumin in the urine.

Q: What you are saying is true. I have also come across patients to whom this happened. The allopathy doctor asked the patient to start having egg, even though the patient was a strict vegetarian.

Dr. Ramya: No, that’s not right. The patient’s body will not be able to digest it if he/she is not accustomed to it. See, when you are a vegetarian, and suddenly you start consuming non-vegetarian food, your body will never be able to digest it because your body is accustomed to digesting only vegetarian food.

Q. So how do you treat a problem like protein leakage through Ayurveda?

Dr. Ramya: The reason why the protein leakage happens is because protein is not being digested properly. In such a condition, if we ask the patient to take more protein, we are just loading his system. So first, stop taking proteins when your body cannot digest it. Secondly, we give them medicines to regulate and improve the quality of the agni bala (digestive fire).  If your agni bala is not good, there is no point taking protein or any other supplements. In fact, taking excess protein without regulating the agni will lead to formation of ama (internal toxins). When it cannot digest, it will get fermented. And when it gets fermented, it starts spreading all over the body leading to some other complication.

Q. What about post-covid infections? What causes it?

Dr. Ramya: Regarding post-covid infections, when they give antibiotics and suppress the virus, for many people, the virus escapes and settles in the joints. That’s when they develop severe joint aches. For some, it goes into the heart muscle. For many people, they develop post-covid severe skin rashes. Some of the viruses are very strong and do not get suppressed with the antibiotics, and escape. That is why conditions like rheumatoid arthritis are called auto-immune diseases because they occur due to suppressing of the immune system. That’s why immune enhancing medicines in Ayurveda are the best way to treat these conditions, rather than suppressing the virus.

See, even if RT-PCR may come as negative after some time, for some people CRP test will be on higher side or D-Dimer will be on the higher side. What does it mean? It means the virus is still active and causing problems. This is just like how in Tuberculosis, the sputum test might be negative but Mantoux Test² will be positive. So I find it difficult to understand the allopathy system sometimes. The post-covid infections indicate that the immunity is still weak. They have suppressed the virus activity, that’s all. But not all viruses become inactive through suppression. The few that remain active will continue to affect the patient.

A better way to do it (for allopathy) is even if they give antibiotics to suppress the virus, let them also give immunity boosters. That is when it will start working well. Actually, it is my personal opinion that when we combine allopathy with ayurveda or homeopathy for emergency situations, the treatment works wonderfully. That way, the patient will have both instant relief and we can prevent side effects too. But due to the ego clashes of practitioners of different systems, such a method is very difficult to execute. And unfortunately, the patient suffers in the process.

Q: Every time an Ayurveda person says that they have a medicine for Covid-19, ICMR says that it is not a medicine and that it is just an immunity booster. They say it as though an immunity booster is something silly and not a treatment. But the fact is that even allopathy has no treatment as such for Covid-19, right? So what do they mean “this is only an immunity booster?” Is there any other way in which the body can fight an infection without boosting the immunity?

Dr. Ramya: Without boosting immunity, the body cannot fight against any infection.

Let us take the example of Nela Nelli – it stimulates the liver. What does that mean? Stimulating the liver means it is stimulating the liver enzymes. Liver has got maximum functions and it is considered as the power house of our body. It produces vitamins, it produces immunoglobulins, it maintains our body heat. So whenever the quality of the enzymes increases it means that the liver is able to work efficaciously regarding its functions. It is able to produce vitamins and the quality of the vitamins will be very good and it will act on our body immediately.

See, people take Vitamin A supplement to improve the eyesight. But when you take Nela Nelli, Vitamin A will be produced in our body and our eye-sight will improve as a result. I have given liver stimulants to many patients for eye problems, and they have recovered. See, if there is a Vitamin A deficiency, we should find out where the Vitamin A is synthesized. Another example is how Vitamin B12 is synthesized in the intestine. So whenever we have a case of Vitamin B12 deficiency, we need to find out where Vitamin B12 is produced. Vitamin B12 is not produced in the liver; it is produced in the stomach layers. That means, Vitamin B12 deficiency will always lead to pitta aggravation. So we have to treat the pitta, so that the Vitamin B12 will be synthesized fast.

Q: So is my understanding correct that there is no other way to defeat this (Covid-19 infection) other than by building the body’s immunity?

Dr. Ramya: Yes, because it is a foreign body. To fight against a foreign body, you need your body’s soldiers to be very strong. Instead, if you tried to suppress it (through allopathy), it may come back. In addition, it will suppress your whole immune system or else it will lead to some other side-effects.

Q: Can you share a little bit about Black Fungus? Is there any treatment in Ayurveda for it?

Dr. Ramya: Yes, we can treat it through Ayurveda. See, black fungus is because of steroid side effects and continuous supply of oxygen. It is just a fungus, and Ayurveda has treatment for fungus issues. Many-a-time people have treated this with anti-fungal drugs in Ayurveda. And it is very easy to treat actually. You can give them some blood purifiers and of course the immunity builders. Like virus, fungus is also a foreign body. And the liver stimulant is required because the liver is the only organ that can prevent side effects and send the steroids out of the body, because it has the function of detoxification.

Q: Last question – Did you ever test for Covid-19 because obviously you were treating patients who were Covid positive?

Dr. Ramya: (laughs) No, no, I have never tested (for Covid-19). As such I didn’t get any symptom. And I usually take one or the other Ayurvedic medicines every day. And you know, most of Ayurvedic medicines contain Neem or Amrutha Balli or Nela Nelli or one of these (which are natural immunity builders). Moreover, my body constitution is such that I never get a fever. The last time when I got a fever was 2012; after that I never got a fever.

Author’s Note:

While opting for treatment for Covid-19 positive persons, it will be quite beneficial for the patient to include Ayurveda (or Homeopathy) in addition to allopathy even if they are not keen on exclusively going for AYUSH mode of treatment. This is the best way to handle the side-effects which are otherwise turning out to be fatal.  

We encourage you to find an AYUSH practitioner nearest to your location, and get in touch with them for yours and your family’s Covid-19 prevention and treatment options. However, since many of you have requested for Dr. Ramya’s clinic details, we are sharing it below with her permission.

If you are in Bengaluru, you can consider an in-person consultation at her clinic. Address is Aajna Ayurvedic Health Centre, #481, 15^th main road, 12^th cross, near NU Hospital, Padmanabhanagar, Bengaluru – 560070. For online consultation with Dr. Ramya Bhat, please take an appointment by calling + 91 86180 62367.

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References:

1. Guduchi is one of the most commonly used herbs in Ayurveda. It has been studied and found effective in viral fevers, as anti-inflammatory, antipyretic and immuno-modulatory interventions. There are three in-silico studies, which show its high binding efficacy against SARS-CoV-2 targets involved in attachment and replication of the virus, as compared to Favipiravir, Lopinavir/Ritonavir and Remdesivir. About 7 studies are also being done under the Ministry of AYUSH on Guduchi as Prophylactic care on about 1.33 Lakh population and with very good results in preventing COVID 19 and in management of asymptomatic COVID 19 without any side effect. Further detailed rationale of its inclusion has been provided in the Interdisciplinary Committee for integration of Ayurveda and Yoga Interventions in the ‘National Clinical Management Protocol: COVID-19’ which is made available in public domain on the Ministry of AYUSH website. Source – https://ayushportal.nic.in/pdf/faq-covid-protocol-Revised.pdf
2. A Mantoux test is a skin test that is used to detect infection by Mycobacterium Tuberculosis (TB). It is used to determine any immune response in the skin, by any individual who could have been or is being exposed to the bacteria
3. Covishield uses a replication-deficient chimpanzee viral vector based on a weakened version of a common cold virus (adenovirus) that causes infections in chimpanzees and contains the genetic material of the SARS-CoV-2 virus spike protein. Source: https://www.livemint.com/science/health/covishield-and-covaxin-against-covid-19-all-you-need-to-know-about-the-vaccines-11609737696608.html