Ayurveda is one of the oldest holistic systems globally, which believes that the balance between mind, body, and soul is essential to health and wellness. Ayurvedic practices maintain health, reduce stress and enhance flexibility, strength, and endurance. The doshas are a necessary aspect of Ayurveda, and any imbalance in the doshas causes health problems.

Ayurvedic treatment begins with internal cleansing and is followed by a special diet, herbal remedies, massage therapy, yoga, and meditation. Ayurveda is an excellent source of information on how to achieve optimal health through self-care.

Let's look at the case study of a woman who wants to balance her life through better nutrition and digestion.

Supplements recommended:- Brahmi, Yashtimadhu, Shatavari, Kapikachhu, Vidarikanda, Triphala Guggulu, Bilva, Musta, Chitraka, Vidanga, Sahacharadi Thailam, Karpasasthyadi Thailam

Vaidya - Namaste Athreya practitioner family and everyone else. Warm, new year wishes to all of you. May health and peace be upon everyone as we pull to help more people who need health and well-being. Our purpose in doing these podcasts is to help our Ayurvedic practitioners to look at different case scenarios, contemplate and critically evaluate how each case can be managed. My name is Vaidya Jay Parla; Athreya herbs and our members of the practitioner’s family bring you the cases to raise awareness and expertise. The practitioners bring in different cases to discuss, and we also get feedback from them. If one has a case to present, they’re more than welcome to send us an email or call us. So we can take up the case and discuss it with other members through these podcasts. Thank you, Dario, for coming back again on our podcast. For our listeners in the practitioner group, Dario is an Ayurvedic practitioner in Tijuana, right off the border of San Diego in Mexico. He is a long-term Ashtanga yogi. He dwelled upon Ayurveda and graduated from the American University of complementary medicine. He has a certificate in Ayurvedic medicine and is also a talented Kirtan singer. If you have a moment to attend his live show, you should get on Facebook Live and listen to the beautiful songs. Thank you, Dario, for joining us.

Dario - Thank you, Vaidya Jay, for the invitation. Of course, it’s always a pleasure to be here and share the cases that I can see.

Vaidya - We had one compelling case of you being a patient and self-administering Panchkarma. It's all experience that you will have imprinted in your memory, and you will continue to grow your practice. Your critical thinking skills will improve when you do this type of case discussion. Today, Dario has another exciting case. We'll listen to him after I finish chanting and invoking Dhanvantari.
Om Namami Dhanwantrayam Aadi Devam, Surasura Vanditham Pada Padmam, Loke Jara Rugbhay Mrityu Nashakam, Datharam Eesham Vividhaushadhinam. Om Shanti Shanti Shanti Hari Om.Let Dhanwantray guide us in this case discussion. Dario, the podium is yours, and you can start sharing your case.

Dario - Thank you, Vaidya Jay. I had a 33-year-old female client who came to see me. She came to see me primarily because she wants to live a more balanced life with better nutrition and digestion. She gave me three points that were important to acknowledge. The first one was that she has been taking medication for anxiety and depression for two years now. She also mentions compelling lumbar hernia, a lump on her lumbar disc L5 and S1. The other thing that she stated is that she has an irritable colon or IBS. She struggled a little bit with weight. I wouldn't say she's that overweight, perhaps a little, but not a lot. Taking care of her weight is just something that has been a part of her life. These are the major issues that she mentioned. She mentioned that her mother and her brother also have anxiety and depression and are taking medication. The other unusual thing is that her mother has the same symptoms of anxiety, depression, and she also has herniated discs on the lumbar spine. I thought it was interesting that the daughter is following in the same footsteps as the mom. All three of them have allergies. Mother, brother, and she all suffer from acne on their faces.

Vaidya - All of them went through that phase where teenagers had severe acne, which continued for a long time. Maybe after 25-30 years, they had these acne problems.

Dario - Exactly. I wanted to see her lifestyle. At what time she goes to sleep and when she wakes up. She goes to bed at midnight, and she wakes up at 4:15 A.M. She was losing a lot of sleep, which could also add to her anxiety.

Vaidya - What work does she do?

Dario - She's studying to be a doctor. She's doing a medical residency. She's been doing it for four months now, and she did mention that it's stressful, but she likes what she does.

Vaidya - You said about her sleeping patterns; she gets about 4-5 hours of sleep.

Dario- Yes. That's it.

Vaidya - What is Prakriti? Whether she is Pitta, Kapha, or Vata?

Dario - I think she’s Pitta-Kapha.

Vaidya - With Pitta-Kapha, the struggle of a bit of weight also makes sense.

Dario- It also comes from her mom.

Vaidya - The mom looks like the captain of the boat.

Dario - Yes. She's very concerned about her children. She's doing a lot of things for them. Even though they're older, she's paying for the therapies and the consultations.

Vaidya - Is she a single mom?

Dario -No, she lives with her husband.

Vaidya - She must be taking on a lot because of the kids. It's going back and forth because the symptoms are very similar. How about the current patient’s eating habits.

Dario - She doesn't have good eating habits. She tells me that dinner is her main meal. She'll have juice and hot cereal in the morning, and then she skips lunch, and after that, she eats around six or seven. She's not eating wrong; she eats vegetables, fish, or salmon and doesn't eat red meat and chicken. The hours that she's eating are not appropriate. Skipping lunch is the first thing that needs to be addressed because that's altering her digestion and metabolism.

Vaidya - Any alcohol, coffee, smoking, marijuana?

Dario - No smoking. She just takes 1 cup of coffee in the morning.

Vaidya - Does she come to you for yoga practice, Dario?

Dario - She went to my classes about two years ago, and then she stopped because she went to a school in LA, so that she couldn't go to the yoga studio any longer. Two weeks ago, she again started taking classes with me via Zoom. Another issue is that she does not exercise much.

Vaidya - How is the menstrual cycle? Did you get her menstrual history?

Dario - Yes, her menstrual cycle started when she was 12. It's regular and lasts for about 5-7 days. It's pretty heavy, and there’s a lot of fluid. There's no pain or discomfort—just the heavy flows.

Vaidya - Does her anxiety or depression relate to her cycle, or is it independent?

Dario - Depression comes with the cycle.

Vaidya - Any dreams during this time, or is she just a good sleeper? She sleeps those 5 hours very solid.

Dario - She sleeps but wakes up tired.

Vaidya - What kind of medication is she taking, and when does she take her antidepressant and anti-anxiety pills?

Dario- She takes them every day.

Vaidya - She takes them in the night and then goes to bed, or does she take it in the morning?

Dario - Let me see if I have those details.

Vaidya - I just think maybe she's knocked off because those pills sort of putting her down to sleep, and when she wakes up groggy. Is her digestion and bowel movements regular?

Dario - Yes, she has one movement in the morning.

Vaidya - Any Gas or bloating?

Dario - It's one thing that is not on my notes, but it's something I need to talk to her about tomorrow.

Vaidya - No Amlapitta or Acid reflux symptoms in the past?

Dario - No

Vaidya - Headaches?

Dario - No. Not any headache.

Vaidya - Urine and sweating are okay; nothing abnormal, right?

Dario - Yes, it looks okay.

Vaidya - Any other part of the body with skin issues other than acne.

Dario - No, that was it. She mentions that she has a sweet and a hot spicy taste in her mouth which sounds strange.

Vaidya - Even though she's not eating, she tastes them in her mouth. That's interesting, Katu and Madhur Rasa.

Dario - She doesn't like cold weather. She says that she's allergic to pollen and pollen dust.

Vaidya - Let us look at what is going on in this case. First of all, I want to see the chronology of all these symptoms. She had back pain in the beginning, depression, and anxiety started two years ago, for which she started taking medication. Before the back pain when she was coming and seeing you for Yoga, Did she mention the lower back pain or low back issues that she's having.

Dario - It was a long time ago, and I don't remember if she mentioned anything like that.

Vaidya - How about IBS? Was it a long-term diagnosis or a recent one?

Dario - It's Four Years with the IBS. She did see a doctor for that, and the doctor said to eat a lot of vegetables and drink more water. She wasn't given any medication.

Vaidya - It's a good thing that she's not on any medication. For all our listeners, these types of cases are unique and exciting. We want to differentiate whether it is the Manasik Vyadhi that turned into Sharirik Vyadhi. From Psychological origin to somatic body manifestation. It looks like because there is a history of Mom and Brother having the same issues, her condition appears to be the result of a preconditioned mental state in which she has to prove herself constantly compelling. She has to stand for herself without much support. For all our listeners, I may be speculating at this point. But there is a strong familial tendency in this case. The mind would have caused the primary Dosha imbalance, causing it to enter a rajasic state. Rajas are capable of aggravating both the Vata and the Pitta. Initially, it looks like Vata because it went into the relationship between Prana and Apana, and Apana got a little disturbed. The function or location of the Vata is Pakvashaya and Kati. Pakvashaya is the large intestine. It first disturbed the large intestine. The dhatus present in the large intestine started becoming weaker, which led to the IBS symptoms. Then the lower back pain or the displacement of the intervertebral discs in the Kati (lower back) also simultaneously happened to cause Vata in the colon to become aggravated with an association with the Pitta. Vata was the primary one, which also went to the spine, involving the lower back. These were unable to continue to move downwards correctly, even though she has regular bowel movements. If Nidra (sleep) is missing, the first Dosha to aggravate is Vata. She must be undergoing rigorous training now because she is in a residency and is expected to perform at her best. She must be in a very demanding position during her residency. That was the start of promoting both Pitta and Vata. Sadhaka Pitta may be involved in the heart; the Bhrajaka is also involved in the skin. All of this is a combination, Vata is primary, and Pitta is secondary; multiple symptomatologies are what we are seeing. In this case, we will simultaneously work with both Manas (Mind) and Deha (Body). For the mind, you want to make sure that it is adequately supported so that, even if she isn't sleeping much, the reason can perform the way she wants it to. There can be a choice of few things for the manas. We can begin with Brahmi tea twice a day, and, along with Brahmi, we can use Yashtimadhu tea. Yashtimadhu is licorice, as all our listeners know. We are using these two because she has a sweet taste in her mouth, which indicates she is longing for sweetness in life. Vata aggravation indicates Madura inclination, and Pitta aggravation indicates Katu. Sometimes she feels sweetness in the mouth, which she is longing for, and the pungent taste is the intensity of life she's experiencing. Yahtimadhu being sweet reduces Tridosha and also balances the Vata and the Pitta. Yashtimadhu is also Medhya (beneficial for Mind). We can use half a teaspoon of Yashtimadhu and one teaspoon of Brahmi. She should drink it as a cold infusion, like a Hema, but more diluted. Add one teaspoon of Brahmi and half a teaspoon of Yashtimadhu to a cup of water and soak it overnight. The following day, mix it, strain it, and drink it. She'll make another batch in the morning and then leave. When she returns in the night, she will drink it and go to bed.

Dario - Okay. How much Brahmi?

Vaidya - One teaspoon

Dario - Mixed with Licorice?

Vaidya - Yes, Licorice, half a teaspoon. Brahmi is Sara, and it is Tikta. Brahmi Sara Tikta Laghurmedhyachashitala. Brahmi is cold in potency, and it is Sara. In this case, the Guna that has increased is Laghu. The Laghu quality is commonly present between the Vata and Pitta. The Laghu quality is moving everything upward. Vata and Pitta containing the Laghu quality can be controlled by the Yashtimadhu. The second quality that is increased is the Tikshna quality of Pitta. The Sara quality can heal the Tikshna quality of Pitta, and that means wherever it is stagnant, you need to make it flow. The one property you find in Brahmi is Sara, and it makes pitta move to be cool. Both of them are Medhya. When you take that, Pitta will start to move from wherever it is stuck. I wanted to ensure that she should not be given herbs like Sarpagandha or something more substantial like Medhyas because she's on medication for depression and anxiety. It should be as mild as possible. Preferably in the morning and night so there is a difference between relaxation and activity, and the body has time to adjust to the mind's rapidity. This is the first method that we are using for this reason.

Dario - You wouldn't add ashwagandha?

Vaidya - Right now, no ashwagandha because the quality we are targeting is the Laghu quality, Tikshna quality, and Chala quality of the Vata and Pitta Doshas. Even though earlier you said that she is Pitta-Kapha Prakriti. She doesn't like the cold weather, and that's because of Vata's aggravation. Our goal is to make sure the Laghu quality is balanced. We are dealing with Yashtimadhu and Brahmi because Madura rasa is essential for Vata. Give her Gritham Abhyanga with Brahmi Gritham. We will suggest that she puts the Ghee on the body and then massage herself when she comes back from her hospital work. She can come to you weekly, and you can perform the Abhyanga for her. At present, it can be difficult because of the COVID, but at some point, you can ask her to come. Gritha Abhyanga is extremely good for Pitta that has Laghu quality and is trying to affect the skin.

Dario -Will that have a buttery smell to it? She may not be used to putting something that smells like butter on her skin.

Vaidya - It does not smell like butter, but you can take less quantity. She can rub the body with one and a half teaspoons of Ghee. Then, we can use the Brahmi Thailam (Oil). I hesitate to use the Thailam because she has Pitta that the Vata is taking with the Laghu quality towards the head and neck region. That's why I thought the Gritham would be okay. Otherwise, we can use the Thailam. You have to apply it, take a bath, and then go to bed so that she feels calmer. The Gritha or Thailam that we use for our Abhyanga makes her feel more grounded and in her body. She has to touch every part of the body to do Abhyanga. She will feel more present in her body when she goes to sleep. She will wake up a little more enthusiastic in the morning. That is the one thing that you can suggest. During the day, Atharva balancing can be perfectly done, a combination of Shatavari with Kapikachhu and a small quantity of Vidarikanda. Suppose she is doing any kind of exercise during the day as an energy-boosting combination food. We can mix one teaspoon of the Shatavari, one teaspoon of Kapikachhu, and one teaspoon of Vidarikanda with almond or any other kind of milk. This will also be Brimhana. We don't want her to gain weight, but what's happening is, She eats a large meal at night and a light meal during the day. Whatever Vata is aggravating during the day because of our activity and Pitta that is aggravated during lunchtime, she will drink it between 11 and three o'clock sometime, which will help her feel like she's been cared for and nourished, and supported. That is the purpose of doing this. One time a day, she will drink that.

Dario - One cup?

Vaidya - In one cup of almond milk, she will add one teaspoon of each of these, then drink it.

Dario - What will be a second option for the milk? What are the types of milk she can add?

Vaidya - She can use Almond milk, Oat milk, and Flax milk easily. We have approached two things with all this, Dario. First, we went to the mind. Second, we are going towards her female being. The third thing is that we need not forget the Agni and Koshta. For that, I would highly recommend that during the day, you give her some cardamom pods. Tell her that these are your pods, and you will eat about two a day. You open them, and you just chew on the seeds. The Pitta is aggravating because of Sheeta virya dravya the cardamom Ela. It also has a calming effect on the mind. So she will eat those pods during the day, like a mouth refresher.

Dario - She can continue doing that for a month?

Vaidya - Yes. In Charaka Samhita, Lavanga and Ela are mentioned as Nitya Dravyas for Mukh Shodhan (Mouth refreshment)

Dario - Hopefully, she'll like them too.

Vaidya - I have never seen a person who says this is not good. After some time, people get used to it. For the Grahani that she's having, I would start with Triphala Guggulu. We will give one Triphala Guggulu in the morning, 1 in the afternoon, but two at night (1,1,2) because she will continue to eat heavy meals at night time. She will not make a drastic change the moment we suggest. Apart from Triphala Guggulu, you can give her Bilva, Musta, Chitraka, and Vidanga. If this combination is too much for her to take, you can just give our Healthy metabolism a combination of Trimada. A healthy metabolism will be given 2 in the morning, 2 in the noon, and two at night after food (2,2,2). These are the internal herbs that we are using, and that is enough because otherwise, it will be too big of a program.

Dario - Yes, overwhelming.

Vaidya - Yes, overwhelming. You can suggest a couple of essential oils that she can put on during the day whenever she feels she's a little anxious. When she puts these essential oils on, she will do 3 minutes of deep abdominal breathing, where she counts 5 or 6 while inhaling, and then she will count 10 or 12 while exhaling. So whatever information she is accumulating makes her anxious is leaving her in the form of a long exhalation.

Dario - At what time would she do this?

Vaidya - Whenever she feels anxious, she will take the essential oils, apply them, and then do the breathing exercise. The essential oil that she can use is bergamot oil which is good. The second oil that she can use is Vetiver oil. Vetiver oil is a cooling oil.

Dario - That's my favorite.

Vaidya - Great. You can ask her to use either Vetiver oil or Bergamot oil. She will keep it in the pocket when she's walking around and smell it from time to time. Sugandha Dravya is a good relief from a bit of mental agitation that will occur during the day. This is what we will do for this patient. You'll be seeing her soon, and then we'll follow up with this case, possibly with another small podcast, to see how she's feeling with all of our suggestions so that our listeners can relate to it. What did we do, and how did it impact the patient? We can use a specific oil on the back.

Dario - Sahacharadi?

Vaidya - Yes, Sahacharadi, or we can use the Karpasasthyadi Thailam, or Snigdha Ushna Dravyas can be used. But right now, the main thing is to get her mind-body together. In our university, we do Kati Basti because it doesn't expose the patient face to face. If it is okay, you can do Kati Basti for her. For Kati Basti, you can use the Sahacharadi Thailam and the Karpasasthyadi Thailam, which is meant for Sandhi, Snayu, and Kandara. I would advise waiting for the first month until her body begins to respond, then we can do the external treatment.

Dario - Sounds good.

Vaidya - It will be a comprehensive program for her to do. We will look forward to your feedback on how Rogi responded to your protocols for our discussions so that all our listeners can also get our feedback form from this case.

Dario - Yes.

Vaidya - Thank you so much for bringing this case, Dario. I'm really happy that we will be able to do these cases more frequently. You can bring any case to us. All our practitioners need to know how to handle it. This is a wonderful case because we'll be treating it as we speak, and then we will come back to reassess our approach. Thank you so much, Dario, for joining us.

Dario - Thank you, Dr. Vaidya Jay. It’s a pleasure.

Vaidya - We look forward to having you again on our Podcast. Namaste.

Dario - Namaste.