Kerala Journal of Ayurveda

Phytoestrogens and Phytoestrogen-Containing Ayurvedic Botanicals in Breast Cancer: A Narrative Review of Molecular, Preclinical and Clinical Evidence

Sruthi K P, Pradeep K — Wed, 30 Sep 2026 00:00:00 +0530

Phytoestrogens are plant-derived polyphenolic compounds capable of interacting with estrogen receptors. They may exert estrogenic, anti-estrogenic, or selective modulatory effects based on several endogenous factors. In Ayurveda, many herbs contain phytoestrogenic compounds are effectively used in various gynaecological disorders. Breast cancer is the most frequent malignancy in women. Approximately 70–80% of breast cancers are ER-positive and depend partly on estrogen signalling for tumour growth.

This narrative review explores the role of phytoestrogen-containing Ayurvedic herbs in breast cancer. Literature was collected from PubMed, Scopus, Google Scholar, ScienceDirect, and Ayurvedic sources. The review focuses on molecular mechanisms, effects on different breast cancer subtypes, estrogen receptor modulation, receptor-independent pathways, and available clinical evidence supporting their integrative therapeutic potential.

Phytoestrogen-containing Ayurvedic Rasayana herbs such as Ashwagandha (Withania somnifera), Shatavari (Asparagus racemosus), and Yashtimadhu (Glycyrrhiza glabra) exhibit diverse biological activities that may influence breast cancer progression. These herbs act through both estrogen receptor (ER)-dependent and ER-independent mechanisms, modulating pathways involved in cell proliferation, apoptosis, inflammation, oxidative stress, and signal transduction. In ER-positive breast cancer, phytoestrogens may produce either anti-proliferative or proliferative effects depending on dose, receptor subtype balance, and endogenous estrogen status. In ER-negative and triple-negative breast cancers, their actions are primarily mediated through anti-inflammatory, antioxidant, and pro-apoptotic pathways. From an Ayurvedic perspective, these Rasayana drugs support systemic balance, tissue rejuvenation, and metabolic regulation, concepts that align with personalized therapeutic approaches. However, concerns regarding dosage, safety, hormone-sensitive tumours, and herb–drug interactions warrant caution. Further well-designed clinical studies are needed to establish their efficacy and safety in integrative breast cancer care.

Unveiling treasures in Ashtavaidya tradition: Patola Kera Ghrutham; A therapeutic review in the purview of Pediatric skin diseases

Anu Mariam Varghese, Lekshmi Priya, Reshma Santhosh, Athulya N B — Wed, 30 Sep 2026 00:00:00 +0530

Kerala Ayurveda is renowned for its Ashtavaidya tradition, which represents a continuous, clinical and textually grounded medical lineage. The Ashtavaidya tradition of Kerala Ayurveda has preserved numerous Anubhoota Yogas developed through sustained clinical experience and classical wisdom. Patola Kera Ghrutham is one such formulation, derived from the classical Patoladi gana described in Ashtangahridaya and widely used in the management of dermatological disorders, particularly in children. This review critically analyzes Patola Kera Ghrutham with respect to its textual basis, pharmacological attributes of individual ingredients, method of preparation, and observed clinical utility in various conditions, with special emphasis on pediatric and sensitive skin disorders. The formulation comprises Patola, Katurohini, Chandana, Madhusrava, Guduchi, and Patha processed in coconut milk. This combination with a coconut based lipid medium enhances palatability, patient compliance, skin nourishment, and therapeutic applicability, especially in pediatric patients. The ingredients possess anti-inflammatory, antibacterial, antifungal, antimicrobial, antioxidant, hepatoprotective, and wound-healing properties. Traditional clinical experience indicates its utility in kapha-pittaja skin disorders, pediatric dermatoses, pruritic conditions, toxicological manifestations, and inflammatory skin diseases. Patola Kera Ghrutham represents a valuable Anubhoota Yoga of the Ashtavaidya tradition with promising applications in dermatological practice. Further clinical studies are warranted to establish its safety and efficacy.

A COMPREHENSIVE REVIEW ON NABHINIRVISHADI AGADA

Devika G S, Shiji R S, Abeena R — Wed, 30 Sep 2026 00:00:00 +0530

Agadatantra, a specialized branch of Ayurveda, is dedicated to the diagnosis, prevention, and management of various toxicological conditions (visha). Kerala has historically held a prominent place in visha chikitsa (toxicology), supported by a wealth of traditional texts and practices. Among the notable contributions is Prayoga Samuchaya, a classical text authored by Kochunni Thampuran, which compiles practical formulations used by Kerala's traditional visha vaidyas. The fifth chapter (Panchama Paricheda) of this text includes an important formulation known as Nabhi Nirvishadi Agada, renowned for its efficacy in managing sarva visha (various poisonings).It has 36 ingredients and mode of administration include jihwagra lepana (application over the tongue tip)and application over the vrana mukha(mouth of the ulcer or wound).

This review paper aims to explore the therapeutic potential of Nabhi Nirvishadi Agada based on Rasa Panchaka principles.

AYURVEDIC MANAGEMENT OF ATTENTION DEFICIT HYPERACTIVITY DISORDER- A CASE REPORT.

Sohini S, M D Sheba, Anilkumar M V — Wed, 30 Sep 2026 00:00:00 +0530

Attention Deficit Hyperactivity Disorder (ADHD) is one of the most frequent neurodevelopmental disorders in childhood, diagnosed in childhood characterized by persistent hyperactivity, impulsivity and inattention which significantly affects the scholastic performance, and impairs in daily living. The prevalence of ADHD in India falls approximately 6–11% of children^. In Ayurvedic medicine, psychiatric and behavioral problems are linked to the vitiation of Dhi (intellect), Dhriti (retention), and Smriti (memory), a state referred to as Prajnaparadha. This case report explores the clinical management of a 6-year-old male child presenting with a neurobehavioral profile, including increased hyperactivity, frequent temper tantrums, inattention, echolalia, and inappropriate laughter. Using the diagnostic framework of the DSM-5, the patient was subjected to a comprehensive one-month therapeutic protocol involving internal Ayurvedic medications, In-Patient (IP) procedural treatments, done ehavioral and speech therapy. Clinical progress was rigorously monitored using the ADHD T2 scale, Vanderbilt parent Assessment Scale, and the Clinical Global Impression (CGI) scale. The results indicated a significant reduction in hyperactive symptoms and an improvement in attention span. These findings suggest that addressing the cognitive triad of Dhi, Dhriti, and Smriti through traditional Ayurvedic interventions can lead to remarkable clinical improvements in such kinds of neurobehavioral disorders, providing promising results.

AYURVEDIC MANAGEMENT OF ERYTHRODERMIC PSORIASIS-A CASE REPORT

Priya Raju, Seemaja G — Wed, 30 Sep 2026 00:00:00 +0530

Erythrodermic psoriasis is a rare and potentially life-threatening variant of psoriasis characterized by generalized erythema, scaling, and systemic manifestations. In Ayurveda, the condition can be correlated with severe Eka Kushta involving Tridosha predominance with Rakta and Rasa dushti. This case report highlights the effectiveness of Ayurvedic management in a 37-year-old male patient with a 17-year history of chronic plaque psoriasis that progressed into erythrodermic psoriasis. The patient presented with widespread erythematous exfoliative lesions involving more than 90% of body surface area, severe itching, burning sensation, pain, oozing lesions, malaise, and chills. Clinical examination and PASI assessment confirmed severe disease with an initial PASI score of 56.5. The treatment protocol included Amapachana, Rookshana, Srotoshodhana, Vicharana Snehapana, Virechana, Takradhara, and Rasayana therapy along with internal medications and external applications. Significant improvement was observed in erythema, scaling, induration, itching, and overall quality of life. The PASI score reduced from 56.5 to 5.1 after treatment. Improvement of 70–80% with better sleep, reduced stress, and enhanced well-being The study suggests that a structured Ayurvedic approach can effectively manage erythrodermic psoriasis and improve clinical outcomes.

Pharmaceutical Development and Analytical Standardisation of Triphaladi Kashaya for the Management of Mukhapaka.

Afiya M Shoukkath, Noble T M — Wed, 30 Sep 2026 00:00:00 +0530

Background: Triphaladi Kashaya is a classical Ayurvedic formulation indicated for the management of Mukhapaka and other oral disorders. Although it has been used in Ayurvedic practice for many years, published data on its pharmaceutical standardisation are limited.

Objective: To prepare Triphaladi Kashaya according to classical Ayurvedic procedures and to establish reference quality parameters through pharmaceutical and analytical evaluation.

Materials and Methods: Triphaladi Kashaya was prepared using Terminalia chebula Retz. (Haritaki), Terminalia bellirica (Gaertn.) Roxb. (Vibhitaki), Phyllanthus emblica Linn. (Amalaki), Cissampelos pareira Linn. (Patha), Vitis vinifera Linn. (Mrdwika), and Jasminum grandiflorum Linn. (Jati), with Madhu (honey) as an adjuvant. The raw drugs were authenticated and evaluated using pharmacognostical and physicochemical methods. The finished formulation was analysed for its organoleptic characters, physicochemical properties, phytochemical profile, total phenolic content, microbial quality, heavy metal content, and pesticide residues using standard analytical procedures.

Results: The prepared Triphaladi Kashaya was light brown in colour with a characteristic odour and a bitter-astringent taste. The formulation showed a pH of 3.92, specific gravity of 1.0358, total solids of 11.3397%, refractive index of 1.349, and 10°Brix. The total phenolic content was found to be 0.38% w/w (tannic acid equivalent). Qualitative phytochemical screening confirmed the presence of carbohydrates, tannins, phenols, flavonoids, terpenoids, and saponins. Microbial counts were well within the prescribed limits, while pathogenic microorganisms, heavy metals, and pesticide residues were absent or within permissible limits.

Conclusion: The study generated a pharmaceutical and analytical profile for Triphaladi Kashaya that may serve as reference data for quality control and standardisation. These findings provide a basis for maintaining the consistency of the formulation and support further pharmaceutical and clinical investigations.

High-Performance Thin Layer Chromatography (HPTLC) Profiling of Methanolic Extract of Shatavari ksheerapaka (milk decoction of dried tuberous roots of Asparagus racemosus Willd.)

Nayana Mathew, P Y Ansary, Shincymol V V — Wed, 30 Sep 2026 00:00:00 +0530

High-Performance Thin Layer Chromatography (HPTLC) is a refined chromatographic technique offering improved resolution and precision for the analysis of plant-based formulations. It is extensively used for identifying and quantifying phytochemical constituents in herbal drugs, supporting their standardization and quality control. Shatavari (Asparagus racemosus Willd.), a key Ayurvedic medicinal plant, contains diverse bioactive compounds with significant therapeutic properties. Shatavari ksheerapaka (milk decoction of dried tuberous roots of Asparagus racemosus Willd.), a classical milk-based Ayurvedic formulation, is widely used in clinical practice; however, its analytical standardization using modern techniques remains inadequate. The present study aimed to establish an HPTLC fingerprint profile of methanolic extract of Shatavari ksheerapaka. Chromatographic analysis was performed on a 5 × 10 cm pre-coated silica gel 60 F254 plate, with separation achieved using a mobile phase consisting of toluene, ethyl acetate, and hexane in the ratio of 6:3:1. Following chromatographic development, the plate was analyzed at 366 nm. The methanolic extract of Shatavari ksheerapaka exhibited four distinct peaks, with a total area of 14838.1 AU at 366 nm, indicating the presence of distinct phytochemical constituents. This chromatographic profiling offers a comprehensive overview of the chemical composition of the formulation, contributing to its quality evaluation and offering a reliable reference for future research.

AN AYURVEDIC PERSPECTIVE ON PHOTOAGING - CONCEPTUAL UNDERSTANDING AND REJUVENATING SOLUTIONS

Anjana Chandran, Anandalakshmy K N — Wed, 30 Sep 2026 00:00:00 +0530

Photoaging is a major contributor to premature skin aging and results from the cumulative effects of ultraviolet (UV) radiation on cutaneous structures. It presents clinically with wrinkles, laxity, dyspigmentation, dryness, and vascular changes, and histologically with collagen degeneration, elastosis, epidermal irregularity, and chronic inflammation. At the molecular level, UV radiation induces oxidative stress, DNA damage, inflammatory mediators, and matrix metalloproteinase activation, accelerating structural breakdown of the skin beyond intrinsic aging.In Ayurveda, aging is described under the concept of Jara and is classified into Kalaja Jara (chronological) and Akalaja Jara (premature). This article interprets photoaging as a form of Akalaja Jara caused by excessive exposure to Atapa, possessing Ushna and Tikṣṇa qualities that primarily aggravate Bhrajaka Pitta in the skin. Persistent Pitta vitiation leads to secondary Vata aggravation, Rakta Dushti, and localized Srotodushti, resulting in impaired nourishment of Twak and progressive degenerative changes. Alterations in Chaya and Prabha correspond to pigmentary disorders and loss of skin radiance observed in photoaging.A combined review of classical Ayurvedic texts and contemporary dermatological literature was conducted to correlate traditional concepts with modern mechanistic pathways. Therapeutic strategies emphasizing Vata–Pitta Shamana, Rakta Prasadana, and Twak Dhatu Poshana are proposed. Interventions such as Rasayana therapy, Varnya, Sothahara, and Sandhaneeya formulations, along with Dinacharya, Ritucharya, and Śodhana procedures, address oxidative damage, inflammation, and tissue degeneration.This integrative model offers a holistic and preventive approach to photoaging .Further clinical and experimental studies are required to validate these approaches.

Revisiting “Thinakudi”: Health Implications in the Framework of Yavagu- An Ethnographic study

Madhu P M, K N Ajithkumar — Wed, 30 Sep 2026 00:00:00 +0530

Theyyam is a ritualistic art form of northern Kerala. This connects demanding physical performances with deep spiritual symbolism. Performers undergo enormous physical strain as they wear elaborate costumes, vibrant makeup, and headgear, often performing for long hours in intense heat and humidity. Coupled with the tight costumes and the absolute physical strain, frequently results in various types of health challenges. To neutralize these issues, they have developed a variety of precautionary measures grounded in their traditional wisdom. An important thing among them, in sustaining their stamina and minimizing discomfort is their habits of certain dietary practices designed to optimize physical efficiency. One such practice is Thinakudi,-drinking the gruel prepared with millet - a ritualistic dietary regimen observed during the pre-performance fasting period. This traditional diet, rich in nutrients and carefully curated to enhance stamina, exemplifies the integration of culture and nutrition in supporting human endurance. This study is to explore the components of Thinakanji (millet gruel), analyzing its nutritional value and to compare it with Ayurvedic dietary regimen, Yavagu. Findings from focus group discussions and in-depth interviews with cultural experts provided critical insights into how these practice help performers maintain peak efficiency, even under extreme physical strain. Exploration of this subject may be meaningfully integrated into the traditional knowledge base of Ayurveda, where various types of gruels are described for specific therapeutic applications. Furthermore, such formulations can be effectively utilized to enhance endurance and support recovery among performers engaged in sports and other physically demanding activities

Strategies for the management of type 2 Diabetes Mellitus among the Ayurveda practitioners of Kerala – Study Protocol for a Grounded Theory Approach

Abhilash Mangampadath — Wed, 30 Sep 2026 00:00:00 +0530

Ayurvedic clinical practice, generally follow a pattern which is difficult to standardize and basically relying upon some intuitions and weekly framed conceptualizations. The first step towards an evidence based clinical practice is to identify the existing practices and to categorize them according to the evidences and rationale. This qualitative study is planned to identify such practices and their rationale in the management of Type 2 Diabetes Mellitus (T2DM) in the setting of Kerala. A grounded theory approach is followed here, since the intention is to find out the existing strategies and their rationale by theoretical sampling and iterative data collection cycles. This will be useful to find out how far these practices are in accordance with the currently available evidences and what can be done to standardize such practices.