E-ISSN:2456-3110

Case Report

Shunthi - Haritaki Choorna

Journal of Ayurveda and Integrated Medical Sciences

2023 Volume 8 Number 5 May
Publisherwww.maharshicharaka.in

Effect of Shunthi-Haritaki Choorna and Kapalbhati in Sthaulya (Obesity): A Case Study

Mevafarosh K.1*, Jain T.2, Singh Mandloi V.3, Marwaha N.4
DOI: http://dx.doi.org/10.21760/jaims.8.5.37

1* Kapil Mevafarosh, Post Graduate Scholar, Department of Swasthavritta, Pt. K.L.S. Govt. (Auto) Ayurveda Collage and Institute, Bhopal, Madhya Pradesh, India.

2 Trupti Jain, Assistant Professor, Department of Swasthavritta, Pt. K.L.S. Govt. (Auto) Ayurveda Collage and Institute, Bhopal, Madhya Pradesh, India.

3 Vijendra Singh Mandloi, Assistant Professor, Department of Swasthavritta, Pt. K.L.S. Govt. (Auto) Ayurveda Collage and Institute, Bhopal, Madhya Pradesh, India.

4 Nitin Marwaha, Professor & HOD, Department of Swasthavritta, Pt. K.L.S. Govt. (Auto) Ayurveda Collage and Institute, Bhopal, Madhya Pradesh, India.

Obesity is a medical condition where body fat has accumulated to an extent that it may have a negative effect on health. A body mass index (BMI) over 25kg/m2 is considered overweight, and over 30kg/m2 is obese. Modernization, stress, bad dietary habits and sedentary lifestyle results into the clinical entity called obesity. In Ayurveda, it has been mentioned under Santarpanjanya Vikara in Bahudoshavastha condition. Ayurveda has a holistic approach towards management of Sthaulya. This is a single case study on effective management of Sthaulya. The treatment was planned as Shunthi-Haritaki Choorna in a dose of 5 gm [2:1] with lukewarm water B.D. after meal and Kapalbhati - 3 rounds (with 1 minute interval of normal breathing) in morning time. Each round will have 4 cycles of 20 strokes (with an interval of 3-4 deep breathing) for 45 days. After completing 45 days, patient felt significant changes in the anthropometrical measurements of the body, along with weight reduction of about 4.2kgs. And improvement in other associated symptoms as well as lipid profile. The current study thereby proves that treatment with Shunthi-Haritaki Choorna and Kapalbhati is a good way to manage overweight and obesity.

Keywords: Shunthi - Haritaki Choorna, Kapalbhati, Sthaulya, Obesity, BMI

Corresponding Author How to Cite this Article To Browse
Kapil Mevafarosh, Post Graduate Scholar, Department of Swasthavritta, Pt. K.L.S. Govt. (Auto) Ayurveda Collage and Institute, Bhopal, Madhya Pradesh, India.
Email: 		Kapil Mevafarosh, Trupti Jain, Vijendra Singh Mandloi, Nitin Marwaha, Effect of Shunthi-Haritaki Choorna and Kapalbhati in Sthaulya (Obesity): A Case Study. J Ayu Int Med Sci. 2023;8(5):222-225.
Available From
https://jaims.in/jaims/article/view/2370

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2023-03-21 2023-03-23 2023-03-30 2023-04-06 2023-04-13
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
Nil Nil Yes 19%

© 2023by Kapil Mevafarosh, Trupti Jain, Vijendra Singh Mandloi, Nitin Marwahaand Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

Journal of Ayurveda and Integrated Medical Sciences 2023;8(5)222
Mevafarosh K et al: Shunthi-Haritaki Choorna and Kapalbhati in Sthaulya (Obesity)

Introduction

Obesity is a complex disorder of the modern world. Due to faulty dietary habits, sedentary lifestyle and growing urbanization, obesity has emerged as the most prevalent sedentary lifestyle disorder in urban society. Presently it has reached at an epidemic proportion globally. In Obesity excessive body weight is associated with various diseases particularly Cardiovascular Disease, Type 2 Diabetes mellitus, Obstructive sleep-apnoea, certain type of Cancer and Osteoarthritis.[1] All of which have negative effects on the quality of life, work productivity, and healthcare costs.

Ayurveda, also rightly explain about Obesity as Atisthaulya and it is considered as one of the Atinindita Purusha. A person in whom there is excessive accumulation of Meda (Fat/adipose tissue) and Mansa (Flesh/muscle tissue) leading to flabbiness of hips, abdomen and breast has been categorised as Atisthaulya.[2]

Case Study

A case of 32 years old male patient came to OPD of Pt. Khushilal Sharma Govt.(auto.) Ayurveda hospital on 21thDecember 2022 and complaining of gradual weight gain in the last 3 years. Along with weight gain, patient had dyspnoea during exertion, excessive sweating, hunger and thirst, heaviness in body, pendulous movement of abdomen and breast. On examination, his weight and height was102.8 kg. and 175cm respectively. On calculation, BMI was 33.6 kg/m2. On the basis of weight, BMI and classical symptomatology, he was diagnosed as a patient of grade-Ι obesity. He had family history of obesity. He was not suffering from any other underlying systemic illness. He had no history of taking medicine for obesity. Patient was thoroughly examined and advised for Fasting Blood Sugar, Thyroid profile and Lipid profile. All these reports were within the normal limits. Ayurvedic treatment Shunthi - Haritaki Choorna and Kapalbhati was given as follow:

  • Haritaki-Shunthi Choorna- In a dose of 5 gm [2:1] with lukewarm water B.D. after meal.
  • Kapalbhati- 3 Rounds (with 1 minute interval of normal breathing) in morning time.
  • Each round will have 4cycle of 20 strokes (with an interval of 3-4 deep breathing).
  • He was advised to restrict high calorie diet like cheese, cold-drink, fatty food, junk food as well as late night food intake.

Observations and Results

Table 1: Signs and Symptoms present in patient

SN  Complaints Grade (BT) Grade (AT)
1. Swedaabadha (Atiswedapravritti) 2 1
2. Kshudhadhikya (Excessive appetite) 2 1
3. Pipasaadhikya (Excessive thirst) 1 0
4. Chalstana (Pendulous movement of breast) 1 0
5. Chaludara (Pendulous movement of Abdomen) 2 1
6. Angagourav (Heaviness in body) 1 0
7. Kshudraswasa (Dysponea during slight exertion) 1 0

Note:

  • No complaint – 0, Presence of mild complaint – 1, Presence of moderate complaint – 2, Presence of severe complaint - 3
  • BT = Before Treatment, AT = After Treatment

Table 2: Clinical Examination of patient

SN    B.T.  A.T.
1. Height (in meter) 175 cm. 175 cm.
2. Weight (in kg) 102.8 kg. 98.6 kg.
3. BMI 33.6 kg/m2 32.2%
4. Body fat % 31.89% 29.69%
5. Measurements    
a. Abdomen (skin fold thickness) 42mm 35mm
b. Thigh (skinfold thickness) 36mm 34mm
c. Chest 109 cm. 107 cm.
d. Abdomen 111 cm. 106 cm.
e. Hip 118 cm. 116 cm.
f. Waist 100 cm. 95 cm.
7. Hip/waist ratio 0.847 0.818

Note:

  • BT= Before Treatment, AT= After Treatment

Table 3: Lipid profile of patient

Investigations  B.T. A.T.
HDL (mg/dl) 45.0 mg/dl 42.3 mg/dl
LDL (mg/dl) 126.62 mg/dl 103.42 mg/dl
VLDL (mg/dl) 26.98 mg/dl 22.08 mg/dl
S. Cholesterol 198.6 mg/dl 167.8 mg/dl
S. Triglycerides 134.9 mg/dl 110.4 mg/dl

After 45 days of treatment, relief was found in weight, BMI, anthropometric measurements associated symptoms and lipid profile.


Journal of Ayurveda and Integrated Medical Sciences 2023;8(5)223
Mevafarosh K et al: Shunthi-Haritaki Choorna and Kapalbhati in Sthaulya (Obesity)

Discussion

  • According to Ayurvedic classics Sthaulya is Vata Kapha predominant metabolic disorder.
  • Increased Medodhatu obstruct the Srotas and block the Vyan Vayu to transport nutrient to other Dhatu and thus Meda Dhatu increases and Uttarottar Dhatu Derangement in Agni is the main reason for obesity. Shunthi and Haritaki both have Deepana, Pachana, Lekhana and Anulomana properties ultimately correct the metabolism.
  • The drug Shunthi and Haritaki possesses Katu, Tikta Rasa and cause Upashoshana of Kleda and
  • Due to Teekshna, Laghu, Gunas, and Ushna Veerya, they help in clearing the Srotas, also acts on Kapha and Vayu to break the Sthaulya Samprapti.
  • Katu, Tikta Rasa present in Shunthi and Haritaki improve Jatharagni and correct digestion and metabolism.
  • Because of Deepana Pachana properties Shunthi is useful in
  • High amount of saponins, phytosterols, chebulinic acid and corilagin present in Haritaki is responsible for the hypolipidemic effect.[3]
  • Gingerenone A, 6-shogaol, and 6-gingerol are bioactive component of ginger show antiobesity effect, through adipogenesis inhibition and the enhancement of fatty acid catabolism.[4]
  • Various study proved Antioxidant, Antibacterial activity, Antiviral activity, Antifungal activity, Anti-inflammatory, Hepatoprotective activity, Cardioprotective activity, Hypolipidemic and hypocholesterolemic activity, Gastrointestinal motility improving and anti-ulcerogenic activity of Terminalia chebula and Zingiber officinale.[5]
  • Shunthi and Haritaki Choorna are well known and authentic herb bearing Deepana, Pachana, Anulomana, Lekhana Since, both the medicines are hot (Ushna Veerya) in nature, the combination effectively metabolises excessive fat and oppose any increment of Kapha and Meda by the viliyan property. Thus, Shunthi and Haritaki Choorna gives relief in Kapha and Meda thickness.[6]



  • Kapalbhati is a fast, rhythmic breathing using abdominal muscles. Kapalbhati involves abdominal muscle contractions with forceful exhalation and natural inhalation. It is a form of abdomino-respiratory-autonomic exercise. Due to this, respiratory, abdominal and gastrointestinal receptors get stimulated. Also, afferents, centers in brain-stem and cortex and, efferents and effectors get stimulated. This leads to synchronous stimulation of autonomic nervous system, hypothalamus, pineal gland and other associated brain structures. Because of this there is synchronous increase in autonomic nervous system, pineal gland, hypothalamus and other central nervous system discharge to all parts of the body including endocrine and metabolic processes. This is responsible for the effect of Kapalbhati on fat metabolism.[7]

Conclusion

In 45 days, patient had lost 4.2kgs of weight and improvement was found in all associated symptoms, anthropometric measurements as well as in lipid profile.

This study showed that Shunthi-Haritaki Choorna and Kapalbhati have showed encouraging result in patient of obesity. Thus, we can say that Shunthi-Haritaki Choorna and Kapalbhati is very good, safe and cost-effective treatment for grade-Ι obesity.

Reference

1. Joshi (deole) Supriya et al. Management of overweight and Obesity through specific

2. Supriya Joshi (Deole), Yogesh S Deole, GH Vyas, SC Dash. Management of Overweight and Obesity through specific Yogic procedures. Ayu-Vol.30 No.4 (October – December) 2009, pp 425-435.

3. Tripathi B. Charaka Samhita, Sutra Sthana, Ashtouninditiya Adhyaya In: 21/4, vol-I 4th ed 1995, Chowkhamba Surbharti Prakashan, Varanasi: 1995; p.398.

4. Acharya J.T., Acharya N.R., Sushruta Samhita of Sushruta, Nibandha Sangraha vyakhya of Dalhana. Chapter 15. Vers 38. Part 1. Varanasi: Chaukhambha orientalia, 7 Edition 2002.P.75.



Journal of Ayurveda and Integrated Medical Sciences 2023;8(5)224
Mevafarosh K et al: Shunthi-Haritaki Choorna and Kapalbhati in Sthaulya (Obesity)

5. Juang LJ, Sheu SJ, Lin TC. Determination of hydrolyzable tannins in the fruit of Terminalia chebula by high-performance liquid chromatography and capillary electrophoresis. J Sep Sci. 2004;27(9):718–724.

6. Stoner G.D. Ginger: Is it ready for prime time? Cancer Prev. Res. 2013;6:257–262. doi: 10.1158/1940-6207.CAPR-13-0055. [PubMed] [CrossRef] [Google Scholar].

7. Meher Sudhanshu et al. Pharmacological Profile of Terminalia chebula Retz. and Willd. (Haritaki) in Ayurveda with Evidences. RJPPD.2018; 10(3):115- 124.

8. Dinkar R Kekan et al. effect of Kapalbhation body mass index and abdominal skinfold thickness at overweight resident doctors. S.R.T.R. Medical College Ambajogai; 2013.


Journal of Ayurveda and Integrated Medical Sciences 2023;8(5)225