E-ISSN:2456-3110

Case Report

Metabolic Syndrome

Journal of Ayurveda and Integrated Medical Sciences

2025 Volume 10 Number 2 FEBRUARY
Publisherwww.maharshicharaka.in

A Case Study on Role of Virechana Karma as a conservative management in Metabolic Syndrome (Santarpana Janya Vyadhi)

Agarwal S1*, Srivastava A2, KK Sharma3, Anand N4
DOI:10.21760/jaims.10.2.54

1* Subhi Agarwal, Post Graduate Scholar, Dept of Panchakarma, Uttarakhand Ayurved University, Rishikul Campus, Haridwar, Uttarakhand, India.

2 Alok Srivastava, Professor and HOD, Dept of Panchakarma, Faculty of Ayurveda, Uttarakhand Ayurved University, Dehradun, Uttarakhand, India.

3 KK Sharma, Professor and HOD, Dept of Panchakarma, Uttarakhand Ayurved University, Rishikul Campus, Haridwar, Uttarakhand, India.

4 Niteshh Anand, Assistant Professor, Dept of Panchakarma, Uttarakhand Ayurved University, Rishikul Campus, Haridwar, Uttarakhand, India.

The prevalence of lifestyle diseases such as hypertension, diabetes mellitus, dyslipidemia, and obesity has skyrocketed in recent years. Among these, Metabolic Syndrome (MS) stands out as a significant public health challenge worldwide, fueled by the rise in obesity and sedentary living habits. This complex condition is characterized by a cluster of interrelated health issues, including abdominal obesity, insulin resistance, hypertension, and hyperlipidemia, all of which significantly increase the risk of cardiovascular diseases and other chronic illnesses. As there is no direct reference of Metabolic Syndrome in Ayurveda. But due to resemblance of its etiopathogenesis and clinical features, it may come under broad umbrella of Santarpanjanyavyadhi, Medopradoshaja Vikara and Medosroto Dusti. Virechana Karma is line of treatment for Santarpanajanya Vyadhi and Bahudoshawastha. The aim of this study was to treat Metabolic Syndrome with Virechana Karma. Weight, Waist circumference, Lipid profile was opted for the assessment of Metabolic Syndrome before and after the treatment. This case study involved a 41-year-old female patient presenting with weight gain, drowsiness, bodily heaviness, disturbed thyroid profile, and hyperacidity in the last four years. Initial assessments revealed elevated levels of total cholesterol, VLDL, and triglycerides. After undergoing Virechana Karma (therapeutic purgation), the patient demonstrated significant improvements in lipid profiles, complete remission of symptoms, and a remarkable weight loss of 4 kg. The impressive outcomes can be attributed to the correction of Agni (digestive fire) through Virechana Karma and the elimination of abnormal lipids from the body. This study strongly supports the efficacy and safety of Virechana Karma in the management of metabolic syndrome.

Keywords: Virechana Karma, Santarpanajanya Vyadhi, Metabolic syndrome

Corresponding Author How to Cite this Article To Browse
Subhi Agarwal, Post Graduate Scholar, Dept of Panchakarma, Uttarakhand Ayurved University, Rishikul Campus, Haridwar, Uttarakhand, India.
Email: 		Agarwal S, Srivastava A, KK Sharma, Anand N, A Case Study on Role of Virechana Karma as a conservative management in Metabolic Syndrome (Santarpana Janya Vyadhi). J Ayu Int Med Sci. 2025;10(2):373-377.
Available From
https://jaims.in/jaims/article/view/4141/

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2025-01-09 2025-01-24 2025-02-04 2025-02-14 2025-02-24
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None Nill Not required 11.36

© 2025by Agarwal S, Srivastava A, KK Sharma, Anand N and 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].

J Ayu Int Med Sci 2025;10(2)373
Download PDFBack To ArticleIntroductionCase ReportObservation and ResultsDiscussionConclusionReferences
Subhi A et al. Virechana Karma in Metabolic Syndrome

Introduction

Metabolic syndrome encompasses a combination of interconnected physiological, biochemical, clinical, and metabolic factors that significantly elevate the risk of cardiovascular diseases, type 2 diabetes mellitus (DM), and all-cause mortality. It includes abdominal obesity, insulin resistance, hypertension, and hyperlipidemia.[1]

Metabolic syndrome poses a complex metabolic disorder and emerges as a clinical challenge in today's society, affecting 11% - 41% of Indians and approximately 1 in 4 adults worldwide.[2] Various diagnostic criteria exist for quantifying MetS, with the International Diabetic Federation (IDF) and the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III)2 being widely used.[3]

According to NCEP ATP III categorized Metabolic Syndrome as, individuals must have at least 3 of these 5 measures must be outside of the cut-points, increased central obesity (waist circumference), Hypertension or Raised systolic and/or Diastolic blood pressure, Serum Dyslipidemia i.e, Decreased high density lipoprotein cholesterol (HDL-C) and Raised Triglyceride (TG), and Impaired fasting blood sugar (FBS).[4]

The decline in physical activity levels in the past decades can be attributed to a combination of factors, including jobs becoming less physically active and more ‘desk based’, the reliance on motorized transport rather than walking and cycling, and the growth in the popularity of sedentary pastimes involving televisions and computers. Individual who watched television or computer ˂ 1 hour daily compared with who carried out those behavior for ˃4 hours had a Two-Fold increased risk of Metabolic syndrome.[5] Metabolic Syndrome can be closely correlated with Santarpanjanya Vikaras, which encompass diseases arising from over-nutrition and defective tissue metabolism. The hallmark feature of Metabolic Syndrome is central obesity, which aligns with the Ayurvedic concepts of Medhovridhi (excess fat accumulation) or Sthaulya (obesity). The causative factors of Metabolic Syndrome closely mirror those of Medoroga in Ayurveda. Both conditions are linked to Atisampurana (excessive consumption of food, particularly Madhura [sweet], Sheeta [cold], and Snigdha [unctuous] diets),

along with sedentary habits like Avyayam (lack of physical activity), Diwaswapna (daytime sleeping), Harsha (excessive indulgence), Achintana (lack of mental engagement), and Beeja Dosha (genetic or hereditary predisposition.[6] According to modern medicine, effective treatment involves targeting the root cause of the disease. Ayurveda aligns with this approach by emphasizing the cleansing of congested Strotas (microchannels) to restore physiological balance. Virechana Karma[7], a highly effective Panchakarma procedure, detoxifies the body by clearing blocked Strotas and expelling vitiated Doshas, thereby alleviating the symptoms of Metabolic Syndrome and promoting overall health.

Case Report

A 41-year-old female patient came to consult in OPD of Panchakarma department in Rishikul ayurvedic medical college with complains of weight gain, drowsiness, bodily heaviness, disturbed thyroid profile, and hyperacidity in the last four years.

H/o Past illness: Thyroid disorder since 4 yrs.

Personal history: Her diet was high in saturated fatty acids, including ghee, butter, and cheese. Due to persistent fatigue, she avoided engaging in physical exercise, contributing to her condition.

General examination:

General condition: Fair
Pulse rate: 80/min
RR: 20/min
BP: 120/80 mm hg
Weight: 79 kgs
Height: 162cm
Temperature: 98°F

Diagnosis:According to NCEP criteria[8] a subject has metabolic syndrome if he or she has three or more of the following; abdominal obesity, hyper triglyceridemia, Low HDL-C, high blood pressure, high blood sugar.

Investigation (before and after treatment):Initial assessments revealed elevated levels of S. Cholesterol (T), LDL, and triglycerides. To address these imbalances, a structured Virechana Karma[9] regimen was planned, for its potent detoxifying and lipid-reducing properties.


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Subhi A et al. Virechana Karma in Metabolic Syndrome

ProcedureDrug, doseDuration
Deepana PachanaChitrakadi Vati 2 tablet thrice a day after taking meal with lukewarm water.3 days
SnehapanaGoo-Ghrita as per Koshtha and Agni (in morning with empty stomach)6 days
Abhyanga SwedanaAbhyanga with Tila Taila (35 min) and Sarvanga Sweda (10-15 min)3 days
VirechanaVirechana Yoga with Trivritta Avleham1 day
Sansarjana KarmaDiet as per Madhyam Shudddhi (from the evening of Virechana Karma day)5 days

Observation and Results

The patient experienced 17 Vegas indicating Madhyama-level Shuddhi (Moderate purification), outcomes were meticulously assessed both before Deepana Pachana (digestive and metabolic enhancement) and after Sansarjana Karma. Patient felt relief in hyperacidity, lightness in body and felt more energetic and refreshed. There was significant improvement in the symptoms as level as the objective parameters given below.

ParametersBefore treatmentAfter treatment
Total cholesterol154134
Triglycerides24693
HDL31.541
VLDL40.918.53
CHOL/HDL Ratio4.893.26
Weight68 kg64 kg
Waist circumference97cm95 cm

jaims_4141_01.jpg
Before Treatment

jaims_4141_02.jpg
After Treatment

Discussion

Metabolic Syndrome can be comparable with Santarpanjanya Vikaras (Comprise of diseases due to over nutrition and defective tissue metabolism). Its main sign is central obesity so may be correlated with Medhovridhi or Sthaulya. Virechana Karma is line of treatment of Bahudoshawastha and Santarpana Janya Vyadhi[10], infact many diseases in which morbid Doshas are present in Medo Dhatu. The superlative treatment for Pitta Dosha and Pitta Sthana Vyadhi (Yakrita) is Virechana Karma. According to Ayurvedic principles, Virechana therapy, a type of therapeutic purgation, can significantly reduce cholesterol levels by decreasing its absorption in the gut, primarily impacting the levels of total cholesterol, LDL cholesterol, and triglycerides, while potentially increasing HDL ("good") cholesterol; this effect is attributed to its influence on the liver function as the primary site of Pitta in Ayurveda, which is associated with lipid metabolism.


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Subhi A et al. Virechana Karma in Metabolic Syndrome

During Snehapana, the intake of polyunsaturated fatty acids stimulates the oxidation of cholesterol into bile acids. When a lipid-rich diet enters the duodenum, the hormone Cholecystokinin is released, triggering gallbladder contraction and bile secretion. Virechana Karma not only promotes this natural process but also restores the proper functioning of Agni (digestive fire) and ultimately optimizes liver functions, contributing to metabolic balance. Once liver function is restored, cholesterol synthesis can be regulated, and cholesterol excretion may increase through stimulated bile production. This process helps transport harmful substances from peripheral tissues to the intestine for elimination. Notably, even when dietary fats are excluded, endogenous fats continue to appear in faeces, suggesting that excess lipids from plasma and tissues are mobilized to the intestine for excretion through Virechana Karma. This underscores the effectiveness of Purvakarma in drawing morbid Doshas from the Shakha (peripheral tissues) to the Kostha (digestive tract), facilitating their complete elimination.

Reduces cholesterol absorption: By inducing bowel movements, Virechana helps eliminate excess cholesterol from the body before it can be reabsorbed into the bloodstream.

Liver function regulation: As the liver is considered the primary site of Pitta in Ayurveda, Virechana is believed to positively impact liver function, thereby aiding in cholesterol regulation.

Lipid profile improvement: Studies have shown that Virechana can lead to a decrease in total cholesterol, LDL cholesterol, VLDL cholesterol, and triglycerides, while potentially increasing HDL cholesterol.

Conclusion

Metabolic syndrome is a constellation of interconnected physiological, biochemical, clinical and metabolic factors that directly increase the risk of CVD and Type 2 Diabetes Mellitus. It can be concluded by above discussion that metabolic syndrome can be compared with Santarpanjanyavyadhi, Medopradoshaja Vikara and Medosroto Dusti. Virechana Karma is line of treatment of Bahudoshawastha and Santarpana Janya Vyadhi.

So, Virechana Karma was very effective in reducing the cholesterol, triglycerides level and VLDL and in increasing HDL (good cholesterol).

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