E-ISSN:2456-3110

Review Article

metabolic diseases

Journal of Ayurveda and Integrated Medical Sciences

2025 Volume 10 Number 7 JULY
Publisherwww.maharshicharaka.in

A review study on the role of Avarana in the clinical presentation and pathogenesis of metabolic diseases

Sisodiya G1*, Singh R2
DOI:10.21760/jaims.10.7.41

1* Garima Sisodiya, Post Graduate Scholar, Department of Rog Nidan Evum Vikruti Vigyan, Pt Khushilal Sharma Govt (Autonomous) Ayurveda College and Institute, Bhopal, Madhya Pradesh, India.

2 Rita Singh, Reader and HOD, Department of Rog Nidan Evum Vikruti Vigyan, Pt Khushilal Sharma Govt (Autonomous) Ayurveda College and Institute, Bhopal, Madhya Pradesh, India.

The Ayurvedic principle of Avarana, which describes the obstruction of Vata’s natural movement by another Dosha or Dhatu, provides a comprehensive lens through which various metabolic disorders now increasingly common globally and in India can be interpreted. In this review, classical sources were systematically examined alongside modern biomedical literature following SANARA guidelines to elucidate how Avarana mechanisms map onto contemporary pathophysiology. Distinct obstruction patterns were identified: in diabetes mellitus and obesity, Kapha and Meda obstruct Vyana and Samana Vata, correlating with insulin resistance and adiposity; in hypertension, Pitta’s encroachment upon Prana Vata parallels autonomic imbalance; in non-alcoholic fatty liver disease, excess Kapha envelops Doṣhivisha, mirroring hepatic steatosis and inflammation; hypothyroidism reflects Kapha’s blockade of Udana Vata, akin to slowed metabolism; In gout, the diseased state develops as aggravated Rakta blocks the movement of Vyana Vata, which parallels the pathological process of elevated uric acid levels and subsequent crystal accumulation in joints; and irritable bowel syndrome embodies mutual obstruction between Samana and Apana Vata, corresponding to dysregulated gut motility. This integrative analysis underscores the value of Avarana in offering personalized diagnostic and therapeutic strategies herbal formulations to remove obstructions, targeted Panchakarma procedures to restore Doshic balance, and lifestyle modifications tailored to the specific Dosha interactions. By bridging classical Ayurvedic theory with modern biomedical insights, this work proposes a nuanced, patient-centric approach for the prevention and management of metabolic disorders, advocating further clinical studies to validate Avarana-guided interventions.

Keywords: Avarana; metabolic disorders; Vata; obstruction; integrative medicine

Corresponding Author How to Cite this Article To Browse
Garima Sisodiya, Post Graduate Scholar, Department of Rog Nidan Evum Vikruti Vigyan, Pt Khushilal Sharma Govt (Autonomous) Ayurveda College and Institute, Bhopal, Madhya Pradesh, India.
Email: 		Sisodiya G, Singh R, A review study on the role of Avarana in the clinical presentation and pathogenesis of metabolic diseases. J Ayu Int Med Sci. 2025;10(7):269-276.
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https://jaims.in/jaims/article/view/4456/

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2025-05-15 2025-05-26 2025-06-06 2025-06-16 2025-06-26
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None Nil Not required 12.36

© 2025 by Sisodiya G, Singh R 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].

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Garima S et al. A review study on the role of Avarana

Introduction

In Ayurvedic medicine, Avarana obstruction of natural flow of Vata Dosha is a central concept in understanding pathogenesis of many metabolic disorders. When Vata’s movement is blocked by other Doshas or bodily substances, it leads to significant physiological disruptions. For example, in diabetes, Vata is obstructed by Kapha and Meda, impairing metabolic function; in hypertension, Vyana Vayu and prana Vayu is blocked by Pitta and Kapha, disturbing circulation; and in NAFLD, excessive Meda obstructs liver channels. Viewing these conditions through lens of Avarana provides a nuanced diagnostic and therapeutic framework with-in Ayurveda. Metabolic disorders such as diabetes, hypertension, NAFLD, gout, and hypothyroidism are increasingly prevalent, particularly in India. Current data show that diabetes affects around 101 million adults, hypertension 29.8%, NAFLD up to 38% in urban areas, gout 0.12–0.4%, and hypothyroidism around 11%, especially in women. This study explores relevance of Avarana in Ayurvedic understanding of these disorders. By integrating classical Ayurvedic theory with modern scientific insights, it aims to clarify underlying mechanisms and evaluate traditional treatments. This approach supports development of holistic, personalized strategies for managing metabolic diseases and advancing integrative healthcare.

Aim and Objectives

Aim

A review study on the role of Avarana in the clinical presentation and pathogenesis of metabolic diseases.

Objective

1. To correlate the concept of Avarana with various disease conditions classified under metabolic disorders.
2. To establish the role of Avarana in the progression of metabolic disorders.

Concept of Avarana

Definition & Etymology

Avarana refers to obstruction or restriction of movement, acting as a hindering factor that disrupts or conceals normal physiological functions.

Key Components

1. Avaraka - The obstructing entity which is strong, vitiated Dosha or Dhatu.
2. Avruta - The obstructed entity which is weakened Dosha or Dhatu.

Causes of Vata vitiation

1. Dhatu Kshaya
2. Marga Avarana

In Dhathu Kshaya, there will be depletion of Rasadi Dhatus that results in vitiation of Vata. In the case of Marga Avarana, the normal pathway of Vata becomes obstructed.

Classification of Avarana.

TypesDescriptionExample
Murta AvaranaObstruction by tangible entities.Pitta or Kapha blocking Vata.
  • Murta on Murta
Solid obstructions like Dhatu blocking Strotas.Ama blocking Rasa Dhatu.
  • Murta on Amurta
Tangible blocking intangible.Pureesh obstructing Apana Vata.
Amurta AvaranaObsturction of Vata on its own types.Prana Vayu obstructing Apana Vayu.
Abhibhavatmaka AvaranaMental disturbance causing physical dysfunction.Stress induced Vata imbalance.

Diagnostic Framework

Acharya Charaka emphasizes that diagnosing Avarana requires assessing changes in Vata’s functions and identifying the site of vitiation. If the obstructing factor is stronger, it suppresses the functions of obstructed entity and vice versa. Chakrapani highlights the role of natural function and loss in functions in diagnosis Sushruta categorizes Avarana into three types Kevala Vata, Dosha-Dhatu Yukta Vata, and Avruta Vata, based on symptomatic presentation and rational analysis. Vagbhatta stresses the importance of repeated examinations and therapeutic trials for an accurate diagnosis.

Metabolic Disorders

Definition:

Metabolic disorders are conditions that disrupt normal metabolism - the process by which the body converts food into energy at the cellular level.


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These disorders may arise from inherited genetic mutations or acquired factors such as lifestyle and diet.

Classification:

1. Primary Metabolic Disorders: Often genetic, such as phenylketonuria or Tay-Sachs.
2. Secondary Metabolic Disorders: Acquired due to environmental, dietary, or lifestyle factors; examples include diabetes, obesity, and non-alcoholic fatty liver disease.

Pathophysiology

These disorders typically involve abnormalities in:

  • Carbohydrate metabolism (e.g., diabetes)
  • Lipid metabolism (e.g., fatty liver)
  • Protein metabolism (e.g., gout)
  • Thyroid hormone production and regulation (e.g., hypothyroidism)

Risk Factors

  • Sedentary lifestyle
  • Poor diet
  • Obesity
  • Genetic predisposition
  • Stress and hormonal imbalance

Clinical Significance:

They often co-exist and lead to complications like cardiovascular disease, kidney disease, and neuropathy, forming a part of the metabolic syndrome spectrum.

Prevalence

Metabolic disorders have become a significant global health concern, with an alarming rise in their prevalence. Diabetes Mellitus affects approximately 537 million adults globally, with India alone accounting for around 101 million diabetic adults. Hypertension impacts about 1.3 billion people worldwide, and in India, it shows a 29.8% prevalence among adults. Non-Alcoholic Fatty Liver Disease (NAFLD), another major metabolic condition, has a global prevalence of around 25%, while in India, it is observed in 32–38% of the urban population. Gout, associated with hyperuricemia, affects 1–4% of the global population, with a relatively lower prevalence in India, estimated at 0.12–0.4%.

Hypothyroidism is also widely prevalent, affecting 5–10% of the global population, and in India, it affects about 11%, with a higher occurrence among women. These statistics reflect the growing burden of metabolic disorders, emphasizing the need for deeper understanding and effective management strategies, including approaches from traditional systems like Ayurveda.

Materials and Methods

This study integrates classical Ayurvedic knowledge with contemporary scientific research to investigate Avarana in metabolic disorders.

Traditional Sources: Analyzed authoritative Ayurvedic scriptures such as Charaka Samhita, Sushruta Samhita, Ashtanga Hridaya, and Madhava Nidana to explore the pathogenesis and management strategies of Avarana.

Modern Scientific Literature: Conducted a search across electronic databases including PubMed and Scopus using keywords like Vata Avarana, Paraspar Avarana Srotorodha, Metabolic disorders, diabetes mellitus, Hypertension, Hypothyroidism, Gout, IBS Fatty liver NAFLD, focusing on peer-reviewed articles from 1990 to 2024.

Data Analysis:

  • Performed a conceptual analysis of Avarana, including its definitions, classifications, and pathophysiological mechanisms.
  • Compared traditional Ayurvedic concepts with modern biomedical understandings.

Quality Assurance:

Adhered to SANARA guidelines to maintain methodological rigor and transparency.

This approach offers a cohesive understanding of Avarana, bridging ancient Ayurvedic principles with current scientific knowledge of metabolic disorders.

Discussion

In Ayurveda, Avarana is key to understanding the pathogenesis of many diseases. It refers to a situation where the normal function of a Dosha especially Vata is impeded by another Dosha, Dhatu, or Mala. This blockage disrupts essential physiological processes, ultimately leading to disease.


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Such perspective allows for correlating the concept of Avarana with various pathological mechanisms observed in multiple metabolic condition. Metabolic disorders are growing global health concern, characterized by imbalances in biochemical processes that affect energy production, nutrient utilization, and waste elimination in this discussion, we will explore the Ayurvedic perspective on metabolic disorders and its connection to Avarana.

How impaired tissue metabolism and fat metabolism dysfunction lead to conditions like obesity and NAFLD. Integrative approaches combining Ayurvedic principles with modern interventions for better metabolic health.

Diabetes Mellitus:

  • Avarana Mechanism: The blockage of Vata by Kapha interferes with Vata’s physiological roles, particularly in maintaining fluid equilibrium and supporting metabolism.
  • Charaka’s Insight: Vata obstructed by Kapha leads to Dhatu Gata Vatae., Vata localized in tissues, causing instability in Meda Dhatu (adipose tissue) and Mutra Vaha Strotas (urinary system).

Pathophysiology

  • Role of Kapha: due to sedentary lifestyle and Guru-Snigdha diet excess of Kapha Dosha → Srotorodha (channel blockage) → Vata cannot maintain fluid regulation and metabolism → Hyperglycemia.
  • Dysfunction of Vata and clinical manifestation:
Symptoms in AyurvedaSymptoms in modernCorrelation
Prabhuta Mutrata (excess urine).PolyureaApana Vayu blocked by Kapha
Avila Mutra (turbid urine).GlycosuriaKapha obstructing Mutravaha Strotas.
Kshudha Adhikyam (excess hunger)Polyphagia.Samana Vata dysfunction due to Avarana.

Therapeutic Approach

To remove excess Kapha, therapies such as Langhana and Rukshana are recommended. Herbal remedies like Musta, Guduchi, and Haridra help reduce Kapha and eliminate. To restore the normal function of obstructed Vata, Basti is used to support Apana Vata, while Tikta Kashaya help clear the bodily channels.

Additionally, an active lifestyle with regular exercise aids in Vata regulation, and following a Kapha-reducing diet further supports balance and overall well-being.

Hypothyroidism

Core Mechanism: Kapha Avarana on Udana Vata

Udana Vata located in chest, governs speech, enthusiasm and metabolism gets obstructed by  Kapha → Metabolic slowdown and thyroid dysfunction.

Sequence of Avarana in Hypothyroidism

1. Agni Mandya (Low metabolism) → Ama (toxins) formation → Aggravates Kapha.
2. Kapha Accumulation → Blocks Udana Vata in Rasavaha, Medovaha Strotas.

Udana Vata Dysfunction

  • Impaired production of thyroid hormones, indicated by a disproportion between TSH and thyroxine.
  • Systemic symptoms (fatigue, cold intolerance, weight gain).
  • Type of Avarana: Murta Avarana: A condition in which the solid and substantial nature of Kapha impedes the function of Udana Vata.

Disease pathway:

FactorRole in Hypothyroidism
DoshaKapha and Vata
DushyaRasa and Meda Dhatu
StotasRasavaha and Medovaha
Stoto DushtiSanga
AdhisthanaSarvashareer

Gout

In pathogenesis of Rakta-Avruta Vata, Rakta becomes vitiated due to an improper diet & lifestyle, involving factors such excess intake of nonvegetarian , salty sour & pungent diet. Thickened blood obstructs Vata, particularly Vyana Vata, which governs circulation, leading to Murta Avarana. This condition correlates with hyperuricemia, where elevated uric acid forms urate crystals in joints, causing gouty inflammation. Enzyme defects like HGPRT deficiency impair purine metabolism, paralleling Ayurvedic Agni Mandya. The disease process begins with Rakta Pradushana from Pitta-provoking diet, followed by Rakta Avruta Vata & culminates in joint erosion as progression.


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FactorRole in AvaranaBiochemical correlation
Rakta: Hyperviscosity, microcirculatory blockage.Creates obstruction in movement of Vata.Hyperurecemia and impaired joint perfusion.
Ranjak Pitta: Purine metabolism failure in liver.Elevated Pitta cause vitiation of Rakta Dhatu.HGPRT enzyme defect cause purine metabolism failure and uric acid imbalance.
Vyana Vayu: Impaired synovial fluid dynamics.Functions obstructed due to vitiated Rakta.Sandhi Shotha which is urate crystal induced synovitis.

Essential Hypertension

Different Ayurvedic scholars offer varied perspectives on hypertension. On closer examination, the disease falls under the concept of Avarana, with its causes and symptoms closely resembling those of Pittavrutta Pranvayu.

Therefore, correlating Essential Hypertension with Pittavrutta Pranvayu simplifies its management.

Etiology of EHT

1. Excessive Salt (Atilavan Rasa Sevan)

  • Causes water retention, increased blood volume, and resistance.
  • Leads to Pittadushti and Raktavriddhi.

2. Excessive Alcohol (Atimadyapan)

  • Weakens heart muscles, raises BP.
  • Causes Pitta and Vata vitiation,

3. Stress (Manovighaat)

  • Activates sympathetic system, increases BP.
  • Atichinta, Bhaya, Krodh aggravate Prana Vayu.

4. Age (Vaya)

  • Arterial stiffness from degeneration.
  • Vata Prakopa, Dhamani Kathinya raise BP.

Pathogenesis - Vitiated Pitta obstructs Prana Vayu, impairing its functions:

  • Hridaya Dharan (heart function)
  • Dhamani Poshan (vascular regulation)

Results in:

  • Raktavriddhi → Increased blood volume & cardiac output
  • Vatadushti → vascular constriction
  • Leads to increased peripheral resistance and cardiac output → Hypertension

Clinical Features

Pittavrutta Pranvayu LakshanaModern Symptoms
BhramaGiddiness
DahaBurning Sensation
RujaHeadache
MoorchaFainting
VamanVomiting

Early stages may be asymptomatic. Later symptoms correlate with Pittavrutta Pranavayu Avarana. Other possible Avaranas linked with EHT are Raktavrutta, Medasavrutta, Kaphavrutta, and Udanavrutta Vata.

Nonalcoholic Fatty Liver Disorder

Correlation of NAFLD with the Ayurvedic concept of Dooshivisha and its pathogenesis through the lens of Kapha Avarana. Here’s a breakdown of how Avarana drives NAFLD:

Kapha Avarana on Dooshivisha: Dooshivisha which is cumulative toxins from incompatible food, preservatives, etc. enters the body but cannot be fully eliminated due to weak digestive and metabolic fire. Kapha Dosha envelops these toxins, rendering them latent but chronically disruptive. Kapha’s dulling properties suppress the toxins acute effects, but prolong their stay in Dhatu.

Pathogenesis

Stage 1: Impaired Digestion

  • Incompatible diet and lifestyle → Weakens digestive fire.
  • Undigested food combined with accumulated toxins becomes encapsulated by Kapha, leading to the formation of abnormal fat globules.

Stage 2: Impaired Tissue Metabolism

  • Kapha’s Avarana specifically targets fat metabolism:
  • Medodhatvagnimandhya leads to Samamedas formation: Faulty fat metabolism → fat globules accumulate in the liver.

Stage 3: Channel Obstruction

  • Accumulation of Samamedas in the liver hampers the activity of Ranjaka Pitta, which governs key metabolic processes in the organ.
  • Avarana of Ranjaka Pitta by Kapha-mediated fat → Liver dysfunction (steatohepatitis, fibrosis).

Symptoms

Kapha Avarana Signs:


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  • Lethargy, excessive sleep, fatigue - classic Kapha symptoms in NAFLD.
  • Malaise/RUQ discomfort due to Srotorodha in

Pitta Avarana Signs:

  • If Ranjaka Pitta is obstructed → Jaundice in advanced stages.

Treatment Implications

1. Remove Kapha Avarana.
2. Detoxify cumulative toxins.
3. Restore Medodhatwagni.

Irritable Bowel Syndrome

There is a strong Ayurvedic correlation between Irritable Bowel Syndrome and Samana Avritta Apan, a subtype of Avarana.

Pathophysiological Correlation

  • IBS is characterized by altered GI motility, visceral hypersensitivity, & stress-induced exac-erbation, mirroring Vata Vikruti in Ayurveda.
  • Samana Vayu located near Jathragni governs digestion, absorption, and nutrient segregation. When vitiated, it obstructs Apana Vayu, leading to mutual obstruction.
  • Vitiated Samana Vayu: Causes incomplete digestion, increased metabolites, and disrupts peristalsis.
  • Obstructed Apana Vayu: Results in erratic bowel movements (diarrhea/constipation), bloating, and abdominal pain.

Clinical Presentation

Saman Avritta Apan SymptomsIBS Symptoms
Grahani RogaMalabsorption and altered bowel habit
ParshwashoolaAbdominal pain with Discomfort.
Amashyagata VedanaPostprandial pain
HrudshoolHeartburn, bloating, dyspepsia

Mechanism of Avarana in IBS

  • Samana Vayu Aggravation: Ruksha and Tikshna qualities impair nutrient-waste separation, causing undigested food to stagnate.
  • Apana Vayu Dysfunction: Obstruction leads to: IBS-C (Constipation): Due to reduced motility.

Conclusion

Avarana serves as vital yet often overlooked conce-pt in Ayurvedic understand. of metabolic disorders.

These conditions such as diabetes, hypertension, NAFLD, gout, and hypothyroidism often arise from the disruption of Vata’s natural flow due to the influence of other Doshas or Dhatus. Identifying the specific obstructed Dosha and the obstructing factor is crucial for effective management, especially given the individualized nature of disease manifestation.

Each patient presents with unique causative factors, levels of Dosha aggravation, site of affliction, and interaction between Doshas and body tissues, which influence the type and extent of Avarana.

By applying the concept of Avarana to the pathogenesis and treatment of metabolic disorders, Ayurveda offers a comprehensive, personalized framework that complements modern medicine. This integrative approach not only enhances diagnostic accuracy but also supports targeted, holistic interventions ultimately working toward Roga Mukti and improved patient outcomes.

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