for the believers of traditional systems of medicine, it may come as a shock to find guggul -- a plant used in nearly 80 ayurvedic medicines -- listed as a "dirty herb" in media reports from the us. The reports cite a study conducted by researchers from the University of Kansas, usa, which indicates that consumption of Gugulipid, a patented chemical derived from guggul (Commiphora mukul), is harmful because it reduces the efficacy of allopathic drugs. Ironically, instead of blaming the product, the media has condemned the herb.
Countering these reports, ayurvedic physicians contend that guggul products are not being used appropriately and the plant is getting maligned unnecessarily. As per ayurveda, the herb should be ideally used to treat arthritis. But in the West (mainly the us), it is marketed as an anti-cholesterol agent after studies conducted by Lucknow-based Central Drug Research Institute (cdri) indicated that the herb's active ingredient can effectively lower the cholesterol level. Supplements containing Gugulipid are commonly available in the us without a prescription. Such self-medication obviously results in problems, and experts assert that the Kansas study rightly highlights the risk of 'off-label' use of the medicine.
During the research, effects of Gugulipid on various human enzymes were studied in vitro with the help of cultured cells. The researchers found that guggulsterones (the active ingredient) triggers pregnane x receptors (pxr) at an abnormal rate, following which allopathic drugs break-up too quickly in the body. pxr is a receptor that recognises the presence of drugs and signals the body to turn on the cyp 3 a 4 enzyme system in the liver to break down the medicines. Around 60 per cent of allopathic drugs are metabolised by the cyp 3 a 4 pathway, including those meant to treat aids , cancer and cholesterol. If pxr receptors are triggered excessively, the cyp 3 a 4 system is stimulated more and the drug is removed from the body much faster than required, rendering it ineffective.
The findings, published in the Journal of Pharmacology and Experimental Therapeutics (Vol 310, No 2, August 2004), are the first comprehensive scientific evidence of how unregulated use of guggul can be harmful. A small-scale study conducted in 1994 by researchers from the Mumbai-based Seth G S Medical College had indicated that a single oral dose of one gramme of Gugulipid could affect the bioavailability of a single oral dose of propranolol (used for controlling hypertension) and diltiazem (meant for treating high blood pressure).
The latest findings highlight the need to spread awareness about the safe usage of ayurvedic medicines. This is a must, as unwarranted media reports could not only shake people's belief in this system of healing, but also affect India economically -- the country exports guggul products on a large-scale. The gratuitous information could lead to a blanket ban on these products in all developed nations, as is the case with ephedra.
According to experts, the process of extracting Gugulipid is also to be blamed for the plight of the herb. Manufacturers make Gugulipid by treating guggul with various solvents. This results in a concentrated form of the medicine that only has the active ingredient. In ayurveda, guggul is treated with herbs, milk and at times cow urine; the final product contains all chemicals present in the herb that work together to bring about the desired affect. Moreover, one mitigates the harmful affects of the other. This advantage is lost when only one compound (the active ingredient) is used. "If only a component of the herb is used, it should be tested against 'specific' disease according to modern pharmacology for its safety and efficacy," asserts Kuldeep Kohli, director of Dabur Research Foundation, Uttar Pradesh.
A proactive approach is required to resolve these issues. "We conducted research on the herb in the 1970s, based on the best available knowledge. The present study shows that research should be an ongoing process," says S Nityanand, former director of cdri. His statement implies that the use of guggul derivatives to reduce cholesterol cannot be completely ruled out. "Gugulipid is safe to use in people who are not taking other medications that are metabolised by the cyp 3 a pathway. But more human clinical trials are needed to adequately address this issue," asserts Jeffrey Leonard Staudinger, one of the authors of the Kansas study. "Instead of saying that ayurveda is bad, the world should stop its misuse. It is important to adhere to traditional knowledge," concludes Balendu Prakash, director of Vaidya Chandra Prakash Cancer Research Foundation, Dehradun.