Using Ayurveda with modern medicine: how to tell your doctor

Many people use Ayurvedic products or therapies at the same time as medicines prescribed by a doctor. This can be done safely, but only when everyone involved knows what you are taking. This article explains why telling your doctor matters, how herbal products can interact with medicines, and a practical way to share information. It uses guidance from the US National Center for Complementary and Integrative Health (NCCIH) and the US Food and Drug Administration (FDA). It does not suggest that any therapy helps with a disease, and your doctor decides your treatment.

1. Introduction

NCCIH explains that many people take herbal supplements together with prescription or non-prescription medicines ^[1]. Ayurveda, India's traditional system of medicine, often includes herbal products, minerals, diet and lifestyle advice ^[6]. A complementary approach is one used alongside conventional care, and NCCIH advises telling all your providers, both complementary and conventional, about every approach you use so that they have the full picture and can coordinate safe care ^[3].

2. Why herbs and medicines can interact

An interaction happens when one substance changes the way another works in the body. NCCIH explains that some herb and medicine combinations can reduce the effect of a medicine, while others can strengthen it, including its side effects. It also states that information on many interactions is limited and that more research is needed ^[1]. A clinical digest for health professionals adds that herbal supplements carry risks like other active compounds, that interactions may involve prescription medicines, non-prescription medicines, other supplements and even food, and that most interactions in current sources are hypothetical, inferred from animal studies, laboratory tests or other indirect methods ^[2].

The best-known examples in these sources involve herbs that are not specifically Ayurvedic, but they show how interactions work.

• St. John's wort often speeds up the breakdown of medicines, which can lower their levels in the body. With certain antidepressants it can also raise the risk of serious side effects ^[1].
• Goldenseal was linked with a fall of about one quarter in blood levels of the diabetes medicine metformin in an NCCIH-funded study of healthy adults ^[2].
• Concentrated green tea products can lower blood levels of some medicines ^[1].
• Ginkgo has been linked with a higher risk of major bleeding when used with warfarin ^[2].

The sources used for this article do not provide a list of interactions for specific Ayurvedic formulations. That is a reason for caution, not a sign that no interactions exist. Ask your registered practitioner for the ingredients of any product, and ask your doctor or pharmacist whether they are a concern with your medicines.

3. Medicines that need extra care

NCCIH points out that medicines with a narrow therapeutic index, where small changes in the amount in the body can cause major problems, need special caution. Examples it lists include warfarin (a blood thinner), digoxin (a heart medicine) and cyclosporine, and the clinical digest also names cancer chemotherapy medicines ^{[1, 2]}. If you take any of these, your doctor must know about every herbal or Ayurvedic product you use.

4. Metals and product quality

Some Ayurvedic products have contained heavy metals such as lead, mercury and arsenic, which are typically not shown on the label ^[5]. The FDA advises doctors to ask patients about all the products they use, including Ayurvedic ones, and to consider metal poisoning if related symptoms appear ^[5]. NCCIH notes that some supplements have been found to contain medicines not named on the label, and that words such as "standardised" or "certified" do not guarantee quality ^[4]. Our article on heavy metals in Ayurvedic medicines gives more detail.

5. How to tell your doctor

NCCIH advises bringing a written list of everything you take, how often you take each product and how much, to every visit ^[1]. Practical tips:

• Include Ayurvedic medicines, powders, oils, tonics, herbal teas and supplements, not only tablets.
• Bring the packets, or photos of the labels, including the ingredient list and batch number.
• Mention any therapies such as Panchakarma, and any new diet plan.
• Tell your Ayurveda practitioner about your prescribed medicines and conditions too.
• Choose practitioners who are willing to work with your other health care providers ^[3].

6. Surgery, pregnancy and children

NCCIH says some supplements can increase bleeding or affect how you respond to anaesthesia, and that you should tell your health care team about every supplement well before an operation ^[4]. It also says that many supplements have not been tested in pregnant or nursing women or in children ^[4], and that some Ayurvedic products may be harmful in pregnancy or while nursing, so you should speak to your own provider first ^[6].

7. Do not stop or delay medical care

NCCIH advises against using an unproven product or practice to delay seeing a health care provider. It also says that stopping or not starting a conventional treatment can have serious consequences, so you should talk to your providers before deciding against a proven treatment ^[3]. Do not stop a prescribed medicine because you have started an Ayurvedic one.

8. When to see a doctor

See your doctor if you plan to start any Ayurvedic product while taking prescribed medicines, if you notice new symptoms such as rashes, stomach upset, dizziness, unusual bruising or bleeding, or if your usual medicine seems to work differently. Seek advice before surgery or tests, in pregnancy, and for children.

In an emergency, call your local emergency number (112 in India, 911 in the United States).

9. Conclusion

Ayurveda and modern medicine can be part of the same person's care only if everyone knows the full picture. Herbal products can change how medicines work, and evidence on many interactions is limited. Keep a written list, show your doctor the products you use, do not stop prescribed medicines without advice, and choose practitioners who work with your doctor.