Ayurveda

Ask Dr. Sheila: How Can Ayurveda Help When Nothing Else Has Worked?

Woman with hands on heart in nature
Woman with hands on heart in nature

For the Ask Dr. Sheila column, Dr. Sheila Patel, Chopra’s Chief Medical Officer, answers questions from our community. If you have a general question for Sheila around health and wellness, please send an email to askdrsheila@chopra.com, and your question may be the one she answers next.

In this article, Dr. Sheila answers a question about how Ayurveda can offer support for health issues when the individual has tried a variety of modalities without success.


“I have chronic health issues and have tried many conventional and holistic treatments but still have symptoms. Can Ayurveda help?”

This is a very common question that I receive as a physician and Ayurvedic practitioner. I have seen many patients in the past who were diagnosed with a variety of ailments, worked up by many specialists, and given treatments but still had symptoms and/or got worse over time.

Understanding Toxin Burden and Your Ability to Heal

From an Ayurvedic perspective, this is easy to explain when you consider the concepts of ama (toxicity) and agni (the ability to ‘digest’ and handle all the input coming into the mind and body). When these concepts are understood, it can help to explain why people can accumulate multiple issues over time and do not respond to standard treatments.

One of the assessments that is done in Ayurveda before a treatment plan is created is an assessment of ‘toxic burden’, or ama. Let’s look at this as far as the physical body is concerned. Understood in a modern context, this assesses the burden of chemicals and unhealthy molecules that are in our system, such as free radicals, inflammatory molecules, and environmental chemicals that are interfering with our body’s natural self-regulatory mechanisms, otherwise known as self-healing.

When these toxins overwhelm the system we don’t feel well—we have pain, fatigue, poor digestion, skin issues, mood issues, hormonal imbalances, brain fog, among other things. These are all signs of high ama, or high toxic burden. And when we have high ama, we suppress our agni, or our ability to heal.

Reducing Toxin Burden through Ayurvedic Cleansing Practices

From an Ayurvedic perspective, when we have high ama we need to reduce the toxic burden before we deal with specific health conditions, or the treatments won’t work. This is done through a variety of cleansing practices, or detoxification. The scientific definition of detoxification is “the process of removing toxic substances or qualities’, or “the physiological removal of toxic substances from a living organism, including the human body” and is becoming an increasingly important concept in the emerging field of environmental medicine.

You may not hear about this in conventional medical settings, because the impact of toxicity, or ama, on our system is not always appreciated. And conventional teaching says that ‘we have natural methods to detox, so there is no need to do a detox’. I’ve heard this many times from other doctors.

While it is true that we have natural ways to detoxify, it is also known that our system can get overwhelmed and in order to properly function, we may need to be replenished with vital nutrients that support the natural detox pathways. As these nutrients get depleted, we need to replenish the many cofactors, vitamins, and minerals that are needed for these chemical detoxification pathways to occur in the liver, blood, intestines, kidneys and other tissues. We also need to support the other tissues and organs in the body to properly eliminate the toxicity.

In Ayurvedic cleansing, all the organs and tissues are supported and utilized for a more complete detoxification process.

Detoxification is not a foreign concept in medicine. Let’s look at an example from conventional medicine. When we drink alcohol chronically, we interfere with the absorption of vital nutrients, including folate and thiamine, even when there is adequate intake of these nutrients. The alcohol itself, as a ‘toxin’, interferes with our natural ability to heal.

In addition, with heavy chronic use, we can deplete our supply of Vitamin B3, zinc, and cofactors needed for alcohol metabolism, such as NAD. We know that our natural detoxification systems can deal with a certain amount of alcohol over a certain period of time, and if we exceed that amount, we feel poorly and can develop deficiencies of nutrients which ultimately lead to disease.

Another example I use to explain this phenomenon is the example of an infection. We can think of the pathogen as a ‘toxin’ because it interferes with our normal physiology. Someone may say ‘we have an immune system to handle pathogens, so we don’t need antibiotics’. While this may be true in some circumstances, once in a while, the system gets overwhelmed and can’t handle the vast number of germs that are in the system. Our immune system, which is designed to get rid of germs, can’t function and we can get very ill. In these situations, we need to remove some of the pathogens, in this case with antibiotics, in order for the body to deal with what remains.

We can extend this understanding of ‘detoxification’ to other toxins that accumulate in our body. These can be an accumulation of environmental toxins or toxic molecules that we create internally such as free radicals and inflammatory molecules. While we can manage a certain amount of toxicity, we can get overwhelmed and can’t repair fast enough. This can lead to disease that does not respond to normal treatments, whether natural or conventional.

A well-designed Ayurvedic cleanse can help remove things that are creating cellular damage, inflammation, hormonal imbalances, and interfering with normal function. This then allows our natural healing systems to function as they are meant to function. This is a very foundational principle in Ayurveda which is why it is recommended to do a gentle detox periodically and avoid the accumulation of ama/toxicity. In medicine, we tend to wait until we see frank disease, but it is often late in process and more challenging to treat.

How Ayurveda Can Support Mindfulness through the Healing Process

One final teaching on disease that Ayurveda gives us is the understanding that we can’t always treat or reverse disease. In a modern understanding, an individual may have genes or genetic tendencies that make some conditions more likely to develop and more difficult to treat. This is where mindfulness and accepting where we are in the present moment can help us to relieve suffering that we may be experiencing from our physical health challenges.

Meditation practices are a crucial part of any treatment plan. This allows us to set intentions for our healing and do what we can in the moment, while releasing attachment to the final outcome. This doesn’t mean we don’t keep trying, or that we like what is happening, but in this surrender, we can transcend the experiences of body and mind and connect to our source of joy.

*Editor’s Note: The information in this article is intended for your educational use only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health providers with any questions you may have regarding a medical condition and before undertaking any diet, supplement, fitness, or other health programs.


Release winter stagnation and refresh your energy with Spring Release and Refresh, a four-part Ayurveda series with Dr. Sheila Patel, available now in the Chopra App under For You.