{"id":71357,"date":"2017-11-05T14:42:46","date_gmt":"2017-11-05T21:42:46","guid":{"rendered":"http:\/\/www.lankaweb.com\/news\/items\/?p=71357"},"modified":"2017-11-05T14:43:00","modified_gmt":"2017-11-05T21:43:00","slug":"awesome-thriphala-aralu-bulu-and-nelli-join-statins-as-cholesterol-busters","status":"publish","type":"post","link":"https:\/\/www.lankaweb.com\/news\/items\/2017\/11\/05\/awesome-thriphala-aralu-bulu-and-nelli-join-statins-as-cholesterol-busters\/","title":{"rendered":"Awesome Thriphala -Aralu, bulu and nelli join statins as cholesterol busters"},"content":{"rendered":"<div id=\"post-266047\" class=\"post-266047 post type-post status-publish format-standard hentry category-news entry single-default\">\n<h2 class=\"by-line\"><span style=\"color: #0000ff;\"><em>By Kumudini Hettiarachchi\u00a0Courtesy Sunday Times<\/em><\/span><\/h2>\n<\/div>\n<div id=\"post-266047\" class=\"post-266047 post type-post status-publish format-standard hentry category-news entry single-default\">\u00a0A humble but magical \u2018trio\u2019 used by ancient veda mahattayas have stunned the world of modern medicine by their \u2018healing\u2019 powers right here in Sri Lanka.<img loading=\"lazy\" decoding=\"async\" class=\"alignright size-full wp-image-266048\" title=\"CholestarolGraphic\" src=\"http:\/\/www.sundaytimes.lk\/171029\/uploads\/CholestarolGraphic.jpg\" alt=\"\" width=\"400\" height=\"516\" \/><\/div>\n<p>The three herbal fruits \u2014 aralu, bulu and nelli \u2014 are potent fighters in the battle against high cholesterol, the Sunday Times learns. Not speculation nor rumour, but tried and tested is the aralu-bulu-nelli combo in an indisputable Clinical Trial (CT) conducted by the guru-gola (teacher-student) pair, Consultant Physician Prof. Colvin Goonaratna and Senior Consultant Cardiologist Dr. Ruvan Ekanayaka.<\/p>\n<p>Thriphala is the most ancient ayurvedic prescription dating back to the time of Charaka, explains Prof. Goonaratna before launching into how the CTs were conducted at Link Natural Products (Pvt) Ltd.<\/p>\n<p>He stresses that he joined this company that manufactures herbal products as its Consultant for CTs after determining that it is 100% herbal. The company\u2019s manufacturing laboratory has got Good Manufacturing Practice (GMP) certification.<\/p>\n<p>Giving the backdrop, Prof. Goonaratna says that reading up on aralu (Terminalia chebula), bulu (Terminalia belerica) and nelli (Phyllanthus emblica), he came across an article in an Indian journal which stated that Thriphala reduces cholesterol after some animal and human studies.<\/p>\n<p>However, no CTs had been conducted and CTs are the gold standard when assessing a drug or a surgical operation,\u201d he says, adding that he then consulted\u201d Dr. Ekanayaka, most probably the only non-heart patient to do so.<\/p>\n<p>Dr. Ekanayaka was very interested and that is how the study, from December 2014 to March 2016, became a reality, with the study being designed by Prof. R. Sooriyarachchi of the Department of Statistics of the University of Colombo, who came up with the required numbers, which they followed to the letter.<\/p>\n<p>Thereafter, Dr. Ekanayaka invited patients from the National Hospital\u2019s Institute of Cardiology who were on 10mg of the atorvastatin, as maintenance\u201d against their cholesterol levels from rising, to take part in the study. These patients had been on an uninterrupted \u2018stable dose\u2019 of atorvastatin for six to nine months for lipid regulation.\u201d<\/p>\n<p>Lipid regulation is essential as hyperlipidaemia is a major risk factor for cardiovascular disease (CVD), which in turn, is the leading cause of morbidity (illness) and mortality (death) in the world. (Hyperlipidaemia means raised serum levels of one or more of total cholesterol \u2014 low-density lipoprotein cholesterol (LDL-C), triglycerides (TGs) or both total cholesterol and triglycerides.)<\/p>\n<p>Combined with lifestyle modifications, lipid-regulating medication is a key component of both primary and secondary prevention, with statins being the undisputed first-line drugs for it. But they have a large number of side-effects, it is learnt.<\/p>\n<p>In this double-blind randomized controlled study, there were two groups of patients:<\/p>\n<div id=\"attachment_266049\" class=\"wp-caption alignleft\">\n<p><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-266049\" title=\"204A8921\" src=\"http:\/\/www.sundaytimes.lk\/171029\/uploads\/204A8921.jpg\" alt=\"\" width=\"400\" height=\"266\" \/><\/p>\n<p class=\"wp-caption-text\">The guru-gola pair: Prof. Colvin Goonaratna (left) and Dr. Ruvan Ekanayaka. Pix by Sameera Weerasekera<\/p>\n<\/div>\n<p>One group of 101 patients on 10mg atorvastatin daily who were each given a Swastha Thriphala Caplet in the morning and two after dinner at night for three months. This was the treatment group.<\/p>\n<p>The other group of 97 patients who were on 10mg atorvastatin daily who got placebos for three months. This was the control group.<\/p>\n<p>The Sunday Times learns that in such a CT, some of the participants (those in the treatment group) are given the medical treatment which the researchers are bent on testing, while others (those in the control group) are given a fake (placebo). \u2018Double-blind\u2019, meanwhile, means that both the researchers and the participants do not know who is getting what, until the study ends.<\/p>\n<p>In a CT, the primary concern is whether by giving the medication the patients will come to harm,\u201d stresses Dr. Ekanayaka, underscoring that regular routine investigations were carried out and a watch kept whether there would be any adverse event.<\/p>\n<p>The only\u201d side-effect was loose stools and that too only in some, points out Prof. Goonaratna.<\/p>\n<p>&nbsp;<\/p>\n<table border=\"0\">\n<tbody>\n<tr>\n<td><strong>Amazing findings<\/strong><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>The findings of the study published as \u2018The effect of thriphala, a herbal Ayurveda formulation, on serum lipids in patients on a maintenance dose of atorvastatin for hyperlipidaemia: A randomized controlled trial\u2019 in the most recent issue of the Ceylon Medical Journal are amazing:<\/p>\n<p>\u00b7 Thriphala not only reduced cholesterol but had an impact on the \u2018bad\u2019 cholesterol overall. Those who got Swastha Thriphala as an adjunct dose to atorvastatin 10mg had a significant\u201d (p&lt;0.0001) reduction in the mean total blood cholesterol; mean cholesterol\/HDL ratio (p&lt;0.0001) and mean non-HDL-cholesterol (p&lt;0.0001).<\/p>\n<p>\u00b7 In contrast, in the control group who took atorvastatin and the placebo, the reduction in total blood cholesterol was negligible (p&lt;0.28) and the cholesterol\/HDL ratio actually increased, albeit by a narrow and non-significant margin.<\/p>\n<p>\u00b7 Thriphala clearly had a beneficial effect on non-HDL cholesterol over and above\u201d the benefits seen only with atorvastatin.<\/p>\n<p>This is particularly significant, says Prof. Goonaratna and Dr. Ekanayaka as the non-HDL cholesterol component of lipids including atherogenic particles are recognized as a risk factor for atherosclerotic disease (build-up of plaque in the arteries).<\/p>\n<p>\u00b7 Thriphala did not increase liver enzymes \u2013 those who were given the caplets remained with perfect livers. There was no effect on the blood-test marker for inflammation in the body \u2014 C-reactive protein (CRP). Usually, CRP which is produced in the liver will increase if there is inflammation.<\/p>\n<p>\u00b7 Thriphala did not induce diabetes, but in fact there seemed to be a mitigatory effect on high sugar levels.<\/p>\n<p>While concluding that Thriphala used in the stipulated dose as an adjunct to atorvastatin 10mg daily significantly enhances its cholesterol reducing action in patients, Prof. Goonaratna and Dr. Ekanayaka add that the use of Thriphala as a single therapy for lipid regulation and the mode of its action deserve\u201d investigation.<\/td>\n<td><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>&nbsp;<\/p>\n<div id=\"attachment_266050\" class=\"wp-caption aligncenter\">\n<p><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-266050\" title=\"204A9799\" src=\"http:\/\/www.sundaytimes.lk\/171029\/uploads\/204A9799.jpg\" alt=\"\" width=\"400\" height=\"295\" \/><\/p>\n<p class=\"wp-caption-text\">The Swastha Thriphala Caplets<\/p>\n<\/div>\n<div id=\"attachment_266051\" class=\"wp-caption aligncenter\">\n<p><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-266051\" title=\"Aralu-(2)\" src=\"http:\/\/www.sundaytimes.lk\/171029\/uploads\/Aralu-2.jpg\" alt=\"\" width=\"400\" height=\"267\" \/><\/p>\n<p class=\"wp-caption-text\">Aralu<\/p>\n<\/div>\n<div id=\"attachment_266052\" class=\"wp-caption aligncenter\">\n<p><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-266052\" title=\"Bulu-(2)\" src=\"http:\/\/www.sundaytimes.lk\/171029\/uploads\/Bulu-2.jpg\" alt=\"\" width=\"400\" height=\"266\" \/><\/p>\n<p class=\"wp-caption-text\">Bulu<\/p>\n<\/div>\n<div id=\"attachment_266053\" class=\"wp-caption aligncenter\">\n<p><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-266053\" title=\"Nelli2\" src=\"http:\/\/www.sundaytimes.lk\/171029\/uploads\/Nelli2.jpg\" alt=\"\" width=\"400\" height=\"267\" \/><\/p>\n<p class=\"wp-caption-text\">Nelli<\/p>\n<\/div>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>By Kumudini Hettiarachchi\u00a0Courtesy Sunday Times \u00a0A humble but magical \u2018trio\u2019 used by ancient veda mahattayas have stunned the world of modern medicine by their \u2018healing\u2019 powers right here in Sri Lanka. The three herbal fruits \u2014 aralu, bulu and nelli \u2014 are potent fighters in the battle against high cholesterol, the Sunday Times learns. Not [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[12],"tags":[],"class_list":["post-71357","post","type-post","status-publish","format-standard","hentry","category-forum"],"_links":{"self":[{"href":"https:\/\/www.lankaweb.com\/news\/items\/wp-json\/wp\/v2\/posts\/71357","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.lankaweb.com\/news\/items\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.lankaweb.com\/news\/items\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.lankaweb.com\/news\/items\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.lankaweb.com\/news\/items\/wp-json\/wp\/v2\/comments?post=71357"}],"version-history":[{"count":0,"href":"https:\/\/www.lankaweb.com\/news\/items\/wp-json\/wp\/v2\/posts\/71357\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.lankaweb.com\/news\/items\/wp-json\/wp\/v2\/media?parent=71357"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.lankaweb.com\/news\/items\/wp-json\/wp\/v2\/categories?post=71357"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.lankaweb.com\/news\/items\/wp-json\/wp\/v2\/tags?post=71357"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}