Rasayana: A call for re-invention to harness its potential in public health
Year: 2024
Type: editorial
Abstract: Rasayana is one of the most hyped subjects in the study of Ayurveda, often diverting attention from its traditional role as part of a holistic regimen rather than a standalone solution for contemporary health challenges. By keeping Rasayana and Vajikarana under the eight major clinical specialties of Ayurveda, ancient sages like Charaka, Sushruta, and Vagabhata have already endorsed their foremost clinical importance. Keeping it at the forefront of clinical medicine has further highlighted its importance as promotive, preventive, and supportive health care before any real curative approach is attempted. Rasayana has fundamentally been defined as pharmacological and nonpharmacological approaches aiming toward disease prevention and ensuring an optimally productive healthy life. The definition of Rasayana by Sharangadhara speaks of this optimally productive life by stating “Labhopayo Hi Shastanam Rasadinam Rasayanam.” Conventionally, Rasayana has also been classified for its anti-aging, disease-preventive, and curative approaches (Rasayanam Cha Taj Gyeyam Yajjajara Vyadhi Vinashanam) but fundamentally it encompasses much more than this narration of Rasayana reeling around its anti-aging and anti-disease approaches.[1] Rasayana, with its fascinating and well-documented benefits documented across Ayurveda classics, holds immense potential to transform contemporary clinical practice. However, the utility of Rasayana in contemporary Ayurveda clinical practice has been limited to specific areas only. The reasons for this are manifold, but the fundamental cause may primarily lie in the need for a deeper understanding of its principles through the lens of contemporary science and its validation through rigorous clinical trials.[2] Moreover, the Ayurvedic protocol of Rasayana intervention to optimize its therapeutic benefits has not been explored, understood, and practiced. The scientific principles behind Rasayana are sometimes misrepresented or exaggerated to meet high consumer demand and commercial interests. There is strong public interest and high consumer demand for Rasayana products, which are often viewed more favorably by public compared to other medicinal formulations with therapeutic benefits. The scope of Rasayana is extensive, encompassing diverse interventions and health benefits, and to ensure its responsible application and optimize its impact, all health claims associated with Rasayana products must be grounded in evidence and backed by rigorous scientific research. Chyavanprasha, valued at Rs. 700 crore in the Indian market, serves as an example of how an Ayurvedic Rasayana product can gain significant market presence, even though robust, evidence-based investigations into the full extent of its benefits are limited. Products containing Rasayana ingredients like Ashwagandha and Shilajit are promoted with considerable vigor in the Indian market, which is largely driven by consumer preference. While this market is often less influenced by clinical trials and scientific studies, it underscores the need for a balanced approach with rigorous scientific validation. The global Shilajit market is estimated to be United States Dollar (USD) 175.6 million in 2023 and is expected to grow at a Compound Annual Growth Rate of 9.0% from 2024 to 2030.[3] The global Ashwagandha extract market size is projected to be USD 698.0 million in 2023. By 2033, the global market for Ashwagandha extracts is projected to reach USD 1523.0.[4] This growth is driven by the increasing demand for Ashwagandha extracts, fuelled by its versatility in addressing a wide range of health concerns, particularly for their stress-reducing properties and adaptogenic benefits. Our concern while writing this editorial is however different. Pharmaceutical companies may focus on market-driven strategies for Rasayana products, achieving commercial success complying to the regulatory norms. The onus of establishing Rasayana's potential in addressing multifaceted health benefits lies with the Ayurveda community. To substantiate and validate its claims and uncover new therapeutic applications, rigorous, well-designed clinical studies can be taken up. While the methodology for such studies mirrors that of regular clinical trials, unique factors such as population heterogeneity and self-medication must be carefully considered, as they can influence the efficacy and safety outcomes of Rasayana formulations. To refine and optimize the use of Rasayana, several critical aspects need to be systematically addressed. These include defining rational protocols for dosage, duration, and outcomes, determining candidate-specific suitability and contraindications, and establishing guidelines for its use in complex clinical conditions, in the wake of compromised pharmacokinetics, or potential herb-drug interactions. The impact of aging on Rasayana pharmacodynamics, the risks of herb-herb or herb-food interactions when multiple formulations are used, and the long-term risk-benefit profile of its usage must also be explored through rigorous research. It is especially important for the Rasayana formulations containing mercury and arsenic compounds besides many other heavy metals.[5] These questions are crucial for understanding how Rasayana can be effectively utilized as a therapeutic agent, with clear, evidence-based clinical benefits. Conducting such studies will unlock the full potential of Rasayana, ensuring that its benefits are realized by the broader population and not limited to specific market segments. Advancing research on Rasayana requires a synergistic collaboration between academia, industry, and government. Achieving substantial scientific progress is crucial to fully elucidate the therapeutic potential of Rasayana, with an evidence-based framework serving as the cornerstone for translating its benefits into meaningful contributions to public health. Principally, Rasayana has the potential to be adopted as a highly suitable and culturally sensitive public health initiative to impart health benefits to the masses. Before doing so, however, substantial homework is required to systematically evaluate its mechanisms of action, establish robust clinical evidence, and determine optimal protocols for its safe and effective use in diverse populations. Suvarnaprashana, which is also a highly acclaimed Rasayana for the pediatric age group has recently been claimed to have the potential of mitigating Japanese encephalitis in its endemic areas.[6] If this is the case, unlocking the myriad versatile potential of Rasayana could pave the way for ground-breaking research, with far-reaching implications for healthcare. Financial support and sponsorship Nil. Conflicts of interests There are no conflicts of interest.
Author: Sanjeev Rastogi
Institution: Government of Uttar Pradesh
Language: English
Subfield: Complementary and alternative medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4405317794