During the COVID pandemic, two herbal medications caught people’s imagination like nothing else – turmeric and Giloy. Both these were used in various forms, as treatment for the patients as well as prophylactic agents for boosting immunity. Similarly, others like Ashwagandha and Chyawanprash were also used in abundance.
Not to be dismissed was the overuse of multivitamins and trace elements like zinc, vitamin D, calcium, etc.
Arguably, all these have been shown to have some beneficial effects. However, the problem arises when these medications are used continuously for months and years, under no medical supervision, as tonics.
Unfortunately, hyped marketing has created an impression that all these are tonics, the connotation of which is that they are good for health and the higher the dose and longer the duration of their use, the better it is.
Research has shown that all these work in the recommended doses for the diseases they are intended to be used. But there are certain side effects which people are blissfully unaware of.
How Healthy Is Giloy?
The word Giloy (Tinos pora cordifolia) finds a mention in the Hindu mythology referring to a mythical heavenly elixir that keeps celestial beings young forever. As long as taken in the dose recommended on the product label or by a health professional, there are not many risks of Giloy in ‘healthy’ people.
However, certain sets of people need to be extra cautious before taking it. For example, in diabetics, it may cause sharp lowering of sugar and a hypoglycemic reaction (characterised by sweating, palpitation, and severe uneasiness), if taken in combination with anti-diabetic drugs.
People who suffer from an an autoimmune disease, like rheumatoid arthritis, lupus, or Crohn’s disease have to be doubly cautious because Giloy could over stimulate the already stressed immune system.
It also is not recommended for pregnant women or lactating mothers.
Is Haldi As Healthy As It Seems?
Especially during the pandemic, turmeric latte or haldi doodh became extremely popular, so much so that some people started taking it three times a day, although you shouldn't ideally take it more than once a day.
The active principle of haldi, the rhizomes of the plant curcuma longa, is curcumin which is a naturally occurring yellow pigment of turmeric having a wide spectrum of biological actions.
It has been used for centuries for its antioxidant, pain-killing, anti-inflammatory, antiseptic, anticarcinogenic, chemopreventive, chemotherapeutic, anti-tumour, and anti-infective properties.
But there have been several case reports of adverse reactions to turmeric during the current pandemic.
The problem seemed to lie in the overuse of turmeric, especially its consumption along with black pepper.
Consumption of high doses of curcumin has adverse effects, including nausea, diarrhea, headache, skin rash, etc, though mild. Use of curcumin with black pepper may potentiate the adverse reactions of the former, because piperine, the active ingredient of black pepper greatly increases absorption of curcumin from the intestine.
One fresh teaspoon of ground turmeric has around 200 milligrams of curcumin. The recommended daily intake is around 200 mg to 500 mg of curcumin.
Are There Other Popular 'Tonics'?
Two other ‘tonics’ that have been widely used are Ashwagandha and Chyawanprash. Ashwagandha is supposed to be an immune modulator and an adaptogen which is believed to help the body resist physical and mental stress.
Therefore, it is used for many conditions related to stress. But it can potentiate the effect of anxiolytics already being taken by the patient. So one has to be very cautious in using this.
Ashwagandha is possibly safe when used for up to three months, according to some studies. One must desist from taking large doses of Ashwagandha to ward off anxiety and insomnia quickly because it may cause an upset stomach, nausea, and vomiting, and in extreme cases liver failure.
As it can increase the activity of the immune system, it has the propensity to cause some drug interactions with those being taken after an organ transplant because the latter are given to suppress the immune system.
As with Giloy, Ashwagandha might lower one's blood sugar levels. Not only that, in large doses taken for long duration, it can also increase thyroid hormone output with its attendant effects.
Further, it can potentiate the effect of certain blood pressure medicines, hence one needs to monitor blood pressure on a regular basis.
What About Chyawanprash?
Coming to Chyawanprash, it is supposed to supercharge immunity and digestive health but the most attractive of its effects are those on slowing the ageing process, improving libido, and fertility.
For these reasons, people tend to use it very enthusiastically and in higher than recommended doses which may cause indigestion, flatulence, bloating, and sometimes, loose stools. Most of these side effects are not serious and generally mild.
There are certain contra indications to taking Chyawanprash like chronic constipation, loose stools, and uncontrolled and brittle diabetes, nocturia (increased frequency of urination at night), nocturnal emissions, etc.
During the pandemic, the excessive use of ‘tonics’ was not limited to the herbal tonics alone. There were many who continued to take vitamin D and zinc for months together.
Some of them came down with weakness, weight loss, muscle pains, constipation, nausea, vomiting, mood swings, etc.
Overdose of vitamin D can also cause increase in calcium in the blood and kidney stone formation. Similarly, taking very high doses of zinc is might cause stomach pain, vomiting, etc.
Another reason for these observed side effects is the drug interactions with simultaneous intake of certain other medications which doesn’t even cross people’s mind. With the possible exception of turmeric, the other so-called tonics are actually medications and are being used rather over-enthusiastically as energy boosters.
As one can see, the problem lies not in the tonics per se but in their overuse and unsupervised consumption.
(Dr Ashwini Setya is the Adjunct Professor in Gastroenterology, ESIC Medical College, Faridabad, and Senior Consultant with Medanta Institute of Digestive & Hepatobiliary Sciences, New Delhi. Dr Setya is also an advisor and consultant in Medical Law and Ethics. He can be reached at ashwini.setya@gmail.com. This is an opinion piece, and the views expressed are the author's own. The Quint neither endorses nor is responsible for them.)
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