When Joe Santabarbara*, an athletic, type A television producer in Dallas, Texas, reached his mid-30s, his health began to unravel. “I developed all sorts of bizarre symptoms,” he recalls. “Liver pain, crushing fatigue, restless legs syndrome, itchiness, hypoglycemia. I had to start working from home because I couldn’t stay awake for two or three hours after meals.”
A nutritionist discovered the source of his problems through a series of blood tests: Joe had hepatitis C (HCV), a blood-borne virus that becomes chronic in 70 to 80 percent of infected patients and often leads to liver disease, along with muscle and joint pain, mood swings, headaches, sleep disorders, fevers, and digestive problems. Like many of the estimated 4.1 million Americans infected with HCV, Joe doesn’t know when or where he got the infection. Most people are symptom-free for years before the virus takes its toll.
After researching allopathy’s standard but severe treatment with the drugs interferon and ribaviran, which can cause a flu-like syndrome, cardiovascular complications, and psychiatric problems, Joe decided to try alternative treatments like Chinese medicine and macrobiotics—but the effects were short-lived. “I knew I had the self-discipline to do whatever it took to heal,” he says, “but I needed a road map.”
Then Joe heard about the Ayurvedic Institute in Albuquerque, New Mexico. Founded by the world-renowned doctor of ayurvedic medicine Vasant Lad, the Ayurvedic Institute is one of the leading ayurvedic health spas and schools in the U.S. In March 1998, Lad diagnosed Joe with a case of excess pitta—a subtle energy that can cause people to mentally and physically overheat when it’s out of balance. And hepatitis C, Lad noted, is a classic pitta condition. Lad said that by adding yoga, a cooling diet, and an herbal regimen to his daily routine, Joe could quell his symptoms. But first, he should participate in a five-day panchakarma treatment.
An ancient cleansing and rejuvenation program, panchakarma is a series of individualized therapeutic treatments that clear ama (toxins) and excess doshas (subtle energies) from the deep tissues of the body. According to ayurveda’s ancient texts, panchakarma can both prevent and cure disease, and it is particularly successful with chronic illnesses that allopathy hasn’t conquered, such as allergies, arthritis, chronic fatigue syndrome, and migraines. On a deeper level, panchakarma can increase an individual’s sense of clarity and inner peace. That’s why yoga practitioners have used it to improve the quality of their spiritual practices for centuries.
Although Joe had never done yoga before, he was willing to give panchakarma a try. He could afford the $2,000 fee, and the treatments were luxurious. Every morning for five days, he was slathered in warm aromatic oil by two massage therapists standing at the left and right side of his body, mirroring each other’s strokes. He then sat in a square white fiberglass steam box for a sweat treatment. Next he rested face-up on a table as a technician poured a thin, continuous stream of warm oil between his eyebrows from a copper vessel, then dusted his body with a sweet-smelling mixture of sandalwood-rose powder and chickpea flour. By the end of these treatments, Joe’s mind was quiet and his muscles had melted into profound relaxation.
According to ayurvedic theory, these preparatory procedures liquefy the body’s impurities and push them toward the gastrointestinal tract. Joe’s main panchakarma treatment, which began on the third day, was a mild daily enema with herbs specific to pitta and liver function to help the impurities exit his body. In the afternoons and evenings Joe rested, took gentle yoga classes, and attended lectures on ayurveda.
“Panchakarma had a profound emotional, physical, psychological effect on me,” he says. “By the end of the program I felt ten years younger.” Hoping for scientific proof, Joe tested the efficacy of panchakarma through blood work. “I asked my lab to do a basic blood chemistry profile and a hepatitis C viral load test the day before I started panchakarma and then a few weeks after my treatments were over,” he says. The results were impressive: The first profile revealed that Joe’s viral load was in the low range at 297,086 virons per milliliter, but that an abnormal number of his liver cells were dying daily. After panchakarma, his viral load decreased by over 100,000 virons per milliliter, and his liver cells returned to normal.
In the weeks and months that followed, Joe’s energy gradually improved, and some of his excess pitta symptoms, such as irritability and itchiness, began to subside. Inspired, he began to follow Lad’s road map to health: eating a diet of bitter, cooling, protein-rich foods (avoiding hot, spicy, sour fare); taking pitta-pacifying herbs; reducing his intake of alcohol and coffee; self-administering mild oil enemas; exercising moderately; and practicing specific asanas.
At Lad’s suggestion, Joe returned for panchakarma every few months for four years. Each time that Joe repeated his pre- and post-panchakarma blood work, the tests showed a substantial decrease in his viral load and a rebalancing of his liver enzymes. And it wasn’t just panchakarma that affected his blood chemistry. In December 1999, he intentionally abandoned all of Lad’s lifestyle advice for 60 days, then repeated the blood tests. His viral load skyrocketed to over 1,500,000 virons per milliliter and his liver cells began dying off again in abnormal numbers. That was enough to convince Joe that the lifestyle changes had a profound effect on his health. (One month later, after another five-day panchakarma treatment, his viral load plummeted by 1,100,000 virons per milliliter and his liver enzymes normalized yet again.)
Joe returned to his ayurvedic lifestyle, and although his HCV symptoms didn’t subside immediately, his fatigue, digestive problems, and hypoglycemia disappeared over the course of three years. Then his restless legs syndrome faded away. To this date, Joe has gone to panchakarma 17 times and tries to follow his road map with an attitude of moderation. “I know what’s good and bad for me, and I try to make good choices more than 50 percent of the time,” he says. “My viral load has stayed in the low to medium-low range for the last four or five years, and my liver enzymes have all stayed within the normal range. I have not been able to clear the virus, but I’m completely symptom-free. None of my Western doctors have admitted it’s possible that panchakarma and ayurvedic lifestyle changes could produce such dramatic results, but I have the empirical data to prove it.”
Cleansing in a Toxic World
Many ayurvedic experts believe that even healthy people need regular panchakarma treatments today because our environment is so polluted. According to research cited by Maharishi Ayurveda, up to 100,000 synthetic chemicals (including PCBs, dioxins, and pesticides like DDT/DDE) are used in modern industrial and agricultural processes. Traces of these chemicals pervade our food, water, air, and even our own bodies, and some are associated with allergies, reproductive disorders, certain types of cancer, and other diseases.
Scientific research suggests that many environmental toxicants are fat soluble and become lodged in the lipid layers of our cells. In a two-month longitudinal study conducted in 1998 at the Raj Maharishi Ayurvedic Health Spa in Fairfield, Iowa, panchakarma helped lighten the body’s toxic load of all 18 participants by reducing the level of several fat-soluble pesticide compounds, including beta-HCH and certain PCBs, by an average of approximately 50 percent compared to controls.
Panchakarma can slow the aging process and enhance vitality.
According to the ayurvedic tradition, panchakarma has a host of other benefits. As Lad explains, “panchakarma removes free radicals, balances cholesterol and triglycerides, regulates blood pressure, and introduces antioxidant enzymes into the body. And because it’s a wonderful source of stress management, panchakarma can even prevent heart attacks, stroke paralysis, and cancer.” Panchakarma can also slow the aging process and enhance vitality and mental clarity. It’s a “cleansing and rejuvenating program for the body, mind, and consciousness,” he says.
How Does Panchakarma Work?
First, an ayurvedic practitioner determines whether you are strong enough to withstand a cleansing regimen, and rules out contraindications such as hypertension, congestive heart failure, and (for women) pregnancy and menstruation. Then he or she assesses your current body-mind state (vikriti) and compares it to the unique ayurvedic constitution with which you were born (prakriti). Both your prakriti and vikriti are a unique blend of the three doshas—vata, pitta, and kapha—and numerous factors can disrupt their delicate balance. As Lad explains, “The wrong diet, habits, and lifestyle, along with seasonal changes, repressed emotions, and stress factors can…change the balance of vata, pitta, and kapha… which affects agni, the gastric fire, and produces ama, or toxins.”
Ama clogs us on all levels and, when left unchecked, becomes the breeding ground for disease. Described in ayurvedic texts as cold, heavy, wet, and sticky, it develops from environmental toxins and internal toxins generated by poorly assimilated food. If you have high cholesterol, hardened arteries, tooth tartar, a coated tongue, joint pain, body odor, or excess mucus, you have the physical symptoms of ama. Energetically, it lurks in the system as fatigue; mentally, ama creates dullness, irritability, and greed. According to ayurveda, panchakarma addresses the root causes of disease by removing years of accumulated ama (along with excess vata, pitta, and/or kapha) and fine-tuning your agni. The job of your ayurvedic practitioner is to tailor a program to rebalance your body and mind.
Traditionally ayurveda recommends doing panchakarma at the junction between each season to clear out impurities generated during the previous season and help you transition smoothly into the next. Lad says that early spring is always a good time to do panchakarma because it can help reduce your sensitivity to pollen and prevent colds.
Panchakarma is a three-stage process that typically lasts for three to ten days in Western ayurvedic clinics. The preparatory phase begins with internal oleation, during which you will drink increasing amounts of ghee (clarified butter) in the early morning and afternoon to lubricate the body’s subtle channels, or srotas. Next, your ayurvedic practitioner will ask you to go on a “sensory diet,” avoiding TV, loud music, drastic weather conditions, strenuous exercise, travel, and sexual activity for the length of your treatment. You’ll also be asked to avoid sugar, caffeine, and alcohol, and to eat light, warm, cleansing dishes like kitchari (basmati rice and mung dal cooked with spices and ghee). As Lad explains, “During panchakarma, your agni, or digestive fire, becomes low. Kitchari is the best food to eat because it is easy to digest, burns ama, detoxifies the body, and balances the doshas.”
The next step is external oleation. Each day, you receive a deep ayurvedic massage that softens and saturates your body with nourishing herbalized oils tailored to your needs. Then a gentle stream of oil is dripped onto your forehead to release mental and emotional strain. These procedures liquefy deep-seated ama in the body’s seven tissues, or dhatus. A daily therapeutic sweat treatment (often in the form of a steam bath) further loosens impurities and dilates the srotas, so the ama and excess doshas can move toward the gastrointestinal tract. Within three to seven days, your ayurvedic practitioner will sense that your excess doshas and ama have become “ripened” and are ready to be released via your main panchakarma treatments.
Traditionally, panchakarma comprises five main procedures, or karmas, that your practitioner can choose from, but since Westerners often find vamana (therapeutic vomiting) and raktamoksha (blood purification through herbs or mild bloodletting) too unpleasant to try, only three are common in the States. Nasya involves putting medicated drops of herbalized oil or powders into the nose to treat diseases of the head, including colds, toothaches, and migraines. Virechana uses strong purgatives to cleanse the small intestine and cure excess pitta problems such as hyperacidity, colitis, and skin diseases. But basti (medicated enema) is perhaps the most profound. According to an ancient text called the Charaka Samhita, basti provides a full 50 percent of panchakarma’s benefits. The colon is the seat of vata, and when this dosha is out of balance, it plays a key role in the development of disease. Recognizing that the colon provides nourishment to the entire body, just like roots for a tree, Charaka wrote, “Basti works from head to toe.” It treats all vata disorders, including constipation, back pain, arthritis, osteoporosis, and impotence.
After your main treatments are over, your ayurvedic practitioner will guide you through “post-procedures” to help you reap the full benefits of panchakarma. Because your digestive system (agni) rests during panchakarma, it’s important to transition back to your regular diet slowly and carefully. If you overload your agni with heavy foods, you’ll generate new ama and the disease process will start all over again. You’ll also need to protect the delicate state of your nervous system by gradually easing into your regular, workaday life. Your practitioner will send you home with your own road map to healing.
As Lad explains, “The purpose of panchakarma is not just to get well but to purify and strengthen the body so that future diseases will not occur.” That’s why he recommends doing rasayana (rejuvenative herbal therapy) once you’ve regained your strength. He offers a metaphor for ayurveda’s philosophy of cleansing and rejuvenation: “If you want to color your shirt, wash it first, then dye it so the color will shine. Your body is the shirt, panchakarma is the washing, and rasayana is the dyeing.”
Panchakarma can help anyone on the yogic path, whether they practice asana, pranayama, meditation, or all of the above.
Once your body has been purified, it is more prepared to accept these rejuvenative therapies, which nourish the body’s tissues and “enhance spiritual vitality,” writes ayurvedic expert Sunil Joshi in Ayurveda and Panchakarma. Joshi explains the most profound elements of panchakarma: “When the false covering of ill health is removed from the mind, senses, and body, our true nature, or prakriti, shines through and is intimately connected to the universal prakriti.” For this reason, panchakarma can help anyone on the yogic path, whether they practice asana, pranayama, meditation, or all of the above.
*Not his real name
2 Precautions for Panchakarma
Participation in a clinical panchakarma requires close supervision by an ayurvedic expert at all times, says Julia Mader, co-founder of Rasayana Cove Ayurvedic Retreat in Central Florida. If your body isn’t properly prepared for cleansing, or if your treatments are incorrectly administered, you can overwhelm your nervous system or dislodge more toxins than your body can handle. There are other precautions to consider.
Find a qualified practitioner. “Ayurveda has evolved over thousands of years,” Mader explains. “Now it’s coming to America and people are making a lot of money off of it.” In the process, however, some practitioners are abandoning important precautions, such as residential care, dietary restrictions, and lifestyle adjustments to cut costs and increase their profits. Make sure your panchakarma practitioner is well qualified and makes your well-being the highest priority, she says.
Have patience in the process. As Mader observes, “I receive a lot of requests for panchakarma from people who just want to get cleansed very quickly—that’s the American way. But ayurveda is gentle, soft, and slow. In panchakarma, we’re trying to create a gentle wave of cleansing, not a tsunami.” When treatments are too severe, she says, the body holds onto ama even more resolutely, and can push toxins deeper into your system instead of releasing them.
6 Panchakarma Clinics You Can trust
The Ayurvedic Institute in Albuquerque, New Mexico, 505-291-9698 ext. 117 www.ayurveda.com
Kanyakumari Ayurveda Education & Retreat Center, Milwaukee, Wisconsin, 414-228-7145 www.kanyakumari.us
Himalayan Institute, Total Health Center, in the Poconos of northeastern Pennsylvania, 570-253-5551 ext. 3100 https://www.himalayaninstitute.org/
Kripalu Center for Yoga & Health, in the Berkshires of western Massachusetts, 800-741-7353 www.kripalu.org
Living Ayurveda, in Monterey, California, 877-777-1127 www.living-ayurveda.com
Rasayana Cove Ayurvedic Retreat, on a nature reserve in Central Florida,
Former Yoga International editor-in-chief Shannon Sexton writes about food, travel, yoga, and natural health.