Panchatikta Ghrita Benefits, Dosage, How To Use, Side Effects, Ingredients, Reference

Panchatikta Ghrita is an Ayurvedic medicine, in herbal ghee form.This medicine has ghee as its base. It is used for preparatory procedure for Panchakarma and also as medicine, mainly for skin diseases. Panchatikta refers to five bitter herbs, which are the main ingredients in this herbal ghee.

Uses

Panchatikta Ghrita benefits: 
It is widely used as medicine and also in preparatory procedure called snehakarma for the treatment of non healing ulcers, skin disease, eczema, worm infestations, hemorrhoids and cough.
Doctors also use this for the treatment of
urticaria, allergic hives, hey fever treatment.

Effect on Tridosha – Calms Vata, Pitta and kapha

Dose

Panchatikta Ghrita dosage: 
As medicine – quarter to half teaspoon with water, usually before food, once or twice a day, or as directed by Ayurvedic doctor.
For Panchakarma preparation – Snehana procedure, the dose depends on the disease status and the judgement of Ayurvedic doctor.

It is usually administered with warm water.

With western medicines
Seek your doctor’s advice if you are taking this product along with other western (allopathic/modern) medicines. Some Ayurvedic herbs can interact with modern medicine.
If both Ayurvedic and allopathic medicines are advised together, then it is best to take allopathic medicine first, wait for 30 minutes and then, after a gap of 15 – 30 minutes, take Ayurvedic medicine or as directed by the physician.

Can this be used while taking Homeopathic medicine?
Yes. This product does not react with homeopathic medicine.

With supplements like multivitamin tablets, Omega 3 fatty acids etc?
Yes. Generally, this product goes well with most of the dietary supplements. However, if you are taking more than one product per day, please consult your doctor for an opinion.

Side Effects

Panchatikta Ghritham Side Effects: 
There are no known side effects with this medicine. However it is best to use this product under medical supervision. Self medication with this medicine is discouraged.
People with diabetes, high cholesterol, heart diseases and high BP should exercise precaution.
In very high dose, it may cause diarrhea and indigestion.

Principle

In this herbal ghee, the herbs are infused in the medium of ghee along with herb water decotion. Then the solid waste herb materials are filtered out. Thus, this herbal ghee contains oil soluble and water soluble phyto-active principles of medicinal herbs.

Contents

Panchatikta Ghrita Ingredients: 

1. Patola (Trichosanthes dioica) – leaf – 240 g
2. Saptachchada (Alstonia scholaris) – stem bark – 240 g
3. Nimba (Azadirachta indica) – stem bark – 240 g
4. Vasa (Adhatoda vasica) – stem bark – 240 g
5. Guduchi (Tinospora cordifolia) – stem – 240 g
6. Water – 19.2 liters, boiled and reduced to 4.8 liters
   Kalka Dravyas:
7. Haritaki (Terminalia chebula) – fruit – 100 g
8. Vibhitaki (Terminalia bellerica) – fruit – 100 g
9. Amalaki (Emblica officinalis) – fruit – 100 g
10. Ghee – 1.2 Kg

Method of Preparation

Coarse powder of ingredients from Neem to Vasa is added with specified quantity of water, boiled till it reduces to quarter part. Ingredients from Haritaki to Amla is powdered and made into paste by adding with specified quantity of water. Ghee added with paste and decoction is heated with continuous stirring over mild fire till there is subsidence of froth and all the moisture content is evaporated. Heating is stopped when the paste rolled between fingers forms varti (wick). It is packed in a tightly closed containers.

Reference

Bhaishajya Ratnavali, 58-Visphotachikitsa Prakarana, 20

Panchatiktha Basti For Osteoporosis

Role of Panchatikta Ghrita enema in prevention and cure of asthi kshaya i.e. osteoporosis & osteopenia – a hypothesis

Since we are discussing about the bones, I shall prefer discussing this topic from the ‘root source of bone and bone marrow formation’ according to Ayurveda.

Like all tissues of the body, the bones and bone marrow tissues are also formed from –

• The nutritional essence derived from ahara rasa i.e. nutritional juice
• From their precursor tissue in the Ayurvedic chronology of formation of tissues i.e. dhatu poshana krama

The asthivaha srotas i.e. channels responsible for bone tissue formation lay in fat tissue and hip bones. This is because according to Ayurveda chronology, bones are formed by their precursor tissue i.e. fat tissue. The hip bones and the pelvis seem like holding the entire upper skeleton and the lower limb bones. Therefore they may be considered as roots of bone formation.
Read – Srotas: Body Channels and Duct systems – Easy Explanation

Similarly the majjavaha srotas i.e. channels responsible for formation of bone marrow tissue lay in the bones and joints of the body. This is because the bone marrow, according to the chronology of tissue formation, if formed from its precursor tissue i.e. bone tissue. The same bone marrow later fills in the bone tissue.

To sum up – the bones are formed from the fat tissue and form bone marrow tissue. The bone marrow is formed from the bone. Therefore in the roots of both channels responsible for formation of bone and bone marrow, one common thing is the bone. In the first context i.e. when bone is formed from the fat, bone is the effect of fat metabolism. In the later context i.e. when the bone involves in bone marrow formation, bone is the cause for formation of marrow. Bone is the common link.
Read – Majja Pradoshaja Rogas – Diseases Due To Pathological Bone Marrow

Now for the next part of our discussion, this basic discussion was needed.

Here it is interesting to observe that asthivaha & majjavaha are the only channels in which a tissue’s precursor tissue has been mentioned.

Fat, the precursor of bone has being mentioned in asthivaha srotas and bone, the precursor of bone marrow being mentioned in majjavaha srotas.

Sanskrit Verses

What does this show?

This shows a strong connection between fat forming, bone forming and bone marrow forming channels. Incidentally these are also the tissues formed in that chronology i.e. fat – bone – bone marrow in that order.
Read – Dhatu – 7 Body Tissues As Explained In Ayurveda

Case 1

The bone tissue is formed from ‘the portions of fat tissue that take part in nurturing and formation of the bone tissue’.

If there is deficit functioning and reduced strength of medo dhatvagni i.e. tissue fire of fat, the bone will be formed inadequately. The weak ‘fat tissue fire’ will not take part in the proper formation of bone. As a result lot of fat tissue is formed. This increased fat blocks all the channels in the body. This leads to deficit formation of all tissues and excessive formation and deposition of fat in the body. This will eventually impact bone formation also.

Similarly accumulation of ama and many intermediate products of tissue metabolism in fat tissue and other channels occurs. This also leads to deficit bone formation.

This shows that an impairment of fat metabolism and consequent block of bone forming channels leads to deficit formation of bone. This may also lead to formation of weak and immature bone tissue. The bone health will deteriorate. All these events will lead to manifestation of asthi kshaya i.e. osteopenia or osteoporosis.
Read – Vata Increase Caused Due to Tissue Depletion: Dhatu kshaya

Case 2

The toots of bone marrow forming channels lie in the bones and joints. Bones and joints are affected and damaged in osteoporosis and osteopenia. 

If bone precursors are not formed adequately due to deficit ‘fat tissue fire’, the ‘bone tissue fire i.e. asthi dhatvagni’ may get exacerbated through chain of formation, as a reflex or feedback mechanism. 

This might cause loss of bone and consequent increase in Vata. 

This again will not allow proper formation of bones and joints which are roots or sources of bone marrow. Consequentially bone marrow is not formed to optimum. These set of events too lead to the manifestation of osteopenia or osteoporosis.
Read – How To Balance Vata Dosha? Line Of Treatment And Reasoning

Logic of using tikta ghrita in enema or as one of the ingredient of bitter milk enema in treating osteoporosis and its probable mode of action

Panchatikta Ghrita / Guggulutiktakam Ghrita can be effectively used in treatment of osteoporosis. This is because –

• It is highly beneficial in correcting the roots of bone tissue channels located in the fat tissue. This enables proper and optimum formation of bone.
• It corrects the fat-bone-bone marrow formation axis as these tissues and their sequential formation are interrelated. The basis of this has been explained in cases 1 & 2 above. This correction of related tissue metabolism at root level enables stoppage of further bone destruction and enables optimum formation of bone tissue.  This eventually combats or prevents osteopenia or osteoporosis.
• The bitter tasting herbs have ‘depleting effect’ on fat tissue. They also kindle the tissue fire and rectify the fat and bone metabolism. The bitter taste also has an important role in cleansing and clearing the clogged channels of transportation and nutrition i.e. srotoshodhaka. The ghee and milk used as base of formulation are highly effective in combating vitiated vata and pitta which are responsible for bone destruction and inflammation. Thus the panchatikta  ghrita, provides tri-phasic action i.e. depletion of excess fat and enabling proper bone formation, providing nourishment and support to the bone tissue and balancing the tissue fires of fat, bone and bone marrow. These roles of the medicated ghee help treating osteoporosis effectively.
•  Since bitter taste has fat (precursor) and marrow (successor) depleting property, it destroys excessive fat and immature marrow formed in the body. It also doesn’t allow the accumulation of mentioned tissues. Thus, bitter taste reduces the burden on bone tissue. It also keeps the pathways of formation and maintenance of bone tissue clear and intact.
• Ghee base of the preparation helps in combating vata. Actually oil base need to be used since oil is the best anti-vata fat. But the inclusion of ghee in this instance might probably be to combat associated pitta too.
• Bitter medicines might be thought of as ‘vata disturbing’. But here we need to see that ‘bitter herbs alone’ are not administered. They are processed in ghee and later with milk. This probably dilutes the vata disturbing properties of bitter taste. Also according to Ayurveda principles, the compound or formulation will have a different action (due to combination and processing) in comparison to the individual compounds. Therefore the final medicine which is administered as enema, panchatikta ghrita in this instance will have a bone supporting, anti-bone-destruction and vata-pitta balancing action. Thus it has disease modifying role in treatment of osteoporosis.
• Bitter herbs act as bio-availability enhancers and transporters of ghee to the target tissue i.e. bone and bone marrow. Bones and marrow are considered as gambhira dhatus i.e. deep seated tissues. They also belong to the intermediate pathways of diseases. The diseases arising in these tissues are difficult to handle. Similarly to make the medicines reach these tissues too is difficult. Ghee, with its supportive role to the bone and bone marrow and having a rasayana effect i.e. rejuvenating and anti-ageing effect on these tissues will prevent degeneration. It also combats vata and pitta. The bitter herbs have minuteness and deep penetrating properties. Only the properties of bitter taste can reach the deeper tissues. Therefore the ghee processed with bitter herbs is administered as enema. In presence of bitter taste, the ghee will not only be transported to the deeper tissues but also will be used to optimum.
• The channel cleansing action i.e. sroto shodhana property of bitter taste also will come in handy. As we have already discussed that increased fat and marrow might occlude the channels of nutrition and hence impair bone formation in osteoporosis. The bitter taste available in the ghee medium will clear the pathways by removing the obstruction along with supporting and nurturing the bone and marrow.
• Bitter taste increases pitta, hence increases the tissue fire. This rectifies the tissue metabolism. Bone and bone marrow are formed in optimum quantity and good quality. This helps in halting the bone destruction and relieves symptoms of osteoporosis.

Do we have any other option other than Panchatikta Ghrita in treating osteoporosis?

Yes, we do. As already discussed Guggulutiktakam Ghrita is one option, so is Tiktaka and Mahatiktaka Ghrita. In my clinical practice, I have got good results with Guggulutiktakam Ghrita rather than Panchatikta Ghritam in treating osteoporosis and osteopenia. I hv used combination of Varanadi Ghrita and Guggulutiktakam Ghrita which forms an awesome combo for enema in these conditions. 

Why should these medicines be administered as enema?

Vasti or enema is said to be the best treatment for vata disorders. Bone destruction as in osteopenia and osteoporosis will eventually lead to vata increase. This increased vata may tend to destroy the other tissues too. This will eventually lead to many vata disorders. At the same time the symptoms of osteoporosis like joint pains, back and neck pain etc might increase due to vata increase. Rectum / colon is the governing center of vata. When the medicines are administered into the colon in the form of enema, the vata will be quickly controlled in comparison to the medicine given in oral route. Thus, it is ideal to administer Panchatikta ghrita alone or in the form of milk enema in the treatment of osteoporosis. The painful symptoms of osteoporosis and osteopenia too will be relieved in quick time with administration of enema. Bone tissue is also one of the main vata seats.

Vata and bone share the resident and residence relationship. Even in this perspective it is ideal to administer the medicines in the form of enema.
Read – Principles Of Making Herbal Ghee – Ghritham

Can these medicines be administered through oral route?

Yes. If we consider Vata, and pathological imbalances in its seats, enema is an ultimate choice.

But it can be administered through oral route

• in those who are not fit to undergo enema treatment,
• in those who are reluctant or hesitate to undergo enema treatment
• in conditions where we want our medicine to pass through the digestive fire, get digested, absorbed and act, and
• as supportive medicine in the follow up of treating osteoporosis

I have seen good results with these medicines when administered through oral route too.  

Some related research studies

One study showed that Panchatikta Ksheera Basti was effective in the treatment of asthikshaya vis-à-vis osteopenia and osteoporosis, especially in relieving the symptoms like pelvic-pain, bone pain and joint pain. Improvement in BMD T score was also found to be encouraging. (research)

Another research article – ‘To evaluate the effect of Arjunadi Sidha Ksheera Basti in comparison with Panchatikta Ksheera Basti in Rajonivrutti Janya Asthi Kshaya w.s.r. to postmenopausal osteoporosis’

It shows promising result of Arjunadi Ksheera Basti in reduction of knee pain and improving Serum Estrodiol level. This can be given as preventive in perimenopausal women and as therapeutic in post-menopausal women. The study statistically revealed that Arjunadi Vasti has significant role in improving the Serum Estradiol level which reflected the reduced intensity of knee joint pain after follow up with Panchatikta Ksheera Basti.

Clinical evaluation of Panchatikta ksheera basti in Sandhigata Vata w.s.r. to osteoarthritis of knee joint – In this study by Sayeed et al. two groups were studied. Among them, one group was given with Panchatikta ksheera basti and another group with Yoga basti with Dashamula niruha and Anuvasana basti with sesame oil. It was found that Panchatikta ksheera basti proves more effective than Yoga Basti with respect to relieving inflammation, pain stiffness and swelling of joints in osteoarthritis.

Read another article – Does Panchatikta ghrita have anti-osteoporotic effect? Assessment in an experimental model in ovariectomized rats

It was found that Panchatikta ghrita significantly improved bone micro architectural parameters like bone mineral density and mineral content at higher dose levels. Decrease in osteoclasts and significant dose dependent increase in bone hardness and elasticity was seen with the mentioned compound which was comparable to standard drugs. Panchatikta Ghrita increased bone mineral density and content, decreased turnover of bone specific biomarkers and osteoclast formation, indicating its protective effect against experimentally induced postmenopausal osteoporosis.

Clinical study on Sandhigata Vata w.s.r to Osteoarthritis and its management by Panchatikta Ghrita Guggulu

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Shloka (Sanskrit Verse)