My approach to hormones in Ayurveda perspective

My approach to hormones in ayurveda perspective 

        Hormones are chemical messengers released from endocrine glands that coordinate the activities of many different cells. Coordination is of multiple organs and systems (srotas) from Central Nervous System to Excretory System. Srotas has been defined as channels in which parinaman and abhivahan takes place. Three factors present in srotas viz: anupahat dhatushma, anupahat marut and anupahat srotas help to maintain sukha ayu, bala varna etc. The coordination between the srotas is brought about by nervous system and endocrine system. Both have the capacity to initiate and inhibit the action thus maintaining the coordination. Nervous system coordinates with help of nerve impulse whereas the endocrine coordinates with the help of hormones which are secreted within the interstitial fluid surrounding the secretory cells which through blood vessels reach the target organs where they carry-out the initiatory or inhibitory action. 
          Hormone release in the hypothalamus and pituitary is regulated by numerous stimuli and through feedback control by hormones produced by the target glands (thyroid, adrenal cortex and gonads). These integrated endocrine systems are called ‘axes.’ Caraka has explained integration (deham tantrayate samyak) with the help of vata and its five types. Although mulasthan of 5 types of vata have been explained at different sites in the body all are interrelated i.e. the reason why paraspara avaran has been mentioned.
           A stressor is a chemical or biological agent, environmental condition, external stimulus or an event that causes stress to an organism. Stressors have physical, chemical and mental responses inside of the body. Physical stressors produce mechanical stresses on skin, bones, ligaments, tendons, muscles and nerves that cause tissue deformation and in extreme cases tissue failure. Chemical stresses also produce biomechanical responses associated with metabolism and tissue repair. Stressor stimulates the hypothalamus. Astangsangrahakar has mention dhi, dhriti, smriti, mano bhodhan as karma of udan i.e. to analyze the situation, for eg. If snake is far away from the body there is no fight or flight situation whereas if it is next to the body there is sudden fight or flight condition. It means udan vayu helps mana to get avabhodhan of the surrounding. It can be compared with analyzing the feedback signal received from various body organs and systems. The situation is analyzed and signal is sent to hypothalamus where pran vayu takes the decision for inhibitory or initiative action to be taken this is understood by the dharan karma of budhi and chitta i.e. mana. Hypothalamus secretes the corticotropin release factor (crf) which stimulates the pituitary gland to release adrenocorticotropic hormone ("ACTH"). Udan vayu by its prayatna and urja karma helps in the secretion. The release factor "ACTH" is taken to adrenal cortex with the help of vyan vayu. Vyan vayu is said to be shigrakari or fast acting i.e. within fraction of seconds ACTH reaches the adrenal cortex. Adrenal Cortex secretes various stress hormones which is stimulated by saman vayu. Mulasthan of saman vayu is in sweda, dosha, ambhuvaha srotas, it signals for the saman anayati karma i.e. to maintain homeostasis thereby releasing the hormones in blood stream. The stress hormone released in blood is again taken by vyan vayu to various organs like heart, intestine etc. to cause the flight-or-fight response. After the response the apan vayu comes into action to excrete the hormones and neutralized the effect.
          Between this flow there is an alternate path that can be taken after the stressor is transferred to the hypothalamus (udan and pran karma), which leads to the sympathetic nervous system (vyan vayu). After which, the adrenal medulla secretes epinephrine (saman vayu) in blood and with the help of vyan vayu spreads throughout the body to cause the flight or fight response.

Prof. Dr. Satyendra Narayan Ojha ,
MD (KC), Ph.D.
Director , Yashawant ayurveda college , Post graduate teaching and research center ,
Kodoli ,Panhala , Kolhapur..
 drsnojha@rediffmail. com

KSHAR AND KSHARSUTRA

Kshara

Kshara is a kind of medication described in Ayurveda Texts for the management of various disorders . The word Kshara(क्षार) is derived from the root Kshar(क्षर्), means to melt away or to perish (क्षर् स्यन्दने). Acharya Sushruta defines as the material which destroys or cleans the excessive/the morbid doshas (Kshyaranat Kshyananat va Kshara). According to the preparation we can consider it to be caustic materials, obtained from the ashes after distillation and are mostly alkaline in nature.

Contents

            1 Types of Kshara

• 2 Drugs Used
• 3 Method of Preparation
• 4 Kshara Sutra
  • 4.1 Method of preparation
• 5 Mode of Action
• 6 Types of Kshar Sutra
• 7 References

Types of Kshara

According to the administration it is of two type 1. Paniya Kshara(for internal Medication) and 2.Pratisaraniya Kshara'(external application). The Paniya Kshara is mostly used for the treatment of diseases like artificial poison, abdominal lump, indigestion, calculus etc. The Pratisaraniya Ksara is used to apply on tumors, piles, fistula in ano, skin diseases etc.

1. ^ Sabda Kalpadrima
2. ^ Susruta Samhita 3/11
3. ^ Susruta Samhita 11

 Drugs Used

Many drugs have been advised by Sushruta and other Ayurvedic texts for the preparation of Kshara. The important among them are - Palasa- Butea monosperma, Erythrina indica, Terminalia belerica, Cassia fistula , Plumbago zeylanica, Holarrhena antidysenterica etc.

 Method of Preparation

According to the three types of Ksharas are prepared on the basis of their strength. 1. Mild - Mridu, 2. Moderate - Madhyama and 3. Strong - Tikshna .The general procedure can be narrated as - 'Mridu'Bhașmīkaraņa (conversion to ash) Adding to water(1:6 ratio) Filtration(21 times) Distillation(boiling the ksarajala still all water evaporates) collection (process called lixiviation) 'Madhyama' Here the procedure is same some extra powders of Katasarkara Bhasma sarkara Ksheerapaka, Samkhanabhi( gravels of lime and ash,oyester-shell & core of conch-shell) are added to the boiling ksharajala before distilling it. 'Tikshna' Similar to madhyama kshara here added is the powders of drugs like Chitraka, danti, vacha etc. inplace of the lime stones.

Kshara Sutra

"Kshar Sutra" (क्षारसूत्र) is a sanskrit phrase in which Kshar (क्षार) refers to anything that is corrosive or caustic; while Sutra(सूत्र) means a thread.It is described by many Ayurvedic texts which originated and flourished in India. It is one among popular Ayurvedic treatment modality in the branch of Salyatantra followed by Susruta.

The Ksharsutra was first mentioned by the "Father of Surgery" Sushruta in his text named SUSHRUT - SAMHITA for the treatment of Nadi Vrana(sinus), Bhagandara (fistula- in - ano), arbuda(excision of small benign tumour) etc..Although Brihattrayi- the chief three texts of Ayurveda mention the use of kshara sutra,there is no description of their preparation properly. It was Chakrapani Dutta in late eleventh century in his book Chakradatta ,first mentioned the method of preparation with a clear-cut indication of its use in bhagandara and arsha(haemorrhoid). In his book Chakradutta explains the method that by smearing a sutra (thread) repeatedly in the latex of snuhi() and haridra(turmeric) powder makes the kshara sutra. Later authors like Bhavamishra, Bhaisajyaratnavali etc. also mention the same method. But because of brevity of preparation and inadequate explanation of procedure of application, it lost its popularity among Ayurvedic surgeons. Later in Rasatarangini a better preparation procedure was introduced still the credit of making it practically in use goes to Prof. P.J.Deshpandey and his coworkers. They rediscovered and standardized the ksharasutra in the present era . The Dept. of Shalya- Shalakya, Faculty of Ayurveda, IMS, BHU should be credited for the abundant use and popularization of this technique.

1. ^ A hand book of Anorectal Disorders and their Ayurvedic Management, Dept. of Salyatantra , GAC, Tripunithura, Kerala

Method of preparation

The standard kshar sutra is prepared by repeated coatings of snuhi ksheera (latex of Euphorbia Nerrifolia), apamarg kshara (ash of Achyranthus aspera) and haridra powder over a surgical linen thread no. 20. This thread is spread throughout lengthwise in hangers. Each thread on the hanger is then smeared with snuhi latex with the help of gauze piece soaked in the latex. This wet hanger is transferred in kshara sutra cabinet.

The same process is repeated next day. Eleven such coatings with snuhi ksheera alone should be accomplished. The twelfth coating is done by first smearing the thread with ksheera and in wet condition thread is passed through the apamarg kshar. It is again transfer into the cabinet for drying. This process is repeated till seven coatings of snuhi ksheer and apamarg kshara are achieved. The final three coatings are completed with snuhi ksheera and fine powder of turmeric in the same fashion. Thus twenty-one coatings over the thread are completed.,

1. ^ A Handbook of Anorectal Disorders and their Ayurvedic Management, Dept. of Salyatantra, GAC, Tripunithura, Kerala
2. ^ Anal Fistula and KST, Pathak S.N., Chawkhamba Krishnadash Academy, Varanasi

 Mode of Action

Kshar Sutra is now a popular treatment modality in India for the management of fistula in ano. Many Clinical trials have done all over in different institutes to evaluate the action. In countries like Srilanka and Japan also many clinical trial has already done and established it. Precisely the action of Kshara sutra is thought to be due to its healing and cleansing effect according to Ayurveda. It can be suggested that due to the anti microbial action, and as a saton it allows the proper drainage of pus from the fistula, that leads to a proper healing. On the other hand the cutting effect of thread incises the skin gradually with out a surgical incision. Many studies confirms that it is more effective in the way of reducing hospital stay and less infection than the conventional seton therapy.Researches suggests that it is having the action of Excision, Scrapping, Draining Penetrating, Debridement , Sclerosing and Healing.it is Bactericidal and Bacteriostatic.

Types of Kshar Sutra

In the textual reference of Chakradatta and Rasatarangini we get only indication of the thread made up of Snuhi, apamarga and Turmeric. Susruta describes about many kind of Kshars like Karaveera, Palasa, Kadali etc. in Susruta Samhita. So many studies have already carried out with variations in the Kshara and the latex. The most remarkable are Guggulu Ksharasutra, Udumbara KS, Gomutra KS, Papaya KS, KS with Ficus carica latex etc.

1. ^ Shukla, N.K. Narang, R. Nair, N.G.K., Radhakrishna, S., Satyavati, G.V.: Multicentric randomized controlled clinical studies of Kshara-sootra in management of fistula-in-ano. Indi J. Med. Res. (B), 177-185, 1994
2. ^ Thakur abhiram at al , Kshara sutra therapy a new dimension, souvenir-Anusastra 2008, Dept. of Salyatantra, GAC, Tripunitura, Kerala
3. ^ Ghanekar BG , Susruta Samhita, Sutra sthana 11, ML Publication, New Delhi,1998

http://www.facebook.com/dr.arun.jha

medical director,chief ayurveda consultant,ayurmangalam hospital ·Jul 2003 to present · Jhansi

ayurmangalam hospital and research centre,

• specialist of ayurved chikitsa, yoga ,panchakarma and naturopathy

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Food For The growing Years...

Food For The growing Years...

During the first few years of life,it is vital to meet a child's nutritional needs in order to ensure proper growth and to establish a lifelong of healthy eating.Eating a meal should be both healthy and enjoyable.Between the ages 2 to 20 the human body changes continuously.Muscles grow stronger,weight can increase.The most striking changes take place during puberty,which occurs between the ages of 10 to 15 in girls and slightly later-between the ages of 12 -19 in boys.

Children need energy for all the growing years.Almost 1,300 calories per day for a 2 year old.1,700 calories for a 5 year old,2,200 calories for a 16 year old girl,and 2,800 calories for a 16 year old boy..The amount of food that a child requires varies according to height,build,gender and activity level.

 As children are growing and developing...bones, teeth, muscles etc, they need more nutritious food that is proportionate to their weight. Food consumed by children should contain proper level of calcium, iron, zinc, vitamin B,C and Vitamin A. It should mainly consist of:

• Low fat
• Non-fat milk
• Decreased intake of whole milk and egg
• Increased snacking.

Nutrient Needs

1....Energy    

The energy needs of a child are determined on the basis of basal metabolism, rate of growth, and activity. Dietary energy must be sufficient to ensure growth and spare protein from being used for energy, without being excessive that it results in obesity. Energy intakes of healthy, growing children of the same age and sex vary depending mainly on their activity level.

2....Protein     

The need for protein per kilogram of body weight decreases from approximately 1.2 g in early childhood to 1g in childhood. Children who are most likely to be at risk for inadequate protein intake are those who have multiple food allergies or those who have limited food selections because of fad diets, behavioral problems or limited access to food.

3....Minerals and Vitamins     

Children between the age group of 1 and 3 are at high risk of iron deficiency (anemia) . The rapid growth period of infancy is marked by an increase in both hemoglobin and total iron mass. In addition, the child's diet may not be rich in iron-containing foods. For this age group, calcium is needed for adequate mineralization and maintenance of growing bone. 

Actual needs depend on individual absorption rates and dietary factors, such as quantities of protein, vitamin D, and phosphorus. Calcium retention in children between 2 and 8 years of age totals approximately 100 mg /day. Children need two to four times calcium per kilogram more than adults. As milk and other dairy products are primary sources of calcium, children who consume none or limited amounts of these foods are at risk of calcium deficiency.

4..Fats....

Consumption of too much dietary fat leads to excessive calorie consumption and weight gain..So as per the recommendations total fat intake should not exceed 30% of calories and saturated fat should account for no more than 10% of total calories. In addition, cholesterol intake should not exceed 300 mg per day.

The value of Dietary fats.....

Fats are probably the most misunderstood nutrients.Although everyone should avoid excess fat,we all need a certain amount for important body functions.Several vitamins (A,D,E and K) can be absorbed only in the presence of fat,and fats are necessary for the production of other body chemicals,including the hormones that transform boys boys and girls into men and women.

5..Fiber.....

With the growing age..the fiber intake should be increased..Children should consume Fiber..Their age +5 grams of fiber...

  Vitamin D is needed for calcium absorption and for deposition of calcium in the bones. This nutrient can also be made available from the action of sunlight on subcutaneous tissues. 

  Zinc is essential for growth. Deficiency results in growth failure, poor appetite, decreased taste acuity and poor wound healing. The best sources of zinc are meat and seafood. 

Iron Deficiency....

Iron is an essential mineral for normal growth and development for a child.There are 2 types of iron...

a)..Heme:..Easily absorbed by humans..

b)..Non heme iron:..Which is poorly absorbed.

Foods that contain heme iron include meat,eggs,fish,poultry,seafood..While the breakfast cereals,legumes(beans),grains,seeds,nuts,dried fruits,and dark green leafy vegetables contain the non heme iron.Children should have a variety of iron containing foods in their diet.In addition,the consumption of Vitamin C rich foods improves the absorption of dietary iron...

Building Bone:...

Calcium.... is important for forming strong.healthy bones during adolescence and preventing osteoporosis later in life.Youths 10 to 16 years old need 3 to 4 milk product servings a day-the equivalent of 2 cups of milk and 2 slices of cheese or 3-4 cups of yogurt/curd every day.

Snacking And Fast Food:

Teenagers often prefer snacks loaded with fat,sugar,and salt:Potato Chips,French fries.pizzas etc.These are high in sodium and strike a poor balance between calories and nutrition.Encourage children to choose food with high in Vitamins,iron,calcium.

It is important for parents who are concerned that their children eat too few vegetables or too many junk foods to take a look at their own eating habits and reevaluate the example they are setting for their kids.

Balance And Variety...

Children need a wide variety of foods..Carbohydrates-breads,cereals,fruits,vegetables-must make up the major part of the diet..protein foods can include meat,fish,milk,soy products and combination of grains and legumes(beans).Milk is an important source of calories,minerals and vitamins.Children 4 to 9 years old should have 2 to 3 milk product servings every day.

A growing Epidemic...Obesity....

There is a big problem of becoming children over weight or obese..The consequences of obesity:high blood pressure,high cholesterol,type 2 diabetes,some cancers,sleeping disorders and orthopedic complications.There is an increased  risk of  heart attacks in teenagers..Overweight children tend to become overweight adults.So now parents must foster positive elements such as healthy eating..by encouraging kids to consume more fruits,vegetables,whole grains ..to avoid foods high in saturated fats for children over 2,encouraging kids to consume more fruits,vegetables,and whole grains...At least 60 minutes of physical activity every day..

Over weight children tend to become overweight adults.Parents must foster positive elements,such as healthy eating,positive body image,active lifestyle early in a child's life.The best approach to control weight in obese youngsters is serving smaller portions and encouraging regular vigorous exercise....

In the next doc file we will see the necessary food elements for the children.....The good and bad food habits...

Ref:

1...Foods Heal Foods Harm...

2...Ebbeling CB, Feldman HA, Osganian SK, Chomitz VR, Ellenbogen SJ, Ludwig DS. Effects of decreasing sugar–sweetened beverage consumption on body weight in adolescents: a randomized, controlled pilot study.

3...Pereira MA, Kartashov AI, Ebbeling CB, et al. Fast–food habits, weight gain, and insulin resistance

4..Ludwig DS, Peterson KE, Gortmaker SL. Relation between consumption of sugar–sweetened drinks and childhood obesity: a prospective, observational analysis

5...Willett W. Nutritional epidemiology.

6...Willett WC. Dietary fat plays a major role in obesity

DrAmita Kulkarni Purohit


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Vata

In Ayurveda, the  Vata has the function of all movement in the mind and body. It controls the flow of blood, the elimination of waste products, the act of breathing, nerve signal flow and the movement of thoughts in the mind. It is considered the leader of the three doshas (energies or energetic principles in the body) as Pitta and Kapha cannot move or exist without it. It is therefore imperative that Vata is brought back into balance whenever it is disturbed.

Here are the lists of things that you feel when Vata is vitiated or disturbed

• Your skin or hair is dry, rough and thin.

• You feel cold easily or have poor circulation with cold hands and feet.

• You are chronically underweight and find it difficult to gain weight.

• Your mind is constantly anxious, restless and agitated and you are prone to worry and fear.

• You experience constipation or have frequent flatulence.

• You suffer from insomnia or have unsettled sleep and disturbing dreams.

• You suffer from vaginal dryness or menstrual cramps and PMT.

• You have spells of forgetfulness and absent mindedness.

• You experience discomfort or stiffness in the joints or lower back pain.

• You easily become fatigued and have poor endurance.

•

How to balance vitiated Vata

• Follow a Vata balancing diet favouring cooked foods rather than raw foods and salads.

• Go to bed early bedtime and have lots of rest.

• Diffuse calming and grounding aromatic oils or incense into your home and office. Orange, geranium, lavender, basil, spruce & fir are excellent in this regard.

• Maintain a regular daily routine by integrating the ‘Daily Routine’ (see later section).

• Give yourself an Abhyanga massage using warm sesame oil each morning.

• Ensure you have regular, daily elimination. Triphala herbal formula helps in this regard.

• Stay warm, especially in cold, windy weather.

• Take gentle walks in the countryside to calm and balance the mind.

• Wear calm, soothing colours such as pastels, green or brown.

• Do not overexert and rest whenever the body becomes tired or over stimulated

• Relax often by practicing meditation, pranayama, Yoga or Tai Chi.

• Chant ‘Ram’ (pronounced ‘rarm’) 108 times each day.

• Read light, humorous, feel-good novels and turn the television off one hour before bed.

• Take up walking, fishing, bird-watching or gardening for general relaxation.

• Take up writing, drawing, painting or acting to balance your creative energies.

• Avoid excessive talking and try to have a day of silence each week.

• Wrap up warm and keep dry in the winter – cover your head on cold, windy days.

• Avoid loud, noisy environments

• Rest for short periods throughout the day

• Avoid excessive use of VDU displays

The Vata balancing diet

• Favour warm, hearty, nourishing foods with added butter/oil – favour salty, sour and sweet tastes.

• Try and reduce light, dry, cold foods and pungent, bitter and astringent tastes

• Hot, milky, creamy cereals (wheat, oatmeal or rice), soups and stews are all very good for pacifying Vata.

• All dairy products are good (ideally organic and unpasturised) – milk should always be boiled first.

• Oils are good but favour ghee, coconut oil, olive oil, Udo’s oil, flax/pumpkin oil and sesame oil.

• Reduce your intake of light, dry, cold foods such as crackers, nuts, seeds and salads.

• Take nuts and seeds in small quantities only – they are best freshly ground with oil added.

• Reduce the intake of all bean products except tofu, mung beans, mung dhal and red lentils.

• The best grains are rice and wheat but you can take barley, corn, millet, buckwheat, rye and oats in moderation.

• Favour stewed and well ripened, sweet or sour fruits but reduce the intake of dry or light fruits such as apples, pears, pomegranates, cranberries, and dried fruits (if uncooked). Dried fruits are good if they are cooked after soaking overnight.

• Sweeteners are good (in moderation), especially jaggary, honey, maple syrup and algarve.

• Vegetables should be cooked and not raw. Peas, green leafy vegetables, broccoli, cauliflower, celery, zucchini and potatoes are acceptable in moderate quantities if they are cooked, especially with Ghee or oil and Vata reducing spices but it is best to avoid sprouts and cabbage.

• Hot, nourishing desserts such as apple pie help pacify Vata.

• Eat a substantial breakfast to help improve energy levels throughout the day.

• Herbal teas (camomile, fennel, basil) with a few digestive biscuits are good for Vata energy slumps.

• Avoid stimulants such as coffee and alcohol.

• Sip hot water throughout the day to flush out impurities and balance Vata.

• Warm milk flavoured with ghee, cardamom, cinnamon and nutmeg is excellent before bed.

Pitta dosha

Pitta dosha is made up of the elements of fire and water through which it manifests the qualities of pungent, hot, penetrating, oily, sharp, liquid, spreading and sour. Its primary function is transformation and is the force of metabolic activity in the body associated with the endocrine function, digestion, body temperature, visual perception, hunger, thirst, and skin quality. In Western terms we can categorise the activities of pitta in terms of amino acids, enzymes, bile, hydrochloric acid and hormones. This explains the seemingly contradictory combination of fire and water to form pitta. Pitta exists as water or oil in the body, thus preserving the tissues from the destructive aspect of fire. It resides in the eyes, blood, sweat glands and lymph but its primary site is in the small intestine. Mentally it plays a role in understanding, in digesting sensory impressions.

Here are the lists of things that you feel when Pitta is vitiated or disturbed

• Your skin is overly oily and prone to acne.

• You are prone to rashes, fevers or inflammatory skin conditions

• You have excessive hunger or thirst.

• You sweat profusely and have overly hot hands and feet.

• You suffer from infections, access acidity, ulcers and heart problems.

• You are overly aggressive and prone to anger and frustration.

• You experience lose or hot, watery stools and diarrhoea-type elimination.

• You tend to be overly critical, domineering, obsessive or controlling in nature.

• You experience frequent eyestrain or tension headaches.

• You are going prematurely grey or balding.

How to balance vitiated Pitta

•Avoid hot substances such as red meat, alcohol and tobacco.

• Avoid excessive fasting and try to eat when you are hungry. Don’t skip meals; especially lunch.

• Exercise moderately (short runs or swims) and only when the weather or climate is cool.

• Walk regularly in nature; especially by the sea. Walking in the moonlight is also very beneficial.

• Especially avoid prolonged exercise in very hot climates or environments.

• Keep your head and skin protected and refrain from sunbathing when the sun is hot.

• Reduce your exposure to hot environments such as saunas and steam rooms.

• Cultivate peaceful emotions and spend more time with people who love and fully accept you.

• Avoid and angry or stressed people and try not to argue – aim to agree more often!

• Take the time to be sweet and sociable and find the time to chat, laugh and play.

• Practice moderation and find time for enjoying leisure activities and appreciating natural beauty.

• Avoid overly competitive sports, deadlines and confrontation in general.

• Practice meditation, cooling forms of pranayama and gentle yoga postures.

• Avoid watching too much television and excessive use of computers.

• Massage the head with coconut oil at night.

• Wear cooling colours – blue, purple, green and avoid wearing red colours.

• Drink pomegranate juice or eat pomegranate seeds. Its astringent and bitter quality helps balance pitta, cleanses the liver and blood and works as an excellent heart tonic.

• Drink 30mls of Aloe Vera each morning.

Pitta Balancing diet:

• Generally favour warm or cool and refreshing foods with the tastes of sweet, bitter and astringent such as; asparagus, lettuce, broccoli, cucumber, raita, mung dhal, summer squashes, courgettes, cilantro, coconut, cucumber, lime and green salads.

• Avoid very oily, salty, sour, fermented or pungent foods and spices such as chillies, alcohol, pickles, vinegar, hard or pungent cheeses, citrus fruits, sour cream, yoghurt, tomatoes, garlic, onions and chillies as they will aggravate the acid and pitta in the intestines and blood.

• Enjoy sweet, juicy seasonal fruits such as peaches, figs and berries.

• Avoid red meat and favour chicken or fish.

• Most vegetables, beans and lentils are good unless they are cooked with too much oil.

• Favour wheat, basmati rice, oats and barley and take corn, millet and rye in moderation.

• Drink cooling herbal teas such as peppermint, spearmint, rose, coriander or liquorice.

• Ghee is cooling and can be used for cooking and spreading on toast. Coconut oil can also be used for cooking whilst Udo’s oil, flax oil or pumpkin oil can be used for salad dressings.

• A nourishing breakfast to balance pitta could include cereal, toast and apple juice.

• Japanese and Chinese type foods and salads are generally good for pitta digestion.

• Always avoid over-eating, especially in the evening.