Does it work? Can triphala act as an antimicrobial?

BACKGROUND:Triphala is one of the most commonly used Ayurvedic preparations. Ayurveda is the traditional medical system of India, but has been spreading in popularity around the world. Given its popularity in India, triphala is one of the more commonly promoted Ayurvedic herbal remedies.

The name triphala comes from two Sanskrit words that literally mean three fruits. Preparations are made from the dried and powdered fruit of three plants. The traditional product contains equal proportions of the three fruit, although some products now combine the plants in different proportions. The three fruits are selected to balance the three elements of life viewed in Ayurvedic medicine as central to health. These are vata, pitta and kapha, which correspond roughly to the ideas of wind, fire and water.

In Ayurvedic medicine, triphala is used for treating infections, digestive disorders, cardiovascular problems and many other conditions. Traditionally, it has been recommended as a daily or weekly supplement to maintain general health. Such uses are thought to arise from its laxative properties, which are believed to help “detoxify” the body by eliminating unwanted materials that accumulate from the diet.

EVIDENCE FROM STUDIES

Analyses of triphala extracts show that they contain vitamin C, antioxidants and a number of other ingredients.

Animal studies have shown that triphala can reduce blood cholesterol levels and have other beneficial effects on blood lipids. Some preliminary research has also indicated that triphala may have activity against cancer cells. However, such research is at a preliminary stage and no studies involving cancer have been conducted on humans.

The antimicrobial effects of triphala have received some attention from researchers. Laboratory studies have shown that triphala is active against a broad spectrum of micro-organisms that are involved in microbial infections.

A study published in 2010 found that triphala was active against microbes isolated from hospital patients, suggesting that the extract might be useful against microbes resistant to antibiotics. A group of tannins found in the extracts are believed to be the active ingredients. These are able to combine with microbial enzymes to prevent them from working properly.

This preliminary research has not led to much research in humans yet. Only one randomised controlled trial was located. Published in 2010, this study was carried out with 1,500 primary school children in India. The aim was to examine the usefulness of triphala as a mouthwash to prevent dental caries. The bacteria involved in dental caries contribute to tooth decay and cavities.

In this study, the children used a mouthwash which contained either triphala extract, chlorhexidine (a common component in popular mouthwashes) or distilled water. After nine months, those using distilled water had significantly increased scores on measures of dental caries. In contrast, those using triphala or chlorhexidine mouthwash had similar reductions in the incidence of caries.

The authors concluded that since the two mouthwashes were similarly effective, but triphala was much less expensive, that triphala could be recommended for dental hygiene.

PROBLEMATIC ASPECTS

No adverse effects were found in the study where children used triphala mouthwash for nine months. However, this did not involve oral consumption of the extract. Such oral supplements are not believed to cause problems, although this has not been studied in controlled settings.

RECOMMENDATIONS

Although Ayurvedic remedies have been used for centuries, few have been studied in controlled trials. Even though it is the most commonly used Ayurvedic remedy, triphala has not been studied extensively. Preliminary laboratory studies show that it may have some useful activities. However, a lot more research is needed before triphala can be recommended to prevent or treat any condition.

Dónal OMathúna has a PhD in pharmacy, researching herbal remedies, and an MA in bioethics, and is a senior lecturer in the School of Nursing, Dublin City University. He is author of Alternative Medicine: The Christian Handbook, Updated and Expanded Edition, Zondervan, 2007