By Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S
Udana Vata is a subtype of vata located in the chest region but moves upwards into the neck / throat and nose and downwards up to the navel. This is a normal process. Navel according to Ayurveda is the main region of pitta, mainly the pachaka or digestive pitta. It is also a seat of governance for pitta. The digestive fire is represented in this pitta. Saman Vat is the vata subtype near the digestive fire i.e. in the navel region which comprises of stomach and intestine wherein digestion and absorption of food takes place.
In Udanavrita Samana, the aggravated Udana Vata invades and envelopes Samana Vata. Later the Udana interferes with the functions of Saman. Samana Vata being enveloped by Udana Vata becomes weak. As a result the pitta is weak, the digestive fire is weak and kapha and ama increase in the stomach. This provides an ideal backdrop for weak digestion. As an influence of weakened digestive fire, the fires located in all the tissues too deteriorate due to feedback mechanism. Due to this the food we take is not converted into energy and represents events leading to weakening of metabolism.
Read – Sub Types Of Vata Dosha: Importance, Salient Features
Senior Professor Dr S.N.Ojha sir has compared hypothyroidism with a condition called Udanavrita Saman.
Udana vata interfering with Samana Vata in comparison to pathological events happening in hypothyroidism
Thyroid gland is located in the neck region which is also the territory of udana vata. Low thyroid hormones cause slowing of metabolism. The metabolic process is governed by pitta and the fire located in it according to Ayurveda. The balance of the gut fire enables balance of the tissue and elemental fires. If the gut fire becomes weak the tissue fires too become weak. So the slowing down of metabolism starts from the gut. Thus Samana Vata is influenced by Udan Vat in Hypothyroidism. The disease onset takes place from Udana Vata and consequential weakening of Saman Vata by Udana Vata. Later decrease in pitta, formation of ama and increase in kapha contributes in the pathogenesis of hypothyroidism.
From the modern perspective the thyroid hormones are responsible for a balanced metabolism and also important for many vital functions in the body. Therefore their manufacture and release from the thyroid glands should be in perfect balance. They should neither be released in excess nor in deficit quantities. (Read about thyroid hormones)
The metabolic activities in the body, are more over dependent on the balance and strength of agni i.e. the digestive / metabolic fire located in our belly. The metabolism also depends on the interaction of the tridoshas with the digestive fire and how these doshas influence it.
But according to modern concept of hypothyroidism, insufficient thyroid hormones are the cause and lowering of metabolism is the effect.
So mandagni i.e. deficit digestive fire is the effect and not the cause of this disease when we translate hypothyroidism into Ayurvedic understanding. But the deficit digestive fire itself is the cause of many diseases according to Ayurveda. It is also may be an effect in some conditions wherein the digestive fire is influenced by many factors including the doshas like kapha. In Ayurveda version of hypothyroidism we are discussing the weak metabolism as the effect and not as a cause.
Read – Understanding Agni: Concept, Definition, Functions, Types
So what is the cause?
Hypothyroidism is a disease characterized by weak metabolism and many diseases appearing on its backdrop.
‘Metabolism is the process by which your body converts what you eat and drink into energy. During this complex biochemical process, calories in the food and beverages are combined with oxygen to release the energy your body needs to function.’
This function, according to Ayurveda is carried over by Agni, the metabolic fire. Agni is represented in the body by Pitta, especially Pachaka Pitta – a subtype of pitta located in the stomach and intestine. After the action of the digestive fire on the food in the stomach many other fires i.e. tissue fires and elemental fires take part in further utilization and conversion of the essence of digestion into body components and energy. This whole process is the Ayurveda explanation of metabolism.
Samana Vata, the master of digestion process and metabolism – The process of initial digestion of food so as to make it usable by the body tissues in the form of energy is carried out by a synchronized chemistry between Samana Vata, Pachaka Pitta and Kledaka Kapha located in the stomach. Pitta cannot function independently if it does not get motivation from Vata. The process of digestion and hence metabolism is led by the power and ignition given to the digestive fire by the Samana Vata. This vata is said to be in close proximity of the digestive fire and governs the digestive functions. This relation between the digestive fire and the samana vata can be compared to the relationship between the air and fire. When breeze flows over the fire, not in a fierce way though, it kindles and increases the fire. Properly channelized air, just as we blow air over burning charcoal or wood can ignite it into large fire. Heavy breeze can put off a weak fire. All these events also take place in the gut and the digestive fire behaves in different ways depending on how the Samana Vata influences it.
When this samana vata is disturbed the entire set up of the digestion in the gut is put into disarray. Udan Vat moves both upwards and downwards from its seat of operation i.e. chest. When it moves down it reaches the level of navel as a part of physiological process. When this vata subtype engulfs the samana vata and disturbs its functions the digestion and metabolic process is put into disarray.
Read – Mechanism Of Avarana, Types, Importance of Vata
Udanavrita Samana – a brief pathogenesis
In Udanavrita Samana – Udana Vata envelops Samana Vata and obstructs its functions. Usually since the enveloping vata is stronger it expresses in a greater way and its symptoms are predominant. Its functions may also be exaggerated. Vata which is enveloped is expressed in a lesser way and its functions are diminished. But it may not always happen as a rule. Many times the symptoms and conditions caused by an obstructed and weakened vata are predominantly evident rather than the strong enveloping vata. This also happens when the invading vata gets cleared off by any intervention or otherwise that the expressions of the enveloped vata are seen clearly in a predominant way.
In this condition Udana Vata is Avaraka. Samana Vata is Avrita. Almost all symptoms caused as an effect of weak metabolism explained in the context of hypothyroidism are those of weakened Samana Vata rather than a strong Udana Vata. But what we need to see is that Udana Vata starts the events. It is on the backdrop of imbalanced Udana Vata that Samana Vata is disturbed. The events caused by imbalance of Udana Vata are causal and diseases caused by deficit Samana Vata are the effects. In clinical diagnosis of hypothyroidism we see the symptoms or diseases caused as an effect of this avarana i.e. the end products of this reaction.
Read – Vata Disorders (Vatavyadhi): Definition, Causes, Symptoms
Why can’t hypothyroidism be Samana Vata functions disturbed as an influence of some other vata subtype other than Udana Vata?
The fact that hypothyroidism can be compared to Udanavrita Samana can be justified by the fact that the disease is caused by hypo-functioning of thyroid gland and this region i.e. neck belongs to the territory of Udana Vata. Since the metabolism is disturbed in hypothyroidism the involvement of samana vata is mandatory. The avarana caused by other subtypes of vata in relation to Samana Vata and its functional deterioration do not sync with the pathogenesis and symptoms of hypothyroidism.
We get to see high TSH in hypothyroidism. This is caused by feedback mechanism caused by low thyroid hormones in the blood circulation which makes pituitary to secrete more Thyroid Stimulating Hormone (TSH). Pituitary is located in the head, the location of Prana Vata. But Pranavrita Udana i.e. Prana Vata meddling with functions of Udana or Udanavrita Prana i.e. Udana Vata interfering with functions of Prana Vata present different set of symptoms which do not match with those of hypothyroidism. Since we are concerned with the slowed down metabolism, a consequence of low thyroid hormones in hypothyroidism, we need to consider a vata subtype which is related to metabolism and that would be Samana Vata. Apana Vata considered with functions of the lower portion of the body and Vyana Vata whose functions are related to entire body do not fit into the explanation of pathogenesis of hypothyroidism but their functions can be disturbed eventually in the later part of the disease process.
Read – How Endocrine System And Hormones Are Governed By Tridosha?
What is the consequence of Samana Vata getting weaker due to its clouding by Udana Vata?
When Samana Vata is clouded by Udana Vata, the functions of Samana Vata get deteriorated.
Availability of less Samana Vata doesn’t provide the necessary ignition to the digestive fire. The digestive fire is represented by the pitta located in the gut. Therefore the gut pitta and the fire seated in it, both get deteriorated.
As a result of deterioration of pitta in the gut, a foundation for deficit digestion and conversion of food is set up. When the heat related to pitta gets decreased, the cold element and the antagonist to pitta located in the stomach i.e. kapha gets increased. The coldness and wetness of kapha further deteriorates the digestion capacity.
Due to all the above said events ama is formed.
The circulating ama, the consequent block of nutritional pathways and tissue channels (srotas) and the feedback received from a low gut fire causes decreased fire in the tissues. This is called as Dhatwagnimandhya – the weakening of tissue fire. Due to this the metabolism i.e. the body’s capacity to convert food into energy becomes lesser and lesser with time. This leads to the manifestation of symptoms of hypothyroidism.
Read – Different Causes For Vata Dosha Imbalance, Increase
Treatment for Udanavrita Samana
As per the principle of treating Avarana, enveloping dosha should be treated first. Here Avaraka is Udana Vata. It is the powerful udana vata that interferes with samana vata and weakens it. This initiates the pathogenesis of hypothyroidism.
Avaraka, according to master Chakrapani is associated with ama. Therefore all treatments essential to digest the ama i.e. pachana treatment should be done. This principle works superbly here because Udana Vata by blocking the Samana Vata is causing slowing down of metabolic process.
Udanavrita Samana is one of those Avaranas which has not been explained in the treatises. We can infer the mechanism of this pathological process on the basis of few avaranas which have been explained.
Below mentioned measures shall be adopted to deal ama associated with Udana Vata –
- Medicines which cause digestion of ama
Read – Ama Chikitsa: Treatment For Ama And Saama Conditions
Udana Vata has upward movement. In Udanavrita Samana it is moving downwards. But Udana also moves towards navel region. Navel region belongs to pitta and digestive fire. It is normal if Udana is moving downwards and not interfering with the functions of Samana. But in Udanavrita Samana the vitiated Udana is interfering with the functions of Samana and also weakening the Samana causing digestive dysfunctions and metabolic problems. The treatment of Udana Vata is reversal of Udana and pushing it back to its natural seat i.e. chest. This can be achieved after ama has been digested properly with above mentioned measures. In fact Udana Vata would get back to its place when ama has been relieved.
The next process is to strengthen the weak Samana Vata. This can be done by –
- Deepana – strategies and medicines to enhance digestive power
- Vamana – if kapha has severely aggravated and is causing lowering of digestive fire, emesis should be administered
- Laghu ahara – light and easily digestible food should be administered until the fire gets back to a state of balance. Gruels processed with fire kindling herbs should be given
- Rasayana and Balya aushadhas – herbs and formulations for rejuvenating the tissues and strengthening the channels should be administered. Also strengthening formulations should be administered. These therapies should be administered after the ama and morbid doshas have been expelled and the digestive fire has been properly kindled. Vardhamana Pippali Rasayana is the best multi-dimensional formulation which can be given in this condition.
Note – These treatment principles of Udanavrita Samana can be used skillfully in treating cases of hypothyroidism. The principles need to be applied as per the context, situation, and stage of pathogenesis and symptoms of hypothyroidism.
In Samanavrita Udana, the aggravated Samana Vata moves upwards into the territory of Udana Vata and envelopes it. As an effect of this pathological event, the Udana Vata becomes weak. There is an influence of this hyperactive samana vata on the udana vata. As Samana Vata increases there is proportional increase in pachaka pitta and in turn the digestive fire. On the other hand there is deterioration in Kledaka Kapha. Since the support and buffer provided by kledaka kapha to the stomach is lost, the combination of samana vata and pachaka pitta becomes even more deadly.
As an influence of increased digestive fire the fires in all the tissues too get severely aggravated due to the feedback mechanism. Due to this, the food we consume gets digested in quick time, rather gets burnt away. Since the food is charred rather than getting properly digested, it is not converted into the nutritional juices. As a consequence the body is not supplied with sufficient nutrition leading to depletion of energy. As a demand for nutrition the tissue fires also go outrageous. All these events lead to excessive stimulation of metabolism.
Read – Types Of Doshas And Their Functions
What happens in Samanavrita Udana?
In Samanavrita Udana – Samana Vata envelops Udana Vata and causes obstruction in its functions. Samana Vata being the dominant vata expresses in a greater way. The symptoms of its aggravation are mainly manifested. The Udana Vata which has been enveloped becomes weaker and its functions also get diminished. On the contrary the symptoms of Udana Vata might get exacerbated as a response to the invading Samana Vata, just like a determined and strong willed prisoner gets agitated with time, becomes restless and try to break the walls and escape. The udana might not be weak, but the samana vata will be dominant. The udana fights to overcome the influence of samana vata. This also happens when the invading samana vata gets cleared off by any intervention or otherwise that the expressions of the enveloped udana vata are seen clearly in a predominant way.
Abnormal increase of core metabolism – Each of these vata subtypes try to dominate the other. The Udana Vata which gets compressed by Samana Vata tries to break the chain and express itself against the Samana Vata. The Samana Vata belonging to the fire zone carries fiery characteristics and once again tries to suppress Udana Vata. Due to these processes there is increase in metabolic process. Everything we eat and drink is burnt. Nutritional juices are either not formed or formed in deficit quantity so as not to suffice the energy needs of the body. There is depletion of energy in the body and symptoms related to high metabolism and low energy are manifested.
Read – Understanding Digestion Process From An Ayurveda View
Impact of increased metabolism on the tissues and channels of the body – The vicious combination of Samana Vata and Pachaka Pitta, apart from attacking the Udana Vata, also invades other tissue fires through Vyana Vata. The tissue fires get exacerbated. When the tissue fire increases it burns its own tissues and also damage the channels carrying these tissues. The nutritional juices to compensate these destroyed tissues are formed in lesser proportion. There is imbalance between demand and supply. With continuous destruction of tissues vata is further aggravated. All these events take place in a cyclic way. This marks the impact of increased metabolism on all the tissues of the body.
Samanavrita Udana – a comparative understanding with Hyperthyroidism
Prof. S.N.Ojha has compared hyperthyroidism with a condition called Samanavrita Udana.
Many symptoms caused as an effect of increased metabolism explained in the context of hyperthyroidism are those of agitated Samana Vata rather than an invaded Udana Vata. It is on the backdrop of imbalanced Samana Vata that the Udana Vata is disturbed. In a way, the events caused by imbalance of Samana Vata are causal and events and diseases caused due to imbalance of Udana Vata are the effects.
It is the high level of thyroid hormones that cause increase in metabolism in hyperthyroidism. In that case the disease onset should take place from the seat of udana vata or udana vata itself. But in Samanavrita Udana we see that the disease starts from the seat of samana vata i.e. gut and ends in seat of udana vata i.e. chest and throat. Here the cause and effect relationship doesn’t sync. For hyperthyroidism to be compared with samanavrita udana the effect should be increased metabolism and the cause should be increased thyroid hormones and not the other way around. Thus in hyperthyroidism the increased digestive fire is the effect and not the cause. But intense digestive fire independently has the capacity to cause many other diseases.
Read – How To Know That Your Digestion System Is Working Fine?
So, how to understand this mechanism according to the concept of avarana?
Teekshnagni, the intense digestive fire – The condition of teekshnagni i.e. intense metabolism and the diseases and symptoms caused by it resembles the explanation of hyperthyroidism. But as said earlier it is the effect of hyperthyroidism. On the other hand the teekshnagni can be caused by any pitta, vata or vata-pitta aggravating factors and not necessarily by hyperthyroidism. And we don’t have any explanation of hyperthyroidism in Ayurveda. So the only possible correlation we can bring into the context of hyperthyroidism is samanavrita udana. Its opposite condition i.e. udanavrita samana has been correlated to hypothyroidism. This is also a reason that the reverse condition samanavrita udana fits into the explanation of hyperthyroidism.
Events in those who already have high gut pitta or severe digestive fire – If Udana Vata is aggravated more than any other vata subtype, it moves ferociously in its designed pathways. When it moves to the navel region it disturbs samana vata and thereby causes its relative imbalance of pachaka pitta. If samana vata is weak udana envelops it and cause symptoms of low metabolism which resembles the clinical picture of hypothyroidism. On the other hand if the samana vata is powerful and if there is already teekshnagni, samana tries to overcome the invading udana and drive it back to its place i.e. chest and throat. In doing so, samana vata will have an upward course, which in healthy conditions does not occur. The samana vata reaches the place of udana and being stronger than udana, will try to envelop and block it. But udana vata too is aggravated as explained already. Now Udana tries to overcome Samana and tends to escape the blockage. The samana gets more aggravated and so does the digestive fire. The core metabolism increases. As a response the fires in all the tissues and elements become severe due to feedback mechanism. Overall metabolism too increases. All these events put together explain the pathogenesis of hyperthyroidism in Ayurveda language.
Events when Samana Vata alone is aggravated – When only Samana Vata gets aggravated due to vata aggravating factors it disturbs pachaka pitta and the digestive fire becomes severe. The kapha in the stomach decreases. The samana vata carrying the fire with it moves upwards towards the seat of udana vata. This can be compared to hot air moving upwards. The hot Samana Vata envelops udana vata. The udana vata tries to overcome this obstruction and express itself. This marks excessive stimulation of thyroid glands and over production of thyroid hormones. This impacts samana vata and make it more aggressive. Aggressive samana exacerbates pachaka pitta and hence the digestive fire. The feedback mechanism of this event increases fire in all the tissues. Thus there is overall increase in the metabolism in the body. This leads to the symptoms of hyperthyroidism.
Read – Dhatu – 7 Body Tissues As Explained In Ayurveda
The battle between fiery samana vata and watery udana vata
Vata is yogavahi i.e. it tends to be fiery when in association with fiery pitta and cold when associated with watery kapha. Samana Vata being in the proximity of digestive fire i.e. pachaka pitta will naturally be hot. Udana Vata located in the chest, seat of kapha, will naturally be cold.
When vitiated Udana Vata reaches the digestive zone i.e. stomach and intestine and disturb the samana vata and envelops a weaker Udana Vata the metabolism becomes weak. This causes symptoms resembling hypothyroidism. Here the cold nature of udana vata is dominating the hot samana vata.
When vitiated Samana Vata reaches the watery zone of Udana Vata and envelops it, the heat dominates the coldness. On the other hand the zone of udana vata gets heated up and udana too acquires hot nature. So there is battle between two heated up vatas. This leads to the events explained above causing the symptoms resembling hyperthyroidism. Here the combination of vata and pitta i.e. hot air subsides kapha in the chest and throat causing a hot and dry environment. This leads to aggravation of udana vata too. Hence in spite of being dominated by the enveloping Samana Vata, Udana too is over expressive.
This event may happen in another way too. The cold Udana reaches the zone of hot Samana but loses its coldness due to excessive heat of aggravated samana vata and increased digestive fire. This makes udana vata dry and hot. But the more powerful samana vata dominates the udana vata, drives it back to its zone and envelopes it. We can also consider samana vata enveloping udana in the seat of digestion itself. The udana tries to overcome this domination and tends to fight back. Its hyper expression and the events leading to hyper metabolism as explained above marks the symptoms of hyperthyroidism.
Read – Upadhatus: Sub-Tissues Of The Body
Symptoms in Samanavrita Udana
Due to the effect of high digestive and tissue fire, diseases and symptoms of high pitta are manifested. This sets up a background for manifestation of inflammatory diseases, depending on the tissues and organs involved. There will be burnouts in the body. Appetite is severe; digestion is fast and there is destruction of tissues. With destruction of tissues vata further gets aggravated and causes more damage in the body.
The functions of Udana Vata is disturbed. The production of speech is hampered. The person is not able to put in any efforts to accomplish even simple tasks and works. He feels low. The energy levels and strength and immunity deteriorates gradually due to the ongoing burnouts caused by increased metabolism. There will be abnormal changes in color and complexion. The thought processing, memory and higher intellectual functions and cognition is disturbed. The diseases related to these functional imbalances will be manifested in due course of time as the disease progresses.
Read – Immunity In Ayurveda: Concept, Diet, Herbs, Medicines, Exercise
Why can’t hyperthyroidism be Udana Vata functions disturbed as an influence of some other vata subtype other than Samana Vata?
The fact that hyperthyroidism is compared with Samanavrita Udana can be justified by the fact that the disease is caused by hyper functioning of thyroid gland. Thyroid gland is situated in the neck and neck is the region of udana vata. Since there is hyper metabolism in hyperthyroidism there should be hyper functioning samana vata and increased digestive and tissue fires associated with this condition in the pathogenesis. The avarana caused by other subtypes of vata in relation to Udana Vata and its functional imbalance do not sync with the pathogenesis and symptoms of hyperthyroidism.
We get to see low TSH in hyperthyroidism. This is caused by feedback mechanism and is caused by high levels of circulating thyroid hormones. This makes the pituitary gland to secrete more TSH. The pituitary gland is located in the seat of Prana Vata i.e. head / brain. The explanation of prana vata enveloping udana vata and udana vata enveloping prana vata and their symptoms do not match with those of hyperthyroidism. The active involvement of apana vata considered with functions of the lower portion of the body and that of vyana vata which functions at the level of entire body cannot be considered in the causation of hyperthyroidism. The functions of apana and vyana vata may get disturbed eventually in the later part of the disease process. In hyperthyroidism we are concerned with enhanced metabolism which is consequence of high circulating thyroid hormones. In this condition we need to consider a vata subtype which is related to metabolism and that would only be Samana Vata.
Therefore Samanavrita Udana is a condition which fits into the explanation of hyperthyroidism from an Ayurveda perspective.
Treatment principles for Samanavrita Udana
As per the principle of treating Avarana, enveloping dosha should be treated first and taken into control of. The enveloping dosha is associated with ama. Therefore treatment for digesting this ama should be administered at the beginning. But in Samanavrita Udana, Samana Vata and digestive fire are strong and intense. When these two are intense there is no chance that the enveloping dosha i.e. Samana Vata is associated with ama because excessive heat digests ama naturally.
Here vata and pitta mitigating measures should be resorted to. This should be done with an intention to calm down the aggressive metabolism and bring it to a state of balance. The aggression of samana vata should be calmed and it should be pushed back to its normal seat i.e. gut. This is achieved by administration of medicines and measures which cause downward movement of samana vata. Further virechana i.e. therapeutic purgation should be given to expel the aggravated vata and pitta and calm the gut environment. Since it is vata that aggravates the pitta and digestive fire and triggers the onset of hyper metabolism its control will put brakes on the pitta and calm it too.
When samana vata and pachaka pitta are controlled the trapped Udana Vata is released. Udana Vata should be taken into control and strengthened by one or more of the below mentioned methods –
- Vata Shamana – vata mitigating herbs, formulations and diet should be given
- Snehana – external and internal administration of medicated fats, the best way to control vitiated vata
- Vasti – medicated enemas for further control of vata should be administered. Mainly the unctuous enemas and milk enemas prepared with bitter herbs or dashamula will be helpful to combat both vata and pitta, to balance the internal fire, to balance the metabolic exacerbations and to reduce inflammation.
- Balya aushadhas – herbs and formulations to enhance strength and restore energy should be given.
- Rasayanas – herbs and formulations to strengthen and restore the tissues and also to strengthen the channels should be administered. The medhya Rasayanas i.e. brain tonics will be very useful in this condition.
The same measures and principles shall be used to treat hyperthyroidism.
Note – Samanavrita Udana is one such type of avarana which has not been described in Ayurveda treatises and so is its treatment. This hypothesis has been built on the basis of inferential knowledge obtained by understanding the concept of avarana and with the knowledge of the avaranas which have been explained in the texts.