Triphala and Cardiovascular Health

Triphala is an ancient and revered Ayurvedic formula consisting of three fruits (amla, haritaki, and bahera). It is considered a rasayana, or adaptogen, and is a balanced tonic appropriate for all constitutions. In North America triphala is known primarily for its beneficial effects on the digestive tract. However, a growing body of research supports the increasing use of this formula for cardiovascular health.

Triphala has many beneficial effects on lipid metabolism in the human body. It has been shown to aid in reducing the weight of obese individuals.i In a study in which mice were fed a high fat diet, triphala administration was effective in decreasing weight gain as well as inhibiting elevation of LDL, VLDL and blood glucose levels. It also increased HDL levelsii and protecting liver function.iii Triphala has also been shown to decrease lipid peroxidationiv which is a major factor in the development of atherosclerosis.

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Amla (Phyllanthus emblica) is the most widely known of the triphala fruits and has many diverse effects that make it very beneficial for healthy cholesterol levels. It has been shown to decrease triglyceride synthesis while increasing the synthesis of HDL. Amla also promotes the absorption of cholesterol into cells, where it performs many critical functions, by increasing expression of the LDL receptor on cell surfaces.v Amla also decreases HMG CoA reductase activity and thus the synthesis of cholesterol.vi True to its reputation as a digestive tonic, it also decreased the absorption of fats and cholesterol.vii Through these diverse factors amla provides natural support for healthy cholesterol levels.

Current understandings of cardiovascular disease have expanded the focus from simply looking at cholesterol levels. Endothelial dysfunction is understood to be a major factor in the development of heart disease. Studies have suggested that the anti-inflammatory and anti-oxidant effects of amla are beneficial in decreasing this dysfunction. A recent study on diabetic humans found that “P. emblica significantly improved endothelial function and reduced biomarkers of oxidative stress and systemic inflammation in patients with type 2 diabetes mellitus, without any significant changes in laboratory safety parameters.”viii A new study performed on obese adults found that in addition to the above mentioned effects amla was able to decrease platelet aggregation. The authors concluded that amla “supplementation may provide beneficial effects in overweight/Class-1 obese adults by lowering multiple global CVD risk factors.”ix These beneficial effects are compounded by the fact that another study found amla reduces CRP levels. 7 It has also been shown to increase the antioxidant capacity of epithelial cellsx and promote nitric oxide production.xi An in-vitro study found that amla’s anti-oxidant effects were due at least in part to amla’s tannin content and were capable of preventing oxidative damage that leads to the progression of atherosclerosis.xii All of these findings taken together demonstrate the powerful benefits of using amla for inflammatory cardiovascular issues.

Haritaki (Terminalia chebula) has very similar properties to amla in regards to heart health. Multiple studies demonstrate that it can increase HDL levels as well as lower triglycerides and LDL level.xiii,xiv Another study looked at haritaki’s ability to address the cardiovascular complications of diabetes. The study found it able to reduce glycation and the endothelial dysfunction that glycation promotes. Haritaki also decreased reactive oxygen species formation in blood vessels and monocyte adhesion to the endothelia.xv The authors found that these activities were largely attributable to the phenolic compound chebulic acidxvi Haritaki’s antioxidant activities have also been shown to decrease lipid oxidation.xvii

The research on amla and haritaki supports the results of studies looking at the entire triphala combination. Triphala shows great promise in the treatment of cardiovascular disease. Science is providing exciting validation for the ancient wisdom that created triphala and extolled to as a primary intervention in healthcare.

References:

i Daru. 2012 Sep 10;20(1):33. doi: 10.1186/2008-2231-20-33. Efficacy of 'Itrifal Saghir', a combination of three medicinal plants in the treatment of obesity; A randomized controlled trial. Kamali SH1, Khalaj AR, Hasani-Ranjbar S, Esfehani MM, Kamalinejad M, Soheil O, Kamali SA.

ii Yakugaku Zasshi. 2007 Feb;127(2):385-8.Hypolipidemic effect of triphala in experimentally induced hypercholesteremic rats.

Saravanan S1, Srikumar R, Manikandan S, Jeya Parthasarathy N, Sheela Devi R.

iii Altern Ther Health Med. 2012 Nov-Dec;18(6):38-45.Triphala and its constituents ameliorate visceral adiposity from a high-fat diet in mice with diet-induced obesity.

Gurjar S1, Pal A, Kapur S.

iv Phytother Res. 2005 Jul;19(7):582-6.In vitro antioxidant studies and free radical reactions of triphala, an ayurvedic formulation and its constituents.

Naik GH1, Priyadarsini KI, Bhagirathi RG, Mishra B, Mishra KP, Banavalikar MM, Mohan H.

v Climacteric. 2015 Apr;18(2):299-310. doi: 10.3109/13697137.2014.933408. Epub 2014 Sep 6.Amla prevents fructose-induced hepatic steatosis in ovariectomized rats: role of liver FXR and LXRα.

Koshy SM1, Bobby Z, Jacob SE, Ananthanarayanan PH, Sridhar MG, Paulose DT.

vi J Ethnopharmacology 2002 Jan;79(1):81-7.Flavonoids from Emblica officinalis and Mangifera indica-effectiveness for dyslipidemia.

Anila L1, Vijayalakshmi NR.

vii Indian J Clin Biochem. 2008 Oct;23(4):378-81. doi: 10.1007/s12291-008-0083-6. Epub 2008 Dec 20.A Pilot clinical study to evaluate the effect of Emblica officinalis extract (Amlamax™) on markers of systemic inflammation and dyslipidemia.

Antony B1, Benny M, Kaimal TN.

viii Diabetes Metab Syndr Obes. 2013 Jul 26;6:275-84. doi: 10.2147/DMSO.S46341. Print 2013.Effects of Phyllanthus emblica extract on endothelial dysfunction and biomarkers of oxidative stress in patients with type 2 diabetes mellitus: a randomized, double-blind, controlled study.

Usharani P1Fatima NMuralidhar N.

ix J Med Food. 2015 Mar 10. [Epub ahead of print]Supplementation of a Standardized Extract from Phyllanthus emblica Improves Cardiovascular Risk Factors and Platelet Aggregation in Overweight/Class-1 Obese Adults.

Khanna S1, Das A, Spieldenner J, Rink C, Roy S.

x J Med Assoc Thai. 2013 Jan;96 Suppl 1:S40-8.Protective effect of Phyllanthus emblica fruit extract against hydrogen peroxide-induced endothelial cell death.

Wongpradabchai S1, Chularojmontri L, Phornchirasilp S, Wattanapitayakul SK.

xi Evid Based Complement Alternat Med. 2013;2013:720728. doi: 10.1155/2013/720728. Epub 2013 Mar 31.Phyllanthus emblica L. Enhances Human Umbilical Vein Endothelial Wound Healing and Sprouting.

Chularojmontri L1, Suwatronnakorn M, Wattanapitayakul SK.

xii Yakugaku Zasshi. 2005 Jul;125(7):587-91.Antiatherogenic effects of phyllanthus emblica associated with corilagin and its analogue.

Duan W1, Yu Y, Zhang L.

xiii See comment in PubMed Commons belowPharm Biol. 2015 Jan 27:1-8. [Epub ahead of print]Anti-hyperlipidemic effect of methanol bark extract of Terminalia chebula in male albino Wistar rats.

Reddy MM1, Dhas Devavaram J, Dhas J, Adeghate E, Starling Emerald B.

xiv J Adv Pharm Technol Res. 2010 Apr;1(2):229-35.Hypolipidemic activity of haritaki (terminalia chebula) in atherogenic diet induced hyperlipidemic rats.

Maruthappan V1, Shree KS.

xv Planta Med. 2011 Jul;77(10):1060-7. doi: 10.1055/s-0030-1270748. Epub 2011 Feb 9.Inhibitory effects of Terminalia chebula extract on glycation and endothelial cell adhesion.

Lee HS1, Cho HY, Park KW, Kim IH, Kim JT, Nam MH, Lee KW.

xvi J Ethnopharmacol. 2010 Oct 5;131(3):567-74. doi: 10.1016/j.jep.2010.07.039. Epub 2010 Jul 24.Preventive effects of chebulic acid isolated from Terminalia chebula on advanced glycation endproduct-induced endothelial cell dysfunction.

Lee HS1, Koo YC, Suh HJ, Kim KY, Lee KW.

xvii Indian J Biochem Biophys. 2005 Aug;42(4):246-9.Antioxidant activity of ethanolic extract of Terminalia chebula fruit against isoproterenol-induced oxidative stress in rats.

Suchalatha S1, Srinivasulu C, Devi S.