Ayurvedic Approach to Duchenne Muscular Dystrophy

Clinical study of Ayurvedic Approach, Mamsagni Rasayana & Panch Karma in the Active Management Of Duchenne Muscular Dystrophy: 28 Patients

  • Mukesh D Jain BSc BAMS MD PPHC (Apollo Hosp) FISCA FAMY (France)
  • Prof M P Pandey Former Dean of Ayurveda, Ravi Shankar University, Program Director, Panch Karma Clinic on Neuro Muscular Disease, Sanjivani Ayurvedic Wellness Center, Supela, Bhilai 490023 India

Abstract:

A small care through clinical research trial involving Gold bhasma based Mamsagni Rasayana (MRG) along with Til-Mash pinda swedana, Shat-Bala Prasarni anuvasana vasti yielded mixed results in 28 boys with Duchenne Muscular dystrophy (DMD). Although this Ayurvedic program did not have the hope for the genetic effect of restoring dystrophin production, it did reduce serum CPK levels. This could be a sign of decreased muscle damage. It is possible that Ayurvedic treatment with MRG allow longer survival by increasing production of muscle CPK enzyme.

Introduction:

Duchenne Muscular Dystrophy is a severe genetically x-linked progressive degenerative disorder of muscle tissue, affects only males. DMD is characterized by (i) Onset of muscle weakness usually before 4 years of age, (ii) Selective muscle involvement of pelvic and pectoral girdles, (iii) Hypertrophy of the calves muscle, (iv) grossly elevated serum CPK levels and (v) Relentlessly progressive weakness of muscle, leading to inability to work within 10 years of onset and later to contractures and thoracic deformity. There is no specific cure in any system of medicine and the death usually occurs before the age of 20 years caused by respiratory failure or less frequently by cardiac involvement.(1)

Pathogenesis:

DMD is a genetic defect and is caused by lack of a single muscle protein Dystrophin (1 of 3000 muscle proteins). Usually DMD is inherited but is also caused by spontaneous mutation more than 30% of the time. Each child of the carrier mother has a 50% chance of inheritance of DMD. Though girls can be carriers, more than 80% show no muscular dystrophy related symptoms. At present a hypothesis postulates a defect in the sarcolemmal membrane which allows a substance (or substances), as yet unknown but which could possibly be calcium, to enter the muscle fibre too freely, and there to activate neutral proteases which, in turn, maintain an excessive degree of muscle catabolism and lead to muscle fibre necrosis. (2, 3, 4, 5)

No treatment is at present known in any system of medicine which has any definite influence upon muscular dystrophy. The absence of specific treatment for muscular dystrophy makes it all the more important to consider alternative approaches of treatment. In India, the Duchenne boys always seek Ayurvedic treatment in the hope for some relief. The Ayurvedic treatment involving medicine and Panch karma massage have shown definite protective influence and longer survival upon muscular dystrophy. Ayurvedic Acharyas carefully consider this condition as adibala-pravrit Mamsa-vata-kshaya due to srotorodha. There is depletion of Mamsagni paving the way of ama formation. It is followed by vitiation of kapha dosha. (6, 7) While srotorodha produces hypertrophy in particular region, it also manifests as first prokopa and then depletion of vata element. This complex pathogenesis is responsible for progressive wasting and necrosis of the affected muscle fibres.

Ayurveda visualizes 13 major types of Agnis (enzyme complex) which are responsible for the process of metabolism. Each of seven dhatus has individual dhatvagnis. The increase or decrease of a particular dhatus depends upon the increase or decrease of respective dhatvagnis. According to Charak, Mamsa-kshaya may be present when there is prolonged majjagata kupita vata. This is always followed by depletion of vata element.

It is genetic predisposition (Beeja dosha) that convert physiological vata element in to pathological morbidity. The srotodushti (? Sarcolemmal membrane defect) is responsible for the mamsa dhatu kshaya.

The concept of Dosha-Dhatu-Mala (D. D. M) is unique in Ayurveda. The dhatus are those substances which are retained by the body and always rejuvenated or replenished. Ras-Rakta-Mamsa-Meda-Asthi-Majja and Sukra are seven dhatus which develops in human body in a fixed, sequential manner one from the other. Each succeeding dhatu is a metabolic refinement of the previous dhatu and get nourished by it. The first dhatu, Rasa (nutrient fluid) is the metabolic end product of the digestion that takes place within gastro-intestinal tract. The Rasa dhatu has to be metabolized in to Rakta dhatu. The Mamsa dhatu comes from Rakta dhatu and in turn, give rise to Meda dhatu. The Asthi dhatu is the product of Meda dhatupaka that contains Majja dhatu which is the prime seat of vata element. ( 6, 8 )

We know that vata (Prana) and Rakta dhatu are two major life sustaining elements in the body. The vata has been attributed like genetic material that carries life information essential for different activities. The Rakta dhatu is the basis of biological force that provides nutrition at cellular level and paves the way of excretion of metabolic toxins. The driving force beyond Rakta dhatu is vata element which circulates itself to cellular level along with Rakta. The conjoint circulation of both Rakta and vata is manifestation of life (Prana). This Prana is responsible for the contraction and relaxation of muscle fibres or muscular activity. It means we have to focus our attention on the dhatvagnis paka of Rasa-Rakta-Mamsa and Meda dhatus besides Asthi and Majja dhatus. In this context Ayurvedic Rasayana therapy has significant role to play. (9, 10)

Rasayana are special ayurvedic resources that increase enzymatic essence of each dhatu starting from Rasa dhatu. The pure gold bhasma in low dose has been used successfully in the management of degenerative diseases of mamsa and Majja dhatu. (11, 12, 13) Usually Rasayana molecule does not work without purificatory procedures. The deepana, pachana process must be strengthened, the dosha must be balanced and metabolic toxins must be eliminated from dhatus through panch karma procedures in order for rasayana molecule to work.

Material & Methods

Keeping in view the complex pathogenesis involved in Duchenne muscular dystrophy, a special Ayurvedic rasayana drug was developed using low dose pure gold bhasma, along with deepan-pachan-srotorodhahara and mamsa dhatu vardhak Ayurvedic resources. The compound prepared and named as Mamsagni Rasayana with Gold (MRG). The active ingredients are bio-enhanced and standardized Marich, Triphala, Gurvel, Guggul, Kuchla, Parad and Gold Bhasma. The dose of the MRG was fixed 20 mg per kilo body weight. The drug was administered orally in two equal doses before meal for a period of 6 months.

Over 55 cases of DMD was enrolled at Panch Karma Clinic of Central Medical Institute, Bhilai and treated during March 1998 and September 2001. We have selected total 28 DMD boys for inclusion in our clinical study. All the Duchenne boys were subjected to 2 weeks Panch karma procedures before administration of oral Mamsagni Rasayana for 6 months. The treatment agenda consisting of (i) Modified Til-Mash Pinda Sweda using fresh leaves of Tejapatra ( Cinnamomum tamala ), Nirgundi (Vitex negundo ) and sprouted Methi ( Trigonella foenum ) seeds as additional ingredients to Til, Masha, unpolished rice and wheat bran, all cooked in the decoction of Bala ( Sida cordifolia ), Ashwagandha ( Withania somnifera ) and milk. (ii) Anuvasana vasti with Shatbala-Prasarni oil.

OBSERVATION & RESULTS

It was observed that degeneration of muscle fibres were arrested after 6 weeks of administration of Mamsagni Rasayana. This was presumed on the basis of reduced CPK level in blood. All the DMD boys who completed clinical Study showed definite sign of improvement such as (i) Weight loss, (ii) Decrease in walking difficulty and (iii) Decrease in the severity of contractures and scoliosis. However DMD boys have shown very slow progress, but it is possible that Ayurvedic treatment program may allow longer survival by increasing production of muscle CPK enzyme (Mamsagni).

Discussion:

Today we know that muscle degenerative wasting conditions in young patients are caused by defect in genes for the muscle proteins. Most of these proteins appear to play a role in supporting the structure of muscle fibres, although some play a role of biochemical enzymes. DMD is caused by lack of dystrophin protein. The Ayurvedic rasayana drugs are well known for its effect to delay / slow or reverse the progressive muscular degeneration. (14). The MRG is supposed to boost Mamsagni at muscle tissue level. It also retards the muscular degeneration due to fat deposition. The Til-Masha Pinda Sweda improves the membrane defect. Since we have noticed a fall in serum Creatine Phosphokinase (CPK) it means there is check on further muscle destruction.

Summary:

Muscular dystrophy is genetic disorder with no satisfactory treatment in any system of medicine. Ayurvedic program of panch karma procedure and rasayana drugs are useful in the long term management of Duchenne muscular dystrophy. There is further need of controlled studies on a large scale with improved trial study and assessment techniques.

References:-

(1) John Walton and David Gardener-Medwin (1988) : The Muscular Dystrophies; In : Disorders of Voluntary Muscles, Ed : Sir Walton (5th Edn), Churchill Livington.

(2) Mokri B, Engel AG (1975) : Duchenne dystrophy : electron microscopic findings pointing to a basic or early abnormality in the plasma membrane of the muscle fibre., Neurology (Minneapolis) 25: 1111

(3) Rowland IP (1976) Pathogenesis of muscular dystrophies. Archives of Neurology 33: 315

(4) Ebashi S, Sugita H (1978) : The Role of calcium in physiological and pathological processes of skeletal muscle. In : abstracts of the Ivth International Congress on Neuromuscular Diseases, Montreal.

(5) Wakyama Y, Bonilla E,Schotland DL (1983) : Plasma membrane abnormalities in infants with Duchenne muscular dystrophy. Neurology (Cleveland) 33: 1368-1370

(6) Nair P Ramchandran et al (1980) : Pseudo-hypertrphic muscular dystrophy- An Ayurvedic Approach. Journal of Res. In Ayurveda & Siddha 1:3 (429-437)

(7) Jain Mukesh D (2000) Genetic Muscular dystrophy. The Madhurima (Bhaskar Weekly) May 2000

(8) Charak Samhita, Chikitsa Sthana 28:14, Chaukhambha Sanskrit Series Office, Varanasi, India

(9) Bhaishajya Ratnavali, Comm. Kaviraj A D Shastri, Chaukhamba Sanskrit Series Office, Varanasi (1991)

(10) Rasayoga Sagar, Krishnadas Academy, Varanasi (1983) V0l I & II

(11) Jain Mukesh D (2001) Muscular dystrophy- Ek Jatil Roga. Journal Nirogadham 23:1 (81-82)

(12) Jain Mukesh D (2001) Fight His Dystrophy Now! Journal of National Integrated Medical Association 43:5(5-7)

(13) Gada Nigraha : Chaukhamaba Sanskrit Series Office, Varanasi (1968)

(14) Jain Mukesh D, Yoga Annapurna and Pandey MP ( 2002) Preliminary Study of Integrated Approach of Panch karma, Yoga and Ayurvedic Medicine in the Management of Muscular Dystrophy : 46 Patients. World Health Review, 1:1 ( 33-35 )

(15) Jain Mukesh D (2003) : Ayurvedic Management of Duchenne Muscular dystrophy: A research report: Light on Ayurveda, Journal of Health, Winter issue 2, Mashpee (USA)

(16) Jain Mukesh D (2005) Panch Karma & Yogic Management of Muscular dystrophy: Arogyadham January 45-47

(17) Jain Mukesh D (2005) Ayurvedic Management of Muscular Dystrophy. Global Ayurveda Vol. 1:3 (24-29)

(18) Jain Mukesh D. (2006) Mamsagni Rasayana in the treatment of Duchenne Muscular Dystrophy: 28 Patients. Ayurvedic Patrika Nasik (MS) India Vol. 1:3 March. 24-29

—————————————————————————————————————————
Address for communications & questions:
Dr Mukesh D Jain
Sanjivani 6/5 Priyadarshani East,
Supela 490023 Bhilai, India
Tel: +91 788 2392358
Email: omninature@india.com

http://www.sanjivaniwellness.org/Research.html

51 Comments

  1. sir this is mahesh and i am from bangalore. i suffer from muscular dystrophy and i have problem while climbing steps and cannot get up from the ground level easily its too hard to get up. But to me this problem started when i was 16 for two to three years i wanted to know about this disorder and did all the tests in nimhans,but cud not get any result for the problem. since i am under continous ayurvedic treatment from last 8years its very helpful to me i am under panchakarma treatment also. sir please help me if their are any methods to improve further

  2. sir,
    i am from coimbatore.my six year old son is having the symptoms of duchhene muscular dystrophy.is it possible to treat him through MRG rasayana and other methods.kindly guide me sir and pls mention whom should i contact regardig this,hope u will do the needful.
    thaking u and requesting ur help once again,
    yours faithfully,
    pushkala

  3. sir,
    i am from delhi.my 15 year old brother is having the symptoms of duchhene muscular dystrophy.is it possible to treat him through MRG rasayana and other methods.kindly guide me sir and pls mention whom should i contact regardig this,hope u will do the needful.
    thaking u and requesting ur help once again,
    yours faithfully
    BHARAT KUMAR SAXENA

  4. Sir,
    My son (adopted) has a patient of Duchchene Muscular dystrophy. Now, he is 4 years old.
    Any medicine available in ayurvedic for curing the dieseas/delay the growth.

    I will be grateful to you, if you could given a correct direction.

    Thanks & Regards

    Prakash Krishna

  5. Sir,
    My nephew sandeep aged 12 years is suffering from DMD, cpk level 9840 presently not able to walk properly, pl suggest any remedy immediately, my mail is given, or my mob N0- 09246627477 at vizag, if u can do some help, we will come to bhilai also at the earliest.
    Raman..

  6. My son is also suffer from DMD since last 2 Yr. as i know there is no treatment of DMD. i am giving him nutrilite suppliment regularly. by the effect of this my son not feel lazyness, tiredness,no pain& energetic

  7. My 17 years son got mascular dystrpy, now e is on wheel chair,Is there any treatment in ayurvdic,please inform me

  8. sir this is Arun and i am from delhi. i suffer from muscular dystrophy and i have problem while climbing steps and cannot get up from the ground level easily its too hard to get up. But to me this problem started when i was 16 for two to three years i wanted to know about this disorder and did all the tests in nimhans,but cud not get any result for the problem. since i am under continous ayurvedic treatment from last 5 years its very helpful to me. sir please help me if their are any methods to improve further

  9. sir, my mother,56yr old, is suffering from MD.. pl guide us if any ayurvedic medicine is avilable. we are from ahmedabad,gujarat,india. waiting for ur reply.

  10. SIR, MY SON IS SUFFER FROM MUSCULAR DYSTROPHY SINCE LAST 3YR AS I KNOW THERE IS KNOW TREATMENT OF DMD .HIS AGE 8YEARS IF ANY TREATMENT AND SUGGESTION GIVE TO ME WE ARE FROM KANPUR .MY SON NOT FEEL LAZYNESS TIREDNESS NO PAIN.CAN YOU HELP ME SIR. HIS TOE IS NOT IN FUNTION. HE IS NOT ABLE TO MOVE HIS TOE. HAND AND LEG IS BEING WEEK AND SQUEEZE DAY BY DAY.

    WE ARE IN TREATMENT OF BABA RAM DEV, BUT NOT FEEL ANY IMPROVEMENT.

    YOU ARE REQUESTED TO GUIDE ME WITH RIGHT TREATMENT AND SAVE MY CHILD’S LIFE. MY CONTACT NO. IS 9311074057. PLS. HELP ME.

  11. Our current understanding of Muscle Dystrophy indicates that there are two general approaches to the treatment that offer hope. The first approach is to develop the technology for effectively re-introducing the deficient gene, or a functional portion of it, into the dystrophic muscles. However, significant technical hurdles have thus far prevented the development of a suitable gene therapies. It is important, therefore, to develop alternative therapeutic strategies for improved quality of Life. The Ayurvedic treatments are meant to slow the progress of the deterioration by regulating the large contribution of immune cells to the death of dystrophic muscle.
    Mamsagni Rasayana 500 mg is found effective to stop further deterioration of muscles. Patient can notice effect within 6-8 weeks. The medicine should be used for 6-8 month. It is taken orally, has the potential to address the underlying degenerative Vata derangement causing destruction of the muscle fibers. It gives better results if used along with TMP ayurvedic therapy and Yogic support.

    Mamsagni Rasayana does not alter the patient’s genetic code or introduce genetic materials into the body. It is natural product developed and being clinically used by AMDS India for Care through ayurvedic research project since 1995. This natural dietary medicament is safe for human consumption.

  12. Sir, my son having dmd kinldy give me correct medicine and address to buy son age is 25 years . I will be greatful to you.

  13. SIR, MY BROTHER IS SUFFER FROM MUSCULAR DYSTROPHY SINCE LAST 10YR AS I KNOW THERE IS KNOW TREATMENT OF DMD .HIS AGE 18YEARS IF ANY TREATMENT AND SUGGESTION GIVE TO ME WE ARE FROM KANPUR .MY SON NOT FEEL LAZYNESS TIREDNESS NO PAIN.CAN YOU HELP ME SIR. HIS TOE IS NOT IN FUNTION. HE IS NOT ABLE TO MOVE HIS TOE. HAND AND LEG IS BEING WEEK AND SQUEEZE DAY BY DAY.

    WE ARE IN TREATMENT OF BABA RAM DEV, BUT NOT FEEL ANY IMPROVEMENT.

    YOU ARE REQUESTED TO GUIDE ME WITH RIGHT TREATMENT AND SAVE MY BROTHER’S LIFE. MY CONTACT NO. IS 9096861422. PLS. HELP ME.

  14. i am in livining in dipration fro long time about 4years.
    i m b. e. holder in ele. commu. branch. i do not good feel. i do not good feel awake after sleep .

  15. Sir,

    My sister son aged 9years is known case of DMD and is on steroids. Kindly help me or inform me the details of your treament and is it available right now and how to approach you.

    Ravi

  16. sir.iam jitinder from haryana.i am 25years old.iam saffaring muscular distorphy from 3year.i am do not climb step,raning.long walk.my treatment is pintajaly vidiapith from 3manth.pl advise batter treatmant.pl conact 09896600722.

  17. Sir, my cousine brother is suffuring from pseudo muscular distrophy for the last 2 years.Kindly explain about it and is any medicine for it ? I will be very greatful for your reply.

  18. sir i am the patient of dmd i am 23 years old if there is treatment plz contact me at the earliest i am waiting for reply

  19. i am 28 yrs old my younger brother 20 yrs we are suffering from Muscular Dystrophy. my cpk is 2000
    and my brother cpk is1600 .
    Is there any cure available ? sir iam in karachi pakistan.
    will be very greatful for your reply.

  20. my son is 10 yr of age & he is suffering from muscular dystrophy( duchanne) detected by doing biopsy test. i am searching the treatment of it. presentely i give him food suppliment of nutrilite brand. with the help of this he is quite energetic but non ambulantry. pl tell me is there isany cure available?
    email- pk_amway@yahoo.in

  21. sir
    my son suffring with muscular destropy desice plese send is there any medicine to cure my son age18
    iam andhrapradesh

  22. hello

    this is prashanth from bangalore, my brother’s son is suffering from dmd, and we have already started ayurvedic trreatment for him, from last 1 year. he got improved about 5%. but still we find swelling on his legs which doctors recognised as symptoms of cpk. is there is any problem of using gold busma which is suggested by the ayurveda doctor. and hope for soon reply.
    thanking you

  23. sir
    my first cousin brother aged 10years is suffering from DMD. He is currently using wheel chair as he is unable to walk. He is unable to sleep properly at night. He can move his arms but with difficulty. sir if this treatment can help him in some manner please guide me accordingly.

  24. Respected Doctor,

    I Aadesh Gupta from Nagpur (Maharashtra) my nephew is suffering from Muscles disease and just few days back doctors had announced that he is suffering from MUSCULAR DIS TROPHY, as we are very up set due to this but any ways we want to cure and save our nephew from the disease, please guide us the best treatment available. we are ready to visit any hospital if some conformation would be made, please we are in need of your guidance/treatment.
    regards aadesh gupta

  25. sir,
    my brother (9 years old),has totally lost his movability…he is unable to walk now ..
    plzzzz give me any suggestion regarding his treatment..
    his health is also deterioting very fastly..
    soo pllzzz..reply me soon!!!

  26. sir my younger couson brother age 7 year suffering from d.m.d. please send if there any medicine to cure. i am from patna.

  27. Hi SIr,

    My son is now 9 years and he is suferring from d m d
    could you please send us the contact whom to contact for treament.

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