Assessing the Effectiveness of Panchatikta Ghrita, a Classical Ayurvedic Formulation as Add-on Therapy to Vitamin D3 and Calcium Supplements in Patients with Osteopenia: A Randomized, Open-Labeled, Comparative, Controlled Clinical Study

From tradition to science: Possible mechanisms of ghee in supporting bone and joint health

Ghee, a traditional form of clarified butter, has been used for centuries in Ayurvedic medicine for its numerous health benefits. Recent scientific studies have begun to elucidate the molecular mechanisms by which ghee may support bone and joint health. This review explores the bioactive components of ghee, including short-chain fatty acids (SCFAs), medium-chain fatty acids (MCFAs), and fat-soluble vitamins (A, D, E, K2), and their potential therapeutic effects on bone density, joint lubrication, and inflammation. SCFAs in ghee can potentially improve joint lubrication and reduce inflammation. MCFAs and conjugated linoleic acid (CLA) exhibit anti-inflammatory properties, modulating cytokine production and oxidative stress pathways. Vitamins D and K2 in ghee can play potentially crucial roles in calcium metabolism and bone mineralization, while vitamin A supports immune regulation and cartilage health. This review integrates traditional knowledge with contemporary scientific research, highlighting the potential of ghee as a complementary therapy for conditions such as osteoporosis and arthritis. By understanding the molecular mechanisms involved, future studies can focus on this field to shed a light on different effects of ghee on bone and joint health.

Health benefits of ghee: Review of Ayurveda and modern science perspectives

The scientific view on dairy fats is undergoing a change. While at one time they were associated with negative health effects, recent scientific research has provided new insights into the functional benefits of dairy fats and their fatty acids. This changing scientific view on dairy fats is also resulting in a scientific interest in Ghee, the clarified butter obtained from milk. Ghee, besides being a traditional milk product of cultural importance in India and finding extensive use in its cuisines, is also one of the most important ingredients of the materia medica of Ayurveda, the traditional system of medicine that originated in India. While modern scientific literature has limited studies on functional benefits of ghee, Ayurveda literature extensively catalogues the therapeutic potential of ghee and details different types of ghee based on source of milk, manufacturing method, maturation and physical phase. This work reviewed the Ayurveda literature on health benefits of ghee and examined the complementarity and gaps between Ayurveda literature and modern scientific literature to identify research questions and hypotheses for further exploring the therapeutic potential of ghee. The Ayurveda literature review involved curation of references to ghee in eleven important Ayurvedic texts spanning over 3000 years. 4000 references to milk and milk products were curated from these texts, of which 2913 mentions were in the context of therapeutic benefits of milk products. Of these, ghee had 774 mentions, the highest amongst milk-based products. These mentions were grouped into 15 benefit clusters. A review of ghee in modern literature published between 1990 and 2023 was also conducted. A comparison of this with the Ayurveda literature showed that there were major differences in the focus areas of health between the two. While recent research primarily focused on ghee's connection with cardiovascular health, wound healing and skin health, Ayurveda prioritized cognitive benefits, gastrointestinal health, and nourishing. These later areas are of growing importance to human health as global population ages, and chronic and brain related diseases start dominating public health concerns. As scientists search for solutions to these, ghee, its usage and formulations in Ayurveda and the detailed associations between ghee's animal source, processing, maturation, phases and health benefits, may have scientific insights to offer that can guide future research.

Plant-derived natural medicines for the management of osteoporosis: A comprehensive review of clinical trials

Background

Osteoporosis is a chronic and systemic skeletal disease that is defined by low bone mineral density (BMD) along with an increase in bone fragility and susceptibility to fracture. This study aimed to overview clinical evidence on the use of herbal medicine for management of osteoporosis.

Methods

Electronic databases including Pubmed, Medline, Cochrane library, and Scopus were searched until November 2022 for any clinical studies on the efficacy and/or safety of plant-derived medicines in the management of osteoporosis.

Results

The search yielded 57 results: 19 on single herbs, 16 on multi-component herbal preparations, and 22 on plant-derived secondary metabolites. Risk of fracture, bone alkaline phosphatase, BMD, and specific bone biomarkers are investigated outcomes in these studies. Medicinal plants including Acanthopanax senticosus, Actaea racemosa, Allium cepa, Asparagus racemosus, Camellia sinensis, Cissus quadrangularis, Cornus mas, Nigella sativa, Olea europaea, Opuntia ficus-indica, Pinus pinaster, Trifolium pretense and phytochemicals including isoflavones, ginsenoside, Epimedium prenyl flavonoids, tocotrienols are among plant-derived medicines clinically investigated on osteoporosis. It seems that multi-component herbal preparations were more effective than single-component ones; because of the synergistic effects of their constituents. The investigated herbal medicines demonstrated their promising results in osteoporosis via targeting different pathways in bone metabolism, including balancing osteoblasts and osteoclasts, anti-inflammatory, immunomodulatory, antioxidant, and estrogen-like functions.

Conclusion

It seems that plant-derived medicines have beneficial effects on bone and may manage osteoporosis by affecting different targets and pathways involved in osteoporosis; However, Future studies are needed to confirm the effectiveness and safety of these preparations.

Vitamin D and Calcium in Osteoporosis, and the Role of Bone Turnover Markers: A Narrative Review of Recent Data from RCTs

Osteoporosis is a common disease, defined primarily by a low measured bone density, which is associated with an increased risk of fragility fractures. Low calcium intake and vitamin D deficiency seem to be positively correlated with the prevalence of osteoporosis. Although they are not suitable for the diagnosis of osteoporosis, the biochemical markers of bone turnover can be measured in serum and/or urine, enabling the assessment of the dynamic bone activity and the short-term effectiveness of the osteoporosis treatment. Calcium and vitamin D are essential for maintaining bone health. The aim of this narrative review is to summarize the effects of vitamin D and calcium supplementation separately and in combination, on bone density and circulating serum and blood plasma vitamin D, calcium, parathyroid hormone levels, markers of bone metabolism concentrations, and clinical outcomes, such as falls and osteoporotic fractures. We searched the PubMed online database to find clinical trials from the last five years (2016-April 2022). A total of 26 randomized clinical trials (RCTs) were included in this review. The present reviewed evidence suggests that vitamin D alone or in combination with calcium increases circulating 25(OH)D. Calcium with concomitant vitamin D supplementation, but not vitamin D alone, leads to an increase in BMD. In addition, most studies did not detect significant changes in circulating levels of plasma bone metabolism markers, nor in the incidence of falls. Instead, there was a decrease in blood serum PTH levels in the groups receiving vitamin D and/or Ca supplementation. The plasma vitamin D levels at the beginning of the intervention, and the dosing regimen followed, may play a role in the observed parameters. However, further study is needed to determine an appropriate dosing regimen for the treatment of osteoporosis and the role of bone metabolism markers.