{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T01:57:18Z","timestamp":1782698238005,"version":"3.54.5"},"update-to":[{"DOI":"10.12688\/wellcomeopenres.15096.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2019,11,1]],"date-time":"2019-11-01T00:00:00Z","timestamp":1572566400000}},{"DOI":"10.12688\/wellcomeopenres.15096.2","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2019,11,1]],"date-time":"2019-11-01T00:00:00Z","timestamp":1572566400000}}],"reference-count":14,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2019,11,1]],"date-time":"2019-11-01T00:00:00Z","timestamp":1572566400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004440","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["106680"],"award-info":[{"award-number":["106680"]}],"id":[{"id":"10.13039\/100004440","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["wellcomeopenresearch.org"],"crossmark-restriction":false},"short-container-title":["Wellcome Open Res"],"abstract":"<ns4:p>Ayurvedic medicine, a traditional system of medicine practiced in the Indian subcontinent is considered to be devoid of adverse events. We report three cases which highlight the possibility of adverse events related with the use of ayurvedic products. A 35 year old woman with hepatitis took ayurvedic powder medicine and swarnabhasma (gold salt) and had her liver injury worsened, possibly due to alkaloids, and developed nephrotic syndrome, possibly due to gold salt. A 57 year old hypertensive man was taking ayurvedic medicine containing reserpine which had long been withdrawn from the allopathic system of medicine due to wide range of side effects. A 47 year old woman with rheumatoid arthritis was taking an unknown tablet containing steroid as an adulterant for 2 years and developed side effects typical of steroid excess. We would like to highlight the fact that ayurvedic medicines do have propensity to cause adverse events due to adulteration or inherent constituents like alkaloids, and hence may not always be completely safe.<\/ns4:p>","DOI":"10.12688\/wellcomeopenres.15096.3","type":"journal-article","created":{"date-parts":[[2019,11,1]],"date-time":"2019-11-01T12:55:10Z","timestamp":1572612910000},"page":"23","update-policy":"https:\/\/doi.org\/10.12688\/wellcomeopenres.crossmark-policy","source":"Crossref","is-referenced-by-count":27,"title":["Adverse events with ayurvedic medicines- possible adulteration and some inherent toxicities"],"prefix":"10.12688","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5119-4082","authenticated-orcid":false,"given":"Buddhi","family":"Paudyal","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4374-0338","authenticated-orcid":false,"given":"Astha","family":"Thapa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keshav Raj","family":"Sigdel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2659-3425","authenticated-orcid":false,"given":"Sudeep","family":"Adhikari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1125-2743","authenticated-orcid":false,"given":"Buddha","family":"Basnyat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2560","published-online":{"date-parts":[[2019,11,1]]},"reference":[{"key":"ref-1","doi-asserted-by":"publisher","first-page":"50-3","DOI":"10.1016\/j.jtcme.2016.02.002","article-title":"A glimpse of Ayurveda - The forgotten history and principles of Indian traditional medicine.","volume":"7","author":"Y Jaiswal","year":"2017","journal-title":"J Tradit Complement Med."},{"key":"ref-2","first-page":"250-7","article-title":"Why do patients choose to consume Ayurvedic Medicines in Nepal? An exploratory study.","volume":"9","author":"G Kafle","year":"2018","journal-title":"International Journal of Ayurvedic Medicine."},{"key":"ref-3","first-page":"15-36","article-title":"Drug Receptors and Pharmacodynamics","author":"M Zastrow","year":"2012"},{"key":"ref-4","doi-asserted-by":"publisher","first-page":"613-626","DOI":"10.1055\/a-0605-3786","article-title":"A Review of the Toxicity of Compounds Found in Herbal Dietary Supplements.","volume":"84","author":"A Hudson","year":"2018","journal-title":"Planta Med."},{"key":"ref-5","doi-asserted-by":"publisher","first-page":"136-9","DOI":"10.1016\/S0165-6147(00)01972-6","article-title":"Toxic heavy metals and undeclared drugs in Asian herbal medicines.","volume":"23","author":"E Ernst","year":"2002","journal-title":"Trends Pharmacol Sci."},{"key":"ref-6","doi-asserted-by":"publisher","first-page":"753-65","DOI":"10.1289\/ehp.99107s5753","article-title":"Metals and kidney autoimmunity.","volume":"107 Suppl 5","author":"P Bigazzi","year":"1999","journal-title":"Environ Health Perspect."},{"key":"ref-7","doi-asserted-by":"publisher","first-page":"463-74","DOI":"10.1504\/IJEnvH.2008.020936","article-title":"Heavy metal poisoning from Ayurvedic traditional medicines: an emerging problem?","volume":"2","author":"P Dargan","year":"2008","journal-title":"International Journal of Environment and Health."},{"key":"ref-8","first-page":"40-6","article-title":"Rauwolfia in the Treatment of Hypertension.","volume":"14","author":"D Lobay","year":"2015","journal-title":"Integr Med (Encinitas)."},{"key":"ref-9","doi-asserted-by":"publisher","first-page":"769-77","DOI":"10.2165\/11587390-000000000-00000","article-title":"Long-term efficacy and tolerability of a fixed-dose combination of antihypertensive agents: an open-label surveillance study in China.","volume":"31","author":"Y Wu","year":"2011","journal-title":"Clin Drug Investig."},{"key":"ref-10","doi-asserted-by":"publisher","first-page":"3021-104","DOI":"10.1093\/eurheartj\/ehy339","article-title":"2018 ESC\/ESH Guidelines for the management of arterial hypertension.","volume":"39","author":"B Williams","year":"2018","journal-title":"Eur Heart J."},{"key":"ref-11","doi-asserted-by":"publisher","first-page":"474-89","DOI":"10.1016\/B978-1-4557-0101-8.00029-1","article-title":"Pharmacologic Management of Hypertension","author":"J Saseen","year":"2013"},{"key":"ref-12","doi-asserted-by":"publisher","first-page":"599-602","DOI":"10.1002\/pds.553","article-title":"Misuse of corticosteroids in some of the drugs dispensed as preparations from alternative systems of medicine in India.","volume":"9","author":"S Gupta","year":"2000","journal-title":"Pharmacoepidemiol Drug Saf."},{"key":"ref-13","first-page":"170-2","article-title":"An analysis of medicines of undisclosed composition for asthma or rheumatoid arthritis.","volume":"28","author":"N Basu","year":"1984","journal-title":"Indian J Physiol Pharmacol."},{"key":"ref-14","doi-asserted-by":"publisher","first-page":"2216-29","DOI":"10.1016\/j.clinthera.2017.09.011","article-title":"Long-term Systemic Corticosteroid Exposure: A Systematic Literature Review.","volume":"39","author":"J Rice","year":"2017","journal-title":"Clin Ther."}],"container-title":["Wellcome Open Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/wellcomeopenresearch.org\/articles\/4-23\/v3\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/wellcomeopenresearch.org\/articles\/4-23\/v3\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/wellcomeopenresearch.org\/articles\/4-23\/v3\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,11,9]],"date-time":"2019-11-09T03:35:07Z","timestamp":1573270507000},"score":1,"resource":{"primary":{"URL":"https:\/\/wellcomeopenresearch.org\/articles\/4-23\/v3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,11,1]]},"references-count":14,"URL":"https:\/\/doi.org\/10.12688\/wellcomeopenres.15096.3","relation":{},"ISSN":["2398-502X"],"issn-type":[{"value":"2398-502X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,11,1]]},"assertion":[{"value":"Indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/4-23\/v3#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.21956\/wellcomeopenres.16470.r35472, Sanjib Kumar Sharma, Department of Internal Medicine, B.P. Koirala Institute of Health Sciences, Dharan, Nepal, 05 Jun 2019, version 1, 1 approved, 1 approved with reservations","URL":"https:\/\/wellcomeopenresearch.org\/articles\/4-23\/v1#referee-response-35472","order":0,"name":"referee-response-35472","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Sudeep Adhikari<\/b>; \n<i>Posted: 29 Jul 2019<\/i>; Thank you for your constructive comments.  We have not performed histopathology and drug analysis report. So we are not sure if the drug contained harmful alkaloids, and if the worsening of the liver disease was due to disease process itself or the unlabeled drug that was given. We have mentioned this in our revised manuscript. Here we wanted to focus that at least the alternative drug our patient tried did not help in her liver problem as is generally believed by Nepalese population.  Although reserpine has safely been used in treating patients with hypertension in some studies in the form of Rauwolfia, the routine use of reserpine as antihypertensive agent has not been recommended by any of the current guidelines of allopathic medicine. Moreover, the ayurvedic preparation our patient was taking for hypertension did not have label regarding amount of reserpine in each tablet. So we have raised the issue about mentioning the exact amount of each chemical constituent in any ayurvedic product so that the patients have some idea about the substance and the quantity being taken.","URL":"https:\/\/wellcomeopenresearch.org\/articles\/4-23\/v3#referee-comment-3904","order":1,"name":"referee-comment-3904","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.21956\/wellcomeopenres.16814.r36106, Kshirod Kumar Ratha, National Research Institute of Ayurvedic Drug Development, Kolkata, West Bengal, India, 29 Aug 2019, version 2, indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/4-23\/v2#referee-response-36106","order":2,"name":"referee-response-36106","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.21956\/wellcomeopenres.16814.r36496, Phaik Yeong Cheah, Mahidol-Oxford University Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand, 10 Oct 2019, version 2, indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/4-23\/v2#referee-response-36496","order":3,"name":"referee-response-36496","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Sudeep Adhikari<\/b>; \n<i>Posted: 30 Oct 2019<\/i>; Thank you for the review.  Corrections of typos and grammatical mistakes have been done in the revised version, especially in the abstract section. The term &quot;adverse events&quot; has been used instead of &quot;adverse effects&quot;.","URL":"https:\/\/wellcomeopenresearch.org\/articles\/4-23\/v3#referee-comment-3992","order":4,"name":"referee-comment-3992","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"This work was supported by the Wellcome Trust [106680]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.","order":5,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}