A review study on the role of Avarana in the clinical presentation and pathogenesis of metabolic diseases

Abstract

The Ayurvedic principle of Avarana, which describes the obstruction of Vata’s natural movement by another Dosha or Dhatu, provides a comprehensive lens through which various metabolic disorders now increasingly common globally and in India can be interpreted. In this review, classical sources were systematically examined alongside modern biomedical literature following SANARA guidelines to elucidate how Avarana mechanisms map onto contemporary pathophysiology. Distinct obstruction patterns were identified: in diabetes mellitus and obesity, Kapha and Meda obstruct Vyana and Samana Vata, correlating with insulin resistance and adiposity; in hypertension, Pitta’s encroachment upon Prana Vata parallels autonomic imbalance; in non-alcoholic fatty liver disease, excess Kapha envelops Doṣhivisha, mirroring hepatic steatosis and inflammation; hypothyroidism reflects Kapha’s blockade of Udana Vata, akin to slowed metabolism; In gout, the diseased state develops as aggravated Rakta blocks the movement of Vyana Vata, which parallels the pathological process of elevated uric acid levels and subsequent crystal accumulation in joints; and irritable bowel syndrome embodies mutual obstruction between Samana and Apana Vata, corresponding to dysregulated gut motility. This integrative analysis underscores the value of Avarana in offering personalized diagnostic and therapeutic strategies herbal formulations to remove obstructions, targeted Panchakarma procedures to restore Doshic balance, and lifestyle modifications tailored to the specific Dosha interactions. By bridging classical Ayurvedic theory with modern biomedical insights, this work proposes a nuanced, patient-centric approach for the prevention and management of metabolic disorders, advocating further clinical studies to validate Avarana-guided interventions.