Category: Heart Health

Heart Health and Best Natural Supplements for Heart

OVERVIEW

मर्माणि बस्तिं ह्रुदयं शिरश्च प्रधानभूथानि………॥(च.चि.२६/३)

ह्रुदयम् चेतनास्थानमुक्तं….।(सु.शा. ४/३४)

Ayurveda has considered the heart as one among the trimarma, seat for ojas, chetana(praana) & tridoshas which specifies the vitality of the organ.

In today & scenario we are facing many health issues because of wrong lifestyle, increased mental worries, & not following the rituals properly. All these may have direct or indirect impact on our heart. According to WHO in 2019, an estimation of 17.9 million people died from CVDs which represents 32% of all global deaths. (1) The increased morbidity & mortality rate is a warning alarm to consider caring of the heart by means of natural remedies, yoga & pranayama. This article helps to understand the importance of the heart & its care in a natural way.

Heart Disease

INTRODUCTION

Concept of heart as in Ayurveda

Acharya Sushrutha explains that formation of heart starts at foetal stage in the month of fourth.

चतुर्थे……गर्भह्रुदयप्रव्यक्तिभावाच्चेतनाधातुरभिव्यक्तो भवति…….(सु.शा.३/१८)

So caring of the heart begins in the mother's womb itself by following proper pregnancy regimens.

While forming the foetus maternal factors contribute towards the formation of the heart. They are the superior part(prasada bhaaga) of Rakta & Kapha.

शोणितकफप्रसादजं ह्रुदयं…। (सु.शा.४/३१)

Heart is compared to the downward faced lotus. Its beats are explained as closure & opening of the lotus.

पुण्डरीकेण सद्रुशं ह्रुदयम् स्यादधोमुखम्॥ (सु.शा.४/३२)

CARDIOVASCULAR DISEASE & CAUSATIVE FACTORS

In classics CVD explained under Hridroga which caused by doshik variation or external injury due to trauma or krimi.

Disorders related to heart & blood vessels are considered as cardiovascular diseases. It can be
congenital (since birth) or non-congenital. CHD occurs due to structural deformity of the heart which ends up in poor performance. Ex ASD, VSD, PAD in general known as hole in the heart. Non congenital diseases include heart failure, CAD, pericardial diseases etc.

Ignoring proper pregnancy care or a person indulging in below things in excess leads to Heart
diseases.

Food factors Activities Psychological factors External factor Risk factor
Dry, unctuous, heavy for digestion Sedentary lifestyle Grief Trauma to heart Hereditary
Sour & salty items, alkali Inadequate Eating, Fasting Anger Infectious diseases obesity
Hot in potency Eating before the digestion of previous food over thinking Diabetes
Sweet & fatty items Excessive eating Fear, Panic High cholesterol & blood pressure
Smoking Risk factor
Physical exercise Hereditary

SYMPTOMS

  • Every type of hridroga has its own signs & symptoms. Some of the cardiac disorders appear asymptomatic also. In general following can be considered
  • Discoloration (pale/cyanosed), Fainting, confusion, Dyspnoea, Anorexia, Nausea/vomiting, Thirst, Abnormal taste in the mouth, Fever, Cough & Pain.
  • Pain in terms of discomfort in the centre of the chest, in the arms, the left shoulder, elbows, jaw, or back.

MANAGEMENT

आहारसम्भवं वस्तु रोगाश्चाहारसंभवाः ।(Cha.Su.28/44)

  • This explains, Food is the source for body formation thus healthy food forms healthy body or else leads to various diseases.
  • Ayurveda believes in saying Prevention is better than cure. Hence it says about Garbhini paricharya( pregnancy care), Dinacharya & ritucharya.

लाघवं कर्मसामर्थ्यं दीप्तोऽग्निर्मेदसः क्षयः ।

विभक्तघनगात्रत्वं व्यायामादुपजायते ॥ (A.H.Su. 2/10)

By doing routine physical exercise one can attain lightness of the body, more physical strength, increased appetite, proper fitness & reduced fat level. Yoga also has similar benefits. Below mentioned asanas helps in relaxation of body & mind, promotes flexibility,improves circulation & strengthens muscles & bones.Both helps in reducing the risk of CVD by lowering blood pressure, cholesterol & blood glucose level.

Prevention or early management can be done by diagnosing the diseases as soon as possible by means of specific investigations like ECG, Echocardiography, Doppler study, Radionuclide test, Doppler study etc.

American Heart Association says to adopt following things

  • Manage Blood Pressure
  • Control Cholesterol
  • Reduce Blood Sugar
  • Get Active
  • Eat Better
  • Lose Weight
  • Stop Smoking

All these are explained in our classics long back in terms of Nidana parivarjana & Pathya paripalana.

CLASSICAL FORMULATION

Treatment based on involved Dosha

VATAJA PITTAJA KAPHAJA
Punarnavadi taila Drakshadi ghrita Katphaladi kashaya
Pushkaramuladi kwatha Kasherukadi ghrita Udumaradi leha
Haritakyadi ghrita Sthiradi ghrita Shilajit Rasayan
Tryushandi ghrita Chyawanprash,
Pathyadi kalka Agastya-haritaki avaleha
Braahma Rasayana

Dose & Anupana depends on the condition of the patient.

Treatment based on severity of Pain(Cha.chi.26/101-102)

The patient in whom

  • The pain becomes severe after consuming food & relieves when the food is completely digested   – Churna of Devadaru, Kushta, Tilwaka, Saindhava & Sauvarchala lavana, vidanga has to be administered with warm water.
  • If the pain gets aggravated during the digestion process – Virechana therapy should be administered using swarasa of Drakshadi madhura dravya.
  • If pain persists & is in severe form after the intake of food, during the digestion process & even after completion then – Virechana should be done by using Danti moola or nishitha moola.

HERBS FOR HEART

Acharya Charaka has mentioned ten herbs under Hridya gana which are said to be Cardio protective. (Cha.Su.4/10)

NAME BOTANICAL NAME USEFUL PART
Amra Mangifera indica Fruit
Amrataka Spondias pinnata Seeds
Lakucha Artocarpus lakoocha Fruit
Karamarda Carissa carandes Fruit
Vrikshamla Garcinia indica Fruit
Amlavetasa Garcinia pedunculata Fruit
Kuvala Zizyphus sativa Fruit
Badara Zizyphus jujuba Fruit
Dadima Punica granatum Fruit
Matulunga Citrus limon Fruit

PROPERTIES & MODE OF ACTION

Most of the above mentioned drugs have sour & sweet taste which helps in regulating cardiac functions. Because of its hot potency (except few) & amla vipaka it helps in reducing lipid & clot deposition & also acts as digestive, carminative & appetizers.

DESCRIPTION OF THE HERBS GOOD FOR HEART HEALTH

1. ARJUNA (Terminalia arjuna)

Arjuna possesses hypocholesterolemic, hypotensive, antiplatelet and thrombolytic activities which plays an important role in the management of cardio-vascular and cerebrovascular disorders. Beneficial effects of Arjuna in patients of chronic stable angina, endothelial dysfunction, heart failure and ischemic mitral regurgitation has been reported in clinical studies.(2) Hence it is a drug of choice in many cardiac diseases. It is used in the form of churna, kwatha, gutika & sheerapaka.

2. PUNARNAVA (Boerhavia diffusa)

It has a cold potency. Also possess hypoglycemic, anti fibrinolytic, immunomodulatory activities. As it contains anti-inflammatory & antioxidant properties, It helps in lowering the risk of congestive heart failure.

3. PIPAL TVAK (Ficus religiosa)

It has Antimicrobial & anti diabetic properties. The fruit which has cold potency acts as cardio tonic.

4. DALCHINI (Cinnamomum zeylanica)

It has the ability to reduce cholesterol level in diabetic patients & lowers the blood glucose level. By which it reduces the risk of CVD.

5. CHHOTI ELAICHI (Elettaria cardamomum)

In classics (Raja nighantu) hridroga is mentioned as one of the indications. It has the Hridya property(Cardiac tonic). It helps in enhancing fibrinolysis properties, reducing blood pressure & improving antioxidant status.

6. ASHWAGANDHA (Withania somniferum)

It is considered as the nervous tonic. This specifically helps in conditions like anxiety, stress, depression etc. It also helps in cardiac health by strengthening heart muscles, maintaining proper blood flow &  cholesterol level. It also has anti diabetic properties.

7. BRAHMI (Bacopa monnieri)

It is known for its medhya property(brain tonic). Brahmi is categorized under Balya gana ( herbs which helps in improving immunity & strength). It has mehajit(anti diabetic)  & antioxidant properties. It helps in maintaining normal vascular muscle functions by increasing the utilization of nitric acid.

8. SHANKAPUSHPI (Convolvulus pluricaulis)

It is also known for its Medhya property & one of the best stress relieving herbs. It also acts as an antidepressant.

Natural Supplements for Heart

Natural Supplements for Heart

HEART CARE PRODUCTS IN PLANET AYURVEDA

Planet Ayurveda is a trusted and famed organisation offering herbal products across all over the world. These products are 100% natural and prepared using standardized extract of herbs. Planet ayurveda products are safe and made without using any chemical, additive, binder, and preservatives. Along with heart health, these products are useful in numerous health ailments.  Following are the list of formulations prepared using above mentioned  herbs in combo named as HEART CARE PACK

  1. ARJUNA CAPSULES
  2. ARJUN TEA
  3. TOTAL HEART SUPPORT
  4. GOTU KOLA CAPSULE

PRODUCT DETAILS

1. ARJUNA CAPSULES

It contains standardized extract of Arjuna (Terminalia arjuna).

Dosage – 2 Capsules, twice daily with plain water.

2. ARJUN TEA

It is an herbal tea which contains Arjuna, punarnava, pipal tvak, Dalchini & Elaichi.

Dosage – 2 Cups, twice daily.

3. TOTAL HEART SUPPORT

It is a capsule made with the combination of Arjuna , Ashwagandha, Brahmi and Shankhpushpi.

Dosage – 2 Capsules, twice daily with plain water.

4. GOTU KOLA CAPSULE

Gotu kola is a very impressive herb that has spectacular effects on stabilizing the plaque in the blood vessels.

YOGA FOR HEART CARE

Standing posture Sitting posture Sleeping posture
Tadasana Marjarasana Bhujangasana
Trikonasana Paschimottanasana Dhanurasana
Utkatasana Ardha matsyendrasana Setubandhasana
Utthita hasta padasana Shavasana
Adho Mukha shavasana

CONCLUSION

तन्महत् ता महामूलास्तच्चौजः परिरक्षिता । परिहार्या विशेषेण मनसो दुःखहेतवः ॥

ह्रुद्यं यत् स्याद्यदौस्यं स्रोतसां यत् प्रसादनम् । तत्तत् सेव्यं प्रयत्नेन प्रशमो ज्ञानमेव च ॥ (Cha. Su. 30/13-14

Person who wants to keep his heart & blood vessels healthy should avoid factors which traumatize the mind. He should consume a wholesome diet, medicine & follow activities which are favourable to Heart & ojas. Whatever the medicines, therapies & yogas mentioned above has its own limits in terms of indication, contraindication & side effects. Hence it should be followed only under the guidance of an Ayurvedic physician.

So why delay, Stay fit Stay healthy

Understanding Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC) – Symptoms, Causes, and Treatment

ABSTRACT

Arrhythmogenic right ventricular cardiomyopathy is a form of heart disease that usually appears in adulthood. Heart disease includes many heart problems which means it includes heart and blood vessel disease. The heart is a muscular organ which pumps blood through the blood vessels of the circulatory system. In humans, the size of the heart is approximately the size of a fist which is located between the lungs in the middle compartment of the chest. Usually, the heart is divided into four chambers: upper left and right atria and lower left and right ventricles.

In a healthy heart, blood flows one way through the heart due to heart valves which prevent backflow. The walls of the heart are made up of three layers epicardium, myocardium and endocardium. The deoxygenated blood enters the heart through the right atrium from the superior and inferior vena cava and further passes to the right ventricle. Cardiovascular diseases are the most common cause of death. It is situated in the mediastinum at the level of T5-T8, a double membrane sc known as pericardium surrounds the heart and attaches to the mediastinum. An adult heart has a mass of 250-350 gm. The fibrous cardiac skeleton gives the structure to the heart and the cardiac skeleton provides the boundary in the heart’s electrical conduction system. In this article, we are going to discuss the causes, symptoms and ayurvedic management of ARVC (arrhythmogenic right ventricular cardiomyopathy).

INTRODUCTION

ARVC (Arrhythmogenic right ventricular cardiomyopathy) is a disorder of the myocardium which is the muscular layer of the heart. This condition causes the part of the myocardium to break down and increases the risk of abnormal heartbeat (arrhythmia) and causes sudden death. It is known as Arrhythmogenic cardiomyopathy (ACM), Arrhythmogenic right ventricular dysplasia (ARVD), which is inherited heart disease. It can be found in association with diffuse palmoplantar keratoderma and wooly hair which is an autosomal recessive condition known as Naxos disease. It is predominantly seen in males, 30-50% have familial distribution. The main clinical hallmark of this disease is ventricular arrhythmias which is arising from the right ventricle. The fatty fibrous tissue replaces the normal heart muscle which interrupts the normal signals in the heart and causes an irregular and life-threatening heart rhythm. Usually begins in the right ventricle (as the right ventricle stretches out and becomes thin and poorly contracts)  but after some time affects the left ventricle, so there is irregular heart pumping so blood backs up in the circulatory system which causes the fluid to build up in the soft tissues and sometimes in the lungs which further causes oedema and shortness of breath and results in heart failure. ARVC is a rare genetic disease which shows symptoms between the age of 10-50 years of age.

ARRHYTHMOGENIC RIGHT VENTRICULAR CARDIOMYOPATHY

PATHOGENESIS

The cause is unknown, but apoptosis (cell death) plays an important role. This disease starts in the subepicardial region and moves towards the endocardial surface which leads to transmural involvement.  There are 2 pathological patterns which are seen in ACM/ARVC- Fatty infiltration and fibro-fatty filtration.

  1. Fatty infiltration-
  2. It is confined to the right ventricle and involves a partial and near complete substitution of the myocardium with fatty tissue without thinning of the walls.
  3. There is evidence of myocyte degeneration and death is seen in 50% of fatty infiltration.
  4. Fibro Fatty Infiltration-
  5. It is the replacement of myocytes with fibrofatty tissues.
  6. Myocardial atrophy is due to injury and apoptosis which leads to thinning of the RV free wall.
  7. These areas are prone to aneurysm formation

STAGES OF ARRHYTHMOGENIC RIGHT VENTRICULAR DYSPLASIA

There are 3 stages of ARVC (Arrhythmogenic right ventricular dysplasia)-

  1. Concealed Stage- There are no symptoms of abnormal heart rhythm while exercising.
  2. Electrical Stage- There is a high risk of ventricular arrhythmias and risk of sudden cardiac death, ECG shows abnormal heart rhythm issues.
  3. Structural Stage- They are at even higher risk of abnormal ventricular rhythm and sudden cardiac death.  

CAUSES

  1. It results from a genetic defect. 60% of people have genetic mutations. Due to mutations in the desmosomes, genes impair the functions of desmosomes, without normal desmosomes, cells of the myocardium detach and die so heart muscles come under pressure. The damaged myocardium gets replaced with fat and scar tissue. As the abnormal build-up walls of the ventricle get stretched out it prevents the flow and leads to changes in arrhythmia.
  2. There are 2 patterns of inheritance for ARVC-
  3. Autosomal Dominant- when one of the parents has a genetic mutation, it is more prevalent in Italy and other geographic areas
  4. Autosomal Recessive- When both the parents have genetic mutations but show no symptoms. It can be seen in Naxos disease which causes the thickening of the skin.
  5. Viral and inflammatory myocarditis
  6. Birth abnormalities which affect the right ventricle

SYMPTOMS

  1. ARVC causes chest pain which seems like a heart attack
  2. Ventricular arrhythmias- The irregular heart rhythms start in the ventricles or the lower chamber of the heart, the most common rhythm is ventricular tachycardia. Almost 77% of people are in this condition.  
  3. Supraventricular arrhythmias are most often in atrial fibrillation
  4. Heart Palpitations- that is the fluttering of the chest which forms abnormal rhythms of the heart.
  5. Chest pain
  6. Sudden cardiac death
  7. Shortness of breath
  8.  Swelling in the legs, ankles and abdomen
  9.  Fainting
  10. Lightheadedness

DIAGNOSIS

  1. Electrocardiogram (ECG/EKG)
  2. A Signal averaged ECG (SAECG)
  3. Cardiac MRI
  4. Holter monitor
  5. Cardiac magnetic resonance imaging (MRI)
  6. Biopsy
  7. Cardiac Computed Tomography
  8. Transthoracic echocardiogram

DIFFERENTIAL DIAGNOSIS

  1. Congenital heart disease-
  2. Partial anomalous venous return
  3. Atrial septal defect
  4. Repaired tetralogy of Fallot
  5. Acquired heart disease-
  6. Tricuspid valve disease
  7. Pulmonary hypertension
  8. Right ventricular infarction
  9. Miscellaneous-
  10. Sarcoidosis
  11. Idiopathic RVOT tachycardia  

TREATMENT

  1. Antiarrhythmic drugs (amiodarone
  2. Blood pressure medications such as Beta blockers and diuretics
  3. Anticoagulant (Warfarin)
  4. Radiofrequency (catheter ablation)
  5. Implantable cardioverter defibrillator (ICD)
  6. Heart Transplant

AYURVEDIC MANAGEMENT

In ARVC (Arrhythmogenic right ventricular cardiomyopathy) this is due to the consumption of causative agents, the doshas get vitiated. These doshas contaminate the rasa dhatus (nutritional fluid in the circulation) and then enter the hridya (heart). On entering the heart through rasa dhatus, the doshas get troubled and cause hrid roga.

  1.  Due to imbalance  Vata doshas cause irregular heartbeat.
  2. As the pitta doshas get aggravated that is responsible for an increased heartbeat.
  3.  As the Kapha dosha gets imbalanced it results in a slow down of heartbeat.

NIDANA

  1. Consumption of too hot foods
  2. Excessive consumption of sour, bitter foods
  3. Excessive thinking, stress
  4. Excessive physical activity
  5. Administration of a strong enema
  6. Excessive indulgence in sexual activity
  7. Frequent vomiting
  8. Excessive formation of ama (toxins)
  9. Forcibly withholding the natural urges
  10. Fear
  11. Panic
  12. Emaciation

TYPES OF HRID ROGAS

Hrid rogas is of 5 types

  1. Vataja Hrid Rogas- heart disease is caused by vitiation of Vata
  2. Pittaja Hrid Rogas- Heart disease is caused by vitiation of pitta
  3. Kaphaja Hrid Rogas- Heart disease due to vitiation of Kapha
  4. Tridoshaja Hrid Rogas- This is caused by the vitiation of three doshas (Vata, Pitta, Kapha)
  5. Krimija Hrid Rogas- Heart disease is caused by worms, bacteria (infections)

1. Vataja Hridrogas – It causes

  • Expansion of heart
  • Churning type of pain
  • Tearing type of pain
  • Cutting type of pain

2. Pittaja Hridrogas – It causes

  • Severe thirst, sucking pain
  • Excessive tiredness
  • Excessive sweating
  • Dryness in the oral cavity
  • Sucking pain

3. Kaphaja Hridrogas – It causes

  • Heaviness in the body
  • Loss of appetite
  • Stiffness
  • Rigidity
  • Excessive salivation

4. Tridosha HridRogas

Whole doshas will be seen in tridosha hridrogas

5. Krimija Hrid Rogas

This is seen in patients who consume apathya ahara vihara, which manifests kleda. Experience the toda (pricking type of pain) in the heart region.

  • Nausea
  • Vomiting
  • Tastelessness
  • Excessive dryness in the body     

HERBS USEFUL IN ARVC (Arrhythmogenic right ventricular cardiomyopathy)

1. ARJUNA

Arjuna (Terminalia arjuna) helps to balance pitta and Kapha doshas and has a great effect on cardiac diseases so known as a cardiac tonic (strengthens the heart and is useful in angina and in high blood pressure). It is used in the treatment of aconite poisoning. Because its kshaya ras is useful in the healing of fractures. Helps to reduce fat and cholesterol levels, useful in chest injuries and in many bleeding disorders./p>

2. BRAHMI

Brahmi (Bacopa monnieri) helps to improve intelligence, acts as an excellent anti-ageing herb and has antioxidant properties. It acts as a nerve tonic which promotes the growth of the brain and helps to improve the coordination between the tongue and limbs. Useful in many psychiatric disorders which improve the quality of life and in many spleen disorders. It is also good for heart disorders so known for its cardiac tone property.

3. SHANKHPUSHPI

Shankhpushpi (Convolvulus pluricaulis) helps to improve intelligence and memory.  It is known for its natural detoxification property, improves strength, induces sleep and helps to improve the quality of hair and promotes hair growth. Shankhpushpi is known for its rasayan property. It helps to improve the complexion of the skin and is used in many skin disorders.

4. VACHA

Vacha (Acorus calamus) helps to balance Vata and Kapha doshas. Vacha helps to relieve the ama dosha so helpful in the digestion process and useful against many psychological imbalances and disorders. It is extensively used in the treatment of obesity which relieves syphilis and in Vata doshas imbalances. Helps to induce uterine contraction so it is useful in dysmenorrhea. Improves speech, memory and intelligence.

HERBAL REMEDIES BY PLANET AYURVEDA FOR ARVC (Arrhythmogenic right ventricular cardiomyopathy)

Planet ayurveda is an ayurvedic manufacturing company that makes all the formulations from its natural resources. They have many branches overseas. Planet ayurveda is a GMP certified company, all products made are free from any preservatives, colors and additional resins. Ingredients are free from any adulterations. Products cause no side effects but provide many health benefits to patients.

PRODUCTS LIST

  1. ARJUNA CAPSULES
  2. ARJUN TEA
  3. TOTAL HEART SUPPORT
  4. HRIDAYARNAVA RASA
  5. BRAHMI VATI 

PRODUCTS DESCRIPTION

1. Arjuna Capsules

Arjuna Capsules are single herbal capsules which are made by planet ayurveda using a single standardized extract of Arjuna (Terminalia arjuna). These capsules help to balance the tridoshas in the body, Help to support the healthy circulation of the heartwhich maintains healthy blood cells and healthy metabolism. Taking these capsules supports the healthy cholesterol level in the body.

Dosage-2 capsules twice daily with plain water after meals

2. ARJUN TEA

Arjuna Tea is a herbal tea formulation which is made by planet ayurveda using various ingredients such as Arjuna (Terminalia arjuna), Dalchini (Cinnamomum zeylanicum), Chhoti Elaichi (Elettaria cardamomum) and many more. This herbal tea is an effective remedy for maintaining heart and blood pressure. It is also helpful in high cholesterol, congestive heart failure and many heart problems. This tea is rich in antioxidants and provides support to the vascular system.

Dosage– 2 cups twice daily

3. Total Heart Support

Total heart support are polyherbal capsules made by planet Ayurveda using ingredients such as Arjuna (Terminalia arjuna), Shankhpushpi (Convolvulus pluricaulis) and many more. This capsule is helpful in balancing Vata and pitta doshas. Helpful in heart disease in the treatment of high cholesterol levels and in congestive heart failure. Due to weakness in heart muscles, there is breathlessness so it is an effective remedy for heart disorders.

Dosage– 2 capsules twice daily with plain water after meals.

4. Hridayarnava Rasa

Hridayarnava Rasa is a tablet formulation which is prepared by planet Ayurveda using ingredients such as Shuddh Parad (Purified mercury), Tamra Bhasma, Shuddh Gandhak and many more. This tablet is helpful in cardiac disorders which further cause breathlessness. Heaviness in the chest and in many heart-related problems. This helps to balance Kapha doshas.

Dosage– 1 tablet twice daily.

5. Brahmi Vati

Brahmi Vati is a classical ayurvedic formulation which is made by planet ayurveda in the form of tablet using ingredients such as Brahmi (Bacopa monnieri), Vacha (Acorus calamus), Swarna Makshika bhasma and many more. These tablets are useful in panic attacks and in maintaining normal blood pressure. It is used in sleeplessness, in chronic fever and anxiety.

Dosage- 1 tablet twice daily with lukewarm water.

CONCLUSION

Arrhythmogenic right ventricular cardiomyopathy is a form of heart disease that usually appears in adulthood. ARVC (Arrhythmogenic right ventricular cardiomyopathy) is a disorder of the myocardium which is the muscular layer of the heart. This condition causes the part of the myocardium to break down and increases the risk of abnormal heartbeat (arrhythmia) and causes sudden death.   ARVC is a rare genetic disease which shows symptoms between the age of 10-50 years of age. On entering the heart through rasa dhatus, the doshas get troubled and cause hrid roga. We discussed many herbal remedies by planet ayurveda which are really effective and cause no side effects.