The Effect Of Thriphala, A Herbal Ayurveda Formulation, On Serum Lipids, In Patients On A Maintenance Dose Of Atorvastatin For Hyperlipidaemia: A Randomized Controlled Trial

Introduction Thriphala, a herbal medicinal formulation, is a bedrock of Ayurveda therapeutics with many postulated benefits.Objectives We performed a clinical trial to test the effects of Swastha Thriphala (R), a proprietary preparation of thriphala, on serum lipid parameters in patients receiving atorvastatin.Methods Consenting adults receiving a maintenance dose of atorvastatin 10mg (Atorlip (R)) daily from a clinic of the Institute of Cardiology, National Hospital of Sri Lanka for lipid regulation, were randomly assigned, after counselling, to receive either the proprietary herbal medicinal product Swastha Thriphala (R) (Treatment Group, n=101) or a placebo (Control Group n=97), at the stipulated dose daily, for three calendar months.Results In the treatment group (n=101) the addition of a proprietary preparation of thriphala formulated as caplets of Swastha Thriphala (R), in the standard daily dosage for three months, as an adjunct to atorvastatin 10mg, had a significant (p<0.0001)reduction in the mean total blood cholesterol, mean cholesterol/HDL ratio (p<0.0001), and mean non-HDL- cholesterol (p<0.0001) when compared to the Control Group (n=97) receiving placebo caplets in the same daily dose, with atorvastatin 10mg, for the same period. In the Treatment Group mean HDL, LDL, HS-CRP, and triglyceride concentrations showed non-significant reductions, and nonsignificant elevations in the Control Group.Conclusions Swastha Thriphala (R) when used in the stipulated dosage as an adjunct to atorvastatin 10 mg daily, significantly enhances its cholesterol reducing action in patients. The use of Swastha Thriphala (R) as single therapy for lipid regulation, and the mode of its action deserve investigation.