The Health Benefits of Triphala

Long used as a general health tonic in Ayurveda, Triphala is now touted as a natural remedy for a variety of health conditions, although research doesn't yet confirm its effects. In Sanskrit, the word Triphala translates to "three fruits," and it is just that: a combination of Indian gooseberry (Emblica officinalis), black myrobalan (Terminalia chebula), and belleric myrobalan (Terminalia belerica). 

In Ayurvedic medicine, Triphala is considered a tridoshic rasayana, meaning that it has the properties to support all three doshas (air/space, fire/water, and water/earth). These qualities are believed to enhance strength and immunity and may be applied to the treatment of numerous health conditions.

Triphala is available in powder, juice, tincture, extract, capsule, or tablet form, and it is increasingly found online and in many natural food and supplements stores.

Health Benefits

According to the Ayurvedic tradition, Triphala has the properties to treat an almost encyclopedic range of health conditions. Some of this is attributed to Triphala's laxative effect, which proponents suggest can "cleanse the system." Depending on how much is prescribed, Triphala may be used as bowel tonic at lower doses, alleviating gas and promoting digestion, or as a purgative (strong laxative) at higher doses.

Beyond its effect on the gastrointestinal tract, Triphala is believed to relieve stress, control diabetes, promote weight loss, reduce cholesterol, alleviate inflammation, and treat a variety of bacterial and fungal infections.

To date, there is little research that strongly supports these claims, mainly because the studies that have been done were small or poorly designed. With that being said, there have been some promising findings in recent years that warrant further investigation.

Weight Loss

According to a 2012 study in Alternative Therapies in Health and Medicine, mice fed a high-fat diet and prescribed a daily dose of Triphala had lower body weight, body fat, total cholesterol, triglycerides, and "bad" LDL cholesterol than untreated mice on the same diet.

Moreover, the treated mice experienced an increase in "good" HDL cholesterol along with improvements in their liver enzymes and oral glucose tolerance, suggesting Triphala may aid in the control of type 2 diabetes.

Whether the same can occur in humans is yet to be proven.

Dental Issues

As with many multi-herbal medications, it is unknown which constituents in Triphala are bioactive. A number of test-tube studies have shown that Triphala exerts anti-inflammatory, antibacterial, and antifungal properties, although these types of results rarely translate to the same degree of effect in humans.

One area in which Triphala may offer benefits is in dental health, including reduction of plaque and the prevention of gum disease and cavities.

A 2016 study in the Journal of Periodontology in 2016 reported that adults prescribed a twice-daily Triphala mouthwash for 60 days had a greater reduction in oral plaque, oral bacteria, and gingivitis than those provided a placebo.

A similar study in Oral Health and Preventive Dentistry concluded that Triphala mouthwash exhibited equivalent efficacy in preventing cavities as chlorhexidine gluconate germicidal mouthwash (available by prescription).

Cataracts

The fruits used in Triphala are rich in vitamin E, flavonoids, and polyphenols, all of which are potent antioxidants. It has been proposed that by neutralizing free radicals that damage cells at the molecular level, the antioxidants in Triphala may slow or prevent the development of certain aging-related diseases. One such example is cataracts.

A 2011 study in the Journal of Ayurveda and Integrative Medicine investigated the effect of Triphala in nine-day-old rat pups with chemically induced cataracts. According to the researchers, half of the rats were given Triphala prior to the induction and the other half were left untreated. At the end of the study, only 20% of the mice given Triphala had cataracts, while 100% of the untreated control group did.

The results suggest that Triphala may aid in the prevention of other aging-related eye diseases, including macular degeneration. Further research is needed.

Possible Side Effects

Because Triphala acts as a mild laxative, it may cause gastrointestinal side effects, including gas, stomach upset, cramps, and diarrhea. Depending on the preparation used, side effects like these may occur with even smaller doses.

If you experience diarrhea or other side effects, you can try reducing the dose if the symptoms are mild. If they do not improve, you should stop taking Triphala altogether.

Little is known about the long-term safety of Triphala, mostly because there is no consistent formula for making it. Doses can differ from one preparation to the next. Some practitioners may also incorporate herbs and other ingredients based on the proposed use.

As such, it is currently difficult to ascertain the long-term safety of Triphala or how it might interact with other medications.

Interactions

As a precaution, you may want to avoid Triphala if you are taking chronic medications for diabetes and hypertension, since it may reduce their efficacy.

Additionally, many of the compounds found in Triphala are metabolized by liver enzymes known as cytochrome P450 (CYP450). Taking Triphala with other drugs that utilize CYP450 may adversely increase or decrease their concentration in the blood.

As such, you may need to avoid Triphala if you're taking any of the following medications or other substances:

• Anti-arrhythmia drugs like quinidine
• Anticonvulsants like Tegretol (carbamazepine) and Trileptal (oxcarbazepine)
• Antifungal drugs like Nizoral (ketoconazole) and Vfend (voriconazole)
• Antipsychotic drugs like Orap (pimozide)
• Atypical antidepressants like nefazodone
• Benzodiazepine sedatives like Klonopin (clonazepam) and Halcion (triazolam)
• HIV drugs like Reyataz (atazanavir) and Crixivan (indinavir)
• Immune-suppressive drugs like Sandimmune (cyclosporine)
• Macrolide antibiotics like clarithromycin and telithromycin
• Migraine medications like Ergomar (ergotamine)
• Opioid painkillers like Duragesic (fentanyl) and alfentanil
• Rifampin-based drugs used to treat tuberculosis
• Alcohol
• Kava kava

To avoid interactions, let your doctor know about any drugs or supplements you are taking, whether they are prescription, over-the-counter, herbal, or recreational.

Dosage and Preparation

Triphala can today be found on many drugstore shelves in supplement, powdered, or liquid forms. You can also source the products online or in stores specializing in Ayurvedic healing.

Capsules and tablets are by far the easiest preparation to use. While most Triphala supplements are sold in 500-milligram (mg) to 1,000-mg doses, the dose refers to the amount of extract used rather than the individual ingredients.

The problem with this is that the extract formula can vary based on which supplier a manufacturer uses. This may not pose any significant risks, but it does demonstrate how variable a product Triphala can be.

There are no universal guidelines for the appropriate use of Triphala, although most manufacturers will recommend one to two tablets or capsules daily. As a rule of thumb, never use more than the recommended dose on the product label.

Triphala juice can be diluted with water to create a mouthwash. The powder is sometimes mixed with coconut or jojoba oil for use in scalp and hair treatments.

When measuring Triphala powder or juice, always use a measuring spoon rather than a dining utensil. Triphala tinctures and extracts are commonly dispensed with an eyedropper.

What to Look For

Unlike pharmaceutical drugs, dietary supplements like Triphala are not strictly regulated in the United States. As such, quality can vary from one brand to the next.

To ensure quality and safety, opt for brands that have been voluntarily submitted for testing by an independent certifying body like the U.S. Pharmacopeia (USP), NSF International, or ConsumerLab. Certification doesn't mean that the product is effective; it simply ensures that it contains the ingredients listed on the product label.

Supplements certified organic by the U.S. Department of Agriculture (USDA) are preferred, because they reduce your exposure to pesticides and other chemicals.

If you decide to use Triphala, you may be better served by buying a brand in your drugstore than seeking the "real" Triphala from an imported source.

In the end, do not be swayed by any health claims a manufacturer may make. Not only is there little current evidence of Triphala's benefits, but it is also illegal for a supplements manufacturer to make health claims under the U.S. Dietary Supplement Health and Education Act of 1994.

Other Questions

Can you get the same benefits by eating the three fruits that make up Triphala?

Theoretically, eating Indian gooseberry (also known as amalaki), black myrobalan (haritaki), and belleric myrobalan (bhibhitaki) can render similar benefits to Triphala. The problem is that the fruits are rarely found fresh in the United States. Most are delivered either dried, powdered, or in supplement form.

The types and uses of the fruits can also vary under Ayurvedic tradition. For example, belleric myrobalan is often mixed with buttermilk to treat gastrointestinal symptoms. Similarly, black myrobalan cultivated in the west-central part of India is preferred by practitioners over other regional varieties.