The Health Benefits of Triphala

Long used as a general health tonic in Ayurveda (the traditional medicine of India), Triphala is now touted as a natural remedy for a variety of health conditions. A blend of three fruits, Triphala contains Indian gooseberry (Emblica officinalis), black myrobalan (Terminalia chebula), and belleric myrobalan (Terminalia belerica). In Sanskrit, the word Triphala translates to "three fruits."

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 is increasingly found online and in many natural food and supplements stores.

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 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 are few studies that strongly support these claims, often because the studies are small or poorly designed. With that being said, there have been some promising findings in recent years that warrant further investigation.

According to a 2012 study in Alternative Therapies in Health and Medicine, animals fed a high-fat diet experienced weight loss and a reduction in high cholesterol when supplemented with Triphala.

The researchers concluded that, after 10 weeks of use, mice prescribed a daily dose of Triphala had lower body weight, body fat, total cholesterol, triglycerides, and "bad" LDL cholesterol than the untreated mice.

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.

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.

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 pretreated mice had cataracts, while 100% of the treated mice did.

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

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 by which the remedy is made. Doses can differ from one preparation to the next. Some practitioners may even incorporate herbs and other ingredients based on the proposed use.

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

As a precaution, you may want to avoid Triphala if you are taking chronic medications for diabetes and hypertension as 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 taking any of the following medications:

• 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

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

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 as the dose is standardized. With that said, the dose doesn't always confer the same breakdown of ingredients.

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.

Unlike pharmaceutical drugs, dietary supplements like Triphala are not strictly regulated in the United States. As such, the 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 as they reduce your exposure to pesticides and other chemicals.

If you decide to use Triphala, you may be better served to buy a brand in your drugstore than seek 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 evidence of Triphala's benefits, but it is also illegal for a supplements manufacturer to make health claims under the Dietary Supplement Health and Education Act of 1994.

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 seen 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 varietals.