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Panchakarma before Planning for Pregnancy or Conception

Author : Gurnam Saini  

 

Panchakarma for Couple In Ayurveda before planning for conception and Pregnancy In Melbourne 

 

The existence and survival of human beings depends upon the virtue of healthy progeny. As per Ayurveda, the thought of better and healthy progeny starts very early, from the time of pre-conception.

 

Ayurveda says a person without a progeny is like a tree without branches and fruits, serving no purpose in its existence. But, if the branches are lame or the fruits are inedible, the tree would still be looked down upon by the society.

 

So, it is not merely giving birth to a progeny that matters. Rather, more significant is that the progeny should be capable both mentally as well as physically to be an active partaker of the society.

 

A healthy baby born out of healthy parents will be strong and development of the child will be at the normal pace. Ayurveda describes many courses of action for the acquisition of healthy progeny. Right from preconception to the neonatal care Ayurveda advises natural and integrated methods for having a healthy progeny.

 

What is the Importance of Panchakarma detox before family planning in Ayurveda for both the male and female partner

 

When both male and female after observing advised regimen perform the coitus and ejaculate non-vitiated shukra (sperm), passing through the yoni (vagina), reaches healthy garbhashaya (uterus) and gets mixed with non-vitiated beeja (ovum), then garbha (conception) is definite, in the same way as milk mixed with yeast forms the curd.

 

Physical as well as mental status of both the partners affects a lot to the baby which would come into the existence by their efforts. Ayurveda believes that if the body and mind of both the partners is not in its purest form than the child may have its impact. Therefore, before planning for a child one must ensure the normalcy of Doshas and Dhatus.

 

For making any thing, we require certain material. Similarly, to achieve a healthy progeny proper status of all the following factors is essential -

 

  • Ritu (day, season etc.)
  • Kshetra (field- female reproductive organs)
  • Bija (seed- ovum & sperms)
  • Ambu (water- nourishment)

 

Ritu (day, season etc.)In Ayurveda, achieving a healthy progeny has been equated with farming. As status of these four components, affects the outcome. The first component is ritu, means proper day, or season.

 

For getting a good crop, specific season for that specific crop is required. If we want to grow that crop in any unusual season, the crop doesn’t grow properly. Similarly, to achieve the pregnancy the first thing is that sexual intercourse should be performed on specific days. The ovulation usually occurs after twelfth day after starting the menstruation. This means that the most suitable time to achieve the pregnancy is 12 – 18 days after starting the menstruation.

 

Kshetra (field- female reproductive organs)is the second component and denotes to field. For growing the crop, a well-prepared field is required. In case of human beings, the woman’s uterus is the field to grow the fetus. Healthy female reproductive organs are the key to get the healthy child. Immature uterus (as in very young age) and any gynecological disease may hamper the conception and proper growth of the fetus, even if it is achieved.

 

Bija (seed- ovum & sperms): The term Bija means seed. Basic component for growing a crop is seed. To get a good crop, seeds of better quality are must. In case of human beings bija denotes to egg (ovum) and sperm. Therefore, for achieving better progeny, mature and healthy egg and good quality (sufficient numbers and good motility) sperms are essential. Qualities of a born child depend on these two as these are the carrier of various good and bad qualities (in their genes).

 

Ambu (water- nourishment)​The last essential factor is Ambu, means water/ nourishment. In case of crop even when we show the crop at proper time (ritu), in a well-prepared field (kshetra), by using good quality of seeds (bija), but no water (ambu) is given then all the efforts to achieve a good crop prove simply a futile exercise. This similarity mentioned in Ayurvedic texts in relation to conception and better progeny in human beings, explains the subject very clearly.

 

Why Panchakarma is so important before pregnancy based on Ayurveda Treatments?

 

Ayurveda strongly recommends that even in healthy cases, both the parents to be, should undergo Panchakarma detox therapy to improve their physical & mental health, mainly to improve the quality of sperm & ovum.

 

If one undergoes Panchakarma, it will not only benefit the child to be but also the gene or tissue strength passes on to the generations that are yet to come. Panchakarma detox should be done at least 1-3 months prior to conception, after which one should follow personalised regimen advised by the Ayurveda physician.

 

Why the need for Panchakarma detoxification?

 

Even though one claims to eat healthy diet & follow healthy lifestyle, there are external factors like stress, pollution, & environmental factors that affect cellular nutrition hence there will be build-up of micro toxins in the body regularly, which is why we age too.

 

If the micro toxin build up is fast, we will have premature ageing. Panchakarma detox therapy may help to remove these micro toxins from the cellular level, thereby balancing the vata, pitta or kapha doshas and nourishing the tissues, especially reproductive tissue. Panchakarma therapy is decided by the Ayurveda doctor after analyzing the Prakriti (Constitution), status of Doshas & tissues, season, etc.

 

What are the five panchakarma Detox Thearpies? 

 

The five Panchakarma therapies are:

 

  • Vamana (Emesis)
  • Virechana (Purgation)
  • Anuvasana Basti (Oil enema)
  • Niruha Basti (Decoction enema)
  • Nasya (Nasal medication)

 

 

Out of these, one or two Panchakarma will be administered for 8 days to 14 days depending upon one’s health status. Also supporting therapies like Abhyanga (Ayurvedic massage) and Shirodhara are also suggested along with Panchakarma detox. Uttarabasti is a special type of Basti indicated to improve the health of male and female reproductive tissues.

 

In present day, due to sedentary lifestyle, hectic work schedule, erratic eating habits and untimely sleep habits, digestion and metabolism is compromised.

 

Vamana and Virechana Panchakarma may be beneficial in correcting metabolic problems thus removing obstruction of Vata Dosha by endotoxins, increasing the cellular nutrition thereby improving health of all tissues including reproductive tissue.

 

Basti is considered the best treatment for regulating the functions of Vata Dosha. As Apana Vata governs the health of the reproductive tissues, Basti is considered an important part of Panchakarma especially before conception. It is detoxifying as well as nourishing in action.

 

Nasya may considered to help to regulate the hormonal such as pituitary gland functions thereby improving ovulation and testosterone levels in female and male respectively. It could also helps to reduce depression and stress.

 

Vamana: The therapy, which may forcibly eliminates morbid Dosha out of the body by means of induced emesis, is known as Vamana Karma. It may be the best therapy for the elimination of morbid Kapha and treating the Kapha disorders. It could eliminates Pitta to moderate extent and has slight Vata eliminating action too.

 

Virechana: The therapy, which eliminates the morbid Dosha through lower channel of the body (large gut) by the action of purgation, is known as Virechana Karma. Vamana and Virechana are considered better measures for the elimination of morbid Dosha amongst the five Karmas. Further, out of these two, Virechana is comparatively more acceptable and less troublesome to the patient. Virechana is the treatment for elimination of morbid Pitta and in this way by eliminating the root cause of Pitta disorders it provides better answers in those disorders. It also eliminates Kapha to some extent as well as little Vata.

 

Preparation for Vamana / Virechana: Administration of Dipana (Appetizing) and Pachana (Digestive) herbs such as Trikatu, Chitraka, Panchakola etc. is done for 3 days to improve the status of Digestive Agni of the person to achieve desired benefits of Panchakarma.

 

After that internal & external oleation and steam are done for a period of 5 to 7 days based on the status of Agni, body strength, season, status of Doshas, etc.

 

External oleation helps to soften the endotoxins, so they can be liquified by the steam and eliminated from the body through Panchakarma. In the morning after responding to the nature's call and ensuring that previous meal has been properly digested, Abhyanga (Massage) and Swedana (Steam) are administered following which medicated ghee is given orally on empty stomach.

 

Thereafter nothing is to be taken internally until the medicated ghee is digested. After getting good appetite, wholesome, light to digest, liquid and warm diet should be taken. Ayurveda Doctor checks for the appearance of the symptoms of proper oleation and when they appear, the ingestion of medicated ghee is stopped and Vamana or Virechana is performed after a gap of one day.

 

 

Administration of herbs for Vamana / Virechana: Vamana herbs are given after taking meal so that the pyloric valve is closed and the ayurveda herbs remain in the stomach. Herbs, which facilitate the excretion of toxins in the stomach which otherwise cannot be passed out of the body.

 

Virechana herbs are given on empty stomach, so that it may pass to the duodenum immediately as pyloric end remains open on empty stomach. Generally, the Virechana herbs are laxative, due to this action the permeability of the capillaries is increased, which further facilitate the excretion of such heavy or big molecules, which in normal conditions may not be able to pass through the mucous membrane of the large gut.

 

 

Samsarjana Krama (Diet Regimen) during the Panchakarma detoxification 

 

 

Vamana Karma on the long run promotes the digestion and alleviates the Dosha, but immediately after Vamana or Virechana, due to irritation to the gastrointestinal tract, the digestive power of the patient becomes very low and the stomach does not tolerate even the usual diet.

 

Hence, a special diet regimen has to be followed after Vamana and Virechana, which is known as Samsarjana Krama. Aim of this diet schedule is to bring the patient gradually to his routine diet and to render the digestion power so strong that later on he can digest even heavy meal. For this purpose, Peya, Vilepi, Akrit and Krita Yusha and Krishara are given gradually.

 

 

Peya (liquid rice): The rice is cooked by adding fourteen times of water until it is almost dissolved and becomes liquid, this preparation is known as Peya. This is carbohydrate rich which gives energy and is easily digested as well. Only less quantity of digestive enzymes will be secreted to digest this thus protecting the gastric mucosa from damage by excess enzyme secretion after Panchakarma.

 

Vilepi (semi liquid rice): The rice cooked by adding four times of water so that it becomes semi-liquid is termed as Vilepi. This is also a souce of carbohydrate which gives energy.

 

Yusha (soup): Ten times of water is added to any one of the pulses and cooked properly so that it contains more liquid and littler solid. When it is taken as such without adding anything, then it is termed as Akrita Yusha, but when added with salt and condiment as well as prepared (Samskarita) with ghee then it is named as Krita Yusha. It is protein rich, hence moderate quantity of digestive enzymes will be secreted to digest it.

 

Krishara (Rice cooked with lentils and ghee): Rice and Mung daal are washed in water and soaked for atleast 30 minutes. Then they are cooked in a pressure cooker or open vessel along with water, ghee, asafetida, cumin and rock salt. When digestive function resumes to normal, one can administer Krishara which has carbohydrate, protein and fat. 

 

Improtance of Ayurveda Herbal Enema Basti before Pregnancy

 

Basti generally denotes the procedure in which the herbs are administered through rectum. In this process, the herb is given in the form of decoction or medicated oil etc. into the rectum, which has to be retained. The maximum retention time in case of Niruha Basti (decoction enema) is 48 minutes while in case of Sneha Basti (oil enema) it may be up to 24 hours for getting the desired therapeutic effects.

 

What are benifits of herbal Ayurveda Basti in Panchakarma?

 

Basti Karma is best amongst the therapeutic measures and is widely indicated for its multiple actions. It is the best treatment for Vata and its disorders but is equally effective in Pitta, Kapha and Rakta disorders provided the appropriate herbs are added in its preparation. Due to its all these multifaceted actions, it is considered as half treatment in Kayachikitsa (internal medicines branch of Ayurveda), though some scholars consider it as complete treatment.

 

What are differents types of herbal Ayurveda Basti?

 

1.Niruha (Asthapana) Basti

The Basti, which contains decoction as its main ingredient and generally has the Shodhana (purificatory) and Langhana (depletion) actions, is known as Niruha / Asthapana Basti.

 

2. Sneha (Anuvasana) Basti: Also known as Oil Enema

The Basti, which contains mainly unctuous material such as oil or ghee, is known as Sneha or Anuvasana Basti. It has Snehana (lubricating) and Brimhana (Nourishing) action on the body. 

 

How differents types of herbal Ayurveda Basti is given?

 

Niruha and Anuvasana Basti cannot be given alone for a longer period. If Anuvasana Basti is given alone for a longer period then it may diminish the digestion. On the other hand, if Niruha is given alone for a longer period then it may cause vitiation of Vata. Hence, it is advisable to administer Anuvasana Basti prior or after the administration of Niruha Basti and vice versa depending upon the condition of the patient. To overcome this problem, three main schedules of Anuvasana and Niruha Basti are mentioned in Ayurveda texts. They are Karma Basti, Kala Basti and Yoga Basti.

 

Karma Basti: A combined schedule of 30 Basti of Niruha and Anuvasana is termed as Karma Basti. It is indicated in affording patients having good strength and tolerance or in the conditions like excessive Vata Dosha situated in deep tissues, diseases of progressive nature and where Basti is specifically indicated.

 

Kala Basti: In Kala Basti a combined schedule of 16 Basti given alternatively (Niruha and Anuvasana) is prescribed. It is indicated in the patients with medium strength of body or vitiated Dosha or Vata is having Anubandha (association) of Pitta.

 

Yoga Basti: Under this schedule 8 Basti are given, alternatively. It is indicated in cases where Vata is not much vitiated or is combined with Kapha.

 

What are methods of Basti Administration in Ayuveda?

 

After passing feces and urine, patient on empty stomach should be prepared with Abhyanga & Swedana. However, the patient should not be very hungry. Patient is asked to lie down comfortably on his left side (left lateral position) and to keep his left arm in the form of pillow. The body is kept straight with right leg flexed over fully extended left leg.

 

Thereafter, the anus and the enema nozzle are lubricated with oil. After removing air bubbles, one fourth of enema nozzle is introduced in the anus slowly following the curves of the spinal column, without shaking or trembling. Then the contents of the enema can are injected into the rectum slowly but continuously taking care that no air should go inside. Once the whole liquid goes inside, the nozzle is removed slowly from the anus.

 

What are General Mode of Action of Ayurveda Vasti?

 

Acharya Sushruta has scientifically and beautifully described the mode of action of Basti where main importance has been given to the Virya (active principle) of the herbs administered in form of Basti.

 

Virya of Basti from colon (Pakvashaya) spreads all over the body in the same manner as the water poured at roots of tree reaches up to the leaves. Virya of such Basti, which comes out earlier as in the case of Niruha with or without accompanying feces, also gets absorbed due to the rapid action of Vata particularly of Apana Vata. At the same time the Virya also draws the morbid Dosha to the colon wherever they are situated in the body, from head to feet. It is obvious from the foregoing that Basti has two main actions.

 

  • First Virya of the Basti herbs gets absorbed, which will act according to its properties and nature.
  • Its second major action is related with the facilitation of excretion of morbid substances responsible for the disease process into the colon.

 

In this way, it has two-edged function i.e. facilitation of the absorption of the content of Basti into the general circulation and facilitation of the excretion of the morbid matter into the colon.

 

All these actions of Basti can be well explained on the basis of known physiological and pharmacological actions mentioned in texts. It is well known that about 60 to 80% water and all electrolytes like sodium, chlorides and potassium are absorbed from the large intestine.

 

In Niruha Basti main content is decoction, which contains water and water-soluble substances of the herbs. The paste (Kalka) and salt are also mixed well in the Basti. So there is no doubt in absorbing the water-soluble contents of the Basti to the general blood circulation through colon.

 

Certain drugs such as anesthetics are given per rectum, which are readily absorbed from gut. Hence, the active principles of Basti herbs may also be absorbed, because they are mainly water-soluble. Therefore, the foregoing pharmacodynamics of Basti herbs as well as physiological and pharmacological functions of colon clearly supports the Ayurvedic view of absorption of Virya of Basti herbs and then it spreads all over the body through general blood circulation.

 

Benefits of using Ayurveda herbal Basti as route of administration of herbs over oral administration of herbs

 

  1. The herbs given in the form of Basti avoids taste and odour to the patient.
  2. High dose of the herb may be given.
  3. Digestive Agni- both Jatharagni (digestive fire) and Dhatvagni (metabolism in liver) are surpassed, thus digestion in the stomach and small intestine and bio-transformation in the liver are avoided.
  4. By selecting specific herbs, it can be employed for multiple actions.
  5. It acts directly on the main seat of Vata, that is Pakvashaya (large intestine), thus by pacifying Vata from its root provides better and long-lasting cure of Vata disorders.
  6. It eliminates the various toxic substances accumulated and formed by the actions of the pathogenic bacteria present in the colon.
  7. It corrects the normal bacterial flora of the intestine.
  8. It withdraws the metabolites from the general circulation to the colon wherefrom they are thrown out of the body.

 

 

Parihara Kala (post purificatory regimen):

 

Due to the purification therapy, body tissues remain under some sort of strain, so it is advisable to observe the post purificatory regimen termed as Parihara Kala. It is to be observed for the period double to the number of days for which Basti has been given. Following should be avoided during Parihara Kala:

  1. Excessive physical and mental exertion
  2. Too much travel
  3. Day sleep
  4. Exposure to cold breeze or hot sun
  5. Untimely or unwholesome foods
  6. Grief and anger
  7. Suppression of natural urges

 

Why Uttarabasti considered very important in Ayurveda before Pregnancy

 

Uttarabasti is a special type of Basti which nourishes the reproductive system as it is has a direct effect. It is administered through urethral route in men and women following local massage and steam over the abdomen, low back region and hips. In women, it is done for 3 to 5 days after menstrual cycle and in men it is done for 6 days in a month.  Medicated oil or ghee is used for the procedure. In women, rupture of follicles, quality of ovum and nourishment of endometrium is achieved through Uttarabasti which helps in implantation of fertilized ovum. In men, this procedure improves the quality and quantity of sperm.

 

Nasya and Pregnancy

 

Administration of medicine through nose is called Nasya. Nasya is considered to help regulate the hypothalamic-pituitary-testicular axis & hypothalamo-pituitary-ovarian axis thus improving reproductive health in both men and women.

 

Procedure of Nasya karma:

After responding to the natural calls, the patient should be given massage and mild sudation of the head and organs above the clavicle. Then the patient is made to lie down on the cot. The head should be slightly lowered, so that the oil may reach in the head. Lukewarm medicated oil or ghee is instilled in one nostril with right hand while slightly raising the nostril with the thumb and index finger of left hand. During this process, the other nostril is kept closed. Similarly, the drops are put in the other nostril. After administration of oil, massage of soles, shoulder, hand and ear should be done again. The patient is asked to spit out the oil/mucous coming in mouth. Then warm saline gargle is done followed by herbal smoke inhalation. After Nasya the patient should avoid sleep, consuming cold food items, exposure to dust, smoke and sun.

 

Other Supportive Ayurveda Therapies before, during and after Pregnancy

 

Abhyanga is blissfully relaxing and comforting at the same time rejuvenating. It allows the body to absorb all the nutrients from the medicated oil into the body through the skin and helps to heal the body. Ayurvedic massage has good effect over all the body systems rather than just a local effect on skin. The skin contains many tiny nerve endings that are connected to hormones, biochemical and neurotransmitters. Endocrine system along with nervous system will receive benefits as well as enhanced immunity.

 

Shirodhara has a positive effect on the body and mind. It activates the pituitary gland, regulates hormones and balances Vata Dosha. Panchakarma helps in all factors for conception by correcting psychology and physiology. By the inclusion of therapies like shirodhara, spiritual and emotional preparation for conception is also happen.

 

Panchakarma is a traditional Ayurveda specific way for bio-purification. Both the partners who are planning to conceive a better progeny should undergo cleansing process as described in Ayurveda. With a systematic cleansing of the body, and the usage of appropriate herbs and diet, the potency and health of the gametes can be enhanced and will definitely bestow with healthy progeny. Various Ayurveda preparations are available in prepared form to avail for those couples who are planning for conceive. Ayurveda suggest consuming these after a proper detoxification for better results. It boosts the reproductive system as well as the whole energy of the body.

 

Considering womb as the abode for the Garbha (foetus) more focus should be given for the female. By doing purificatory process in woman who is planning to conceive, various benefits are acquired. Some of them are:

  • Helps to regular natural detoxification of the organs
  • Helps to withstand hormonal changes during pregnancy
  • Stress relief
  • Increases quality of ovum
  • Improve endometrial lining

 

Benefits of Ayurveda Procedure

Ayurveda perspective for health is a holistic one. In case of Garbha also, Ayurveda advocates the same. By properly following Panchakarma before conception, wide range of benefits can be acquired. It has the following benefits:

  • Benefits to the Progeny
  • Benefits to Mother
  • Benefits to the society

 

Benefits to the Progeny

  • To enhance desired qualities
  • To ensure excellent health
  • Superior Intelligence
  • Mental strength
  • Physical fitness
  • Overall growth, no anomalies
  • Full term growth

Benefits to the Mother

  • Experience the joy of pregnancy and make it a memorable journey
  • Trouble free and disease-free pregnancy
  • No complication in prenatal and antenatal period
  • Ensures natural delivery
  • Full term pregnancy
  • Better post-natal recovery

 

Benefits to the Society

  • Ensures the future citizens are healthy
  • Intelligent and physically fit society
  • Culturally and morally rich society
  • Reduce the rate of mortality and morbidity

 

References:

 

  • Agnivesa’s Charaka Samhitha. Text with English Translation and Critical Exposition based on Chakrapani Datta’s Ayurvedadipika by Ram Karan Sharma and Vaidya Bhagwan Dash. Vol V. Chaukambha Sanskrit Sansthan, Varanasi, English Version, Vol-5. Edition-2005. 
  • Astanga Hrdaya of Vagbhata Vol. II . Nidaan Sthana, Chikitsa Sthana and Kalpa-Siddhi Sthana. Edited by Kanjiv Lochan. English Version. Chaukambha Sanskrit Sansthan Publishers, Varanasi, 1st Edition-2017. 
  • Critical Analysis of Ayurvedic Formulations. (Sahasrayogas and Other Samhitas). By Dr. L. Mahadevan. Sarada Mahadeva Iyer Ayurvedic Educational & Charitable Trust, Kanyakumari, Tamilnadu. 2nd Edition- 2018. 

 

If you wish to consult Ayurveda, you may choose to contact one of our Ayurveda Practitioners Gurnam Saini or Pooja Saini in Melbourne. Both of our Practitioners are Qualified Ayurveda Doctors from India. You may contact us at "Pure Herbal Ayurved Clinic".  People who can't reach us personally, may choose for online Ayurveda consultation. 

 

 

 

 

 

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Author Bio:

Gurnam Saini has over 15 years’ experience in Ayurvedic naturopathy treatments in Melbourne, Australia. He has completed his bachelor degree in Ayurvedic Medicine and Surgery from Baba Farid University of Health Sciences, India. He has done MD in Alternative Medicine and certificate courses in Panchakarma Detox, Pulse diagnosis and skin care. He is also a member of the Australasian Association of Ayurveda (AAA). He has won awards for ground-breaking work in Ayurveda globally. Read More

 

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  • I decided to take my 10 yr old daughter to Dr Saini after 9.5 yrs of struggling with eczema and food intolerances, and no solutions found but topical, long term use of cortisone creams. After only one month, we saw massive improvements in her skin, finally clearing up the majority of her eczema. This was done with herbal capsules and without needing to remove various foods from her diet. That improvement allowed us to tackle other health concerns like her consistent disturbed sleep. Now 4 months on, her skin is perfect, and her sleep is mostly uninterrupted. Any sporadic nighttime waking is for a very short period of time. And even better, now we can focus on her digestion which is my last concern for her. I can’t recommend Ayurvedic medicine enough to gently and naturally heal and balance out your body. l had done lots of reading on Ayurveda before we tried it, and all my expectations have been met and I’m sure will be exceeded in the near future. Thank you Dr Saini, for your kind and gentle consultations, and genuine interest in better health outcomes for your patients.


    Deniel Condon

  • Thank you Dr Saini for the remarkable improvement in my health since first seeing you only 3 months ago. With herbal supplements, herbal teas and a single panchakarma treatment I have already experienced the following benefits that western medicine had not been able to assist: * Lower blood pressure permitting a reduction in medication. * Reduced anxiety. * No dizziness or fainting following sudden exercise such as climbing stairs. * Eye floaters gone. * Persistent (2 year) cough almost gone. * Frequent reflux gone. With continued treatment and lifestyle changes I am looking forward to: * normal blood pressure without medication, * weight loss without strict diets, * cough gone!


    Ray Dempsey

  • It was a wonderful experience with u guys.A natural way to fight the disease with no side effects of treatment.


    Harmeet Kaur

  • I cannot recommend highly enough. This has been my first experience with Ayurvedic medicine and the Panchakarma cleanse and I can finally say that after years of striving for better health and wellbeing, I finally understand what is going to work for me moving forward. Having experience a traumatic event and subsequent PTSD 5 years ago, my gut and my body became increasingly compromised. In this time I have been diagnosed with fibromyalgia, complex regional pain syndrome and various ailments of the gut. I came to see Dr Saini and Pooja at a time that I felt frustrated with my years of work to see some more obvious progress with my healing. Having completed the Panchakarma cleanse, I am feeling fully renewed. Awake. Settled. I no longer struggle to wake each morning and get through each day. My appetite feels steady and all cravings have completely ceased. I now have some tools under my belt to fall back on when I know my digestive system needs a break. This cleanse has been a complete game changer. Thankyou Dr Saini and Pooja for you incredible guidance and support. Liz


    Lizmo 29