Medicinal properties in Ayurveda: Fresh fruit is refrigerant, diuretic and laxative. Fruit is also carminative and stomachic. Dried fruit is sour and astringent. Bark is astringent. The herb is also aphrodisiac, haemostatic, nutritive tonic and rejuvenative. It increases red blood cell count. Amalaki is one of the highest natural source of Vitamin C (3,000 mg per fruit).Amla fruit paste is main ingredient of Chavyanprash, a popular Ayurvedic tonic. Amla is known as amritphala in Sanskrit, which literally means the fruit of heaven or nectar fruit. It is so called because it is rich in many desirable properties.

It was described in a 7th century Ayurvedic medical text. According to several scholars, the sage Chyawan is reputed to have restored his vitality with this fruit. Researches of modern times have proved that Regular use of Amla enhances production of Red Blood Cells, strengthens teeth, hair and nails. Regulates Blood Sugar and lipids in cell membranes has anti-inflammatory effect. It is found to be useful in hemorrhoids, gastritis and colitis. It is also proved to be effective in eye problems especially in inflammations, Improves sight and is useful for cataracts. Prevents premature graying of hair and makes them strong and free from dandruff. Improves immunity and protects heart, brain and other vital organs of body.

Main classical uses: Amla is used in numerous formulations in Ayurveda. Main formulations containing Amla are: Amalaki churan, Triphala, Chyavanprasha, Brahma rasayana, Dhatri lauha and Dhatri rasayana.

References:

• Dravyaguna Vigyan, By- Prof. Priyavrat Sharma, Published By- Chaukhambha Bharti Academy, Varanasi. INDIA.
• Bhavprakash Nighantu, By- Dr. Ganga Sahay Pandey & Dr. Krishna Chandra Chunekar.
  Published By- Chaukhamba Bharti Academy, Varanasi. INDIA.

Clinical studies / Clinical justification:
The herb Amalaki is well supported with research papers published all over the world in renowned medical research journals of recent times. Summary of some of the research papers is given below to support its inclusion in NEEROGA Capsules.

• 1) J Ethnopharmacol. 2006 Mar 8;104(1-2):113-8. Epub 2005 Oct 13.

Vitamin C content and antioxidant activity of the fruit and of the Ayurvedic preparation of Emblica officinalis Gaertn.

Scartezzini P, Antognoni F, Raggi MA, Poli F, Sabbioni C.
Faculty of Pharmacy, Department of Biology, University of Bologna, Via Irnerio 42, 40126 Bologna, Italy. scartezzini@biocfarm.unibo.it

Emblica officinalis Gaertn. is one of the most important plants of Ayurved, the traditional Indian medicine. In this ancient medicine, the fruit of Emblica officinalis is processed according to a method named "Svaras Bhavana", whereby the therapeutic potential of the plant is enhanced by treating the main herb with its own juice. For many years, the activity of the fruits was attributed to the high content of ascorbic acid; however, this has recently been questioned. The aim of the paper is to clarify this matter. A reliable and feasible HPLC method with diode array detection has been developed for the determination of ascorbic acid in Emblica fruit and particularly in Emblica fruit processed according to the Ayurvedic method. The antioxidant effects have also been evaluated in comparison to the real levels of Vitamin C by different antioxidant tests. The data obtained show that the Emblica fruit contains ascorbic acid (0.4%, w/w), and that the Ayurvedic method of processing increases the healthy characteristics of the fruit thanks to a higher antioxidant activity and a higher content of ascorbic acid (1.28%, w/w). It has also been found that Vitamin C accounts for approximately 45-70% of the antioxidant activity.

---

• 2) Cancer Lett. 2006 Jan 18;231(2):206-14

Potential of traditional ayurvedic formulation, Triphala, as a novel anticancer drug.

Sandhya T, Lathika KM, Pandey BN, Mishra KP.

Radiation Biology and Health Sciences Division, Bhabha Atomic Research Centre, Mumbai 400 085, India.
The cytotoxic effects of aqueous extract of Triphala, an ayurvedic formulation, were investigated on human breast cancer cell line (MCF-7) and a transplantable mouse thymic lymphoma (barcl-95). The viability of treated cells was found to decrease with the increasing concentrations of Triphala. On the other hand, treatment of normal breast epithelial cells, MCF-10 F, human peripheral blood mononuclear cells, mouse liver and spleen cells, with similar concentrations of Triphala did not affect their cytotoxicity significantly. The drug treatment was found to induce apoptosis in MCF-7 and barcl-95 cells in vitro as determined by annexin-V fluorescence and proportion of apoptotic cells was found dependent on Triphala concentration. MCF-7 cells treated with Triphala when subjected to single cell gel electrophoresis, revealed a pattern of DNA damage, characteristic of apoptosis. Studies on Triphala treated MCF-7 and barcl-95 cells showed significant increase in intracellular reactive oxygen species (ROS) in a concentration dependent manner. ROS increase was, however, found to be insignificant in MCF-10 F as well as in murine spleen and liver normal cells. In vivo, direct oral feeding of Triphala to mice (40 mg/kg body weight) transplanted with barcl-95 produced significant reduction in tumor growth as evaluated by tumor volume measurement. It was also found that apoptosis was significantly higher in the excised tumor tissue of Triphala fed mice as compared to the control, suggesting the involvement of apoptosis in tumor growth reduction. These results suggest that Triphala possessed ability to induce cytotoxicity in tumor cells but spared the normal cells. The differential effect of Triphala on normal and tumor cells seems to be related to its ability to evoke differential response in intracellular ROS generation. The differential response of normal and tumor cells to Triphala in vitro and the substantial regression of transplanted tumor in mice fed with Triphala points to its potential use as an anticancer drug for clinical treatment.

---

• 3) Indian J Exp Biol. 1999 Jul;37(7):676-80.

Antioxidant activity of active tannoid principles of Emblica officinalis (Amla).

Bhattacharya A, Chatterjee A, Ghosal S, Bhattacharya SK.

Department of Chemistry, Bose Institute, Calcutta, India.
The antioxidant activity of tannoid active principles of E. officinalis consisting of emblicanin A (37%), emblicanin B (33%), punigluconin (12%) and pedunculagin (14%), was investigated on the basis of their effects on rat brain frontal cortical and striatal concentrations of the oxidative free radical scavenging enzymes, superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPX), and lipid peroxidation, in terms of thiobarbituric acid-reactive products. The results were compared with effects induced by deprenyl, a selective monoamine oxidase (MAO) B inhibitor with well documented antioxidant activity. The active tannoids of E. officinalis (EOT), administered in the doses of 5 and 10 mg/kg, i.p., and deprenyl (2 mg/kg, i.p.), induced an increase in both frontal cortical and striatal SOD, CAT and GPX activity, with concomitant decrease in lipid peroxidation in these brain areas when administered once daily for 7 days. Acute single administration of EOT and deprenyl had insignificant effects. The results also indicate that the antioxidant activity of E. officinalis may reside in the tannoids of the fruits of the plant, which have vitamin C-like properties, rather than vitamin C itself.

---

• 4) Phytother Res. 2005 Jul;19(7):582-6.

In vitro antioxidant studies and free radical reactions of triphala, an ayurvedic formulation and its constituents.

Naik GH, Priyadarsini KI, Bhagirathi RG, Mishra B, Mishra KP, Banavalikar MM, Mohan H.

Radiation Chemistry and Chemical Dynamics Division, Bhabha Atomic Research Centre, Trombay, Mumbai-400085, India.
The aqueous extract of the fruits of Emblica officinalis (T1), Terminalia chebula (T2) and Terminalia belerica (T3) and their equiproportional mixture triphala were evaluated for their in vitro antioxidant activity. gamma-Radiation induced strand break formation in plasmid DNA (pBR322) was effectively inhibited by triphala and its constituents in the concentration range 25-200 microg/mL with a percentage inhibition of T1 (30%-83%), T2 (21%-71%), T3 (8%-58%) and triphala (17%-63%). They also inhibited radiation induced lipid peroxidation in rat liver microsomes effectively with IC(50) values less than 15 microg/mL. The extracts were found to possess the ability to scavenge free radicals such as DPPH and superoxide. As the phenolic compounds present in these extracts are mostly responsible for their radical scavenging activity, the total phenolic contents present in these extracts were determined and expressed in terms of gallic acid equivalents and were found to vary from 33% to 44%. These studies revealed that all three constituents of triphala are active and they exhibit slightly different activities under different conditions. T1 shows greater efficiency in lipid peroxidation and plasmid DNA assay, while T2 has greater radical scavenging activity. Thus their mixture, triphala, is expected to be more efficient due to the combined activity of the individual components.