What is a Panchakarma Cleanse? An Easy Guide for Beginners

Ayurveda Panchakarma Cleanse is a series of five detox therapies. These heal and tone the body’s tissues, blood, skin, major organs and systems.

Ayurveda is India’s millennia old science of health and longevity. Ayurveda stresses the importance of preventative care far more than disease management. By maintaining harmony in the basic building blocks of our body, the bio-energies of Vata, Pitta and Kapha, we reverse disease.

With daily rituals and a seasonal diet we balance the bio-energies of Vata, Pitta and Kapha. As the day turns to night, the seasons and the solstices cycle through, the energies in the body shift as well. An Ayurvedic person stays in homeostasis by following Ayurvedic wisdom. This leads to a stable state of pleasant mind, loving heart and active body. When disease begins to take a hold of the body tissues, the bio-energies of Vata, Pitta and Kapha turn erratic. The unbalanced energies in turn helps disease take root and spread.

Sattva is the guiding aspect of Universal Consciousness. Once the disease takes root, Sattva alone is unable to calm the energies of Vata, Pitta and Kapha. Ayurveda physicians apply Panchakarma cleanse therapies to help the body reconnect to it’s natural Sattvic intelligence, to heal and bring the body back to vibrant health. The five Panchakarma detox procedures that support and complement each other are:

Sunbathing covered with herbs

~ Virechana purge of small intestines

~ Vamana flush of the upper gastrointestinal tract

~ Nasya cleanse of sinuses

~ Vasti wash of colon

~ Rakta Moksha to restore purity of blood.

Panchakarma cleanse is the most powerful therapy in the clinical practice of Ayurveda.

Panchakarma is classified as a Sodhana Chikitsa or a purgative/ evacuative therapy to balance the bio-energies, tissues, physiological systems and all functions of the body.

Sodhana Chikitsa cleansing herbs and therapies heal by loosening, binding, extracting and flushing out endogenous toxins called Ama. Ama, the build up of residual toxins due to poor digestion, circulation and elimination, blocks the channels of the body. This blockage manifests as disease in the body tissues.

The term Panchakarma applies to all procedures that heal by purifying toxic residue left behind due to inefficient digestion and waste elimination.

The residual waste called Ama, an ayurvedic term for endogenous toxins that translates as ‘not-me’ and also as ‘undigested’, is the primary cause of dis-ease based on Ayurveda’s perspective on health and healing.

Ama collects over time as tissues degenerate, the passage of waste materials is blocked, and the body’s regulatory functions grow weak causing a host of symptoms to affect the body and mind.

(Panchakarma is pronounced as punch-uh-kur-muh, in case you are wondering)

Restoring health with Panchakarma Cleanse

The goal of an efficient Panchakarma is to restore health by purifying and cleansing all the major systems of the body.

Once harmony is achieved between the body’s basic energies Vata, Pitta and Kapha, the body’s seven types of tissues, the three main waste elimination processes, the sense organs and the mind, vibrant health is a natural outcome.

To Ayurveda vibrant health is synonymous with radiant beauty.

Ayurveda upholds health, beauty and purity as supreme virtues. By cleansing the body, we naturally cleanse the mind and the soul of negative impressions and stored memories. When we make poor decisions about diet, lifestyle and relationships, this brings us pain. We not only affect our bodies’ appearance and symmetry, we ultimately degrade our consciousness.

Ayurveda Acharya Sushruta, who is said to have lived around 1000 BC in Varanasi, defines health as:

“Sama dosha, sama agnischa sama dhatu mala kriyah

 Prasanna aatme, indriya, manaha, swastha ithi abhidheeyate” ||41||

– Sushruta Samhita, Sutra Sthaana, Chapter 15, verse 41

Based on Dr. Onkarnath Tripathi’s explanation of these verses, “health is the state of equilibrium of the three subtle gunas of the body, Sattva, Rajas and Tamas. This intelligence is connected to the Supreme consciousness and correspond to the fundamental dosha energies of Vata, Pitta and Kapha.

When the agni or the Pitta digestive functions in the body are in equilibrium in the stomach (jatara-agni), within the tissues (dhatu-agni), within the five basic elements (bhuta-agni) and in the major seats of combustive activity – the eyes as alochaka-agni: the heart as saadhaka-agni: the skin as bhraachaka-agni: the digestive system as pachaka-agni: the blood as ranjaka-agnithen health is a evident.

Health is when the seven layers of tissuesrasa, the juicy first extract of digested food: rakta blood formed from the nutrient dense digested matter : mamsa, muscle formed from this healthy blood :medha, fat arising within the muscle: asthi, the skeleton that frames the structure: majja, marrow and nerves of the body: shukra /arthva reproductive tissues of sperm and ovum – produced from the nutritive essence of digested food, are in optimal balance.

A content soul, with sense organs in serene balance and a pleasant mind results in a healthy human firmly centered in themselves (swastha, established within the self)

This equilibrium and balance of physical, mental, psychological, and psychosomatic ultimately leads to harmony of body, speech and mind (kayik, vachik, manasik).”

You may have seen individuals who may or may not be conventionally good looking but are unforgettable because of their wholesome healthy bodies, pleasant open face and an optimistic outlook towards life.

Such a person’s Vata, Pitta and Kapha energies reach the highest expressions of Prana vital force, Tejas, luminous cellular metabolism, and Ojas, optimal immunity and strength.

Such a person’s health is not just a blessing to themselves but a benefit to all he/she comes in contact with.

This is the highest goal Ayurveda aims to meet.

Swedana steam treatment

~ Sama dosha, sama agnischa sama dhatu mala kriyah

~ Prasanna aatme, indriya, manaha, swastha ithi abhidheeyate” ||41||

~ Sushruta Samhita, Sutra Sthaana, Chapter 15, verse 41

Panchakarma is the most powerful cleansing therapy in the clinical practice of Ayurveda. It is classified as a Sodhana Chikitsa or purgative/ evacuative intervention to stabilize the tissues, systems, and functions of the body.

Yoga is key for harmonizing Prana

All therapies that are intensely purgative and evacuative in nature, have the longest-lasting effect and restore the body back to its natural state of balance (Prakriti). Most of the Panchakarma therapies like Vamana, Virechana, Nasya, Niruha Vasti, enemas with water-based herbal extracts come under Sodhana therapies.

Contemplation is important during a Panchakarma.

Snehana literally means loving in Sanskrit. All oil-based therapies applied on the skin, applied nasally, used for cleansing the colon, soaking of joints, streaming over the sense organs and the head, are essentially loving snehana therapies that affect the heart chakra as much as they heal the disease.

Panchakarma Cleanse in Clinical Ayurveda

Ayurveda groups all clinical therapies under two categories:

Langhana / Apatarpana and Bri(n)hana / Santarpana

A physician overseeing a Panchakarma will draw from both classes of therapies. She will employ therapies that are fast acting and expulsive and counter the effect with gentle and nourishing therapies, calibrating the treatment plan based on how the patient is responding.

Langhana / Apatarpana in panchakarma

Apartarpana are therapies that reduce, expel and arrest the chaos of the basic bio energies of Vata circulation, Pitta conversion and Kapha construction.

Panchakarma therapies are mostly Langhana therapies, their main goal is to swiftly move in and restore balance. Here are the four major categories of Langhana therapies:


All intense therapies are purgative and evacuative in nature, meaning the toxins are flushed out through the colon, vomiting, sneezing etc.

They restore the body back to its natural state of balance (prakriti) for a longer duration than the easier nourishing therapies.

Most Panchakarma therapies like Vamana, Virechana, Nasya, Niruha Vasti, enemas with water based herbal extracts, come under Sodhana therapies.


Shamana is a broad term for gentle treatments that promote healing by steadying and stabilizing impaired body functions. Shamana brings temporary relief by calming the Vikriti or acquired imbalances that overlay the Prakriti, unique natural state of balance of a body.

Herbs for revving up digestion and hunger, improving sleep, Yoga, sun bathing etc. are some Shamana therapies given during Poorva Karma or as preparatory treatment prior to the main treatment.

Pacifying Shamana therapies – Abhyangam oil massage of the head, feet, ears and body, Shirodhara steady stream of oil on the forehead and Swedana sauna or steam till profusely sweating – may bring temporary relief from vitiated doshas but the disturbed dosha are permanently brought to balance only by Panchakarma purgative therapies.


These therapies are drying in nature and work well for reducing vitiated Kapha and excessive mucus in the body.


These therapies induce profuse sweating to bring the Ama Visha out through the pores. Some examples are Njavarakizhi, Elakizhi, Choorna Sweda, herbal bath, steam sauna. Please scroll to the end of the page for further explanation of these terms.

Bri(n)hana therapies in panchakarma

Bri(n)hana / Santarpana are a class of therapies that help tone and increase body mass. They are gentle and pleasurable compared to Langhana therapies. This class of therapies work best for those who are recovering from illness, childbirth and those who are malnourished.

Brinhana treatments, during the end of the Panchakarma, involve nourishing herbs and tonics prescribed to help gain weight and strength especially after the weight loss of the langhana treatments.


Snehana literally means loving in Sanskrit. All oil based therapies applied on the skin, applied nasally, used for cleansing the colon (anuvasana vasti,i.e, herbs extracted in oils), soaking of joints, streaming over the sense organs and the head, are essentially loving snehana therapies that affect the heart chakra as much as they heal the disease.

These therapies are one of the most enjoyable experiences of a Panchakarma as warm hands apply oils in soothing strokes.

Body temperature herbal oils are also used either in the form of steady stream or as generous soaking mediums to ease the muscles and heal the localized, underlying Vata, Pitta, Kapha disorder.

Snehana therapies combined with massage and steam baths are offered throughout the Panchakarma treatment.

Some examples of Snehana therapies are Snehapanam, Abhyanham massage, Shiro Vasti, Shirodhara, Pizhichil, Shiro Pichu etc. These therapies are explained at the end of the article.


Sthambana therapies are staunching in nature and arrest the disorder of the elevated dosha, stop the flow of discharge or blood bringing healing and relief.

The 3 stages of a Panchakarma Cleanse Therapy

A Panchakarma program is created after thoroughly studying the patients’ health and history.

Usually a consultation will take about an hour during which the physician checks the pulse, tongue, stool, urine, sound of voice, body temperature, health of the eyes, and shape of the body.

The physician will examine the patient and ask questions to understand the state of the dosha and health of body tissues, the place of stay, strength of the body, phase in the patient’s life, digestive fire, the body type, age, dosha of the mind, food habits and life circumstances. This is called ashta sthana (8 locations) and dasha vidha pareeksha (10 type examination), a total of 18 key questions to capture the full picture of a patient’s condition.

Ayurveda therapies, referenced from Dr. Ninivaggi and Dr.Valiathan’s texts on Ayurveda

Modern Ayurveda physicians will also examine health reports, and current medications.

After this is done to the physician’s satisfaction, a chart of Panchakarma treatment program is drawn out.

Before the therapists begin the Panchakarma evacuative therapies the patient’s body is prepared with Poorva Karma therapies, literally, ‘before’ or ‘preparatory’ therapies. Physicians only supervise the treatments; all treatments are done by therapists. This is important to understand as you choose an Ayurveda Panchakarma center for your well-being.

The main therapy or Pradhana Karma will be any of the five major Sodhana therapies mentioned above that are applied to cleanse the nasal passages, the colon, skin, blood and the gastrointestinal tract.

Paschata karma or the finishing therapies are guidance offered after a Panchakarma is completed. This advice helps the patient keep the freshly cleansed body protected from extremes of heat and cold, heavy food and energy intense activities. The body tissues are renewed and receptive like a newborn baby’s and need a few days to transition to the hectic pace of a normal modern life.

Talam, herbal paste to reduce swelling and pain in the head, neck and shoulders

Poorva Karma: The Preparation for Panchakarma Cleanse

These therapies pacify flared up dosha and start to direct them to the gastrointestinal tract. Without loosening and channeling deposits of Ama and calming disorderly dosha, main Panchakarma therapies will be contraindicated. Panchakarma should therefore be done only under the care of a well-qualified Ayurveda physician and well-trained therapists.

Usually these preparatory therapies last for several days up to a week.

Shamana pacifying therapies are:

~Deepana with herbs and tonics of hot potency orally taken with food to help the digestive fire grow strong. Some of the herbs are fennel, turmeric, asafetida (hingu in Sanskrit), dry ginger, black pepper, pippali long pepper, cumin etc. These spices are a staple in Indian Ayurvedic cuisine. The daily intake of such spices helps to digest any Ama that might form in the gut on a daily basis.

~Paachana tonics made of bitter and aromatic spices that help the body burn the Ama in the gut, on the cellular level and in the organs. Some of the herbs are Guduchi, holy basil, turmeric, dry ginger, pepper etc.

~Langhana fasting or reducing the quantity of food, restricting the number of meals and fasting from sunrise to sunset. For example, eating two meals within 8 hours of the day, breakfast at 10 am followed by dinner at 6 pm.

~Trit water fasting or limiting stimulating drinks like tea, soft drinks, carbonated drinks and coffee.

~Yoga to move the imbalance of Vata, Pitta and Kapha to prevent the dosha from taking root in a body part or organ, as the medicines, herbs, and therapies that start to move them from their locations.

~Atapa sevana is sunbathing to increase pitta energy to naturally burn toxins and to assist the detoxing activities of the liver, the enteric system and body cells.

~Marutha sevana is taking walks in the wind, by the beach or open spaces for the body to renew with gusts of fresh air.

Pradhana Karma / Panchakarma cleanse Proper:

During Panchakarma, the physician focuses on efficiently drawing out endotoxins trapped in the body cells, joints, muscles and under the skin. The toxins are bound with herbal medicines and channeled into the blood and then to the intestines via the liver. From these accessible channels the physician then induces purgation with therapeutic enemas, diarrhea and vomiting.

These intense cleansing therapies require high degree of expertise and as such Panchakarma should be undertaken only under the care of a well-qualified Ayurveda physician and well-trained therapists.

The five major Sodhana or cleansing therapies are as follows.

Swedana steam bath, Ayurveda therapies do not heat the head.

Nasyam/ Navana/ Nasta Karma

The nose is the gateway to the head. Ayurveda physicians use this entry point to bring healing sneha or oils laden with herbal extracts to the channels of the head, throat and shoulders.

The herbs spread quickly into the Shringaataka marma spot at the base of the head, traveling through the veins and micro capillaries in the face and head, bringing the dosha energies back to their Sattvic harmony.

During a Panchakarma, virechana purgative nasyas are applied and when the blocked kapha is expelled. This is followed by samana or pacifying and br(i)nhana or nourishing nasya.

  • Virechana nasya is useful for diseases of kapha origin that cause pain, ulceration, rashes, hoarseness etc. It is also useful for lethargy, sleep disorders, mental disorders and diseases that affect the throat region. Nasya could be in the form of a powder snuff, oil, juice or any other liquid medium.

  • Br(i)nhana or strengthening nasya is offered for tinnitus, speech disorders, pain in the jaw, grinding of teeth, halitosis and lock jaws etc.

  • Shamana nasya is given to persons with premature wrinkles, graying hair, pigmentation and frequent bleeding of the nose.

  • Marshya Nasya is large quantities of herbal extracts of up to 32 drops.

  • Pratimarshya Nasya is daily nasya of 1-2 drops of organic ghee or sesame oil that can be performed for health maintenance at home.

  • Pradhamana is nasya of herbal powders inhaled through a tube.

Nasya is not done after taking a meal, when hung over, when on ghee snehapana therapy, when the patient is feeling intense thirst, when pregnant or on the menses, when injured etc. It is also avoided when one has undergone severe purgative therapies, is weak, has the urge to pass a bowel movement, is recovering from illness, has bleeding disorders or has a cough or cold. It is also avoided on days the patient has been given enema, etc.

In short it is offered only when the patient is strong enough to handle the therapy. It is also not offered when the sky is clouded and rain is predicted, nasya at a Panchakarma retreat is offered only on sunny afternoons so the body can metabolize the medicines easily.

Dosage of therapeutic nasya offered by a physician can be 6-10 drops in each nostril.

Based on the Samhitas, nasya is offered to a patient after a head massage and steaming of the face, neck and shoulders. The patient lies down comfortably with his arms outstretched and legs propped up on cushions. The head is tilted back and the physician warms up the nasya oil in a gold, silver or copper bowl before pouring the drops in each nostrils.

The patient should stay in bed without sleeping till he/she feels alert and fresh from the medication.

When done by an unqualified physician, nasya can cause weakening of vision, headaches, fever, breakouts, dizziness, fainting and burning sensation in the chest and face.

Nasya is not done on children younger than 7, and adults older than 80.

A successful nasya is when you feel energetic, are able to sleep deeply at night and wake up refreshed early in the morning.

Vamana / THERAPEUTIC vomiting

Vamana is the first major Panchakarma therapy that follows a course of drinking herbal ghee (snehapana, sneha = oil, pana = drinking) and fasting.

Vamana acts on Kapha buildup in the chest, upper gastrointestinal tract and the head for this reason it is an excellent therapy for individuals with Kapha constitution and Kapha imbalance. Some of the conditions are asthma, respiratory tract infections, allergies, early stages of diabetes, obesity, migraine headaches, sluggish metabolism and poor appetite.

On the previous day Kapha or mucus producing foods like rice, yogurt, milk, sweets, jaggery, black gram and sesame are given.

Large quantities of natural herbal purgatives like saline, licorice, decoctions and milk are given to successively cleanse the upper intestinal tract, the stomach, the liver and the chest. Vamana is offered only once to those who are strong enough to go through this therapy. About 4-8 cups of each liquid is drunk and then purged, as most patients begin throwing up on their own.

Those who are unable to throw up, are asked to stimulate the back of the throat to activate the gag reflex.

The vomit successively brings up digested food, the herbs and drinks, mucus foam, bile and then the vitiated bio-energies.

A successful vamana makes the patient feel light, relieved, pleasant minded and hungry. An inadequate vamana brings a feeling of heaviness, lethargy, and skin rashes may appear. The physician carefully examines and remedies adverse effects.

In case of emaciated persons, pregnant, menstruating and postpartum women, alcoholics, people with heart disease, bleeding, acute fevers, respiratory bleeding, Vamana is contraindicated. Those suffering from facial paralysis, emesis will increase the severity of their disease.

Virechana / THERAPEUTIC purgation

Virecana, therapeutic diarrhea, is done after Vamana to cleanse denser toxins that are of sticky Kapha and acidic Pitta in nature. The body draws out these endotoxins from the liver, gallbladder, spleen and tries to eliminate them through the small intestines but because the elimination is weak, the toxins make a home there instead.

Once these Kapha-Pitta dominant toxins settle in the small intestines they start to manifest symptoms like inflammatory conditions, allergies, rashes, protracted fevers, diarrhea, acne, toxic load in the blood, abnormal functioning of the liver etc.

Virechana is best done during hot weather as pitta naturally gets aggravated and is easier to channel out of the body. Virechana is offered for 1-3 days, depending on the patient’s condition, with supportive snehana oleation therapies.

One requires good digestive agni fire for the virechana drugs to be effective. A good virechana brings about a feeling of lightness and ease in the body. Taste and appetite increases.

An inadequate virechana causes additional heaviness to the body, abdominal bloating and discomfort is noted, the patient loses appetite, becomes nauseous and vomits often with little to no bowel movement. It is important to be under a qualified physician’s care so remedies can be applied immediately.

Protracted fevers, hemorrhagic disease, abdominal tumors, abscesses, disease of spleen, hemorrhoids, bloating, intestinal worms, irregular patches on the skin, conjunctivitis, ulcerations of the eye, migraine, reverse peristalsis, constipation, vomiting, small pox etc. are cured by virechana.

Alcoholics, menstruating, pregnant, postpartum women, severely constipated patients, patients with wounds to the rectum, rectal disorders like prolapse and painful fissures, patients with respiratory disorders and having chronic diarrhea are contraindicated, and if done without a physician’s supervision, may even lead to death.

Vasti / Basti ENEMA

A Basti/ Vasti enema is half the treatment in itself, Acharya Charaka calls it the ‘greatest and the most effective’ treatment of all. The colon, urinary bladder and urethra are irrigated, nourished and flushed clean with herbal decoctions and oil extracts.

Vasti is performed on patients who have health concerns of Vata origin, and if done by itself like virechana, then Autumn or Fall when Vata is high in the environment is the best time.

There are three kinds of Vasti:

  • Anuvaasana / Maatra Vasti or oil based enema is given to those with severe dryness, who have high vata and who have a powerful digestive Agni. It is offered early morning or in the afternoon after lunch is digested. For extreme cases it is also done before bedtime and retained overnight. This is a snehana oleation therapy.

  • Aasthapana / Niruha Vasti is an enema with herbal drugs extracted in liquid. This enema is solely offered early in the morning or in the afternoon after lunch is digested. The duration of holding in is 15 – 50 minutes.

  • Uttara Vasti is enema of the urethra and urinary bladder.

The drugs used may be for utklesana, exciting the doshas for expulsion like a coffee enema, samsodhana purifying, samsamana balancing doshas, lekhana scraping of toxins, br(i)nhana nourishing, vajikarana aphrodisiac , piccha vasti enema with slimy drugs to improve lubricative properties of the colon, madhutailika enema with honey and oil which is gentle for frequent use in even children, etc.

***Please do not do any kind of enemas without a physician’s supervision or instruction.***

Vasti is a safe procedure and seldom causes harm when done under a qualified physician, however some points need to be kept in mind.

Vasti is done after the previous meal is digested so the upward movement of the intake of herbals continues without causing blockage and worsening of any obstructed channels in the torso, neck and head.

A successful Vasti creates a sense of well being in the body, the body feels light and a feeling of great relief is felt. Appetite and digestion improves. The patient stays on a light, easily digestible meal regimen.

The following patients are contraindicated; children under 12, elders above 75 years of age; emaciated and severely underweight individuals; patients with recent fevers, anemia, jaundice, diabetes, inflammation and blockage of sinuses, diseases of the spleen, severe bloating, diarrhea; inflammation of the eyes due to kapha and pitta; severe constipation; severe obesity; enlarged glands in the neck, and intestinal parasites.

The colon is a highly absorptive organ and it is important for a physician’s guidance to know which enema to apply under what health conditions.

One formula does not fit all.

Raktha Moksha / Blood purification

Raktha moksha is the final panchakarma therapy. Ayurveda surgeon Acharya Sushruta was the first to perfect and promote this treatment for its ability to purify blood, which he regarded as the basis for healthy dhatu tissues and organs.

The body’s digestive fire agni, the quality of raktha blood and imbalance of pitta bio-energy is closely related.

If the patient has high heavy metal content in their blood, have inflammation, or have severe toxicity due to other reasons, bloodletting is done by:

  • Pracchana is done by quick small downward cuts with a sharp scalpel. Micro needling is a kind of Pracchna.

  • Siravyadha venesection by using a syringe.

    • Jalauka using leeches is considered the most gentle and effective. This is offered in India and must only be performed by a qualified physician who is able to identify safe animals and perform this procedure in a clinical environment.

(Hirudin is one of the most powerful anti-coagulants out there and in modern surgery leeches are making a come back post surgery for improving blood circulation to reattached body parts.)

Incisions for bloodletting are made only on body parts devoid of tendons, joints, bones and vital marma spots and after tying a thread or tape, firmly above the site of the incision.

The following patients are contraindicated; children under 12, elders above 75 years of age; emaciated and severely underweight individuals; patients with anemia; edema; asthma; impotency; menstruating, pregnant, postpartum women etc.

A village temple in South India, you can visit such places of beauty after your Panchakarma treatment.

PASCHATA Karma / Uttara Karma: Post Panchakarma cleanse Guidelines

When a Panchakarma is successfully completed, the physician offers guidelines to maintain health and take the prescribed medications for the next 3-6 months.

These guidelines include diet and lifestyle recommendations to ease entry into a normal daily routine once the patient is home.

Toning rasayana herbs are given to restore strength and provide vital nutrients.

During these days the patient is gradually given a steady diet of easy to digest foods like congee and kitchari, as the tissues are in a state of heightened receptivity and any excesses in food, exercise or exposure to the elements may adversely effect health.

Maintaining Balance of the bio energies

We help our Vata, Pitta, Kapha energies to maintain equilibrium with appropriate dinacharya and ritucharya, daily and seasonal rituals.

This steadies the doshas and brings them back to balance throughout the year in spite of the rhythmic cycling of the sun, the seasons and the solstices leading to temperature fluctuations, rise and fall of humidity and dryness in the atmosphere.

A tribal elder from the South of India, going to the temple. These sights can be enjoyed after your Panchakarma is over.

Our bodies are naturally blessed with Sattva intelligence to balance Vata, Pitta and Kapha energies by efficiently eliminating that which harms and hinders.

The energies are meant to stabilize by the rhythms of bowel movements, urination and sweat, the major wastes of our body. These are called trimala: tri=three, mala=waste. Tears and menstrual blood are also waste eliminating, Vata-Pitta-Kapha balancing functions.

However due to unhealthy lifestyle and diet choices, emotional disturbances for no apparent reason, suppression of natural urges and poor-quality sleep, we collect endogenous toxins, Ama.

Ama constricts the flow of fluids and energy within the body channels and calcifies into deposits of toxic build up especially in the gut, colon, muscles, bones, joints, and under the skin.

Over a period, even in healthy bodies, just as a jar of water left on a countertop for too long develops sediment, these toxic deposits build up and ripen conditions for dis-ease.

You may notice the following symptoms present:

·   Feeling tired and sleepy after meals, energy dips during the day that require caffeinating.

·   Fatigue and inability to focus

·   Waking up feeling anxious or miserable or with a feeling of dread for no reason

·   unexplained aches and pains, quick to injure and bruise. Delayed recovery.

·   Inability to stop doing what is known to be harmful, compulsive consumption, binge eating, binge watching TV, shopping, scrolling on social media for hours etc

·   A thick coating on tongue, swelling, and teeth marks, frequent dry mouth, metallic or sour taste

·   Discoloration of the skin and inflammation in the body

·   Poor digestive health, acid reflux, constipation or noticeable bloating

·   Body odor, unnaturally smelly poop, bad breath, smelly sweat, urine, discharge or period

·   Lack of motivation, quick to lose temper, loss of pleasure in life

·   Period turns painful, irregular, too much or scanty

When we learn to live with these symptoms for years, they begin to take root as chronic disease which may be difficult to treat.

Some of the common ailments that clients find relief with a Panchakarma are insomnia, rheumatoid arthritis, polycystic ovarian syndrome PCOS, fibromyalgia, colitis, hypertension, heart disease, to name a few.

Who cannot do Panchakarma Cleanse Therapy?

Panchakarma cleansing therapies are not done on children under 10 and adults over 70 years of age. The final decision rests with your Ayurveda physician.

Evacuative purgative therapies like Panchakarma are not offered to patients who are weak from prolonged illness, addictions, pregnant women and people who are healing recent injuries.

Patients with immune deficiency, malignancy, thyroid imbalances, diabetes, hypertension are not candidates for eliminative Panchakarma and are helped with other palliative Ayurveda therapies

Please note that Ayurveda is limited in its scope to treat conditions that require emergency lifesaving interventions and surgery, acute onset of infectious diseases, cancer etc. After you have recovered and have steadily gained weight for six months, you may be eligible for a Panchakarma to cleanse the body of medication residue, soften and heal scars and reverse damage from chemotherapy drugs.

Guidance on maintaining health

When health has been regained, then Ayurveda advises the following to maintain this blessing:

Nityam hitahara viharasevi samikshyakari vishayepasakthah

Daatha samah sathya parah kshamavanathpopasevi cha bhavatya rogah ||43||

In the disease prevention chapter 5 of the Ashtanga Sangraha, verse 43 the key to maintaining health is given.

It is said the healthy balanced state of dosha energies are maintained by a daily diet of wholesome foods, by carefully considering pros and cons of all activities we may set out to do, and by staying even keel.

By enjoying the pleasures of life in moderation and by being charitable to those in need we assist our bio-energies to stay steady.

When we treat all living beings with equal compassion, and follow the path of satya truth, forgiving mistakes made by those around us, we stay healthy and sound in our mind.

A healthy person keeps the company of the upstanding and the learned.

All these habits help a person continue to live a long disease-free life.

Ayurveda and the three universal causes of disease

When the basic energies of Vata circulation, Pitta conversion and Kapha construction are thrown out of balance, when the waste elimination is compromised, when the tissues do not receive adequate nourishment from wholesome seasonal food, and when the mind and the sense organs are in a state of distracted chaos, the body is no longer healthy.

There are three main reasons for the dosha energies to go out of order. This disorder ripens the conditions for disease to take hold in the body.

Asatmendriyartha Samyoga

Indriyas are the sense organs that are constantly being pulled into the direction of what we desire to possess or shrink away from.

When we run after harmful sensual stimuli that infiltrate our consciousness, it leaves an imprint behind. As these impressions collect over time it weakens our connection to the integrated whole.

It solidifies and grows the ego in perverted ways.

Some examples are watching violent videos, maintaining relationships with unwholesome individuals, listening to hate inducing lyrics, eating the meat of inhumanely slaughtered animals etc. 

What is stored in our energy body transfers to those who are weak and receptive around us, like our children and those who admire us and look up to us. These negative influences then transfer to our future generations as ancestral trauma.


When a person willfully commits crimes of wisdom or prajna-aparadha, they sink further into their negative ego self. Living a life from the negative aspirations of the ego makes us forget the connection to the integrated field of consciousness.

We forget our well-being is tied to the well-being of the whole.

These transgressions lead to error prone thought, action and speech, inflicting pain on the self and others, negatively affecting the relationship to self, to the family, to the community and ultimately, the health of the planet.

Sarpa kopa or ‘wrath of the snakes’ is one of the primary reasons for our current suffering, we have destroyed natural habitats and the creatures that keep the planetary biome healthy.

Kala Parinama

The Vata, Pitta and Kapha energies in the body are constantly responding to the changes within the body and the environment. This is called Kala-Parinama, the result of the change of light and dark, waxing and waning of the Moon, the march of the seasons, the movement of the solstices and the planets.

Panchakarma Cleanse Treatment: Frequently Asked Q & A

Here are some frequently asked questions about Panchakarma treatments and therapy.

What is Panchakarma treatment cost?

A Panchakarma stay at a reputed center in India will cost between $120/ day on the low end and about $800/ day on the higher end. Total cost for 14 days will be at least $1500.

This cost depends on the location of the center, season you are traveling, range of treatments offered, quality of medicines used, and total number of treatments the physician in charge is willing to add on to a standard plan to effectively heal your main health concerns.

This is not how you will be eating at a Panchakarma center, even though this is an Ayurvedic meal 🙂

Please remember the operational costs for hiring strong candidates as employees, periodically training them, offering them industry standard benefits and fair wages are part of this cost. These factors have a direct bearing on your experience at the retreat, as the guest spends majority of her time interacting with staff and therapists.

There are legitimate ways retreats keep costs down, by hiring family members and manufacturing medicines in-house.

Even a $120 – $175/day basic stay will provide you a clean, hygienic facility with several qualified physicians on duty, well trained therapists, western washrooms, space to stroll, pray and meditate. This cost includes daily therapies for about 1-3 hours, daily consultations, three meals and adequate beverages, unlimited medicines, daily housekeeping, government taxes etc.

Airport pickup and Yoga classes may be payable extra at facilities on the lowest end.

The centers are expensive during the winter months when tourist arrive in droves. Between October to March, reputed Ayurveda centers are fully booked and charge higher as demand exceeds supply.

In the United States, an at-home Panchakarma with support from a physician or practitioner and in-person treatment at a retreat center costs anywhere upwards of $300/day. Residential stay packages are between $500-$1000/ day depending on how upscale the center is.

What is done in Panchakarma?

During a Panchakarma the patient undergoes many preparatory, pacifying and detoxing therapies to bring the disturbed doshas back to balance and a state of steady health.

Palliative care is also offered to patients who may be facing chronic health challenges like Parkinson’s disease, recovering from Cancer, have painful inflammatory conditions.

Cleansing therapies are also performed which may bring out emotional distress in the patient. During emotional challenges, the Ayurveda physicians do their best to address and provide spiritual counselling. However it is best to have online consults with a psychotherapist from your own country who is qualified and well versed in understanding your social context and cultural needs.

Panchakarma is also ideal for healthy individuals who may have any or all of these symptoms – pain, depression, fatigue, constipation, nausea, loss of appetite, difficulty sleeping, and anxiety.

How long does Panchakarma treatment take?

During an authentic clinical grade Panchakarma the body is made pliable and receptive with massages and digestion enhancing medicines as Poorva Karma. Only after this preparation, the Panchakarma therapies are offered to extract and cleanse the Ama Visha or endogenous toxins. After Panchakarma, Paschaata Karma or finishing therapies to restore a pleasant state of health is offered. All this requires at least 14 days.

A two week stay would normally be structured as 3-8-3 days depending on the physician’s opinion.

Ideally, whether healthy or facing a health challenge, 21 days are required to reap the full benefit of the therapies, firmly establish healthy habits and center in the newly found sense of self.

If the patient is facing a serious condition, is on heavy dose of medicines or has been asked to undergo surgery, then a minimum of 28 days is required to make a difference.

A hundred years ago, royal patrons in Kerala would undergo a Panchakarma for three full months as a yearly cleansing of the body, mind and spirit. This was an important time when the duties as a monarch was deferred to subordinates. The ruler would spend time in prayer and penance, austere diet and quiet contemplation. This is the gold standard Panchakarma.

The final word on how long a Panchakarma should be done lies with the physician who has thoroughly studied the patient’s history and has clarified her doubts.

Does Panchakarma have side effects?

Panchakarma is an intense therapeutic treatment which requires that the patient be relatively healthy, strong, resilient and to endure some uncomfortable procedures. Shodhana purification therapies are not offered to children, patients over 70, pregnant women, patients who have a history of heart disease, hypertension, alcoholism, drug addiction, and have immunity disorders which may flare up during the therapies.

There are many layers of embedded toxicity within the body tissues, the somatic body and the psyche. Progressive Panchakarma helps to cleanse each of these layers, even removing the samskaras, tendencies collected over life times.

A Panchakarma is only as good as the professional expertise of the Physician, the time given for the treatment, the budget to afford a stay at the best Panchakarma centers and the willingness to follow strict rules throughout.

Many clients go right back to an intense work schedule and demanding fitness programs and usually discover, the body needs a few days of rest to ease in to life as usual. Some arrive home to find that their priorities have changed from before and rearrange their life, their social circle and significant relationships to suit their new preferences. Usually newfound diet and lifestyle choices are maintained as they feel nourishing and wholesome.

What is the benefit of Panchakarma?

A Panchakarma restores the dosha balance of Vata, Pitta, Kapha biological forces in the body. Once these energies are in balance many patients report partial to complete restoration of full health (depending on how chronic their condition was), a strong sense of self and a pleasant state of mind.

Here are some benefits my past wellness clients have experienced from their stays at Ayurveda retreats in India and Bali:

  • Regular bowel movements

  • Deep, restful sleep

  • Sense of joy and calm

  • Flexibility in joints

  • Deep intuition

  • Slowing down of pace

  • Healthy digestion

  • Healthy complexion

  • Patience and generosity

  • Strength and defined muscular structure

  • Enjoy exercise and movement

  • Appreciation for life

  • Stronger hair and nails

  • Deepening spiritually

  • Improved immunity

  • Balanced hormones and improved hormonal health*

  • Resolution of some chronic health conditions*

  • Lower dependence on medication

  • Restored period cycles and improved gynecological health*

  • Return of libido

  • Heavy metal load in blood reduced*

  • Markers predicting onset of chronic diseases back within range*

  • Conception

    *Depends on individual outcomes and patient history

Please click here to read my personal account of benefits from my first Panchakarma.

Can Panchakarma be done at home?

The answer is both yes and no, depending on where you are from.

If you are from Kerala or from a physician’s lineage, the answer is yes. Many perform Panchakarma at home, because the people of Kerala are well versed in Pathya, strict rules of diet and conduct that must be maintained for the best results.

The people of Kerala, live a life guided by Ayurveda and perform their yearly cleanses during the monsoon month of July called Karkida Masam. It is fairly easy for family members to support each other during this involved process, that requires significant change in diet and lifestyle like preparing special rice gruels, processing herbal medicines, not watching TV, abstaining from sex and emotional excess.

A client visiting a retreat and experiencing an Ayurvedic cleanse for the first time, will require full support for a successful Panchakarma. It is not advisable to stay elsewhere and travel to your Panchakarma center for treatments in an effort to save a few dollars. Diet and lifestyle changes are supremely important and the outcome depends on whether the pathya rules were followed.

The company of those who do not understand what you are going through, who are enjoying a loud party, beer and fish fry vacation, inadequate help in preparing meals and medicines, and distressing travel from the Ayurveda center to your home or hotel base may ruin a Panchakarma even before you begin.

New habits are established in new surroundings. It is best to stay at the Ayurveda facility, to take time to go inward away from the distractions of family and work obligations.

Those who are deeply committed to self-care choose this path even though it may be slightly more expensive and demands more time away from work.

I have properties at all budget points in my portfolio.

Does Panchakarma help in PCOS?

Panchakarma has been found to be effective in many chronic health conditions like Poly Cystic Ovarian Syndrome aka PCOS, Fibromyalgia, Ulcerative Colitis, Psoriasis etc.

An individual’s outcome depends on the expertise of the physician she chooses (not everyone is an expert in everything) and her inner resolve to go through challenging therapies. The outcome also depends on the budget and the time the patient is willing to invest in self-care.

Panchakarma is also ideal for healthy individuals who may have any or all of these symptoms that affect the quality of their life – malaise, pain, depression, constant fatigue, constipation, gastric trouble, loss of appetite, difficulty sleeping, impaired fertility, unexplained painless growths, discoloration and chronic anxiety.

You may read my blog on benefits of a Panchakarma here

How many types of Panchakarma are there?

Panchakarma is the umbrella term for the five pacifying and evacuative therapies, or Samana and Shodhana in Sanskrit. The doshas of Vata, Pitta and Kapha are pacified, gathered and expelled by many individual therapies depending on the patient’s constitution, response to the treatments and the physician’s expertise.

Broadly speaking, the five main therapies are:

  • Vamana – induced therapeutic vomiting (emesis) after Snehapana ghee fast therapy to cleanse the stomach and upper GI tract.

  • Virechana – induced diarrhea to cleanse ama visha / endogenous toxin in the small intestines

  • Vasti/ Basti – enema with herbal oils and decoctions to cleanse the colon.

  • Nasyam/ Navana/ Nasta Karma – application of medicines through the nose for diseases of the head, throat and shoulders.

  • Rakta Moksha – purifying the blood of ama visha or endogenous toxins either by bleeding through cutting or with leech therapy.

A Panchakarma is a highly personalized treatment plan and no two patients may receive the same treatment even though they may both be experiencing a “Panchakarma”.

There are different flavors of Panchakarma based on the personality and expertise of the physician.

Some are cautious and some are risk takers, some push the limits, some back off as soon as the patient seems to be in distress. All these factors go into how the treatment unfolds and the journey the patient gets to walk with the physician and his able support staff.

A panchakarm cleanse is a considerable investment of time and money, and you will want to make sure you are guided well. My services to you, the client, are free for most routine bookings.

Please reach out to me through my trip inquiry page, so I can help you make a booking based on your unique needs. You can read my reviews here


I cannot thank Salila enough for going out of her way and beyond to make my stay as special as it was. I really got a sense of peace and I also want to thank every one who works at the retreat for making my stay so much better. Words can only express so much which is why I’m leaving some pictures of this awesome retreat here for who ever is inspired to take some well deserved time for self care level 50! It’s been 3 months since, and my health is back on track. I would do this all over again through Salila. I recommend Salila to book any flights and retreats to anyone that wants to have a beautiful experience Contact her ASAP.

Further Reading

To understand the Mahagunas of Sattva, Rajas and Tamas, read my blog here.

To understand the basic forces of Vata, Pitta and Kapha, click here.

Additional Ayurveda Therapies during Panchakarma Treatment

Pizhichil/ Kayasekam: Pizhichil means “squeezing”. Pizhichil is done by pouring lukewarm medicated oils in steady gentle stream through a little decanter or a bolus of oil with rhythmic massage. Two or four trained therapists perform this massage. The patient is made to lie down on a special wooden bed and turned on their sides to let the steady stream calm the entire nervous system.

Pizhichil is Kerala Ayurveda specific treatment and is done for 60-90 minutes and for up to 7 days, depending on the physicians estimate. This treatment is useful in arthritis, hemiplegia, paralysis, nervous weakness and nervous disorders.

Pinda swedam: In this sweating or Swedana treatment, therapists stamp the whole body or the part that needs healing with a bolus made of nyavara rice (njavara kizhi), bran, herbs, mud or meat cooked in herbal extracts, sour liquids or oils. The boluses (pinda or kizhi) are made of fresh muslin bags. Two or four therapists apply this treatment for about 60-90 minutes per session.

This treatment is offered for upto 14 days. This is excellent for pain in the joints, weakness of muscles, high blood pressure and high cholesterol.

Udwarthanam: This is an exfoliating massage done with copious amounts of coarsely ground sweet spices and herbal powders. The powder may be dry or slightly wet with herbal oils or extracts. This is done for patients with obesity, cellulite, impaired circulation and skin disorders. This is also a beautifying treatment.

Abhyangam: This massage improves circulation, lymphatic drainage and provides stress relief among a host of other benefits. Two therapists perform the massage for 45 minutes stroking rhythmically. Abhyangam massage is done using copious oils personalized to body type, season and health condition.

Each Ayurveda house has a distinct style of Abhyangam massage. It is offered during the entire stay duration of Panchakarma.

Elakki Thirummu: This Kerala martial style of massage is a sports style massage which helps to heal inflammation, injuries and damage to the muscles caused by intense physical training.

Vajikarana Massage: This massage tones and improves blood flow to the genital region.

Elakizhi/ Pathra Pinda Swedam: Leaves of herbs as well as whole herbs and herbal powders are made into a bolus in muslin cloth bundle. This bolus is heated dry or dipped in hot medicated oils for 45 minutes per session. This continues for a specified period as instructed by the physician.

Choorna Pinda Swedam: Choorna pinda sweda is a fomentation procedure done with the boluses of various medicated powders. It can be done as snigdha(with oil) or rooksha (dry) according to the condition.

Pinda Sweda treatments of sweating and drying with boluses of medicines is effective for sciatica, lumbago, arthritis and muscular pain.

Snehapanam: In this therapy medicated ghee is offered to the patient to drink for 3-5 days till the body absorbs the oils. This therapy is an important part of Panchakarma.

Kativasthi: A dam of black gram flour is made to hold warm medicated oil for 45-60 minutes. This is an excellent treatment for back pain and spinal disorders.

Urovasthi: Similar to the medicated pool of oil for the back, this therapy is done on the heart for respiratory and circulatory disorders of the heart.

Januvasthi: A pool of medicated herbal extracts in oil held over the knees to heal wear and tear of the cartilage.

Yoni Prakshalanam: Vaginal enemas cleanse the genitals and nourish reproductive tissues.

Dhaanyamla Dhaara: This is the rhythmic pouring of a specially fermented herbal extract all over the body. Usually 2 therapists will perform the treatment for about 45 minutes. This treatment is found to be beneficial for hemiplegia and paralysis.

Lepanam: A medicated paste is applied on one part or all over the body to help remove toxins, to improve the complexion or to help nurture the skin. Keeping the paste on for longer than the prescribed time has a negative effect.

Uttaravasthi: This therapy involves medicated oil/ghee enema in the uterus (in female) and urinary bladder (in male) for certain conditions.

Avagaha Swedam: In this sweating therapy patient sits immersed in a tub of medicated hot water.

Thala Pothichil/ Shirolepanam: In this therapy medicated paste applied on the scalp to heal disorders of the scalp like premature graying, flaky scalp etc. The paste is kept on for about 30-45 minutes.

Thalam: This therapy heals nose, throat and eye disorders and brings relief for insomnia, migraine headaches. Herbal pastes are mixed with oils and applied to the top of the head for 20-45 minutes. When dry, the paste is washed away.

Shirovasthi: In this therapy warm medicated oils are poured into a cap fitted on the head and allowed to stand for 15 minutes to an hour. Treatment is repeated for up to 7 days. It is beneficial for facial paralysis, migraines and other disorders of the head.

Shiropichu: In this treatment a piece of cloth soaked in medicated oils is placed on the scalp till the oils saturate the scalp, helping with conditions like premature graying, flaking, hair loss.

Shirodhaara: Shiro dhaara in Sanskrit means shiro=head, dhaara=streaming. During this procedure body temperature herbal oils, medicated milk(ksheera dhaara), medicated butter milk(takra dhaara), or herbal decoctions are poured on the forehead in a gentle pendulum like motion for about 45 minutes a day for up to 7 days as instructed by the physician.

This therapy is offered for insomnia, headaches, memory loss and stress.

Gandusha: In this procedure medicated herbal oil or decoction is held in the mouth for a time and then is spat out. The patient is given facial steam and massage before taking about a quarter or a third of the mouthful of liquid or paste.

As the medicine or oil is held in the mouth, excess kapha moves into the mouth from sinuses, ears and eyes. The used liquid should be repeatedly spat out and fresh liquid held in the mouth for about 3-7 times till the cheeks show signs of a successful treatment, i.e, beads of Kapha begin to appear.

Kavala: This is the Sanskrit term for “oil pulling”. Any herbal medicinal or plain oil, juice or milk is held in the mouth, swirled and pulled through the teeth to extract toxins.

This is a healing strengthening therapy for the face, jaws, gums and teeth.

Same as Gandusha, improperly done Kavala can cause; loss of sensation of taste, bad taste, loss of appetite, excess salivation and a coating inside the mouth.

Excessive Kavala and Gandusha therapy causes dryness of the mouth, ulceration, weakness of the facial muscles, loss of taste, increased heart rate, weakness of voice and ringing in the ears.

Dhoomrapanam: Inhalation of medicated smoke from a lighted medicated wick made of cotton or silk dipped in medicinal juices or a cheroot made of dried herbs like turmeric.

This is a Rukshana or drying therapy and helps the soft sinus tissues to absorb nasya oils. Smoking herbal fumes also helps to reduce kapha in the throat and sinuses. Anyone below 18 years of age is not offered a dhoomrapanam treatment.

all information contained here is cited from:

‘Ashtanga Sangraha’ translated by Prof. K. R. Srikantha Murthy

Various Ayurveda texts, Dr. Valiathan

‘A Comprehensive Guide to Ayurveda’ by Dr. Frank Ninivaggi.

Medical information reviewed by Dr. Vignesh Ramanathan Devaraj of Sitaram Ayurveda

Images courtesy – CGH Hotels

Want to read more Ayurveda? I am happy to be featured as one of the top 30 Ayurveda blogs on Feedspot.