Curated Journaling 1

 Ayurveda is the concept of a beautiful, yet rather delicate, balance and integration that exists between the mind, body, spirit, and environment. It “entails a scientific tradition of harmonious living” (Mukherjee et al, 2016). In correspondence with the theme of this course, we will be primarily investigating the balance between body systems, between the body and mind, and the balance between the body and its external environment. When these balances are supported, the result is a functional being with the ability to thrive. However, if these balances are disturbed, the consequences can be detrimental. Although, it is important to note that not every imbalance will have critical implications. The body is resilient, and it is designed to respond and adapt. It is important to be able to differentiate between prolonged, major imbalances, and small deviations that the body can accommodate for and/or fix. A question that has frequently crossed my mind throughout the duration of my studies thus far is where is the line drawn between these two different occurrences? This will be discussed in the following paragraph. 

As previously mentioned, for me, there is a small gray area that exists between insignificant deviations and critical imbalances. At what point should one become concerned about an abnormality? When does a fluctuation or imbalance result in pathology? These are reasonable questions. In fact, these are questions that healthcare professionals must ask themselves almost every day. I was inspired to use previous course materials in order to help differentiate between the two concepts. I was recently enrolled in a physiology course; physiology is the broad study of the functions and mechanisms in living organisms. A word that one will hear quite often in any physiology course is homeostasis. Homeostasis is a term that might be likened to ayurveda, they are related concepts. However, the two terms differ slightly in their exact interpretations. Homeostasis is much like a balance – it is the state of steady internal chemical and physical conditions that living systems maintain. When homeostatic imbalances occur, there are positive and negative feedback mechanisms unconsciously employed to return the living system back to its proper state. Nevertheless, if the deviation is critical enough or the feedback loop fails, a more significant imbalance can occur. Ultimately, this can potentially result in a serious pathology. Conversely, Ayurveda is a more general idea that refers to the stable balance that exists between the mind, body, spirit, and environment of living systems. In conclusion, I believe that homeostatic imbalance is slightly different from ayurvedic imbalance, but it can also promote ayurvedic imbalance. It can be hypothesized that prolonged and/or severe homeostatic imbalances within an organism or its environment lead to ayurvedic imbalance and disease causation.

In order to better understand how imbalances occur, where they occur, and the cascading effects of particular imbalances, one must first be familiar with metabolic pathways. Metabolism is another general term quite frequently used in biological courses such as physiology, microbiology, cell and molecular biology, and biochemistry. Metabolism is defined as “the chemical changes that take place in a cell or organism” (NCI, 2024). These chemical changes are responsible for producing the energy and materials required by cells and organisms to grow, differentiate, replicate, and function properly. Functioning metabolic pathways promote ayurvedic balance in the body. The large majority, if not all of, metabolic pathways must be heavily regulated in order to maintain homeostatic balance within the body. This regulation is vital in ensuring the proper outcomes of pathways. In spite of that, if the concentration, temporal and/or spatial order, or charges of metabolites within the pathways are disrupted, then the results could be disastrous. Dysfunctional or imbalanced metabolic pathways are oftentimes causative of severe pathologies. To emphasize the sheer exactness observed within metabolic pathways, I would like to draw on a topic from previous coursework discussed in cell and molecular biology. Metabolic pathways are regulated by numerous mechanisms, one of which are receptor mediated pathways. These pathways rely on specific metabolite-receptor interactions as a means of triggering recognition and response mechanisms. Considering the multitude of pathways involved in human physiology, one might imagine that there is an equally large number of receptors, and this is true! Consequently, receptors are highly diverse and specialized to bind incredibly specific targets, or what can be referred to as ligands. An example of a familiar receptor mediated metabolic pathway is the insulin mediated GLUT4 pathway. This pathway is responsible for regulation of blood glucose, it maintains proper balance of glucose between cells and the blood. When this pathway experiences imbalance, it is very common to observe pathology. Diabetes is the most commonly observed disease that results from dysregulation of the insulin-GLUT4 pathway.

According to the CDC, diabetes is amongst the top ten most prevalent chronic diseases in the United States (2024). There are two types of diabetes, each with different underlying causes. Type I DM is an autoimmune dysfunction, and it occurs in those who have a genetic predisposition. Cells of the body’s immune system begin to recognize insulin producing cells as foreign or threatening and they attack these cells. As a result, individuals with T1DM suffer from insufficient insulin production. Conversely, Type 2 DM generally occurs due to adjustable lifestyle factors, and it results in desensitized insulin receptors. While these diseases occur due to different dysfunctions, they both result in hyperglycemia and a decreased ability to regulate blood glucose. It is important to note that approximately 90%-95% of individuals with diagnosed diabetes suffer from T2DM (U.S. House of Representatives, Diabetes Caucus, 2024). In correspondence with the overarching theme of this course, diabetes, and specifically T2DM, is a great example of a pathology caused by an ayurvedic imbalance. Further investigation has led to the conclusion that the most pertinent ayurvedic imbalances correlated with diabetes include, but are not limited to, poor diet, physical inactivity, overweight and obesity, and high levels of oxidative stress and inflammation (NIDDK, 2024). Furthermore, the direct physiological imbalances caused by diabetes oftentimes result in further imbalances of implicated body systems, particularly cardiovascular and renal complications (Matheus et al, 2013) and (Kumar et al, 2023).

Unfortunately, just as the diagnosed individual will experience suffering associated with their diabetes diagnosis, society as a whole is also adversely affected. In conjunction with the substantial number of people living with diagnosed diabetes, the costs related to the disease are rather large as well. The American Diabetes Association (ADA) estimated that there was $245 billion in costs in 2012 related to individuals with diagnosed diabetes. In 2022, this amount was nearly doubled with costs summing to a whopping $413 billion (ADA, 2023). While these numbers are significant, they are not surprising. In my own time spent working as a patient care technician on the medical/surgical floor of a rural hospital. I would estimate that approximately 25% of patients that spent time in the unit had diagnosed T2DM. This personal observation aligns with the statistic that one in every five healthcare dollars is spent on care for individuals with diagnosed diabetes (ADA, 2012). One might ask the question: how are these costs accrued? There are obvious costs associated with managing the disease – insulin, diagnostic tools, and direct care related to treating the disease. Moreover, a majority of the financial burden can be attributed to providing care for the negative implications of the disease on other body systems. In true ayurvedic nature, the body systems are all intricately designed to overlap and work together. When imbalance occurs in one physiological system, others are affected. As previously noted, an individual living with diagnosed diabetes is at a particularly high risk for severe cardiovascular, neural, and renal dysfunction as well. These complications are rather major and costly. Nevertheless, it must be noted that these complications can potentially be mitigated if one is diligent in controlling their diabetes.

As noted in the previous paragraph, the increase in the prevalence of diagnosed diabetes is nothing short of alarming. What can be done to alleviate the suffering of those living with diagnosed diabetes? What can be done to decrease the financial burden that society faces regarding the disease? These are questions that riddle healthcare workers, policy makers, and businesses alike. Stemming from the ancient ideas of ayurveda is traditional ayurvedic medicine. Ayurvedic medicine aims to treat the whole patient, and not just the disease. An ayurvedic treatment approach emphasizes the uniqueness of each individual observed – bio-identity, SES, biochemical and physiological conditions (Mukarjee et al, 2016). When creating an ayurvedic treatment plan, there are three objectives: 1) the treatment should target the underlying cause of the disease, not just the symptoms, 2) the treatment should educate and inform the patient of the underlying cause of the disease, and 3) the treatment should aim to balance the physical, mental, and spiritual functions of the patient. Traditional allopathic medicine has revolutionized the way our society treats illnesses. However, utilizing a treatment approach that combines the cutting edge technology and pharmaceuticals offered through allopathic medicine with the traditional, holistic approach ayurvedic medicine emphasizes, could offer great value to individuals and society.