Potential of Guduchi-Tinospora cordifolia (Willd.) Miers. (.) in the management of lifestyle disorders: a comprehensive review

Aishwarya A Joglekar; Mahesh K Vyas; Meera K Bhojani

doi:10.4103/jism.jism_24_22

REVIEW ARTICLES

Year : 2022 | Volume : 10 | Issue : 2 | Page : 90-103

Potential of Guduchi-Tinospora cordifolia (Willd.) Miers. (.) in the management of lifestyle disorders: a comprehensive review

Aishwarya A Joglekar¹, Mahesh K Vyas¹, Meera K Bhojani²
¹ Department of Samhita Siddhant, All India Institute of Ayurveda, New Delhi, India
² Department of Sharir Kriya, All India Institute of Ayurveda, New Delhi, India

Date of Submission	05-Mar-2022
Date of Acceptance	27-May-2022
Date of Web Publication	28-Jun-2022

Correspondence Address:
Aishwarya A Joglekar
Department of Samhita Siddhant, All India Institute of Ayurveda, New Delhi
India

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jism.jism_24_22

Abstract

Introduction: Lifestyle disorders such as dyslipidemia, hypertension, diabetes mellitus, chronic obstructive pulmonary disorders (COPD), stroke, and cancer pose a great risk to mankind aggravating cardiovascular manifestations leading to increased morbidity and mortality in population. The major causes of such disorders include faulty lifestyle comprising of a variety of factors including smoking, alcohol consumption, use of tobacco and other narcotic substances, sedentary lifestyle, and stress. Ayurveda promotes the use of potent herbs or herbal combination for the mitigation of various disorders. Guduchi (Tinospora cordifolia Willd. Miers. (.)) is one such herb widely used in Ayurveda in the preventive and treatment process of almost all the diseases. It is therefore also indicated for the purpose of prevention, management of lifestyle disorders, and the complications of the same. Materials and Methods: This review tries to focus on the applications of this multidimensional herb in the management of lifestyle disorders such as diabetes mellitus, obesity, cardiovascular disorders, COPD, and cancer. The relevant research by the contemporary sciences on the subject along with classical Ayurveda text-based references and indications of Guduchi in related conditions according to Ayurveda is discussed in the article. Discussion: The literary review suggests that many research works have been conducted in this arena to prove the efficacy of this wonder herb, and its constituents are also mentioned to underline the evidences. The references from the Ayurveda texts also underline the multidimensional activity of Guduchi on different body Strotasa. Conclusion: The ancient treasure of knowledge coupled with the scientific validation supports the multidimensional activity of Guduchi.

Keywords: Ayurveda, Guduchi, lifestyle disorders, multidimensional activity, pharmacological profile, Tinospora cordifolia (Willd.) Miers

How to cite this article:
Joglekar AA, Vyas MK, Bhojani MK. Potential of Guduchi-Tinospora cordifolia (Willd.) Miers. (.) in the management of lifestyle disorders: a comprehensive review. J Indian Sys Medicine 2022;10:90-103

How to cite this URL:
Joglekar AA, Vyas MK, Bhojani MK. Potential of Guduchi-Tinospora cordifolia (Willd.) Miers. (.) in the management of lifestyle disorders: a comprehensive review. J Indian Sys Medicine [serial online] 2022 [cited 2023 Jun 7];10:90-103. Available from: https://www.joinsysmed.com/text.asp?2022/10/2/90/348473

Introduction

The world has undergone revolutionary changes in all the vistas of technological, social, and socio-behavioral fields. With the advent of globalization and digitalization, the modernized or especially the westernized way of living has sowed its seeds into the culture and lifestyle of entire world. Lifestyle disorders are a resultant of this paradigm shift contributing to a major burden on the health system. Lifestyle disorders such as dyslipidemia, hypertension, diabetes mellitus, chronic obstructive pulmonary disorders (COPD), stroke, and cancer not only pose a great risk to cardiovascular manifestations but also are leading causes of mortality.^[1] The main cause of such disorders includes faulty lifestyle comprising of factors such as smoking, alcohol consumption, use of tobacco and other narcotic substances, sedentary living, and stress. These are also termed as chronic, non-communicable, degenerative disorders accounting for physical and psychological disability.^[2] It is important to note that the conventional system of medicine has scarcity of solutions for the treatment and prevention of such lifestyle disorders. Ayurveda is probably the only system of medicine having potential to prevent and even completely treat such disorders promoting holistic wellbeing. Ayurveda promotes the use of potent herbs or a herbal combination for the mitigation of a range of such disorders. It advocates the idea of treating the individual by using the drug as a whole and not merely the extracts or components of the drug. One single herb thus can have multidimensional applicability and targeted response pertaining to multiple organs and human systems. Guduchi (Tinospora cordifolia Willd. Miers. (.)) is such herb widely used in Ayurveda in the mitigation or initiation of treatment process of almost all the diseases. It can therefore be explored for its potential in the prevention and management of lifestyle disorders and their complications. This article throws light on the therapeutic application of Guduchi in the major lifestyle disorders such as diabetes mellitus, obesity, COPD, cardiovascular diseases, and cancer. The references mentioned in the Ayurveda classics and recent advances pertaining to therapeutics and research in conventional medicine were thoroughly searched to fill the knowledge gap and support the claims registered.

Data Source

The available literatures pertaining to the therapeutic and pharmacological aspects of Guduchi according to Ayurveda and contemporary medical sciences were searched to extract the related advances of research done on Guduchi (T. cordifolia (Willd.) Miers.). The classical references pertaining to the inclusion of Guduchi and its formulations in the treatment of disorders such as Prameha, Sthoulya, Hridroga, Kasa, Shwasa, and Rajayakshama, Arbuda-Granthi Chikitsa were searched for in Charaka Samhita, Sushruta Samhita, Vagbhatt Samhita (both Ashtang Hridaya and Ashtang Sangraha), Chakradatta, and Bhaishajya Ratnavali. Online medical literature libraries such as PubMed Online, Google Scholar, and AYUSH Portal were searched for the research on the drug. Vast literature was found related to advances in research in context to the concerned herb. The various preclinical and clinical studies were found, highlighting the applicability of the drug in the management of almost every condition. Concerning the field of Ayurveda, the research related to systematic reviews of mention of the herb in Samhita and a range of clinical studies were also found.

Pharmacological Profile of Guduchi

T. cordifolia (Guduchi) is a large, glorious, perennial, deciduous, climbing shrub of weak and fleshy stem that grows abundantly throughout India. In recent times, Guduchi has gained its due respect through the extensive and evidence-based research. It has been studied for its biochemical, physicochemical, and phytochemical properties for the in-vitro and in-vivo models along with numerous randomized controlled trials and other large-scale clinical studies. A variety of active components derived from the plant such as alkaloids, steroids, triterpenoid lactones, aliphatic compounds, and glycosides have been isolated from the different parts of the plant body, including stem, root, and whole plant.^[3] It has been assessed for its antioxidant, immunomodulatory, analgesic, anti-inflammatory, antibiotic, hypoglycemic, anti-hyperglycemic, hypolipidemic, anti-arthritic, anti-spasmodic, adaptogenic, and anti-neoplastic activity. Guduchi is a strong neuroprotective, hepatoprotective, immunomodulatory cytotoxic drug. Its isolated phytoconstituents and extracts such as tinosporin, berberine, and mangnoferrin are also studied for their varied activities. It is indicated in the range of disorders such as fever, jaundice, diabetes mellitus, helminthic infestations, arthritis, cancer, acid peptic disorders, diarrhea, anorectal disorders, and skin diseases. This multidimensional activity proves its immense potential for the management of lifestyle disorders.^[4] According to the literature pertaining to Ayurveda,^[5] it is Katu-Tikta-Kashaya Rasatmaka (pungent, bitter, astringent in taste), Madhura Vipaki (sweet biotransformed rasa), Ushna Virya (hot potency) climber having Rasayana (rejuvenating), Sangrahi (absorbent), Balya (beneficial for strength), Agnideepana (appetizing or carminative) properties helpful in the pacification of Tridosha, Ama and indicated in disease conditions such as Trushna (thirst), Daha (burning sensation), Prameha (diabetes), Kaasa (cough or respiratory problems), Pandu (anemia), Kamala (jaundice), Kushtha (skin diseases), Anaha (distension), Jwara (pyrexia), Krimi (helminthic or microbial infestations), Vami (emesis), and so on. It acts mainly on the Rasavaha Strotas (channels carrying rasa dhatu) further strengthening all the other Strotas (physiological channels and systems of body). It thus acts multidimensionally on the multiple systems of the body providing complete health and remission of lifestyle-related problems. [Figure 1] highlights the same.

Figure 1: Multidimensional activity of Guduchi in the management of major lifestyle disorders based on its pharmacological action

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The effects of pharmacological constituents of Guduchi in the management of lifestyle disorders are explained in [Table 1]. The Ayurveda-based pharmacological array of Guduchi is also explained in [Table 2].

Table 1: Pharmacological aspects of Guduchi helpful in the management of lifestyle disorders

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Table 2: Ayurveda-based pharmacological array of Guduchi^[35]

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This study is an attempt to extract the relevant information regarding the domains of Guduchi that can address the most pressing lifestyle disorders such as diabetes, obesity, cardiovascular disorders, cancer, and COPD. Few important active constituents are also studied to determine the therapeutic potential of the herb.

Guduchi in Diabetes Mellitus

Diabetes mellitus is the leading cause of death and disability across the globe imposing a great economic and health burden on the society. Type 1 diabetes related with the immune function and the malfunctioning of the cells of Langerhans in pancreas, resulting in little or no production of insulin. Type 2 diabetes is the abode of various metabolic diseases having potent cardiovascular risks. Here insulin resistance in the peripheral organs and cells progressively results into the malfunctioning of the cells of Langerhans.^[36] Type 1 thus involves immune and degenerative pathology, whereas type 2 has inflammatory and regulatory mechanism. The main goal of treatment of diabetes involves both decreasing mortality and alleviating symptoms, i.e., reducing morbidity and normalizing blood sugar levels. Guduchi can hence help in the effective management of the condition through its multitargeted approach as it addresses both the inflammatory and degenerative mechanisms. It helps to manage both the complications of disease and lowering of blood sugar levels. According to Ayurveda, diabetes is commonly compared with the disease Prameha. The Nighantu texts like Raja-nighantu and Bhavaprakash nighantu mention its Pramehahara, Mehahara, and Mehaghna properties.^[37] Guduchi is indicated in various Santarpanjanya Vyadhi, which represents the disease arising from the sedentary and faulty lifestyle.^[38] It is also indicated in Kwatha (decoction) form in the different types of Prameha including Kaphaja and Pittaja Prameha.^[36] It possesses Tridosha-shamaka, Amapachaka, Yakruttoejaka (hepatostimulant), Laghu (promotes lightness in body), Agnideepana (metabolic enhancer), and Rasayana properties making it optimum for the treatment of Prameha. In the recent times, extensive research on this herb has reinstated its utility as a potent hypoglycemic and anti-hyperglycemic agent in [Table 3].

Table 3: Recent researches on antidiabetic potential of Guduchi

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The pathology of diabetes involves the disturbed metabolism of fat as well, and the obesity and deranged lipid profile also alter the blood sugar level. It is therefore recommended that the management of lipid disorders is pivotal for the treatment of diabetes. Due to its anti-obesity and lipid-lowering action, it also helps to correct the dyslipidemia associated with diabetes and insulin resistance, further correcting the pathology of diabetes. Preclinical researches have proved that in gestational diabetes mellitus (GDM), the dietary supplements of the plant showed significant protection against the diabetes-related maternal and fetal oxidative stress,^[44] thus indicating the safety of Guduchi in pregnancy-related conditions as well. Due to aforesaid immunomodulatory, antioxidant, and immune-regulatory activity, it helps in improving the quality of life of diabetics by acting as a rejuvenator, tonic, hematinic, cardioprotective agent. It also helps to counter the complications and signs and symptoms related to the consumption of oral hypoglycemic agents. It is thus a principle component of many commercial Ayurvedic antidiabetic drugs such as Diabecon (Himalaya Company product), Diasulin, and Diabeta (developed by Ayurveda Cure Herbal Products company).^[40] It can work miracles in the control of diabetes when used in combination with the other hypoglycemic drugs such as Jambu (Syzygium cumini), Amalaki (Emblica officinalis Gaertn.), Gudamar (Gymnema sylvestre), Kutaja (Holarrhena antidysenterica), and so on.^[45] Many formulations are being developed in the Ayurveda pharmaceutical industry to explore this potential of Guduchi as an antidiabetic agent.

Guduchi in Obesity

Obesity is again a malnutrition or disturbed metabolism-related disorder in which there is imbalance in the intake and consumption of the energy again resulting from hereditary and lifestyle-related issues. There is disturbance in the lipid metabolism resulting from the pathology of adipocytes and adipokines. This mainly represents itself as an increase in levels of cholesterol, triglycerides, LDLs, and reduction in the HDLs.^[46] Obesity involves chronic low grade inflammatory pathology that can lead to atherosclerosis and endothelial damage. Guduchi being a lipid-lowering drug, its anti-inflammatory potential also helps to a great extent in preventing the cardiovascular manifestations. In Ayurveda, this condition is comparable to Sthoulya which invloves pathology related to Rasa and Meda Dhatu. It is again a type of Santarpanjanya Vyadhi resulting from Kapha Dosha and Ama Dushti. Hence, Guduchi is indicated as a drug of choice in this condition. The Guduchi-Bhadra-Mustadi Yoga indicated in the Sthoulya Chikitsa is thus very potent in the effective management of the condition and is used by many practicing Vaidyas for the successful management of obesity.^[37] Recent researches on Guduchi reveal many insights on its anti-obesity action proving it to be a safer, precise option for the management of obesity [Table 4].

Table 4: Recent researches on anti-obesity potential of Guduchi

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Thus Guduchi here acts as a Medo-doshara Rasayana (pacifying the vitiation of the Meda Dhatu), thus also reducing the harmful effect on the other Strotas.

Guduchi in Cardiovascular Disorders

As mentioned earlier, Guduchi is the best Rasayana drug helpful in maintaining and promoting the functioning of a range of Dhatu or organ systems. It has immunomodulatory potential thus providing potent cardioprotective action. The antioxidant, anti-inflammatory, and anti-hyperlipidemic activities of Guduchi also aid in providing the improved cardiac health. Being a Medhya Rasayana (promoting intellectual faculties), it has effect on reducing the stress, anxiety, and related psychosomatic conditions.^[50] Stress being an important triggering factor for the cardiovascular-related conditions such as hypertension, ischemic heart disease, and stroke, Guduchi can help to pacify this condition.^[51]Acharya Charaka has mentioned various yogas containing Guduchi in the management of Hridroga in the Chikitsasthana of Charak Samhita like Haritakyadi Ghrita in Vataja Hridroga, Bramha Rasayana, Agastya Rasayana, and so on.^[52] The review of recent researches on the cardioprotective activity of Guduchi can be summarized in [Table 5].

Table 5: Recent researches on cardioprotective potential of Guduchi

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Guduchi in COPD

This condition has resulted as a repercussion of industrialization and globalization. Smoking is the main cause of the initiation and exaggeration of this condition. It is the condition comprising chronic bronchitis, emphysema-like pathology that causes the irreversible or partially reversible obstruction of the airflow into the lung tissue. This results from the inflammatory response of the lung to dust, smoke, and gases. This can result in lung fibrosis, loss of lung elasticity, mucus hypersecretion, and closure of small airways.^[58] It involves many dietary factors such as deficiency of vitamin C and other micronutrients and lifestyle-related factors such as tobacco smoking, air pollution (indoor and outdoor), alcohol, low socio-economic status, occupation-related causes, and so on, making it a potent lifestyle disorder highlighting the importance of lifestyle changes for the same. Guduchi is again an important herb for the management of Pranavaha Strotas Vyadhi. It has been indicated in the Samhita for the treatment of conditions such as Shwasa, Kasa, and Rakshasa.^{[59],[60],[61]} It is an important component of various Yusha (medicated soups) explained in Shwasa Chikitsa, formulations like Chitrakadi Leha in Kaphaja Kaasa, Guduchyadi Ghrita in Kshayaja Kasa. Guduchi has potent immunomodulatory activity combined with antioxidant properties rendering it to be a strong respiratory tonic which can help in the management of complications such as recurrent respiratory tract infections, pnuemothorax, weight loss in patients with COPD, pulmonary hypertension, chronic cor pulmonale, and right heart failure related to COPD. The recent researches with purview of the respiratory tonic and immunomodulatory potential of Guduchi are summarized in [Table 6].

Table 6: Recent researches on potential of Guduchi in respiratory conditions

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Guduchi in Cancer

Cancer is again an emerging health problem proving to be a major cause of mortality and morbidity across the globe. It is unorganized uncontrolled growth of cells leading to the invasion of normal tissues and cell functioning. There are defects at the gene level resulting in the untoward proliferation of cells. There are many carcinogenic factors such as smoking, tobacco chewing, radiation, and use of irritants that emerge from the faulty lifestyle.^[68] Cancer is thus a result of long-term cell inflammation and cell injury. In conditions such as obesity, insulin sensitivity, diabetes, and metabolic syndrome, there is hyperadiposity resulting in chronic low-grade inflammation, thus increasing the susceptibility of cancer.^[69] Guduchi is helpful in the management of all such disorders along with the inflammatory conditions making it the drug of choice for the preliminary management of any type of cancer, especially in early stages. Guduchi has also been studied for its anti-cancer effects, specially to avoid post-chemotherapy and post-radiation complications. It has cytotoxic, anti-inflammatory, antioxidant radical scavenging, immunomodulatory and anti-proliferative activities, enhancing its anti-neoplastic activity.^[70],[71] This can be summarized in [Table 7].

Table 7: Recent researches on anti-cancer/anti-neoplastic/cytotoxic potential of Guduchi

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Besides the preventive potential of Guduchi in the treatment of various types of cancers, its curative value cannot be undermined as well. Different formulations of Guduchi including Guduchi Kwath, Guduchi Sattva, Guduchi Swarasa, Guduchi Choorna, Guduchi Ghana Vati, and Rasayana Choorna Vati are used for the betterment of patient conditions in leukemia, breast cancer, oral cancer, gastrointestinal tumors, etc. and are a part of routine practice among the Ayurveda physicians.^[78] In this case, the Guduchi acts as a Dhatuposhaka (tonic for the Dhatu), Amapachaka, Rasayana Dravya, managing the vitiation of Tridosha and Triguna (Sattva, Raja, and Tama). A cell line study on the evaluation of combinatorial effect of T. cordifolia and Zingiber officinale on human breast cancer cells showed the synergistic effect of Guduchi and Shunthi, resulting in the targeted gene action along with the apoptosis of the cancer cells.^[79] The studies have proven that the Guduchi grown on the trees of neem (Azadirachta indica) and mango (Mangifera indica) has better activity not only against cancer but also against other diseases.^[80] Thus it has unexhausted potential for the treatment, prevention, and palliation of cancer.

The mention of Guduchi in the chapters resembling these major lifestyle disease conditions according to Ayurveda across varied Samhita and ancient texts is discussed in [Table 8]. These highlight the multidimensional activity of the drug along with its different dosage forms under various conditions [Table 8].

Table 8: Mention of Guduchi in lifestyle disorders according to Ayurveda

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Discussion

Lifestyle disorders are posing a great threat to the health of every individual due to the westernization of diet and lifestyle.^[141] The technological advancements contribute to the sedentary lifestyle and work-related stress. There is a great disparity between the need and usage of calories and energy causing nutritional starvation, leading to downregulation of the functioning of the body systems. The metabolic resistance leads to adiposities, insulin resistance, endothelial dysfunction, and chronic inflammation leading to worsening of the condition. Diabetes, obesity, cardiovascular diseases, cancer, and COPD are the resultant of the faulty lifestyle and have all the above-enlisted pathologies in common. These are chronic, non-communicable disorders that are difficult to manage and can progress into more severe and morbid chronic conditions. The conventional medicinal system lacks in the domain of prevention and effective management of these conditions, for which the traditional systems of medicine like Ayurveda can provide holistic solutions.^[142] Guduchi is one such herb mentioned in Ayurveda having multidimensional utility and attributes helpful in correcting the pathology at Dosha and Dhatu levels. It thus helps in improving in the quality of life by preventing the complications and chronicity of the enlisted disorders. It has a potential effect on almost all the Strotasa in the body and has Tridosha Shamaka and Ama Doshahar effect on the body. It is indicated in the treatment of all these disorders according to Ayurveda. The different classical and proprietary formulations containing Guduchi are easily available in the market and are extensively used by the practitioners to reap encouraging results of the drug. In recent times, extensive researches are carried out to explore the therapeutic utility for validation of claims made by Ayurveda. The pharmacological and the contemporary researches also generate the evidence. This can be determined by the robust evidences in the domains of in-vitro, in-vivo, and clinical research done on the herb. The pharmacological framework of Guduchi reveals many important constituents such as alkaloids, glycosides, sterols, carbohydrates, proteins, and micro-nutrients beneficial in all the disorders mentioned earlier. The different alkaloids such as tinosporin, berberine, choline, magnoflorine, palmetine, and isocolumbin act on the biochemical and inflammatory markers of all the enlisted disorders. The glycosides such as Tinocordiside, Tinocordifolioside, Cordioside, and Cordifolioside have tissue protective activities. The natural steroids like Beta-sitosterol and Gamma-sitosterol also help to maintain the metabolism. It is rich in almost all the macro and micronutrients, thus enhancing the nutraceutical activity of the herb. The anti-inflammatory, antioxidant, immunomodulatory, adaptogenic, and cytotoxic properties of Guduchi lie at the epicenter of its multidimensional action. Researches have proved that it can act as potent antidiabetic, anti-obesity/hyperlipidemic, cardioprotective, respiratory tonic, and anti-neoplastic herbs and hence can be used in the management of conditions such as diabetes mellitus, obesity, cardiovascular disorders, COPD, and cancer, respectively. It can be implemented in daily life as a nutraceutical or supplementary food to make it an indispensable part of daily life. When coupled up with lifestyle changes, Guduchi in the form of Swarasa or freshly prepared juice or even in the powdered form can help in reversal in these conditions. It can be made as a part of daily lifestyle. The healthy lifestyle including avoidance of calorie-rich foods, fatty diets, regular exercise, and optimized mental health status is essential to obtain the benefits of consumption of Guduchi.

Conclusion

Lifestyle disorders are both pressing and emerging problem in the society with varied etiological factors and clinical presentations. The contemporary sciences to a great extent fail to cater to the holistic preventive aspects of such disorders. Guduchi has been in practice for the treatment of all kinds of ailments since times immoral. Its multidimensional activity can thus help in the management and prevention of lifestyle disorders such as diabetes, obesity, cancer, COPD, and cardiovascular diseases. Many research works have been conducted in this arena to prove the efficacy of this wonder herb and its chemical constituents to underline the evidences. The ancient treasure of knowledge coupled with the scientific validation supports the hypothesis. There is tremendous scope for further research on the various aspects of the pharmacological diversity and action of Guduchi. Thus it is boon for the physicians which should be exploited to its maximum limit to reap the health benefits.

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Conflicts of interest

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References

1.	Freisling H, Viallon V, Lennon H, Bagnardi V, Ricci C, Butterworth AS, et al. Lifestyle factors and risk of multimorbidity of cancer and cardiometabolic diseases: A multinational cohort study. BMC Med 2020;18:5.
2.	Non Communicable Diseases [Internet] [cited February 14, 2022]. Available from: https://www.who.int/westernpacific/health-topics/noncommunicable-diseases. [Last accessed on March 22, 2022].
3.	Srivastava AK, Singh VK Tinospora cordifolia (GILOY): A magical shrub. Asian J Adv Med Sci 2021;3:22-30.
4.	Saha S, Ghosh S Tinospora cordifolia: One plant, many roles. Anc Sci Life 2012;31:151-9.
5.	Sharma R, Amin H, Ruknuddin G, Prajapati P. Therapeutic vistas of Guduchi (Tinospora cordifolia (Willd.) Miers): A medico-historical memoir. J Res Educ Indian Med 2014;20:121-35.
6.	Ajebli M, Khan H, Eddouks M Natural alkaloids and diabetes mellitus: A review. Endocr Metab Immune Disord Drug Targets 2021;21:111-30.
7.	Sharma P, Dwivedee BP, Bisht D, Dash AK, Kumar D The chemical constituents and diverse pharmacological importance of Tinospora cordifolia. Heliyon 2019;5:e02437.
8.	Shah SMA, Akram M, Riaz M, Munir N, Rasool G Cardioprotective potential of plant-derived molecules: A scientific and medicinal approach. Dose Res 2019;17:1559325819852243.
9.	Prasher P, Sharma M, Mehta M, Paudel KR, Satija S, Chellappan DK, et al. Plants derived therapeutic strategies targeting chronic respiratory diseases: Chemical and immunological perspective. Chem Biol Interact 2020;325:109125.
10.	Lu JJ, Bao JL, Chen XP, Huang M, Wang YT Alkaloids isolated from natural herbs as the anticancer agents. Evid Based Complement Alternat Med 2012;2012:485042.
11.	Khattak S, Khan H Phyto-glycosides as therapeutic target in the treatment of diabetes. Mini Rev Med Chem 2018;18:208-15.
12.	Abdel-Sattar E, Mehanna ET, El-Ghaiesh SH, Mohammad HMF, Elgendy HA, Zaitone SA Pharmacological action of a pregnane glycoside, russelioside B, in dietary obese rats: Impact on weight gain and energy expenditure. Front Pharmacol 2018;9:990.
13.	Timalsina D, Pokhrel K, Bhusal D Pharmacologic activities of plant-derived natural products on respiratory diseases and inflammations. BioMed Res Int 2021;2021:1-23.
14.	Glycosides from medicinal plants as potential anticancer agents: Emerging trends towards future drugs—PubMed [Internet] [cited February 11, 2022]. Available from: https://pubmed.ncbi.nlm.nih.gov/29611474/. [Last accessed on April 3, 2022].
15.	Reddy NM, Rajasekhar Reddy N. Tinospora cordifolia chemical constituents and medicinal properties: A review. Sch Acad J Pharm 2015;4:364-9.
16.	Wang JF, Zhang HM, Li YY, Xia S, Wei Y, Yang L, et al. A combination of omega-3 and plant sterols regulate glucose and lipid metabolism in individuals with impaired glucose regulation: A randomized and controlled clinical trial. Lipids Health Dis 2019;18:106.
17.	Kim HP, Lim H, Kwon YS Therapeutic potential of medicinal plants and their constituents on lung inflammatory disorders. Biomol Ther (Seoul) 2017;25:91-104.
18.	Poli A, Marangoni F, Corsini A, Manzato E, Marrocco W, Martini D, et al. Phytosterols, cholesterol control, and cardiovascular disease. Nutrients 2021;13:2810.
19.	Grattan BJ Jr. Plant sterols as anticancer nutrients: Evidence for their role in breast cancer. Nutrients 2013;5:359-87.
20.	Pandey V, Vaishya J, Balakrishnan P, Nesari T Nutritional aspects of Tinospora cordifolia (Giloe). Medicinal plants. Int J Phytomed Relat Ind 2020;12:158.
21.	McRae MP Dietary fiber intake and type 2 diabetes mellitus: An umbrella review of meta-analyses. J Chiropr Med 2018;17:44-53.
22.	Dietary Fiber is Beneficial for the Prevention of Cardiovascular Disease: An Umbrella Review of Meta-analyses [Internet] [cited February 11, 2022]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5731843/. [Last accessed on March 22, 2022].
23.	Kan H, Stevens J, Heiss G, Rose KM, London SJ Dietary fiber, lung function, and chronic obstructive pulmonary disease in the atherosclerosis risk in communities study. Am J Epidemiol 2008;167:570-8.
24.	Shankar S, Lanza E Dietary fiber and cancer prevention. Hematol Oncol Clin North Am 1991;5:25-41.
25.	McMacken M, Shah S A plant-based diet for the prevention and treatment of type 2 diabetes. J Geriatr Cardiol 2017;14:342-54.
26.	Kahleova H, Fleeman R, Hlozkova A, Holubkov R, Barnard ND A plant-based diet in overweight individuals in a 16-week randomized clinical trial: Metabolic benefits of plant protein. Nutr Diabetes 2018;8:58.
27.	Hu FB Protein, body weight, and cardiovascular health. Am J Clin Nutr 2005;82:242S-7S.
28.	Yazdanpanah L, Shidfar F, Moosavi AJ, Heidarnazhad H, Haghani H Energy and protein intake and its relationship with pulmonary function in chronic obstructive pulmonary disease (COPD) patients. Acta Med Iran 2010;48:374-9.
29.	Naghshi S, Sadeghi O, Willett WC, Esmaillzadeh A Dietary intake of total, animal, and plant proteins and risk of all cause, cardiovascular, and cancer mortality: Systematic review and dose–response meta-analysis of prospective cohort studies. Br Med J 2020;370:m2412.
30.	Chehade JM, Sheikh-Ali M, Mooradian AD The role of micronutrients in managing diabetes. Diabetes Spectr 2009;22:214-8.
31.	Garcí a OP, Long KZ, Rosado JL Impact of micronutrient deficiencies on obesity. Nutr Rev 2009;67:559-72.
32.	Micronutrients and Cardiovascular Health [Internet]. @nutri-facts [cited February 12, 2022]. Available from: https://www.nutri-facts.org/en_US/news/articles/micronutrients-and-cardiovascular-health.html.
33.	Zhai T, Li S, Hu W, Li D, Leng S Potential micronutrients and phytochemicals against the pathogenesis of chronic obstructive pulmonary disease and lung cancer. Nutrients 2018;10:813.
34.	The Ayurvedic Pharmacopoeia of India. Part I. 1st ed. New Delhi: Department of AYUSH, Ministry of Health and FW; 2001. p. 53-5.
35.	Banday MZ, Sameer AS, Nissar S Pathophysiology of diabetes: An overview. Avicenna J Med 2020;10:174-88.
36.	Sharma R, Amin H, Galib, Prajapati PK Antidiabetic claims of Tinospora cordifolia (Willd.) Miers.: Critical appraisal and role in therapy. Asian Pac J Trop Biomed 2015;5:68-78.
37.	Charaka Samhita, Sutra Sthana, Santarpaniya Adhyaya, 23/3–8, Available from: http://niimh.nic.in/ebooks/echarak. [Last accessed on November 22, 2021].
38.	Charaka Samhita, Chikitsa Sthana, Prameha Chikitsa Adhyaya, 6/50, Available from: http://niimh.nic.in/ebooks/echarak. [Last accessed on November 22, 2021].
39.	Sahu R, Mohapatra TK, Subudhi BB Drug interaction potential of Tinospora cordifolia: A review. Res J Pharm Technol 2018;11:5179-83.
40.	Modak M, Dixit P, Londhe J, Ghaskadbi S, Devasagayam TP Indian herbs and herbal drugs used for the treatment of diabetes. J Clin Biochem Nutr 2007;40:163-73.
41.	Manjunath SE, Nayak RP, V KG, Rai M Evaluation of hypolipidemic effect of Tinospora cordifolia in cholesterol diet induced hyperlipidemia in rats. Int J Basic Clin Pharmacol 2017;5:1286-92.
42.	Shirolkar A, Sharma B, Lata S, Dabur R Guduchi Sawras (Tinospora cordifolia): An ayurvedic drug treatment modulates the impaired lipid metabolism in alcoholics through dopaminergic neurotransmission and anti-oxidant defense system. Biomed Pharmacother 2016;83:1265-77.
43.	Devi P Role of Tinospora cordifolia in metabolic health disorders: An updated review. Himalayan J Health Sci 2021;6:15-23.
44.	Shivananjappa MM, Muralidhara . Abrogation of maternal and fetal oxidative stress in the streptozotocin-induced diabetic rat by dietary supplements of Tinospora cordifolia. Nutrition 2012;28:581-7.
45.	Patel DK, Prasad SK, Kumar R, Hemalatha S An overview on antidiabetic medicinal plants having insulin mimetic property. Asian Pac J Trop Biomed 2012;2:320-30.
46.	Redinger RN The pathophysiology of obesity and its clinical manifestations. Gastroenterol Hepatol (N Y) 2007;3:856-63.
47.	Mandar BK, Khanal P, Patil BM, Dey YN, Pasha I In silico analysis of phytoconstituents from Tinospora cordifolia with targets related to diabetes and obesity. In Silico Pharmacol 2021;9:3.
48.	Ibid. 57.
49.	Stanely Mainzen Prince P, Menon VP, Gunasekaran G Hypolipidaemic action of Tinospora cordifolia roots in alloxan diabetic rats. J Ethnopharmacol 1999;64:53-7.
50.	Agnivesha, Charaka Samhita, Chikitsa Sthana, Rasayana Chikitsa Adhyaya, 1/3/30–32. Available from: http://niimh.nic.in/ebooks/echarak. [Last accessed on November 22, 2021].
51.	De Hert M, Detraux J, Vancampfort D The intriguing relationship between coronary heart disease and mental disorders. Dialogues Clin Neurosci 2018;20:31-40.
52.	Charaka Samhita, Chikitsa Sthana, Trimarmiya Chikitsa Adhyaya, 26/83–99, Available from: http://niimh.nic.in/ebooks/echarak. [Last accessed on November 22, 2021].
53.	Chaudhary S, Godatwar PK, Sharma R In vitro thrombolytic activity of Dhamasa (Fagonia arabica Linn.), Kushta (Saussurea lappa Decne.), and Guduchi (Tinospora cordifolia Thunb.). Ayu 2015;36:421-4.
54.	Sharma AK, Kishore K, Sharma D, Srinivasan BP, Agarwal SS, Sharma A, et al. Cardioprotective activity of alcoholic extract of Tinospora cordifolia (Willd.) Miers. in calcium chloride-induced cardiac arrhythmia in rats. J Biomed Res 2011;25:280-6.
55.	Rao PR, Kumar VK, Viswanath RK, Subbaraju GV Cardioprotective activity of alcoholic extract of Tinospora cordifolia in ischemia–reperfusion induced myocardial infarction in rats. Biol Pharm Bull 2005;28:2319-22.
56.	Kesarwani N Evaluation of cardioprotective effect of Tinospora cordifolia against isoprenaline induced myocardial infarction in rats. 2014;13.
57.	Salve BA, Tripathi RK, Petare AU, Raut AA, Rege NN Effect of Tinospora cordifolia on physical and cardiovascular performance induced by physical stress in healthy human volunteers. Ayu 2015;36:265-70.
58.	Kant S, Gupta B Role of lifestyle in the development of chronic obstructive pulmonary disease: A review. Lung India 2008;25:95-101.
59.	Charaka Samhita, Chikitsa Sthana, Hikka-Shwasa Chikitsa Adhyaya, 17/200, Available from: http://niimh.nic.in/ebooks/echarak. [Last accessed on November 22, 2021].
60.	Charaka Samhita, Chikitsa Sthana, Kaasa Chikitsa Adhyaya, 18/130, Available from: http://niimh.nic.in/ebooks/echarak. [Last accessed on November 22, 2021].
61.	Charaka Samhita, Chikitsa Sthana, Urakshaata Chikitsa Adhyaya, 11/80 Available from: http://niimh.nic.in/ebooks/echarak. [Last accessed on November 22, 2021].
62.	Borse S, Joshi M, Saggam A, Bhat V, Walia S, Marathe A, et al. Ayurveda botanicals in COVID-19 management: An in silico multi-target approach. PLoS One 2021;16:e0248479.
63.	Mishra A, Kumar S, Pandey AK Scientific validation of the medicinal efficacy of Tinospora cordifolia. Sci World J 2013;2013:292934.
64.	Balkrishna A, Khandrika L, Varshney A Giloy Ghanvati (Tinospora cordifolia (Willd.) Hook. f. and Thomson) reversed SARS-CoV-2 viral spike-protein induced disease phenotype in the xenotransplant model of humanized zebrafish. Front Pharmacol 2021;12:1-14.
65.	Vikrant VK, Upadhyay A, Mutha R, Harshitha KS Exploring the potential role of herbal ayurveda formulation Vasadi Kashaya in chronic obstructive pulmonary disease—A review. J Ayurveda Integr Med Sci 2021;4:144-8.
66.	Ministry of Ayush [Internet]. [cited November 22, 2021]. Available from: https://www.ayush.gov.in/. [Last accessed on March 22, 2022].
67.	Kumar R A randomized study of effect of Tinospora Cordifolia in chronic bronchitis patients. IOSR J Dent Med Sci 2018;17:5-10.
68.	Cooper GM The Cell: A Molecular Approach. 2nd ed. Sunderland, MA: Sinauer Associates; 2000. The Development and Causes of Cancer. Available from: https://www.ncbi.nlm.nih.gov/books/NBK9963/.
69.	Coussens LM, Werb Z Inflammation and cancer. Nature 2002;420:860-7.
70.	Reddi KK, Tetali SD Dry leaf extracts of Tinospora cordifolia (Willd.) Miers. attenuate oxidative stress and inflammatory condition in human monocytic (THP-1) cells. Phytomedicine 2019;61:152831.
71.	Polu PR, Nayanbhirama U, Khan S, Maheswari R Assessment of free radical scavenging and anti-proliferative activities of Tinospora cordifolia Miers. (Willd.). BMC Complement Altern Med 2017;17:457.
72.	Jagetia GC Anticancer activity of Giloe, Tinospora cordifolia (Willd.) Miers. Ex Hook F & Thoms. Int J Complement Alt Med 2019;12:79-85. doi: 10.15406/ijcam.2019.12.00453
73.	Bala M, Pratap K, Verma PK, Singh B, Padwad Y Validation of ethnomedicinal potential of Tinospora cordifolia for anticancer and immunomodulatory activities and quantification of bioactive molecules by HPTLC. J Ethnopharmacol 2015;175:131-7.
74.	Jagetia GC, Rao SK Evaluation of the antineoplastic activity of Guduchi (Tinospora cordifolia) in Ehrlich ascites carcinoma bearing mice. Biol Pharm Bull 2006;29:460-6.
75.	Patil D, Gautam M, Gairola S, Jadhav S, Patwardhan B Effect of botanical immunomodulators on human CYP3A4 inhibition: Implications for concurrent use as adjuvants in cancer therapy. Integr Cancer Ther 2014;13:167-75.
76.	Sharma N, Kumar A, Sharma PR, Qayum A, Singh SK, Dutt P, et al. A new clerodane furano diterpene glycoside from Tinospora cordifolia triggers autophagy and apoptosis in HCT-116 colon cancer cells. J Ethnopharmacol 2018;211:295-310.
77.	Beriwal V, Singh B, Thapliyal S, Thapliyal S A clinical evaluation of Guduchi (Tinospora cordifolia) and Yashtimadhu (Glycyrrhiza glabra) as chemopreventive agent in cancer treatment. Asian J Oncol 2019;05:064-71.
78.	A review on clinical and experimental studies on Ayurveda and leukemia. February 14, 2022 [cited February 14, 2022]. Available from: https://www.mjdrdypv.org/preprintarticle.asp?id=316408;type=0. [Last accessed on March 22, 2022].
79.	Javir G, Joshi K Evaluation of the combinatorial effect of Tinospora cordifolia and Zingiber officinale on human breast cancer cells. 3 Biotech 2019;9:428.
80.	Neem Giloy [Internet]. Love Heals Cancer [cited November 22, 2021. Available from: https://lovehealscancer.org/cancer-care/neem-giloy/. [Last accessed on March 22, 2022].
81.	Charak Samhita, Chikitsasthana, Prameha Chikitsa Adhyaya, 6/ 26–3.0. Available from: http://niimh.nic.in/ebooks/echarak [Last accessed on May 22, 2022].
82.	Charak Samhita, Chikitsasthana, Trimarmiya Chikitsa Adhyaya, 26/99. Available from: http://niimh.nic.in/ebooks/echarak [Last accessed on May 22, 2022].
83.	Charaka Samhita, Sutrasthana, Ashtauninditiya Adhyaya, 21/22. Available from: http://niimh.nic.in/ebooks/echarak [Last accessed on May 22, 2022].
84.	Charaka Samhita, Chikitsasthana, Hikkashwasa Chikitsa Adhyaya, 17/94, Available from: http://niimh.nic.in/ebooks/echarak [Last accessed on May 22, 2022].
85.	Charaka Samhita, Chikitsasthana, Hikkashwasa Chikitsa Adhyaya, 17/102. Available from: http://niimh.nic.in/ebooks/echarak [Last accessed on May 22, 2022].
86.	Charaka Samhita, Chikitsasthana, Kasa Chikitsa Adhyaya, 18/35. Available from: http://niimh.nic.in/ebooks/echarak [Last accessed on May 22, 2022].
87.	Charaka Samhita, Chikitsasthana, Kasa Chikitsa Adhyaya, 18/54. Available from: http://niimh.nic.in/ebooks/echarak [Last accessed on May 22, 2022].
88.	Charaka Samhita, Chikitsasthana, Kasa Chikitsa Adhyaya, 18/161–162. Available from: http://niimh.nic.in/ebooks/echarak [Last accessed on May 22, 2022].
89.	Sushrut Samhita, Chikitsa Sthana, Prameha Chikitsa Adhyaya, 11/9. Available from: https://niimh.nic.in/ebooks/esushruta/?mod=read. [Last accessed on March 22, 2022].
90.	Sushrut Samhita, Chikitsa Sthana, Granthi-Apachi-Arbuda-Galaganda Chikitsa, 18/5. Available from: https://niimh.nic.in/ebooks/esushruta/?mod=read. [Last accessed on March 22, 2022].
91.	Sushrut Samhita, Chikitsa Sthana, Granthi-Apachi-Arbuda-Galaganda Chikitsa, 18/7. Available from: https://niimh.nic.in/ebooks/esushruta/?mod=read. [Last accessed on March 22, 2022].
92.	Sushrut Samhita, Chikitsa Sthana, Shosha Chikitsa, 41/38. Available from: https://niimh.nic.in/ebooks/esushruta/?mod=read.
93.	Sushrut Samhita, Chikitsa Sthana, Kaasa Chikitsa, 52/42. Available from: https://niimh.nic.in/ebooks/esushruta/?mod=read. [Last accessed on March 22, 2022].
94.	Vagbhatt, Ashtang Sangraha with Shashilekha Commentary by Indu Edited by Pandit Hari Sadashiv Shashtri Paradkar, Chikitsa Sthana, Prameha Chikitsa, 14/6. Varanasi: Chaukhamba Surbharati Prakashana; 2018. p. 514.
95.	Vagbhatt, Ashtang Sangraha with Shashilekha Commentary by Indu Edited by Pandit Hari Sadashiv Shashtri Paradkar, Chikitsa Sthana, Prameha Chikitsa, 14/7. Varanasi: Chaukhamba Surbharati Prakashana; 2018. p. 514.
96.	Vagbhatt, Ashtang Sangraha with Shashilekha Commentary by Indu Edited by Pandit Hari Sadashiv Shashtri Paradkar, Chikitsa Sthana, Prameha Chikitsa, 14/8. Varanasi: Chaukhamba Surbharati Prakashana; 2018. p. 514-5.
97.	Vagbhatt, Ashtang Sangraha with Shashilekha Commentary by Indu Edited by Pandit Hari Sadashiv Shashtri Paradkar, Chikitsa Sthana, Prameha Chikitsa, 14/15, Varanasi: Chaukhamba Surbharati Prakashana; 2018. p. 516.
98.	Vagbhatt, Ashtang Sangraha with Shashilekha Commentary by Indu Edited by Pandit Hari Sadashiv Shashtri Paradkar Chikitsa Sthana, Prameha Chikitsa, 14/18. Varanasi: Chaukhamba Surbharati Prakashana; 2018. p. 516.
99.	Vagbhatt, Ashtang Sangraha with Shashilekha Commentary by Indu Edited by Pandit Hari Sadashiv Shashtri Paradkar, Sutra Sthana, Dwividhopakramaniya Adhyaya, 14/15. Varanasi: Chaukhamba Surbharati Prakashana; 2018. p. 185-6.
100.	Vagbhatt, Ashtang Sangraha with Shashilekha Commentary by Indu Edited by Pandit Hari Sadashiv Shashtri Paradkar, Uttartantra, Granthiarbudashleepadaapachinaadipratishedha Adhyaya, 25/3. Varanasi: Chaukhamba Surbharati Prakashana; 2018. p. 809.
101.	Vagbhatt, Ashtang Sangraha with Shashilekha Commentary by Indu Edited by Pandit Hari Sadashiv Shashtri Paradkar, Uttartantra, Granthiarbudashleepadaapachinaadipratishedha Adhyaya, 25/17. Varanasi: Chaukhamba Surbharati Prakashana; 2018. p. 810.
102.	Vagbhatt, Ashtang Sangraha with Shashilekha Commentary by Indu Edited by Pandit Hari Sadashiv Shashtri Paradkar, Chikitsa Sthana, Kasa Chikitsa, 4/3. Varanasi: Chaukhamba Surbharati Prakashana; 2018. p. 447.
103.	Vagbhatt, Ashtang Sangraha with Shashilekha Commentary by Indu Edited by Pandit Hari Sadashiv Shashtri Paradkar, Chikitsa Sthana, Kasa Chikitsa, 4/16. Varanasi: Chaukhamba Surbharati Prakashana; 2018. p. 447-5.
104.	Vagbhatt, Ashtang Sangraha with Shashilekha Commentary by Indu Edited by Pandit Hari Sadashiv Shashtri Paradkar, Chikitsa Sthana, Kasa Chikitsa, 4/41. Varanasi: Chaukhamba Surbharati Prakashana; 2018. p. 452.
105.	Vagbhatt, Ashtang Sangraha with Shashilekha Commentary by Indu Edited by Pandit Hari Sadashiv Shashtri Paradkar, Chikitsa Sthana, Kasa Chikitsa, 4/44 Chaukhamba Surbharati Prakashana; 2018. p. 452.
106.	Vagbhatt, Ashtang Sangraha with Shashilekha Commentary by Indu Edited by Pandit Hari Sadashiv Shashtri Paradkar, Chikitsa Sthana, Shwasa-Hiddhma Chikitsa, 6/12–13. Reprinted 2018. Chaukhamba Surbharati Prakashana; p. 463.
107.	Vagbhatt, Ashtang Sangraha with Shashilekha Commentary by Indu Edited by Pandit Hari Sadashiv Shashtri Paradkar, Chikitsa Sthana, Rajayakshma Chikitsa, 7/13. Chaukhamba Surbharati Prakashana; 2018. p. 468.
108.	Vagbhatt, Ashtang Sangraha with Shashilekha Commentary by Indu Edited by Pandit Hari Sadashiv Shashtri Paradkar, Chikitsa Sthana, Rajayakshma Chikitsa, 7/18. Chaukhamba Surbharati Prakashana; 2018. p. 468.
109.	Vagbhatt, Ashtang Sangraha with Shashilekha Commentary by Indu Edited by Pandit Hari Sadashiv Shashtri Paradkar, Chikitsa Sthana, Rajayakshma Chikitsa, 7/39. Chaukhamba Surbharati Prakashana; 2018. p. 469.
110.	Chakrapani, Chakradatta with English Translation by Prabhakara Rao. Varanasi: Chaukhambha Orientalia; 2018. Chakradatta Prameha Chikitsa; p. 215.
111.	Chakrapani, Chakradatta with English Translation by Prabhakara Rao. Varanasi: Chaukhambha Orientalia; 2018. Prameha Chikitsa; p. 216.
112.	Chakrapani, Chakradatta with English Translation by Prabhakara Rao. Varanasi: Chaukhambha Orientalia; 2018. Prameha Chikitsa; p. 217.
113.	Chakrapani, Chakradatta with English Translation by Prabhakara Rao. Varanasi: Chaukhambha Orientalia; 2018. Sthoulya Chkitsa; p. 222.
114.	Chakrapani, Chakradatta with English Translation by Prabhakara Rao. Varanasi: Chaukhambha Orientalia; 2018. Sthoulya Chkitsa; p. 223.
115.	Chakrapani, Chakradatta with English Translation by Prabhakara Rao. Varanasi: Chaukhambha Orientalia; 2018. Sthoulya Chkitsa; p. 224.
116.	Chakrapani, Chakradatta with English Translation by Prabhakara Rao. Varanasi: Chaukhambha Orientalia; 2018. Galagandagandamalaa pachiarbudachikitsa; p. 248.
117.	Chakrapani, Chakradatta with English Translation by Prabhakara Rao. Varanasi: Chaukhambha Orientalia; 2018. Rajyakshma Chikitsa; p. 62.
118.	Chakrapani, Chakradatta with English Translation by Prabhakara Rao. Varanasi: Chaukhambha Orientalia; 2018. p. 64.
119.	Chakrapani, Chakradatta with English Translation by Prabhakara Rao. Varanasi: Chaukhambha Orientalia; 2018. p. 66.
120.	Chakrapani, Chakradatta with English Translation by Prabhakara Rao. Varanasi: Chaukhambha Orientalia; 2018. p. 67.
121.	Chakrapani, Chakradatta with English Translation by Prabhakara Rao. Varanasi: Chaukhambha Orientalia; 2018. p. 105.
122.	Chakrapani, Chakradatta with English Translation by Prabhakara Rao. Varanasi: Chaukhambha Orientalia; 2018. Chakradatta, p. 108.
123.	Govindadas Sen, Bhaishajya Ratnavali, Prameha Roga-Adhikara, 37/7. Varanasi: Chaukhamba Orientalia; 2020. p. 696.
124.	Govindadas Sen, Bhaishajya Ratnavali, Prameha Roga-Adhikara, 37/9. Varanasi: Chaukhamba Orientalia; 2020. p. 697.
125.	Govindadas Sen, Bhaishajya Ratnavali Bhaishajya Ratnavali, Prameha Roga-Adhikara, 37/22. Varanasi: Chaukhamba Orientalia; 2020. p. 698.
126.	Govindadas Sen, Bhaishajya Ratnavali, Prameha Roga-Adhikara, 37/29. Varanasi: Chaukhamba Orientalia; 2020. p. 700.
127.	Govindadas Sen, Bhaishajya Ratnavali, Prameha Roga-Adhikara, 37/36. Varanasi: Chaukhamba Orientalia; 2020. p. 700.
128.	Govindadas Sen, Bhaishajya Ratnavali, Prameha Roga-Adhikara, 37/54. Varanasi: Chaukhamba Orientalia; 2020. p. 702.
129.	Govindadas Sen, Bhaishajya Ratnavali, Prameha Roga-Adhikara, 37/62. Varanasi: Chaukhamba Orientalia; 2020. p. 703.
130.	Govindadas Sen, Bhaishajya Ratnavali, Prameha Roga-Adhikara, 37/173. Varanasi: Chaukhamba Orientalia; 2020. p. 713.
131.	Govindadas Sen, Bhaishajya Ratnavali, Prameha Roga-Adhikara, 37/217. Varanasi: Chaukhamba Orientalia; 2020. p. 717.
132.	Govindadas Sen, Bhaishajya Ratnavali, Prameha Roga-Adhikara, 37/232. Varanasi: Chaukhamba orientalia; 2020. p. 718.
133.	Govindadas Sen Bhaishajya Ratnavali, Prameha Roga-Adhikara, 37/241. Varanasi: Chaukhamba orientalia; 2020. p. 719.
134.	Govindadas Sen, Bhaishajya Ratnavali, Medo Roga-Adhikara, 39/43. Varanasi: Chaukhamba Orientalia; 2020. p. 727.
135.	Govindadas Sen, Bhaishajya Ratnavali, Medo Roga-Adhikara, 39/445. Varanasi: Chaukhamba Orientalia; 2020. p. 727
136.	Govindadas Sen, Bhaishajya Ratnavali, Galaganda-Gandamala-Apachi-Granthi-Arbuda-Vignyaniya Adhyaya, 44/34. Varanasi: Chaukhamba Orientalia; 2020. p. 803.
137.	Govindadas Sen, Bhaishajya Ratnavali, Galaganda-Gandamala-Apachi-Granthi-Arbuda-Vignyaniya Adhyaya, 44/70. Varanasi: Chaukhamba Orientalia; 2020. p. 807.
138.	Govindadas Sen, Bhaishajya Ratnavali, Rajayakshma Adhikara, 14/24. Varanasi: Chaukhamba Orientalia; 2020. p. 406.
139.	Govindadas Sen, Bhaishajya Ratnavali, Rajayakshma Adhikara, 14/25. Varanasi: Chaukhamba Orientalia; 2020. p. 406.
140.	Govindadas Sen, Bhaishajya Ratnavali, Rajayakshma Adhikara, 14/60. Chaukhamba Orientalia; 2020. p. 409.
141.	Nations U. Lifestyle Diseases: An Economic Burden on the Health Services [Internet]. United Nations. United Nations [cited February 14, 2022]. Available from: https://www.un.org/en/chronicle/article/lifestyle-diseases-economic-burden-health-services. [Last accessed on March 22, 2022].
142.	Bodai BI, Nakata TE, Wong WT, Clark DR, Lawenda S, Tsou C, et al. Lifestyle medicine: A brief review of its dramatic impact on health and survival. Perm J 2018;22:17-025.