New developments in cancer nanomedicine & sense of déjà vu from Swarna bhasma, a medieval Ayurvedic medicine.

A recent research study published in the journal Nanoscale has highlighted how nanoparticles, particles having size in the range of 1 to 100 nanometres (for reference, your average paper sheet is 75,000 nanometres thick) coated with cancer meds can prove a potent drug delivery vehicle for selectively killing only the cancerous cells and sparing normal cells in the body.

Mechanism of action of cerium oxide nanoparticles

A major problem in consideration in the study was that curcumin (the main active compound in turmeric), though having a potent action in treating cancers, has too bad solubility and volatility issues for it to reach the target tumor tissue in adequate quantities. In the study, this was solved by using nanoparticles of cerium oxide coated with dextran and loaded with curcumin, for stabilizing and delivering the curcumin alongwith cerium oxide to the cancerous tissue of a neuroblastoma, the most common type of cancer in infants. The study has met with significant results that open up a spectrum of possibilities and further research avenues for using drug coated nanoparticles of various substances in not only cancer, but a wide range of medical conditions.
Original study can be read here.

However, why does this intrigue me so much, and what has it got to do with Ayurveda? 

[SPOILER ALERT: It’s not about curcumin, 

BOREDOM ALERT: Lengthy technical article ahead.]

Nano-Gold mass spectrometry – image courtesy of Pacific Northwest National Laboratory

Swarna Bhasma, also called as Suvarna Bhasma, is an ultra-fine powdered Ayurvedic medicine made of 90% elemental/oxidized gold, treated with herbal extracts. The name literally means ‘Gold Ash’, though it is somewhat a misnomer. This relatively recent medicine (1,500 years old is, after all, ‘recent’ in Ayurvedic terms) is widely used in combination with different herbs, in a number of severe stage medical conditions including insulin resistant Type II diabetes mellitus, paralysis of various etiologies, ageing related disorders, low sperm count, abnormally morphed sperms, mental retardation, tuberculosis and many more, with significant success. It is also not uncommon to use turmeric-treated Swarna bhasma in treating many of these diseases, including ‘Arbuda‘, the generalized class of diseases in Ayurveda, that includes but is not limited to, cancers. It is also described as ‘Yogvaahi‘, or a ‘bioenhancer’ vehicle that amplifies the effects of whichever herb it is combined with. This has been affirmed by in-vitro trials that demonstrated its action on tight cell junctions, that improves drug penetration into the target tissue.

Sounds very similar? Now comes the funny part:
Swarna Bhasma’s particle size is the subject of a bitter dispute amongst scientists, with different studies pegging it to be from about 50 nm (mostly in studies having an Ayurvedic pharmacologist as a team member) to about 50,000 nm (in studies done only by modern pharmacologists) on average. This essentially implies that, according to some experts, Swarna Bhasma IS a nanomedicine, while according to others it is NOT. Also, while some have found its gold content to be up to ~95%, others have found only ~52%, when all studies claim to have procured the test samples “from reputed pharmacies” without naming the details. 

How under the sun is so much variation possible between the results? Critics would be quick to accuse that it is because Ayurvedic medicines inherently have no standardization norms, but let me highlight some technical facts. There seems to be no definition in any of the studies, of what they mean by a “reputed pharmacy” when there is a big problem of rampant fake medicines in Ayurveda. 

  •  Were those test sample manufacturers GMP certified (Yes, Ayurvedic manufacturers have GMP certifications applicable to them too)?
  • Were they following the standards laid down by the Ayurvedic Pharmacopoeia of India (the official standardization manual for Ayurvedic drugs in India)?
  • How much Ayurvedic sales turnover or other achievements did the pharmacies have in order to be considered “reputed”?
  • Did they employ a qualified Ayurvedic pharmacist who oversees Ayurvedic medicine sales (Yes, Ayurvedic pharmacy is a complete separate discipline, with a separate “B.Pharm in Ayurveda” degree qualification. Your usual B.Pharm. pharmacist knows next to nothing about Ayurvedic drugs, but won’t confess that to you, since they know that you too are as ignorant as them)?
  • Did the manufacturer even have a verified valid FDA licence (unfortunately, fake Ayurvedic medicines make it to the medicine market very easily in India due to the widespread misconception amongst even pharmacists, that Ayurvedic drugs have no standardization whatsoever to be verified)?

All these questions are conveniently left unanswered by every researcher, in order to make their own claims look more appealing. Only one prominent study in the PubMed repository, out of the dozens I looked up, was addressing these questions partially at least by naming the source pharmacy. It found the mean particle size to be at 717nm and 669nm each, in two procured samples, but then again, the manufacturer’s credentials remain an undisclosed mystery.

Still doesn’t totally explain the way-too-wide variations, does it? Without touching the subjects of the politics and economics behind medical research, we’ll explore some more technical part here. 

It is common in mineral-based Ayurvedic medicine manuscripts for the same name to be given to different formulations in different texts of various periods. So, Indian FDAs make it mandatory to mention the source text on the packing label, and the source text name is an essential part of the drug name itself.

Unfortunately, the dozens of modern research studies I went through had no idea of the fact that Swarna bhasma (R.R.S.), Swarna bhasma (A.P.I.) and Swarna bhasma (A.K.K.) could be three similar products in pharmacological properties but totally different products in composition and manufacture method (only to mention three of the multiple variants), and described proudly that they had scientifically studied “Swarna bhasma” (no mention of variant), without even a hint of how they were generalizing something very very specific. That’s the state of scientific research when it comes to Ayurveda.

So in the end, the heaps and heaps of (not-so-) scientific research available about Swarna bhasma bring us to no particularly useful conclusion, NEITHER positive NOR negative, except for what we already had, it is a millennia old tried and tested medicine. No, that doesn’t mean I wouldn’t want to see it researched better scientifically, its variants each better standardized and put to the test of pinpoint accurate randomized clinical trials, but the huge number of non-technical factors that don’t allow it to happen would make a separate and most controversial blog article about medical research, so better leave that part aside as for now.

A crystallized gold nugget : image courtesy Rob Lavinsky

Some may be tempted by now, to ask about the metal toxicity issues of this preparation. The second study I mentioned sheds some good light, but I won’t consider it too as an all-round valid source, for the reasons I already explored. However, readers would be fascinated to know that gold nanoparticles have been found very useful in multiple medical applications, and their toxicity levels are so far not considered an adverse indicator within a usage limit of upto 30 mg/day for a healthy adult. This is, incidentally the same max dosage of Swarna bhasma as prescribed in Ayurvedic sources. Still, Swarna bhasma isn’t only gold, as we’ve seen already. The remaining part consists mainly of Silica (1.14%), Iron (0.14%), phosphates, potash and traces of copper and magnesium, which can safely be neglected at a 30mg/day dosage. Another interesting compilation study [here] for those interested in deeper scientific information about toxicity and biodispersion. Sadly however, Swarna bhasma being a mineral-based preparation, was still banned in USA the last time I checked.

“Okay, but what are the take-home points from this?”

  • “Can it cure cancer?” As for now, a ‘No’ would be the proper answer to give. However, if proper research and innovations in its herbal treatment are done, it bears potential that one day we may see a much cheaper and effective Ayurvedic cancer nanomed developed from it. But till then, my fingers are crossed.
  • “Can I use it safely as a medicine/supplement in the other diseases mentioned?” YES, in fact it is considered the first line drug for azoospermia, oligospermia and severe insulin resistance; BUT it is strictly not something to be taken from any dubious manufacturer/pharmacy, and without a qualified practitioner’s prescription.
  • “Is it scientifically proven effective?” Nano or not, Swarna bhasma is a known potent medicine having been found effective in Level 2 and Level 3 studies; but existing trial results are not very helpful to either totally prove or disprove it on Level 1 criteria. A lot more work needs to be done on that yet.
  • “Should I be worried about metal toxicity?” NO, it bears no metal toxicity issues within the specified dosage limits. 

And that, folks, is all of the Dr. Herbz digest for today.
Stay Healthy, stay Happy!!!

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