Indian woman receiving shirodhara

Panchakarma, the ancient Ayurvedic detoxification procedure, is now becoming mainstream due to its rising popularity amongst public figures like performance artist Katy Perry and most recently, athlete Aaron Rogers. If you’re curious about how Panchakarma can help you, this article will take you beyond the celebrity hype. We’ll introduce you to the ancient healing methods, as practiced for thousands of years in Kerala, India.

Geetanjali, a young singer has a chronic cough and vocal nodules; she often loses her voice. She has tried vocal therapy, and it was suggested she remove her tonsils and adenoids, without an assurance that this will address her issues. Geetanjali is a calm, sweet, sensitive, creative soul who also has issues with insomnia, anxiety and knee pain. Of late she has been rather low, with the pandemic, climate change and her role as a crisis counselor impacting her mental health. Her Vaidya works to address Vata imbalance and over time, the cough diminishes, vocal nodules disappear, and her sleep greatly improves. But, she still has underlying depression, a tendency to debility and cravings for sweet food and cold, carbonated drinks. She also worries that despite her sporadic bursts of yoga, her knee issues continue. Her Vaidya recommends a Panchakarma to address the continued Vata imbalance.

What is Panchakarma?

The word Panchakarma means “five actions”. This highly detailed, individualized, and powerful Shodhana (cleansing) is used in Ayurveda as a preventive protocol or to address the disease process using bodywork therapies, customized formulations and oils, and specialized dietary and lifestyle guidelines. Each program is individualized for the Rogi’s unique constitution (Prakriti), imbalances (Vikrati) and health goals. Panchakarma cleanses and purifies the entire mind-body-spirit complex. 

Despite common misconceptions, Panchakarma is neither a ‘gut-cleanse’ nor a set of massages at a spa and definitely not a fad! It is a very powerful and deeply therapeutic intervention. 

According to Vaidya. Jayarajan Kodikannath, CEO and Chief Ayurveda Consultant, Kerala Ayurveda USA, “Panchakarma is one of the most advanced processes of purifying and resetting the whole body mind system. Not only is it effective in solving existing disorders, but it empowers the system to resist the recurrence of the problem in the future.”

Panchakarma involves primarily five therapies:

  • Vamana (therapeutic emissis) 
  • Virechana (therapeutic purgation)
  • Vasti (therapeutic enema)
  • Nasya (nasal administration)
  • Raktamokshana (bloodletting)

Of these, Vamana and Raktamokshana are not currently allowed in the US, but are practiced in other parts of the world.

loose powder herbs displayed in silver dishes

The Panchakarma process

Panchakarma involves three stages – a preparation stage, the actual cleansing therapies, and the post-cleanse rejuvenation. The objective is detoxification and elimination of accumulated imbalances. This is done by first prompting the body to digest any physiological, psychological and/or environmental Ama (toxins). Then the focus is on strengthening and rekindling Agni (digestive and metabolic fire), clearing channels, Shodhana or cleansing of aggravated Dosha imbalances (and bringing them to the gut for elimination). Once the elimination is complete, it’s  followed by rejuvenation therapies to restore, recoup, strengthen and nourish the channels and our overall system. 

The entire process can be designed for a week or up to a month and beyond. The stages include:

Purva Karma or preparation

Purva karma generally includes:

  • Adjustments to one’s diet and lifestyle.
  • Digesting Ama (Pachana) and strengthening  Agni (Deepana) with targeted formulations. 
  • Snehana (iInternal and external oleation) – Snehana involves two parts. The first, Abhyantara (or Snehapana), consists of ingesting herb infused ghee, oils, majja (marrow) or vasa (animal fats) in increasing quantities and the second, Bahya,  or external oleation using warm massage with targeted oils
  • Swedana – Dry or moist Sudation or sweat-inducing therapies like Churna Pinda, Nadi or Bashpa Swedana are used to dilate channels and aid detoxification, allowing for the easy removal of Ama

Purva Karma procedures help loosen Ama and move it from the tissues to the GI tract for elimination.

pada abhyanga massage

Pradhana Karma or “main action”

At this stage Ama is eliminated and a series of therapies are administered to address the Rogi’s imbalances. Their duration, selection, sequence and use and dosage of formulations is completely individualized.

Therapies could include a combination of:

  • Virechana
  • Nasya
  • Vasti, which is of two types
    • Sneha Vasti – Involving the use of medicated oil or ghee
    • Niruha vasti – Made from herbal formulations

Other therapies and bodyworkShodhana could involve many layers and hundreds of iterations. Some of these therapies are performed as part of Purva Karma and could be repeated during Pradhan Karma. This is based on the Clinician’s assessment including  stage and nature of disease, its chronicity, status of Ama, and which Doshas are out of balance. 

Examples are:

  • Patra potli sveda (a combination of abhyanga and sudation with the application of heat using a heated bolus of herbal leaves),
  • Takradhara (poring of medicated buttermilk)
  • Shirodhara (pouring warm, medicated or herb infused oil, milk or water over the head for a stipulated period)
  • Pichu (thick cotton wool soaked with warm medicated oil applied over the affected area)
  • Pizhichil (dipping a cotton cloth in oil and squeezing it to drip like a stream on the body)
  • Kati Vasti ( a semi-solid paste of black gram powder is formed into a bund or ring into which warm, herb infused oil is poured. The oil is left for a stipulated time period, with frequent replacements to ensure it stays warm)

Paschat Karma or Rasayana, the rejuvenation phase

Paschat karma involves rejuvenative formulations, recipes, dietary regimen and lifestyle (Achar Rasayana, being happy, non-violent etc). 

A slow transition back after cleansing is encouraged to affect healthy, long-term changes. The system is reset and vulnerable, like a clean, vacuumed room and one has to be careful not to let dirt in. 

Rejuvenating Rasayana herbs and formulations are ingested to enhance and balance Agni, clear and nourish Srotas or channels (Sroto Vishodhanam), increase strength or Balyam and improve immunity or Vyadhikshamatwam.


Why we need Panchakarma


We are faced with an epidemic of stress according to WHO; this impacts our mental health, sleep and lifestyle choices. 


There are a spate of nutritional challenges that include deficiencies and obesity. The UN has dubbed 2016-2025, “the Decade of Action on Nutrition”; 88% of nations and 2 billion people worldwide suffer from malnutrition and the pandemic has only worsened this statistic. 

Processed Foods

Processed and ‘fast’ food was meant to increase convenience but has caused many negative challenges with nutrition.  Consider this; a packet of chips costs less than an organic apple. Besides many other risks, eating these foods may kill people more prematurely than cigarette smoking. 

Environmental toxins

We live in an artificial manner with environmental pollutants and toxins; fertilizers, preservatives, mercury in fish, acid rain, smog, synthetic chemicals, toys and jewelry that could contain lead, hormones in dairy products, non organic and genetically modified foods, contaminated beef and many factors that impact health. 


As communicable disorders seemed to be on the decline, pathogens became a worry again with the Covid-19 pandemic. The Ayurvedic approach is to focus on strengthening the host rather than the pathogen. 

Lifestyle and inflammation 

Lifestyle based, autoimmune and metabolic disorders abound; more than half of America suffers from a lifestyle based disorder like Type-2 diabetes, kidney, lung or joint diseases, cardiovascular issues and certain forms of cancer, according to CDC. Inflammation is an underlying cause in all diseases from the common cold to cancer. The fact is that chronic, degenerative diseases, metabolic syndromes and cancers share a common pathological feature and that is inflammation.

Benefits of Panchakarma

According to this research paper, “A Practical Handbook of Panchakarma Procedures”, ‘Panchakarma is a minimal invasive bio-cleansing procedure advised in lifestyle, metabolic, autoimmune diseases and.. in healthy individuals as a preventive measure’. 

Panchakarma resets the digestive and metabolic fire or Agni, which maintains health, homeostasis, body functioning, strength and immunity. It removes Ama or toxins formed within our body as a result of inadequate digestion which could result from our own imbalances, lifestyle, or psychological issues like trauma and environmental toxins. 

Ama can cause heaviness, lethargy, mucus build up, lowered immunity, colds, flu, stiff joints, white coating on the tongue, brain fog, issues with digestion, depression, and all kinds of diseases and chronic disorders. These disorders combined with the epidemic of stress are the bane of the 21st century. According to the CDC, 6 in 10 US adults have some form of chronic lifestyle based disorder. One in three are afflicted by what is called metabolic syndrome. These chronic disorders are the leading cause of death and disability in the country. 

Environmental toxins abound and researchers have identified nearly 800 chemicals of concern that are linked to many ailments like diabetes, certain forms of cancer, cardiac and fertility issues.

Panchakarma helps address these issues and restore health. Its benefits include:

  • Prevention and disease management
  • Addresses the root causes of disease, rather than just treating symptoms
  • Provides a long-term solution to health issues
  • Panchakarma is a natural, traditional and holistic solution which improves physical, psychological, physiological and spiritual health
  • Individualization to address the uniqueness of each person
  • Addresses chronic illnesses like respiratory and cardiovascular issues, joint disorders, dermatological and psychological disorders, addiction and gastrointestinal problems 
  • Removes Ama build up due to environmental toxins
  • Non-surgical, benign intervention 
  • Helps prevent recurrence of diseases; diet, lifestyle changes and herbal formulations can go only thus far in managing disorders. This is a deeper and much more powerful intervention. 
  • Improves digestion, metabolism, elimination and helps restore sleep cycles 
  • Leads to deep nourishment and rejuvenation, enhances immunity and longevity and radically improves overall health 
  • It enhances physical strength, glow of the skin, vigor, vitality and fertility
  • Panchakarma helps reduce stress, improves clarity, enthusiasm and overall mental health 
  • Eligibility for cleansing and contraindications are carefully examined to ensure safe, effective procedures are included in the protocol 
  • Panchakarma, unlike other cleanses, is a powerful and holistic long-term health intervention providing individualization, rejuvenation, boosting of immunity, and is designed and supervised by clinicians and technicians
  • Panchakarma is considered a powerful immune boosting protocol during pandemics

Do you seek the safe, long-term therapeutic, supervised intervention of Panchakarma? Are you interested in studying Panchakarma?

Contact someone on our team to seek an Ayurvedic Consultation with one of our highly trained Vaidyas. 

Interested in studying Panchakarma? Read more about how it can advance your career here.

If you have a massage therapy practice, how can the study and incorporation of Panchakarma support it? Read more here.

About the author

  • Anuradha Gupta

    Anuradha “Anu” Gupta is a NAMACB Certified Ayurvedic Practitioner, Engineer, MBA, Meditator, Writer, 200hr Yoga Teacher and Ayurvedic Doctor. She serves as Guest Faculty Member, Content Specialist and AP Mentor at at Kerala Ayurveda Academy & Wellness Center. She also runs her own Ayurvedic practice, Ayurvedic Footprints.

    Anu has an extensive corporate background. She worked for...

Panchakarma: Ayurveda’s natural cleanse