Drinking cow urine is known to be harmful – so why do people consume it every day in India?

It was a surprise how many Indians were shocked by the study’s findings – drinking cow urine was found to be significantly harmful to human health.

The research carried out by the Indian Veterinary Research Institute (IVRI) discovered urine samples from healthy cows contained 14 types of harmful bacteria. Escherichia coli, which causes stomach infections, was most commonly detected.

Cow urine has long been purported as having a host of health-giving benefits by those who practise ‘Ayurveda’, an alternative, holistic medicine system that derives its teachings from Hindu scriptures and can trace back its roots in India more than 2,000 years.

Involving a mixture of herbal medicines, medical oils and mineral substances, as well as adherence to a strict diet and often the practice of yoga and meditation, Ayurveda is considered a pseudoscience by many in the West.

But at least 77 percent of Indians use Ayurvedic products, according to a 2017 report, with this figure expected to have grown further since the Covid-19 pandemic.

The industry is worth £7.8 billion, and a quick Google search displays a host of major Ayurveda firms advertising products.

Patanjali, India’s largest Ayurvedic firm, sells a medicine containing bottled cow urine for 50p which promises to “cure eczema, control diabetes and cancer”. Easy Ayurveda, another brand, provides customers detailed instructions on how to distil urine, claiming it is useful against a host of conditions from leprosy to asthma.

Infamously, during India’s devastating Covid-19 second wave, several parliamentarians from India’s ruling Bharatiya Janata Party (BJP) even advised their constituents to drink cow urine to avoid infection from the virus.

The findings from the IVRI might not come as a shock to many scientists and doctors around the world, but they have again raised questions of India’s poorly-regulated Ayurveda industry and the belief it might be doing more harm than good.

Ayurveda’s critics do agree that there are compounds and medicines used in the ancient practice which can play a pivotal part in modern medicine today.

As early as 300 BC, there are records of Indian Ayurvedic physicians using the seeds of the velvet bean plant to treat symptoms of Parkinson’s disease.

The seeds contain high levels of levodopa, an amino acid that was found to be an effective dopamine replacement agent and is now considered the gold standard treatment for Parkinson’s patients.

“There are many medications within Ayurveda that are effective that have been adopted into western medicines,” explains Dr Ramanan Laxminarayan, the Founder and Director of the One Health Trust, a leading public health research organisation headquartered in Washington DC and Delhi.

“Ayurveda has phenomenal potential but it can’t be evaluated adequately by a western, reductionist approach. It is a systemic approach, the ultimate level of personalised medicine and relies on a physician who can treat your needs, specifically.”

Dr Laxminarayan advocates for a science-based approach to public healthcare but says this can be twinned with the benefits of Ayurveda.

He consumes Arjuna powder on a daily basis, for example, a powdered bark from the Arjuna tree which scientific studies have shown can lower cortisol and blood pressure.

Even this correspondent, a resident of India for over four years now, consumes Ashwagandha supplements, which derive from a flowering shrub found in India and the Middle East, which studies suggest can bolster the immune system and reduce stress.

Regulation across the Indian health sector remains the major issue. This doesn’t just apply to Ayurveda but also its pharmaceutical industry – at least 70 children in the Gambia and 20 children in Uzbekistan died last year after consuming cough syrups allegedly manufactured in India.

India’s pharmaceutical and Ayurveda industries are one of the country’s few manufacturing successes and, therefore, there is little political will to enforce quality control checks or publish studies critical of the industry.

But, in 2017, a right to information request found nearly 40 percent of Ayurveda products tested by the Indian government were found to be of substandard quality, including several items sold by Patanjali.

Items were found to contain toxic levels of heavy metals, including lead, as well as insecticides, pesticides, industrial solvents, antibiotics and steroids.

‘Business, masquerading as healthcare’

Most European countries have now banned Ayurveda products due to concerns over manufacturing practices.

In the United Kingdom, Ayurveda products are available but hundreds of items have been banned over the last decade after they were found to be unsafe.

“A lot of products on the market now do not follow classic Ayurvedic instruction but instead are manufactured by private companies,” explains Dr Abby Philips, a hepatologist based in the southern Indian state of Kerala, who investigates adverse effects of Ayurveda.

“They are marketed as food supplements so there is no need for the companies to run clinical trials. They are then given a good ‘seal of manufacturing’ and their products are sold all over the country.”

Dr Philips says he consults between 10 to 12 patients a month at his clinic in the city of Kochi. He says liver and kidney failure are the most common ailments and symptoms can almost always be directly linked to when a patient began taking Ayurveda products.

“People should understand that Ayurvedic herbal medicines are usually not natural and safe and a lot of people are suffering from side effects,” adds Dr Philips.

“It is my strong opinion that I don’t think Ayurveda should play any role in public health. It is purely a business, masquerading as healthcare and people should not opt for it.”

In addition to the financial benefits, the BJP’s promotion of Ayurveda fits their broader Hindu nationalist narrative and the owners of major Ayurveda companies can enjoy a mutually beneficial relationship with the party.

Take Patanjali, which aims to turn over £15 billion in annual sales by 2025. The company is headed by Baba Ramdev, a 57-year-old self-styled Hindu yoga guru who has 11 million followers on Facebook and regularly fills stadiums with his sermons.

Mr Ramdev has regularly appeared on stage with India’s Prime Minister, Narendra Modi, and has vocally spoken out in support of the party, which has in turn publicly promoted Patanjali products.

“There is so much promotion of Ayurveda in India from politicians and other key stakeholders and it is because of this the practice has become so popular in India in recent years – not because of clinical evidence,” argues Dr Philips.

“There is a huge political role and nationalistic appeal. It’s nationalism, tradition and cultural values all wrapped together and sold to the Indian population.”

Shortly after Mr Modi was first elected in 2014, he created an entire new government ministry to promote yoga and Ayurveda and the practice seems here to stay.

Notably, during the Covid-19 pandemic, senior BJP officials appeared in public with Mr Ramdev to promote Coronil, a pill containing 53 plant-based chemicals that the latter alleged would cure a patient of coronavirus in seven days.

There was no scientific evidence for this and the product was heavily criticised by India’s doctors. Despite a criminal case being filed against Mr Ramdev, the government in the BJP-ruled state of Haryana still announced they would still distribute Coronil to the public.

The scandal around Coronil and more recently on the consumption of cow urine have both defamed Ayurveda as a practice in India and could detract from the discovery of important, new public healthcare tools, experts worry.

“In terms of Ayurveda, the challenge is subjecting practices and modalities to much more stringent testing and approvals, but many of these protocols remain to be developed” argues Dr Laxminarayan.

“Certainly, there are many hidden gems in Ayurveda but also a lot that are poorly validated and not supported by evidence. Separating what is effective and safe from what is not is the task that lies ahead.”

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