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Rheumatoid arthritis (RA) is a chronic inflammatory disorder of Joints that causes pain, swelling, stiffness and loss of function in affected joints. Unlike the common arthritis, it is an autoimmune disease, that is, our own immune system mistakenly attacks our healthy cells as in infections, wounds, and foreign objects. In addition to joints, it can also affect other body organs like eyes, heart, lungs etc.
In Ayurveda, RA is called as AMAVATA, where AMA means toxic particles evolved from improper digestion and assimilation. The AMA is, then, emulsified with Vata and gets spread on whole body and localized on joints, hearts, lungs and other parts of body. Our defence mechanism treats the AMA as a foreign body and forms the antibodies in order to fight.  But, when it combines with AMA, it acts as an abnormal immune complex which leads to inflammatory changes and contribute to disease process.

Risk Factors:
Gender: Developing RA is 2 to 3 times more common in women.
Heredity: People may be affected if they have a history of RA in their families. Age: Although rheumatoid arthritis can develop at any age, it likely to develop between the ages of 25 and 55.
Coffee and Cigarettes: Some studies have suggested that Smokers are also more at risk for developing RA Diet Habit: According to Ayurveda, it is the main risk factor for developing RA. Untimely and improper diet habit may leads to alteration in digestive power which is responsible for production of AMA.

Signs and symptoms:
•    Involvement of symmetrical joints, morning stiffness, pain and swelling in joints, first involvement of small joints of finger and toes, nodules, deformity are the signs and symptoms of classical RA.
•    Stiffness: Reduced mobility or movement of the affected joints. It is prominently seen early in the morning.
•    Swelling: The area around the affected joint is swollen and puffy.
•    Pain: in Ayurveda, the pain is described as the pain just like scorpion bite. •    Nodules: These are hard bumps that appear on or near the join, may develop in nearly one-third of people who have rheumatoid arthritis. They often are found in the pressure points in the body like elbows. •    Joint Deformity: In classical and chronic RA, joint deformity like anterior subluxation of metacarpo-phalengeal joint, ulnar deviation, swan neck deformities etc are seen.

Extra-articular features:
Anorexia, loss of weight, lethargy, fever, depression, anemia, myolgia, pericarditis, cardiomyopathy, pleurisy, carpal tunnel syndrome etc.

Management:
Diet and Life Style modifications.
Patient digestive power is week. So he/she should take easily digestible, light and compatible food mixing with stomachic and digestive herbs like dry ginger, long piper, leadwort, garlic, cinnamon and cloves Amavata patient's diet should include leaves of Patola, Vastuka, Goshura etc.  should take old rice, garlic, bitter gourd and horse gram in his/her diet.
Avoid consumption of curd, milk, buttermilk, fish, jaggery, oily foods, junk and fast foods, salty and sour foods, black gram, cold drinks.

•  always use hot water to bathe •  Avoid cold breeze and excessive wind.
•  Empty bowels regularly. •  Do not control natural urges. •  Avoid late nights and afternoon naps.
Should take fomentation through warm sand particles packed in a piece of contton.

Drug Therapy:
The aim of drug therapy is increasing the digestive power, removing of toxic or detoxification, correcting the immune response, relief from pain and swelling and minimizing the deformity.
1. Ama-Pachan or Anti-toxic Drugs
These medicines avoid the formation of toxin by enhancing digestive and assimilative power. a) Panchkola Qwath
b) Amavatari Rasa
c) Agnitundi Wati
d) Chitrakadi Wati e) Rasonadi Wati

2. Rog Pratirakshytmak or Immunomodulators:
As RA is an autoimmune disease, these medicines are prescribed to correct and enhance the immunity.
a) Aswagandha
b) Guduchi
c) Amrita Guggulu

3. Bedanahar or Anti-inflammatory and Anti-Rheumatic Drugs.
These medicines are effective in pain and inflammation. They help to slowdown the disease progression.
a) Yograj Guggulu
b) Maha Yograj Guggulu
c) Sinhanad Guggulu

Panchakarma or Detoxification Therapy:
Panchkarma is used to clean the body of toxic materials left by disease and improper diet habit. Ayurveda says that imbalanced doshas create waste matter. This waste matter is called Ama in Ayurveda. Ama is a foul smelling, sticky, noxious, substance that needs to be evacuated from the body as thoroughly as possible. Panchakarma permanently eliminates these toxins from the body, allowing healing and restoration of the tissues, channels, digestion and mental functions.

Yoga:
Yoga keeps the body free from impurities that are accumulated inside our body due to our bad food habit, wrong behavior and other external agents. In Ayurveda, various yogic practices are used for keeping equilibrium between the body, mind, and self, in order to establish health and harmony.

The American Dietetic Association defines a vegetarian diet, or lacto-ovo vegetarian diet, as one that does not include meat, fowl, seafood, or products containing those foods. The lacto-vegetarian diet also excludes eggs and primarily consists of grains, vegetables, fruits, legumes, seeds, nuts, and dairy products. The vegan, or total vegetarian, eating pattern excludes eggs, dairy, and other animal products. Within these broad definitions, there is still variation in the degree to which animal products are excluded.

A well-planned vegetarian diet can meet current recommendations for all vital nutrients, including protein, omega-3 fatty acids, iron, zinc, iodine, calcium, and vitamins D and B-12. However, use of supplements or fortified foods may be helpful to boost intake of important nutrients in certain cases.

The American Dietetic Association contends that carefully planned vegetarian diets, including vegan diets, are healthful and nutritionally sufficient for individuals of all ages, including pregnant or lactating women, infants, children, adolescents, and athletes. During pregnancy, adherence to a nutritionally adequate vegetarian diet can lead to positive health outcomes for both the mother and infant.

Furthermore, well-constructed vegetarian diets may offer health benefits in terms of preventing and treating certain chronic diseases, including heart disease, cancer, obesity, and diabetes. Vegetarian diets are linked to lower risk for death from ischemic heart disease, according to findings of an evidence-based review. In addition, low-density lipoprotein cholesterol levels, blood pressure, and body mass index appear to be lower in vegetarians than in nonvegetarians, as do rates of hypertension, type 2 diabetes, and cancer.

The position paper also reviews available evidence concerning the effects of vegetarian diets on cardiovascular disease, obesity, osteoporosis, renal disease, dementia, diverticulitis, and rheumatoid arthritis.

Specific vegetarian considerations regarding specific nutritional programs are also reviewed, including the Special Supplemental Nutrition Program for Women, Infants, and Children; child nutrition programs; feeding programs for elderly adults; corrections facilities programs; military and armed forces programs; and other institutions and quantity food service organizations.

During the next decade, the number of vegetarians in the United States is expected to increase. Vegetarian diets are typically characterized by certain healthful features that may lower the risk for chronic disease — notably, reduced consumption of saturated fat and cholesterol and increased consumption of fruits, vegetables, whole grains, nuts, soy products, fiber, and phytochemicals with potent antioxidant, antiproliferative, and cancer-protective activity.

However, individual diets should be evaluated to ensure that they are nutritionally adequate, given the variability of dietary habits among vegetarians. Other important roles for food and nutrition professionals are to educate vegetarians regarding sources of key nutrients, food purchase and preparation, and individual dietary modifications to meet their specific requirements.

Recommendations for a Healthy Vegetarian Diet

Specific recommendations to help ensure that vegetarians have healthful diets with sufficient nutrients are as follows:

    * The diet should contain a wide variety of healthful foods, including whole grains, vegetables, fruits, legumes, nuts, and seeds, as well as dairy and eggs if desired.
    * Consumption of foods that are high in sugar, sodium, and fat, particularly saturated fat and trans-fatty acids, should be minimized.
    * The diet should contain a wide range of healthful fruits and vegetables.
    * For vegetarians who consume dairy products and eggs, moderation is recommended, as well as use of lower-fat dairy products.
    * A regular source of vitamin B-12 is recommended, as well as of vitamin D if sunlight exposure is limited.
    * Nutritionists should be able to recommend local, reliable sources for purchase of vegetarian foods, or mail-order sources in some communities where suitable local sources are unavailable.
    * To facilitate meeting nutrient needs on a vegetarian diet, clinicians should collaborate with family members, especially the parents of children following vegetarian diets.
    * Practitioners unfamiliar with the principles of vegetarian nutrition should help their vegetarian patients find a nutritionist or other qualified provider to advise them regarding their diet.

"It is the position of the American Dietetic Association that appropriately planned vegetarian diets, including total vegetarian or vegan diets, are healthful, nutritionally adequate, and may provide health benefits in the prevention and treatment of certain diseases," the position paper authors write. "Well-planned vegetarian diets are appropriate for individuals during all stages of the lifecycle, including pregnancy, lactation, infancy, childhood, and adolescence, and for athletes.... Food and nutrition professionals can assist vegetarian clients by providing current, accurate information about vegetarian nutrition, foods, and resources."
http://cme.medscape.com

Ingredients:
Bhringraj (Eclipta alba): One part
Hena (Lawsonia inermis) powder: one part
Amala (Emblica officinalis ) powder: Half part
Bibhitaki/Barro (Terminalia belerica): Half part
Kakmachi (Solanum nigrum ) powder: 1/4th part
Black Til seed (Sesamum indicum): 1/4th part

mix all powder in a container. Add sufficient quantity of the decoction of tea leaves to make paste. For tea decoction you can boil tea leaves just like making tea.Again add two teaspoonful of curds. Make a good paste of everything. Put this paste into iron pot for 12 hours.Then, apply this paste on your hair. keep it for an hour. Then wash you hair to remove paste. Do not use shampoo. Finally massage with sesame oil after hair get dried. Them you can use shampoo to get lovely hair with dark brown color

- Drink plenty of liquids like coconut water, sugarcane juice, buttermilk or at least 10 glasses of water a day.
- Eat light food- avoid hot, spicy, oily meals and eat foods having high in water content including frits, salads, soups and buttermilk.
- Lassi made from churned curd, cream and ginger or powder of fried barley dissolved in water acts as a re-hydrating agent in summer.
- A fresh green mango baked in hot ash or raw mango with salt can quench excessive thirst.
- Avoid alcoholic beverages and drinks containing caffeine (tea and coffee), which can make the condition of heat worse.
- Curd rice prepared by adding boiled rice to curdling milk and kept overnight, should be eaten in morning with plenty of raw onions.
- While going out, wear a white handkerchief or use an umbrella to block sunrays.
- Do outdoor work in the early mornings or late evenings.
- Wear light colored, loose fitting cotton clothes, preferably muted colors such as tan.
- Take frequent baths and showers and apply chandan (sandalwood) paste to body for cooling the body.
- Smoking can constrict blood vessels and impair the ability to acclimatize to heat, so quit it