Issue : 01 DOI :
INTERNATIONAL
JOURNAL
OF
DIAGNOSTICS
AND
RESEARCH
Volume : 02
Copyright @ : - Dr. Gitika Chaudhary Inter. J.Digno. and Research IJDRMSID00046 |ISSN :2584-2757
14
Abstract
Non-alcoholic fatty liver disease (NAFLD), encompassing a range of liver conditions including Grade 3
fatty liver (severe hepatic steatosis), represents a significant global health issue exacerbated by rising
obesity, diabetes and metabolic syndromes. Modern medical treatments largely focus on lifestyle changes
with limited pharmacological interventions. This case study explores the effectiveness of a comprehensive
Ayurvedic management strategy in treating a 68-year-old male with Grade 3 fatty liver. The personalized
therapeutic regimen included ayurvedic medications, combined with Panchakarma detoxification therapies
and specific dietary adjustments. Post-treatment evaluations demonstrated notable improvements: a
reduction in liver size from 144mm to 127mm, normalization of liver echotexture, significant decrease in
ALT levels and improved glycaemic control. These results highlight the potential of Ayurvedic treatments
in managing advanced stages of NAFLD by restoring Doshic balance, enhancing metabolic processes and
reducing systemic toxins. The findings suggest a viable complementary approach to conventional
treatments, emphasizing the need for further research to integrate Ayurveda into global strategies battling
NAFLD.
Keywords: Ayurveda, non-alcoholic fatty liver disease, Grade 3 fatty liver, Ayurvedic medicine,
YakritVikara.
P
ISSN No. : 2584-2757
Volume : 02
Issue : 04
Publisher
ROGANIDAN VIKRUTIVIGYAN PG ASSOCIATION
FOR PATHOLOGY AND RADIODIGNOSIS
DOI
: 1 0 . 5 2 8 1 / z e n o d o . 1 6 0 3 0 0 9 0
Reg. No. : MAHA-703/16(NAG)
Year of Establishment – 2016
INTERNATIONAL JOURNAL OF DIAGNOSTICS AND RESEARCH
Corresponding author: Dr. Gitika Chaudhary
Article Info: Published on : 15/07/2025
Impact Factor : 1.013
Comprehensive Ayurvedic Management of Grade 3 Fatty Liver (Yakrit Vikara):
A Case Report
Acharya Manish Ji
1
, Dr. Gitika Chaudhary
2
, Dr. Richa
3
, Dr. Rachana
4
1
Director, Meditation Guru, Jeena Sikho Lifecare limited.
2
Senior Consultant, General Surgeon, BAMS, PGDIP, PGDGS, MS (Ay.), Jeena Sikho lifecare limited.
3
Research officer, BAMS, PGDIP, CICR, CAIM, CMW, Jeena Sikho lifecare limited.
4
Consultant, BAMS, NDDY, PGDIP, Jeena Sikho lifecare limited Clinic Baltana.
Cite this article as: - Dr. Gitika Chaudhary (2025) ; Comprehensive Ayurvedic Management of Grade 3 Fatty Liver (Yakrit
Vikara): A Case Report ;Inter.J.Dignostics and Research 2 (4) 14-28, DOI : 1 0 . 5 2 8 1 / z e n o d o . 1 6 0 3 0 0 9 0
G
A
R
V
Issue : 04
INTERNATIONAL JOURNAL OF DIAGNOSTICS AND RESEARCH [ISSN No.: 2584-2757]
Volume : 02
Copyright @ : - Dr. Gitika Chaudhary Inter. J.Digno. and Research IJDRMSID00046 |ISSN :2584-2757
15
Introduction
Non-alcoholic fatty liver disease (NAFLD) is a
spectrum of liver disorders characterized by
excessive fat accumulation in hepatocytes,
excluding alcohol consumption as a primary cause.
Grade 3 fatty liver, also known as severe hepatic
steatosis, represents an advanced stage of NAFLD,
often associated with complications such as
fibrosis, cirrhosis and an increased risk of
hepatocellular carcinoma (HCC)
[1,2]
. The global
prevalence of NAFLD is rising due to the
increasing burden of obesity, diabetes mellitus and
metabolic syndrome, making it a significant public
health concern
[3]
. Despite advances in modern
medicine, pharmacological management for
NAFLD remains limited, with a strong emphasis on
lifestyle modifications and control of metabolic risk
factors
[4]
. In this context, Ayurveda, a traditional
Indian system of medicine, offers a holistic
approach to manage liver disorders through
personalized therapeutic regimens involving
ayurvedic medicines, detoxification therapies
(Panchakarma) and dietary recommendations
[5]
.
Ayurvedic interventions target the root causes of
fatty liver, such as impaired digestion (Agni), toxin
accumulation (Ama) and dosha imbalances,
especially Kapha and Pitta
[6]
. This case study
highlights the efficacy of Ayurvedic treatment in
managing Grade 3 fatty liver by addressing its
pathophysiology from an integrative perspective. It
demonstrates the potential for improving liver
health through a combination of ayurvedic
medicines, Panchakarma therapy and lifestyle
modifications, which align with the Ayurvedic
principle of restoring homeostasis within the
body
[7]
.
Non-alcoholic fatty liver disease (NAFLD) is the
most common chronic liver disease worldwide,
affecting approximately 25-30% of the global
population
[8]
. The prevalence of advanced stages,
including Grade 3 fatty liver, is higher in
individuals with metabolic syndrome, type 2
diabetes mellitus and obesity
[9]
. NAFLD is
particularly prevalent in developed countries, with
rates reaching up to 40% in the United States and
the Middle East
[10]
. In India, the prevalence ranges
between 9-32%, with increasing cases reported due
to rapid urbanization, sedentary lifestyles and
dietary changes
[11]
.
NAFLD not only affects adults but is also a
growing concern in paediatric populations, with an
estimated 3-10% of children and up to 38% of
obese children being affected
[12]
. The disease is a
leading cause of liver-related morbidity and
mortality, underscoring the need for effective
prevention and treatment strategies
[13]
.
Case Report:
Patient History and Information:
The patient, a 68-year-old male, had a history of
inconsistent adherence to dietary modifications
recommended for hypertension and fatty liver
management. He had not shown a consistent
engagement with either allopathic or Ayurvedic
medications, and there had been no indication of
him taking regular treatments from either approach.
Diet and Lifestyle History: The patient led a
largely sedentary lifestyle characterized by minimal
physical activity, mostly involving seated tasks and
brief walks within his neighbourhood. His dietary
habits included a high intake of carbohydrate-rich
and unhealthy fats, with frequent consumption of
Issue : 04
INTERNATIONAL JOURNAL OF DIAGNOSTICS AND RESEARCH [ISSN No.: 2584-2757]
Volume : 02
Copyright @ : - Dr. Gitika Chaudhary Inter. J.Digno. and Research IJDRMSID00046 |ISSN :2584-2757
16
fried snacks and sugary desserts. Fresh fruits and
vegetables are rarely included in his meals and he
had a preference for sugary beverages.
Medicine History:
Sr.
No.
Medicine Name
Dosage
1.
Ursodeoxycholic acid
OD
Surgical History: There were no reports of any
surgical interventions.
Family History: Detailed family medical history
not been provided, which could be relevant for
understanding potential genetic predispositions to
metabolic conditions.
Onset and Disease Progression:
The patient presented with discomfort in the right
upper abdomen. He also reported poor appetite and
occasional nausea. Patient also complained of
coughing with sputum and lower back pain with
Numbness in the lower extremities. Physical
examination revealed obesity, with a body mass
index (BMI) of around 29 kg/m². On abdominal
examination, hepatomegaly was noted with mild
tenderness in the right hypochondrium, but there
were no signs of ascites or splenomegaly.
Cardiovascular assessment showed blood pressure
at 120/80 mmHg, consistent with his history of
hypertension and a regular heart rate of 88 beats per
minute. Further examination indicated mild pitting
oedema in both ankles, but no signs of jaundice,
spider angiomas or palmar erythema were
observed. The patient’s skin and sclera were
normal, with no visible icterus. There was no
evidence of hepatic encephalopathy or confusion,
suggesting no advanced complications like liver
failure. These clinical findings aligned with the
diagnosis of advanced fatty liver disease
compounded by his metabolic and hypertensive
history.
Samprapti of Yakrit vikara
In Ayurveda, Yakrit Vikara refers to disorders
related to the liver, primarily seen as an imbalance
in the Pitta dosha, which the liver predominantly
houses alongside some aspects of Kapha. The
Samprapti (pathogenesis) typically begins with the
aggravation of Pitta due to factors such as improper
diet, excessive intake of alcohol, or emotional
stress. This aggravated Pitta then combines with
ama (toxins resulting from improper digestion) and
spreads to the yakrit (liver), impairing its ability to
purify blood and metabolize fats efficiently. The
disruption can lead to a variety of liver issues such
as inflammation, jaundice, or fatty liver disease. In
many cases, disturbed Kapha may accumulate,
further complicating the condition by obstructing
liver channels and impairing its function.
Initial Factors (Poor diet, lifestyle habits,
excessive alcohol, etc.)
↓
Aggravation of Pitta (and possibly Kapha or
Vata)
↓
Formation of Ama (toxins)
↓
Ama with Pitta affects the liver (Yakrit)
↓
Disturbance in Ranjaka Pitta (responsible for
bile production)
↓
Leads to disturbance in liver functions
↓
Manifestation of Symptoms (jaundice, fatigue,
etc.)
↓
Yakrit Vikara (Liver Disorder)
Issue : 04
INTERNATIONAL JOURNAL OF DIAGNOSTICS AND RESEARCH [ISSN No.: 2584-2757]
Volume : 02
Copyright @ : - Dr. Gitika Chaudhary Inter. J.Digno. and Research IJDRMSID00046 |ISSN :2584-2757
17
Vital Parameters:
● Body Mass Index (BMI): The patient
presents with a BMI of approximately 29
kg/m², categorizing him as overweight.
● Blood pressure : 120/80 mmHg
● Heart Rate: Regular, at 88 beats per
minute.
Ayurvedic Examination:
Table No. 1. Ashtavidha Pariksha (Eight-fold
Examination) .
S. No
Examination
Findings
1.
Nadi (Pulse)
Vata-Pittaj
2.
Mutra (Urine)
Avikrita
3.
Mala (Stool)
Avikrita
4.
Jihva (Tongue)
Saam
5.
Shabda (Voice)
Spashta
6.
Sparsha
(Touch)
Anushna Sheeta,
tenderness in the right
hypochondrium upon
palpation.
7.
Drika (Eyes)
Avikrita
8.
Akriti
(Appearance)
Madhyam
Table No. 2. DashavidhaPariksha (Ten-fold
Examination)
Sr.
No
Examination
Findings
1.
Prakriti (Constitution):
VataPittaj
2.
Vikriti (Imbalance):
Pittaj
3.
Sara (Tissue Excellence):
Madhyam
4.
Samhanana (Body Build):
Moderate
5.
Pramana (Body
Proportions):
Within
normal
limits.
6.
Satmya (Adaptability):
Avar
7.
Satva (Psychological
Strength):
Madhyam
8.
Ahara Shakti (Digestive
Strength):
Madhyam
9.
Vyayama Shakti (Exercise
Capacity):
Madhyam
10.
Vaya (Age):
68yr old,
Vriddha
Diagnostic Assessment :
Laboratory Results:
1. Liver Function Tests: Within Normal
Limits
Imaging Results:
1. Ultrasound: done on 27/04.2024 suggested
the
● Findings indicate liver measure ~144mm,
Granular in echo texture consistent with Liver
Parenchymal Disease (grade 3 fatty liver
disease).
2. Fibro Scan: done on 2/5/2024
● Measured liver stiffness of 5.5kPa, suggesting
significant fibrosis possibly on border of
early cirrhosis.
● CAP (Controlled Attenuation Parameter)
score was 337 indicative of significant grade
3 fatty liver disease
Ayurvedic Diagnosis:
In Ayurveda, liver disorders are frequently linked to
imbalances in Pitta dosha, which governs
metabolism and transformation. Kapha dosha,
responsible for structure and lubrication, can also
be involved, especially in later stages or specific
conditions. In grade 3 liver disease, the pathology
may involve a more profound Pitta aggravation,
leading to severe inflammation and damage. There
may also be Kapha involvement, which can
manifest as structural changes like fibrosis or
cirrhosis.
Treatment Plan :
Ayurvedic Diet Plan:
[14]
The dietary guidelines provided by Jeena Sikho
Lifecare Limited Hospital include the following
key commendations:
Issue : 04
INTERNATIONAL JOURNAL OF DIAGNOSTICS AND RESEARCH [ISSN No.: 2584-2757]
Volume : 02
Copyright @ : - Dr. Gitika Chaudhary Inter. J.Digno. and Research IJDRMSID00046 |ISSN :2584-2757
18
a. Foods to be avoided:
● Do not consume wheat, refined food, milk
and milk products, coffee and tea and
packed food.
● Avoid eating after 8 PM.
● During solid consume as small bite and
chew 32 times.
b. Hydration:
● During water intake, take sip by sip and
drink slowly to ensure the amount of water
intake each time.
● Drink about 1 liter of alkaline water 3 to 4
times throughout the day.
● Include herbal tea, living water and
turmeric-infused water part of daily routine.
c. Millet Intake:
● Incorporate five types of millet into your
diet: Foxtail (Setariaitalica), Barnyard
(Echinochloaesculenta), Little
(Panicumsumatrense), Kodo
(Paspalumscrobiculatum) and Browntop
(Urochloa ramose).
● Use only steel cook wares for preparing the
millets
● Cook the millets only using mustard oil.
d. Meal Timing and Meal Structure:
1. Early Morning (5:45 AM): Herbal tea,
curry leaves (1 leaf-1 min/5 leaves-5
min) along with raw ginger and
turmeric.
2. Breakfast (9:00-10:00 AM): The patient
had given steamed fruits (Seasonal),
steamed sprouts (according to the
season) and a fermented millet shake (4-
5 types).
3. Morning Snacks (11:00AM): The
patient had given Red juice (150 ml)
and soaked almonds.
4. Lunch (12:30 PM - 2:00 PM): The
patient had received Plate 1 and Plate 2.
Plate 1 will include a steamed salad,
while Plate 2 with cooked millet-based
dish.
5. Evening Snacks (4:00 – 4:20 PM):
Green juice (100-150 ml) along with 4-5
almonds.
6. Dinner (6:15-7:30 PM): The patient had
served a steamed salad, chutney, and
soup, as Plate 1, along with millet
khichdi as Plate 2.
",
"
Bhavaprakasha Nighantu, Dhanyavarga,
Verse on Yava (Barley)
[15]
e. Fasting:
● It is advised to observe one-day fasting.
f. Special Instructions:
● Express gratitude to the divine before
consuming foods or drinks.
● Sit in Vajrasana (a yoga posture) after each
meal.
● 10 minutes slow walk after every meal.
g. Diet Types:
● The diet comprises salt-less solid, semi-
solid and smoothie options.
● Suggested foods include herbal tea, red
juice, green juice, a variety of steamed
fruits, fermented millet shakes, soaked
almonds and steamed salads.
Issue : 04
INTERNATIONAL JOURNAL OF DIAGNOSTICS AND RESEARCH [ISSN No.: 2584-2757]
Volume : 02
Copyright @ : - Dr. Gitika Chaudhary Inter. J.Digno. and Research IJDRMSID00046 |ISSN :2584-2757
19
II. Lifestyle Recommendations were-
(i) Include meditation for relaxation.
(ii) Practice barefoot brisk walk for 30 minutes.
(iii) Ensure 6-8 hours of quality sleep each
night.
(iv) Adhere to a structured daily routine.
1. Ayurvedic Treatment Protocol:
Table No. 3 – Ayurveda Treatment Protocol
Date
Ayurveda Treatment
16/05/2024
Medh Cap 1BD
(Adhobhakta with
KoshnaJala)
Asthiposhaka Vati 2 BD
(Adhobhakta with
KoshnaJala)
Lipi Cap 1 BD
(Adhobhakta with
KoshnaJala)
Dr Immune Tab 1 tab BD
(Adhobhakta with
KoshnaJala)
Orthonil Syrup 15ml BD
(Adhobhaktaa with
samamatra KoshnaJala)
DS powder ½ Tsp HS
(Nishikala with
KoshnaJala)
Date
Ayurveda Treatment
11/07/2024
Asthiposhaka Vati 2 BD
(Adhobhakta with
KoshnaJala)
Lipi Cap 1 BD
(Adhobhakta with
KoshnaJala)
Ciro Cap 1 BD
(Adhobhakta with
KoshnaJala)
SypLivforte 15ml BD
(Adhobhaktaa with
samamatraKoshnaJala)
Date
Ayurveda Treatment
16/08/2024
Asthiposhaka Vati 2 BD
(Adhobhakta with
KoshnaJala)
Lipi Cap 1 BD
(Adhobhakta with
KoshnaJala)
Orthonil Syrup 15ml BD
(Adhobhaktaa with
samamatraKoshnaJala)
Dr Immune Tab 1 tab BD
(Adhobhakta with
KoshnaJala)
Date
Ayurveda Treatment
30/09/2024
Medh Cap 1BD
(Adhobhakta with
KoshnaJala)
Cough har churna 1/2tsp
TDS (Adhobhakta with
KoshnaJala)
Syp Jeevan amrita 20ml
BD (Pragbhakta with
samamatra Koshna Jala)
Liv DS Cap 1 capsule BD
(Adhobhakta with
KoshnaJala)
SypBroncho 15ml BD
(Adhobhaktaa with
samamatra KoshnaJala)
DS powder ½ Tsp HS
(Nishikala with
KoshnaJala)
AarogyaVati 1BD
(Adhobhakta with
KoshnaJala)
Date
Ayurveda Treatment
11/11/2024
AarogyaVati 1BD
(Adhobhakta with
KoshnaJala)
SamaVati 1 tab BD
(Adhobhakta with
KoshnaJala)
Dr Liv Shuddhi Tab 1 tab
BD (Adhobhakta with
KoshnaJala)
Syp Jeevan amrita 20ml
BD (Pragbhakta with
samamatra KoshnaJala)
Issue : 04
INTERNATIONAL JOURNAL OF DIAGNOSTICS AND RESEARCH [ISSN No.: 2584-2757]
Volume : 02
Copyright @ : - Dr. Gitika Chaudhary Inter. J.Digno. and Research IJDRMSID00046 |ISSN :2584-2757
20
Follow-Up and Outcomes
After 6 months of Ayurvedic treatment, the results
that were seen are
Table No. 4 – Outcomes – Objective
Parameters
Parameters
Pre-
Treatment
Post-
Treatment
Alanine
Aminotransferase
(ALT):
95 U/L
(indicative of
liver
stress/damage)
45 U/L
(within
normal
range,
indicating
improved
liver health)
CAP
337(Db/m)
238(Db/m)
FibroScan (Liver
Stiffness):
5.5 kPa (not
suggestive of
notable
fibrosis)
5 kPa
(Slightly
improved)
Fasting Blood
Glucose:
150 mg/dL
(indicative of
poorly
controlled
diabetes)
120 mg/dL
(improved
but still
above
normal,
reflecting
better but not
ideal
glycaemic
control)
USG Parameter
Values
liver measure
~144mm,
Granular in
echotexture
consistent
with Liver
Parenchymal
Disease (grade
3 fatty liver
disease).
~127mm,
Normal
echotexture
suggestive of
a normal
scan.
The changes in the subjective parameters that was
observed are
Table No. 5- Outcomes – Subjective Parameters
Parameters
Pre-
Treatment
Post-Treatment
Fatigue
Levels:
The patient
reported
significant
fatigue,
impacting daily
activities.
The patient
experienced
considerably less
fatigue, enhancing
quality of life and
activity levels.
Right
Upper
Quadrant
Pain:
The patient
frequently
experienced
discomfort and
dull pain in the
right upper
abdominal
area.
The patient
reported a
significant
reduction in
abdominal
discomfort, only
occasionally
feeling mild pain.
Appetite
Changes:
The patient
noted a poor
appetite, often
felt nauseous
after eating.
The patient's
appetite was
improved
substantially, with
nausea greatly
diminished.
Image 1: USG Before Treatment
Issue : 04
INTERNATIONAL JOURNAL OF DIAGNOSTICS AND RESEARCH [ISSN No.: 2584-2757]
Volume : 02
Copyright @ : - Dr. Gitika Chaudhary Inter. J.Digno. and Research IJDRMSID00046 |ISSN :2584-2757
21
Image 2: USG After Treatment
Mechanism of Action of the medicines
1. AsthiposhakVati - "AsthiPoshakVati" is
an Ayurvedic formulation specifically
designed to support bone health and tissue
regeneration. This ayurvedic compound
includes elements like Godanti (Gypsum),
which is known for its high calcium
content and helps in bone fortification.
ShudhShilajit is rich in minerals and aids in
enhancing the bioavailability of other
nutrients essential for bone metabolism and
overall rejuvenation. Ashwagandha serves
as a stress reliever and has anti-
inflammatory properties, which are crucial
in maintaining overall bone and joint
health. Hadjorh (Cissus quadrangularis),
the star ingredient, is widely recognized for
accelerating bone healing, enhancing
calcium absorption and generally
strengthening the skeletal system.
Tabaqsheer (Bambusa arundinacea) and
Pippali (Long pepper) improves nutrient
assimilation and boosts overall digestive
and respiratory health, indirectly
supporting bone health. AmbaHaldi
(Curcuma amada) contributes anti-
inflammatory and antioxidant properties,
protecting tissues including bones from
oxidative stress and inflammatory damage.
Together, these ingredients make
AsthiPoshakVati a comprehensive bone
health supplement that not only strengthens
bones but also enhances joint mobility and
helps in the repair and regeneration of
damaged tissues.
2. Lipi Cap - "Lipi Capsules" are formulated
with a comprehensive blend of Ayurvedic
herbs and minerals targeted at enhancing
lipid metabolism and supporting
cardiovascular health. Key ingredients
include Arjuna, known for its
cardioprotective properties, and Guggulu,
which is effective in managing cholesterol
levels. Haridra (turmeric) and Amla
(Indian gooseberry) provide potent anti-
inflammatory and antioxidant benefits,
helping to reduce oxidative stress and
improve overall heart health. Bhumiamla
and Guduchi strengthen liver function,
crucial for effective lipid metabolism.