Evaluation of Vamana and Virechana as Interventions to Decelerate the Aging Process in Healthy Adult Volunteers: Protocol for an Exploratory Single-Arm Clinical Trial.
Soman D, Nv R, Nk P • JMIR research protocols • 2026
This paper presents a protocol for an exploratory single-arm clinical trial to investigate whether Ayurvedic seasonal purification procedures (Vamana and Virechana) can decelerate aging by modifying serum malondialdehyde, total superoxide dismutase, and telomerase activity in healthy adults aged 35-65.
Key Findings
Background
The study is designed as an exploratory single-arm pre-posttest trial with no control group, enrolling 53 healthy adult volunteers aged 35 to 65 years.
Sample size is 53 participants between 35 and 65 years old.
The study explicitly lacks a control group and is described as exploratory.
The study uses a pre-posttest design with measurements taken on day 0 and on the 18th-20th day following completion of Samsarjana karma.
The trial was prospectively registered in the Clinical Trial Registry-India (CTRI/2024/02/062176).
Total study duration is 3 years, with each participant's trial duration ranging from 18 to 20 days.
Methods
Primary biological endpoints include serum malondialdehyde (MDA), total superoxide dismutase (T-SOD), and telomerase activity, chosen as markers relevant to oxidative stress and aging.
Serum MDA is a marker of oxidative stress (lipid peroxidation).
T-SOD is an antioxidant enzyme whose activity reflects oxidative defense capacity.
Telomerase activity is included as a marker related to cellular aging and telomere maintenance.
All three biomarkers will be measured at baseline (day 0) and after completion of Samsarjana karma (day 18-20).
Methods
Participant eligibility requires a BMI between 18.5 and 25 kg/m² with stable weight for 3 months prior to enrollment, madhyama koshta (medium bowel evacuation nature), and eligibility for both therapeutic emesis and purgation.
BMI eligibility range is 18.5 kg/m² to 25 kg/m².
Weight must have been stable for the 3 months immediately prior to the study.
Madhyama koshta status is assessed using a questionnaire.
Participants must be both Vamanarha (eligible for therapeutic emesis) and Virechanarha (eligible for therapeutic purgation).
Methods
The interventions follow a seasonal schedule, with Vamana (therapeutic emesis) performed in spring and Virechana (therapeutic purgation) performed in autumn, each preceded by oleation and fomentation procedures.
Vamana is performed in the spring season and Virechana in the autumn season.
Both procedures are preceded by Snehana (oleation) and Swedana (fomentation).
Each procedure is followed by Samsarjana karma, a specialized dietary regimen whose duration depends on the degree of purification achieved.
This combined seasonal purification is referred to as 'ritu sodhana.'
Methods
Statistical analysis will use paired-samples t tests or Wilcoxon signed-rank tests for continuous primary endpoints, with missing data handled via available case analysis cross-verified by a baseline observation carried forward sensitivity test.
Choice between paired t test and Wilcoxon signed-rank test will depend on data distribution.
Missing data will be managed under a missing completely at random (MCAR) assumption using available case analysis (pairwise deletion).
A conservative baseline observation carried forward (BOCF) sensitivity test will cross-verify the primary analysis.
Effect size will also be calculated in addition to hypothesis testing.
Results
Recruitment began in March 2025, with data already collected from 27 participants who voluntarily participated in the spring Vamana procedure.
Recruitment started in March 2025.
Data for 27 participants who underwent Vasantha Vamana (spring therapeutic emesis) were collected in March and April 2025.
Data analysis for these participants is described as pending at the time of publication.
The full study is expected to be completed by the end of December 2026.
Discussion
The authors acknowledge the study will provide only hypothesis-generating evidence and will serve as a precursor to adequately powered confirmatory trials on the aging process.
The study is explicitly described as exploratory and lacking a control group, limiting causal inference.
The authors state the data 'will serve as a necessary precursor to adequately powered, confirmatory trials on the aging process.'
The efficacy of ritu sodhana for health span and decelerating aging in healthy individuals is characterized as 'a gray area' in the existing literature.
The study is described as 'hypothesis-generating' rather than confirmatory.
What This Means
This research describes the design of a clinical trial testing whether two traditional Ayurvedic cleansing procedures — therapeutic vomiting (Vamana) in spring and therapeutic purging (Virechana) in autumn — might slow down aging-related biological changes in healthy adults. The study is enrolling 53 people between the ages of 35 and 65 who meet specific health criteria, including a healthy body weight and normal digestive function. Researchers will measure three biological markers in participants' blood before and after the procedures: malondialdehyde (a marker of cellular damage from oxidative stress), superoxide dismutase (an antioxidant enzyme), and telomerase activity (an enzyme linked to how cells age). Changes in these markers could indicate whether the procedures have a protective or rejuvenating effect at the cellular level.
This research suggests that the Ayurvedic practice of seasonal purification, known as 'ritu sodhana,' may have measurable biological effects on oxidative stress and cellular aging markers, though this has not yet been confirmed. As of early 2025, data from 27 participants who completed the spring vomiting procedure had been collected but not yet analyzed. The full study, including the autumn purging phase, is expected to wrap up by December 2026.
It is important to note that this is a protocol paper — it describes the study design rather than reporting results — and the trial itself has no control group, meaning it cannot definitively prove that the procedures caused any changes observed. The authors themselves acknowledge the study is exploratory and 'hypothesis-generating,' intended to provide preliminary data to support larger, more rigorous trials in the future. This kind of early-stage research is a first step toward understanding whether traditional Ayurvedic practices might have scientifically measurable effects on human aging biology.
Soman D, Nv R, Nk P. (2026). Evaluation of Vamana and Virechana as Interventions to Decelerate the Aging Process in Healthy Adult Volunteers: Protocol for an Exploratory Single-Arm Clinical Trial.. JMIR research protocols. https://doi.org/10.2196/99146