Triphala’s characteristics and potential therapeutic uses in modern health

Abstract

Ayurveda, a traditional Indian medical system, offers a comprehensive approach to health promotion, disease prevention, and body rejuvenation, emphasizing wellness, vitality, and holistic well-being. Triphala, a well-established polyherbal Ayurvedic formulation, comprises equal proportions of Emblica officinalis (Amalaki or Amla), Terminalia bellerica (Bibhitaki or Bahera), and Terminalia chebula (Haritaki or Harad), demonstrating exceptional efficacy in gastrointestinal health and rejuvenation therapy. Triphala Rasayana, a polyherbal formulation, has been employed in Ayurveda, Siddha, and Unani medicine systems to address various health conditions. Its medicinal attributes include antioxidant, anticancer, antidiabetic, antimicrobial, immunomodulatory, and anticataract properties, making it a vital component in gastrointestinal treatment, particularly for functional gastrointestinal disorders. With its rich history in Ayurveda, Triphala’s unique tridoshic properties harmonize the body’s three essential energies - Vata, Pitta, and Kapha - fostering overall well-being and diverse health applications. The phytochemical composition of Triphala Rasayana is scrutinized, revealing essential bioactive compounds like phenolic acids, tannins, and flavonoids, which contribute to its antioxidant, anti-inflammatory, and antimicrobial effects. The therapeutic properties of Triphala span antidiabetic, hepatoprotective, and immunomodulatory effects, underpinned by studies demonstrating its benefits for oxidative stress, metabolic disorders, and immune enhancement. The review also underscores Triphala’s role in gastrointestinal health, promoting beneficial microbiota and alleviating digestive issues, alongside its cardioprotective effects. Concluding with a call for advanced research into its pharmacodynamics and molecular mechanisms, the document advocates for integrating this potent Ayurvedic remedy into modern therapeutic regimens.

Introduction

Ayurveda is a traditional holistic medical system that originated in India, emphasizing personalized health, disease prevention, and overall well-being. The word Ayurveda is derived from Sanskrit, where “Ayu” signifies life and “Veda” refers to knowledge or science, meaning “the science of life”. This ancient practice focuses on maintaining harmony between the body, mind, and spirit, strongly emphasizing an individual’s natural constitution (Prakriti) for diagnosis and treatment. Foundational Ayurvedic texts, including Charaka Samhita, Sushruta Samhita, and Ashtanga Hridaya, contain extensive knowledge of medicinal herbs, therapeutic formulations, and lifestyle guidelines to promote health and manage diseases [1].

Ayurvedic medicine encompasses a multifaceted approach to healthcare, incorporating herbal remedies, mineral-based formulations, and personalized dietary guidelines. It is based on the Panchtatvas (five elements) - earth, water, fire, air, and space - which combine to form the Tridosha system (Vata, Pitta, and Kapha), which categorizes bodily functions into three distinct doshas: Vata (air and space), Pitta (fire and water), and Kapha (earth and water). Each individual’s unique constitution, or Prakriti, influences their disease susceptibility and optimal treatment strategies. Ayurveda comprises eight branches of medicine, including Kayachikitsa (internal medicine), Shalyatantra (surgery), Rasayana (rejuvenation therapy), and others [2].

A fundamental principle of Ayurveda is its polyherbal approach, where multiple medicinal plants are strategically combined to enhance therapeutic efficacy and mitigate potential toxicity. Classical Ayurvedic texts, including the Charaka Samhita and Sushruta Samhita, emphasize this synergistic interaction, recognizing that the bioactive constituents of individual herbs may be insufficient to achieve optimal pharmacological outcomes. Additionally, Ayurveda incorporates specialized therapeutic modalities such as Panchakarma (systematic detoxification), Rasayana (rejuvenation and geriatric therapy), and Satvavajaya (psychotherapeutic interventions for mental well-being) to address physiological, psychological, and metabolic health comprehensively. With increasing empirical evidence supporting its efficacy, Ayurveda is progressively integrated into complementary and alternative medicine, offering a holistic and sustainable framework for disease prevention and health promotion [3].

The “Three-Fruit Harmony” formulation, comprising Amla, Haritaki, and Baheda, is a well-known blend called Triphala, which is known for its detoxifying and rejuvenating properties and is believed to support digestion, boost immunity, and regulate metabolic processes [4]. Another notable formulation is Ashwagandha (Withania somnifera), employed for its adaptogenic properties, helping manage stress, enhancing cognitive function, and improving physical endurance [5]. Brahmi (Bacopa monnieri) is commonly utilized in Ayurvedic formulations to enhance cognitive function, retain memory, and reduce anxiety [6]. Shankhapushpi (Convolvulus pluricaulis), another herb frequently included in formulations, is known for its neuroprotective properties and is used to treat mental fatigue and enhance intellectual capacity [7].

Ayurveda’s comprehensive approach also extends to treating chronic conditions like heart problems, liver issues, and diabetes. Formulations like Nishamalaki, a combination of haldi (C. longa) and amla (E. officinalis), are traditionally employed to manage blood sugar levels and improve insulin sensitivity. Similarly, Arjuna (Terminalia Arjuna) is incorporated into formulations for cardiovascular health, given its cardioprotective properties [8].

Ayurveda has eight primary branches, and Rasayana is one of them that focuses on rejuvenation by enhancing nutrient utilization in the body [9]. Rasayana, an Ayurvedic concept, harnesses the power of plant-based elixirs to revitalize the body. Charaka Samhita outlines that these rejuvenating plants enhance vital energy in cells and tissues, fostering holistic wellness [10].

A well-known recognized and polyherbal formula consisting of three myrobalans species that are found in the Indian subcontinent is Triphala; in Sanskrit, it means three fruits. It consists of E. officinalis (Amla), T. bellerica (Bibhitaki), and T. chebula (Haritaki) in a 1:1:1 ratio. Triphala is known for its tridoshic rasayana in Ayurveda, and it delays aging and rejuvenation in different age groups [8].

In this formulation, Amalaki, also known as the Indian Gooseberry, Bibhitaki, and Haritaki. According to the ancient literature of Ayurveda like Charak Samhita and Sushruta Samhita, in ancient Indian medicine, Triphala has been consumed for thousands of years in a balanced amount for longevity. As per Charak, if peoples want to live 100 years without feeling aged and having any health issues, they have to consume Triphala mixed with honey and clarified butter (ghee) [11].

In ancient texts, Triphala is considered ‘Mahaaushadhi’, also called ‘Supreme Medicine’, and is used in Ayurvedic medicine to treat gastrointestinal issues. Its versatility allows for a variety of applications. Triphala is a resourceful polyherbal formulation with various advantages like free radical scavenging, antioxidant, immunomodulatory, anti-inflammatory, and many more. It has infinite activities related to stress, cancer, mutations, dental, antibacterial, liver health, digestive system, skin, and hair. Triphala, an Ayurvedic powerhouse, offers numerous health benefits. This polyherbal blend supports digestive wellness, reduces cholesterol levels, and improves circulation. Additionally, Triphala relaxes bile ducts, prevents immune system decline, and balances the endocrine system. Its hematopoietic properties also stimulate red blood cell and hemoglobin production [12].

In this polyherbal mix, every fruit exerts its effect on the body’s various systems in a synergistic form. Some researchers conclude that E. officinalis (Amla) is rich in carbs and medicinal compounds like ascorbic acid, tannins, mucic acid, flavone glycosides, and many more [13,14]. The amount of vitamin C is highest in the amla range between 400 and 500 mg per 100 ml of fruit juice, which is more than many times found in other fruits like lemon, apple, pomegranate, and grapes [15]. Like this second fruit, Bibhitaki also contains some nutritional compounds like tannins, bellericanin glucoside, gallic acid, galvanic acid, termilignan, thannilignan, methylenedioxy flavone, chebulagic acid, and carbs [16]. The third one, Haritaki, varies in tannin concentration by 30 to 35 percent with the geographical distribution of plants. A study by Juang and co-researchers revealed the complex composition of Triphala’s hydrolyzable tannins. The research identified 14 distinct components: chebulagic acid, gallic acid, punicalagin, neochebulinic acid, corilagin, ellagic acid, and other bioactive compounds. Some other minor compounds are maslinic acid, terflavin A, punicalagin, and galloyl glucose, like polyphenols [17].

Combining these three dried fruits is more beneficial than a single fruit. In Table 1, we explain the characteristics of the Triphala and the nature and the working of each plant in the Triphala polyherbal mix. The current review on Triphala focused on proving this polyherbal mix’s pharmacological effects and highlighted the possibility of future possibilities on many clinical approaches with Triphala.

Table 1.

Properties and effects of every constituent of Triphala

Constituents	Properties
Amalaki (Amla)	E. officinalis, known as Indian gooseberry, is a potent herb with dry and heavy qualities and effectively balances Pitta dosha, cooling body heat and enhancing digestion and metabolism. Its unique flavor and taste provide refreshment and health benefits. Rich in rejuvenating properties, E. officinalis reduces hair fall, improves skin health, enhances vision, and aids memory. It supports sensory processing, promotes healthy bowel movements, acts as an expectorant and bronchodilator for respiratory issues, and assists with infertility.
Haritaki (Harad)	T. chebula, or Haritaki, a cherished herb in Ayurveda, has a unique taste profile, combining five of the six tastes with a primarily astringent. Its post-digestive effect is sweet, and its potency is warm. Haritaki’s light and dry qualities make it an effective Vata, Pitta, and Kapha doshas balancer, particularly alleviating Vata imbalances. As a potent Rasayana or rejuvenating, Haritaki works efficiently on skin disorders like wound healing, CNS disorders, inflammation in the respiratory system, gastrointestinal disorders like indigestion, jaundice, hemorrhoids, liver, and spleen issues, acts as a mild laxative that enhances metabolism, fertility, and renal disorders and while also detoxifying the body and promoting overall well-being.
Bibhitaki (Baheda)	T. bellerica or Bibhitaki is an herb characterized by its bitter, astringent, sweet taste and warming potency. Its dry and light qualities make it an effective digestive and respiratory health remedy. At the same time, its detoxifying, anti-inflammatory, and antimicrobial properties confer additional benefit targets. Kapha dosha is related to the mind-body element associated with earth and water. It efficiently treats disorders related to hair greying, achromoderma, insomnia, blindness, myopia, neurological disorders, blood-related issues like hemoptysis, gut issues like vomiting, nausea, anorexia, helminthiasis, and libido enhancer.

In Ayurvedic tradition, Emblica officinalis (Amla or Indian Gooseberry) holds sacred significance. This ancient tree, believed to be the first on earth according to Indian mythology, thrives in tropical and subtropical regions of Asia, including China, Pakistan, Sri Lanka, South Asia, and Malaysia [18]. The phytochemical profile of dried fruit of Amla (Emblica officinalis or EO) is characterized by an abundance of bioactive compounds, including phenolic compounds, amino acids, alkaloids, isostrictiniin, ellagic acid, apigenin, chebulinic acid, quercetin, gallic acid, chebulagic acid, tannins, and carbohydrates. Notably, EO’s fruit juice boasts the highest vitamin C content among fruits, with an impressive 478.56 mg/100 ml, enhancing the nutritional value of blended fruit combinations [19].

Terminalia chebula, a robust tree from the Combretaceae family, thrives across Asia. Its diverse names reflect its cultural significance: Dark Myrobalan, Ink Tree, Haritaki, Harad, Harada, Karkchettu, and Kadukkaya. In Tibetan tradition, it’s considered the “King of Medicine”. At the same time, its Sanskrit name, Haritaki, signifies its association with Lord Shiva in Indian mythology and its purported ability to alleviate various ailments [20]. A comparative study revealed that Terminalia chebula fruit exhibits an unparalleled richness in bioactive compounds. Specifically, it demonstrated the highest levels of total phenols, flavonoids, gallic acid, catechin, chlorogenic acid, and coumaric acid among ten tested wild edible fruits, underscoring its potential health benefits [21]. Another study found some other biological compounds found in fruit extract are ellagic acid, arjunglucoside I, gallic acid, terflavin A, luteolin, 2,4-chebulyl-d-glucopyranose, punicalagin, arjungenin and chebulinic acid [22].

Terminalia bellirica, or bibhitaki, is a medicinal plant widely used in pharmaceutical and nutraceutical applications. It grows in deciduous forests across India below 3,000 feet. T. bellerica mainly contains alkaloids, flavonoids, glycosides, cardiac glycosides, phenolic compounds, fatty esters, lignans, phlobatannins, terpenoids, and tannins like ethyl gallate, chebulaginic acid, gallolyl glucose, β-sitosterol and gallic acid [11].

According to [23], Triphala fruit extracts typically contain phenolic acids, flavonoids, and tannins. Phytochemical analysis using HPLC, Folin-Ciocalteau, and Folin-Denis methods reveals Triphala’s exceptionally high content of bioactive compounds. Specifically, it contains around 35% tannins and 40% polyphenols, making it an ideal candidate for in-vivo research due to its substantial gallic acid content. After analysis of Triphala in high-performance liquid chromatography, they found ascorbic acid, gallic acid, syringic acid, tannic acid, and epicatechin in 0.036%, 0.026%, 0.016%, 0.024%, and 0.012% w/w. Many forms of Triphala present in Ayurveda exert different effects on the body; in Table 2, we explain them in detail.

Table 2.

Variations in Triphala and their specific uses according to Ayurveda

Variety of Triphala	Making methods and their specific uses	References
Triphala churna (Powder)	It is made by taking haritaki, bibhitaki, and amla and finely grinding in the ratio of 1:1:1 or 1:2:4 as needed. It is suggested to be consumed with ghee (clarified butter), milk, or honey for maximum benefits.	[95]
Triphala kwatha (Decoction)	Kwatha is made by taking Triphala churna and water in a 1:16 ratio and boiling until the water is half evaporated; then, this decoction is strained using a sieve or cloth. This decoction is used in cellulite, worm infections, and urine-related disorders. A decoction is a washing agent for eyes and open wounds and gargling during pharynx inflammation, causing a sore throat.	[96]
Triphala taila (oil)	Triphala tail is an ayurvedic medicinal oil form of Triphala prepared through control heating infusion of Triphala powder in coconut oil or sesame oil. This versatile oil is utilized in diverse therapeutic applications, including gargling, topical application, snuffing, enema, and oral consumption, to address various health concerns such as obesity, stress, and itching.	[96]
Triphala masi (ash)	The production of Triphala Masi involves heating Triphala powder in an iron vessel within a controlled environment, maintaining temperatures below 450°C. This process yields Masi, a transitional product containing organic and inorganic components. When heated further above 450°C, Masi transforms into Bhasma, a pure white ash. When making masi, thermal degradation happens at higher temperatures, and then raw material and heat are lost, creating unstable compounds. Due to the high amount of carbon, it is black. It can be combined with honey or sesame oil and applied externally to promote wound healing. It is also used as an ingredient in toothpaste to treat dental disorders like Pyorrhea and tooth loss.	[24]
Triphala gritha (in ghee or clarified butter)	Mix Triphala paste and Trikatu (long pepper, black pepper, and ginger) in a ratio of 3:1 in ghee or milk, and cook this for a long time. It is commonly used in treating disorders related to the eyes, such as conjunctivitis, blindness, cataracts, and jaundice, and it prevents premature hair greying, hair loss, and tumors.	[96]

Properties of Triphala

Antimicrobial activity

Triphala Mashi possesses remarkable antibacterial properties that are effective against a broad spectrum of microorganisms. The study demonstrates that the high tannin and phenolic content in Triphala Mashi contributes to its antibacterial efficacy, exhibiting dose-dependent inhibition of both Gram-negative and Gram-positive bacteria [24]. As per a study on HIV-infected patients, this polyherbal mix and individual fruit contents significantly decreased a group of bacteria like pseudomonas, aeruginosa, staphylococcus aureus, and vibrio cholera and proved that Triphala’s active phytochemicals might pass bacterial cell wall and enter in the bacteria [25]. Triphala mashi is less effective than Triphala churna and significantly lowers the number of salmonellae, staphylococcus aureus, vibrio cholera, and bacillus collected from workers’ open wounds. It also suppresses the growth of urinary tract infection bacteria and bacteria on surgical wounds and shows efficient inhibition of enterococci [26]. For clinical isolates obtained from HIV-infected patients, Triphala aqueous and alcoholic extract both show antimicrobial efficacy [25]. Researchers found that ethanolic extract and aqueous extract of Triphala churn and mashi show a high inhibitory effect against antibiotic-resistant strains of bacteria obtained from clinical isolates, and for E. coli and S. aureus aqueous extract is more efficient than ethanolic extract [24]. Daily consuming Triphala as a supplement has less chance of gut infections. Triphala churna and mashi prove that Triphala churna is more efficient in showing antibacterial against salmonella, staphylococcus, pseudomonas, etc. It also shows extreme antibacterial inhibition for resistant strains of bacteria and fights against human infectious bacteria [26]. A recent clinical study found that Triphala mouthwash 25% alone and in combination with 0.2% chlorhexidine, significantly reduced salivary Streptococcus mutans in orthodontic patients over 10 days. The combined formulation exhibited antibacterial efficacy comparable to chlorhexidine alone (P = 0.251) while reducing its side effects [27].

Antioxidative activity

Excess and uncontrolled production of free radicals in cells may cause accelerated diseases and cell damage. To overcome this situation, antioxidants protect cells from damage and many diseases. Chemically reactive species having one or more unpaired electrons are called free radicals, and for stability, electrons withdrawn from them cause intense damage to other presenting molecules [28]. Triphala 70% methanolic extract showed significant antioxidant activity in in vitro experiments. In an experiment, Triphala exhibited radioprotective effects when mice faced gamma radiation. Examples of naturally found antioxidants like GSH (glutathione), vitamins A, C & E, carotenoids, and some antioxidant enzymes like GPx (glutathione peroxidase), SOD (superoxide dismutase), and CAT (catalase) present in eukaryotic cells [29]. Triphala administration has been demonstrated in animal tests to boost SOD, GPx, and CAT activity, as well as enhance GSH levels, perhaps leading to a reduction in stomach cancers in mice [30]. In research, Triphala was found to have similar effects when provided to rats under noise stress [31]. Triphala’s antioxidants may promote eye health. In one study, when cataracts induced in mice by selenite were inhibited by Triphala administration, the amount of glutathione in mice eye lenses efficiently increased. The final result proved that Triphala-administered mice eye lenses have significantly higher concentrations of glutathione-S-transferase, superoxide dismutase, glutathione peroxidase, and catalase-like antioxidant enzymes compared to the control mice group in the experiment. Mice treated with Triphala acquired cataracts at a lower rate than those in the control group. This impact may be due to Triphala’s antioxidant properties [32]. Rats are treated with methotrexate and then administered with triphala. Their intestinal mucosa shows decreased MPO and XO levels and increased GSH levels. Triphala exhibits radioprotective effects in mice subjected to lethal doses of γ-radiation. Specifically, Triphala supplementation significantly reduces xanthine oxidase (XO) activity, a key enzyme involved in oxidative stress, while concurrently increasing superoxide dismutase (SOD) levels, a crucial antioxidant enzyme. This dual mechanism helps mitigate radiation-induced damage [33,34]. Multiple observations and illnesses support Triphala’s antioxidant properties and ability to protect against stress.

A recent study demonstrated that Triphala methanol extract exhibits enhanced antioxidant and cytotoxic properties, particularly in a non-equivalent ratio (2:1:1) with increased Amalaki. GC-MS analysis identified key bioactive compounds, including polyphenols, flavonoids, and triterpenes, contributing to their superior free radical scavenging activity and total phenolic content. Additionally, an MTT assay on N4X4 brain cancer cells revealed that this optimized formulation exerts stronger cytotoxic effects than the traditional 1:1:1 ratio, indicating its potential in oxidative stress-related diseases and glioblastoma therapy. These findings suggest that modifying Triphala composition could enhance its therapeutic efficacy, reinforcing its role as a promising natural anticancer and antioxidant agent [35]; some researchers studied the antioxidant properties of silver nanoparticles made from a Triphala extract. They found that the extract and nanoparticles had antioxidant effects, increasing with the dose. The extract contained phenolic compounds and flavonoids, which helped scavenge free radicals. Interestingly, the nanoparticles showed stronger antioxidant effects than the extract alone [35].

Anti-inflammatory activity

Studies demonstrate Triphala’s potent anti-inflammatory effects in Wistar albino rats with induced arthritis. Administration of Triphala (100 mg/kg) from day 11 to 18 after arthritis induction significantly reduced oxidative stress and inflammation. Results showed decreased lipid peroxidation (41.5%), glycoproteins (hexose (43.3%), hexosamine (36.5%), sialic acid (33.7%), and lysosomal enzymes (β-galactosidase (22.9%), N-acetyl β-glucosaminidase (22.1%), acid phosphatase (52.4%), cathepsin-D (27.7%)). Additionally, inflammatory mediators (VEGF, TNF-α, PGE2, IL-1β, MCP-1) in blood and paw tissues were substantially decreased [36].

Triphala performs equivalent to standard medication treatment for various biochemical measures of inflammation [37]. Triphala outperforms Indomethacin, a nonsteroidal anti-inflammatory drug (NSAID), in alleviating arthritis and inflammation. Its anti-inflammatory efficacy is attributed to its inhibition of Nuclear Factor-kappa B (NF-kB) activation, a key regulator of inflammation. This suppression reduces the production of proinflammatory molecules, including Cyclooxygenase-2 (COX-2), a receptor activator of NF-kB Ligand (RANKL). Triphala administered in arthritic tissue efficiently reduces lipid peroxidation and improves antioxidant levels [36]. In another experiment, animal studies estimated that when we take 3 mg/kg body weight indomethacin for comparative analysis with 1 mg/kg body weight of Triphala oral dosing demonstrates remarkable anti-arthritic and anti-inflammatory effects in Swiss albino mice with Freund’s adjuvant-induced arthritis. Treatment with Triphala efficiently reduces Paw thickness to near-normal conditions; lysosomal enzymes, Tissue marker enzymes, and Glycoproteins prove significant inhibition, showcasing Triphala’s efficiency in alleviating arthritis and inflammation [37]. Using Triphala can prevent uveitis caused by E. coli lipopolysaccharide injections. Triphala treatment significantly reduced inflammation in the anterior segment compared to control groups. It was found that endotoxin-induced chorioretinitis is prevented by triphala administration. Gallic acid, a natural substance that inhibits COX-2 selectively and reversibly, could be a promising candidate for producing a powerful anti-inflammatory medication [38].

Wound healing activity

Triphala extract ointment performs efficient wound healing of granulated tissue of open wounds in lab study animals by reducing bacterial count and improving collagen, uronic acid, and hexosamine, which helps in wound healing [39]. When Triphala was used with collagen sponges, it quickly and efficiently improved wound sealing with improved water uptake and thermal stability. Wound healing leads to enhanced tissue regeneration. Epigallocatechin gallate and collagen interaction promotes rapid wound healing [39].

In another study, researchers applied dressing made up of Triphala alcoholic extract on microbes-infected wounds. The conclusion proved that the efficacy of dressing increases with a reduced inflammatory phase after treatment harmonized with tissue matrix metalloproteinase expressions, and it also shows an inhibitory effect on wound pathogens [39].

Anticataract activity

Cataracts, a leading cause of vision impairment worldwide, result from oxidative stress-induced damage to lens proteins, leading to opacification and loss of transparency. Several studies have demonstrated the potential of Triphala, an Ayurvedic polyherbal formulation composed of Terminalia chebula, Terminalia bellerica, and Phyllanthus emblica, in delaying cataract progression due to its strong antioxidant, anti-glycation, and anti-lipid peroxidation properties. In a selenite-induced cataract model, administration of Triphala extract at doses of 25, 50, and 75 mg/kg significantly reduced cataract incidence, with the 25 mg/kg dose preventing nuclear cataract formation in 80% of cases. Triphala enhanced antioxidant enzyme activity (SOD, CAT, GPx, GST) while lowering lipid peroxidation markers (MDA), effectively preventing protein aggregation and maintaining lens clarity. These findings indicate that Triphala modulates oxidative stress and stabilizes crystalline lens proteins, making it a promising natural candidate for cataract prevention [40].

A complementary study examined the efficacy of Triphala Ghrita, a ghee-based formulation of Triphala, in galactose-induced cataracts in Swiss albino rats. Oral administration of Triphala Ghrita at doses of 216 mg, 1080 mg, and 2160 mg per 200 g body weight exhibited dose-dependent cataract protection, with the 1080 mg dose demonstrating the most significant delay in cataract progression. Notably, rats treated with this dose showed no stage II cataracts at 14 days and no stage III cataracts at 21 days, whereas the control group exhibited 100% mature cataracts within 30 days. The ghee-based formulation improved bioavailability, enhancing the effects of gallic acid, ellagic acid, and ascorbic acid, which protect against oxidative stress and lipid peroxidation [41].

Therapeutic implications

Triphala, a polyherbal formulation, consists of three rejuvenating fruits described in Ayurveda. Its versatility allows for a variety of applications. Many ancient literature and research have estimated that Triphala is immunomodulatory, anti-inflammatory, antioxidant, and active in lowering ROS. In the past 20 years, scientific studies have concluded that Triphala has multiple benefits in the body: free radical scavenging, anti-inflammatory, antipyretic, antidiabetic, hepatoprotective, gastrointestinal protective, wound healing, antitumorigenic, adaptogenic, radioprotective (Figure 1) [12].

Figure 1.

Potential health benefits of Triphala.

Benefits include appetite stimulation, reduced gastric acidity, prevention of dental cavities, pain and fever management, infection prevention, antioxidant defense, stress resilience, adaptation, metabolic regulation, cellular protection, wound healing, tissue repair, and chemopreventive [12]. The formula contains antioxidants like ellagic acid, tannins, gallic acid, and chebulinic acid, which may contribute to its immunomodulatory properties [42]. Triphala has many bioactive chemicals like flavonoids, saponins, anthraquinones, and carbohydrates [43].

Triphala-derived polyphenols and chebulic acid are transformed into beneficial compounds by human gut microbiota that reduce oxidative damage in the body [44]. Studies have shown that Triphala’s aqueous and alcoholic extract has properties that cure diarrhea and enhance gastrointestinal health [24].

Triphala administration shows a significant neuroprotective effect in rodent models [34]. Triphala supplementation significantly elevates crucial antioxidant, phospholipid levels, and protein glutathione in the intestinal epithelium and villi. Concurrently, it decreases the concentrations of xanthine oxidase and myeloperoxidase enzymes associated with oxidative stress. These findings suggest that Triphala’s high antioxidant capacity underlies its potent neuroprotective properties. Different research has observed that when stress is induced in rats’ gastrointestinal systems, it causes ulcers. Triphala reduces these ulcers to a certain level and prevents the formation of new ulcers [45]. A clinical trial found that using Triphala reduced constipation, mucus, stomach pain, hyperacidity, and flatulence in patients with gastrointestinal diseases. It also improved stool frequency, yield, and consistency [46]. In mouse models, some researchers saw that it reduces inflammation of the inner lining of the colon area in the large intestine [47].

Antidiabetic effects

There are many severe diseases worldwide in developed and developing countries, and Diabetes mellitus is one of them that has killed many people in the whole world for a long time. Diabetes is the most common endocrine condition worldwide, highlighting the need for improved access to supplementary hypoglycemic therapy for holistic care. When experimental research was performed on standard control and diabetic rats treated with alloxan 120 mg/kg bodyweight, an oral dosage of Triphala in 100 mg/kg bodyweight drastically lowered blood sugar levels in both control and diabetic rats. Triphala has been studied for a long time in alloxan-induced diabetic models and high fructose diet models having diabetes mellitus, and results show that daily oral administration of Triphala applies a long-term antidiabetic effect [48,49]. Invitro experiments that inhibit lipid peroxide formation and scavenge free radical species result in a reduction in blood glucose levels [48]. Triphala extract has been shown to significantly reduce blood sugar levels in both standard and diabetic rats within a few hours. Daily dosing results in a prolonged antidiabetic effect [50].

Triphala has hypoglycemic consequences. Patients with type 2 diabetes often experience elevated after-meal spikes in blood glucose levels in carb-rich food. After a meal, complex carbs are digested by alpha-amylase and alpha-glucosidase, elevating blood sugar levels above normal levels [51]. Triphala is high in phenolics and flavonoids when the administration of Triphala guggul tablet or churn form; as a result, that increased oral glucose tolerance and decrease in serum glucose levels of alloxan-induced diabetic rat models as compared to normal control rats [51].

Triphala works based on applying an inhibitory effect on digestive enzymes to decrease blood sugar levels, comparable to the effects of diabetes medications. Studies in past experiments proved that Triphala blocks pancreatic glycolytic enzymes (alpha-amylase and alpha-glucosidase) to lower the rate of conversion of complex carbs into glucose molecules. A study of diabetic patients who regularly administered 5 g triphala powder for 45 days without insulin dependency showed a lowering of blood sugar levels [52]. Triphala may help avoid glycation by promoting lower blood glucose levels.

Triphala Rasayana modulates pancreatic islet β-cell dynamics through the incretin/cAMP signaling cascade. Treatment with Triphala Rasayana Elevates key signaling molecules: Gastric inhibitory polypeptide (GIP), Protein kinase B (Akt), Glucagon-like peptide-1 (GLP-1), Cyclic adenosine monophosphate (cAMP), GLP-1 receptor (GLP-1R) and Protein kinase A (P-PKA). The release of insulin was also increased. The methanolic extracts from T. bellirica and P. emblica have inhibitory effects on a-amylase and a-glucosidase. Methanolic extracts from T. bellirica and P. emblica exhibit antidiabetic properties by blocking glycation and inhibiting α-amylase and α-glucosidase [53].

Cardioprotective effects

Heart-related and cardioprotective benefits are shown by ethnopharmacological studies on Triphala Rasayana and their constituent. Triphala extract exhibits antioxidant effects by extending the lag phase, reducing conjugated diene production, and decreasing TBARS formation dose-dependently [54]. Pretreatment with P emblica, a crucial component of Triphala, yields beneficial cardiovascular effects like improving left ventricular function, preserving antioxidant levels, restoring hemodynamic function, inhibits lipid peroxidation [55]. Methanolic extract of T. bellirica (an essential Triphala constituent) protects against cardiac damage in rats, reducing CK-MB activity and MDA levels while increasing GSH at 250-500 mg/kg [56]. Triphala Rasayana treatment yields beneficial effects on lipid profiles, including significant reductions in total cholesterol levels, decreased low-density lipoprotein (LDL), Lower very-low-density lipoprotein (VLDL), and reduced free fatty acid levels [57]. Triphala Rasayana offers protection against cardiovascular and cerebrovascular disorders. A study identified that three essential herbs from Triphala Rasayana have 23 bioactive compounds with therapeutic potential and 65 target genes associated with Cardiovascular and Cerebrovascular Diseases (CCVDs), so these findings highlight Triphala Rasayana’s potential in mitigating cardiovascular and cerebrovascular risks.

An experimental study investigated the anti-hyperlipidemic effects of Triphala in high-fat diet (HFD)-induced hyperlipidemia in rats. Two formulations of Triphala (1:1:1 and 1:2:4) were tested, with the 1:2:4 ratio demonstrating superior lipid-lowering effects. Triphala treatment significantly reduced serum total cholesterol, triglycerides, and non-HDL cholesterol levels while increasing HDL cholesterol, showing efficacy comparable to atorvastatin (10 mg/kg). Additionally, Triphala lowered lipid peroxidation levels in the liver, suggesting its antioxidant and hepatoprotective potential. These findings highlight the therapeutic potential of Triphala in managing hyperlipidemia and reducing cardiovascular risks, reinforcing its role as a natural alternative for lipid regulation [58].

The experiment of 48 days performed on rats by feeding a customized diet with Triphala showed efficient lowering in free fatty acids levels, VLDL, LDL, and total cholesterol [57]. In a study on rats fed an atherogenic diet, Triphala’s one constituent, Haritaki, was most efficient in lipid-lowering effects in the treated group of rats, resulting in low total cholesterol, TGA, and total protein and increases in HDL compared to the standard rat group [59].

Anticancer effects

Triphala administration has been found effective against various types of cancers, including colon, pancreas, cervical, ovarian, breast, and lymphatic melanomas [60,61]. Triphala administration lowers the growth rate of some cell lines like MDA-MB-231 (triple-negative breast carcinoma), PANC-1 (pancreatic adenocarcinoma), HeLa (cervical adenocarcinoma), and as well as suppressing HeLa cell clonogenicity. The disruption of the tubulin protein secondary structure mediates this antineoplastic effect. Triphala disrupts microtubule dynamics, inducing programmed cell death in cancer cells [62]. Triphala is also efficient at inhibiting gynecological cancer cell proliferation. Administration of rasayana is efficient in lowering the proliferation and causing apoptosis in cell lines like SKOV-3, HEC-1B, and HeLa. Cell cycle analysis and Ki-67 protein expression confirmed antiproliferative and proapoptotic activity. Triphala decreased phospho-NF-κB p56, phosphor-p44/42, and phospho-Akt levels in gynecological neoplastic cells. This implies that the NF-κB/p53, PI3K/Akt/mTOR, and MAPK/ERK pathways might play a role in the apoptosis triggered by Triphala. Triphala exhibits anti-metastatic properties by inhibiting cancer cell migration in vitro, complementing its antiproliferative and apoptotic effects, and preventing cancer from spreading in tissue [61,63].

Cytotoxic and antitumor activity of this polyherbal mix is due to 2 significant phytochemicals named chebulinic acid and gallic acid; it is believed that they are both synergistically responsible for Rasayana anticancer activity [64]. Triphala has been demonstrated in numerous studies to have antineoplastic effects on cancer cell lines from the breast, prostate, colon, and pancreatic [65]. Triphala modulates normal and malignant cell lines differently, as evidenced by cell line data analysis. Triphala increases ROS in cancer cells only to perform its cytotoxic ability. When we compare tissue samples, Triphala administers models found fast apoptosis to lower tumor growth [66]. Triphala’s anticancer mechanism involves inhibition of cell proliferation, Activation of the Wnt signaling pathway, enhanced resistance to apoptosis, and suppression of oncogenes like Cyclin D1 and c-Myc. Additionally, Triphala induced apoptosis through the intrinsic mitochondrial signaling pathway. Triphala powder therapy increases cytotoxic T cells and boosts immune function and natural killer (NK) cells in healthy individuals [67]. Triphala Rasayana interacts with tubulin, exhibiting potential antiproliferative effects, making it a promising anticancer agent [62]. Triphala’s anticancer effects on pancreatic tumor xenografts estimated that oral administration of Triphala (50-100 mg/kg, 5 days/week) significantly inhibits Capan-2 pancreatic tumor xenograft growth [68]. Chebulinic acid exhibits cytotoxic effects on triple-negative breast cancer cells (MDA-MB-231), while Triphala inhibits angiogenesis by blocking VEGF/VEGFR2 signaling. Triphala prevented angiogenesis by blocking several VEGF/VEGFR2 signaling pathway components [69].

In recent research on tumors, Triphala (TRP) has shown significant antitumor effects against oral squamous cell carcinoma (OSCC) by inactivating the PI3K/Akt signaling pathway. TRP inhibited cell proliferation, migration, and invasion while promoting apoptosis in OSCC cell lines (CAL-27 and SCC-9). Molecular docking and functional assays confirmed that TRP modulates key genes, including AKT1, EGFR, JUN, ESR1, and RELA. In vivo studies using a zebrafish xenograft model demonstrated TRP’s ability to suppress tumor growth and metastasis. A PI3K activator (740Y-P) also reversed TRP’s effects, while a PI3K inhibitor (LY294002) enhanced its antitumor efficacy. These findings highlight Triphala’s potential as a natural therapeutic for OSCC treatment [70]. A recent study demonstrated the green synthesis of iron oxide nanoparticles (TIONPs) using Triphala churna, with an average size of 29-74 nm. TIONPs exhibited significant cytotoxicity against triple-negative breast cancer (TNBC) and epidermoid skin carcinoma cell lines, inducing apoptotic cell death. Additionally, their superparamagnetic properties suggest the potential for targeted drug delivery, highlighting Triphala-derived TIONPs as a promising nanomedicine approach for TNBC treatment [71].

Anti-obesity effects

In recent studies, Triphala has shown promising anti-obesity effects, reducing body weight, serum glucose, cholesterol, triglycerides, and inflammatory markers in high-fat diet-induced obese rats. It improved HDL, adiponectin, and antioxidant enzyme SOD, while histological analysis revealed a reduction in adipocyte size and liver fat accumulation. Molecular analysis confirmed the downregulation of key lipogenic genes (SREBP-1c, PPAR-γ, ACC, ACSS2, and FASN), indicating its role in lipid metabolism regulation. Additionally, Triphala restored serotonin and dopamine levels, suggesting its potential for appetite control. These findings highlight Triphala as a natural therapeutic for obesity management [72]. Recent metabolomic studies have demonstrated the impact of Triphala extracts on gut microbiota and metabolic pathways, highlighting its potential role in obesity management. Using an in vitro human gut model, researchers observed that while Triphala did not significantly alter microbial diversity, it induced metabolic reprogramming with 305 up-regulated and 23 down-regulated metabolites across 60 metabolic pathways. Triphala activated phenylalanine, tyrosine, and tryptophan biosynthesis, pathways essential for energy metabolism regulation. These findings suggest that Triphala exerts anti-obesity effects by modulating gut microbial metabolism, providing a strong basis for its potential as a natural therapeutic for metabolic disorders [73].

Hepatoprotective effects

One of the most dangerous medical conditions is still liver disease, and the allopathic system does not provide adequate preventative medications for medicine; many depend on supplementary and alternative therapies. According to several clinical research in the last two decades, Triphala has shown encouraging outcomes in lowering liver disease symptoms and improving liver function stones. Triphala and its constituents, Amla, Haritaki, and Bibhitaki, are all promising, efficient hepatoprotective agents [74]. Triphala was most effective when prepared ultrasonically, indicating that macromolecular compounds mediate the protective action against liver injury and that the hepatoprotective effectiveness is diminished when macromolecular substances are lost due to hydrolysis. Small compounds like gallic and ellagic acid are produced in more significant quantities when Triphala is hydrolyzed; nevertheless, research has shown that these acids have low bioavailability, poor absorption, and easy saturation [75].

Administration of Triphala in daily life significantly lowers proinflammatory cytokines like lipid peroxidase and TNF-α levels. It restores the levels to normal of some antioxidant enzymes found in liver like GPx (glutathione peroxidase), CAT (catalase), GRx (glutathione reductase), glutathione (GSH), GST (glutathione-S-transferase) and SOD (superoxide dismutase), This reduced liver damage, as seen by decreased levels of and alkaline phosphatase (ALP), aspartate alanine aminotransferase (ALT) and aminotransferase (AST), Triphala’s liver-protective effects were confirmed by histological examination, validating reduced liver damage [76]. Triphala shows efficient pretreatment effects against induced liver damage at 100 mg and 300 mg/kg bodyweight; 300 mg/kg bodyweight dosages are more beneficial than 100 mg/kg. The dose-dependent efficacy of Triphala is verified by liver function tests (levels of Bilirubin ALP, AST, and ALT) and renal function tests (levels of urea, creatinine, and uric acid) in the optimum range [77].

In Triphala churna, gallic acid, chebulinic acid, and corilagin acid are their principal constituent. Its activity is to protect the liver by reducing inflammation and excess lipid accumulation and modulating the gut microbiota. It has been demonstrated that feeding rats a high-fat diet with Triphala inhibits the development of NAFLD in a dose-dependent way and with efficacy comparable to simvastatin. Triphala may lessen the accumulation of hepatic triglyceride and cholesterol levels and the inflammatory reactions that accompany them [78].

Neuroprotective effects

Triphala treatment significantly improved cognitive function in C57BL/6 and 5xFAD, APP/PS1 transgenic mouse models of Alzheimer’s disease by modulating the amyloid precursor protein (APP) pathway, reducing amyloid plaque formation and neuroinflammation, and restoring the gut-brain axis. It enhanced beneficial gut microbiota, including Bacteroides, Proteobacteria, and Actinobacteria, essential for gut homeostasis and neuroprotection. Additionally, dual-mode (morning and evening) administration of Triphala exhibited superior preventive and therapeutic efficacy, suggesting its potential as an effective strategy for Alzheimer’s disease treatment through gut microbiota modulation and neuroinflammatory regulation [79]. Also, recent research has highlighted the neuroprotective effects of Triphala polyphenols, particularly in promoting resilience against stress-induced depression and cognitive impairment. Triphala has been shown to regulate 5-hydroxytryptamine (5-HT) and brain-derived neurotrophic factor (BDNF) receptors, essential for maintaining brain function under stress.

Additionally, it influences the gut microbiota and antioxidant-related signaling pathways, which play a key role in neuroprotection. However, challenges remain in improving blood-brain barrier (BBB) permeability and systemic bioavailability to enhance its therapeutic efficacy. While preclinical studies support its benefits, well-designed clinical trials are necessary to establish its role in treating stress-related mental health disorders, reinforcing its potential as a natural therapeutic for cognitive and psychological resilience [80].

Recent studies have demonstrated the therapeutic potential of Triphala in mitigating cognitive dysfunction and anxiety induced by chronic sleep deprivation (SD). Triphala significantly alleviated SD-induced behavioral abnormalities and prevented histopathological damage in hippocampal neurons, suggesting its role in preserving brain function under chronic stress conditions. The neuroprotective effects of Triphala were associated with the modulation of multiple biological pathways, including inflammation, oxidative stress, immune responses, metabolism, and neurotransmitter communication. Additionally, Triphala promoted nuclear translocation of nuclear factor erythroid 2-related factor 2 (Nrf2) and activated the Nrf2/heme oxygenase-1 (HO-1) signaling axis, a critical pathway for cellular defense against oxidative damage. The administration of an Nrf2 inhibitor (ML385) counteracted these neuroprotective effects, confirming the pivotal role of the Nrf2/HO-1 axis in mediating Triphala’s benefits. These findings highlight Triphala’s potential as a nutraceutical agent for preventing cognitive impairments and anxiety linked to chronic SD, offering a novel natural intervention for sleep-related neurodegenerative disorders [81].

Effects on immunomodulatory disorders

An immunomodulator is a drug that alters or modulates the immune system to aid the body’s response to a sickness or infection. Immunomodulators can impact several areas of the immune system. Some types function broadly, while others target extremely specialized pathways. As per findings of the last few years, as an efficient immunomodulator, Triphala is also known for its ability to reduce the presence of proinflammatory mediators, and its constituents have been shown to reduce inflammation. Triphala Rasayana contains various active compounds, including gallic acid, chebulagic acid, ellagic acid, flavonoids, tannins, and phenols. These compounds may cause the plant’s potent immunostimulatory and immunosuppressive effects, and as per these findings, researchers proved that triphala is an efficient herbal immunomodulator [82]. When assessed using the carbon clearance test and the Delayed-Type Hypersensitivity (DTH) [Foot Pad Swelling] reaction, Triphala exhibits immunomodulatory activity. When taken orally at 500 and 1000 mg/kg, Triphala mega extract increased the carbon clearance index, indicating improved nonspecific immunity and mononuclear macrophage phagocytic function, resulting in the DTH response or cell-mediated immunity. T cells were stimulated with Triphala mega extract. Phytochemicals present in Triphala, like flavonoids, alkaloids, tannins, saponin glycosides, and phenolic substances, are mainly responsible for Triphala’s significant immunomodulatory properties [83]. Another study finds that the administration of Triphala dosage at 100 mg/kg and 500 mg/kg shows a rise in the carbon clearance index and intensifies nonspecific immunity and mononuclear macrophages’ phagocytic activity [84]. Triphala Rasayana and its metabolites, including Ballerini and 4-O-methylmalonic acids, suppressed cyclooxygenase (COX-2), some interleukin IL6 and IL-1β, Tumor necrosis factor (TNF-α), and essential macrophages [85].

Researchers estimated the immunomodulatory efficacy of this polyherbal mix. Initial research demonstrated a notable increase in natural killer (NK) cells, B lymphocytes, and cytotoxic T lymphocytes. Hence, this research suggests that Triphala may offer a natural and effective way to boost the immune system in individuals with HIV/AIDS, providing a valuable adjunct therapy. Further findings reinforced this by showing that Triphala significantly boosted immune function through elevated NK cells, B lymphocytes, and cytotoxic T cells [67].

Gastrointestinal protective effects

Functional gastrointestinal disorders (FGIDs) are accepted as prevalent diagnoses in gastroenterology and are regarded as diverse [86]. The prevalence of gastrointestinal disorders is alarming, with 50% of adults experiencing gastrointestinal disorders (GERD, IBS, constipation), 35% of individuals over 65 years old being affected, 11% of Americans having chronic digestive diseases, and estimated that digestive issues increase with age. According to the 2010 research, only 60 to 70 million people in the United States suffer from digestive problems [87].

Triphala’s chemical components are known to produce an environment conducive to the development and expansion of good intestinal bacteria and an unfavorable one for the demise of harmful intestinal bacteria. Even when taken daily, Triphala, an intestinal regulator, is considered safe as food. Triphala helps treat liver disorders, leucorrhoea, constipation, headaches, and dyspepsia.

Gallic acid and quercetin are two of the phytochemicals present in Triphala rasayana, which promote the growth of beneficial bacteria like Lactobacillus and Bifidobacteria while preventing the growth of harmful bacteria like Escherichia coli. Lactic acid bacteria possess tannase enzymes, breaking down plant tannins like gallic acid in Triphala Rasayana. Triphala Rasayana polyphenols, such as ellagic acids and chebulinic acid, and the human gut microbiome convert triphala into active compounds called urolithins, unlocking its health benefits. These active metabolites lower the inflammation in gastrointestinal tissue and prevent ROS-induced injuries in intestinal cells [88]. In Wistar rats, Triphala extract (1000 mg/kg body weight, po) significantly reduced ulcer index and lipid peroxide while increasing mucus, catalase levels, SOD, and GSH (Glutathione) in Indomethacin (10 mg/kg body weight, po)-induced stomach ulcer [89].

Protection from radiations

Studies on induced mutation animal models proved that Triphala helps protect and reverse DNA damage and mutation [90]. Preventing DNA damage is crucial as it is often the starting point for cancer development. Treatment with Triphala in animals and in cell lines studies to reduce mutagenesis caused by chemical and radiation damage [66]. Triphala, a traditional Ayurvedic formulation, has been found to exhibit radioprotective properties by significantly decreasing reactive oxygen species (ROS) levels in HeLa cells subjected to ionizing X-ray radiation or bleomycin-induced oxidative stress, suggesting its potential utility in protecting against radiation-induced cellular damage. These factors are known to cause DNA strand breaks [91]. In invitro studies, researchers found that Triphala administration lowers the γ-induced plasmid DNA strand breaks; Triphala extract decreases lipid peroxidation in radiation-induced rat liver microsomes and scavenging free radicals, including superoxide. High-quality phenolic content like gallic acid is responsible for its free radical scavenging activity [92]. When mice are administered with Triphala supplement 3 days before total body γ-radiation exposure, 60% of mortality is reduced in the mice group [93]. Triphala exhibits radioprotective effects by oxidoreductase, reducing superoxide dismutase activity, inhibiting xanthine, and mitigating DNA damage in mice exposed to radiation. Triphala’s antioxidant properties may provide protection even after exposure to oxidative stress. Research demonstrates that administering Triphala extract (10 mg/kg), 10 mg, is 1/28 part of the LD₅₀ estimated in research for five days before gamma radiation exposure significantly protects mice against radiation-induced damage [94]. Research demonstrates Triphala’s radioprotective effects due to its antioxidant and free radical scavenging properties. Studies show that intraperitoneal administration of 10 mg/kg Triphala for five consecutive days protects against ionizing radiation, resulting in a dose reduction factor of 1.15 [94]. Triphala’s radioprotective effects were demonstrated in mice through 1 g/kg oral administration for 14 days (7 days pre- and post-radiation). This treatment prevented oxidative damage within cells and tissues, restored normal xanthine oxidase (XO) and superoxide dismutase (SOD) activity in intestinal tissue, and reduced DNA damage in leukocytes and spleen cells [33].

Conclusion

Triphala Rasayana, a polyherbal formulation rooted in Ayurveda, has demonstrated diverse pharmacological properties, including antioxidant, antimicrobial, anti-inflammatory, anticataract, antidiabetic, antiobesity, hepatoprotective, neuroprotective, cardioprotective, anticancer, and immunomodulatory effects. The synergistic interaction of Emblica officinalis, Terminalia bellerica, and Terminalia chebula enhances its efficacy in treating metabolic disorders, gastrointestinal diseases, and oxidative stress-related conditions. The presence of gallic acid, chebulagic acid, ellagic acid, flavonoids, and tannins supports its pharmacological significance, making it a promising candidate for natural therapeutics.

This review is significant in bridging traditional Ayurvedic knowledge with scientific research. While Triphala has been widely used for centuries, its molecular mechanisms and clinical applications require further validation. Compiling preclinical and clinical studies, this review highlights Triphala’s potential for integration into modern medicine. Recent research has demonstrated its role in regulating glucose metabolism, lipid profiles, and inflammation, with advancements in nanotechnology improving bioavailability. However, challenges remain in formulation standardization, pharmacokinetics, and optimal dosage determination.

To establish Triphala as a globally accepted therapeutic agent, future research must focus on pharmacokinetics, bioavailability, and molecular mechanisms, particularly its effects on gene expression, microbiota modulation, and cell signaling pathways. Well-designed clinical trials are essential to validate its long-term efficacy and safety. Advanced drug delivery approaches, such as nanoparticle-based formulations, may enhance its therapeutic impact. Additionally, toxicological studies are required to ensure safety, minimize side effects, and assess herb-drug interactions.

As research continues to uncover new bioactive compounds and mechanisms, Triphala has the potential to become an integral part of integrative healthcare. Its scientific validation will enable its transition from traditional medicine to evidence-based clinical practice, offering a natural, effective approach to managing chronic diseases and promoting overall health.

Disclosure of conflict of interest

None.