Ayurveda Q & A PDF Print E-mail
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Written by Dr. Tom Yarema   

Ayurveda has been practiced in the U.S. for only about 30 years, yet it is one of the systems of medicine native to India. It is thousands of years old and is yoga’s sister science. Readers are invited to submit questions for “Ayurveda Q & A” to This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

Dr. Tom Yarema
Dr. Tom Yarema

Q: I am a 25-year-old woman who has been practicing yoga for six years. While enrolled in a six-week summertime teacher training program in Florida where our classes were held in a hot room, I started experiencing some unexpected and uncomfortable symptoms including: headache, dry eyes and itching behind my ears and around my scalp. Additionally, I started experiencing hip and elbow bursitis, which I don’t understand since I’m in great shape and stretch often. I’ve been more sore than usual while practicing and my significant PMS symptoms (which I haven’t had for nearly six years) have returned along with spotting in the middle of my cycle. I’ve been waking up every night around 2 A.M., I walk around the house and then go back to sleep. I have fair, freckled skin, red hair and have always been athletic. I have a great passion for practicing and teaching yoga and I’m worried that I won’t be able to go on practicing if I feel this way.

A: In evaluating any situation, or encouraging a person to practice self-inquiry, I look at the four domains of being: physical, mental, emotional and spiritual. In our information age, we have a tendency to be very mental and in that, we experience an incomplete development of the emotional and spiritual bodies, so considering all four in every aspect of life is important.

Within the four domains, look at relationships within and among the doshas (energetic qualities): vata (air and ether or space elements), pitta (fire and water) and kapha (water and earth) in the 24-hour cycle of the day and the 28-day lunar cycle of the month. While this is an oversimplification of the relationship between the three doshas, energy (vata) becomes matter (kapha) and vice versa under the balanced transmutive force of an appropriately regulated fire (pitta).

You seem to have a fundamentally pitta constitution (as evidenced by your athletic, mesomorph body, red hair and freckled skin) and are currently in the pitta phase of life, which is adulthood. These stack up with the hot humid environment and the summer or pitta season to magnify the effects of pitta for better or for worse. This causes evaporation or burning of the vata dosha, so you have heat rising rather than being grounded in the center of the body. Heat rising up into the head causes the headaches, dryness of the tear ducts, drying out the oils of the skin and creates a rash on the upper backside of the body (the sides of the body exposed to the sun if you were pulling weeds).

Exacerbations of the PMS symptoms are also related to excess heat rising. Throughout the 28-day lunar cycle, times when the pitta dosha is magnified include the week before menstruation and a short period during ovulation.

During the 24-hour daily cycle, pitta is increased before and after midnight and before and after high noon. When you expose yourself to intense heat in the middle of the day, or you work through your lunch hour rather than taking a break and cooling down, it weakens the body and diminishes overall performance. Without time to take a break or cool down, the body might not be strong enough to actually stay asleep during the night, the necessary time for the pitta organs of the body, including the small intestine and liver, to repair, detoxify and generate new tissue. When you get up and walk around in the middle of the night, this disperses your built-up heat energy, allowing you to drop back to sleep.

Bursitis is also related to heat. Excess heat and inflammation can interfere with the regeneration of tissue and joint capsules, which is supposed to occur during the night while we’re asleep. When there is a lack of adequate regeneration, inflammation, pain or injury can occur with even minimal exercise or stretching, at thresholds that are below where a person would usually injure herself. Imbalances during the pitta time of life can often lead to accidents and injuries for that reason.

The body has natural self-healing mechanisms to dissipate heat: fever, in which heat is dispersed out from the skin in all directions, bruises, spotting, bleeding in the GI track (detected or undetected), nosebleeds or menstruation.

All your symptoms are part of one phenomenology and can be remedied by some simple cooling techniques. But if conscientious cooling doesn’t appropriately mitigate these issues, you may want to consider finding an alternative environment, such as a cooler room, in which to pursue your passion.


Pay greater attention to your diet and nourish yourself with the sweet, bitter and astringent foods, all of which cool overheated pitta. Have some dark green leafy vegetables at every meal. Choose sweet rather than sour fruits, and try cooling teas such as peppermint or hibiscus. Melons of all varieties are fabulous for dropping pitta. Eliminate or reduce nightshades; these include
tomatoes, bell peppers as well as hot peppers like chili or jalapeno, eggplant and white potatoes. Other foods to be wary of are garlic, onions and anything hot and spicy.


The cooling breath, shitali or shitkari, can reduce excess heat. There are several variations of the breath, which are best learned from a teacher. They involve breathing in through the mouth, through a u-shaped tongue, gritted teeth or pursed lips, and then out through the nose or mouth.

Routine…Take a Break

In the middle of the day, when the sun is at its highest, take a break and cool off. Rather than going for a midday jog in a hot humid environment, slow down and walk in a cool environment where you can feel a gentle breeze across your skin that creates refreshing, evaporative cooling. If you’re in a hot humid climate and you have access to air conditioning, this can cool you off. Do a complete channel change during that noon time.


The use of Vedic Astrology can determine if there are any planetary influences, especially from Mars, in the short or long-term, which may be increasing pitta.


If things are going in the right direction, your insomnia should be one of the first things to improve, then the itchiness, headaches and then the dry eyes. Pitta is a combination of fire and water, like a steam locomotive. It can also be a graceful manifestation of the water cycle in nature and if we find that grace, we can have a productive and outrageously fun life.

The information provided here is for educational purposes only. Before using any Ayurvedic remedies, consult with a qualified Ayurvedic practitioner or healthcare provider. This article represents the opinion and recommendation of the author and does not necessarily reflect the views of LA YOGA Ayurveda and Health magazine.

Dr. Thomas R. Yarema, MD is the medical director at the Center for Wellness and Integrative Medicine in Aptos, CA, the national director for the Kerala Ayurveda Clinics, formulator of Zrii and the coauthor of Eat Taste Heal: ayurvedaonline.com. For more information about a distance-learning program for Ayurvedic wellness counselors, visit: ayurvedaacademy.com. Dr. Yarema is leading a group of people to Ayurvedagram in India for panchakarma and facilitated introductions to the holders of Vedic wisdom from Jan30 - Feb14, 2009. Contact: This e-mail address is being protected from spambots. You need JavaScript enabled to view it .


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