Ama in Ayurveda: The Traditional Idea of Undigested Residue

What ama means

In Ayurveda, ama (often translated "undigested" or "uncooked") is the traditional name for material that the body has not fully transformed. It is described as "uncooked food," as incomplete transformation of nutrients, or as "toxins." [1] It is tied to Agni, the digestive fire: the texts say that when Agni is weak, food is incompletely digested and ama results. [1] Ayurveda's own texts therefore treat ama as a cause, or early stage, of disease. This page explains a traditional idea. It is not a test, a diagnosis or a reason to "cleanse."

How the tradition describes it

One review summarizing the tradition says ama is thought to enter the circulation, block the body's channels (srotas) and settle in tissues (dhatus), where it is said to provoke an inflammatory response. [1] See Dhatus, Malas and Srotas. Another review gathered causes and symptoms of chronic inflammation from Ayurvedic texts, including ama-related ones, and proposed parallels with modern ideas of inflammation. [2]

The word "toxins" in English translations is misleading. In Ayurveda ama is not described as one chemical. It is part of the tradition's way of explaining how illness begins, and it is not a medical finding.

Ama is not the same as a toxin in toxicology

In medicine, a toxin or poison is a specific substance with a known effect at a known level, such as lead or arsenic, and it can be measured in blood or urine. Lead, mercury and arsenic are a real concern in some Ayurvedic products: NCCIH reports that some Ayurvedic preparations contain these metals in amounts that can be toxic, and that a 2015 survey found 40 percent of users had elevated blood lead. [3] That is a measurable contamination problem, and it is a separate matter from ama. See Ayurvedic Products: Heavy Metals and Product Quality.

If you are worried about poisoning from any product, plant or metal, call your local emergency number, or in the United States call Poison Help at 1-800-222-1222 (see Poison Help by Country).

Is there a way to measure ama?

Researchers in India have tried to turn the idea into a score.

• Ama assessment instrument in amavata. In a study of 79 people with rheumatoid arthritis (called amavata in Ayurveda), a 10-item ama score based on features from the texts correlated only slightly with the blood marker ESR (r about 0.29 at baseline) and the disease activity score DAS-28 (r about 0.23). The authors argued it still tracked change over time. [4]
• A published comment said such tools need joint counts and more comprehensive ama-specific features, and that patient-reported scores have limits. [5]
• A modern reading. A review proposes that the ama idea resembles gut inflammation, increased intestinal permeability and microbiome disruption. It offers this as an interpretation of the ancient concept. [1] It is a hypothesis, not a demonstrated equivalence.

Evidence label: traditional use only for ama as a cause of illness; preclinical or exploratory for scoring tools. Proper evidence not found for a laboratory test that measures "ama," or for a trial showing that lowering ama through an intervention explains better health. We looked in PubMed and Europe PMC for ama, Ayurveda and measurement. We found instrument development and commentary.

"Removing ama" and cleansing

Ayurvedic texts and reviews connect ama with cleansing procedures such as panchakarma, described as multi-day regimens meant to move ama out of the body. [1] Outside the tradition, NCCIH says there have been few studies of "detoxification" programs in people and that they were of low quality, that a 2015 review found no compelling research for detox diets as a way of removing toxins, and that US regulators have acted against detox products that had hidden ingredients or false claims. [6] NCCIH also says colon cleansing has limited evidence and can have serious side effects, and that laxatives and fasting can cause dehydration and dangerous electrolyte imbalance. [6] This site does not give instructions for cleanses. Read Panchakarma and Ayurvedic Cleansing Procedures, Detox and Cleanse Claims and Detox Programs and Chelation Claims.

What to do with digestive or joint symptoms

If you have bloating, indigestion or joint pain, an ama explanation should not replace an exam. See Digestive Symptoms: When to Get Help. Do not use Ayurveda to postpone seeing a conventional provider about a medical problem. [3]