Ayurveda & Malabsorption

So what is Malabsorption exactly?

This is a very common symptom that I see in patients coming to my clinic or via video call  when I have conducted a visual analysis.

Malabsorption is precisely as it sounds, a disorder that revolves around not absorbing your nutrients properly. This means that you are taking in healthy foods, but you are not absorbing the vital macro- and micro-nutrients such as proteins, fats, vitamins, or minerals that they contain. For example, one may be a regular meat eater, take an iron supplement daily, and still be suffering from iron-deficiency anemia. So, despite your efforts for getting a wide range of nutrients in your diet, your system is still deficient in certain areas causing fatigue, weakness, brittle hair and nails, lowered immunity, and so on.  

Now that we know what malabsorption is, how can we tell if we are being affected by it? Luckily, there is a long list of common signs and symptoms for malabsorption, some objective (meaning you can physically see it) and others subjective (meaning you can feel it). The more signs and symptoms that you’re experiencing, the more likely you are to be suffering from this issue and, potentially, the more powerful the malabsorption may be. 

Common Signs and Symptoms of Malabsorption

Brittle nails and/or bones

Dry or thinning hair

A prominent line from the outer nostril down to the respective outer lip, even when not smiling (see picture #1 below)

Teeth marks on the perimeter of the tongue (see picture #2 below)

Longitudinal lines on the nails (see picture #3 below)     

White spots on the nails (see picture #4 below)

Anemia

Low energy

Chronic fatigue

Chronic digestion issues such as gas, bloating, hyperacidity, and indigestion

Diarrhea and/or constipation

Undigested food in the stools

Oily stools (specific for malabsorption of fats)

History of intestinal disorder (Crohn’s disease, ulcerative colitis, celiac disease, IBS, etc.)

Physical Signs of Malabsorption

1. Nasolabial fold

Prominent lines that run from the nostrils down to the outer lips are a clear sign of malabsorption.  Unfortunately, this is very common in many individuals.  

2. Teeth marks around the perimeter of the tongue.

A revealing sign is teeth imprints on the perimeter.  The stronger the imprints, the more severe the malabsorption. 

3. Longitudinal lines on the nails.

Another common sign of Malabsorption is vertical lines on the nails. As you may guess, the deeper the grooves, the more severe the malabsorption.  

4. White spots on the nails.

You may have noticed white spots appearing on your nails from time to time.  This is another sign of malabsorption and specifically relates to calcium, zinc, and/or magnesium.  

If you are experiencing a handful of these symptoms, you may be suffering from some level of malabsorption, especially if the symptoms are digestion-related. Before we discuss treatment options for malabsorption, let us first detect the causes. After all, the first line of any Ayurvedic treatment should always be to remove the causes.

Common Causes of Malabsorption

Improper or imbalanced digestion, a.k.a. vitiated Agni (number one cause!!)

Excessive toxins in the GI tract, a.k.a. ama 

Stress, anxiety, or other emotional imbalance

Intestinal disorder (Crohn’s disease, ulcerative colitis, celiac disease, IBS, etc.)

Inflammation in the GI tract

Intake of allergenic foods (dairy, soy, gluten, sugar, etc.)

Improper Food Combining

Parasites

Dysbiosis (improper balance of gut flora)

Chronic diarrhea or excessive bowel movements 

Certain medications including frequent use of antibiotics

Thyroid disorder (hyper or hypo)

Diabetes

Excessive alcohol intake

Excessive laxative use

Family history (a predisposition but not necessarily a cause)

Although there is a long list of common causes, the main cause is, by far, impaired digestion. In fact, most of the following causes lead to impaired digestion, so typically an imbalanced Agni or digestive fire is almost always the main issue. 

If we are not digesting our food properly, how can we be absorbing the nutrients properly?

This also means that although a food may be considered the “food of the Gods,” “superfood,” or any other cliche term out there, if it is causing you gas, bloating, constipation, loose stools, or anything in between, then, unfortunately, this superfood is not so super for YOU (yes, this includes smoothies and raw juices, too). 

So, as you can imagine, the most important factor in the treatment of malabsorption will be to strengthen and balance the digestive fire (Agni). This includes the essential factor of finding out the underlying cause of the digestive issue (i.e. allergenic foods, toxins, stress, parasites), and treating all associated factors simultaneously. The more chronic the malabsorption, the longer the treatment process may be. Also, the stronger the imbalance, the more important it will be to follow the treatment protocol fairly precisely, especially in the beginning. 

Since malabsorption has so many potential causes, I have provided a general list of treatment options for you to follow; however, they may not all pertain to your specific needs. Therefore, it is best to choose the recommendations that make the most sense to you. If your underlying causes are not so clear, you may need a more focused and specialised treatment protocol through an individual consultation with an Ayurvedic specialist who will provide you with a detailed treatment regimen specific to your needs. Until then, here are some recommendations to put into practice.

Ayurvedic Treatment Options for Malabsorption

1. Eat a simple diet of warm, well-cooked foods.

When there are telltale signs of a weak or imbalanced digestion, the best thing you can do is simplify.  Eating a fairly consistent diet of well-cooked (yes, mushy) foods such as soups, broths, stews, kitchari, crock pot meals, stir-fry, oatmeal, porridges and the like, will give your fire a much-needed rest and, therefore, allow it to process through the old while taking in the new. 

Alternatively, you should also be avoiding raw, cold, dry, and rough foods at this time, as these are among some of the hardest foods for your digestion. Of course, if your fire is robust and strong it is no problem, but when the fire is weak, raw foods can be too much for your gut to handle. This includes salads, raw juice, smoothies, crackers, rice cakes, dry toast, pretzels, and popcorn to name a few.    

2. Limit meat consumption.   

This may not be necessary for everyone dealing with malabsorption, but if you are suffering from a digestive issue, then meat should become an occasional meal for the time being. Meat, especially red meat and pork, take much longer to process and breakdown and often cause sluggishness, blockages, or obstruction in the GI tract when consumed too often. This becomes even truer when the meat is eaten later in the day. 

Therefore, meat should be consumed mid-day only and should be limited to an average of 2-3 times a week, allowing at least one day in between meat consumption. If meat is eaten more often, the best way to consume it for your digestive fire is through a meat broth or crockpot stew (since the meat is easier to digest in this form).           

3. Make sure you get a wide variety of colours in your diet each and every day.        

A common (and expensive) mistake is relying on vitamins and supplements to get your daily nutrients. I have seen clients who take more than 30 supplements a day, and yet they are still suffering from a wide range of health issues. This is because our digestion is not strong enough to process all of these vitamins and supplements; instead of helping the issue, you are clogging the channels further and creating more toxins in your system. 

In order to ensure you are getting your full range of nutrients and absorbing them properly, it is always best to go with colorful, whole food options. This means you will want to eat real fruits and vegetables, along with easy to digest options such as bone broth, meat broth, whole grains, legumes, and other healthy (preferably fresh, home-cooked) food types. Also, remember that the darker the colour, the stronger the antioxidant potency. Think beets, dark leafy greens, blueberries, black grapes, carrots, sweet potatoes, red peppers, and other beautiful treats from Mother Nature.  Fruit and vegetables in season will be more beneficial and aligns with Ayurveda ethos.

4. Take a digestive aid before each meal.

When your digestion is in a weakened state, you not only need to change your diet and eat healthier but also focus on ways to rev up your fire during the healing process. Remember that even healthy foods can cause disruption if you are not digesting and absorbing them properly and are not conducive to your body-mind type. 

Therefore, it will be essential to simultaneously take some digestive aids, preferably directly before each meal (this helps to prepare the digestion for the food to come). Your Ayurveda Practitioner will be able to advise you on the best digestive aid according to your condition and archetype. These may involve fresh ginger, CCF tea, lukewarm water & Lassi.

5. Fast one day a week.

If there are clear signs that your digestion and metabolism are not quite up to speed, a great way to give them a bit of a rest is to apply a fast one day each week for several weeks, depending on the severity of the issue. Ideally, you will also be choosing the same day each week to keep some consistency in the program. This should be planned ahead of time and set to a day that you do not have work, travel, or any strenuous activities planned.     

Once you determine the day that works for you, then you can plan out the fast itself. The best fast for increasing the digestion in the warmer seasons will be to eat a small bowl of papaya for each “meal” and nothing else. During the colder months, this should be switched to mung (moong) broth made with some ginger and digestive spices. Warm to hot water should be taken often between “meals,” but black teas, juices, and all other fluids should be avoided.        

6. Perform a mild detox or Kitchari cleanse.

If your malabsorption issues are chronic or strong in potency, you may be needing to perform a mild cleanse or detox. In Ayurveda, we often do the Kitchari mono-diet cleanse while also taking in medicated ghee, detoxifying herbs, and eliminating promoting herbs. This gives the digestion a break through the simple mono-diet while flushing out the system, clearing the channels, and igniting the digestive fire. 

7. Spice up your meals.

Another great way to make your food more digestible and nutrients more absorbable is to add some warming, digestive spices to your meals. The best options are ginger, turmeric, fennel, coriander, cumin, brown mustard seed, fenugreek, cinnamon, cardamom, cloves, and ajwain (also known as caraway, thymol seeds, bishop’s weed, or carom)

8. Drink a digestive tea between meals.

As we continue with the theme of revving up your fire, here is another common Ayurvedic remedy for this. Taking in a digestion-enhancing tea between meals will help you to process through the previous meal while also preparing the gut for the next. This should become a daily habit for the most noticeable results, especially if your malabsorption is a chronic issue. 

The simplest and most classical digestive tea is the age-old ginger tea with lemon and honey. Other effective options include: CCF Tea, Tulsi, Turmeric, and Ginger Tea

Caffeine-Free Chai

9. Reduce the stress in your life.

A huge cause of digestive issues involves too much stress. Stress not only causes hormonal imbalances (hormones regulate our digestion) and weight gain around the midsection (which creates a sluggish metabolism), it also causes constriction throughout the entire body including the GI tract. 

You can picture the GI tract as a canal where food and fluids are taken from one location to another. When we constrict this area, the canal becomes obstructed and things begin to back up. This backing up of food matter creates indigestion, fermentation, and leads to toxic accumulation. The toxins further clog the channels and create more pathology and chaos in the GI tract. 

So, the more we can let things go and take some deep breaths throughout the day, the more space we will create in our system and the more freely our food will be able to flow through. If you’re dealing with a lot of stress in your job, relationship, or life, it is essential that you focus on reducing stress levels on a daily basis by performing some necessary self-care techniques. 

Some Useful De-Stressing Tools Include:

Ginger Baking Soda Baths

Self-Oil Massage (Abhyanga)

Daily walks outside

Hiking or spending some peaceful time in nature

Journaling

Yoga

Breathing Techniques

Meditation

Therapy (talk, sound, art, etc.)

Reducing your workload

Prioritising your necessities

10. Promote healthy gut flora through probiotics and herbs.

If you suspect malabsorption and there is a history of antibiotics, toxins in the system, chronic stress, parasites, candida, or anything of the like, there is a good chance that you may be experiencing dysbiosis or an imbalance of gut flora. Once the healthy bacteria are weakened by any number of these common issues, the unhealthy bacteria can take over and cause chronic indigestion, toxins, and malabsorption. 

To treat this issue, you can take in some yogurt, lassi, kefir, or other healthy probiotic drink on a daily basis for several weeks. You only need a small amount (2-4 Tbsp) after meals, 1-2 times daily. You should favor homemade yogurt as this is more beneficial than store bought. You should also avoid any fruit flavored yogurts as fruit and dairy should never be mixed together (this will cause further indigestion). Instead, favor plain, organic options and add a bit of honey and cinnamon if needed. 

11. Treat parasites.

If parasites are suspected, this should be treated as soon as possible. You can do this by using the proper antiparasitic herbs, performing a cleanse, eating an “antiparasitic diet,” and performing some herbal enemas specific for treating parasites. This should also be done simultaneously with increasing the digestion and promoting healthy gut flora back into the system. 

We hope you found this overview informative. With Love, your Breathe Ayurveda team 🌺

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