A little over a year ago, I started working with the Ayurvedic doctor Jessica Vellela. My friends have had a lot of questions, mainly about why I’m reading their messages at 4:45 AM. I’ll try to answer them here, with a minimum of Sanskrit buzzwords.
What does Doing Ayurveda involve for you?
I maintain an early sleep schedule. I wake up between 4 and 6:30 AM and fall asleep around 9 or 10 PM, with some slippage when I’m traveling. I also try, less successfully, to adhere to a consistent meal schedule.
I take herbal medications, which I’ll discuss more later, at specific times of day. I perform heat treatments and oil massages on myself. I drink hot water rather than cold water and do lots of other little lifestyle things.
Eating is complicated and the core of the whole practice. One important principle is that the flavor and textural properties of a given type of food–heating or cooling, soft or chewy or crunchy, sweet or sour or salty–directly correspond to that food’s effects on the mind and body. Another is that improperly digested food becomes toxic waste in the body, leading to illness. Food might be digested improperly because you’ve eaten too much, or because your body can’t make use of specific ingredients or nutrients, or because you’ve eaten foods with directly conflicting qualities at the same time and they’re fighting it out. All the subtle hallmarks of indigestion that people mostly write off, like burps or acid reflux or feeling tired after a meal, are signs of worse consequences later.
I try to eat foods that will have the effects I’m looking for. In some ways, my diet lines up with commonplace dietary advice, and in other ways, it doesn’t. (I have digestive issues if I don’t eat lots of starchy carbohydrates, and cold, uncooked “health” foods like salads, raw fish, and giant slices of avocado are difficult for anyone to digest.)
At first, Jess gave me a lot of specific instructions to eat or stop eating certain foods. Over time, I developed much more sensory clarity about how different foods affect my body. If I look at a plate of food or vividly imagine eating a specific dish, I can run a simulation of exactly how it’ll feel in my body, predicting how it will digest and whether it will make me feel sick. Now that I have that ability, the food regimen is more about following my body’s signals while continuing to make my intuition more precise.
Exercise followed a similar trajectory to food—lots of specifics and limitations at first, more intuitive and expansive now.
Why did you start?
I have two chronic medical conditions: one genetic, one an autoimmune disease that began after I got mononucleosis as a teenager. I’d also accumulated a lot of semi-related problems: food intolerances, a broken bone in my spine, and acid reflux and hormonal issues that started during a bout of COVID and never stopped. For someone with either original condition, I’m considered a mild case, but everything added up.
My family and I spent many hours and thousands of dollars pursuing the conventional medicine approach, with little to show for it. Apparently there is nothing that can be done for my genetic condition, and the prognosis is that my body will continue to degrade for the rest of my life. For the autoimmune condition, there are biologics I could go on that would stop the inflammation, with the caveat of being permanently dependent on a drug. However, the standard of care is not to prescribe them until your joints are already severely damaged, and you’ve tried multiple cheaper medications with horrible side effects. One of my friends, who has a similar condition and is in much worse shape, still had to fight for months to get on biologics. Needless to say, I was not satisfied with these answers.
I spent a lot of time “biohacking.” I experimented with my diet, supplements, exercises and stretches, meditation, psychedelics, bodywork, and self-therapy. I found a lot of levers I could pull to either heal my body a little bit or get better at enduring discomfort. I was able to hold down jobs and complete my undergraduate and master’s degrees. More cracks started to show during my PhD. I was demotivated due to a poor research-group fit and exhausted from working through pain. I was also getting burnt out on Make Body Work Good, which had for so long been a fun, exciting project.
Last year, I saw several recommendations for MyAyu (at the time, part of a company called Radiance) on Twitter, from friends, and in private Slack and Discord groups. A lot of these recommendations had the specific traits I use to find signal in the noise that is most of alternative medicine. People described lifelong or years-old conditions reversing, and qualitatively new experiences of health, things they could never have predicted happening. (This is a heuristic I’ve come to from personal experience, but there’s some scientific backing: the placebo effect is mostly mean reversion, so it’s interesting when you find a case of someone not reverting to their mean.) One reported experience that was particularly exciting to me was a lot of people resolving their food intolerances: I had thought of mine as a fixed feature of my life, often expanding and claiming more of the territory of cuisine, but never retreating.
I was drawn to Ayurveda’s tactile, Powder Game-like description of the world in terms of elemental forces. I also appreciated the philosophy of solving health problems deeply, rather than slapping a Band-Aid on symptoms–or in my case, not even that. I had also been despairing about my career. Every job I was genuinely interested in was at least a 9-5, hours I knew I couldn’t sustain for very long. I figured betting on MyAyu was likely to pay off both financially and in quality of life. At this point, I feel quite confident that it has!
Aren’t you literally a rationalist, why are you doing this pseudoscience?
I’m an instrumental rationalist (finance bro). We don’t obsess over a specific system of knowledge, we just want to win.
That being said, I think about this all the time. I have somewhere between a long blog post and a book brewing about truthfinding in alternative medicine. If you’re interested in this topic, I can’t recommend Elena Lake’s blog post, Why Well-Trained Human Senses Are The Most Mathematically Rigorous Wellness Approach, highly enough.
I would also point you toward Mark Lippman’s metaphysical assumptions, which I generally share. TL; DR: Physics as we know it is real, but human senses and the unconscious transmit far more subtle, precise signals than most of us acknowledge, creating a materialist basis for divinity, energy and elemental phenomena, karma, and all that other good stuff.
I will keep this answer shorter than a book (barely).
Like I said before, Western medicine wasn’t really working for me in practice. For chronic conditions and general vitality, I’m not sure it even works in theory!
If you’ve never read a mainstream nutrition paper, I would recommend doing so to attain the right level of cynicism. The vast majority of them are riddled with p-hacking, have tiny sample sizes, or don’t test the actual hypothesis they claim to be about. Many are funded by agricultural lobbies or governments with an incentive to promote specific ingredients (see: many Canadian studies claiming maple syrup is better for you than cane sugar.)
I would go one step further than everyone else who used to read Slate Star Codex. I claim that clinical trials are a decent tool to decide what chemicals to release into the unsuspecting American populace, but they’re the wrong tool to answer the questions I care about.
I often talk to a kind of people I’ll describe as the Nothing Ever Happens Guys. I used to be one myself. Their point of view is total nihilism about both mainstream medicine’s approach to general wellness and alternative “woo” traditions. The Nothing Ever Happens Guys believe that high quality randomized controlled trials fail because it doesn’t matter what you eat or do, as long as your calories, macros, and fruits and vegetable intake are vaguely reasonable.
I believe that some RCTs fail because they are trying to test deeply contextual and situational advice, on people (or usually, mice) that advice may not even apply to. All foods and herbal medicines will be good for some people and bad for others. Ayurveda uses a set of diagnostic categories that are different from Western medicine’s, but more fine-grained and tied to root causes rater than symptoms.
Clinical trial participants are chosen based on modern diagnostic categories, which come from a different ontology than the ancient and non-Western treatments being tested. They don’t necessarily have the actual condition or phenomenon these remedies were meant for. Most trial participants probably don’t have the same level of sensory clarity about what’s going on in their bodies that I have spent years developing, and even if they did, no one’s writing down their detailed thoughts on how they feel. Very often, despite the medical establishment’s best efforts, they are professional lab-rats who lie about their clinical trial history to enter new ones, with bodies that are already weird and fucked up from a lifetime of ingesting random substances.
In general, I’ve found that just trying different things ends up giving me more of the kind of information I want than reading papers.
Re: lots of scam Ayurvedists existing: they absolutely do! I would not advise choosing an Ayurvedic doctor without looking into their credentials, style of thinking and working, and patient experiences, and trusting your gut if anything feels wrong.
Sometimes, the people with the most hostile questions are operating under a lot of racial stereotypes about the Mysteries of the Orient. The other most hostile people are usually Indian, and that I totally understand. Anything your parents do is cringe. If someone told me they were getting into traditional Jewish medicine, I would ask where they got the idea that Jews have ever been healthy.
Are there parts you don’t believe?
Of course. I find it difficult to square the ancient sages’ injunctions that heated honey will kill with the reality that many cultures, including my own, drink honey-sweetened tea and bake honey into pastries.
I am open to the idea that heated honey is bad in subtler ways, but it’s a moot point because my body hates honey in any form.
Why Ayurveda, rather than another system of elemental or humoral medicine?
Mostly because I knew of somewhere to start. If I had gotten an equally high-signal recommendation for a TCM practitioner or European herbalist or Native American healer, I would have tried that instead.
Traditional Chinese Medicine and Ayurveda’s energetic perspectives on the world are similar. When you look up what each tradition thinks about a plant native to both China and India, they track each other very closely. Both have some idiosyncrasies. I don’t put much stock in the TCM (and European homeopathic) idea of “like treats like,” or in Ayurveda’s distaste for fermented foods and eating plants/animals that haven’t fully matured. In any case, it seems like both traditions will do a fine job of resetting the temperature and moisture and textural qualities and toxic-waste levels of your organs, which is what I was looking for.
The Western world’s herbal traditions are less formal and internally consistent than Ayurveda and TCM, but they are clearly exploring similar territory. I take a lot of inspiration from Hildegard von Bingen’s dietary recommendations. For people with complicated problems, I would expect the best herbalists to be equally good and the others to be worse than nothing.
There is a good argument for choosing Ayurveda specifically, although I didn’t know it at the time I started working with Jess. Ayurveda has a vibrant research community in India, where she trained, focused on the physical and biomedical side of the practice. This is the part that has teeth, and it’s great if you can find a way in.
Most presentations of Ayurveda in the West are very New Age and focused on the spiritual side and lifestyle habits. (These fill the entire spectrum from intellectually and spiritually rigorous practices, to “turmeric mommy bloggers,” to outright scams.) The spiritual aspects are as important as the raw biology, but they’re not going to address disease as quickly as herbal formulations and give up the diagnostic power of modern imaging and blood tests. With the New Age approach, I think there is a real possibility of initiating a challenging process of waste detoxification and trauma release, and ultimately becoming worse off because you don’t have the right tools to finish it.
Unfortunately, the biomedical-Ayurveda research community rarely publishes in English or in open-access journals. I really wish I had a better idea of what they were up to.
Is Indian food healthier?
Lol, lmao, no. There are way too many spices and contrasting flavors and fried foods for Ayurveda’s minimalist sensibility. Your best bet are the mild, mushy rice-and-pulse dishes that are mostly cooked at home: khichdi, kitchari, and so on. (Most of these originated in Ayurveda.)
It’s probably best to think of Ayurveda as a contrarian strain against the surrounding culture of the time.
Jess once commented that some of the Ayurvedic doctors she studied with in India knowingly lead very unhealthy lifestyles. I wonder if this is because the standards for a healthy life are too high for anyone to meet, let alone while working long hours in often grinding poverty. A lot of people deal with being told to do the impossible by self-sabotage. The patient gets told to wake up at 5am and drink some fennel tea and goes home smiling, with no idea how big the iceberg is. The doctor reads the Necronomicon, I mean Caraka Samhita, and drinks himself to sleep.
What are the formulations like?
Herbal and ghee-based potions in a dizzying array of form factors: decoctions, oils, powders, pills, medicated alcohols, and one paste so thick I can barely wedge a spoon in. Most of them taste pretty bad, with a few exceptions. This is no accident: in Ayurveda, bitter flavors are used to neutralize excess heat and expel wastes from the body. I also drink a lot of herbal tea (mainly fennel, marshmallow root, licorice, and ginger.) I think herbal teas are underrated because most will be useless for most people. When you take the exact right one for your body at a given time, it’s as noticeable as any of the more exotic formulations.
I have two general observations about the formulations.
One is that tasting a formulation makes it much, much easier to learn how it affects my body. This is a huge advantage of drinking teas or oils over swallowing pills. It takes a few days or weeks to memorize the flavor and elemental or energetic effects, but once I do, I have a very good sense of when it would be good to take them and when it would be better to skip.
The other is that the ones that make me feel amazing, the ones I would nominate for Nick Cammarata’s “safer MDMA you can use like coffee,” have all been medicated oil or ghee. These are tricky to take; messy, especially foul-tasting, and actively harmful if you’re not hungry or your digestive capacity is running low; but worth it. I think this is partly due to the particular nature of my problems (oddly, I usually find fatty foods very difficult to digest), and partly due to the way fat enhances bioavailability of other compounds. Some of the oils and ghees have such a powerful soothing quality that I get angry about them being gatekept from a profoundly mentally ill populace.
(In fact, they haven’t been gatekept at all, but repackaged according to reductionist philosophy with varying levels of success. Bacopa and ashwagandha are available as supplements, divorced of the carrier oil and complementary ingredients. I have not tried any of those, but I have doubts about whether they’d work as well in isolation or with vague diagnostic categories like “anxiety.”)
How has your health changed? Are you a cracked 10x founder mode literal Hindu god yet?
Hahahaha the only thing cracked about me is my psyche.
Many things improved in a straightforward, linear way:
I no longer have chronic or severe migraines. I’m not really sure whether to credit this to Ayurveda or to leaving grad school (given the time they started, I wouldn’t be surprised if they were a psychosomatic response to being somewhere I didn’t want to be). In the past several months I’ve had one short migraine, right after a trip where I drank way too much caffeine.
About 6 months in, I took a formulation that, among other things, replenishes the gut microbiome. After a few doses, I lost my dairy intolerance completely and permanently, and my seed oil intolerance became mild enough to dramatically expand my eating possibilities.
I’ve barely had any skin rashes since starting.
My exercise endurance is much higher, and I no longer get hives/itching from cardio.
My muscles feel very different in a way that’s hard to describe. I used to have a subtle full-body soreness that isn’t really there anymore, replaced by limbs that feel warm, solid, and supple. My muscles are less tense, and the muscle tension that remains is less painful.
I no longer have period cramps. (I do get one cramp, just a single contraction, per period.)
When I get mosquito bites, they no longer swell up to the size of a dime or leave dark scars. I honestly did not even think of that as a health problem but it’s a nice bonus.
In many of the big categories–digestion, joint inflammation, hormones, energy, mental health–the process was more “two steps forward, one step back.” These have all gotten a lot better over time, but with weeks or months where I was more disabled than when I started. Some of this is the natural fluctuation of autoimmune disease with stress and seasons. (One big perk has been external motivation to track my health, so I understand the patterns much better now!)
Some of this is because last summer, I knowingly exhausted myself to retrain for a career change and apply for jobs while still very sick. I don’t mean that by the rarified Ayurvedic standards of self-care, I mean things like studying while I was too nauseous to eat more than 800 calories a day or crawling out of bed to take a Zoom interview then right back in. Needless to say, it took a few months to recover from that.
Mostly, getting worse to get better is the expected trajectory for Ayurveda. It is a “rip-the-bandaid-off” school of medicine. If toxins entered your body, they need to come out somehow. A major method of healing is just relaxing enough that your body thinks “great, now it’s time to fix everything I’ve been duct-taping over so we could fight for survival.” I know a couple very healthy and very sick people who have continuously improved, but most people who have the means and motivation to start Ayurvedic treatment were moderately sick and scraping by. They went through similar struggles, seeing real improvements after a year or so. This is true whether they were working with Jess or with another Ayurvedic doctor.
I maintain it is worth sticking it out, as it is the only method I know of to reverse your Random Debuffs.
How do you currently interface with Western medicine?
Western medicine is really good at its main aim, saving people from acute, life-threatening, easily identifiable illnesses and injuries! Obviously, if I get hit by a car or have a heart attack, I very much hope someone calls an ambulance. I continue to get the normal amount of checkups, testing, and vaccinations.
I have a transhumanist streak, and I think it can be worthwhile to transform your body in ways not available to the ancients. I still plan on getting laser eye surgery and having my eggs frozen in the next couple years. I don’t think Ayurveda is philosophically incompatible with gender transition, cosmetic treatments, or recreational drugs in moderation, although it will make you prefer smaller interventions and much more time to restore your body’s baseline afterward. (I think it is philosophically incompatible with GLP-1s and other peptides: this is the path of pursuing metabolic flourishing, not settling for a first-order approximation.)
I’m not a total purist, but I’ve become increasingly uncomfortable taking medications or supplements without a strong felt-sense of exactly what they do to my body. I have that kind of relationship with a few medications, but it’s very difficult to develop one with pills you swallow whole. I use specific Ayurvedic alternatives to a couple of OTC meds and common prescriptions (the antacid and yeast infection remedy, in particular, are much better than any medication I’m aware of), and others I’ll usually forgo for issues that resolve on their own. As far as I know, painkillers specifically are not a thing: if something hurts, why wouldn’t you just treat the root cause?
It is often socially advantageous to have a “medical record” or “doctor’s note.” You can nearly always get the magic PDF without undertaking treatment you don’t consent to.
What’s the 80/20 Ayurvedic routine? (Alternately, what can I safely try on my own?)
Go to sleep between 7 and 10 PM, wake up without an alarm at around 5 or 6 AM. (This may or may not be possible in your body’s current state, but it’s more alterable by intention than you think.)
Eat meals consisting of one starch, one protein, and some vegetables, thoroughly cooked, with one herb or spice at a time or none at all. When you want to eat a more varied diet (and you will), choose complementary flavors and ingredients cooked together over dishes with lots of contrasting flavors, textures, and temperatures.
Eat at the same mealtimes every day, and eat slowly, to 75% fullness rather than 100%. When you’ve eaten just enough, you’ll feel a tiny burp-like release and your plate will start to look less vivid and enticing.
Drink water and other beverages warm; if it’s too hot for that, use room temperature food and water rather than refrigerator-cold.
Exercise to a level that makes you feel energized rather than exhausted, drained, or like your body’s been “punished enough.” For anyone else reading this who has exercise-induced histamine reactions, don’t push through them.
What are the best resources to learn more?
You can always look things up in the Caraka Samhita, the foundational text of Ayurvedic internal medicine. The style is clear but laconic, to put it mildly. You will have a LOT of questions, and LLMs are not great at interpreting this text.
My Ayurvedic doctor, Jessica Vellela, offers an online course and has written multiple textbooks for training Ayurvedic practitioners.
Robert Svoboda’s book Prakriti is more centered on the spiritual and psychological than biomedical side of Ayurveda. In some places it conflicts with Jess’s approach, particularly specific food recommendations or overly narrow claims about personality. That being said, it’s both deep and approachable. After reading it, I reached a turning point where everything in my treatment made more sense and sensory clarity picked up faster.
Unfortunately, the most accurate and comprehensive web resource for specific foods and formulations is “Easy Ayurveda Hospital.” The sites with more polished or Western aesthetics mostly come from the less rigorous New Age tradition, and they are usually trying to sell you something. Like the classical texts, it needs more context and localization than AI can currently deliver, but reading Prakriti helped.
Herbal Reality is great for understanding the energetic principles that unite different strains of traditional medicine and learning how they manifest in different cultures.
I actively anti-recommend most popular Ayurveda books and cookbooks. I read a bunch when I had a much more limited diet and got sad about it, and they were all very bad. They are over-indexed on Indian cuisine, underprioritize warm cooked foods (the #1 most important change to make if you are sick enough to care about Ayurvedic eating), and treat the doshas, the elemental forces of Ayurveda, like Hogwarts houses. I’ve heard that Divya Alter’s What To Eat for How You Feel might be an exception.
Please leave any more questions you have in the comments!
Oh wow the being able to tell how good impacts you resonates so much. I described it in almost the same words even!
Thanks for this, and nicely written