Author: Dr. Vikram Chauhan

September 22, 2026

Herbal Remedies of Seasonal Affective Disorder (SAD) – Causes, Symptoms, Diagnosis & Treatment

ABSTRACT

Seasonal Affective Disorder (SAD) is a form of recurrent mood disturbance in which depressive symptoms appear during a particular season and improve when the season changes. It is commonly associated with reduced exposure to natural daylight, especially during autumn and winter, and may present with persistent sadness, low motivation, fatigue, increased sleep, changes in appetite, difficulty concentrating, and social withdrawal. Alterations in the body’s circadian rhythm, melatonin secretion, serotonin activity, and sleep-wake cycle may contribute to its development. Although SAD is often considered a subtype of major depressive disorder, its predictable seasonal pattern distinguishes it from many other depressive conditions. Diagnosis requires careful assessment of the timing, duration, severity, and recurrence of symptoms while excluding other medical or psychiatric causes.

Seasonal Affective Disorder (SAD)

STATISTICS FOR SEASONAL AFFECTIVE DISORDER

SAD affects approximately 1%–10% of the general population.
Pooled prevalence is about 5.01%, while subsyndromal SAD is around 9.37%.
Summer-pattern SAD accounts for approximately 0.57%.
SAD may represent around 10% of diagnosed depressive episodes.
Symptoms generally persist for 4–5 months each year.
SAD most commonly begins during young adulthood, particularly between 18 and 30 years.

INTERESTING FACTS ABOUT SEASONAL AFFECTIVE DISORDER

It can follow a calendar: SAD often returns around the same time each year, making its pattern surprisingly predictable.
Location matters: SAD tends to be more common in regions with greater seasonal changes in daylight.
Summer SAD exists: SAD is not limited to winter; a smaller group of people experience a seasonal pattern during summer.
It can occur in children: Although commonly recognized in adults, seasonal mood changes can also affect children and adolescents.
It is more than the “winter blues”: SAD is a clinically recognized condition, whereas ordinary wintertime low mood may not meet diagnostic criteria.
Daylight can influence biological timing: Seasonal changes in daylight can interact with the body’s internal clock, which helps explain why SAD follows a seasonal rhythm.
The pattern can change: A person’s seasonal mood pattern may vary over different stages of life rather than remaining identical every year.
Geography does not tell the whole story: Latitude, climate, lifestyle, individual susceptibility, and access to daylight can all contribute to differences in how frequently SAD is reported.

INTRODUCTION

Seasonal Affective Disorder (SAD) is a clinically recognized mood disorder characterized by a recurring relationship between depressive episodes and a particular time of the year. Unlike depressive conditions that may occur without a recognizable seasonal pattern, SAD follows a temporal rhythm, with periods of emotional disturbance occurring during specific months and remission during other parts of the year. This recurring nature makes seasonality an important component of clinical assessment. SAD is most commonly associated with the autumn and winter months, although a smaller proportion of individuals experience symptoms during spring or summer. Its occurrence varies across geographical regions, and differences in daylight exposure across seasons have contributed to considerable interest in the relationship between environmental changes and mental health. The condition may influence daily functioning, interpersonal relationships, academic or professional performance, and overall quality of life.

CAUSES AND RISK FACTORS OF SEASONAL AFFECTIVE DISORDER

This disorder develops through a combination of biological, environmental, genetic, and lifestyle-related factors. The causes and risk factors are as follows in detail:

Seasonal changes in daylight

Reduced daylight during certain seasons may affect brain systems involved in mood regulation and biological timing.

Circadian rhythm disruption

Changes in the light-dark cycle can disturb the body’s internal biological clock and alter normal sleep-wake regulation.

Altered serotonin activity

Seasonal changes may influence serotonin pathways involved in emotional regulation, potentially contributing to depressive symptoms in susceptible individuals.

Melatonin changes

Variations in light exposure can affect melatonin production and timing, influencing sleep patterns and circadian regulation.

Genetic susceptibility

A family history of depression, bipolar disorder, or SAD may increase an individual’s vulnerability.

Female sex

SAD has been reported more frequently among women than men, although the reasons for this difference remain incompletely understood.

Higher latitude

Living farther from the equator, where seasonal differences in daylight are greater, is associated with higher reported rates of winter-pattern SAD.

Bipolar disorder

People with bipolar disorder may experience a seasonal pattern in the timing of depressive or manic/hypomanic episodes.

Environmental and lifestyle factors

Seasonal changes in daily routine, physical activity, social interaction, and outdoor exposure may contribute to vulnerability in susceptible individuals.

SIGNS AND SYMPTOMS OF SEASONAL AFFECTIVE DISORDER

The clinical presentation of SAD can extend beyond ordinary low mood. Its recurring seasonal pattern and distinctive changes in biological and behavioral functioning are particularly important when recognizing the disorder. The signs and symptoms include:

Atypical depressive features

Winter-pattern SAD may show increased sleep, increased appetite, carbohydrate cravings, and weight gain rather than the reduced sleep and appetite often associated with typical depression.

Seasonal hypersomnia

A person may sleep substantially longer than usual yet continue to feel unrefreshed or excessively sleepy during the day.

Season-linked energy shift

A noticeable reduction in physical and mental drive may develop during the affected season, often interfering with normal daily activities.

Carbohydrate-focused cravings

Some individuals develop a strong preference for carbohydrate-rich foods, particularly during the colder or darker months.

Seasonal social withdrawal

Individuals may progressively reduce social interaction and participation in activities that they normally maintain.

Distinctive cognitive slowing

Thinking, concentration, decision-making, and mental responsiveness may feel noticeably slower during the affected season.

Seasonal hypersensitivity to environmental change

Mood and functioning may fluctuate noticeably as daylight duration and seasonal conditions change.

Functional impairment with repetition

The symptoms become clinically significant when they repeatedly interfere with occupational, academic, interpersonal, or everyday functioning across seasonal cycles.

Summer-pattern presentation

Although less common, summer SAD can present with a different pattern, including reduced sleep, decreased appetite, weight loss, agitation, and increased restlessness.

DIAGNOSIS OF SEASONAL AFFECTIVE DISORDER

The diagnosis of Seasonal Affective Disorder (SAD) is primarily clinical and depends on identifying a consistent relationship between depressive episodes and a particular season. There are various diagnostic tests that are as follows:

Clinical History

The clinician records the onset, duration, severity, and recurrence of depressive symptoms. Changes in mood, sleep, appetite, energy, concentration, and daily functioning are assessed.

Assessment of Winter or Summer Pattern

Winter pattern may identify hypersomnia, increased appetite, carbohydrate cravings, and seasonal weight gain. Summer patterns may reveal insomnia, reduced appetite, weight loss, agitation, or increased restlessness.

Symptom Questionnaires

Standardized depression or SAD-related questionnaires may be used to measure symptom severity and support the clinical assessment. Questionnaires are supportive tools rather than substitutes for professional diagnosis.

Functional Assessment

The clinician evaluates whether seasonal symptoms interfere with work, education, relationships, self-care, or everyday responsibilities. This helps distinguish clinically significant SAD from temporary seasonal changes in mood.

Psychiatric Evaluation

Current or previous episodes of major depression and bipolar disorder should be explored because SAD can occur in association with these conditions.

MANAGEMENT OF SEASONAL AFFECTIVE DISORDER

It should be individualized according to the seasonal pattern, severity of depression, functional impairment, previous episodes, and coexisting psychiatric or medical conditions. The management may require various approaches like:

Bright Light Therapy

It is a major treatment for winter-pattern SAD. A light box providing approximately 10,000 lux is commonly used. It is generally used in the morning, often for about 20–45 minutes daily, according to clinical guidance and the device’s instructions. The device should be designed specifically for SAD and should filter out potentially harmful ultraviolet (UV) radiation.

Cognitive Behavioral Therapy

It can help modify negative seasonal thoughts and unhelpful behavioral patterns. CBT for SAD may incorporate behavioral activation, encouraging regular engagement in meaningful activities. It can also help improve coping skills, stress management, sleep habits, and adherence to healthy routines.

Antidepressant Medications

These may be considered when symptoms are moderate to severe, persistent, or inadequately controlled with non-drug approaches. Bupropion extended-release has been used for prevention of recurrent seasonal depressive episodes. Selective serotonin reuptake inhibitors (SSRIs) and other antidepressants may also be considered depending on the clinical presentation.

Vitamin D Assessment

Vitamin D supplementation may be considered particularly in winter-pattern SAD when deficiency is present. Spending time outdoors during daylight hours can increase exposure to natural light. Morning outdoor activity may be incorporated into the daily routine, particularly during seasons with reduced daylight.

Structured Sleep Routine

Maintaining consistent sleep and wake times can help support regular circadian rhythms. Excessive daytime sleeping and prolonged naps should generally be avoided when they worsen the sleep-wake pattern.

Management of Summer-Pattern SAD

It generally focuses on evidence-based treatments for depression, including psychotherapy and appropriate medication when indicated.

Social and Behavioral Support

Maintaining regular contact with family, friends, colleagues, and supportive social networks can help counter seasonal withdrawal. Relaxation practices such as meditation, yoga, and stress-management techniques may complement the primary treatment plan.

AYURVEDA INSIGHTS

From an Ayurvedic perspective, Seasonal Affective Disorder can be understood through the interaction of Manas (mind), Dosha, Agni (metabolic and digestive function), and seasonal changes (Ritucharya). The transition between seasons may influence Vata and Kapha, particularly when changes in coldness, dryness, reduced sunlight, inactivity, and daily routine disturb the body’s physiological balance. Kapha aggravation may be associated with heaviness, lethargy, excessive sleep, and reduced motivation, while Vata imbalance may contribute to mental restlessness, irregular sleep, and emotional instability. Ayurveda also emphasizes the role of Sattva (mental clarity and balance) and considers regular sleep, appropriate diet, physical activity, exposure to natural daylight, meditation, yoga, Abhyanga (oil massage), and adherence to seasonal routines as supportive measures for maintaining mental and physiological equilibrium. Individual assessment of Prakriti (constitution), Vikriti (current imbalance), Agni, and lifestyle can help guide a personalized Ayurvedic approach.

PATHOGENESIS OF SEASONAL AFFECTIVE DISORDER

From an Ayurvedic viewpoint, the development of seasonal mood disturbance may be conceptualized as a Samprapti (disease process) arising from an incompatibility between the individual’s internal state and recurring seasonal influences. Kala (time) and Ritu (season) can modify Dosha activity and bodily functions, while disruption of Ritucharya (seasonal regimen) may interfere with the body’s natural adaptation. In susceptible individuals, this may initiate Dosha Vaishamya (functional imbalance), followed by disturbance in the normal functions of Manas (mind). Predominance of Tamas may manifest as mental inertia and reduced engagement, whereas disturbed Rajas may interfere with emotional steadiness and mental organization. Continued imbalance can affect Manovaha Srotas, producing dysfunction in the pathways responsible for mental activity and emotional regulation. If these changes persist, Dhi (intellectual discrimination), Dhriti (mental restraint), and Smriti (memory) may become functionally impaired, influencing motivation, decision-making, and adaptation to routine activities.

HERBAL REMEDIES FOR SEASONAL AFFECTIVE DISORDER BY PLANET AYURVEDA

Planet Ayurveda is a well-established Ayurvedic healthcare organization that works to promote the ancient knowledge of Ayurveda through natural remedies and holistic health solutions. The company develops a wide range of herbal formulations using pure, high-quality ingredients and standardized herbal extracts, with a focus on maintaining safety, authenticity, and effectiveness. Following the principles of classical Ayurveda, Planet Ayurveda aims to support overall health by addressing the underlying causes of health concerns and encouraging balance in the body, mind, and emotions. With an emphasis on quality, natural ingredients, and traditional approaches supported by modern research, the organization works toward making Ayurvedic wellness solutions available globally. We will explore various herbal approaches used for the management of Seasonal Affective Disorder according to Ayurvedic principles. The herbal formulations are:

Neurogenie Capsules
Ashwagandha Capsules
Calm Easy Tea

Herbal Remedies For Seasonal Affective Disorder (SAD)

PRODUCT DESCRIPTION

1. Neurogenie Capsules

These contain Brahmi (Bacopa monnieri) and Ashwagandha (Withania somnifera), two traditionally used Ayurvedic herbs associated with mental and nervous-system support. In the context of Seasonal Affective Disorder, this formulation may be considered as a supportive Ayurvedic approach for maintaining mental balance, coping with stress, and supporting healthy sleep and cognitive function during seasonal changes. Brahmi is traditionally valued as a Medhya Rasayana (cognitive rejuvenative), while Ashwagandha is regarded as a Rasayana with adaptogenic properties.

Dosage: 2 capsules twice a day after meals with plain water.

2. Ashwagandha Capsules

These contain Ashwagandha (Withania somnifera), an Ayurvedic Rasayana (rejuvenative herb) traditionally used to support resilience, mental balance, and overall wellbeing. In the context of Seasonal Affective Disorder, Ashwagandha may be considered as a supportive Ayurvedic option for individuals experiencing stress, disturbed sleep, low energy, or difficulty adapting to seasonal changes. Its traditional use is particularly associated with promoting calmness and supporting healthy nervous-system function.

Dosage: 1 capsule twice a day after meals with plain water.

3. Calm Easy Tea

It contains a combination of Ashwagandha (Withania somnifera), Brahmi (Bacopa monnieri), Licorice (Glycyrrhiza glabra), Green Tea (Camellia sinensis), Ginger (Zingiber officinale), and Cinnamon (Cinnamomum verum). In an Ayurvedic supportive approach to Seasonal Affective Disorder, this herbal tea may be incorporated into a wellness routine aimed at maintaining mental calmness, relaxation, and daily balance during seasonal changes. Ashwagandha and Brahmi are traditionally valued for supporting mental wellbeing, while ginger and cinnamon are traditionally used to support digestion. Green tea provides a mild source of caffeine and antioxidants.

Dosage: 1 cup daily.

DIETARY TIPS FOR SEASONAL AFFECTIVE DISORDER

The foods which can be included in the diet are as follows:

Green leafy vegetables: Kale, spinach and similar greens supply folate and other micronutrients that support overall brain health.
Whole grains: Oats, barley, and quinoa provide B-group vitamins that contribute to normal nervous-system function.
Dairy foods: Fresh milk, curd, and other dairy products can provide protein, calcium, and other nutrients as part of a balanced diet.
Nuts and seeds: Almonds, flaxseeds, and other nuts and seeds offer healthy fats, including plant-based omega-3 fatty acids, along with minerals that support neurological health.
Fruits: Avocados, berries, and other nutrient-dense fruits provide vitamins, minerals, fiber, and antioxidant compounds that contribute to overall wellbeing.

The foods to avoid in this disorder include:

Highly processed foods and added sugars: Frequent intake may cause rapid fluctuations in blood glucose and energy levels, which can affect overall mood and wellbeing.
Excessive caffeine and alcohol: High caffeine intake may interfere with sleep, while alcohol can disrupt normal sleep quality and emotional balance.
Excessively spicy foods: Very spicy meals may aggravate Pitta and, in susceptible individuals, contribute to digestive discomfort and imbalance of Vata.
Heavy and excessively fatty meats: These may feel difficult to digest and, from an Ayurvedic perspective, can aggravate Kapha, contributing to heaviness and sluggishness.
Stale or repeatedly reheated foods: Ayurveda recommends favoring freshly prepared meals, as stale foods may be considered less supportive of balanced digestion.

CONCLUSION

Early recognition, regular monitoring, and an individualized care plan are important for maintaining emotional wellbeing and preventing seasonal disturbances from affecting daily life. Consistent sleep, balanced nutrition, physical activity, adequate daylight exposure, meaningful social interaction, and appropriate psychological support can contribute to better overall functioning. Preventive strategies may also be considered when a recurring seasonal pattern is established. From an Ayurvedic perspective, following Ritucharya (seasonal regimen), supporting Agni (digestive and metabolic function), and promoting Sattva (mental clarity and stability) may offer complementary support for maintaining balance through seasonal transitions.

September 21, 2026

Upadoz / Upadacitinib in IBD: Can JAK1 Inhibition Change the Inflammatory Story?

Abstract

Inflammatory bowel disease (IBD), encompassing ulcerative colitis and Crohn’s disease, involves persistent immune activation and dysregulated cytokine signaling that can lead to recurrent intestinal inflammation and tissue injury. Upadacitinib, marketed as Upadoz, is an oral, selective JAK1 inhibitor that targets intracellular cytokine signaling and interrupts downstream JAK-STAT pathways involved in immune activation. By acting closer to the signaling machinery rather than a single extracellular inflammatory mediator, JAK1 inhibition represents a distinct therapeutic strategy in IBD. Clinical evidence has demonstrated meaningful improvements in clinical remission, endoscopic response, and disease control in moderate-to-severe ulcerative colitis and Crohn’s disease.

Upadoz / Upadacitinib in IBD

Introduction

Inflammatory bowel disease (IBD) represents a complex group of chronic intestinal disorders in which persistent immune activation, abnormal cytokine signaling, and disruption of mucosal integrity contribute to ongoing disease activity. Ulcerative colitis and Crohn’s disease differ in their anatomical patterns and pathological characteristics, yet both involve interconnected inflammatory pathways that can sustain intestinal damage and recurrent symptoms. The Janus kinase-signal transducer and activator of transcription (JAK-STAT) pathway occupies an important position in cytokine-mediated immune signaling. JAK1 participates in signaling triggered by several cytokines implicated in intestinal inflammation, making selective JAK1 inhibition an attractive therapeutic approach. Upadacitinib, marketed as Upadoz, is an oral JAK inhibitor with preferential activity against JAK1. By interfering with intracellular phosphorylation and subsequent STAT activation, it can modulate signaling from multiple cytokine pathways rather than targeting a single extracellular mediator. Its oral administration and relatively rapid pharmacological action further distinguish it from several conventional biologic approaches.

Pharmacological Profile of Upadacitinib

Hepatopulmonary syndrome develops mainly as a consequence of chronic liver dysfunction and portal hypertension, which produce abnormal changes in the blood vessels of the lungs. The central abnormality involves excessive widening of small pulmonary blood vessels. This dilatation interferes with the normal movement of oxygen from the air spaces of the lungs into the bloodstream, resulting in reduced arterial oxygen levels. Several liver-related conditions can contribute to the development of HPS.

Drug class: Upadacitinib is an oral small-molecule Janus kinase (JAK) inhibitor with preferential activity against JAK1.
Molecular action: It binds to the ATP-binding region of JAK1 and inhibits its kinase activity. This reduces phosphorylation and activation of downstream STAT proteins involved in cytokine-mediated gene transcription.
Cytokine modulation: JAK1 participates in signaling by several cytokines, including pathways involving interleukin-6, interferons, and other cytokines that contribute to immune regulation. Inhibition therefore influences multiple inflammatory signals simultaneously.
Pharmacokinetic profile: Upadacitinib is administered orally and is rapidly absorbed, reaching peak plasma concentrations within a few hours. Its pharmacokinetic properties support once-daily administration.
Metabolism: The drug undergoes hepatic metabolism, predominantly involving CYP3A4, with additional contribution from other metabolic pathways.
Elimination: Upadacitinib and its metabolites are eliminated through both fecal and urinary routes, with unchanged drug accounting for only a limited proportion of total elimination.
Half-life: Its effective terminal half-life is approximately 8–14 hours, supporting sustained pharmacological activity with once-daily dosing.
Therapeutic positioning in IBD: Upadacitinib is used for appropriate patients with moderate-to-severe ulcerative colitis and Crohn’s disease, particularly when conventional or biologic therapies have not provided adequate disease control or are unsuitable.
Safety considerations: Important monitoring considerations include infections, herpes zoster, hematological abnormalities, liver enzyme changes, lipid alterations, and thromboembolic or cardiovascular risks in susceptible patients.
Clinical significance: Its oral route, selective JAK1 activity, and ability to modulate intracellular signaling from several cytokine pathways make upadacitinib a distinct targeted option within the expanding therapeutic landscape of IBD.

Upadacitinib: Mechanism of Action in IBD

Upadacitinib is an oral, selective Janus kinase 1 (JAK1) inhibitor that modulates intracellular cytokine signaling involved in immune activation and intestinal inflammation. Its therapeutic activity is based on interference with the JAK-STAT signaling pathway, an important intracellular mechanism through which numerous cytokines regulate immune-cell function. Following cytokine binding to specific cell-surface receptors, receptor-associated JAK enzymes become activated and phosphorylate signal transducer and activator of transcription (STAT) proteins. These phosphorylated STAT proteins subsequently translocate into the nucleus, where they influence transcription of genes involved in inflammatory responses, immune-cell differentiation, proliferation, and survival. Upadacitinib selectively inhibits JAK1, thereby reducing signaling mediated by cytokines that depend substantially on JAK1-containing receptor complexes. In IBD, modulation of JAK1 signaling can affect multiple inflammatory pathways simultaneously rather than neutralizing a single cytokine outside the cell. This pharmacological approach may reduce downstream immune activation and inflammatory gene expression within intestinal tissues.

The Inflammatory Pathways Driving IBD

Inflammatory bowel disease develops through a complex interaction between intestinal immunity, the gut microbiome, epithelial barrier function, and environmental influences. Rather than being driven by one inflammatory molecule, IBD involves several interconnected signaling networks that amplify and sustain inflammation.

Breakdown of the Intestinal Barrier

The intestinal epithelium forms the first protective interface between the body’s immune system and luminal contents. In IBD, impaired epithelial integrity can increase intestinal permeability, allowing microbial products and other luminal antigens to interact more extensively with immune cells. Alterations in tight-junction proteins can further compromise barrier function.

Abnormal Recognition of Intestinal Antigens

The intestinal immune system normally distinguishes harmless dietary and microbial components from potentially harmful signals. In IBD, this regulatory balance becomes disturbed. Pattern-recognition receptors on epithelial and immune cells detect microbial components and activate intracellular inflammatory pathways.

Activation of Innate Immune Responses

Macrophages, dendritic cells, neutrophils, and other innate immune cells participate in the early inflammatory response. Activated macrophages can release inflammatory mediators such as tumor necrosis factor-alpha (TNF-alpha), interleukin-1 beta (IL-1 beta), and interleukin-6 (IL-6).

Dysregulated T-Cell Responses

Adaptive immunity has a major role in maintaining chronic intestinal inflammation. T-helper 1 (Th1) responses and cytokines such as interferon-gamma are particularly relevant to Crohn’s disease.

JAK-STAT Signaling

The Intracellular Communication Hub – The Janus kinase-signal transducer and activator of transcription (JAK-STAT) pathway is one of the major signaling mechanisms involved in this process. Cytokine binding to its receptor activates associated JAK enzymes, which phosphorylate STAT proteins.

From Local Inflammation to Tissue Damage

Persistent inflammatory signaling eventually affects the structural integrity and function of the intestinal mucosa. Repeated immune-cell infiltration and inflammatory mediator release can interfere with epithelial repair. Chronic inflammation can therefore contribute to ulceration, impaired barrier function, fibrosis, stricturing, fistula formation, and other disease complications, particularly in Crohn’s disease.

Can JAK1 Inhibition Change the Inflammatory Story?

Inflammation in inflammatory bowel disease (IBD) is not controlled by a single molecule or one isolated pathway. Several cytokines communicate with immune cells and intestinal tissues at the same time, creating a continuous inflammatory network. This complexity is one reason why controlling IBD can be challenging, particularly in patients with moderate-to-severe disease or inadequate response to previous treatments. Thus, JAK1 inhibition represents a shift from targeting individual inflammatory mediators toward modifying a central intracellular signaling pathway involved in multiple cytokine responses.

Broader inflammatory control

JAK1 participates in signaling from multiple cytokine receptors. Its inhibition can therefore reduce several inflammatory signals simultaneously.

Reduced immune-cell activation

By limiting JAK-STAT signaling, upadacitinib can decrease downstream processes that sustain intestinal inflammation.

Improved disease activity

Reduced inflammatory signaling can help control symptoms and promote improvement in objective measures of intestinal inflammation.

Relevance to difficult-to-treat IBD

Upadacitinib provides an additional treatment option for patients with moderate-to-severe ulcerative colitis or Crohn’s disease, including those with inadequate response to previous therapies.

Rapid and convenient approach

Its oral administration and relatively rapid clinical response add practical advantages to its therapeutic profile.

Potential Impact on Intestinal Inflammation

As inflammatory signaling decreases, several components of the disease process may improve. Reduced immune activation can contribute to lower inflammatory activity within the intestinal mucosa, while improvement in mucosal inflammation may support restoration of intestinal function.

JAK1 Inhibition Is Not Simply About Suppressing Immunity

The therapeutic objective is not to eliminate immune activity. The immune system remains essential for protection against infections and other threats. The goal is to reduce excessive or inappropriate inflammatory signaling while maintaining adequate immune function. This balance is central to understanding both the benefits and safety considerations of JAK1 inhibition.

Dosage and Treatment Considerations of Upadacitinib

Upadacitinib treatment in inflammatory bowel disease follows an induction-maintenance approach, with a higher dose used initially to control active disease and a maintenance regimen used for sustained disease control.

Ulcerative Colitis

The recommended induction dose for adults with moderate-to-severe ulcerative colitis is 45 mg once daily for 8 weeks. The usual maintenance dose is 15 mg once daily. A 30 mg once-daily maintenance dose may be considered in patients with refractory, severe, or extensive disease when clinically appropriate.

Crohn’s Disease

The recommended induction dose for adults with moderate-to-severe Crohn’s disease is 45 mg once daily for 12 weeks. The recommended maintenance dose is 15 mg once daily. A 30 mg once-daily maintenance dose may be considered for patients with refractory, severe, or extensive disease.

Administration

Upadacitinib is taken orally once daily. The extended-release tablet should be swallowed whole and should not be crushed, split, or chewed. It can generally be taken with or without food.

Assessment Before Treatment

Before initiating therapy, patients should be evaluated for active infections and relevant risk factors. Baseline assessment generally includes complete blood count, liver function, lipid profile, tuberculosis screening, and hepatitis evaluation, together with a review of vaccination status and concomitant medications.

Monitoring During Treatment

Regular monitoring is important to assess both therapeutic response and tolerability. Depending on the patient’s clinical condition, this may include: complete blood count, liver enzymes, lipid profile, signs and symptoms of infection, inflammatory markers, and objective assessment of intestinal inflammation when appropriate.

Infection Considerations

Because JAK inhibition modifies immune activity, upadacitinib can increase susceptibility to infections. Particular attention should be given to tuberculosis, herpes zoster, and serious or opportunistic infections. Treatment decisions should be reassessed if a significant infection develops.

Long-Term Treatment

Maintenance therapy requires periodic reassessment of disease control, treatment benefit, and safety. The maintenance regimen should be individualized according to disease severity, therapeutic response, tolerability, and the patient’s overall risk profile.

Ayurveda Insights

From an Ayurvedic perspective, the inflammatory pattern of IBD can be understood through the interaction of Agni, Ama, Dosha imbalance, and impaired Grahani function. Disturbed digestion and metabolism may lead to Ama formation, while aggravated Vata and Pitta can contribute to altered bowel function, intestinal irritation, and inflammatory manifestations. Grahani is considered closely connected with the proper maintenance of digestion and absorption, making its functional disturbance relevant when interpreting chronic gastrointestinal disorders. Although Upadoz / Upadacitinib acts through the modern JAK1 pathway and does not have a direct Ayurvedic equivalent, its role in regulating excessive inflammatory signaling can be viewed alongside the Ayurvedic objective of restoring balance in Dosha, Agni, and Grahani function.

Pathogenesis of Inflammatory Bowel Disease According to Ayurveda

From the Ayurvedic perspective, the pathological progression can be described as a Samprapti involving disturbance of the gastrointestinal tract and subsequent involvement of the Doshas. Initial dietary and lifestyle factors can disturb normal intestinal physiology, followed by vitiation of Vata, Pitta, or their combination according to the individual’s presentation. Vitiated Vata can drive abnormal intestinal movement and pain, whereas aggravated Pitta can intensify intestinal irritation, burning, loose stools, and bleeding. Kapha, when involved, can contribute to excessive mucus and heaviness. With continued Dosha aggravation, these factors affect the functional integrity of Grahani, resulting in impaired retention and elimination of intestinal contents. In advanced or persistent disease, repeated Dosha disturbance can produce deeper involvement of the intestinal tissues, explaining the chronic and relapsing nature of gastrointestinal pathology from an Ayurvedic viewpoint.

Alternatives of Upadicitinib in Management of Inflammatory Bowel Disease by Planet Ayurveda

Planet Ayurveda is a well-established Ayurvedic healthcare organization that works to promote the ancient knowledge of Ayurveda through natural remedies and holistic health solutions. The company develops a wide range of herbal formulations using pure, high-quality ingredients and standardized herbal extracts, with a focus on maintaining safety, authenticity, and effectiveness. Following the principles of classical Ayurveda, Planet Ayurveda aims to support overall health by addressing the underlying causes of health concerns and encouraging balance in the body, mind, and emotions. With an emphasis on quality, natural ingredients, and traditional approaches supported by modern research, the organization works toward making Ayurvedic wellness solutions available globally. We will explore various herbal approaches used for the management of Inflammatory Bowel Disease according to Ayurvedic principles. The herbal formulations are:

Product description

1. Kutajghan Vati

It contains Kutaja (Holarrhena pubescens), can be considered an Ayurvedic herbal formulation for supporting bowel regulation in gastrointestinal disorders characterized by frequent or loose stools. Kutaja is described in Ayurveda for its Grahi and Kashaya properties, which help support intestinal tone and stool consistency. Its astringent nature may also help maintain the integrity of the intestinal mucosa and reduce excessive intestinal secretions. In the context of IBD, Kutajghan Vati may be incorporated as an adjunctive Ayurvedic approach for managing diarrhea, bowel frequency, and associated gastrointestinal discomfort.

Dosage: 2 tablets two times a day after meals with plain water.

2. Atisaran Mukti

It is an Ayurvedic herbal formulation containing Kutaja (Holarrhena antidysenterica), Bilwa (Aegle marmelos), Saunf (Foeniculum vulgare), Dhaniya (Coriandrum sativum), Nagarmotha (Cyperus scariosus), Anar (Punica granatum), Chhoti Elaichi (Elettaria cardamomum), and Jaiphal (Myristica fragrans). The combination is primarily focused on supporting healthy bowel function and improving stool consistency. Kutaja and Bilwa possess Grahi properties that help regulate excessive intestinal fluid loss, while Nagarmotha and Dhaniya support digestion and reduce gastrointestinal discomfort. Anar provides an astringent action, while Saunf and Elaichi support digestion and ease abdominal uneasiness.

Dosage: 1 capsule two times a day after meals with plain water.

3. Pitta Balance

Pitta Balance is an Ayurvedic formulation comprising Jaharmohra Pishti (natural calcium compound), Kaharawa Pishti (natural calcium compound), Akik Pishti (agate compound), Giloy Satva (Tinospora cordifolia extract), and Mukta Pishti (natural calcium compound derived from pearls). The formulation is intended to support Pitta balance and gastrointestinal comfort, which is relevant when burning sensation, loose stools, and intestinal irritation accompany digestive disturbances. Giloy Satva contributes its Pitta-shamaka and Rasayana properties, while the mineral and gemstone-based Pishtis are traditionally used for their cooling and soothing qualities.

Dosage: 1 capsule twice a day after meals with plain water.

4. Vatsakadi Churna

It is an Ayurvedic herbal formulation containing Kutaja (Holarrhena antidysenterica), Bilva (Aegle marmelos), Saunf (Foeniculum vulgare), Dhaniya (Coriandrum sativum), Anar (Punica granatum), Nagarmotha (Cyperus scariosus), and Jaiphal (Myristica fragrans). The formulation is primarily useful for supporting bowel regulation and digestive function, particularly when loose stools and increased bowel frequency are prominent. Kutaja and Bilva provide Grahi and astringent properties that help maintain healthy stool consistency, while Nagarmotha and Jaiphal support digestion and intestinal function. Saunf and Dhaniya may help relieve bloating and abdominal discomfort.

Dosage: 1 teaspoonful twice a day after meals with plain water.

5. Arjuna Capsules

It contains Arjuna (Terminalia arjuna), can be included as supportive Ayurvedic therapy in the broader management of inflammatory bowel disease (IBD). Arjuna is recognized in Ayurveda for its Kashaya (astringent) and Ropana (tissue-supporting) properties, which may be relevant when intestinal mucosal irritation and weakness accompany chronic bowel disorders. Its antioxidant and anti-inflammatory properties also provide a rationale for supporting tissue protection during persistent inflammatory conditions.

Dosage: 1 capsule twice a day after meals with plain water.

6. Motion Stop Tablets

These contain Kutaja (Holarrhena antidysenterica), Bael (Aegle marmelos), Haldi (Curcuma longa), Anar (Punica granatum), and Nagarmotha (Cyperus scariosus) along with suitable pharmaceutical excipients. The formulation is focused on supporting bowel regulation, particularly when frequent or loose stools are present. Kutaja and Bael possess Grahi and astringent properties that help support healthy stool consistency, while Nagarmotha assists digestive function. Haldi provides antioxidant and anti-inflammatory properties, and Anar contributes astringent support for intestinal function. In the Ayurvedic management of IBD, Motion Stop Tablets can be considered supportive care for diarrhea and increased bowel frequency.

Dosage: 2 tablets twice a day after meals with plain water.

7. Vasaka Capsules

These contain Vasaka (Adhatoda vasica), can be included as supportive Ayurvedic therapy in the management of inflammatory bowel disease (IBD), particularly when Pitta-associated inflammatory features are prominent. Vasaka is recognized in Ayurveda for its Tikta and Kashaya Rasa and Pitta-pacifying properties. Its bioactive constituents, particularly vasicine and vasicinone, contribute to its pharmacological profile. The herb is also valued for antioxidant and anti-inflammatory activity, which may support tissue protection during persistent inflammatory states.

Dosage: 1 capsule twice a day after meals with plain water.

8. Coolstrin A Capsules

These contain Sheesham (Dalbergia sissoo), Vasaka (Adhatoda vasica), Anar (Punica granatum), Zandu (Jatropha curcas), and Arjuna (Terminalia arjuna). The combination can be considered as supportive Ayurvedic care for maintaining gastrointestinal health during chronic inflammatory bowel conditions. Sheesham and Vasaka provide traditionally recognized astringent and Pitta-supportive properties, while Anar helps support healthy bowel consistency. Arjuna contributes Kashaya properties along with antioxidant activity, and Zandu adds to the formulation’s herbal profile.

Dosage: 1 capsule twice a day after meals with plain water.

9. Coolstrin B Capsules

These contain Lodhra (Symplocos racemosa), Dhataki (Woodfordia fruticosa), Lajjalu (Mimosa pudica), Mochrus (Salmalia malabarica), and Nagkesar (Mesua ferrea). This combination provides herbs with predominantly Kashaya (astringent) and Grahi properties, making it relevant for supporting bowel regulation when loose stools and excessive intestinal secretions are present. Lodhra and Nagkesar are traditionally valued for supporting tissue integrity, while Lajjalu and Mochrus contribute astringent and restorative properties. Dhataki further supports gastrointestinal function and mucosal stability.

Dosage: 1 capsule twice a day after meals with plain water.

10. Aegle Plan Capsules

These contain Bilwa (Aegle marmelos), can be considered as supportive Ayurvedic care in inflammatory bowel disease (IBD), particularly when loose stools and disturbed bowel function are prominent. Bilwa is recognized for its Grahi, Kashaya, and Deepana properties, supporting stool consistency, digestive function, and intestinal stability. Its fruit contains bioactive constituents that contribute to its astringent and gastrointestinal-supportive profile.

Dosage: 1 capsule twice a day after meals with plain water.

11. Halorhena + Capsules

These contain Kutaja (Holarrhena antidysenterica), can be included as supportive Ayurvedic care in inflammatory bowel disease (IBD), particularly when frequent or loose stools are prominent. Kutaja is well recognized in Ayurveda for its Grahi, Kashaya, and Deepana properties, which support stool consistency, intestinal function, and digestive capacity. Its major alkaloids, including conessine, contribute to its pharmacological profile and gastrointestinal activity. In the Ayurvedic management of IBD, Halorhena + Capsules may help support bowel regulation and intestinal comfort during episodes of increased stool frequency.

Dosage: 1 capsule twice a day after meals with plain water.

12. Hemostop-B Powder

It is an Ayurvedic formulation containing Jhnadu, Priyangu (Callicarpa macrophylla), Parnabeej, Durva (Cynodon dactylon), Amalaki (Phyllanthus emblica), Lotus (Nelumbo nucifera), Punnag (Calophyllum inophyllum), Ayapan (Eupatorium ayapana), Raktniryas, and Mishri. The formulation brings together herbs traditionally valued for Kashaya (astringent), Raktasthambaka (blood-stabilizing), and Pitta-supportive properties. Amalaki and Durva provide antioxidant support, while Priyangu, Lotus, and Punnag contribute astringent properties that support tissue integrity.

Dosage: 1 teaspoonful twice a day after meals with plain water.

13. Mimosa-Di Capsules

These contain Lajwanti (Mimosa pudica), can be considered supportive Ayurvedic care in inflammatory bowel disease (IBD), particularly when frequent loose stools and intestinal irritation are present. Lajwanti is traditionally recognized for its Kashaya (astringent) and Grahi properties, which support healthy stool consistency and bowel regulation. Its plant constituents also contribute antioxidant and tissue-supportive activity, providing a rationale for its use in gastrointestinal disorders. In the Ayurvedic management of IBD, Mimosa-Di Capsules may help maintain intestinal stability and support digestive comfort during bowel disturbances.>

Dosage: 1 capsule twice a day after meals with plain water.

Conclusion

Upadoz / Upadacitinib represents an important development in the evolving management of inflammatory bowel disease by targeting JAK1-dependent intracellular signaling. Its ability to influence multiple cytokine pathways provides a distinct therapeutic approach for controlling intestinal inflammation in appropriately selected patients with moderate-to-severe ulcerative colitis and Crohn’s disease. Upadoz / Upadacitinib represents a modern targeted approach to inflammatory signaling, while Ayurveda provides a broader framework centered on digestive and systemic balance.