International Journal of Community Medicine and Public Health

Gaikwad KB et al. Int J Community Med Public Health. 2026 May;13(5):2539-2549

http://www.ijcmph.com

pISSN 2394-6032 | eISSN 2394-6040

Review Article

DOI: https://dx.doi.org/10.18203/2394-6040.ijcmph20261448

Bridging Ayurveda and biochemistry: a scoping review of Agni and metabolism

Kirti B. Gaikwad*, Meera K. Bhojani

Department of Kriyasharira, All India Institute of Ayurveda, Sarita Vihar, New Delhi, India

Received: 27 February 2026

Accepted: 20 April 2026

*Correspondence:

Dr. Kirti B. Gaikwad,

E-mail: dr.kirti.aiia399@gmail.com

Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

ABSTRACT

Agni is described in Ayurveda as the fundamental principle governing digestion, metabolism, tissue transformation, and vitality. Thirteen types of Agni: Jatharagni, seven Dhatvagni, and five Bhutagni are considered essential for physiological balance. However, their mechanisms remain largely conceptual, with limited systematic correlation to contemporary metabolic science, restricting broader scientific interpretation. A scoping review was conducted following Arksey and O’Malley framework and PRISMA-ScR guidelines. A structured search was performed across PubMed, Web of Science, Google Scholar, DHARA, Ayush Research Portal, and ARD. Studies published between January 2010 and December 2024 were screened. Twenty-four eligible research studies were included for final analysis. Data extraction was performed using JBI SUMARI tool. The included studies demonstrated functional parallels between Jatharagni and digestive enzyme activity, gastric secretions, and enteric regulation. Dhatvagni showed correlation with tissue-level metabolic processes, endocrine modulation, and cellular respiration parameters including thyroid function, lipid profile, glucose metabolism, and mitochondrial activity. Bhutagni was interpreted in relation to hepatic biotransformation, cytochrome P450 pathways, detoxification processes, and immune-metabolic responses. However, objective quantification tools for Agni assessment remain insufficient. The review identifies emerging integrative interpretations between Ayurvedic Agni and modern metabolic science. While conceptual correlations are evident, further structured clinical and molecular research is required for measurable validation.

Keywords: Agni, Jatharagni, Dhatvagni, Bhutagni, Digestion, Metabolism, Detoxification

INTRODUCTION

Ayurveda describes Agni as the fundamental principle governing digestion, metabolism, and biological transformation. Although commonly translated as “fire,” Agni represents a broader life sustaining mechanism; in the Brahmasutra it signifies life itself, and Shabdakalpadruma enumerate multiple synonyms reflecting its multidimensional nature.1 Classical texts further describe Agni as the vital force responsible for continuous physiological transformation within the body.2,3

Thirteen types of Agni are described in classical literature.4 Among them, Jatharagni governs primary digestion; Dhatvagni facilitates tissue-level metabolic transformation; and Bhutagni is associated with elemental modification of substances.5 While these descriptions are conceptually elaborate, structured scientific correlation with measurable biochemical parameters remains limited.

Modern biomedical science explains digestion and metabolism through enzymatic activity, endocrine regulation, cellular respiration, and hepatic detoxification mechanisms.6 Established methodological frameworks for scoping reviews are provided by the Joanna Briggs Institute (JBI) and PRISMA-ScR guidelines. However, no dedicated scoping review synthesizing correlations between Agni subtypes and contemporary metabolic pathways was identified. Therefore, this review aims to map and summarize existing research exploring integrative perspectives between classical Agni concepts and modern biochemical processes.

This scoping review was undertaken with the following objectives:

Knowledge gap analysis

To analyze classical descriptions of Jatharagni, Dhatvagni, and Bhutagni and compare them with contemporary biochemical and physiological concepts.

To identify gaps in molecular-level understanding of Agni within current scientific literature.

Therapeutic applications

To explore correlations between Agni-modulating interventions (dietary regulation, herbal formulations, and Panchakarma) and measurable biochemical or physiological outcomes related to digestion and metabolism.

To assess existing clinical evidence supporting Agni-centered therapies in specific disorders and identify areas for future clinical trials integrating modern methodologies.

Clinical diagnostic assessment

To examine whether modern diagnostic parameters (e. g., liver function tests, lipid profile, thyroid profile, blood glucose levels, BMI) can serve as measurable indicators reflecting functional status of Agni.

To explore the feasibility of integrating traditional Ayurvedic assessment with contemporary diagnostic tools.

Research perspective

To propose methodological approaches for investigating Agni using modern experimental, clinical, and systems biology tools.

To outline future research directions aimed at elucidating molecular mechanisms underlying Agni-related metabolic transformation.

LITERATURE REVIEW

Study design

This scoping review protocol developed according to the framework proposed by Arksey and O’Malley and it complies with JBI recommendations for elaborating scoping review used.7,8 This scoping review followed the PRISMA-ScR guidelines (Preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews).9 The search strategy includes a combination of keywords and MeSH terms related to Ayurveda, Agni, digestion, metabolism, and cellular processes.

Review questions

The review was guided by the following review questions: (1) How are Jatharagni, Dhatvagni, and Bhutagni described in classical Ayurvedic literature? (2) What anatomical and functional attributes are assigned to each subtype? (3) Where do conceptual boundaries of Agni overlap or diverge from modern biochemical and physiological frameworks? (4) What measurable biochemical processes have been correlated with Agni in published studies? (5) What molecular mechanisms have been proposed to explain effects of Agni-modulating therapies? (6) What therapeutic interventions are designed to regulate Agni? (7) What clinical evidence supports these interventions? (8) Can modern diagnostic tools assist in assessing functional status of Agni? (9) What are the key research gaps requiring further investigation?

Search strategy

A structured three-step search strategy was employed. Initial search terms were identified and aligned with relevant MeSH terms. Using PubMed as the primary database, the search was extended to Web of Science, Google Scholar, AYUSH research portal (ARP), DHARA, AYUSHDHARA, and the AYUSH Database for Research (ARD).

Keywords included: “Ayurveda,” “Agni,” “Jatharagni,” “Dhatvagni,” “Bhutagni,” “digestion,” “metabolism,” “cellular respiration,” “enzymes,” “hormones,” “enteric nervous system,” “detoxification,” and “immune function.”

Boolean operators “AND” and “OR” were applied appropriately.

The following three concept clusters were included: (1) Ayurvedic Concept of Agni (2) Digestion and Cellular Metabolism (3) Pre-clinical and clinical studies highlighting therapeutic intervention and procedures for modulating Agni.

Inclusion criteria

Articles published in peer-reviewed journals from January 2010 to December 2024 that incorporated in integrating approach and minute understanding of concept of Agni, digestion, metabolism at cellular level, detoxification and related concepts of metabolic transformation within the Ayurvedic framework were included. The rationale for this date range is to ensure that the most relevant research findings should captured. Studies published in any language with available English translations were included.

Exclusion criteria

Studies were excluded if they discuss only Ayurveda or modern biochemical, physiological processes related to digestion, metabolism, cellular function, or detoxification; reviews (mini, narrative), editorials and grey literatures. Studies that focus exclusively on other Ayurvedic concepts (e.g., Doshas, Prakriti) without a clear connection to Agni. Studies published in other than English languages without available English translations. Studies that doesn’t meet inclusion criteria, such as abstracts without sufficient detail and unavailable full texts, duplicate records. Studies that are solely discuss philosophical or theoretical aspects of Agni without any attempt to co-relate it to measurable biochemical or physiological parameters.

Screening and selection process

This scoping review implemented a structured screening and selection process in accordance with the PRISMA-ScR guidelines. A comprehensive electronic search was conducted across selected databases using predefined keywords and Boolean operators. Filters for full-text availability, language (English), and publication period (January 2010-December 2024) were applied prior to screening.

Subsequently, titles and abstracts were screened against predefined inclusion criteria, followed by full-text assessment of eligible studies.

Phase 1: Title and abstract screening

After completion of the search, all retrieved articles were collected and organized using Microsoft excel. Any duplicate citations were removed at this stage with conditional formatting. The titles and abstracts were retrieved from the database searches and subjected to screening using Microsoft excel with the predetermined inclusion criteria for the review. Document screening decisions were made (include/exclude/unsure) for each article and discrepancy were resolved through discussion and consensus.

Phase 2: Full-text review

After retrieval of all studies that passed the title and abstract screening, Eligibility assessment was done on the basis of pre-defined inclusion and exclusion criteria. Detailed Assessment of study methodology, assessment criteria, results, and discussion was done. Document passed eligibility assessment for each full-text article were included and others were excluded with the reasons for exclusion. Discrepancies were resolved through discussion and consensus.

Sources that were found to be potentially relevant and fulfill the inclusion criteria undergone comprehensive review, citation details were integrated into the JBI System for the Unified management, assessment, and review of information (SUMARI) for full-text assessment.

PRISMA flow diagram

A PRISMA-ScR flow diagram was used to visually represent the screening and selection process, including the number of articles identified, screened, excluded, and included at each stage.

Data extraction

Data extraction was done from articles selected in the scoping review using the JBI SUMARI data extraction tool. This scoping review aimed at yielding a descriptive summary of all the results. The components listed in below 1 will be considered while extracting the data-Title, authors, year of publication, country, study design, study objectives, study duration, population (Diagnostic details), sample size, age (in years), sex (M/F), AYUSH intervention, control, outcome measures insignificant safety (AE/SAE/ADR), drop outs, citation, significant values, insignificant values and additional remarks for type of Agni and its modern correlation.

A data extraction was performed with 22 selected studies. The insights gained were used to modify the draft data extraction tool as necessary. Any refinements were documented in the final scoping review. Authors of articles were contacted to resolve data discrepancies or obtain supplementary information.

COLLATING, SUMMARIZING, AND REPORTING THE RESULTS

The data extracted from the included studies was compiled into a database in a descriptive format and the results were charted to provide an organized overview of the findings from the included studies. This involved a summary of the key findings, methodological approaches, and study characteristics. A thorough analysis and discussion of the findings was conducted, specifically addressing each of the predefined questions of the scoping review. A conceptual mapping framework visualized Agni and modern science relationships. Results were reported using a PRISMA-ScR flow diagram, descriptive summaries, and thematic presentation. The discussion addressed implications, gaps, limitations, and clinical review questions whereas reporting ensures transparency and reproducibility.

OBSERVATIONS

An electronic search across selected databases identified 230 records. An additional 11 records were identified through institutional repositories and manual searches, resulting in a total of 241 records. After removal of duplicate citations (n=39), 202 records were screened based on title and abstract.

During title and abstract screening, 173 records were excluded for not meeting the predefined inclusion criteria. Twenty-nine full-text articles were assessed for eligibility. Of these, seven studies were excluded due to lack of measurable biochemical correlation, narrative/conceptual design, or absence of direct relevance to digestive and metabolic pathways. Finally, 22 studies were included in the scoping review (Figure 1).

Figure 1: Scoping review process adapted from the PRISMA statement. | IDE NTI FIC ATI ON SC RE EN IN G EL IGI BI LI TY STU DIES INCL UDE D Records identified through database searching (n= 230) Additional Records identified through other sources.(ARD & College Library (n= 11) Records After Duplicate Removed (n=202) Records screened by reading title and abstracts (n=202) Records excluded (n=173) Full text articles assessed for eligibility (n=29) Full text articles excluded with reasons (n=7) 1. Mukta et al. – Case study without measurable metabolic parameters. 2. Nair AG et al. – Case study lacking objective biochemical correlation. 3. Tareen SHK et al. – Narrative review. 4. Op den Kamp YJM et al. – Case study not directly related to digestion/metabolism. 5. Karami-Mohajeri S et al. – Conceptual review without primary data. 6. Pearson SJ et al. – Theoretical study without clinical evidence. 7. Wange Mangala Dilip et al. – Review article (secondary literature). Studies included (n=22)
Figure 1: Scoping review process adapted from the PRISMA statement.

*The diagram summarizes the identification, screening, eligibility, and inclusion phases of the scoping review.

Characteristics of included studies

Among the 22 studies included in the scoping review, one was an open-label clinical trial and one was a randomized controlled trial. Five studies were clinical interventional studies, while the remaining fifteen were case-based clinical reports. The included studies were subsequently categorized based on their functional alignment with classical Agni subtypes, namely Jatharagni, Dhatvagni, and Bhutagni, to facilitate thematic synthesis and interpretative analysis (Table 2).

Quality appraisal of included studies

Quality appraisal of the included studies was performed using the JBI critical appraisal checklists appropriate to the study design. Randomized controlled trials, quasi-experimental studies, observational studies, and conceptual/laboratory-based studies were assessed separately. Appraisal findings are presented in Tables 3-6.

Outcomes assessed

Outcomes assessed are summarised in Table 7.

Seven studies primarily addressed digestive disorders such as Grahani, Agnimandya, and Ajirna. Interventions included herbal formulations, dietary modifications, and Panchakarma procedures. Outcome measures predominantly consisted of symptomatic improvement, appetite regulation, bowel pattern normalization, and limited biochemical parameters. These findings suggest functional correspondence with digestive transformation processes attributed to Jatharagni.

Nine studies focused on metabolic and endocrine-related conditions, including Sthaulya, Artavakshaya, inflammatory disorders, and broader metabolic dysfunction. Reported outcome measures included body weight, BMI, lipid profile and selected hormonal parameters. These findings indicate tissue-level metabolic modulation, functionally aligned with classical descriptions of Dhatvagni.

Six studies, including 1 multi-omics clinical trial, evaluated biochemical and cellular metabolic processes such as erythrocyte bioenergetics and systemic metabolic regulation. Measured parameters included ATP production and metabolic pathway markers.

These findings demonstrate indirect parallels with elemental and cellular transformation processes described under Bhutagni. Across included studies, clinical improvement was reported following Agni-modulating interventions. However, standardized assessment tools for Agni not identified, and biochemical correlations inconsistently reported across studies.

Table 1: Electronic search strategy and stepwise application of filters used for study selection.
Table reproduced from source PDF page 5
Table 2: General characteristics of included studies.
Table reproduced from source PDF page 5
Table 3: JBI critical appraisal-randomized controlled trials.
Table reproduced from source PDF page 6
Table 4: JBI critical appraisal-quasi-experimental studies.
Table reproduced from source PDF page 6
Table 5: Critical appraisal table-conceptual and laboratory-based study.
Table reproduced from source PDF page 6
Table 6: Critical appraisal table-observational and case studies.
Table reproduced from source PDF page 7
Table 7: Outcomes assessed in selected studies.
Table reproduced from source PDF page 7, part 1 of 2
Table reproduced from source PDF page 8, part 2 of 2

DISCUSSION

The present scoping review synthesized evidence from 22 included studies to explore the functional correspondence between the classical concept of Agni and measurable physiological and biochemical processes. The included literature demonstrates thematic clustering around digestive regulation, tissue-level metabolism, and cellular bioenergetics.

Digestive regulation and functional correlates of Jatharagni

Joshi et al demonstrated significant improvement in Agnimandya following lifestyle modification and herbal intervention, indicating restoration of primary digestive transformation.10 Similarly, Shruthi MN and Jadhav PS reported symptomatic correction in Grahani and Ajirna, with improvements in appetite as well as bowel regulation.11,12

Nair et al observed marked clinical improvement in Vataja Grahani following Takra Basti, suggesting functional normalization of gut activity.13 Yadav et al further reported modulation of gut microbiota following Virechana, indicating a potential digestive–metabolic interface.14 Rajani et al demonstrated symptomatic relief linked to improved digestive function.15

Collectively, these studies suggest that clinical correction of indigestion correlates with physiological processes attributed to Jatharagni.

However, most relied on symptom-based scoring rather than enzymatic assays or gastric secretory markers.

Tissue-level metabolic modulation and the conceptual scope of Dhatvagni

Pattonder et al reported metabolic stabilization in hypertension following Ayurvedic therapy, suggesting systemic tissue-level modulation.16 Harishma Asok et al observed improvements in lipid profile following Goghrita administration, indirectly reflecting Medo-Dhatvagni correction.17

Bansode and Chavan reported improvements in menstrual regularity and endometrial parameters, suggesting modulation of Rasa-Rakta-Artava Dhatvagni.18,19

Musculoskeletal case studies by Walke, Patil, Patil, Raut and Walake demonstrated improvements in inflammatory and degenerative joint conditions, indirectly supporting restoration of tissue metabolism.20-24

These findings indicate tissue-level metabolic influence aligned with classical descriptions of Dhatvagni. However, objective hormonal profiling and mechanistic validation were inconsistently reported.

Cellular bioenergetics and biochemical transformation: expanding the framework of Bhutagni

D’Alessandro et al demonstrated increased ATP production, reduced 2,3-DPG levels, and improved erythrocyte stability in a multi-omics trial.25 Although not framed in Ayurvedic terminology, these cellular bioenergetic improvements conceptually parallel transformation processes described under Bhutagni.

Biochemical pathways such as cytochrome P450-mediated metabolism further provide a molecular framework for elemental transformation and detoxification processes traditionally attributed to Bhutagni.

However, direct empirical correlation between classical elemental metabolism and modern molecular pathways remains theoretical.

Among the 22 studies, only one randomized controlled trial and one open-label experimental study demonstrated structured methodology. The majority were case-based reports with limited confounder control. Standardized assessment tools for quantifying Agni were not identified.

Biochemical markers were inconsistently incorporated, and mechanistic explanations were largely inferential rather than experimentally validated.

Conceptual gaps and directions for translational research

Future research should prioritize the development of validated and reproducible assessment tools for Agni, enabling objective clinical stratification beyond symptom-based evaluation. Integration of endocrine profiling, enzymatic assays, metabolomic analysis, and inflammatory biomarkers would strengthen biochemical correlation with classical functional descriptions. Additionally, well-designed controlled in vivo and in vitro experimental studies are required to elucidate mechanistic pathways underlying Agni-modulating interventions. Incorporation of systems biology approaches and computational modeling may further help in mapping tissue-level metabolic transformations described under Dhatvagni and Bhutagni. Such multidisciplinary integration is essential to advance the measurable translation of classical Agni principles within contemporary biomedical research frameworks.

Limitations

This review is limited by the absence of validated tools for quantifying Agni, which restricts direct correlation with biochemical markers. The majority of included studies were case-based with limited control of confounders and inconsistent laboratory integration. As a scoping review, methodological synthesis was descriptive rather than quantitative. Additionally, exclusion of grey literature and restricted database access may have limited comprehensive evidence capture.

CONCLUSION

This scoping review mapped available evidence exploring correlations between the classical concept of Agni and contemporary metabolic science. The included studies demonstrate thematic alignment of Jatharagni with digestive regulation, Dhatvagni with tissue-level metabolic modulation, and Bhutagni with cellular bioenergetics. However, objective biochemical validation remains limited. The findings highlight the need for standardized Agni assessment tools and rigorously designed clinical and experimental studies integrating molecular, endocrine, and systems biology approaches. Such efforts are essential for advancing measurable translation of classical Agni principles into modern biomedical research.

ACKNOWLEDGEMENTS

The authors would like to thank to Dr. Anju Aravind T. (PhD Scholar), Dr. Garima Pandey, Dr. Priyanka Taneja, Dr. Rohan Pol (PG Scholar) and Dr. Neha Maske (PG Scholar), All India Institute of Ayurveda, New Delhi, for their valuable assistance.

Funding: No funding sources

Conflict of interest: None declared

Ethical approval: Not required

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