The Mindfulness of Yoga as a Body Medication

Yoga is integral to my academic pharmacology teaching, clinical pharmacy involvement, flight instructing, and daily life. Yoga is a gift to my mind, body, and spirit. My body is in serenity and bliss as I leave each of my morning yoga classes. 

Yoga means union. Yoga is a union of mind, body, and spirit. The rhythmic yoga breath, postures, and meditative elements bring participants a mindfulness state and physical benefit. Yoga is a “moving meditation.” Studies have shown the effects of yoga practice on the brain. The incredible benefits of yoga begin to change the body instantaneously. Yoga has become the most prominent complementary health approach for adults in the United States.

The brain-changing data has now opened up some understanding of the benefits.

Being a pilot over 65, I have spent multiple hours thinking about my brain. Can I stay sharp enough to maintain my proficiency? The instrument-proficient pilot has to have brain proficiency to accomplish our tasks. As an instructor, this is a two-prong proficiency of instructing and maintaining my flying skills.

A study in 2019 evaluated 11 studies on the effects of yoga on the brain. The study examined the effects of yoga on brain structures, function, and cerebral blood flow. The investigators looked at brain changes using MRI and SPECT brain scans. The conclusions from the study showed promising results that yoga might mitigate age-related neurodegenerative declines. Functional connectivity in the neural network increased, and less age-related atrophy was observed in the yoga group (Brain Plasticity 5 (2019) 105-122).

In my own experience, yoga is a mind and body medication therapy. The NIH has studied and recommended yoga for hypertension, depression, pregnancy, lower back pain, atrial fibrillation, addiction, multiple sclerosis, cancer, COPD, and poststroke conditions. Data on many diseases state utilizing yoga may alleviate, in many cases, reduce the number of drugs a patient may have to administer. The trick is to make the connection and utilize the synergistic effect of medicines and yoga for the patient’s health.

The percentage of adults who had received any mental health treatment for depression increased from 2019 to 2021. This data was for adults of all ages, from 19.2% to 21.6% (CDC Sept 2022). Studies are looking at yoga’s impact on increasing the brain’s neuroplasticity.

Non-suicidal out-patients with depression were offered yoga alone or yoga with antidepressants. Antidepressant therapies, such as selective serotonin reuptake inhibitors (SSRI) like fluoxetine (Prozacâ), cause an elevation in the brain-derived neurotrophic factor. The depression severity was rated on the Hamilton Depression Rating Scale before and at three months during the study treatments. Serum brain-derived neurotrophic factors (BDNF) were measured at the same points. The antidepressants studied with yoga were escitalopram (Lexaproâ), fluoxetine (Prozacâ), duloxetine (Cymbaltaâ), sertraline (Zoloftâ), amitriptyline (Elavilâ), and mirtazapine (Remeronâ). There were sixty-two patients and three arms in this study. One arm was yoga alone (n=19), one was yoga and medications (n=22), and one was medications alone (n=21). Patients receiving yoga with or without antidepressants had a greater reduction in depression scores than antidepressants alone. In the yoga-only group, there was a high correlation between the decline of Hamilton Risk scores and a rise in BDNF levels (Indian J Psychiatry. 2013 Jul; 55(Suppl 3): S400-S404).

Nearly half of adults, 47% or 116 million in the United States, have hypertension (CDC 10/14/22). Hypertension leads to stroke, heart disease, and vascular disease. The vascular disease puts a patient at risk for dementia later in life (JAMA. 1999;281(5):438-445). Two hypertension trials, SHEP using a beta blocker + diuretic and SYS-EUR using calcium channel blocker + ACE inhibitor + diuretic, demonstrated decreasing blood pressure led to a decrease in the risk for dementia. A study evaluated 35 elderly patients, including 25 in the treatment group and 10 in the control group. The treatment arm consisted of patients taking antihypertensive medications for moderate levels of high systolic and diastolic blood pressure. A twenty-minute yoga session was scheduled five times a week for 15 days. Blood pressure readings were taken ten minutes before yoga and 10 minutes post-yoga intervention. The control arm continued routine treatment. The mean systolic and diastolic blood pressure in the yoga group was lowered from 154.5 to 130.4 and 92.2 to 82.8. The study demonstrates that in the control group, there were no changes in the systolic and diastolic blood pressure levels (Dhivya Bharathi, A(2016)Effect of yoga-nidra on blood pressure among elderly with hypertension residing at selected nursing homes, Coimbatore. Sri Ramakrishna Institute of Paramedical Sciences, Coimbatore).

Asthma is a sudden and severe bronchoconstriction of the lungs. According to the CDC, eight percent of the U.S. population was reported to have asthma in 2021. From the CDC mortality data, in 2021, there were 4,145 asthma deaths. Allergens most commonly cause asthma. Allergens include food, chemicals, industrial irritants, pets, and seasonal causes such as grasses and plants. The inflammatory process caused by allergens is the primary process in asthma attacks. Corticosteroid inhalers play the most prominent role in stopping the inflammatory processes of asthma. Evidence-based treatment therapies for asthma are bronchodilation and corticosteroid inhalers. The goal of therapy is to prevent acute asthma attacks. A six-month trial evaluated 250 patients with mild to moderate asthma and yoga participation. The study assessed the improvement of respiratory function and quality of life with an asthma quality of life questionnaire (AQOL). The trial design evaluated yoga + standard medication therapy versus standard medication therapy alone. Post-intervention, the yoga group showed better improvement trends in total AQOL scores than the control group. In comparison, asthma symptoms, functional limitations, emotional functions, and environmental stimuli also showed a significant improvement in the yoga group compared to the control group (Advances in Integrative Medicine, Volume 6, Issue 4, December 2019, pages 163-166).

Yoga may be an excellent overall health regimen for you if you are looking for a great way to gain strength and flexibility and bring a little serenity into your life. You do not need to turn your body into a pretzel and have the flexibility of Gumby. You can do yoga sitting down, lying down, or a combination of both. All you need is a yoga mat and your yoga breath. The health benefits are great, both inner and outer. Yoga may enhance your quality of life and that of people with specified existing medical diseases taking medications. The possibilities are endless. Be safe and happy flying.

Larry M. Diamond, PharmD, CFII

Larry Diamond has a Doctor of Pharmacy Degree and has been a pharmacist for 37 years. Larry’s pharmacy practice has been as a Clinical Pharmacy Specialist in Cardiology, Orthopedic Surgery Specialist and most recently Clinical Pharmacy Coordinator. He is a CFII, a pilot for 33 years and has been an AOPA member since 1984.

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