Contraindications and safety checklist

Appendix B: Contraindications and safety checklist

Ayurveda works best when it is:

• personalised
• supervised when needed
• paced sensibly
• honest about boundaries

Quick navigation

• 1) Urgent medical red flags
• 2) Red flags to see a clinician soon
• 3) When to delay deep cleansing or get clearance first
• 4) Therapy-specific contraindications and pause signs
• 5) Herbs and supplements safety checklist
• 6) Fasting and cleansing safety checklist
• 7) During-programme stop signs
• 8) Guest safety habits that prevent most problems

How to use this checklist

Use this in three ways:

• Before you start any programme (especially cleansing or Panchakarma)
• Before any therapy session (oil, heat, powders, head therapies, nasya)
• If anything feels “not right” during a programme

If you are ever unsure, speak to your clinician.

1) Urgent medical red flags (get urgent medical care)

• Chest pain, pressure, or tightness
• Breathing difficulty, severe breathlessness, blue lips, severe wheezing
• Fainting, collapse, or near-fainting that feels dangerous
• Signs of stroke: facial droop, weakness, confusion, slurred speech
• Severe abdominal pain, especially sudden or worsening
• Persistent vomiting, inability to keep fluids down
• Blood in vomit, blood in urine, blood in stool, black tarry stools
• Severe dehydration: confusion, very low urine output, dizziness on standing, extreme weakness
• Persistent high fever, fever with stiff neck, or fever with confusion
• Severe headache with new features, especially with vision changes, weakness, or fever
• Sudden severe pelvic pain or heavy bleeding
• Severe allergic reaction: facial swelling, throat tightness, rash with breathing issues
• Suicidal thoughts, self-harm thoughts, or a mental health crisis

2) Red flags to see a clinician soon (within days)

Speak to a clinician soon if you have:

• Unexplained weight loss
• Persistent fatigue that does not lift with rest
• Persistent night sweats with other concerning symptoms
• Persistent reflux with pain, difficulty swallowing, or waking choking
• Ongoing diarrhoea for more than a few days
• Constipation with severe pain, persistent change in bowel habit, or blood
• New persistent bloating, especially with weight loss or pain
• Persistent urinary symptoms: burning, pain, blood, difficulty passing urine
• New lumps, swelling, or persistent unexplained pain
• New or worsening anxiety, panic symptoms, or depression

3) Situations where you should delay deep cleansing or get clearance first

These do not mean you cannot do Ayurveda.

They usually mean you should start with stabilisation and consultation-led planning, not deep cleansing.

Pregnancy and breastfeeding

• Avoid strong cleansing and strong herbs unless clinically supervised
• Avoid any therapy that causes dizziness, overheating, or strain

Recent surgery, acute injury, or ongoing healing

• Avoid cleansing, intense heat, and strong procedures
• Start with gentle recovery support and clinician guidance

Acute illness or infection

• Fever, flu-like symptoms, acute diarrhoea, vomiting, infections
• Delay therapies and any cleansing until fully recovered

Significant weakness or depletion

• Very low weight, severe fatigue, dizziness, anaemia risk
• Start with nourishment, rhythm, and sleep support first

Unstable medical conditions

Examples include:

• uncontrolled high blood pressure
• unstable diabetes
• serious heart conditions
• kidney disease or liver disease
• seizure disorders
• severe asthma
• active autoimmune flare-ups without medical oversight

Eating disorder history or active restrictive eating patterns

• Avoid cleansing and fasting approaches
• Keep any plan clinician-led and trauma-informed

Mental health instability

• Severe depression, panic attacks, trauma symptoms that are easily triggered
• Use gentle stabilisation, professional support, and safe pacing

4) Therapy-specific contraindications and “pause signs”

Use this section to know when to avoid or modify specific therapies.

Abhyanga (oil massage)

Pause or avoid if:

• Fever, acute infection, flu-like illness
• Acute diarrhoea or vomiting
• Active skin infection, open wounds, spreading rash
• Acute inflammation that feels hot, swollen, sharp
• Very severe pain after an injury without assessment

Use caution if:

• You bruise easily or are on blood thinners
• You have very sensitive or acne-prone skin (face oil may be skipped)
• You have severe heat patterns (oil choice and pressure must be adapted)

Swedana (steam and heat therapies)

Pause or avoid if:

• Fever, acute infection, active illness
• Severe dehydration or heat intolerance
• Severe dizziness, fainting tendencies, uncontrolled blood pressure issues
• Active inflammatory flare with heat, redness, swelling
• Severe skin irritation that worsens with heat

Use caution if:

• Pitta heat patterns are high (milder heat and shorter duration may be needed)
• Vata is very high (heat must be gentle and paired with grounding care)

Stop immediately if:

• You feel dizzy, faint, nauseous, overheated, panicky, or unwell

Udvartana (powder therapy) and strong friction work

Pause or avoid if:

• Very dry, cracked, sensitive skin
• Active rash, eczema flare, psoriasis flare, skin infection
• Bruising tendency or blood thinner use
• Severe anxiety or nervous system fragility (can feel overstimulating)

Use caution if:

• Vata is high (may need oil-based therapies first)
• You are heat reactive (powders must be selected carefully)

Shiro therapies (Shirodhara, Shirovasti, Shiro Pichu)

Pause or avoid if:

• Fever, acute illness
• Severe dizziness, fainting episodes, unstable blood pressure
• Severe migraines with new features, neurological red flags
• Recent concussion or head injury
• Active scalp infection, open wounds, severe rash
• Severe mental health distress without support

Stop if:

• Anxiety spikes sharply, dizziness rises, overheating occurs, headache worsens

Nasya (nasal therapies)

Pause or avoid if:

• Fever or acute infection
• Frequent nosebleeds
• Severe sinus pain with intense symptoms needing assessment
• Severe nausea or weakness on the day
• Pregnancy without clear supervision

Stop if:

• You feel faint, very nauseous, or symptoms worsen sharply

Netra therapies (eye therapies)

Do not proceed if:

• Eye injury
• Severe pain, sudden vision change, flashing lights
• Discharge, severe redness, suspected infection

These require medical assessment first.

Karna therapies (ear therapies)

Do not proceed if:

• Ear pain with fever
• Discharge from the ear
• Sudden hearing loss
• Severe dizziness or vertigo
• Suspected perforated eardrum

These require medical assessment first.

Marma therapy (vital point work)

Pause or avoid if:

• Acute injury, fresh trauma, fracture, post-surgery healing
• Severe inflammation or infection
• Severe bruising tendency or blood thinners without clinician approval
• Severe mental distress where touch feels unsafe

Marma work should be gentle, consent-led, and never forced.

5) Herbs and supplements safety checklist

Herbs can support health. Herbs can also interact with medication.

Do not start strong herbs without clinician guidance if you take:

• Blood thinners or antiplatelet medicines
• Diabetes medication or insulin
• Thyroid medication
• Blood pressure medication
• Sedatives, antidepressants, mood stabilisers
• Immunosuppressants
• Chemotherapy or post-transplant medicines

Extra caution required if you are:

• Pregnant or breastfeeding
• Managing liver or kidney disease
• Prone to allergies or severe sensitivities
• Taking multiple supplements already

Safe practice rules:

• Start one new product at a time
• Keep doses conservative
• Track sleep, digestion, mood, elimination
• Stop if you develop rash, breathing symptoms, severe digestive upset, dizziness, or anxiety spikes
• Choose reputable sources with clear labelling and quality control

6) Fasting and cleansing safety checklist

Fasting and cleansing are not automatically suitable.

Avoid fasting or strong cleansing if:

• You are pregnant or breastfeeding
• You have an eating disorder history
• You are underweight or depleted
• You have unstable blood sugar or diabetes without medical oversight
• You have a history of fainting
• You have severe anxiety or insomnia
• You are recovering from illness or surgery
• You have kidney or liver disease without medical guidance

Stop immediately if:

• You feel faint, confused, weak, or shaky
• You have palpitations or chest symptoms
• You cannot sleep at all
• You become severely anxious or panicky
• You develop severe digestive symptoms

7) During-programme stop signs (tell the clinician immediately)

Speak up immediately if you experience:

• Near-fainting or fainting
• Severe dizziness
• Severe weakness
• Overheating or feverish feelings
• Severe anxiety, panic symptoms, or emotional distress that feels unmanageable
• Severe headache or unusual headache
• Severe abdominal pain
• Bleeding
• Chest symptoms or breathlessness
• Any symptom that scares you

Good care welcomes communication.

8) The guest safety habits that prevent most problems

These habits protect you during any wellness programme:

• Be honest about medical history and medication
• Ask what the goal of each therapy is
• Ask what to avoid afterwards
• Rest after therapies instead of rushing into stimulation
• Keep dinner lighter than lunch
• Protect the evening and sleep runway
• Walk gently after meals if approved
• Hydrate steadily, not excessively
• Avoid alcohol during deeper programmes
• Speak up early if anything feels wrong

Quick self-check before any programme

Tick yes or no:

• ☐ I have disclosed all medical conditions and medication
• ☐ I can rest properly during the programme
• ☐ I can follow a simple food plan without panic
• ☐ I understand that benefits build through rhythm, not intensity
• ☐ I know my red flags and I will speak up early
• ☐ I have aftercare time protected after the programme

If several of these are “no”, ask for a gentler plan first.