Ayurveda and the Gut–liver–pancreas Axis: Integrating Traditional Concepts With Contemporary Insights Into the Microbiome, Metabolism and Inflammation

The gut–liver–pancreas axis represents a complex bidirectional communication network connecting the gastrointestinal tract, liver and pancreas through microbial, metabolic, endocrine, neural and immune pathways. Increasing evidence indicates that alterations in gut microbiota, intestinal barrier integrity and microbial metabolites contribute to metabolic disorders including obesity, type 2 diabetes mellitus and metabolic dysfunction-associated steatotic liver disease (MASLD). Short-chain fatty acids, bile acids, microbial products and gut-derived hormones participate in the regulation of glucose and lipid metabolism, inflammation and pancreatic endocrine function. Ayurveda provides a traditional framework in which digestion and metabolism are central to health. Concepts including Agni, Āma, Doṣa, Ahara, Jatharagni and Dhātu Agni describe different aspects of digestion, transformation and systemic homeostasis. Although these concepts originate from a different theoretical framework than contemporary biomedical science, they may provide useful hypotheses for investigating the relationship between diet, gastrointestinal function, metabolism and systemic inflammation. This review explores the possible interface between Ayurvedic concepts and contemporary understanding of the gut–liver–pancreas axis, with particular emphasis on gut microbiota, intestinal barrier function, microbial metabolites, bile-acid signalling, insulin resistance and inflammatory pathways. The potential relevance of Ayurvedic dietary and lifestyle principles in metabolic health is also discussed. Importantly, traditional concepts should not be regarded as direct equivalents of modern biological entities without appropriate experimental validation. Integrating Ayurvedic clinical phenotyping with microbiome science, metabolomics and conventional metabolic biomarkers may provide a promising framework for future research in personalized and integrative medicine.