Nidan Section of the NAMACB Ayurvedic Health Counselor (AHC) Exam

Monica B Groover
2 days ago
6 min read

Nidan or cause of vata imbalance in this girl is that she is eating ice cream in snow.

By Monica Groover

Nidan in the exam context is about gathering and interpreting information to determine a client's imbalance. For example, in the photo above this girl is eating ice cream in cold snowy weather. This will imbalance her vata and kapha doshas and may result in low digestive fire, perhaps a cold and dryness in her body, according to Ayurvedic principles.

If you are studying or want to become a Vedic Ayurveda Counselor and then take the NAMACB exam, you need to know the scope and understand this topic completely. I found in my own practice and as a teacher for 20 years, students do NOT know what nidan is. Just FYI--we call our program Vedic Ayurveda Counselor but NAMA (National Ayurvedic Medical Association) calls it AHC, if you wondering what that is. In this article, and podcast I will talk about Nidan and the scope of practice and how to prepare for the NAMACB Exam. There are also 10 multiple choice questions below, you can take the quiz. (Do not scroll all the way below just yet--answers are below).

So, lets get started. Nidan draws from classical texts like Charaka Samhita (Nidana Sthana) but is tailored to the AHC scope: preventive wellness, not curative medicine.

Core Concepts of Nidan

In Ayurveda, "Nidan" refers to the causes or etiological factors of a disease, as well as the diagnostic process used to identify those causes. The term is central to the Five Nidanas or Pancha Nidanas, which involves understanding the aetiology (Nidan), prodromal signs (Purvarupa), clinical features (Rupa), therapeutic responses (Upashaya), and pathogenesis (Samprapti) to properly diagnose and treat a disease.

Nidan as Hetu or cause

Definition: The cause of an imbalance that may ultimately make someone sick is called Nidan in ayurveda.
Examples: These can include factors like improper diet, lifestyle choices, environmental influences, and imbalances of the doshas.
Phases: Causative factors are categorized into three phases: Samvayikarana (aggravation of doshas), Asamvayikarana (combination of doshas and affected tissues), and Nimitkarana (specific causes like diet and lifestyle).

Nidan is an ancient form of assessment.

Understanding the Nidan helps a physician identify the root cause of a disease and differentiate between similar conditions. Nidan is the process of identifying the causes (hetu/nidana) of doshic vitiation, such as improper diet, lifestyle, or seasonal influences. It uses three pillars: darshana (observation), sparshana (touch), and prashna (questioning).
By identifying the Nidan, Ayurvedic practitioners can implement Nidan Parivarjan, which means avoiding the causative factors to treat and prevent recurrence of the disease.

Link to Doshas and Body Systems: Assess how vata, pitta, and kapha (plus subdoshas) affect dhatus (tissues), srotas (channels), agni (digestive fire), and ama (toxins). Evaluate digestion, elimination, sleep, stress, energy, and emotions.
Pathogenesis (Shad Kriyakala): Know the six stages of imbalance progression—crucial for scope decisions for those who practice Ayurveda:
1. Sanchaya (Accumulation): Early buildup in dosha sites (Vata in colon, pitta in liver and kapha in upper parts of the body. An example would be dryness and constipation for vata).
2. Prakopa (Provocation): Dosha becomes aggravated (e.g., vata will cause dryness to increase and constipation worsens).
3. Prasara (Spread): Dosha moves through channels (AHC max scope—counsel here. This is where the Ayurveda counselor can stop--rest is outside their scope. They can suggest abhyanga oil massage, eating ghee, taking herbs that support both dryness, constipation and diet that pacifies vata. FULL STOP!!).
4. Sthana Samshraya (Localization): Settles in weak tissues (refer out to practitioner).
5. Vyakti (Manifestation): Visible disease (beyond AHC scope).
6. Bheda (Disruption): Chronic or fatal (always refer).

AHCs handle only the first three stages; anything beyond requires referral to an Ayurvedic Practitioner (AP) or medical doctor.

Key Assessment Methods (Pariksha)

The exam tests practical application of these tools:

Trividha Pariksha: Darshana (visual: tongue, eyes, nails), Sparshana (tactile: pulse, skin), Prashna (verbal: history, symptoms).
Ashtavidha Pariksha (Eightfold Exam): Pulse (nadi), urine (mutra), stool (mala), tongue (jihva), sound (shabda), touch (sparsha), eyes (netra), general exam.
Dashavidha Pariksha (Tenfold): Adds pulse strength, vein resilience, skin/muscle tone, etc.
Special Tests: Urine oil-drop (tailabindu pariksha—snake-like spread indicates meda excess/diabetes risk), tongue diagnosis (coated = ama; scalloped edges = vata).

You'll also need to interpret family history, compliance, and red flags (e.g., high blood pressure, severe pain).

High-Yield Study Topics for Nidan

Focus on these for 80% exam coverage:

Case History Interpretation: Differentiate symptoms (e.g., hot flashes in menopause = pitta vikriti vs. deeper imbalance).
Dosha Identification: Match symptoms to subdoshas (e.g., anxiety + dry skin = prana vayu vata).
Red Flags & Referrals: Immediate MD referral for emergencies (chest pain, vision loss); AP for manifested disease.
Agni & Ama Assessment: Weak agni leads to ama—assess via appetite, bloating, coated tongue.
Sanskrit Terms: Memorize nidana, hetu, samprapti (pathogenesis), and pariksha types.

Pro Tip: Use the official NAMACB Sanskrit Glossary during the exam—practice looking up terms quickly.

Mock Exam Questions: Nidan-Focused Scenarios

Here are 10 original multiple-choice questions modeled after the NAMACB style. Answers with explanations at the end. If you would like more questions, you can buy my STUDY GUIDE or set up a mock exam with 100 questions with me. I will simulate the exam, you will be proctored and I will give you feedback in real time. Buy 2.5 hour of my time and mock exam here. Alternatively, you can buy our study guide also.

In Nidan, the primary tool for assessing a client's vikriti through verbal inquiry is: a) Darshana pariksha b) Sparshana pariksha c) Prashna pariksha d) Nadi pariksha
A client reports mild bloating after meals and occasional fatigue, with a coated white tongue. This suggests: a) Pitta prakopa b) Kapha sanchaya with ama c) Vata prasara d) Balanced agni
Which stage of Shad Kriyakala is within the AHC scope for counseling a client with early indigestion? a) Sthana Samshraya b) Prasara c) Vyakti d) Bheda
During Ashtavidha Pariksha, a snake-like spread in the urine oil-drop test indicates: a) Strong agni b) Meda dhatu excess (risk of prameha) c) Vata imbalance only d) Kapha ama
To differentiate post-menopausal hot flashes from a deeper pitta vikriti, the AHC should ask about: a) Family history only b) Diet and stress patterns over the past year c) Exercise routine d) Seasonal changes
A rapid, bounding pulse is characteristic of: a) Vata dosha b) Pitta dosha c) Kapha dosha d) Tridoshic balance
In Nidan, identifying the hetu (cause) of doshic imbalance includes assessing: a) Only genetic prakriti b) Ahara (diet), vihara (lifestyle), and ritu (season) c) Advanced lab tests d) Surgical history
A client with dry, brittle nails and anxiety should be assessed for: a) Alochaka pitta excess b) Prana vayu vata vikriti c) Shleshaka kapha deficiency d) Ranjaka pitta ama
When must an AHC refer a client presenting with uncontrolled hypertension? a) Immediately to emergency care b) After prakriti assessment c) Only if herbs fail d) Within AHC scope for diet advice
The tenfold examination (Dashavidha Pariksha) includes assessing: a) Pulse, urine, and stool only b) Mala, mutra, shabda, sparsha, draka, netra, jihva, nadi, and two additional factors c) Herbs and formulations d) Panchakarma readiness

Answers & Explanations

c) Prashna involves questioning for history and symptoms.
b) White coating = kapha ama; bloating/fatigue = early accumulation.
b) Prasara is the max for AHC (spread but not manifested).
b) Tailabindu test: Snake spread signals fat tissue imbalance.
b) Nidan requires exploring lifestyle/diet to rule out deeper causes.
b) Pitta pulse: Fast and forceful.
b) Hetu includes modifiable factors like diet and routine.
b) Dry nails/anxiety = vata subdosha signs.
a) Red flag—immediate medical referral required.
b) Includes eight from Ashtavidha plus akriti (form) and prakriti.

How to Prepare for the Nidan Section

Timeline: Dedicate 2–3 weeks; it's interconnected with Fundamental Principles (25% of exam).
Resources:
- NAMACB AHC Study Guide (free download).
- Charaka Samhita Nidana Sthana (focus on early chapters).
- "Ayurvedic Tongue Diagnosis" by Walter Shantree Kacera for visuals.
Practice Tips: Do 50+ case scenarios daily. Quiz yourself on Shad Kriyakala stages and referral rules—many fails come from scope confusion.
Common Pitfall: Don't overthink advanced pathology; stick to preventive Nidan.

Mastering Nidan equips you to confidently assess and guide clients toward balance. If you're studying for the full exam, pair this with our guides on doshas and recommendations. Questions? Drop a comment below!

Namaste—may your Nidan knowledge bring clarity to every consultation. 🪔

Updated November 25, 2025, based on current NAMACB guidelines.