हिंदी ब्लॉग 
Anemia is defined as a low hemoglobin concentration/ may be due to either low red cell mass/ increased plasma volume. Low Hb is <13.5 g/dL for men and <11.5g/dL for women. It can be due to reduced RBCs production/ loss of RBCs due to several causes. Some forms of anemia include aplastic anemia/ folic acid deficiency anemia/ hemolytic anemia/ sickle cell anemia.
According to the Ayurveda concept, Anemia is generally known as Pandu Roga. It is due to less amount of blood( rakta-alpata). Pandu is considered as Rakta Pradoshaja Vikara. In this case, the patient skin color changes to shveta peet(pandu varna).
Pandu ( Anaemia) according to Acharya Charak is mainly classified into five types:-
1) Vataja
2) Pittaja
3) Kaphaja
4) Sannipataja
5) Mridu Bhakshan Janya
Anemia Causes
- Blood loss/ decreased red blood cell production/ increased red blood cell breakdown
- Trauma/ gastrointestinal bleeding
- Iron deficiency
- Vitamin b12 deficiency
- Thalassemia
- Bone marrow neoplasms
- Genetic conditions ( sicke cell anemia/haemophilia)
- Certain autoimmune diseases
- Blood loss/fluid overload
- Kidney failure
- Some endocrine disorders
- Protein malnutrition
- Hepatic failure
- Aplastic anemia
- Drug-induced anemia
- Scurvy
Anemia Symptoms
- Fatigue/ Weakness
- Decreased energy
- Weakness/ Numbness
- Palpitations
- Lightheadedness
- Looking pale
- Cramps
- Breathlessness
- Dyspnoea
- Tinnitus
- Anorexia
- Coronary Artery Disease
- Dryness of skin
- Excessive salivation
- Indigestion
- The yellowness of urine/stool
- Loss of glow
- Tinnitus/ vertigo
- Fever
- Hair fall
- Excessive sleep/excessive salivation
- Cramps in the calf region
When to See Your Doctor for Anemia Disease?
If signs and symptoms appear for a long-duration / some of the following symptoms appear, then you should consult doctor as soon as possible :
- Tiredness/ vertigo/ excessive fatigue
- Pale skin/ pale eyes
- Rapid heartbeat ( tachycardia)
- Palpitations occur for long
- Blood in urine/ stool
- Heavy menstrual periods
- Hereditary anemia conditions
Diagnosis
- Hb Examination and levels
- CBC ( Complete Blood Count)
- Vit B12 levels
- Homocystene Serum
- Ferritine Serum’
- Peripheral smear microscopic examination
- MCV (Mean Cell Volume) investigation.
- In Ayurveda, differential diagnosis is examined by checking vata/pitta/kapha prakriti.
Prevention of Anemia
- Proper nutrition and diet of Iron.
- Prevent yourself from infectious and parasitic diseases.
- When signs and symptoms appear then consult doctor soon.
- By examining yourself by doctor to check any other disease leading anemia.
- Take iron supplements under the guidance of Doctor.
Risk Factors of Anemia
- Premature birth
- Excessive menstruation
- Being pregnant/ giving birth
- Diet low in vitamins
- Family history
- Chronic illness ( AIDS/Diabetes/ Kidney disease/ Heart failure/ Liver disease)
- Trauma
General Tips
- 3 gm Gooseberry powder three times a day with honey.
- Dry Grapes intake
- 1cup beetroot juice + 1 cup apple juice + mixed with sugar/honey = once a day
- Fresh pomegranate/ fresh bananas
- Intake of jaggery
- Intake of anjeer ( fig)
- Broccoli/ green leafy vegetables/ carrot/ spinach.
- Peanut butter
- Intake of kidney beans/ black- eyed peas
- Avocadoes
What to Avoid?
- Salty/ sour/ spicy /hot diet
- Exposure to sunlight
- Drinking and smoking
- Excessive exercise
- Junk foods
What to Eat?
- Green leafy vegetables such as spinach
- Carrot/carrot dishes
- Dates
- Cherry/ cranberry
- Jaggery
- Anjeer ( fig)
- Pomegranate/ banana
- Grapes/ mango/ apple
- Eggs
- Beetroot juice
- Apple juice
Questions & Answers
Q.1 What are the reference ranges of Hb in adults and children?
Ans- Reference ranges are -
- Men = 14- 18 g/ dL
- Women = 12-16 g/dL
- Pregnant women > 11g/dL
- Newborn = 14-24 g/dL
- 0-2 weeks = 12-20 g/dL
- 2-6 months = 10-17 g/dL
- 6 months/ 1 year = 9.5-14g/dL
- 1) 6 years = 9.5 - 14 g/dL
- 6-18 years = 10-15.5 g/dL
Q.2 Is it normal to have Hb value high?
Ans- No, it's not to be normal while having high Hb values. High Hb values occur when the body requires an increased Oxygen carrying capacity. It may result in polycythemia/ Heart diseases/ COPD/ emphysema/ heart failure/ kidney Cancer/ liver cancer/ dehydration/ etc.
Q.3 What are the causes of High Hb values?
Ans- Many factors and various causes are associated with high Hb values like -
- Smoking
- Increase count of RBCs
- Bone marrow produces many RBCs
- Drugs that increase your erythropoietin that further will stimulate RBCs production.
- Chronic kidney disease, etc.
Q.4 What sign does eyelid color shows when anemia occur?
Ans- ‘Conjunctival pallor’ is the classic sign of anemia. The pallor refers to the vasculature on the inner surface of the lid lacking Hb conc. It is usually caused by a reduction in blood flow and oxygen / by decreased no. Of RBCs.
Q.5 What are the classifications of Anemia?
Ans- Anemia is generally classified by two methods:-
1) Morphological
2) Etiological
1) Morphological - It mainly depends upon the size and color RBC. It includes:-
- Normocytic Normochromic Anemia
- Macrocytic Normochromic Anemia
- Macrocytic Hypochromic Anemia
- Microcytic Hypochromic Anemia
2) Etiological - Depends on cause/ origin, it includes -
- Hemorrhagic Anemia
- Hemolytic Anemia
- Nutrition deficiency Anemia
- Aplastic Anemia
- Anemia of chronic disease
Q.6 What happens when Hb value gets lower in Pregnant women? How can it overcome?
Ans- Hb value gets lower due to insufficiency of RBCs to carry oxygen to tissues. During pregnancy, as a growing fetus also requires oxygen and blood supply, so, it is important to increase iron supplements and dietary intake. Hb low value in pregnancy leads to weakness/ fatigue/ pale/yellowish skin/ breathing shortness/ chest pain/ cold hands and feet/ headaches.
Q.7 What are the various dietary intake to come over the deficiency of Anemia?
Ans- Various dietary intake includes:-
- consumption of fortified foods.
- vitamin A-rich foods/folic acid/ vitamin B-12/ Iron-rich supplements and food in the diet
- Foods that rich in vitamin-c ( fruits/tuber/ green leafy vegetables) should be consumed at mealtimes.
- Vitamin B-12 rich animal products
- Folic acid rich legumes.
- beta-carotene/ vitamin A-rich foods
- restrict consumption of tea/coffee/ cocoa between meals/ 1 hr after meals, since it inhibits iron absorption.
- avoid intake of milk/ milk-related products at meals as calcium in milk inhibits iron absorption.
Q.8 How the deficiency of Iron affect the Nervous and Endocrine system?
Ans- It alters the production of Triiodothyronine ( T3) and thyroid function in general, production of catecholamines and other neurotransmitters, it results in impaired temperature response to a cold environment.
Q.9 Where Folate is found and what are the causes of its deficiency?
Ans- It is found in green vegetables, nuts, yeast & liver/ synthesized by gut bacteria. Causes of its deficiency include poor diet e.g. poverty, alcoholics, elderly/ increased demand, e.g. pregnancy/ increase cell turnover/
Malabsorption/ drugs/alcohol/ antiepileptics etc.
Q.10 What kind of treatment is available in Ayurveda for Anemia?
Ans- In Ayurveda medicine, treatment generally includes Nidaan Parivarjan, Samshodhana chikitsa( nidan parivarjan, aabhyantar snehana, tikshana samshodhan with vamana or virechana,raktabasti, Samshamana chikitsa includes rasa, virya ayurveda drug formulations according to vata/pitta/kaphaja/sannipataja prakritis.
REFERENCES:-
1. Longmore, Wilkinson, Davidson, Foulkes, Mafi, Oxford Handbook of Clinical Medicine 8th Edition.
2. Kayachikitsa Volume-2 by Prof. Ajay Kumar Sharma (2017)
3. Charak Samhita, Chikitsa Sthana - ch-16
4. Madhava Nidana, Ch-8
5. J.Alastair Innes, Davidson’s Essential of Medicine 2nd edition
6. K Sembulingam, P Sembulingam, Essentials of Medical Physiology 6th Edition.
