Anemia is described as decrease red blood cells or haemoglobin concentration in the blood than the normal range.

Haemoglobin is an iron containing protein molecule which carries oxygen to the body tissues.

If Haemoglobin concentration is below normal level then it leads to decreased supply of oxygen to body cells.

Haemoglobin level less than lower limits of normal range falls under the condition of anemia.

In adults the lower limit of Haemoglobin for males is 13.0 g/dl, for females - 11.5 g/dl.

At birth the lower limit of Haemoglobin is 15 g/dl.

There are many causes of Anemia which can be broadly classified into three main types: -

1) Anemia due to increased blood loss
It can be caused either due to acute blood loss after any severe injury or chronic blood loss like peptic ulcers, piles, inflammatory bowel diseases or cancer, Worm infestation.

2) Anemia due to impaired red blood cell production
Red Blood cells may be defective or insufficient due to Iron deficiency, Vitamin B12 deficiency, folic acid deficiency, defective stem cells, bone marrow diseases, any genetic defect, due to chronic diseases like liver or heart diseases. Few examples of this type of anemia are - Thalessemia, Sickle cell Anemia, Megaloblastic Anemia, Iron deficiency Anemia.

3) Anemia due to increased red blood cell destruction also called as Hemolytic anemia
An increased rate of red blood cell destruction which cannot be compensated by new red blood cells leads to hemolytic anemia. It can occur due to following reasons - Burn injury, Auto immune disorders, certain drugs, defects in red blood cells, enlarged spleen, various toxin effects, various grafts or prosthetics.


Common signs and symptoms which can be found in any type of anemia includes - Pallor of skin and mucus membrane, Weakness, Fatigue, Shortness of breath, Dizziness, Decreased or loss of appetite. Severe anemia may also cause Palpitations. Apart from common clinical features there may be some sign and symptoms which indicate the specific cause of anemia–

  • Koilonychia (spoon shaped nails) and pica in Iron deficiency anemia.
  • Numbness or burning sensation in extremities, smooth red inflamed tongue (Glossitis) in case of Vitamin B12 Deficiency.
  • Jaundice in case of hemolytic anemia.
  • Bony deformities in case of Thalassaemia Major.
  • Enlarged Lymph nodes, Recurrent mouth and throat infections and bleeding from various sites like gums, nose, skin in case of Aplastic anemia.


In Ayurvedic texts, Anemia has been described as “Pandu Roga”.
The word "Pandu" means the yellowish white or muddy colour. Anemia is characterized by yellowish white tint on skin, eyes and nails, hence it is known as "Pandu Roga" in Ayurveda.

Causative factors

According to different Acharyas, the causative factors of Pandu Roga can be summed up as follows:-

  • Intake of excessive salty, sour, alkaline or spicy diet and eating soil.
  • Malnutrition.
  • Excessive physical exertion.
  • Holding natural urges.
  • Stress, anxiety, depression or other mental disorders.
  • In case of improper panchkarma treatment.
  • Due to other diseases like Rakta Arsha, Rakta pitta, Rakta Pradara etc.


The causative factors mentioned above lead to Agnimandya (Low metabolism) and aggravation of Pitta dosha (Predominantly), Vata Dosha and Kapha Dosha. Mandagni causes accumulation of Aam (Toxins) which blocks the nutritive channel of body. As a result, Rasa Dhatu is not formed properly which in turn leads to improper formation of other subsequent Dhatus. This results in Letharginess, weakness, low immunity of body and other clinical features. The aggravated Pitta dosha situated in skin makes it look dull and pale. Due to the pallor of skin, it is called as Pandu Roga.


General Clinical features of Pandu roga are: -

  • Pallor of skin.
  • Weight loss.
  • Loss of natural glow of skin.
  • Sluggish functioning of sensory organs (Shithila Indriya).
  • Tinnitus (Karna kshweda).
  • Weakness.
  • Indigestion.
  • Decreased Appetite.
  • Dizziness.
  • Fatigue.
  • Shortness of breath.
  • Swelling around eyes.
  • Cold intolerance.
  • Drowsiness.
  • Thinning of hair.
  • Feeble voice.
  • Excessive salivation.
  • Pain or cramps in calf region.

Clinical features on the basis of predominant Dosha are:-

1. Vataja Pandu - Pale, reddish or blackish discolouration of skin, dryness, constipation, body ache, pricking sensation in Body, swelling in body parts, tremors.

2. Pittaja Pandu - Yellowish or greenish yellow discolouration of skin, fever, burning sensation in body, heat intolerance, decreased appetite, excessive thirst, sweating, loose motions.

3. Kaphaja Pandu - Pale whitish skin, heaviness, drowsiness, giddiness, difficulty in breathing, lethargy, swelling in body, fatigue.

4. Sannipataja (All three doshas) Pandu - Mixed features of all three doshas.

Principle of Treatment

The line of treatment includes - Avoiding causative factors (Nidaan Parivarjana), Panchkarma procedures for detoxification of body and improving the Agni status of body and then specific treatment of Predominant Dosha involved.


  • Identify and treat the cause of Anemia.
  • Herbal combinations – Triphala churna, Amalki churna, Vishaladi churna, Navayasa churna.
  • Rasa aushadhi (Herbo mineral Preparations) - Navayasa Lauha, Swarn Makshik Bhasma, Punarnava Mandoor, Tapyadi lauha, Kasis bhasma, Arogyavardhini vati.
  • Kwath (Decoctions) - Punarnashtak kwaath, Phaltrikadi kwaath.
  • Asava/Arishta (Alcoholic preparations) - Punarnavarishta, Lohasava, drakshasava.
  • Awaleha (Lickable preparations) – Drakshawaleha.


  • Eat light and easily digestible food items as Agni is weak in anemia. Heavy food items will create indigestion and more toxin accumulation in body.
  • In case of Iron deficiency Anemia, take 1 whole apple or 1 glass of apple juice empty stomach in the morning regularly for 10 - 15 days.
  • Increase the intake of vegetables like beetroot, carrots, tomatoes, spinach, kale, broccoli, coriander leaves, black sesame seeds in your diet as these are rich source of Iron and vitamins. These nutrients are important for development of red blood cells.
  • If suffering from constipation, take 5 gm of Harad (Terminalia chebula) Powder with luke warm water at night
  • Intake of fruits like oranges, guava, gooseberry, lemon provides vitamin C to body which helps in absorption of Iron.
  • Take 1 apple, half beetroot, 1 cup of pomegranate seeds and 1 amla. Take their juice twice a day for 15 to 30 days.
  • Never add raw spinach leaves with juice as oxalic acid present in raw leaves prevent the absorption of iron in body.
  • Prepare the vegetables in iron vessel as it fortifies the food prepared in them.


The purpose of Ayurvidya is to promote broad consumer understanding and knowledge of various health topics. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider regarding your medical condition or treatment and before undertaking any new health care regimen.