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