ITP (Immune thrombocytopenia) – What is it, How is it Caused & Is it Treatable?
Abstract
Idiopathic thrombocytopenia purpura is characterised by persistent thrombocytopenia and is an auto-immune disorder. In this platelets are attacked in their premature stage by the reticuloendothelial system and particularly in the spleen. In most cases the cause is idiopathic but in some of them, particular conditions are involved. These secondary causes are like infections, accompanied by coexisting antibodies.
The environmental and genetic factors also impact platelet turnover and its response to ITP-directed therapy. A better understanding of the pathophysiology of these diseases helps in proper diagnosis and treatment which are patient-specific. In the modern system of medicine, steroids are used in patients with ITP. They do have side effects in the patients. But in Ayurveda, many useful herbal drugs have been used for many centuries in the treatment of bleeding disorders.
INTRODUCTION
Platelets are very important in the maintenance of normal hemostasis and vascular repair. Due to decreased platelets, it causes Bruising, Petechiae, and Immune-mediated thrombocytopenia purpura; it is one of the most common forms of autoimmune disease which affects both children and adults. Idiopathic thrombocytopenia is a condition in which platelet antibodies accelerate platelet destruction and inhibit their production. The main characteristic of this is bleeding which correlates generally with the severity of the thrombocytopenia.
There are two types of ITP
1. Acute Thrombocytopenia Purpura
Acute Thrombocytopenia Purpura-This is most commonly found in young children. The main symptoms of this are a viral illness. It completely disappears within 6 months and does not reoccur. It is the most common form of the disorder.
2. Chronic Thrombocytopenia Purpura
Chronic Thrombocytopenia Purpura– This disease can happen to anyone at any age, and symptoms can last from six months to several years. Adults have more tendency to suffer from this disease than children but it does affect adolescents. Females have more chances to develop than men. Chronic ITP can recur often and it requires continuous treatment with follow-up.
SYMPTOMS
- Purpura
- Petechiae
- Nose bleeds
- Bleeding in the mouth
- Blood in the vomit
- Bleeding in the head
TREATMENT OF ITP IN MODERN MEDICINE
Corticosteroids are the first line of therapy in the treatment of ITP. But there develops a dependency on steroids within patients’ bodies after initial treatment with corticosteroids. And long-term use of steroids has side effects like osteoporosis, uncontrolled sugars and hormonal imbalance.
Azathioprine or revolade, danazol, dapsone etc are second-line agents but with limited efficacy. The patient’s condition is the main turning point in whether to choose second-line treatment or not. However sometimes it depends on the availability of the medicines. As immunosuppressants azathioprine/ revolade etc. have been used for treating ITP for many years. It is a cost-effective and ready-to-use drug in countries like India. Azathioprine is considered to be safe during pregnancy and for lactating mothers also. But still, there are reports of their side effects and doubts about their efficacy.
Adverse Effects
Leukopenia is the most adverse effect of these drugs along with the anemia and also hepatobiliary laboratory dysfunction is noted in patients. Serious adverse notes like sepsis in the patients. Some patients show neutropenia which is resolved after cessation of azathioprine.
AYURVEDIC VIEW
Thrombocytopenia purpura treatments are available in modern science, namely, corticosteroids etc. which have lots of side effects and last when no options are left they do surgery. On another side, Ayurveda explains its causes, pathogenesis and management. It can be correlated with Raktapitta as mentioned in Ayurveda. The ayurvedic treatment for raktapitta was written in classical textbooks with medicated food for patients.
The term raktapitta means a collection of bleeding disorders such as nasal bleeding, bleeding through the vagina, ear, mouth, rectum and urethra. The main reason for Raktapitta is the vitiation of pitta dosha and pitta gets vitiated due to its causative factors such as diet having amal(sour), lavan(salt), katu(pungent) rasa food in the diet. Gradually vitiated pitta ultimately vitiated rakta dhatu which have similar properties. Raktapitta disease mainly affects the Raktavaha srotas and its roots i.e liver and spleen.
In this condition vitiated blood reaches every part and bleeding from different parts occurs. Both kinds of treatment in Ayurveda were described as Shodhana and Shaman . It all depends on the patient’s strength and disease manifestation. Shodhan can be done by siravedh, jalauka vachana etc in this vitiated blood is taken from the body. In shaman treatment various herbal remedies are recommended like: Durwa (Cynodon dactylon), Amalaki (Emblica officinialis), Shatavari (Asparagus racemosus), Ashwagandha (Withania somnifera) etc. They have anticoagulation and antineoplastic property which helps in the
HERBAL REMEDIES BY PLANET AYURVEDA FOR ITP
Planet Ayurveda is one of the leading companies in the field of Ayurvedic medicines. Planet Ayurveda has its own manufacturing that has taken reference for each formulation and medicine from classical medicinal textbooks. Planet Ayurveda products have GMP certified having no harmful contents. The herbal products do not contain any kind of preservatives, flavours or additives. For treating diseases like ITP which are chronic conditions they also provide herbal products like Ashwagandha capsules, Giloy capsules, Gandhaka Rasayana, Kumar Kalyan ras etc these all are included in the ITP care pack. The ITP care pack gives not only treatment but also helps in increasing the strength of the body in patients.
ITP CARE PACK
PRODUCTS DESCRIPTION
1. IMMUNE BOOSTER
In ITP patient immunity is very weak because this patient is prone to other diseases. For removing this weak immunity problem the immune booster capsule is used. Its main ingredients are: Grape seed(Vitis vinifera std. ext.), Go-Piyush(Bovine colostrums std. ext.), Bhumi amla(Phyllanthus niruri std. ext.), Amalaki (Emblica Officinalis)
Dosage: 2 capsule should be taken twice daily
2. ASHWAGANDHA CAPSULES
Ashwagandha (Withania somnifera) is helpful in patients with leucoderma, depression, insomnia, weight gain, immunity and muscle strength. It is used in ITP patients because it is known as shophahara (reduces inflammation), kshathara (useful in injury healing), vranan hanti (quick wound healing) etc. It improves overall health and gives better results in boosting immunity.
Dosage: 2 capsules twice daily with plain water after meals.
3. GILOY CAPSULES
Giloy (Tinospora cordifolia) is a well-known immunomodulatory herb which is used in treating autoimmunity. It balances tridosha (vata, pitta, kapha) i.e called doshatrayhara. These can also be used in the treatment of fever, diabetes, anaemia, jaundice, asthma etc. Giloy is also considered as effective in increasing platelets.
Dosage: 1 capsule twice daily after meals.
4. GANDHAK RASAYAN
Gandhaka Rasayana is a polyherbal formulation which uses shudha gandhak (sulphur). It is recommended in the treatment of skin diseases, itching, chronic fever, urinary tract disorders etc. It improves immunity, fertility, potency, nourishment, body strength, digestion improves, etc.
Dosage: 2 tablets twice daily with plain water
5. GREEN ESSENTIALS
It is made up of Grape seed (Vitis Vinifera), Wheatgrass (Triticulum Aestivum), Spirulina (Spirulina Platensis), and Green tea (Camellia Sinensis), Amla (Embllica Officinalis). These all contain chlorophyll and have antioxidant properties i.e it is used in ITP for purifying the blood. These capsules are also useful in balancing pitta doshas which get vitiated in ITP.
Dosage: 2 capsules (twice) daily after meals.
6. KUMAR KALYAN RASM.
It is a polyherbal formulation which is helpful in detoxifying the blood. It consists of Kumari rasa (Aloe vera juice ), Ras sindoor (purified mercury), Mukta bhasma(purified pearl), Swarna bhasma (purified gold bhasma), Abhrak bhasma (purified mica bhasma), Loh bhasma (bhasma prepared from the iron) etc. It is considered to be very effective in Rasayana and used in the treatment of many diseases.
Dosage: 1 tablet twice daily after meals.
7. BRAHMI CHYAWANPRASH
It is considered to be a very effective immunity and memory booster. Brahmi (Bacopa monnieri) is also an excellent anti-ageing, anti-diabetic and antioxidant herb. It results in the cellular form; its active content, brahmin, is very effective as an antioxidant and also protects the blood vessels, and nerves.
Dosage: 1 teaspoonful twice daily with plain water after meals.
8. SUVARNA BASANT MALTI RAS
Its main ingredients are Swarna bhasma (purified gold), Mukta bhasma (pure pearl), Maricha (Piper nigrum) and Gandhaka (pure sulphur) etc. This formulation has minerals in the purified form which are a rich source of zinc. Zinc is helpful in the formation of RBC which is a very important component of blood. This is also helpful in maintaining platelets number i.e it is used in ITP.
Dosage: 1 tablet twice daily after meal with plain water after meals.
CONCLUSION
ITP is believed to be heterogeneous disease with a relapsing-remitting course and various kinds of treatment can be used. Steroid drugs may show effects in the patients but they do have side effects which are discussed above. On the other hand, ayurvedic herbal medication gives benefits with no side effects. Ayurvedic herbal medicine gives safe results and now they have proven evidence also. In today’s times, Ayurveda attains the interest of individuals because in chronic conditions the body gives effective results using herbal medicine.
