A REVIEW ON MEDICINAL PLANTS AND FORMULATIONS

RECOMMENDED IN SIDDHA LITERATURES FOR THE

MANAGEMENT OF IRON DEFICIENCY ANEMIA
Vajahath Ali A *1, Govindaraj B2, Megala K3, Bharathi B4, Velpandian V5, Saravana
Devi M.D6
*1
Post Graduate Scholar, Post Graduate Department of Gunapadam, Govt. Siddha
Medical College, Chennai
2
Post Graduate Scholar, Post Graduate Department of Gunapadam, Govt. Siddha
Medical College, Chennai
3
Post Graduate Scholar, Post Graduate Department of Gunapadam, Govt. Siddha
Medical College, Chennai
4
Post Graduate Scholar, Post Graduate Department of Gunapadam, Govt. Siddha
Medical College, Chennai
5
Professor, Post Graduate Department of Gunapadam, Govt. Siddha Medical College,
Chennai
6
Professor, Post Graduate Department of Gunapadam, Govt. Siddha Medical College,
Chennai

*Corresponding Author: Dr. A. Vajahath Ali; Mail Id: vajagsmc@gmail.com; Cell

No.:8122500315

1
ABSTRACT

Siddha Medicine is one of the oldest systems of medicines in the world, which have
herbal, herbo-mineral and animal based formulations for 4448 diseases as mentioned in
siddha text. Paandu noi, is a disease mentioned in the siddha literature Padhartha Guna
Sinthamani. Its symptoms can be correlated with Iron Deficiency anemia which is one of the
major health issues affecting every ethnic group in the world. This paper presents various
formulations in the siddha literatures indicated for iron deficiency anemia.

KEYWORDS

Siddha, Iron Deficiency Anemia, Paandu noi, Herbal, Herbo-mineral,

INTRODUCTION

Anemia is an important health issue in the global population, affecting every ethnic
group and social strata. As per the WHO definition Anemia is a condition in which the
number of red blood cells (and consequently their oxygen-carrying capacity) is inadequate to
meet the body’s physiologic needs. According to the WHO’s estimate the prevalence of
anemia worldwide in 2019 was 39.8% among children aged 6 to 59 months, 36.5% among
[1]
pregnant women and 29.9% among women of reproductive age. NFHS-5 (National Family
Health Survey) reveals that the prevalence of Anemia in India is 67.1% in children (6-59
months), 57% in women of reproductive age, 57.2% in Non-pregnant women of reproductive
age, 52.2% in pregnant women and 25% in Men.3 Among the various factors, iron deficiency
contributes 50% in causing anemia.[2] The causes of iron deficiency are Malabsorption due to
Celiac disease, Duodenal resection/gastric bypass surgery, Inflammatory bowel disease (ileal-
jejunal disease and/or anemia of chronic disease), Helicobacter pylori gastritis, Autoimmune
gastritis, Dietary causes due to Malnutrition, Increased Demand in Pregnancy, lactation,
Childhood, Erythropoiesis-stimulating agents (in chronic kidney disease, chemotherapy-
induced anemia), Gynecologic causes includes menorrhagia and upper Gastrointestinal causes
includes Gastric/duodenal ulcer Esophagitis and Lower gastrointestinal blood loss
Hemorrhoids, anal fissures, rectal ulcers, Autoimmune gastritis. [3, 4]

Siddha system of medicine classffied the disease into 4448 on the basis of
derangement of three humors (Vali, Azal, Iyam). Paandu is literally means paleness in tamil
which is a disease mentioned in Padhartha Guna Sinthamani (Siddha literature) with
symptoms of shortness of breath, loss of appetite, nausea, dizziness, irregular heartbeat,
paleness of conjunctiva and nail bed, fatigue, dryness of skin which can be co-related with

2
iron deficiency Anemia. Siddha system has various forms of herbal, poly-herbal and herbo-
mineral formulations which has possible therapeutic potential to treat anemia. The aim of this
review is to discuss about the therapeutics in Siddha for the treatment of Anemia.
Hematinic activity herbs mentioned in Siddha text Gunapadam, part-1
(Mooligaivaguppu) are given in the Table 1.
Table 1: Herbs indicated for Iron Deficiency Anemia (IDA)
S.No Tamil Name Botanical Name Part Used
1. Atthi Ficus racemosas Dry fruit
2. Maadulai Punica granatum Fruit
3. Paerseechham Phoenix dactylifera Fruit
4. Nelli Phyllanthus emblica Unripen fruit
5. Thippili Piper longum Dry fruit
6. Murggai Moringa oleifera Leaves
7. Kariveppilai Murray koengi Leaves
8. Mookkirattai Bohavia diffusa Whole Plant
9. Ellu Sesamum indicum Seed
10. Karisalai Eclipta prostrata Leaves
11. Chukku Gingiber officinale Rhizome

Table 2- Poly-herbal formulations indicated for Iron Deficiency Anemia (IDA)

S. Name of the Dose Adjuvant Reference Pg.

No formulation /Song
No
1 Vilvathy 5-10g Sarabendhira Vaithiya Muraigal- 49-50
Legiyam Paandu Kaamalai Sigicchai [5]
2 Amukkara 500-100mg Honey Agasthiyar Vaithiya Irattina 129-
Chooranam Churukkam [6] 130
3 Elumicchapaza 5-10gm Sarabendhira Vaithiya Muraigal- 42-43
Legiyam Paandu Kaamalai Sigicchai [5]
4 Inji kuzambu 5-10 ml Sarabendhira Vaithiya Muraigal- 5
Paandu Kaamalai Sigicchai [5]
5 Thiratchathi 1-2gm Honey Theraiyar Karisal [7] 85-86
Chooranam
6 Karisalai 2-4gm Akasthiyar Vaithiya Ratthina 40-41

3
 Legiyum Surukkam [6]
7 Sarabunga 5gm Akasthiyar Vaithiya Ratthina 40-45
Vilvathy Surukkam [6]
Ilagam
8 Karipanathi 5gm Honey Akasthiyar Vaithiya Ratthina 40-45
Legiyum Surukkam [6]
9 Adathodai Nei 5gm Chukku Agasthiyar Vaithiya Kaviyam- 229-
decction 1500 [8] 230
10 Madhulai 10-15 ml Siddha Vaithiya Thirattu [9] 258
Manapagu
11 Thirinethira 1gm Water Koshayee Anoboga Vaithiya 103
Chooranam Bramma Ragasiyam-2 [10]

Table 3- Herbo-mineral formulations indicated for Iron Deficiency Anemia (IDA)

S. Name of the Dose Adjuvant Reference Pg. /

No formulation Song
No
1 Ayasambeera 100 - 200 m honey Gunapadam part2&3 [11] 59
Karpam g
2 Ayabirungaraja 500 mg;BD honey Gunapadam part2&3 [11] 59
karpam
3 Ayaparpam 65-130 mg Honey Gunapadam part2&3 [11] 94

4 Aarumuga 65-130mg honey Siddha Vaithiya Thirattu [9] 138

chendhoorum
5 Annabedhi 50-100mg honey Gunapadam,part 2&3 [11] 305
Chendhoorum
6 Vedi Annabedhi 50-100mg honey Gunapadam,part 2&3 [11] 305
Chendoorum
7 Thanga Parpam 65-100mg honey Agasthiyar Vaithiya 107-
Ratthina Surukkam [6] 108

8 Kaandha 65-100mg honey Agasthiyar Paripooranam 93-95

4
 chendoorum -400 [11]
9 Paavana Kadukkai 1gm Water Theraiyar Padhal Thirattu 32-33
[12]

10 Maha Vasantha 1;BD Muppalai Siddha Vaithiya Thirattu [8] 67-71

Kusumagaram Juice
11 Manduraathi Adai 30-60 ml Gunapadam,part 2&3 [10] 117
Kudineer
12 Nanthi mezhghu 100-500gm Palm Siddha Vaithiya Thirattu [8] 187-
jaggery 193
13 Kantha chenduram 100-200 mg honey Gunapadam,part 2&3 [10] 142-
143
14 Thanga 65-100mg honey Agasthiyar Vaithiya 153-
[6]
chendoorum Ratthina Churukkam 155
15 Linga Chendoorum 65-130mg Ginger Agasthiyar Paripooranam 182
Juice -400 [12]

16 Kaala Mega 488 mg honey Agasthiyar Paripooranam 119-

Narayana -400 [12] 121
Chendoorum
17 Meganatha Kuligai 1-2 pills Ginger Siddha vaithiya thirattu [9] 41
decoction
18 Aya Chendoorum 60-130 mg Honey Akasthiyar Paripooranam 93-95
-400 [11]
19 Gowri Sinthamani 65-130mg Erukkilai Akasthiyar Vaittiya 355-
chendoorum paluppu Kaviyam-1500 [8] 358
juice
20 Kumattik kuzambu 300mg Palm Siddha Vaithiya Thirattu [9] 67-71
jaggery
21 Khantaga 3gm Water Pulippani-500 [14] 50
Rasayanam
22 Lakshmi Narayana 2-3 Water Sigiccha Rathna Deepam [15] 136-
Mathirai 137
23 Swarna Boopathi 1 pill Water Sigiccha Rathna Deepam [15] 149

5
 Kuligai
24 Linga Pathangam 30-60mg Palm Theraiyar karsal-300 [7] 8
jaggery
25 Sinjathi Legiyam 10gm Water Sarabendhira Vaithiya 7
Muraigal-Paandu Kaamalai
Sigicchai [5]
26 Naayuruvi urandai 1 pill Water Sarabendhira Vaithiya 14
Muraigal-Paandu Kaamalai
Sigicchai [5]

In the management of Iron deficiency anemia, the first line of treatment is oral iron
administration. There are more forms of iron salts, those have different side effects. The main
side effects of oral iron preparations include metallic taste, temporary staining of
teeth enamel as well as gastrointestinal symptoms such as nausea, vomiting, abdominal pain,
[16]
flatulence, constipation, and dark stools. Consumption of ferrous sulphate has significant
[17]
adverse reaction on gastrointestinal system but does not find a relation with dose.
Nonabsorbed iron could disturb gut microbiota, leading to enhanced intestinal pathogen
[18]
concentration and potential infection. In a double-blind and placebo study, adverse effects
of tablets containing various iron compounds were studied in 1496 samples reveals that
Ferrous sulphate, ferrous gluconate, ferrous fumarate and ferrous glycine fumarate had more
or less the same incidence and adverse reactions includes nausea, constipation,heartburn,
[19]
epigastric pain. A result of a study conducted on 45 patients for clinical comparison of
annabedhi chendhoorum and elemental iron in the treatment of Iron Deficiency Anemia
reports that after a 45 days of treatment both annabethi chendoorum and elemental iron
effective equally but in the case of adverse reaction, annabedhi chendoorum was quite better
[20]
than elemental iron. Thus Siddha preparations have less side effects than synthetic
preparations. Siddha preparations like ayasambeerakarpam, thiratchathi chooranam have
Ascorpic acid is essential for the reduction of Ferric into the ferrous state by the apical
membrane-bound enzymes present in human enterocytes. Siddha preparations like
ayasambeerakarpam, thiratchathi chooranam has ascorpic acid which is essential for
absorption of iron. Herbal preparations like Thirinethira Chooranam contain gastroprotective
herbs like dry ginger, pepper, pomegranate which are helpful in treating iron deficiency
anemia associated with mal-absorption, gastrointestinal diseases and hemarrohids. Some

6
preparations containing herbs like asafoetida, alovera gel which are useful in treating iron
deficiency anemia associated with uterine disorders. Herbo-mineral preparations indicated for
iron deficiency anemia like Ayachendoorum has anti-ulcer properties which are useful in the
treatment IDA associated with gastric and duodenal ulcer. Siddha Preparations contain herbs
like sweet flag (Acorus calamus) which have Antihelmentic property are use in the treatment
of iron difficiency anemia associated with parasitic infections.

CONCLUSION

As per the Thirukkural, “Diagnose the disease, detect its root cause, discern its cure
and then act optly, Siddha preparations indicated for Iron Deficiency Anemia act not only as
iron supplementation but also it may treats root causes of the disease because of its synergistic
effect. Pharmacological and clinical studies have to be carried out to understand
pharmacokinetics and pharmacodynamics to globalize these medicines and combat against
Iron Deficiency Anemia.

REFERERNCES

7
1. WHO, Global Anaemia estimates, 2021 Edition. [cited 2021 Dec. 08] Available from:
https://www.who.int/data/gho/data/themes/topics/anaemia_in_women_and_children.
2. Belwal E, Pandey S, Sarkar S. Anemia Prevalence in India Over Two Decades:
Evidence from National Family Health Survey (NFHS). International Journal of
Science and Healthcare Research. 2021;6(Issue: 4; Oct.-Dec. 2021):336.
3. Sembulingam p. Essentials of Medical Physiology. 6th ed. Jaypee Brothers Medical
Publishers (P) Ltd.; 2012.
4. Hill McGraw Iron deficiency and other hypoproliferative disorders. Harrison’s text
book of clinical medicine18th edition, (2012)
5. Vasudeva Sasthiri K, Venkattarajan S, Sarabendhira Vaithiya Muraigal- Paandu
Kaamalai Sigicchai, Saraswathi Mahal Tanjore, Pg. No-4243,5,85-86
6. S.P.Ramachandiran, Agathiyar Vaithiya Rathina surukkam, Thamarai noolagam
Chennai-26, 2ndedition, Feb 1998; Pg. No- 107-108, 129-130, 41, 40-45
7. Dr.R.Thiyagarajan, Theraiyar Karisal, Narayanasami Mudhaliyar and sons, Pg. No-
85-86, 8
8. Dr.Madhavan.Agasthiyar Vaithiya Kaviyam-1500. 1st ed.Tamil University, Tanjore
Pg.No- 229-230, 355-358.
9. Dr.K.N.Kuppusamy Mudhaliyar,Dr.K.S.Uththamaraayan, Siddha Vaidhiya Thirattu,
Department of Indian Medicine and Homoeopathy, 1st edition, Reprinted 2009; Page
no 138, 67-71, 187-193, 41, 67-71, 258
10. Ramachandiran S.P, Koshayee Anoboga Vaithiya Bramma Ragasiyam-2, 2 nd edition
Thamarai noolagam, Chennai-26, Page No-103.
11. Dr. R. Thiyagarajan, Gunapaadam Thadhu jeeva vaguppu Part 2 and 3.9 th
ed.Chennai;2016,Deptarment of Indian Medicine and Homeopathy,
P.No:59,94,305,117
12. Rathina Nayakar, Agathiyar Paripooranam-400, B. Rathina Nayakar and Son’s
Chennai-79, 2008; Page no 93-95,182, 119-121,93-95
13. S.S.Anandhan,R.Thiyagarajan, Therayar Paadal Thirattu, Department of Indian
Medicine and Homeopathy,2nd edition, 1975; P.No:32-33
14. Rathina Nayakar, Pulipaani vaithiyam-500, B. Rathina Nayakar and Son’s Chennai-
79, 2008; Song No: 324-330, Pg.No-50
15. Kannusamipillai, Sigiccha Rathna Deepam, 4th edition-2012, Thirumagal Vilasa
Acchagam, Pg. No- 136-137,149

8
16. Osmosis.org.[cited2022May18].Availablefrom:
https://www.osmosis.org/learn/Iron_preparations:_Nursing_Pharmacology
17. Tolkien Z, Stecher L, Mander AP, Pereira DI, Powell JJ. Ferrous sulfate
supplementation causes significant gastrointestinal side-effects in adults: a systematic
review and meta-analysis. PLoS One. 2015 Feb 20;10(2)
18. Foucar K. Diagnostic pathology: Blood and bone marrow. 2nd ed. Philadelphia, PA,
USA: Elsevier - Health Sciences Division; 2017.
19. Hallberg L, Ryttinger L, Sölvell L. Side-effects of oral iron therapy. A double-blind
study of different iron compounds in tablet form. Acta Med Scand Suppl [Internet].
1966;459:3–10. Available from: http://dx.doi.org/10.1111/j.0954-6820.1966.tb19403.
20. Arbind Kumar Choudhary R, Sivaraj R, Sivaraj U, Abirami R. Clinical comparison of
Annabedi Chendhuram (siddha system of medicine) and elemental iron in the
treatment of iron deficiency anaemia. IP int j compr adv pharmacol [Internet].
2020;3(4):142–5

ACKNOWLEDGEMENT

I am sincerely thankful to all the faculties of Post graduate department of Gunapadam,

Govt. Siddha Medical College, Chennai for their guidance and support.