E-ISSN:2456-3110

Case Report

ITP

Journal of Ayurveda and Integrated Medical Sciences

2025 Volume 10 Number 7 JULY
Publisherwww.maharshicharaka.in

Integrative Management of ITP through Ayurveda: A Clinical Case Study

Chauhan V1*, Chauhan M2
DOI:10.21760/jaims.10.7.50

1* Vikram Chauhan, MD in Ayurveda (Dravyaguna), BAMS, NDDY.

2 Meenakshi Chauhan, MD in ALT-MEDICINE, BAMS (GOLD MEDALIST).

Immune Thrombocytopenic Purpura (ITP) is a bleeding disorder marked by low platelet count, which can be correlated with Raktapitta and Tridosha imbalance in Ayurveda, primarily involving vitiation of Pitta and Rakta Dhatu. Ayurvedic management focuses on balancing doshas, purifying the blood, and enhancing bone marrow function using herbs like Ashwagandha, Amalaki, Giloy, and Punarnava. This paper presents an Ayurvedic perspective on ITP and highlights the potential of holistic, natural interventions in improving patient outcomes.

Keywords: Immune Thrombocytopenic Purpura, Ayurvedic Treatment, Herbal medicine for ITP, Low Platelet count, Immunomodulation

Corresponding Author How to Cite this Article To Browse
Vikram Chauhan, MD in Ayurveda (Dravyaguna), BAMS, NDDY, , , , .
Email: 		Chauhan V, Chauhan M, Integrative Management of ITP through Ayurveda: A Clinical Case Study. J Ayu Int Med Sci. 2025;10(7):323-328.
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Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2025-05-16 2025-05-27 2025-06-07 2025-06-17 2025-06-27
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© 2025 by Chauhan V, Chauhan M and Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

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Vikram C et al. Integrative Management of ITP through Ayurveda

Introduction

Idiopathic Thrombocytopenic Purpura (ITP) is an autoimmune disorder in which the immune system mistakenly destroys the body’s own platelets, which are essential for blood clotting. This leads to a significantly reduced platelet count, causing symptoms like easy bruising, frequent nosebleeds, prolonged bleeding and small red or purple skin spots called petechiae.

ITP is classified based on duration, age and cause. Acute ITP, common in children, often follows a viral infection and usually resolves within six months without treatment. Chronic ITP, more common in adults, especially women under 40 years, lasts longer than six months.

In Ayurveda, ITP can be correlated with Tiryakgata Raktapitta, which is a Pitta-dominant Tridoshaj disease. This disease is categorized under 8 Mahagadas (Major diseases) due to its severity. It is also known as Immune Thrombocytopenia. Severe cases may lead to mortality due to excessive loss of blood.[1]

Raktapitta is discussed in Ayurvedic scriptures immediately following the chapter on Jwara (fever), as it is considered to arise from Santapa (intense internal heat), a key symptom of Jwara.

Because both conditions share similar causative factors, Acharya Sushruta chose to elaborate on Raktapitta after describing Pandu Roga (anaemia), highlighting their interconnected nature.

The management of ITP in Ayurveda may include Pitta Pacifying, Immune boosting, Detoxifying and Rasayana drugs. These herbs may include Ashwagandha, Giloy, Durva, Carica papaya, Yashtimadhu, Punarnava, etc.

We report a case of a 34-year-old female from Kutch, Gujarat, who had a low platelet count, which was managed by Ayurvedic herbs and formulations.

Case Report

Patient Information and Clinical Findings

A 34-year-old female presented with a history of spotting during pregnancy, prompting her to visit her local hospital for a checkup. Her doctor advised her to wait a few days and monitor the symptoms.

Later, her vaginal bleeding increased daily, and she experienced a miscarriage. Subsequently, she developed red spots, dizziness, back pain and severe weakness, first noticed in July 2024.

She had red spots all over her body and her platelet count dropped during this period. The doctor recommended regular blood tests and Anti-Nuclear Antibody (ANA) tests. The patient had no symptoms of gum or nose bleeding and had regular periods with normal bleeding.

At that time, her platelet count dropped to 28,000. She visited her local hospital, where the doctor prescribed Prednisolone 50 mg, but despite taking the medication, her platelet count continued to drop.

Additionally, she experienced side effects such as back pain, acne, and facial swelling. After extensive research, she discovered Planet Ayurveda and began treatment in September 2024.

Diagnosis

In July 2024, her platelet count was 28,000 and when she started treatment from Planet Ayurveda, her platelet count was 35,000. The diagnosis of the patient, according to her clinical findings (CBC) and symptoms, is as follows:

SNDateBefore TreatmentAfter Treatment
1. 5 September 2024Platelet count- 35000
2. 8 October 2024Platelet count- 82000
3. 5 November 2024Platelet count- 240000
4. 9 December 2024Platelet count-230000
5. 6 January 2025Platelet count-160000
6. 6 February 2025Platelet count-172000
7. 10 March 2025Platelet count-176000
8. 9 April 2025Platelet count-164000

Investigation

The investigation of the patient is done by Antinuclear Antibody (ANA) test and haematological investigation (Complete blood count) and assessing the physical symptoms. The following table shows the improvement in the symptoms before and after treatment:

Timeline

The timeline of the treatment of the patient is mentioned in the table below:


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SNDateBefore TreatmentAfter Treatment
1. 5 September 2024Spots on the body, weakness, dizziness, Backache
2. 8 October 2024Backache (Better), Mild weakness
3. 5 November 2024Mild Weakness
4. 9 December 2024Weakness (Better), Back pain
5. 6 January 2025Mild Back pain
6. 6 February 2025Mild back pain
7. 10 March 2025Asymptomatic
8. 9 April 2025Asymptomatic

Therapeutic Intervention

Therapeutic intervention in ITP primarily aims to increase platelet count, reduce bleeding risk, Body detoxification and modulate immune response. The aim of Ayurveda is primarily to manage ITP with the help of herbal formulations. Here are some of the formulations that are given to the patient:

1. Swarn Vasant Malti Rasa - A classical Ayurvedic formulation include Swarna Bhasma (Gold calx), Mukta Bhasma (Calx of pearl), Shuddha Hingula (Ore of mercury and sulphur), Kali Maricha (Piper nigrum), Kharpara (Zinc), Shuddha Parad (Purified mercury) and Shuddha Gandhak (Purified sulphur) for their synergistic therapeutic effects. Swarn Bhasma helps to calm an overactive immune system, and Kharpara Bhasma (Zinc) stimulates the bone marrow, enhancing platelet production, etc.

2. Ashwagandha Ghan Vati - It contains Ashwagandha (Withania somnifera) as a main ingredient, which contains active alkaloids, Withanolides that help to manage ITP by regulating immune function, reducing inflammation and supporting overall recovery and platelet stability. It acts as a natural catalyst that enhances the effects of other herbal medicines.

3. Giloy Ghan Vati - It contains Giloy (Tinospora cordifolia) as a main ingredient, which contains active alkaloid Berberine and terpenoids that help improve platelet count in ITP by modulating immunity, supporting bone marrow and reducing inflammation.

4. Plato Plan Capsules - This is an effective formulation of Planet Ayurveda that contains mainly Erand Karkati (Carica papaya), Ashwagandha (Withania somnifera), Giloy (Tinospora cordifolia) and many more. These ingredients contain active compounds Papain (Erand Karkati), Berberine and terpenoids (Giloy), withanolides (Ashwagandha) and ascorbic acid (Amalaki). These compounds help boost platelet production, regulate immunity, reduce inflammation and support bone marrow. Papain from Erand Karkati (Carica papaya) exhibits proteolytic activity that helps break down proteins and may support increased platelet production.

5. Plato Plan syrup - Planet Ayurveda’s Plato Plan Syrup contains mainly Erand Karkati (Carica papaya), Ashwagandha (Withania somnifera), Giloy (Tinospora cordifolia), Amalaki (Emblica officinalis) and many more. These ingredients possess active compounds like papain and flavonoids from Papaya leaf, withanolides from Ashwagandha, Berberine and terpenoids from Giloy, vitamin C and gallic acid from Amalaki, resveratrol from Draksha (Vitis vinifera), and punarnavine from Punarnava (Boerhavia diffusa). These ingredients support healthy platelet production, balance immunity and reduce oxidative stress.

6. Kaharva Pishti - Kaharva Pishti (also known as Amber Pishti) is a traditional Ayurvedic formulation made from purified amber resin, which is processed with rose water (Gulab Ark) using classical Ayurvedic methods (Pishti preparation). It is useful in bleeding disorders and thus helps to manage bleeding due to its cooling properties.

7. Kamdudha Ras - Kamdudha Ras contains Mukta Bhasma (calcium carbonate), Praval Bhasma (calcium, magnesium, iron), Shankha Bhasma (calcium, phosphorus), Shukti Bhasma (calcium salts) and Giloy Satva (Berberine and terpenoids) that contain hemostatic and cooling properties and help in managing symptoms of ITP by reducing bleeding tendencies, balancing Pitta Dosha and reducing internal heat and inflammation.

8. Drakshasav - It contains ingredients like Munnaka (Vitis vinifera), Laung (Syzygium aromaticum), Jaiphal (Myristica fragrans), Laung (Syzygium aromaticum) and many more that contain active compounds such as Resveratrol, flavonoids and minerals which help improve platelet count by reducing inflammation, supporting immune modulation and promoting Hematopoiesis.


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9. Pitta Balance capsules - Pitta Balance capsules of Planet Ayurveda contain Giloy Satva (Berberine and terpenoids), Mukta Pishti (calcium carbonate), Akik Pishti (trace minerals), Jahar Mohra Pishti (magnesium silicate) and Kaharva Pishti (amber calcium) that pacify Pitta Dosha, provide cooling effect, Stop bleeding, regulate immunity, reduce inflammation, support bone marrow and promote healthy platelet production.

10. Yasthimadhu Ghan Vati - Yasthimadhu in the formulation contains the active component Glycyrrhizin, derived from the root of Glycyrrhiza glabra (Liquorice). Glycyrrhizin is known for its anti-inflammatory, immunomodulatory and antioxidant properties. In Ayurveda, it is known as Shonitsthapana (blood-stabilizing properties).

11. Punarnava Mandur - Punarnava Mandur cont-ains Punarnava (Boerhavia diffusa), Mandur Bhasma (Calcined red oxide of iron), Trivrit (Operculina turpethum), Haritaki (Terminalia chebula),


Amalaki (Emblica officinalis), Shunthi (Zingiber officinale), Pippali (Piper longum), Maricha (Piper nigrum), Vidanga (Embelia ribes), Chitrak (Plumbago zeylanica) and others that contains punarnavine, turpethin, gingerols, piperine, ascorbic acid and iron, which reduce inflammation, improve haemoglobin, support liver and spleen health and enhance platelet production.

12. Orthovita Oil - It contains ingredients like Shul Gajendra Oil, Gandhapura Oil, Turpentine Oil, Saindhavadi Taila, Prasarini Oil and Camphor. Contains active compounds like Sesquiterpenes, Camphorene, borneol, Cinnamaldehyde and eugenol, which help to manage inflammation, relieve muscle and joint pain, improve circulation and enhance flexibility, making it effective for managing back pain and stiffness.

All of the above medicines are really helpful in the management of symptoms of ITP and also help in improving immunity and platelet count of body.


Follow-Ups

SNDateMedicines
1. 5 September 2024 - 8 October 2024Swarn Vasant Malti Ras (1 tablet twice daily), Platoplan Capsule (2 capsules twice daily), Ashwagandha Ghan Vati (2 tablets twice daily), Kamdudha Ras (2 tablets twice daily), Kaharva Pishti (2 tablets twice daily), Platoplan Syrup (2 tsp twice daily), Drakshasav (2 tsp twice daily)
2. 8 October 2024 - 5 November 2024Swarn Vasant Malti Ras (1 tablet twice daily), Platoplan Capsule (2 capsules twice daily), Ashwagandha Ghan Vati (2 tablets twice daily), Kamdudha Ras (2 tablets twice daily), Kaharva Pishti (2 tablets twice daily), Platoplan Syrup (2 tsp twice daily), Drakshasav (2 tsp twice daily)
3. 5 November 2024 - 9 December 2024Swarn Vasant Malti Ras (1 tablet once daily), Platoplan Capsule (1 capsule twice daily), Ashwagandha Ghan Vati (2 tablets twice daily), Kamdudha Ras (2 tablets twice daily), Kaharva Pishti (2 tablets twice daily), Platoplan Syrup (2 tsp twice daily), Drakshasav (2 tsp twice daily)
4. 9 December 2024 - 6 January 2025Swarn Vasant Malti Ras (1 tablet once daily), Giloy Ghan Vati (2 tablets twice daily), Ashwagandha Ghan Vati (2 tablets twice daily), Platoplan Syrup (2 tsp twice daily), Drakshasav (2 tsp twice daily)
5. 6 January 2025 - 6 February 2025Pitta Balance capsule (1 capsule twice daily), Giloy Ghan Vati (2 tablets twice daily), Ashwagandha Ghan Vati (2 tablets twice daily), Platoplan Syrup (2 tsp twice daily), Drakshasav (2 tsp twice daily), Platoplan Capsule (1 capsule twice daily), Kamdudha Ras (1 tablet twice daily)
6. 6 February 2025 - 10 March 2025Pitta Balance capsule (1 capsule twice daily), Giloy Ghan Vati (2 tablets twice daily), Ashwagandha Ghan Vati (2 tablets twice daily), Platoplan Syrup (2 tsp twice daily), Drakshasav (2 tsp twice daily), Platoplan Capsule (1 capsule twice daily), Yashtimadhu Ghan Vati (2 tablets twice daily), Orthovita Oil for Local application
7. 10 March 2025 - 9 April 2025Pitta Balance capsule (1 capsule twice daily), Giloy Ghan Vati (2 tablets twice daily), Ashwagandha Ghan Vati (2 tablets twice daily), Platoplan Syrup (2 tsp twice daily), Platoplan Capsule (1 capsule twice daily), Yashtimadhu Ghan Vati (2 tablets twice daily), Orthovita Oil for Local application, Punarnava Mandur (2 tablets twice daily)
8. 9 April 2025Ashwagandha Ghan Vati (2 tablets twice daily), Yashtimadhu Ghan Vati (2 tablets twice daily), Platoplan Syrup (2 tsp twice daily), Orthovita Oil for Local application

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Discussion

Idiopathic Thrombocytopenic Purpura (ITP) was first described by German physician Paul Gottlieb Werlhof in 1735.[2] He documented a case involving a 16-year-old girl who developed bleeding symptoms such as nosebleeds (epistaxis) and vomiting blood (hematemesis) following an infection. In ITP, histopathology typically shows a normal or increased number of megakaryocytes in the bone marrow, reflecting a compensatory response to peripheral platelet destruction.

In Ayurveda, the concept of Raktapitta vitiation, the imbalance begins with the aggravation of Pitta Dosha due to the consumption of hot, sour, sharp, pungent and salty foods, along with exposure to excessive heat. This disturbed Pitta then contaminates the Rakta Dhatu (blood) because of their similar qualities. As both Pitta and Rakta (blood) increase, the fluids from other Dhatus (tissues) begin to mix with the blood, causing an abnormal rise in blood volume, which leads to bleeding from both upper and lower body parts.[3] Raktapitta primarily affects the blood vessels and their roots, namely the liver (Yakrit) and spleen (Pliha).[4] The vitiated blood crosses tissue barriers and circulates through the vessels, eventually resulting in bleeding from various orifices. Below is the detailed pathophysiology of Raktapitta:

Due to the intake of Nidana (Causative factors)
↓
Pitta gets vitiated and mixes with Rakta (blood)
↓
Pitta’s heat pulls fluids from Mamsa (Muscle Tissue), Meda (Adipose Tissue or Fat), etc., into Rakta (blood)
↓
Rakta (blood) Dhatu increases beyond a normal level
↓
Blood volume and pressure rise in the vessels
↓
Heat and pressure damage vessel walls
↓
Blood leaks from the body’s openings (Nav Dwar)
↓
Bleeding seen from mouth, nose, ears, eyes, skin, anus, penis, vagina
↓
Raktapitta

The management of symptoms of ITP in this patient is done by above mentioned medicines. These Ayurvedic formulations offer a holistic approach in managing ITP by combining immune modulation, anti-inflammatory, and hematopoietic properties. Above mentioned formulations contain ingredients like Swarn Bhasma and Kharpara Bhasma that stimulate bone marrow and calm immune overactivity, while herbs like Ashwagandha, Giloy, and Carica Papaya regulate immunity and boost platelet production.

Mineral Bhasmas and cooling agents help reduce bleeding and balance Pitta Dosha. Overall, these medicines support platelet stability, reduce inflammation and promote recovery, making them effective natural therapies for enhancing platelet count and managing ITP symptoms.

Conclusion

After the patient began treatment with Ayurvedic formulations in September 2024, her platelet levels gradually returned to the normal range within two months. Over the course of the following six months, her platelet count was within the normal limits, showing significant improvement. Along with the restoration of her platelet count, all of her previous symptoms, including red spots, dizziness, back pain, and severe weakness, resolved.

Furthermore, the side effects she had been experiencing due to the Prednisolone (such as back pain, acne and facial swelling) also completely subsided after she switched to the Ayurvedic treatment. This positive response to the Ayurvedic formulations not only improved her physical health but also helped her regain a sense of well-being and stability.

Patient Consent

Written informed consent had been obtained from the patient

Patient’s Perspective

The patient was satisfied with the given treatment.

Declaration of Generative AI in Scientific Writing

During the preparation of the manuscript, Generative AI or AI-assisted technology was not used for the writing process.


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References

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4. Acharya YT, editor. Charaka Samhita of Agnivesha, Chikitsa Sthana. Ch. 4, Ver. 10. Varanasi: Chaukhamba Surbharati Prakashan; 2005. p. 428 [Crossref][PubMed][Google Scholar]

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