Ayurvedic Treatment for Idiopathic Thrombocytopenic Purpura with Herbal Remedies

Abstract

Idiopathic Thrombocytopenic Purpura (ITP) is an autoimmune condition characterized by a reduced platelet count in the bloodstream. It is an autoimmune disorder that results in reduced platelet count in the blood. It has varying incidence and prevalence rate depending on age and gender. In children,ITP occurs at a rate of approximately 1.9 to 6.4 cases per 100,000 children each year, with the condition most commonly affecting those between the age of 2 and 6. In contrast, adults experience lower incidences, with about 3 to 4 cases per 100,000 people annually. However, ITP tends to be more prevalent among women, particularly those between 20 and 50 years old. The prevalence of ITP is harder to pinpoint due to the chronic nature of some cases, but it is clear that ITP can affect individuals of any age. Immune Thrombocytopenic Purpura (ITP) can be correlated with Tiryagata Raktapitta in certain ways, especially in terms of their clinical manifestations and the underlying principles related to blood pathology.

Introduction

Idiopathic Thrombocytopenic Purpura (ITP) is an autoimmune disorder in which the immune system generates antibodies that target and destroy the body's own platelets (thrombocytes). This leads to purpura, characterized by small blood spots appearing under the skin due to bleeding. Under normal conditions, when a blood vessel is injured, hemostasis is activated to stop the bleeding. ITP can be a serious condition, the prognosis is generally favourable for most people, especially when the disease is diagnosed and managed early.

How ITP Causes Platelet Destruction

In ITP, B-cell activation triggers the production of IgG autoantibodies that specifically target platelet glycoproteins, such as GPIIb/IIIa and GPIb/IX. These antibodies coat platelets, marking them for destruction by the immune system. The immune system recognizes these antibody-coated platelets as non-self (foreign). Splenic macrophages (immune cells in the spleen) identify and bind to the antibody-coated platelets. The splenic macrophages engulf and destroy the antibody-coated platelets, leading to extravascular hemolysis. As platelet destruction increases, the number of platelets in the blood drops, leading to thrombocytopenia. This makes it harder for the blood to form clots, putting people at risk for easy bruising, bleeding and other complications such as hemorrhage in severe cases.

Types of Idiopathic Thrombocytopenic Purpura (ITP)

Types of ITP can be classified on the basis of the duration and underlying causes they are as follow:

1. Primary ITP (Idiopathic)

• This is the most common form of ITP and occurs without any underlying disease or known cause.
• It’s thought to be an autoimmune disorder where the body’s immune system mistakenly attacks and destroys its own platelets.

2. Secondary ITP

It occurs as a result of another condition or factor that triggers the immune system to attack platelets.

3. Acute ITP

• Often occurs in children, typically following a viral infection.
• Symptoms develop suddenly and are usually severe but often resolve on their own or with short-term treatment.

4. Chronic ITP

• It is a long term condition that persists for more than 12 months.
• It can affect both adults and children.
• It often requires long-term treatment.

5. Persistent ITP

It is a form of ITP that lasts for 3 to 12 months.

Causes of Idiopathic Thrombocytopenic Purpura (ITP)

The exact cause of Immune Thrombocytopenic Purpura (ITP) is often unknown, especially in primary ITP, but there are several factors that can contribute to its development. Here are the main causes:

1. Primary ITP (Idiopathic)

It is thought to be autoimmune. Its exact cause is unknown.

2. Secondary ITP (due to underlying condition)

• Viral Infections: HIV, Hepatitis C, Epstein-Barr, CMV, Varicella-zoster.
• Autoimmune Diseases: Systemic lupus erythematosus (SLE), Rheumatoid arthritis.
• Medications: Heparin, Quinine, Penicillin, Chemotherapy drugs.
• Post-Viral/Infectious: Can develop after viral infections, especially in children.
• Lymphoproliferative Disorders: Lymphoma, Leukemia.

3. Genetic Factors

Family history of autoimmune conditions or ITP may increase the risk.

4. Environmental Factor

Infection, stress or vaccination may trigger ITP in some cases.

Signs and Symptoms of Idiopathic Thrombocytopenic Purpura (ITP)

Early recognition of signs and symptoms can help in early detection of ITP, they are as follow:

1. Easy Bruising - Frequent and unexplained bruise from minor bumps, due to low platelet count.
2. Petechiae - Small red or purple dots on the skin, often appearing on legs or feet, caused by tiny blood vessel rupture.
3. Purpura - Large purple or red patches on the skin from bleeding under the skin, usually without injury.
4. Prolonged Bleeding - Extended bleeding from cuts, scrapes, or minor injuries, and frequent nosebleeds or gum bleeding.
5. Heavy Menstrual Bleeding (Menorrhagia) - Women may experience unusually heavy or prolonged menstrual problems.
6. Fatigue - Feeling usually tired or weak.
7. Internal Bleeding - Symptoms of internal bleeding such as blood in the urine or stool.
8. Enlarged Spleen (Splenomegaly) - In some cases, the spleen may become enlarged, causing discomfort in the upper left abdomen.

Diagnosis of Idiopathic Thrombocytopenic Purpura (ITP)

Diagnosis of ITP involves a series of steps to confirm a low platelet count and rule out other potential causes of thrombocytopenia. They are as follow:

1. Medical history
2. Physical exam to check common signs of ITP such as bruising, petechiae, purpura, as well as enlarged spleen.
3. Blood tests
   • Complete blood count (CBC)
   • Peripheral blood smear
4. Antibody testing to check autoantibodies against platelets.
5. Imaging tests
   • Ultrasound
   • CT scan
6. Rheumatoid Factor and ANA (if suspected autoimmune cause) - Tests for autoimmune conditions like Systemic Lupus Erythematosus (SLE).

Management of Idiopathic Thrombocytopenic Purpura (ITP)

Management of ITP involves a range of treatments aimed at increasing platelet count, reducing immune-mediated platelet destruction, and preventing bleeding. Treatment of ITP involves:

1. First-line Treatments

• Corticosteroids (e.g., Prednisone): Suppress immune response to increase platelet count.
• IVIg: Rapid platelet increase, especially for bleeding or surgery.
• Anti-D Immunoglobulin (for Rh-positive): Alternative to IVIg for raising platelet levels.

2. Second-Line Treatments

• Rituximab: Targets B-cells to reduce autoantibody production.
• Thrombopoietin Receptor Agonists (Eltrombopag, Romiplostim): Stimulate platelet production in the bone marrow.

3. Platelet Transfusion

Used in severe bleeding or extremely low platelet counts.

4. Supportive Care

Avoid injury and monitor platelet counts regularly.

5. Surgical Option

Splenectomy: Removal of the spleen to reduce platelet destruction in chronic cases.

Complications of Idiopathic Thrombocytopenic Purpura (ITP)

• Intracranial bleeding
• Subarachnoid haemorrhage
• Gastrointestinal haemorrhage
• Hematuria
• Severe menorrhagia

Ayurvedic Aspect

According to ayurveda, Raktapitta occurs when pitta contaminates the rakta due to its ushana guna (hot quality), causing it to leak from the body through various routes. This condition is categorised into three types based on the direction of the blood flow. They are as follow

• Udharvagata raktapitta - Caused by the snigdha (oily) and ushna (hot) qualities of Pitta, leading to bleeding from upward orifices like the mouth, nose, ears, and eyes.
• Adhogata raktapitta - Triggered by hot and dry food, which vitiates vata and pitta, causing bleeding from lower orifices such as the rectum, vagina and urinary tract.
• Tiryak gata raktapitta - When all doshas are aggravated, wrestling in bleeding into the subcutaneous tissue and skin, causing bruising or petechiae.

Idiopathic Thrombocytopenic Purpura (ITP) can be associated with tiryak raktapitta. The clinical representation of tiryak raktapitta aligns with the symptoms of ITP, especially the subcutaneous bleeding and easy bruising. When certain nidanas (factors) are consumed, they aggravate the pitta dosha. This contamination of pitta mixes with the blood, causing it to become impure. The hot nature of pitta causes the liquid element of other tissues like mamsa dhatu (muscle) and meda dhatu (fat) to leak out of their respective tissues and mix into blood. This increases the amount of rakta dhatu (blood) beyond its normal level. As a result, the volume of the blood flowing through the blood vessels increases, creating excessive pressure. The heat from the pitta combined with high blood pressure weakens the wall of the blood vessel, causing them to rupture. This leads to blood leaking out through various orifices of the body, such as the mouth, nose, ears, eyes, skin, anus, penis and vagina, these are the body`s nav dwar (nine opening). This leakage of blood contaminated by Pitta through these orifices is called Raktapitta. When the blood becomes even more vitiated, it can flow out through Romakupa (hair follicles), which is known as Tiryak Gata Raktapitta. This is a condition dominated by Pitta, which can eventually evolve into a Tridoshaja Vyadhi (a disorder involving all three doshas) with Pitta being the primary dosha involved.

Samprapti (pathology) ghatakas (components)

• Dosha (humor) - Pitta Pradhana Tridoshaja
• Dushya (affected tissues) - Rakta (blood), Rasa (plasma), mamsa (muscle), Sira (blood vessel)
• Agni (fire) - Jatharagni (digestive fire), Dhatvagni (metabolic fire), Bhutagni(fire that possesses elements)
• Aama(toxin) - Kostha (stomach)
• Srotas (channel) - Raktavaha (channel carrying blood), Rasavaha (channel carrying plasm), Annavaha (channel carrying food) and other Srotas according to Avastha.
• Sroto Dusti - Sanga (congested), Vimarga Gamana (improper movement) and Atipravrutti (excessive flow)
• Adhistana (location) - Yakrut (liver) and Pliha (spleen)
• Vyaktasthana (site of manifestation) - Tiryaka Bahya Srotas
• Rogamarga (path of disease progression) - Bahya (outer) and Abhyantara (interior)

Management (according to ayurveda)

In ayurveda, the treatment would focus on balancing pitta, promoting blood health and purifying the body of toxins. Pitta and rakta (blood) pacifying drugs such as Guduchi (Tinospora cordifolia), Kutaj (Holarrhena antidysenterica), Ashwagandha (Withania somnifera) and Brahmi (Bacopa monnieri). Panchkarma therapies such as virechana (purgation) and raktamokshana (bloodletting) can be used in detoxification of the body and cleansing blood. The combination of cooling, detoxifying and immune strengthening herbs along with proper lifestyle modification can help manage these conditions effectively.

Herbal Remedies for ITP by Planet Ayurveda

Planet Ayurveda is a GMP-certified company, meaning they carefully craft all their products with the highest quality herbal extracts, under expert supervision. They take pride in creating preservative-free products to help minimize the risk of any side effects. One of their offerings, the ITP Level-1 (Basic Pack), is specifically designed to help manage ITP with natural, herbal support.

1. Plato Plan Syrup
2. Ashwagandha Capsules
3. Punarnava Mandur
4. Hemo Plan Syrup
5. Suvarna Basant Malti Ras

ITP Level-1 (Basic Pack)

Product Descriptions

1. Plato Plan Syrup

It is a herbal formulation offered by Planet Ayurveda, designed to support overall health and wellness. It contains a blend of natural herbs such as Giloy (Tinospora cordifolia), Erand Karkati (Carica papaya), Ashwagandha (Withania somnifera), Amalaki (Emblica officinalis) and several other herbs. This syrup is often used to assist in managing conditions like ITP (Immune Thrombocytopenic Purpura) by boosting the body's immune response and supporting platelet production.

Dosage - 2 teaspoons twice a day.

2. Ashwagandha Capsules

These capsules are a popular herbal supplement made from the standardized extract of ashwagandha (Withania somnifera). Ashwagandha is often utilized for its immune-boosting, anti-inflammatory, and adaptogenic properties. Individuals with ITP often experience fatigue due to low platelet counts or the side effects of medications. Ashwagandha is known to improve energy levels and combat fatigue, supporting overall physical and mental well-being.

Dosage - 1 capsule twice a day.

3. Punarnava Mandur

It is a traditional Ayurvedic formulation that combines several powerful herbs, including Punarnava (Boerhaavia diffusa), Shunti (Zingiber officinale), Pippali (Piper longum), Maricha (Piper nigrum), Amalaki (Emblica officinalis), Haritaki (Terminalia chebula), and several other herbs.This combination is used to promote overall health and manage various conditions, including Immune Thrombocytopenic Purpura (ITP), by supporting platelet production and overall immune function.

Dosage - 2 tablets twice a day.

4. Hemo Plan Syrup

It is a herbal formulation that contains a combination of potent Ayurvedic herbs such as Manjistha (Rubia cordifolia), Shatavari (Asparagus racemosus), Gorakhmundi (Sphaeranthus indicus), Draksha (Vitis vinifera), and several other herbs. This blend of herbs is known for its ability to support blood health and manage various conditions, including Immune Thrombocytopenic Purpura (ITP).

Dosage - 2 teaspoons twice a day.

5. Suvarna Basant Malti Ras

It is a traditional Ayurvedic formulation known for its rejuvenating, immune-boosting, and blood-purifying properties. It is typically used to address a variety of health concerns, including immune disorders and blood-related issues. This formulation plays a vital role by modulating the immune system, helping to reduce the immune response that destroys platelets. It helps in detoxifying the body, ensuring that toxins are efficiently removed and circulation is improved.

Dosage - Take 1 tablet daily, chewed with lukewarm water.

Conclusion

In this article I have concluded about Idiopathic Thrombocytopenic Purpura (ITP). We discussed its causes, types, symptoms, pathogenesis, diagnosis, management, complications, ayurvedic aspect and its herbal remedies by planet ayurveda. In both ITP and tiryak raktapitta, ayurveda focuses on restoring pitta balance, purifying the blood and addressing any underline ama (toxin) in the body.

Ayurvedic Remedies for ITP - Immune Thrombocytopenic Purpura

Idiopathic Thrombocytopenic Purpura or Immune Thrombocytopenic Purpura (ITP) is a syndrome in which our immune system gets activated against our own body cells thereby resulting in decreased count of platelets. As a result of which reddish or purple spots, bruises, internal or external bleeding etc can occur in the body depending on the severity of the condition.

AYURVEDIC CONCEPT OF ITP

In Ayurveda, ITP comes under the context of 'Raktapitta' (bleeding disorders). Here, aggravation of pitta dosha takes place in the body which in turn vitiates the rakta dhatu (blood). This vitiation mainly commences in the spleen and liver, as these are considered to be the main sites of rakta (blood) and progresses to other parts of the body. Although modern science considers it to be a disease of unknown origin, Ayurveda mentions the excess usage of ushna (hot), theekshana (sharp), amla (sour), katu(pungent) and vidahi (which causes burning sensation) food items, over exposure to heat and sun etc as the main underlying causes for ITP.

AYURVEDIC TREATMENT

In the treatment of ITP, Ayurveda mainly focuses on pitta shamana (normalising pitta), without disturbing the other doshas. Strength of the patient, severity of disease and abstaining from the etiological factors are also given prime importance. Either ‘Langhana’ (fasting) or ‘Tarpana’ (nourishing therapy) is administered by considering the involvement of ‘amadosha’ (toxic waste). Elimination therapies like ‘vamana’ (medicated emesis) or ‘virechana’ are advocated in extremely aggravated dosha conditions keeping in view of the strength of the patient. Strict diet and regimen has to be followed post these therapies.

For drinking purposes, water boiled and cooled with drugs like chandana (Santalum album), usheera (Vetiveria zizanioides), Musta (Cyperus rotundus), Parpataka (Fumaria officinalis) etc is generally given. Otherwise simply boiled and cooled water can also be used. Water is given either in small quantities or till the limit of satisfaction. Since madhura (sweet), thiktha(bitter) and kasaya (astringent) tastes reduce pitta dosha, these can be predominantly used by ITP patients. Commonly available items like Aloe vera, wheat grass, Papaya leaves, pomegranate, gooseberry etc can be used judiciously in this condition as it helps in increasing the platelet count. Despite being sour in nature gooseberry is indicated in ITP, as it is having sweet taste after digestion which is beneficial. Sheeta Virya (cold potency) drugs like Arjuna (Terminalia arjuna), Durva (Cynodon dactylon), chandana (Santalum album), Ashoka (Saraca asoca) etc are much useful in pitta imbalance disorders like ITP.

AYURVEDIC REMEDIES FOR ITP FROM PLANET AYURVEDA

Planet Ayurveda renders the best suitable treatment for ITP. These medicines stimulate the bone marrow for platelet production, pacifies pitta and maintains equilibrium. They are:

PRODUCTS LIST

1. Plato Plan Syrup
2. Ashwagandha Capsules
3. Punarnava Mandur
4. Hemo Plan Syrup
5. Suvarna Basant Malti Ras

ITP Level 1 (Basic Pack)

PRODUCTS DESCRIPTION

1. Plato Plan Syrup

Planet Ayurveda unveils the Plato Plan syrup which enhances the bone marrow functions thereby increasing the platelet production. The ingredients involved are herbs like Eranda karkati (Carica Papaya), Guduchi (Tinospora cordifolia), Wheat grass (Triticum aestivum), Ashwagandha (Withania somnifera), Amalaki (Emblica officinalis), Shigru (Moringa oleifera), Jeevanthi (Leptadenia reticulata) and Draksha (Vitis vinifera). It helps in boosting the immune mechanism and brings up the platelet level to the required amount. The ingredients pacify the pitta dosha without disturbing vata and kapha doshas.

Dosage - 2-3 teaspoonful twice a day after meal.

2. Ashwagandha Capsules

Planet Ayurveda offers Ashwagandha capsules which is the standardized extract of Ashwagandha in a vegetarian capsule form. Ashwagandha works impressively on the immune system and thereby increasing the number of platelets. It also improves the quality of other components of blood and helps to make the body healthy. So it is highly recommended for use in ITP patients, along with other medicines.

Dosage - 1 capsule twice daily after meal.

3. Punarnava Mandur

Punarnava mandur is a classical Ayurvedic formulation manufactured by Planet Ayurveda which is worth using in disorders like ITP. The main ingredients used are herbs like Punarnava (Boerhavia diffusa), Shunti (Zingiber officinale), Pippali (Piper longum), Maricha (Piper nigrum), Amalaki (Emblica officinalis), Haritaki (Terminalia chebula), chavya (Piper chaba), Haridra (Curcuma longa), Vidanga (Embelia ribes), Chitrakmool (Plumbago zeylanica) and Mandur bhasma (Ferric oxide). It is extensively used in almost all types of anaemia as it improves the quality of blood. It has got a noticeable effect in ITP through its action on the liver and in blood circulation.

Dosage - 2 tablets twice daily after meal.

4. Hemo Plan Syrup

Planet Ayurveda brings the Hemo Plan syrup to combat ITP. It consists of ingredients like Manjistha (Rubia cordifolia), Shatavari (Asparagus racemosus), Gorakhmundi (Sphaeranthus indicus), Ashwagandha (Withania Somnifera), Draksha (Vitis vinifera) and Sariva (Hemidesmus indicus). The ingredients are almost cooling in nature which normalizes the pitta dosha.

Dosage - 2-3 teaspoonful twice a day after meal.

5. Suvarna Basant Malti Ras

This medicine from Planet Ayurveda is a mixed herb-mineral preparation containing purified heavy metals and herbs. It contains ingredients like Swarna bhasma (calcined gold), Mukta bhasma (calcined pearl), purified Hingul (cinnabar), Maricha (Piper longum), Kharpara bhasma (calcined zinc), Pippali (Piper longum), Sunti (Zingiber officinale) etc. It is a potent Rasayana (rejuvenative) and is effective in liver and spleen problems as well as general debility. For maximum benefits, it is advisable to take under the guidance of an Ayurvedic expert.

Dosage - 1 tablet to be chewed with honey after meal once or twice daily.

HOW AYURVEDIC TREATMENT IS BEST OF ALL AVAILABLE TREATMENTS

Contemporary system of medicine generally uses steroids, intravenous immune globulins and certain other drugs that increase platelet count for combating ITP. Immunosuppressants are also made use, when required, to suppress the activity of the immune system. A permanent or complete cure cannot be assured even after taking these treatments which are highly expensive and risky, with side-effects. As a last resort, splenectomy is also opted more often when the situation worsens. Here, Ayurveda offers a holistic approach with natural medicines by considering bodily as well as mental stigma of the patient. Strength of the patient is tried to be maintained well throughout the treatment. Equal importance is given to preventive, curative as well as restorative aspects. Diet and lifestyle modifications are adopted which are customised to the disease and the individual.

Ayurveda comes as a rescuer for ITP patients with utmost chances of a hassle free living just like any other normal people.

Ayurvedic treatment for ITP (Idiopathic thrombocytopenic purpura)

INTRODUCTION

Idiopathic thrombocytopenic purpura (ITP) is a bleeding disorder in which the immune system destroys platelets, which are necessary for the blood clotting. It is an autoimmune disease with antibodies detectable against several platelets surface antigens. It is also known as immune thrombocytopenic purpura. Normally, the blood clots due to the presence of the platelets in the blood; if platelet count decreases, then blood clot formation takes place slowly and as a result there is an excessive bleeding. It affects both children and adults. In children it usually recovers by itself without treatment but in adults, the disorder is chronic. Idiopathic thrombocytopenic purpura is more common in women than men and more common in children than adults. In children the disorder often, occurs after viral infection such as mumps and the flu. In adults, it is more often chronic disease and occurs after the viral infection and with the use of certain drugs like in pregnancy.

WHAT ARE THE CAUSES OF IDIOPATHIC THROMBOCYTOPENIC PURPURA?

The exact cause of idiopathic thrombocytopenic purpura is not known.

In this disease, the immune system does not work properly and start attacking the platelets, as if they are foreign substance for the body. Antibodies produced by the system get attached to the Platelets. The spleen, which helps to fight against the infection recognizes the antibodies and removes the platelets from the system. In ITP the platelet count is below 20,000, while normally it is 150,000 platelets per micro liter of circulating blood.

WHAT ARE THE DIFFERENT TYPES OF THE IDIOPATHIC THROMBOCYTOPENIC PURPURA?

The different types of the Idiopathic thrombocytopenic purpura are as follows:

• Acute ITP: It is the most common type of disorders. It usually lasts less than six months and mainly occurs in the children.
• Chronic ITP: It usually lasts for six months or more than that. It is mainly seen in teenagers and adults.

WHAT ARE THE SIGNS AND SYMPTOMS OF THE IDIOPATHIC THROMBOCYTOPENIC PURPURA?

• Formation of the purpura (bruises).
• Superficial bleeding in the skin that appears as of pin-point sized reddish purple spots usually on the lower legs.
• Bleeding from the nostrils and gums.
• Blood in urine and stools.
• Menorrhagia (Excessive bleeding).
• Prolonged bleeding from the cuts.
• Excessive bleeding during surgery.

WHAT CAN BE THE RISK FACTORS OF THE IDIOPATHIC THROMBOCYTOPENIC PURPURA?

Idiopathic thrombocytopenic purpura can occur at any age, there can be few risk factors:

• Sex: Women are more prone to this disease than men.
• Recent Viral Infection: Viral infections like mumps and the flu are the risk factor for this disease.

WHAT CAN BE THE COMPLICATIONS OF THE IDIOPATHIC THROMBOCYTOPENIC PURPURA?

The most common complication of the ITP is intracranial hemorrhage.

Normally for the treatment corticosteroids are used, prolonged use of corticosteroids will produce some of the side effects, which are as follows:

• Cataract.
• Osteoporosis.
• An increased risk of infection.
• High blood sugar.
• A loss of muscle mass.

WHAT ARE THE METHODS TO DIAGNOSE THE IDIOPATHIC THROMBOCYTOPENIC PURPURA?

Following are the methods to diagnose the idiopathic thrombocytopenic purpura:

• Medical history.
• Physical examination.
• Complete blood count.
• Bone marrow examination.

AYURVEDIC TREATMENT FOR ITP (IDIOPATHIC THROMBOCYTOPENIC PURPURA)

Planet Ayurveda is a herbal manufacturing company. It provides herbal formulation for the various health diseases. As we know in idiopathic thrombocytopenic purpura platelets count decrease. Planet ayurveda provides an effective Ayurvedic treatment for ITP (Idiopathic thrombocytopenic purpura). These are herbs especially to increase the platelet count.

HERBAL REMEDIES FOR ITP

ITP Combo Pack For Adults

1. Immune Booster - 2 capsules twice daily
2. Ashwagandha Capsules - 2 capsules twice daily
3. Giloy Capsules - 1 capsules twice daily
4. Gandhak Rasayan - 2 tablets twice daily
5. Green Essentials - 2 capsules twice daily
6. Kumar Kalyan Ras - 1 tablets twice daily
7. Brahmi Chyawanprash - 1 teaspoonful twice daily
8. Suvarna Basant Malti Ras - 1 tablet twice daily

These should be consumed for 1 or 2 months and the results will be visible. The allopathic medicines of the patients can be reduced slowly. The above mentioned combination contains Ayurvedic herbo mineral and metallic preparations as well. All preparations are safe for human consumption and are approved by government of India for their use in various health conditions.

ITP Combo For Children (3 Years To 14 Years)

1. Giloy Capsules - 1 capsule twice daily
2. Ashwagandha Capsules - 1 capsule twice daily
3. Gandhak Rasayan - 1 tablet twice daily
4. Immune Booster - 2 capsules twice daily
5. Green Essentials - 1 capsule twice daily
6. Brahmi Chyawanprash - 1 tablespoonful twice daily
7. Pitta Balance - 1 capsule twice daily
8. Kumar Kalyan Ras - 1 tablet twice daily
9. Suvarna Basant Malti Ras - 1 tablet twice daily

ITP Combo For Infants (Less Than 3 Years)

Since ITP affects many children but there are herbs and herbo mineral preparations which can help the infants and small children very much. Slowly reduce their dosage of steroids as soon as the effect of herbs / herbomineral compound is visible.

1. Giloy Capsules - 1 capsule twice daily
2. Ashwagandha Capsules - 1 capsule twice daily
3. Gandhak Rasayan - 1 tablet once daily
4. Immune Booster - 1 capsule twice daily
5. Kumar Kalyan Ras - 1 tablet once daily
6. Infee Syrup - 2 teaspoonful twice daily
7. Arvindasava Syrup - 2 teaspoonful twice daily
8. Praval Panchamrit - 1 tablet twice daily

Open up the capsules and pour the ingredients in a bowl and mix them with the Syrups. Crush the tablets and mix the powder in the syrup and then feed the child this mixture twice daily.

WHAT ARE THE PRECAUTIONS FOR THE IDIOPATHIC THROMBOCYTOPENIC DISORDER?

The cause of ITP is not known, hence there is no specific way to prevent this. However, bleeding and injury can be serious for the ITP sufferer, to decrease the chances of the bleeding injuries:

• Children should wear helmets while playing.
• Avoid playing contact sports like football.
• Avoid medications like aspirin and ibuprofen as these medications decrease platelet activity.