Changes in Hemoglobin Concentration Following Drakshapanak Administration in Adults with Previously Diagnosed Iron Deficiency Anemia

Authors

  • Kamla R. Nagar Associate Professor, Department of Diet and Nutrition (Ayurveda Poshanahara), National Institute of Ayurveda (DU), Jaipur, Rajasthan, India. Author
  • Durgawati Devi Professor and Head, Department of Diet and Nutrition (Ayurveda Poshanahara), National Institute of Ayurveda (DU), Jaipur, Rajasthan, India. Author
  • Shivani Saxena M.Sc. Scholar, Department of Diet and Nutrition (Ayurveda Poshanahara), National Institute of Ayurveda (DU), Jaipur, Rajasthan, India. Author
  • Suman Rulaniya PhD Scholar, Department of Kaumarbhritya, National Institute of Ayurveda (DU), Jaipur, Rajasthan, India. Author
  • Promila Yadav MD Scholar, Department of Kaumarbhritya, National Institute of Ayurveda (DU), Jaipur, Rajasthan, India. Author
  • Mamta Tanwar MD Scholar, Department of Kaumarbhritya, National Institute of Ayurveda (DU), Jaipur, Rajasthan, India. Author

Keywords:

Ayurveda, Drakshapanak, Hemoglobin, Iron deficiency anemia, Pandu roga, Pilot study

Abstract

Background: Iron deficiency is a major contributor to anemia globally. Ayurveda describes Pandu Roga with clinical features that overlap with anemia, and dietary formulations (Ahara Kalpana) may have a supportive role. Drakshapanak is a polyherbal beverage containing fruit-based, sweetening, and aromatic ingredients and was investigated in a pilot clinical study.
Materials and Methods: This prospective, single-arm, pre–post interventional pilot study enrolled 10 adults aged 18–45 years at the National Institute of Ayurveda, Jaipur, India. Participants had previously diagnosed iron deficiency anemia, with baseline hemoglobin concentrations within the study-defined mild-to-moderate range. Drakshapanak was administered daily for 60 days, with follow-up visits on days 15, 30, 45, and 60. The primary outcome was the change in hemoglobin concentration from baseline to day 60. Baseline and post-intervention values were compared using a paired t-test.
Results: All 10 participants completed the study. Mean hemoglobin concentration increased from 11.05 ± 1.14 g/dL at baseline to 11.63 ± 1.32 g/dL on day 60. The mean paired increase was 0.58 ± 0.38 g/dL (95% confidence interval, 0.31–0.85), representing a 5.25% increase from baseline (t = 4.83; P = 0.0009).
Discussion: The statistically significant mean increase of 0.58 g/dL in hemoglobin suggests a potential supportive effect of Drakshapanak; however, the small sample size, absence of a control group, and lack of iron-status biomarkers limit definitive interpretation of the findings.
Conclusion: Drakshapanak administration was associated with a modest increase in hemoglobin concentration over 60 days. Larger controlled studies incorporating iron-status biomarkers are required

References

1. World Health Organization. Guideline on haemoglobin cutoffs to define anaemia in individuals and populations. Geneva: World Health Organization; 2024.

2. World Health Organization. WHO guideline on use of ferritin concentrations to assess iron status in individuals and populations. Geneva: World Health Organization; 2020.

3. Snook J, Bhala N, Beales IL, Cannings D, Kightley C, Logan RP, Pritchard DM, Sidhu R, Surgenor S, Thomas W, Verma AM, Goddard AF. British society of gastroenterology guidelines for the management of iron deficiency anaemia in adults. Gut. 2021;70(11):2030-51. doi: 10.1136/gutjnl-2021-325210

4. Charaka. Charaka samhita of agnivesha, with vidyotini hindi commentary by kashinath shastri and gorakhnath chaturvedi. Chikitsa sthana. Ch. 16., Ver. 12. Varanasi: Chaukhambha Bharati Academy; 2018. p. 488.

5. Kaiyadeva. In: Sharma PV, Sharma GP, editors. Kaiyadeva nighantu (pathyapathya-vibodhaka). Kritanna varga. Ch. 5., Ver. 115. Varanasi: Chaukhambha Orientalia; 2006.

6. Boato F, Wortley GM, Liu RH, Glahn RP. Red grape juice inhibits iron availability: Application of an in vitro digestion/Caco-2 cell model. J Agric Food Chem. 2002;50(23):6935-8. doi: 10.1021/ jf025832q

7. Ma Q, Kim EY, Lindsay EA, Han O. Bioactive dietary polyphenols inhibit heme iron absorption in a dose-dependent manner in human intestinal Caco-2 cells. J Food Sci. 2011;76(5):H143-50. doi: 10.1111/j.1750-3841.2011.02184.x

8. Khattab HA, El-Shitany NA, Abdallah IZ, Yousef FM, Alkreathy HM. Antihyperglycemic potential of Grewia asiatica fruit extract against streptozotocin-induced hyperglycemia in rats: Anti-inflammatory and antioxidant mechanisms. Oxid Med Cell Longev. 2015;2015:549743. doi: 10.1155/2015/549743

9. Imran I, Javaid S, Waheed A, Rasool MF, Majeed A, Samad N, Saeed H, Alqahtani F, Ahmed MM, Alaqil FA. Grewia asiatica berry juice diminishes anxiety, depression, and scopolamine-induced learning and memory impairment in behavioral experimental animal models. Front Nutr. 2021;7:587367. doi: 10.3389/fnut.2020.587367

10. Vayalil PK. Antioxidant and antimutagenic properties of aqueous extract of date fruit (Phoenix dactylifera L., Arecaceae). J Agric Food Chem. 2002;50(3):610-7. doi: 10.1021/jf010716t

11. Amorós A, Pretel MT, Almansa MS, Botella MA, Zapata PJ, Serrano M. Antioxidant and nutritional properties of date fruit from Elche grove as affected by maturation and phenotypic variability of date palm. Food Sci Technol Int. 2009;15(1):65-72. doi: 10.1177/1082013208102758

12. Chen J, Lam CT, Kong AY, Zhang WL, Zhan JY, Bi CW, Chan GK, Lam KY, Yao P, Dong TT, Tsim KW. The extract of Ziziphus jujuba fruit (jujube) induces expression of erythropoietin via hypoxia-inducible factor-1α in cultured Hep3B cells. Planta Med. 2014;80(17):1622-7. doi: 10.1055/s-0034-1383049

13. Harish Nayaka MA, Sathisha UV, Manohar MP, Chandrashekar KB, Dharmesh SM. Cytoprotective and antioxidant activity studies of jaggery sugar. Food Chem. 2009;115(1):113-8. doi: 10.1016/j. foodchem.2008.11.067

14. Elbagory M, El-Khateeb N, El-Nahrawy S, Omara AE, Alhag SK, Elbyaly MY, Goala M, Kumar P, Singh R, Andabaka Z, Širić I. Assessment of carbohydrates, minerals, and potentially toxic elements: Risk evaluation in traditionally produced sugarcane jaggery. Food Prod Process Nutr. 2026;8:14. doi: 10.1186/s43014- 025-00357-6

15. Duarte-Almeida JM, Novoa AV, Linares AF, Lajolo FM, Genovese MI. Antioxidant activity of phenolics compounds from sugar cane (Saccharum officinarum L.) juice. Plant Foods Hum Nutr. 2006;61(4):187-92. doi: 10.1007/s11130-006-0032-6

16. Kadam US, Ghosh SB, De S, Suprasanna P, Devasagayam TP, Bapat VA. Antioxidant activity in sugarcane juice and its protective role against radiation induced DNA damage. Food Chem. 2008;106(3):1154-60. doi: 10.1016/j.foodchem.2007.07.066

17. Alizadeh Behbahani B, Falah F, Lavi Arab F, Vasiee M, Tabatabaee Yazdi F. Chemical composition and antioxidant, antimicrobial, and antiproliferative activities of Cinnamomum zeylanicum bark essential oil. Evid Based Complement Alternat Med. 2020;2020:5190603. doi: 10.1155/2020/5190603

18. Jamal A, Javed K, Aslam M, Jafri MA. Gastroprotective effect of cardamom, Elettaria cardamomum Maton. Fruits in rats. J Ethnopharmacol. 2006;103(2):149-53. doi: 10.1016/j. jep.2005.07.016

19. Kazemi S, Yaghooblou F, Siassi F, Rahimi Foroushani A, Ghavipour M, Koohdani F, Sotoudeh G. Cardamom supplementation improves inflammatory and oxidative stress biomarkers in hyperlipidemic, overweight, and obese pre-diabetic women: A randomized doubleblind clinical trial. J Sci Food Agric. 2017;97(15):5296-301. doi: 10.1002/jsfa.8414

20. Devi SL, Kannappan S, Anuradha CV. Evaluation of in vitro antioxidant activity of Indian bay leaf, Cinnamomum tamala (Buch. -Ham.) T. Nees & Eberm using rat brain synaptosomes as model system. Indian J Exp Biol. 2007;45(9):778-84.

21. Rao CV, Vijayakumar M, Sairam K, Kumar V. Antidiarrhoeal activity of the standardised extract of Cinnamomum tamala in experimental rats. J Nat Med. 2008;62(4):396-402. doi: 10.1007/s11418-008- 0258-8

22. Chahar MK, Kumar DS, Lokesh T, Manohara KP. In-vivo antioxidant and immunomodulatory activity of mesuol isolated from Mesua ferrea L. Seed oil. Int Immunopharmacol. 2012;13(4):386-91. doi: 10.1016/j.intimp.2012.05.006

23. Chakraborty D, Arefin P, Bhattacharjee SC, Hasan M, Sarkar R, Das S, Rahman S, Habib MS, Islam S, Jahan F, Ray G, Ferdous J, Farhana F, Islam MA. Biological activity of Mesua ferrea (Nageswar) seed extracts: An in vitro and in silico study. Inform Med Unlocked. 2023;36:101166. doi: 10.1016/j.imu.2023.101166.

24. Khajuria A, Thusu N, Zutshi U. Piperine modulates permeability characteristics of intestine by inducing alterations in membrane dynamics: Influence on brush border membrane fluidity, ultrastructure and enzyme kinetics. Phytomedicine. 2002;9(3):224- 31. doi: 10.1078/0944-7113-00114

25. Shoba G, Joy D, Joseph T, Majeed M, Rajendran R, Srinivas PS. Influence of piperine on the pharmacokinetics of curcumin in animals and human volunteers. Planta Med. 1998;64(4):353-6. doi: 10.1055/s-2006-957450

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Published

2026-09-30

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Section

PILOT STUDY