ABSTRACT
There are a number of hemorrhagic conditions that can affect a person's life. Most of the causes of hemorrhagic or bleeding disorders are either hereditary or acquired or autoimmune. Some of the bleeding disorders are haemophilia, von willebrand disease. Glanzmann Thrombasthenia is one among hemorrhagic disorders. Glanzmann Thrombasthenia is a rare bleeding disorder characterised by spontaneous and prolonged bleeding that starts from the birth. Glanzmann Thrombasthenia can cause easy bruising, recurrent epistaxis (bleeding from nose) and gingival bleeding more frequently. In the following text, we shall look into some details of Glanzmann Thrombasthenia and its management in the contemporary system of medicine as well as in the traditional system of Indian Ayurvedic medicine. Let's discuss!!
INTRODUCTION
Glanzmann Thrombasthenia is an abnormal and rare condition of the platelets when platelets have low levels of glycoprotein or defective glycoproteins. The condition can manifest itself with frequent nosebleeds, heavy blood loss during menses, petechiae under the skin and bruises. Further the condition also results in heavy and unstoppable bleeding caused by minor or major trauma. A quarter of patients suffering from Glanzmann Thrombasthenia may have bleeding in the gastrointestinal tract which is usually seen later in life. In rarest of the rare conditions, people with the condition may have bleeding in the joints (hemarthrosis) and in the skull which is pronounced as intracranial haemorrhage. In Ayurveda, the condition can be well compared with raktapitta. The condition occurs due to pitta dosha dushti. In the text below we shall have a detailed overview of the condition in Ayurveda.
CAUSES OF GLANZMANN THROMBASTHENIA
- Glanzmann Thrombasthenia is a inherited condition of an autosomal recessive or can be acquired due to an autoimmune disorder.
SIGNS AND SYMPTOMS
- Easy bruises
- Epistaxis (nose bleeding)
- Gum bleeding
- Bleeding in the gastrointestinal tract
- Heavy post operative bleeding
- Postpartum bleeding
- Heavy bleeding during menstruation
- Spontaneous bleeding is rare but can occur
INVESTIGATIONS
- Golden standard diagnostic technique for Glanzmann Thrombasthenia is Light transmission aggregometry.
MANAGEMENT
- Avoiding consumption of antiplatelet agents and antiinflammatory drugs.
- Folate and iron supplements for the anaemic condition caused by excessive bleeding.
- Maintaining dental hygiene reduces chances of gum bleeding
- Desmopressin improves hemostasis
- Hormonal contraceptives help in excessive bleeding during menses
- Transfusing platelets in case excessive or heavy bleeding.
- Hematopoietic stem cell transplantation (HSCT) in recurrent severe haemorrhages.
AYURVEDIC OVERVIEW
Glanzmann Thrombasthenia is a serious and worrisome condition which manifests itself with uncontrolled bleeding even from a minor injury and bleeding from the nose, heavy menstrual bleeding, bleeding from the gums. This occurs due to a hereditary and autoimmune condition. In Ayurveda, the condition is best compared with raktapitta. Raktapitta is a condition that occurs due to pitta dosha vitiation with rakta as dushya. The condition is related to the dushti of raktavaha srotas. Due to pitta aggravating factors, pitta gets vitiated and gets into the blood (rakta dhatu). Due to heating or warming properties of pitta the dhatus gets liquified and starts coming out of the body openings. This blood is vitiated and impure. As per the properties of rakta that have bled, raktapitta is differentiated into types such as vataja raktapitta, pittaja raktapitta and others. And depending upon the route from which bleeding occurs, it differs into urdhva, adhoga and tiryag raktapitta. In Glanzmann Thrombasthenia, the bleeding occurs from the lower openings as well upper opening in the body which makes it relatable with tiryaq raktapitta. Therefore, management is based on the pacification of the pitta dosha. There are a number of causes for the condition of raktapitta. One of the main causes is consumption of hot, sour, spicy, salty and bitter substances. Stress is also a leading cause of the condition, consumption of salty food with milk. Endotoxins get accumulated in the body with faulty dietary habits, which is the culprit behind a number of conditions. Endotoxins here also can give origin to the acquired form of Glanzmann Thrombasthenia. As the condition is caused by pitta dosha, the management depends on the pacification of the pitta dosha. There are a number of ayurvedic formulations available which pacify the pitta dosha and help in controlling the excessive bleeding. Shankh bhasma, praval panchamrit, praval pishti, trinkant pishti, bol parpati, eladi vati, laksha churna, ushiradi churna, draksharishta, lodhrasav, ushirasava, , durvadi ghrita, kamdev grita, mochras etc. Chandan water, parpat water are beneficial in the bleeding condition of Glanzmann Thrombasthenia.
HERBAL REMEDIES FOR GLANZMANN THROMBASTHENIA BY PLANET AYURVEDA
Planet Ayurveda is an eminent GMP certified, ISO 9001:2015 certified,and US-FDA registered Ayurvedic Company, which adheres to the objective of manufacturing quality Ayurvedic products as mentioned in a number of ancient texts of Ayurveda. Formulations are manufactured without additives and preservatives and other kinds of chemicals or artificial flavouring agents which can have a number of side effects on the human body. Products manufactured at Planet Ayurveda are pure and devoid of any kind of adulteration. The products are purely organic and vegetarian and gluten free and halal certified. Planet Ayurveda has come up with some of its formulations that can benefit people suffering from Glanzmann Thrombasthenia.
Following is the list of formulations that are helpful in managing Glanzmann Thrombasthenia:
- IMMUNE BOOSTER
- GILOYGHAN VATI
- KUMAR KALYAN RAS
- SWARN VASANT MALTI RAS
- GREEN ESSENTIALS
- PUNARNAVA MANDUR
- SPIRULINA CAPSULES
PRODUCTS DESCRIPTION
1. IMMUNE BOOSTER
Immune Booster is a product of Planet Ayurveda that boosts immunity to fight a number of health problems. Immune booster is filled with herbs including Amalaki (Emblica officinalis), Bhumi amla (Phyllanthus niruri), Grape seed (Vitis vinifera) and bovine colostrum. Bhumli amla is best indicated in digestive issues which further helps in better absorption and assimilation of nutrients. It is beneficial in recurrent urinary tract infection. Immune booster simply acts against diseases like cancer, asthma, infections, hereditary conditions, acquired problems etc. Ingredients contain essential nutrients. Nutrients including multivitamins enhance immunity. Amalaki is rasayana as per ayurveda texts that assists overall well being of a person. Immunity is everything that is required to fight a number of problems. By good immunity conditions like Glanzmann Thrombasthenia are less harmful and improve the condition of the patient.
Dosage: Two capsules twice a day with plain water after meals.
2. GILOYGHAN VATI
Giloyghan vati is filled with the rasayana properties of herb giloy (Tinospora cordifolia) and is ghan (concentrated part) of giloy. As giloy is rasayan it affects every system of the body positively. Furthermore, giloy cleanses the blood and removes toxins out of it. Giloy pacifies all the three dosha thus benefiting in the condition of Glanzmann Thrombasthenia. As it cleanses the blood and pacifies the pitta dosha thus overcomes the condition of easy and excessive bleeding as in the disorder of Glanzmann Thrombasthenia.
Dosage: Two tablets twice a day with lukewarm water after meals.
3. KUMAR KALYAN RAS
Kumar Kalyan Ras is a classical ayurvedic formulation that enhances immunity, thus helps in fighting the various disease causing agents and prevent certain infections and immunity related conditions. The formulation also helps in jwara (fever) , kasha and swasha etc. The formulation is composed of the ingredients such as: Ras sindoor, Moti pishti, Swarna makshik bhasma etc. This formulation consists of purified metal components so it contains good values that improves good health. It can be used as immunostimulatory because it helps to develop nonspecific immunity and its rasayana effect improves memory and overall wellness. As it stimulates and boosts the immunity, it is helpful in managing the autoimmune type of Glanzmann Thrombasthenia.
Dosage: One tablet twice a day to be chewed.
4. SWARN VASANT MALTI RAS
Swarn Vasant Malti Ras is a herbo-mineral formulation which is filled up with the goodness and properties of various herbs and minerals. The product is composed of shuddha parada (purified mercury), Mukta bhasma (calx of pearl), Swarna bhasma (gold calx), Shuddha hingula (an ore of sulphur and mercury), shuddha gandhak (purified sulphur), trikatu (dried ginger, Black pepper and long pepper), tamra bhasma (copper calx) and loha bhasma (iron calx). Furthermore it contains juice extract of datura (Datura metel), kutki (Picrorhiza kurroa), nimbu swaras (Lemon juice), Kantkari (Solanum xanthocarpum). Swarn vasant malti ras is a miraculous formulation in a number of conditions. Swarn Vasant Malti Ras is known for its immune boosting property. By its immune boosting property it benefits the people suffering from Glanzmann Thrombasthenia. It increases the blood volume and helps the people with low blood volume and those who have gone anaemic due to Glanzmann Thrombasthenia.
Dosage: One tablet twice a day to be chewed.
5. GREEN ESSENTIALS
The ingredient of Green Essentials is Wheat Grass powder (Triticum aestivum). It detoxifies the liver and also relieves stress. It aids digestion and balances all the doshas of the body i.e Vata, Pitta, and Kapha. It provides complete nourishment because of its enrichment in powerful nutrients. It boosts metabolism. It has anti bacterial, anti inflammatory, antioxidant properties. It is an excellent source of Vit A,C,B, K, E, iron, chlorophyll, 17 amino acids, phytonutrients, and calcium. Furthermore, it enhances the immunity to fight certain conditions. It is useful in autoimmune conditions. In Glanzmann Thrombasthenia, it helps in preventing the overbleding and managing the condition appropriately. As it is enriched in nutrients thus it fulfils the lost beneficial products in the bleeding. Therefore, it helps in the rare disease of Glanzmann Thrombasthenia.
Dosage: One capsule twice a day with plain water after meals.
6. PUNARNAVA MANDUR
Punarnava mandoor is a classical ayurvedic formulation which includes punarnava (Boerhaavia diffusa), Shunthi (Zingiber officinale), Pippali (Piper longum), Maricha (Piper nigrum), amalaki (Emblica officinalis), haritaki (Terminalia chebula), chavya (Piper chaba), haridra (Curcuma longa), vidanga (Embelia ribes), mandoor bhasma (Ferric oxide calx), chitrak mool (Plumbago zeylanica). Punarnava mandoor is a beneficial formulation for improving the blood quality by its blood purifying properties. Further it helps in increasing the blood haemoglobin in anaemic conditions. Therefore it is beneficial in bleeding disorders by fulfilling the deficiency caused by the excessive bleeding. Punarnava mandoor is a beneficial formulation in Glanzmann Thrombasthenia.
Dosage: Two tablets twice a day with lukewarm water after meals.
7. SPIRULINA CAPSULES
Spirulina capsules are filled with Spirulina (Arthrospira platensis), a cyanobacteria species, which is widely used in various health issues. Spirulina is known as a 'superfood' and also called a 'miracle from the sea'. It is useful in conditions. Spirulina boosts immunity and helps in a number of conditions that are of autoimmune origin. It increases the production of white blood cells. Furthermore, it is enriched with vitamins C, E and B6. Spirulina increases the blood haemoglobin levels that are lost in the excessive bleeding led by Glanzmann Thrombasthenia. Spirulina capsules enhance immunity, purifies the blood and maintains high energy levels in the body. Thus it is useful in Glanzmann Thrombasthenia.
Dosage: Two capsules twice a day with plain water after meals.
CONCLUSION
As we discussed Glanzmann Thrombasthenia, it is one of the rare conditions held responsible for the excessive bleeding which can be in the form of epistaxis, heavy bleeding in menstruation, easy bruising, excessive bleeding even from a minor injury. In short this is a bleeding disorder of abnormal platelets which have autoimmune and hereditary origin. In Ayurveda the condition is compared with raktapitta which is a pitta dominant disorder. In overcoming the condition, pitta dosha pacification is the mainstay of the management. In the contemporary system of medicine there is no appropriate management available of the condition whereas in Ayurveda, there are a number of formulations available as we discussed above that effectively manages the condition and symptoms associated with Glanzmann Thrombasthenia.