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Shilajit in management of iron deficiency anaemia

  • PGP College of Pharmaceutical Sciences and Research Institute
Velmurugan Vivek. et al. / JPBMS, 2010, 1 (01)
1 Journal of Pharmaceutical and Biomedical Sciences (JPBMS), Vol. 01, Issue 01
Available online at
, B.Vivek
, D.Sheshadri Shekar
, SP. Sudha
& T. Sundaram
Department of Pharmacology, Sri K.V College of Pharmacy, M.G.Road, Chickballapur. (KA)-562101
Department of Pharmaceutical chemistry, Sri K.V College of Pharmacy, M.G.Road, Chickballapur. (KA)-562101
Department of Pharmaceutics, Sri K.V College of Pharmacy, M.G.Road, Chickballapur. (KA)-562101
The Shilajit as a dietary supplement was examined for iron deficiency anaemia in experimental animals. In this study diet
induced and bleeding technique were used to evaluate the iron deficiency anaemia. In diet induced, low iron diet from
sigma and in bleeding technique bled 2ml of blood from each animal for 5 alternative days was used to induce iron
deficiency anaemia (IDA), the animals which did not developed anaemia i.e. haemoglobin level < 9g/dl, were rejected and
replaced with new animals. The Shilajit 500 mg/kg shows significant (p<0.01) increase in Hb, RBC & PCV values in both
the model. According to our results Shilajit in doses of 500 mg/kg reveals anti-anaemic activity.
Key words: Shilajit, iron deficiency anaemia, haemoglobin, bleeding technique & low iron diet.
Anaemia is a decrease in number of red blood cells (RBCs)
or less than the normal quantity of hemoglobin in the
blood. Anemia is estimated to affect nearly two thirds of
the pregnant women in developing countries[1].Iron
deficiency anemia is responsible for 95% of the anemias
during pregnancy[2-3], [(Breymann C) (Yaqoob N), 2002].
In underdeveloped countries, anemia is a major
contributory factor to maternal morbidity and
mortality[4].Shilajit, a traditional medicine has been used
for cardioprotective, anti-asthmatic, anti-diabetic,
hepatoprotective, anaemic and potent CNS activity for
ages[5].In the Charak Samhita, Shilajit is described as a
product of four minerals: gold, silver, copper and iron,
whereas Susruta Samhita included two more minerals,
lead and zinc in its composition[6].The present study has
been designed to evaluate the anti anaemic activity of
shilajit in bleeding and diet induced IDA model in rats. The
drug has been able to raise the Hb.
satisfactory level
when used in severely anemic iron deficient in rats.
Materials and Methods
Shilajit Dose Determination
The dose of shilajit was determined by acute toxicity study.
As per OECD 425 guidelines the acute toxicity study was
studied and it was found that the LD
is 5000 mg/kg body
weight. The effective dose calculated from one by tenth of the
Animal experiments
The animal experimental protocol was approved by
*Corresponding Author
Department of Pharmacology,Sri K.V College of Pharmacy,
M.G.Road,Chickballapur. KA-562101
Mobile: 09663337129
Institutional Animal Ethical Committee as per the guidance of
the Committee for the Purpose of Control and Supervision of
Experiments on Animals (CPCSEA) 117/99/kvcp.
Iron deficiency model
Bleeding Induced IDA
This test was followed by the method described by
McCance, R. A., 1937 with some modifications. In the
model a total of 18 rats were divided into three groups of
six each. The Group II &III rats were rendered Anemia by
removing 2ml of blood from retro orbital plexus of each
rat for 5 alternative days. Group III rats were treated with
Shilajit 500mg/kg/day from the11th day after conforming
anemia to 20
day from the initial bleeding. The blood
samples were collected on 21
day for estimating the
haematological parameters.
Low Iron Diet Induced IDA
Three groups of six rats each were used for study. Group I
was maintained on normal rat diet, whereas Group II & III
were maintained on an iron deficient diet.[7-8], for 13
days before study. The diet was served in porcelain dishes.
The rats were fasted 1 day before study and Shilajit was
administered to Group III rats, 14 days after beginning the
iron-deficient diet upto 20
day. The blood samples were
collected at the end of the 20
day for estimating the
hematological parameters.
Bleeding induced IDA
Shilajit significantly increased the level of Hb, HCT and
RBC against the anaemia induced by bleeding. The values
are shown in the Table 1
Low iron diet induced IDA
Velmurugan Vivek. et al. / JPBMS, 2010, 1 (01)
2 Journal of Pharmaceutical and Biomedical Sciences (JPBMS), Vol. 01, Issue 01
Results (Table 2) reveled that Shilajit shows the significant (p < 0.01) anti-anaemic activity at dose of 500mg/kg.
Table 1: Effect of Shilajit on bleeding induced IDA Table 2 : Effect of Shilajit on low iron diet induced IDA
Groups Hb g/dl HCT % RBC
8.2 ± 0.2460
23.85± 0.2997
5.46 ±0.2305
15.3± 0.2217
45.16± 0.6344
Values are in mean ±SEM; (n=6), ** p<0.01 vs. induced Values are in mean ±SEM; (n=6), ** p<0.01 vs. induced
control control
The Shilajit’s increased the Hb, HCT and RBC when
assessed using the bleeding model and in low iron diet
induced model. About 1 mg of iron is lost each day through
sloughing of cells from skin and mucosal surfaces,
including the lining of the gastrointestinal tract[9].
Menstruation increases the average daily iron loss to
about 2 mg per day in premenopausal female adults[10].
The iron depletion leads to Hb deficiency. Hemoglobin
(found inside RBCs) normally carries oxygen from the
lungs to the tissues, anemia leads to hypoxia (lack of
oxygen) in organs, because all human cells depend
on oxygen for survival. Shilajit containing iron, when taken
as a dietary supplement it increase the haemoglobin level
and it neutralizes the regular loss and during
menstruation. Hence the present study shows that Shilajit
exhibited activities in various degrees against both models
of IDA.
In conclusion, this study has shown that the Shilajit having
significant anti-anaemic activity in both model. Our data
obtained from the present study suggest that the Shilajit
can be taken as a dietary supplement in the management
of iron deficiency anaemia.
1.Breymann C. Iron deficiency and anemia in pregnancy:
Modern aspects of diagnosis and therapy. Blood Cells Mol
Dis 2002; 29: 506-16.
2.Breymann C. Anemia working group. Current aspects of
diagnosis and therapy of iron deficiency anemia in
pregnancy. Schweiz Rundsch Med Prax 2001; 90:1283-91.
3.Yaqoob N, Abbasi SM. Nutritional iron deficiency in our
population. J. Coll Physicians Surg Pak 2002; 12: 395-7.
4.Saeed M, Khan TA, Khan SJ. Evaluation of risk factors in
antenatal care. Mother and child 1996; 34: 139-142.
5..Acharya SB, Frotan MH, Goel RK, Tripathi SK, Das PK.
Pharmacological actions of Shilajit. Indian J Exp Biol. 1988;
26(10): 775-7.
6.Ghosal S, Singh SK, Kumar Y, Srivatsava R.
Antiulcerogenic activity of fulvic acids and 4-metoxy-6-
carbomethyl biphenyl isolated from shilajit. Phytother Res.
7.McCance RA, Widdowson EM. Absorption and excretion
of iron. Lancet 1937; 2, 680.
8.Pollack S R, Kaufman M, Crosby WH.Iron absorption: the
effect of an iron-deficient diet. Science 1964; 144, 1015
9.Cook JD, Skikne BS, Estimates of iron sufficiency in the
US population. Blood. 1986; 68, 726.
10.Bothwell T H. and Charlton, R. W. (). A general
approach of the problems of iron deficiency and iron
overload in the population at large. Seminars in
Hematology. 1982; (19) 54.
Hb g/dl
7.90 ± 0.12
23.91± 0.60
5.33 ±0.23
12.81± 0.45
45.95± 0.84
... In adequate iron intake, or lack of dietary iron in a form that can be absorbed, as well as chronic iron loss by excess volume of mestrual fluid or other chronic bleeding, causes irondeficiency anemia, with decreased rates of erythrocyte formation and haemoglobin synthesis (3) . ...
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The study was conducted to show the relation and the effect of menarche on some biochemical parameters on blood serum of secondary school girls at menarche. From two different socioeconomic status (48) samples were collected from girls students [18 which live in higher socioeconomic status as (group I) and 30 in low socioeconomic status as (group II) with menstrual cycle and (20) school girls without menstrual cycle from different socioeconomic status as control 8 which live in higher socioeconomic status, 12 in low socioeconomic status to each group] with ages ranges between (12-15) year. The biochemical parameters studied were iron, total iron binding capacity (TIBC), unsaturation iron binding capacity (UIBC), transferrin, haemoglobin (Hb), vitamin C and E. No significant difference between biochemical parameters when measures within group I and II when compared with their controls, but there were significant decrease between group II and I when compare together in all biochemical parameters except that Hb and vitamin E. Also the results showed no correlation between measured biochemical parameters and age at menarche and nutrition.
... Besi merupakan mikronutrien yang berperan pada pembentukan hemoglobin sebagai molekul pembawa oksigen, dan juga sebagai unsur pembentuk protein yang mengandung besi, seperti sitokrom, xantin oksidase, dan ribonukleotida reduktase (Provan, 1999). Defisiensi besi diduga sebagai salah satu faktor predisposisi SAR. ...
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Recurrent aphthous stomatitis (RAS) is a type of lesion of the oral mucous consisting of sudden acute, painful, being recurrent, non-infectious, non- vesicular, and immunologically mediated. Chronic iron deficiency will result in iron deficiency anemia which is one of RAS predisposing factors. To ilustrate the complexity of RAS in iron deficiency anemia following the treatment strategies. Case Report: Outpatient woman, thirty years old, not married yet; came with painful aphthous on her tongue causing stiff tongue sensation and difficult to speak. She has frequent aphthous since last two months. Case Management: Diagnosis of RAS was derived from history and clinical presentation whereas iron deficiency anemia condition was derived from hematology examination. Patient has been instructed to increase iron source diet and limit tea consumption. Chlorhexidine gluconate and bee propolis were used as RAS medication. Ferro gluconate, ferrazone, and ascorbic acid were delivered as iron deficiency therapy. RAS treatment in iron deficiency anemia has to be considered both of RAS and iron deficiency condition related to their correlation.
... Iron deficiency anemia (IDA), is introduced as an insufficient iron concentrations in the human body that lead to reduction in the level of red blood cells (RBCs) or Hemoglobin (HB) in the blood [1]. ...
... Demirin ağızdan günlük verilmesi sonucu emilimin her gün istenilen düzeyde olamayacağı düşünülür. Bunun nedeni, bir gün önce alınan yüksek miktardaki demir, ertesi gün alınan demirin emilimini azaltır ve mukozal blok etkisine yol açar (11,23,24) . Demir metabolizmasının ve hepsidinin buradaki görevinin son yıllarda daha da anlaşılması yeni ara- Yalnızca çocuk ve erişkinlerdeki anemi tedavisi için değil, anemik olmayan çocuklarda ve gebelerde de haftalık ya da aralıklı demir profilaksisi günlük uygulamaya alternatif etkili bir yöntem olarak sunulmuştur (25)(26)(27) . ...
... Iron deficiency anaemia was induced by feeding the animals exclusively on the formulated iron deficient diet for 8 weeks. Haemoglobin (Hb) concentration was used as index for anaemia and rats with Hb concentration of < 11g/dl (Velmurugan et al., 2010) were used for the study. ...
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The effect of 10% supplementation of fermented and unfermented Telfaira occidentalis and Gnetum africanum leaves for 21 days on haemoglobin-iron, haematological parameters and serum ferritin was investigated to determined if the leaves could replenish haemoglobin in iron deficient rats. Iron deficiency significantly (p<0.05) decreased the relative weight gain, haemoglobin-iron, serum ferritin, haemoglobin (Hb), and mean corpuscular haemoglobin concentration (MCHC), when compared to the iron sufficient control rats. Rats fed with T. occidentalis had a significantly (p<0.05) increased serum ferritin compared to those fed with G. africanum leaves. The levels of haematological parameters of rats in the iron deficient group were not significantly (p>0.05) different from the iron sufficient and leaves supplemented groups. However, haemoglobin concentration of rats on iron sufficient diet, fermented and unfermented T. occidentalis leaves and those treated with FeSO4 were significantly (p<0.05) higher than that of rats in the iron deficient, fermented and unfermented G. africanum groups respectively. Percentage change in Haemoglobin-iron was lower for rats supplemented with the fermented forms of both leaves. This study shows that T. occidentalis has a significant (p<0.05) haemoglobin regeneration potential compared to G. africanum, and fermentation did not significantly (p>0.05) enhance the haemoglobin regeneration potential of both leaves.© 2015 International Formulae Group. All rights reserved.
... Shilajit, also known as shilajit, mumijo, and momia, is used in the Ayurveda, the traditional Indian system of medicine [2] . The complement system is involved in many disease syndromes that have been traditionally treated with extracts of shilajit and other humic substances containing high levels of Fe (e.g., arthritis and asthma) [3,4] and they are also used for anti-oxidant, hypoglycemic and iron deficiency anemia [5,6] . In the Charak Samhita, shilajit is described as a product of four minerals i.e. gold, silver, copper and iron, whereas in the Susruta Samhita it included two more minerals, i.e. lead and zinc in its composition [7] . ...
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To evaluate the safety of shilajit by 91 days repeated administration in different dose levels in rats. In this study the albino rats were divided into four groups. Group I received vehicle and group II, III and IV received 500, 2 500 and 5 000 mg/kg of shilajit, respectively. Finally animals were sacrificed and subjected to histopathology and iron was estimated by flame atomic absorption spectroscopy and graphite furnace. The result showed that there were no significant changes in iron level of treated groups when compared with control except liver (5 000 mg/kg) and histological slides of all organs revealed normal except negligible changes in liver and intestine with the highest dose of shilajit. The weight of all organs was normal when compared with control. The result suggests that black shilajit, an Ayurvedic formulation, is safe for long term use as a dietary supplement for a number of disorders like iron deficiency anaemia.
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We have previously shown improved hemoglobin (Hb) repletion efficiency by supplementing a 50:50 mixture of short (P95) and long-chain (HP) inulin (Synergy 1, BENEO-Orafti) into a corn-soybean meal-basal diet (BD) for young pigs. In this study, weanling pigs (5 or 6 wk old) were fed the BD or the BD + 4% of P95, HP, or Synergy 1 (50:50 mixtures of HP and P95) for 5-7 wk. Blood Hb concentrations of pigs were measured weekly and digesta samples were collected at the end of the trial. In a replicate experiment, total RNA was isolated from the liver and mucosa of duodenum, ileum, cecum, and colon of all pigs at the end of the trial. Relative mRNA expression of 27 genes, including iron and inflammation-related genes, was quantified using real-time quantitative-PCR. Although all 3 types of inulin resulted in similar improvements (P < 0.05) in blood Hb concentration and liver ferritin protein amount, neither type of inulin was detectable in the digesta of cecum or colon. Supplemental inulin enhanced the expression of iron-storing protein genes but decreased that of inflammation-related genes. Such effects were more pronounced (P < 0.05) in the mucosa of the lower than the upper gut and were seen on 7 genes in liver. In conclusion, all 3 types of inulin shared similar efficacy and possibly similar modes of action in improving dietary iron utilization by young pigs. Suppressing inflammation-induced genes that can negatively influence iron metabolism might help explain the benefit of inulin.
Ferastral, a new iron-poly (sorbitol-gluconic acid) complex for parenteral use has been given to 22 patients with iron deficiency anaemia. The patients were divided in two groups. Group I received a suboptimal dose of Ferastral iron corresponding to 90% of the iron calculated to normalize the haemoglobin value. Increases in total haemoglobin and also blood losses were measured. The availability of the injected iron for haemoglobin synthesis ranged from 63% to 111%. Group II received an amount of Ferastral-iron calculated to be necessary for normalization of the haemoglobin plus an additional 500 mg of Ferastral-iron. In this group the haemoglobin increase was rapid. In 7 weeks 10 out of 14 patients had reached a normal haemoglobin level.
A clinical investigation of an iron-poly (sorbitol-gluconic acid) complex, Ferastral, for the treatment of iron deficiency anaemia has been performed. The study was designed to determine the dose schedule, efficacy and tolerance of the drug. Two dose intervals were used, 500 mg of iron once a week or every third day. The study comprised 26 adult patients. After single doses of 500 mg of Ferastral given every third day levels of iron and unsaturated iron binding capacity (UIBC) in serum were estimated. Maximum values of iron in serum after the first injection were reached after 24 hours in two patients. After the second injection there was a further increase in the iron concentration with maximum values after 24 to 48 hours. A decrease in UIBC was seen in all patients. Urinary excretion of iron was about 15%. Most of the excretion took place during the first 72 hours following the injection. The haemoglobin increase was more rapid in the group receiving 500 mg of iron every third day. The difference was statistically significant two to four weeks after commencing treatment. After five weeks the difference in haemoglobin increase was no longer statistically significant. After eight weeks the mean haemoglobin had reached 13.1 g/100 ml in the group treated once a week and 13.4 g/100 ml in the group treated every third day. The preparation was well tolerated by all patients treated. No local or general side effects were observed.
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Traditionally the iron status of a population is assessed by estimating the prevalence of iron deficiency anemia. This approach is inadequate in countries where the diet is heavily fortified with iron because it conveys no information about the iron-replete segment of the population. In the present study iron status of a US adult population was evaluated using data collected in the second National Health and Nutrition Examination Survey (NHANES II). Body iron was estimated in each of 2,829 individuals from measurements of hemoglobin concentration, serum ferritin, transferrin saturation, and erythrocyte protoporphyrin. When individuals between 18 and 64 years of age were divided on the basis of sex and menstrual status, body iron reserves were normally distributed and averaged 309 mg in women 18 to 44 years, 608 mg in women 45 to 64 years, and 776 mg in men 18 to 64 years. The dispersion of storage iron in these groups was similar, with standard deviations of 346, 372, and 313 mg, respectively. The prevalence of iron deficiency anemia was surprisingly low, ranging from only 0.2% in adult men to 2.6% and 1.9% in pre- and postmenopausal women, respectively. Epidemiologic methods that examine iron status in the entire population assume importance in light of evidence that in certain segments of the US population, iron deficiency anemia is now less common than the homozygous state for hereditary hemochromatosis.
Objective: To document the most common cause of anemia in a rural population. Design: Prospective, case series. Place and Duration of Study: The study was conducted from June, 1999 to June, 2001 at the department of Medicine, Fauji Foundation Hospital, Rawalpindi, (Pakistan). Material and Methods: The subjects were mainly young adults, middle aged men and non-pregnant women presenting with symptoms and signs of anemia. Main outcome of study were types of anaemia, prevalence and causes of iron deficiency anemia. Results: A total of 205 patients presented with findings consistent with the presence of anaemia. The predominant type of anemia was hypochromic microcytic in 93 (43.36%) cases, followed by hematological malignancies in 46 (22.43%) cases. Iron deficiency was noted in all 93 cases. The main cause of iron deficiency was nutritional deficiency in 86 (41.95%) patients. The mean ferritin levels in these iron deficient patients were 5.6 hg/ml. The mean age was 32 years. Conclusion: The iron deficiency is still the commonest cause of anemia. The main cause of high prevalence of iron deficiency is nutritional inadequacy owing to low socioeconomic conditions. Women bear the main brunt of iron deficiency. Iron deficiency can be overcome by directing the financial resources to the vulnerable segments of population and enhancing their access to iron-rich foods.
Fulvic acids (FA) and 4′-methoxy-6-carbomethoxybiphenyl (MCB, 1), two major organic compounds isolated from Shilajit (a humus product), were screened for anti-ulcerogenic activity in albino rats. Both FA and MCB showed significant anti-ulerogenic effects in the battery of tests accepted for this purpose. The mechanism of anti-ulcerogenic action was studied with MCB on the basis of its effects on mucin content (gastric juice carbohydrates and carbohydrate/protein ratio) and on the concentration of DNA and protein in the gastric juice. The MCB-induced changes in the mucosa provided resistance against the effect of ulcerogens and also against shedding of mucosal cells. A preliminary acute toxicity study indicated that both FA and MCB had a low order of toxicity.
Anaemia is one of the most common risk factors in the area of obstetrics and perinatal medicine. During pregnancy and in the puerperium it is associated with an increased incidence of both maternal and fetal morbidity and mortality, the extent of which is dependent upon the severity of anaemia and the resulting complications. In order to correctly diagnose the type and degree of anaemia, a prerequisite for selection of the proper therapy, one must first of all correctly differentiate between the relative, i.e., the physiological anaemia of pregnancy due to the normal plasma volume increase during pregnancy, and "real anaemias" with various different pathophysiological causes. When defining the Hb cutoff value for anaemia in pregnancy, the extent of the plasma volume changes with respect to the gestational age must be taken into consideration. It has been found that haemoglobin values < 11.0 g/dl in the first and third trimesters, and < 10.5 g/dl in the second trimester may point to an anaemic situation which should be further clarified. The first important steps for diagnosing anaemia in a pregnant patient include a thorough check of her medical history and a medical examination. This procedure often lays the basis for a correct diagnosis. The current gold standard to detect iron deficiency remains the serum ferritin value. To be reliable, this requires the ruling out of an infection (chronic or acute) as a cause of the anaemia. We recommend a complete laboratory test for the exact haematological status as well as the assessment of specific chemical laboratory parameters. These should include a palette of additional, promising new parameters such as hypochromic red cells and transferrin receptors which allow more accurate detection of iron deficiency and differential diagnosis of iron deficiency anaemia. After correct diagnosis, major emphasis should be put on safe and effective treatment of anaemia which again depends on severity of anaemia, time for restoration and patients characteristics. Today effective alternatives to oral iron only or blood transfusion such as parenteral iron sucrose complex and in selected cases also recombinant erythropoietin have been investigated and show promising results concerning effective treatment of anaemia during pregnancy and postpartum.
The prevalence of iron-deficiency anemia in different regions of the world ranges from 12 to 43%. The increased iron requirement in pregnancy and the puerperium carry with it an increased susceptibility to iron deficiency and iron-deficiency anemia and perioperative or peripartal blood transfusion. Prevention and correction presuppose reliable laboratory parameters and a thorough understanding of the mechanisms of iron therapy. The Hb level alone is insufficient to guide management. A complete work-up (ferritin, transferrin saturation) is essential, preferably with hematological indices such as hypochromic and microcytic red cells and reticulocytes, classified by degree of maturity, in particular, before parenteral therapy is given. Since ferritin acts as both an iron-storage and acute-phase protein, it cannot be used to evaluate iron status in the presence of inflammation. A high ferritin level thus requires the presence of an inflammatory process to be eliminated before it can be taken at face value. If the C-reactive protein level is also raised, the soluble TfR concentration can be used, since it is unaffected by inflammation. Inadequate understanding of the complex chemistry of parenteral iron administration was previously responsible for serious side effects, such as toxic and allergic reactions, and even anaphylactic shock, in particular with dextran preparations. However, the current type II iron complexes that release iron to the endogenous iron-binding proteins with a half-life of about 6 hours are not only effective but carry a minimal risk of allergic accident and overload, especially after a comprehensive pretreatment work-up. Our departmental data collected over 8 years and backed by postmarketing experience in 25 countries indicate that iron sucrose complex therapy is a valid first-line option for the safe and rapid reversal of iron-deficiency anemia.
A diet deficient in iron causes a rapid, marked increase in iron absorption in rats. The increased absorption occurs in the absence of a significant change in iron stores as judged by the effect of an equivalent change in stores produced by phlebotomy, and in the absence of increased erythropoietic activity as judged by the rate of removal of iron-59 from the plasma.
Evaluation of risk factors in antenatal care
  • M Saeed
  • T A Khan
  • S J Khan
Saeed M, Khan TA, Khan SJ. Evaluation of risk factors in antenatal care. Mother and child 1996; 34: 139-142.