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Immune thrombocytopenia (ITP)

Ayurveda about ITP

One of the major functions of bone marrow is production of platelets and since the main cause of ITP is decreased production of platelets we can conclude that majjagata vatavyadhi (vitiated vata residing in bone marrow) leads to ITP.

ITP is a result of vitiation of vata and majja, this implies that to treat ITP we have to treat both these issues.

Causative factors for Vata vitiation

  • Having diet which consists of dry, cold food
  • Excessive fasting
  • Excessive Swimming, exercise or any other physical activities in excess
  • Suppression of natural urges

Because of the above mentioned factors the aggravated vata moves and resides in the bone marrow as it is already vitiated due to factors like consumption of incompatible food combinations  (pizza with coke, citrus fruits with milk etc). Hence it is advisable to avoid such a diet or consume in very limited proportions. Such eating habits lead to vitiated pitta in the body which being a compatible element with blood results in vitiating the blood too. This phenomenon aggravates the ITP. 

Majja is one of the 7 dhatus. Unhealthy and incompatible foods have become an inseparable  part of the modern lifestyle, this type of diet leads to various health issues. Such a diet interferes with the metabolism of Dhatus, which obstructs the process of development of Dhatus and causes diseases of different nature. Majja also gets affected with such diet and hence is unable to produce optimal count of platelets leading to ITP

Got a purple patch on your skin? Or suddenly bruises/ wounds take time to clot? Your blood report says Low platelet count? If the answer to any of these questions is yes then you might be curious about the underlying reasons. In the article below we shed some light about the disease and how we can tackle it.

Idiopathic Thrombocytopenic Purpura also known as, Immune Thrombocytopenic Purpura (ITP),  is a blood disorder caused by the immune system attacking platelets identified by a temporary or continuous decrease of the platelet count and depending upon the degree of thrombocytopenia, increased risk of bleeding. 

ITP is a non-contagious disease.

The term “idiopathic,” used in the former name of the condition, means “of unknown cause” In the past, it was used because the cause of ITP wasn’t well understood. However, it’s now clear that the immune system plays an important role in the development of ITP, thus its newer name, immune thrombocytopenia.

What is ITP

Now Let’s break down the term thrombocytopenia, the word "Thrombocytes" are your platelets, and "penia" means you don't have enough of something. Put those terms together, and you get "thrombocytopenia." 

Since the disease revolves around platelets I will first explain briefly about platelets.

Blood cell, also called a hematopoietic cell, hemocyte, or hematocyte, is a cell produced through hematopoiesis and found mainly in the blood. Major types of blood cells include red blood cells (erythrocytes), white blood cells (leukocytes), and platelets (thrombocytes). Together, these three kinds of blood cells add up to a total 45% of the blood tissue by volume, with the remaining 55% of the volume composed of plasma, the liquid component of blood.

Unlike red and white blood cells, platelets are not actually cells but rather small fragments of cells. Platelets help in the blood clotting process (or coagulation) by gathering at the site of an injury, sticking to the lining of the injured blood vessel, and forming a platform on which blood coagulation can occur. This results in the formation of a fibrin clot, which covers the wound and prevents blood from leaking out. Fibrin also forms the initial scaffolding upon which new tissue forms, thus promoting healing.

The normal range (99% of population analyzed) for platelets is 150,000 to 450,000 per cubic millimeter. If the number of platelets is too low (either due to decreased production or increased destruction) it may lead to Internal bleeding or bleeding subcutaneously.

People with ITP often have many purple bruises called purpura on the skin or mucous membranes inside the mouth. These bruises may also appear as pinpoint-sized red or purple dots on the skin called petechiae. Petechiae often look like a rash.

In ITP, the immune system produces antibodies against platelets. These platelets are marked for destruction and removal by the spleen, which lowers the platelet count. The immune system also appears to interfere with cells responsible for normal platelet production, which can further lower the number of platelets in the bloodstream.

Children may develop ITP after a viral infection and usually recover fully without treatment. In adults, the disorder is often long term.

Types of ITP

The two main types of ITP are acute (short term) and chronic (long term).

  • Acute Thrombocytopenic Purpura
    • Acute ITP is the most common form of ITP. Most commonly seen in young children (ages two to six years).
    • Characteristics of acute ITP include:
      • Symptoms that follow a viral illness, such as chickenpox.
      • Very sudden onset.
      • Symptoms that disappear in less than six months (often within a few weeks).
      • Treatment is often not needed and the disorder usually does not recur.
  • Chronic Thrombocytopenic Purpura
    • Adults have this type of ITP more often than children, but it does affect adolescents.
    • Characteristics of chronic ITP include:
  • The disorder can happen at any age.
  • Symptoms can last a minimum of six months, several years or even a lifetime and treatment is a necessity here.
  • Women develop it two to three times more often than men.

 Symptoms of ITP

  • Bruising easily
  • Pinpoint-sized petechiae, often on the lower legs
  • Spontaneous nosebleeds
  • Bleeding from the gums (for example, during dental work)
  • Blood in the urine, stool
  • Abnormally heavy menstruation
  • Prolonged bleeding from cuts
  • Profuse bleeding during surgery
  • Joint Pain

Treatment

Modern medicine treatment for ITP suggests use of steroids or other similar medications to increase platelet count, even though this may help in treating ITP, steroids have negative impact on our immune system i.e they suppress the immune system, reducing the activation/efficacy of it, this leaves our body vulnerable to other diseases. 

Complications of ITP treatment

The treatments for ITP can have more risks than the disease itself. The long-term use of steroids dominated medication can cause serious side effects, including:

  • osteoporosis
  • cataracts
  • a loss of muscle mass
  • an increased risk of infection
  • Diabetes

Other general complications include

  • fatigue
  • nausea
  • headaches
  • Fever and chills