Herbal blood tonics for anaemic conditions

Nigerian researchers have in clinical studies shown that extracts of fluted pumpkin, cowhage or velvet bean, fig and sorghum could be effectively used to improve blood count, as an alternative or compliment to blood transfusion, and heal anaemic conditions such as in sickle cell anaemia and malaria. CHUKWUMA MUANYA (Assistant Editor) writes.

*Fluted pumpkin leaves, cowhage, fig, sorghum, others show promise, researchers find
Nigerian researchers have shown the efficacy of fluted pumpkin vegetable extracts in the management of severe anemia in children.

According to the study published in The Internet Journal of Alternative Medicine and The study was published in Tropical Journal of Pharmaceutical Research, case reports of two severely anaemic patients, whose parents refused blood transfusion and were subsequently managed with oral intakes of the fluted pumpkin vegetable extracts, with satisfactory rise in the haematocrit levels.

The results showed that the pre-pumpkin extracts administration pack cell volume of 15 per cent in both of them, rose to 20 per cent in one and 25 per cent in the other, 24 hours post administration of the extract.

The researchers concluded: “The fluted pumpkin vegetable extract was efficacious in the management of severe anemia in these two children and may be useful in pediatric patients with severe anemia whose parents refuse blood transfusion. The vegetable extract may have an even greater role in the prevention of anemia if intake is instituted early. Wider studies are needed to investigate these hypotheses.”

Commonly called fluted pumpkin, Telfairia occidentalis is called Ugu in Ibo; Aworoko, Eweroko in Yoruba, Ikong or Umee in Efik and Ibibio, and Umeke in Edo

Anaemia is a common childhood disease in the third world countries. It is sometimes life threatening and may require urgent blood transfusion. However parents occasionally refuse blood transfusion because of religious or other reasons. Members of the Jehovah witness sect usually refuse blood transfusion for themselves and their wards because of some biblical injunction. The problems and costs attending blood transfusion in our poorly developed health services often tempt some parents to refuse the procedure. It is therefore imperative for physicians to be aware of all available alternatives to blood transfusion.

Fluted pumpkin was found useful in correcting anaemia in a study of some African pregnant women. In the study, thirty anaemic pregnant women with base line pack cell volumes of 20.8+/-2.0 per cent were given freshly prepared fluted pumpkin mixture, containing its fluid extract, raw eggs and evaporated unsweetened milk, orally three times daily for seven days. The mean pack cell volume was observed to have increased to 29.5+/-2.2 per cent, a day following the administration of the mixture.

There is no documentation of the use of fluted pumpkin in the management of anaemia in children. However, this study by researchers at the Department of Paediatrics, Ladoke Akintola University Teaching Hospital, Osogbo, Osun State, led by Dr. Olusola Adetunji Oyedeji, draws the attention of medical practitioners managing children to the possibility of fluted pumpkin acting as a surrogate to refused blood transfusion in anaemic children. It may also have a role in preventing anaemia.

The researchers also acknowledged the contributions of Prof. G. A. Oyedeji of the department of Pediatrics, Obafemi Awolowo University, Ife, Osun State.

The researchers wrote: “Life threatening anaemia is a common emergency among Nigerian paediatric admissions. Malaria, sickle cell disease, glucose 6-phosphate dehydrogenase deficiency and septicemia are common causes. The logical and most effective method of managing such cases to is by blood transfusion. However, as in these reports, parents occasionally refuse blood transfusion for their children because of religious, cultural, financial and other reasons.

“In our practice setting, the direct cost of screening and transfusion services to the patient for a pint of blood ranges between $10 and 20. This is often unaffordable to many parents. Thus in a study of patients discharged against medical advice, financial constraints was given as the reason for refusing blood transfusion by the parents of some severely anemic, because of their inability to procure the blood needed for transfusion. Cultural practices in many parts of Africa dictate that mothers should obtain permission from their husbands before submitting their children for medical care and procedures like blood transfusion. This may make a mother refuse transfusion when the family situation is not congenial. Sometimes such fathers are unavailable or inaccessible to give consent.

“Concerning complementary and alternative medicine (CAM), most physicians are poorly informed on, the use of herbs for medical conditions. Sometimes patients and their relations are better informed compared to the attending physician. This was the case in these two patients, in whom the fluted pumpkin was effective. Fluted pumpkin is an indigenous pumpkin to the eastern parts of Nigeria. Usually, it is administered either as an extract obtained from blending or manually squeezing the soaked vegetable leaves in tepid water in order to extract the fluid, or it can be eaten as a cooked vegetable. Its mechanism of action is not known. Extracts from fluted pumpkin are known to have reducing and free radical scavenging properties through its antioxidant phyto-constituents such as vitamin C and phenols. These anti-oxidants may reduce tissue and red cell destruction by free radicals. The fluted pumpkin is also rich in folic acid and iron, which may be more easily bio-available for erythropesis compared to nutrients from other sources. Due to the fact that there are no suitable alternative oxygen carrier substitutes for haemoglobin, erythropoesis remains the safest means of alleviating hypoxemia from very low haematocrit levels.

“The two cases have also shown that fluted pumpkin acts very fast and its effects were evident within 24 hours. Other haematinics such as erythropoetin, iron, folic acid and vitamin B complex do not work as fast as fluted pumpkin. It takes a range of five days to three weeks after administration before their effects can be seen. The other advantages of fluted pumpkin over blood transfusions are avoidance of transmission of infections and blood transfusion reactions. In addition, the cost of administering fluted pumpkin is much less than giving a pint of blood, or erythropoeitin. Fluted pumpkin therapy reduces the number of days that the patient spends on admission, waiting for the improvement in pack cell volume when being managed with haematinics. All this not withstanding, blood transfusion acts faster than any other method by raising the pack cell volume immediately the blood is transfused.

“In order to reduce the morbidity and mortality associated with anemia in children whose parents refuse blood transfusion for them, the etiology of the anemia should be investigated and treated promptly. Fluted pumpkin extracts should be administered. The vegetable can also be given as part of the diet to children predisposed to developing severe anemia, such as sicklers and G-6-PD deficient patients when they are being treated for malaria. Thus fluted pumpkin has both prophylactic and curative roles and it has the potentiality of reducing the frequency and problems of blood transfusion in paediatric practice. Detailed studies of its mechanism of action should however be undertaken prior to liberalizing its use. Cautionary measures may also need to be taken with respect to prolonged use, especially in sicklers, in order to prevent pathologic tissue deposits of iron. The use of alternative methods of treatment is rapidly increasing among patients and the physicians needs to be conversant with these therapies.”

Commonly called cowhage, velvet bean (Agbala or Agbaloko in Ibo and Werepe in Yoruba), the leaves and seeds of Mucuna pruriens could be effectively used to boost blood levels and fertility in women.

So patients with low blood levels may no longer have need for blood transfusion and taking of blood capsules or tonics. Also, women that are looking for the fruit of the womb need not despair.

A study published in journal Biokemistri by researchers from Nnamdi Azikiwe University, Awka, Anambra State, comparative effects of ethanolic extracts of Ficus carica (fig tree) and Mucuna pruriens leaves on haematological parameters in albino rats.

The comparative effects of the ethanolic extracts of Ficus carica (fig) and Mucuna pruriens (cowhage or velvet bean) on haematological parameters were investigated in albino rats. The animals were divided into three main groups: group 1 which, served as the control, received 5.0ml/kg body weight of normal saline, while groups two and three received a daily administration (per os) of 200mg/k/g body weight of extracts of M. pruriens and F. carica respectively for 14 days.

Results showed that the extracts significantly increased the haemoglobin concentration, Packed Cell Volume (PCV) and red blood cell count by the 14th day when compared with the control.

F. carica was found to be more effective than M. pruriens in elevating the red blood cell count, especially by the 14th day. The two extracts, however, significantly decreased the total white blood cell count, as well as the percentage neutrophils, when compared with the control group, but not significant between test groups, even by the 14thday. Phytochemical analyses showed the presence of alkaloids, flavonoids, saponins, cardiac glycosides and carbohydrates in both plants. Tannins were present in F. carica but not in M. pruriens. These results thus justify the ethnobotanical use of these plants as blood building herbs.

Also, researchers have demonstrated the anti-anaemic potentials of aqueous extract of sorghum (Sorghum bicolor) stem bark in rats.

Sorghum bicolor belongs to the plant family Poaceae. It makes a refreshing non-alcoholic beverage, kunu-zaki (in Hausa), and tasty pap, akamu (in Ibo), and thick porridge, tuwo dawa (in Hausa). It is fermented to make sorghum beer called burkutu or pito, or made into flour and mixed with bean flour then fried to make dawaki.

Temidayo Oladiji, T. O. Jacob and Musa Yakubu of the University of Ilorin, Kwara State, published the study in Journal of Ethnopharmacology.

The researchers investigated the effects of oral administration of aqueous extract of Sorghum bicolor stem bark at the doses of 200, 400 and 800 mg/kg body weight on iron sufficient and iron deficient weaning rats. Weaning rats of 21 days old were maintained on iron sufficient and iron deficient diets for six weeks before the administration of the aqueous extract of Sorghum bicolor stem bark at various doses for seven days. Proximate analysis of the iron sufficient and iron deficient diets showed that they were similar except in the amount of iron.

Phytochemical screening of the extract revealed the presence of alkaloids and saponins. Extract administration produced significant increase in haemoglobin, packed cell volume and red blood cells in iron sufficient and iron deficient groups. There was also significant increase in the catalase activity of the rat liver and kidney without any significant change in the serum catalase activity.

The results revealed that extract administration has restored the anaemic condition in the iron deficient group and thus lend credence to its use in folklore medicine in the management of anaemia.

Another study published in African Journal of Biomedical Research evaluated pharmacological effect of a Nigerian Polyherbal health tonic tea in rats.

The researchers from the Departments of Pharmacology and Pathology/Forensic Medicine, Lagos State University College of Medicine, Ikeja, Lagos, conducted a fourteen day study, designed to investigate the haematological and biochemical effects of single, daily oral doses of 100 – 600 mg/kg of a Nigerian Polyherbal Tonic Tea (PHT) in four groups of adult Wistar rats.

Acute oral toxicity test of PHT at the limit dose of 5000 mg/kg was also conducted using Up-and-Down Procedure on statistical software programme (AOT425StatPgm, Version 1.0.). Results showed PHT to induce significant dose-related elevation in the PCV, platelet, total leukocyte counts and lymphocyte differentials, while causing significant suppression of granulocyte differentials in dose-related fashion. PHT, also, induced a significant dose-dependent rise in the fasting blood sugar, which was at variance with its folkloric use as an oral hypoglycemic agent. PHT did not induce mortality at the tested limit oral dose, indicating its relative oral safety up to 5000 mg/kg on acute exposure.

PHT is one of the several polyherbal remedies in Nigeria, used in folkloric medicine in Southwest Nigeria for the treatment of an array of diseases affecting humans. It is composed of pulverized, dried leaves of Persea Africana or avocado pear (Lauraeae), Morinda lucida (Rubiaceae), Magnifera indica or mango (Anacardiaceae), Carica papaya or pawpaw (Caricaceae), Vernonia amygdalina or bitter leaf (Compositae) and Cassia occidentalis or stinging weed/coffee weed (Caesalpiniaceae), all combined in equal weight ratio.

Morinda lucida belongs to the plant family Rubiaceae. It is commonly called Brimstone tree. It is Oruwo or Erewo in Yoruba, Eze-ogu or Njisi in Ibo.

PHT is used for the treatment of pain, blood deficiencies, hypertension, diabetes mellitus, malaria, fever, inflammations, as immune booster and in the improvement of blood circulation.