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Ayurvedic Protocol for Pandu (Anemia)

Ayurvedic Protocol for Pandu (Anemia)

by Kottakkal Support February 23, 2021


Kottakkal USA_Anemia

When someone is diagnosed with anemia, it means they have low hemoglobin. (Hemoglobin is the main protein in red blood cells.) When hemoglobin is low, there is less oxygen able to be transported by the blood through the body.

It’s a common condition, affecting 5.6% of the US population with 1.5% having moderate to severe anemia (1).

Ayurveda has a similar disorder to anemia, called pandu. In Sanskrit, pandu means the skin appears pale white or yellow. This is because the complexion of the skin is maintained by rasa and rakta dhatu, while the texture is maintained by mamsa dhatu and unctuousness is maintained by meda dhatu.

Together these four dhatus are important for maintaining a healthy appearance of skin.

Pandu is a disorder caused by vitiated pitta. Due to pitta’s hot and sharp qualities, digestion is impaired. The dhatuagni or sequential nourishment of rasa, rakta, mamsa and meda produce poor quality tissue. The first step in Ayurveda to correct anemia is to heal the digestion and balance pitta.

Initial Symptoms of Pandu

  • Palpitations
  • Dryness
  • Lack of sweating
  • Fatigue

Signs of Pandu

  • Dhatushaithilya – weak tissues
  • Dhatugaurava – lazy tissues
  • Varnakshaya poor complexion
  • Balakshaya – physical weakness
  • Snehakshaya – systemic dryness
  • Ojagunakshaya depletion of vitality
  • Raktalpata poor quality deficient blood
  • Medalpata poor quality deficient fat
  • Nihasarta – overall poor-quality tissues
  • Shithilendriya – impairmentor dull senses
  • Vaivarnya – skin discoloration
  • Panduta –pale skin

Symptoms of Pandu

  • Karnakshweda – ringing ears
  • Bhrama – vertigo
  • Jwara – chronic fevers
  • Shishiradwesha – intolerant of cold
  • Daurbalya weakness
  • Shrama – fatigue
  • Nindraluta excessive sleepiness
  • Annadwesha – loss of appetite
  • Sthivanadhikya excessive sputum
  • Aruchi aversion to food
  • Hatanala poor digestion
  • Gaurava heaviness
  • Sadana body ache
  • Gatra shoola – pain
  • Mriditiv gatrata kneading pain
  • Pidita unmathit gatrata – churning or pressing pain
  • Pindikodweshtanam pain in calf muscles
  • Katiurupadaruka Sadana pain in legs, thighs, lumbar
  • Shwasa dyspnea
  • Arohaneayasa dyspnea on exertion
  • Akshikutashotha pre-orbital swelling
  • Harita lomata greenish body hair
  • Shirnalomata falling body hair
  • Hatprabhatva poor luster
  • Kopana irritability
  • Alpawaka less speaking

Five Types of Pandu 

  1. Vatika pandu Dryness of the skin and eyes, reduced urine output, black discoloration, tremors, pricking sensation, burning sensation and giddiness.
  2. Paittika pandu Yellow discoloration of the skin, urine and eyes, burning, thirst, fever, diarrhea, and dark yellow discoloration of the body parts.
  3. Kaphaja pandu White discoloration of skin, urine and eyes, nausea, oedema, drowsiness, laziness, and heaviness of the body parts.
  4. Tridosaja pandu  Mixed features of all the above three types of anemia.
  5. Mrittika bhakshana pandu – caused by the intake of mud (soil contamination). Symptoms include dryness, fatigue, indigestion, debility of the sense organs, loss of libido and lustre, swelling beneath the eyes, chin, foot, umbilical area and genitalia, and diarrhea with blood in the stool.

Ayurvedic Protocol

A person with pandu should first be given tiksnaemetic and purgation therapies after the administration of internal oleation (snehana) for cleansing of the body (shodhana). For snehana oleation the patient should be given Mahatikta Ghritam or Kalyanaka Ghritam.

Dietary Recommendations

After shodhana (vamana and virechana) various Ayurvedic products are recommended along with honey, ghee and loha (iron). Iron rich products include Lohasinduram (7) Capsules or Loha Asavam. The exact Ayurvedic protocol is based upon the severity of pandu and the person’s signs and symptoms. Good dietary sources of iron include raisins, beets, molasses, spinach, legumes like soybean, kidney bean, and lentils. Foods that increase strength and energy should also be included like wheat, almonds, pumpkin seeds, cow milk, ghee, tofu, apples, grapes, pomegranate, dates, and honey.

Foods and Activities to Avoid

Avoid foods that are sour, salty, spicy, all dry foods, bitter gourd, mustard, pickles, alcohol, exposure to sunshine, excess exercise, excess sexual indulgence, and emotions of anger or jealousy. All of these will further aggravate pitta dosa. 

Kottakkal Products for Pandu

Loha Asavam (iron) a good source of iron, useful for iron deficient anemia.

Kumarya Asavam (aloe + iron) supports diabetes, anemia, liver disorders, dysfunctional uterine bleeding and menopausal syndrome.

Draksha Arishtam (raisins) useful for anemia, fatigue, dyspepsia, andconstipation.

Ayaskriti (raisins) supports anemia, UTI, uretheral/vaginal discharges, hotflushes.

Punarnava Manduram (iron) useful for anemia, generalized edema, indigestion.

Punarnavadi Kwatham effective for anemia, edema, fever,cough, dyspnea.

Lohasinduram (7) Capsules (iron) supports Iron-deficiency anemia.

Dadimadi Ghritam (pomegranate) useful for anemia, acid peptic disorder, prenatal care, bronchial asthma, menstrual irregularities, normalizes peristalsis.

For more information about AGNI: THE AYURVEDIC CONCEPT, purchase this book by Ayurvedic experts from Kottakkal Arya Vaidya Sala, available on our online store.


1. Le CH. The Prevalence of Anemia and Moderate-Severe Anemia in the US Population (NHANES 2003-2012). PLoS One. 2016 Nov 15;11(11): e0166635. doi: 10.1371/journal.pone.0166635. PMID: 27846276; PMCID: PMC5112924.

Original source: Dr JV Hebbar,

Disclaimer: These statements have not been evaluated by the Food and Drug Administration. Kottakkal Ayurveda products and this information is not intended for use in the diagnosis, treatment, cure, or prevention of any disease. If you have serious, acute, or chronic health problems, please consult a trained health professional. If you are seeking the medical advice of a trained Ayurvedic practitioner or doctor, call (800) 215-9934 or email us at and we will provide you with one of our affiliated Ayurvedic professionals. Check with your doctor before taking herbs when pregnant or nursing.

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