Herbs, plants used in medicine or as a seasoning, are a major and long-standing component of Chinese, Ayurvedic (Indian), European, and Native American medicine as well as other traditional healing systems. In time, some of the herbs have become mainstream medicines as pharmaceutical companies isolated the active ingredients, patented them, and marketed them as drugs. For example, aspirin was first extracted from the bark and leaves of the willow tree and vincristine, a chemotherapy agent used to treat some chronic cases of ITP, is derived from the rosy periwinkle.
How can this help?
Below are examples of herbs that have been successfully used by some to treat ITP. There are scores of herbs and herbal combinations that can affect the blood or bone marrow, so this list is just a sample. See also the "Traditional Chinese Medicine (TCM) and Ayurvedic Medicine" page.
Traditional Chinese Medicine (TCM) divides ITP into different categories: heat (inflammation-related), Qi deficiency (production-related), and blood stagnation (circulation-related). In the TCM system of healing people with different disease characteristics would be treated slightly differently, separating or combining the approaches, perhaps adding herbs to help stop bleeding. The clinical trials listed below do not reflect the individual's condition and personalized solution frequently used in Chinese medicine because it is necessary to standardize treatments in clinical trial design.
Decoction of Nourishing Blood and Eliminating Purpura (DNBEP)
In this study, 55 patients in the treatment group were compared to 22 patients in the control group. The treated group had a significant improvement in platelet count and symptoms compared to the controls. (Yang 1999)
Dihuang Zhixue Capsule
Forty-one children with chronic ITP were randomized into two groups. One of the groups was given Dihuang Zhixue and the control group was given cyclosporin A. The children in the treatment group showed more improvement than the control group and had no apparent adverse reactions compared with 39 adverse reactions in the control group. (Liu 2008)
In a 1993 Japanese study, kami-kihi-to (jia-wei-gui-pi-tang), a traditional herbal preparation used in both Japan and China, was given to ten patients with ITP. Seven of them had an increased platelet count, decreased anti-platelet antibodies, and no side-effects from the treatment. (Yamaguchi 1993)
Minor Decoction of Bupleurum
In the ten people with ITP given this herbal mixture, the treatment for six was considered markedly effective and one was considered fairly effective. Three were lost to follow-up. (Duan 1995)
Replenishing Qi and Tonifying Kidney
Of the 41 children given this herbal preparation, 24 were cured, 6 recovered, 10 improved and 1 failed the treatment. Twenty-two of those in the cured category were followed for 10 months with no recurrence. (Shi 1991)
Roasted Licorice Decoction (RRLD)
Forty-three people were randomized to a low-dose corticosteroid dose plus RRLD or low-dose steroids alone. The treated group had a more pronounced response with fewer adverse effects. (Luo 2001)
In a published case, a 51 year-old male diagnosed with Evan’s syndrome was treated with prednisone with no improvement. After Sairei-to was added, his platelet count and hemoglobin improved and he was able to reduce the prednisone. He had no side effects. (Horikoshi 1995)
Shengxueling (SXL), a traditional Chinese medicine, was compared to prednisone in a group of 86 ITP patients. It was more effective than prednisone and lessoned bleeding side-effects. In another study 73% of 37 people given SXL responded to the treatment. (Zhou 2005, Shao 2007)
In a study of 61 patients with ITP divided between a prednisone group and one treated with Zhinu (ZN) I-II, those in the prednisone group had a better initial response. However, in a 12-month follow-up, those in the ZN I-II group had a better platelet response, a lower relapse rate, and no obvious side effects. (Zeng 1996)
Other Chinese Herbs
Many studies have been published in Chinese journals showing the effectiveness of Chinese herbal medicine in treating ITP. In his report, "Treatment of ITP with Chinese Medicine" Subhuti Dharmananda, Ph.D., Director, Institute for Traditional Medicine, Portland, Oregon, describes the rationale for the use of various Chinese herbs and summarizes the results of 17 studies published in China.
Ayurvedic Herbs (India)
Amrit Kalash and MA631
Herbal mixtures Amrit Kalash tablets and nectar (MA4, MA5) modulate the immune system (Inaba 1995, 2005), exhibit strong antioxidant properties (Scartezzini P, Speroni E 2000, Dwivedi 2005, Sharma 1992, Cullen 1997), and help protect against neuro-degenerative diseases such as dementia and Alzheimer’s (Vohra 2002). MA631 also has anti-oxidant properties (Sharma book). These are all features that can improve platelets and the difficulties of living with ITP.
The Gayathri Institute of Ayurvedic Medical Science in Kerala, India, is conducting a clinical trial using a combination of four different herbal products. They conclude that their herbal combination has been successful in treating ITP.
Papaya Leaf (Malaysia)
Researchers at the Asian Institute of Science and Technology in Malaysia found that papaya leaves and pegaga (Centella asiatica) juice can increase the platelet count of people diagnosed with dengue fever, a mosquito-transmitted viral disease affecting many millions and characterized by persistent thrombocytopenia. The initial study, done in mice, comparing papaya leaf to a placebo, demonstrated that the papaya leaf suspension was responsible for raising the platelet count (Kathiresan 2009). More research on Papaya Leaf for low platelets is underway.
Blood Well/Restore Immune
In the PDSA Survey of Non-traditional Treatments of ITP more than 60% of those surveyed felt the Blood Well/Restore Immune products helped their platelet count and bleeding symptoms while 22% felt the products had a sustained effect.
Since herbs, like other plants, can vary depending on their growing conditions, handling, and processing, they may contain contaminants (Gershwin 2010) and toxins (Saper 2008.) They can also interact with conventional medications in ways that may not be obvious. Since there are very few studies that show the effects of mixing herbal preparations with conventional medications, if there are problems, it is difficult to determine the cause (Lai 2010). Some herbs can also have side effects that could cause problems for people with ITP, such as harming the bone marrow (Pyatt, 2000). Other herbs can cause thrombocytopenia (Royer 2010).
As with all treatments for ITP, it is important to work with an herbalist who has knowledge and experience with the disease and the herbs prescribed.
“I sent away for the Ambrosia nectar, Ambrosia pill and MA 631. I take E 400, sesame and I was taking 1500mg of vitamin C but I was told to stop taking the vitamin C when I started the Amrit. I started taking the Amrit about four weeks ago when my platelet count was 27,000 and now it is 58,000. Needless to say my doctor is both shocked and excited. He said this week 'your count is 58,000 keep taking your herbal concoction'.” -Cherie
“My father (a medical doctor) was diagnosed with ITP approximately 4 years ago. He has been through numerous types of treatments from oral medication to a splenectomy. I just wanted to drop a quick message that he has been on an herbal tea type of medicine for 6 months and his platelet count has been stable (in the 140,000 range).” -David
“My daughter was suffering from ITP the past two years and her platelet count was 2,000. For the past six months her Ayurvedic treatment was started under the observation of Dr. Sachin Sarpotadr and good results began coming in. Her platelet count started increasing. When her hemogram (blood test) was checked, her platelet count increased from 2,000 to 60,000. Also her total hemoglobin increased from 7 to 10.” -Umesh
“Now I can't say what exact combination of Tai Chi, herbal medicine, stress management, has given me a drug free (prednisone) life. But it has amazed my hematologist and internal medicine specialist.” -Peter
Cullen WJ et al. “Effect of Maharishi AK-4 on H2O2-induced oxidative stress in isolated rat hearts.” J Ethnopharmacol. 1997 May;56(3):215-22. http://www.ncbi.nlm.nih.gov/pubmed/9201611
Duan Y et al. “Treatment of primary thrombocytopenic purpura by modified minor decoction of bupleurum.” J Tradit Chin Med. 1995 Jun;15(2):96-8. http://www.ncbi.nlm.nih.gov/pubmed/7650970. English Summary
Dwivedi C et al. “Antioxidant and protective effects of Amrit Nectar tablets on adriamycin- and cisplatin-induced toxicities.” J Altern Complement Med. 2005 Feb;11(1):143-8. http://www.ncbi.nlm.nih.gov/pubmed/15750373
Gershwin ME et al. “Public safety and dietary supplementation.” Ann N Y Acad Sci. 2010 Mar;1190:104-17. http://www.ncbi.nlm.nih.gov/pubmed/20388141
Horikoshi A et al. “[A case of Evans's syndrome in which thrombocytopenia and hemolysis was improved by Sairei-to].[Article in Japanese] Rinsho Ketsueki. 1995 Oct;36(10):1237-9. http://www.ncbi.nlm.nih.gov/pubmed/8531338
Inaba R et al. “Effects of Maharishi Amrit Kalash 5 as an Ayurvedic herbal food supplement on immune functions in aged mice.” BMC Complement Altern Med. 2005 Mar 25;5:8. http://www.ncbi.nlm.nih.gov/pubmed/15790423
Inaba R et al. “Immunomodulatory effects of Maharishi Amrit Kalash 4 and 5 in mice.” Nihon Eiseigaku Zasshi. 1995 Oct;50(4):901-5. http://www.ncbi.nlm.nih.gov/pubmed/8538064
Kathiresan S et al. “Thrombocyte counts in mice after the administration of papaya leaf suspension.” Wiener Klinische Wochenschrift. Volume 121, Supplement 3, 19-22, 2009. http://www.springerlink.com/content/u324w41p1mx1245x/
Lai JN et al. “Should herbs take all the blame? Causality assessment of a serious thrombocytopenia event.” J Altern Complement Med. 2010 Nov;16(11):1221-4. Epub 2010 Oct 27. http://www.ncbi.nlm.nih.gov/pubmed/20979526
Liu QC et al. “Clinical observation on the treatment of childhood refractory idiopathic thrombocytopenic purpura with Dihuang Zhixue Capsule.” Chin J Integr Med. 2008 Jun;14(2):132-6. http://www.ncbi.nlm.nih.gov/pubmed/18679605
Luo YG et al. “[Clinical study on effect of recombinant roasted licorice decoction combined with low-dose glucocorticoids in treating idiopathic thrombocytopenic purpura].”[Article in Chinese] Zhongguo Zhong Xi Yi Jie He Za Zhi. 2001 Jul;21(7):501-3. http://www.ncbi.nlm.nih.gov/pubmed/12575392
Pyatt DW et al. “Hematotoxicity of the chinese herbal medicine Tripterygium wilfordii hook f in CD34-positive human bone marrow cells.” Mol Pharmacol. 2000 Mar;57(3):512-8.http://www.ncbi.nlm.nih.gov/pubmed/10692491
Royer DJ et al. “Thrombocytopenia as an adverse effect of complementary and alternative medicines, herbal remedies, nutritional supplements, foods, and beverages.” Eur J Haematol. 2010 May;84(5):421-9. http://ouhsc.edu/platelets/MSDITPHerbal.pdf.pdf
Saper RB et al. “Lead, mercury, and arsenic in US- and Indian-manufactured Ayurvedic medicines sold via the Internet.” JAMA. 2008 Aug 27;300(8):915-23. http://www.ncbi.nlm.nih.gov/pubmed/18728265
Shao KD, Zhou YH, Shen YP, et al. “Treatment of 37 patients with refractory idiopathic thrombocytopenic purpura by shengxueling.” 2007. Chinese Journal of Integrative Medicine. March 13 (1):33-36. http://www.ncbi.nlm.nih.gov/pubmed/17578315
Sharma HM et al. “Inhibition of human low-density lipoprotein oxidation in vitro by Maharishi Ayur-Veda herbal mixtures.” Pharmacol Biochem Behav. 1992 Dec;43(4):1175-82. http://www.ncbi.nlm.nih.gov/pubmed/1475302
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The Tillotson Institute of Natural Health. http://www.tillotsoninstitute.com/diseases/itp-ideopathic-thrombocytopenic-purpur.html
Ven Murthy MR et al. “Scientific basis for the use of Indian ayurvedic medicinal plants in the treatment of neurodegenerative disorders: ashwagandha.” Cent Nerv Syst Agents Med Chem. 2010 Sep 1;10(3):238-46. http://www.ncbi.nlm.nih.gov/pubmed/20528765
Vohra BP et al. “Dark neurons in the ageing cerebellum: their mode of formation and effect of Maharishi Amrit Kalash.” Biogerontology. 2002;3(6):347-54. http://www.ncbi.nlm.nih.gov/pubmed/12510173
Vohra BP et al. “Maharishi Amrit Kalash rejuvenates ageing central nervous system's antioxidant defense system: an in vivo study.” Pharmacol Res. 1999 Dec;40(6):497-502. http://www.ncbi.nlm.nih.gov/pubmed/10660948
Yamaguchi K, et al. “Effects of kami-kihi-to (jia-wei-gui-pi-tang) on autoantibodies in patients with chronic immune thrombocytopenic purpura.” Am J Chin Med. 1993;21(3-4):251-5.http://www.ncbi.nlm.nih.gov/pubmed/8135169
Yang Y et al. “[Clinical study on treatment of chronic idiopathic thrombocytopenic purpura by Decoction of Nourishing Blood and Eliminating Purpura]” Zhongguo Zhong Xi Yi Jie He Za Zhi. 1999 Jan;19(1):29-33.[Article in Chinese] http://www.ncbi.nlm.nih.gov/pubmed/11783257
Zeng FC et al. “[Clinical study of zhinu-I,-II in treating 61 patients with idiopathic thrombocytopenic purpura].[Article in Chinese] Zhongguo Zhong Xi Yi Jie He Za Zhi. 1996 Apr;16(4):207-9. http://www.ncbi.nlm.nih.gov/pubmed/9206241
Zhou YM, Huang ZQ, Hu MH, Zhou SH, et al. “Clinical study on the effect of Shengxueling on idiopathic thrombocytopenic purpura.” 2005. Chinese Journal of Integrative Medicine, March 11 (1): 60-64. http://www.ncbi.nlm.nih.gov/pubmed/17578315
PDSA thanks Paul Kempisty MSTOM. L.Ac. for reviewing this page.