BRIDGING AYURVEDA AND HEMATOLOGY: INGREDIENT RATIONALE AND HYPOTHESIZED ACTION OF RAKTAMRUT VATI IN HEMOPHILIA

Abstract

Background: Haemophilia A and B are rare X-linked bleeding disorders caused by deficiency or absence of coagulation factor VIII (FVIII) or factor IX (FIX) essential for normal blood clotting. Despite advances in factor replacement and non-factor therapies, challenges such as high treatment costs, inhibitor development, breakthrough bleeding, and progressive arthropathy persist, particularly in low- and middle-income countries. In Ayurveda, the clinical manifestations of haemophilia may be interpreted in the context of Raktavaha Strotodushtijanya Vyadhi such as Raktapitta, Pandu and Vatarakta. Raktamrut Vati is a novel polyherbo-mineral formulation comprising nine classical ingredients, including Dravyas from Panchavalkala Varga, Swarna Bhasma, and four Bhavana Dravyas including cow’s milk used as processing media. All ingredients were rationally selected for their potential haemostatic, anti-inflammatory, joint-protective, and quality-of-life enhancing effects, while aiming to provide an affordable adjunct to standard care. Methods: A narrative integrative review was conducted of classical Ayurvedic texts alongside PubMed and Scopus indexed literature on haemophilia pathophysiology and the phytochemistry and pharmacology of each ingredient. The findings were correlated with Ayurvedic concept of pathogenesis (Samprapti) and contemporary understanding of bleeding and tissue injury. Results: In Ayurvedic terms, the formulation combines haemostatic (Raktastambhana), Pitta-pacifying and blood-restoring (Rakta-prasadana), digestive and Vata-balancing, and rejuvenating (Rasayana) actions. Biomedical evidence suggests that its constituents act downstream of the factor defect through four mechanisms: support of platelet and mucosal haemostasis, antioxidant protection against haem-iron-driven tissue injury, inhibition of NF-κB, cytokine, cyclooxygenase and VEGF signalling in the synovium, and promotion of tissue repair, analgesia and hepatic function. Several ingredients also showed antiplatelet or anticoagulant activity in experimental studies. Conclusion: Raktamrut Vati has a coherent Ayurvedic and biomedical rationale as a multi-target adjunct to standard haemophilia care. However, its net haemostatic effect must be established through preclinical and controlled clinical studies before any therapeutic claims are made.