This document is a project submitted by Shruti Singh to the Jayoti Vidyapeeth Women's University in partial fulfillment of the requirements for a Bachelor of Homoeopathic Medicine and Surgery degree. It examines the role of homeopathic medicines in treating iron deficiency anemia. The project was conducted under the supervision of Dr. Meenakshi Soni and certifies that the work is original and of standard quality. It includes chapters on epidemiology, etiology, pathophysiology, clinical features, diagnosis, differential diagnosis, management with modern medicine, and homeopathic management of iron deficiency anemia.

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A PROJECT
ON
ROLE OF HOMOEOPATHIC MEDICINES IN IRON
DEFICIENCY ANEMIA
Submitted in Partial Fulfillment of the Requirement for the Degree of
BACHeLOR OF HOMOEOPATHIC MEDICINE AND
SURGERY
Guided by Submitted by
JV’n Dr. Meenakshi Soni JV’n Shruti Singh
Assistant Professor JV-U/14/7246
Department of Repertory
Jayoti Vidyapeeth Women’s University
Jaipur, Rajasthan
Faculty of HOMOEOPATHIC SCIENCE
Jayoti Vidyapeeth Women’s University, Jaipur

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JAYOTI VIDYAPEETH WOMEN’S UNIVERSITY, JAIPUR
CERTIFICATE
This is to certify that the project entitled “ROLE OF HOMOEOPATHIC
MEDICINES IN IRON DEFICIENCY ANEMIA” submitted by SHRUTI
SINGH to the JAYOTI VIDYAPEETH WOMEN’S UNIVERSITY,
JAIPUR as a partial fulfillment for the requirement of the degree of Bachelor
of Homoeopathic Medicine and Surgery, is a bonafide work carried out by
her under my supervision. Her approach to the subject has been sincere,
scientific and analytical.
This work is recommended for the degree of “Bachelor of Homoeopathic
Medicine and Surgery”.
Place: Jaipur Dr. Meenakshi Soni
Date: Assistant Professor,
Department of Repertory

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JAYOTI VIDYAPEETH WOMEN’S UNIVERSITY, JAIPUR
CERTIFICATE
This is to certify that project entitled “ROLE OF HOMOEOPATHIC
MEDICINES IN IRON DEFICIENCY ANEMIA” is a bonafide work carried
out by Shruti Singh of batch 2014-15, as a partial fulfillment of the requirement
for the award of the degree of “Bachelor of Homoeopathic Medicine and
Surgery.”
The work confirms to the standard of “JAYOTI VIDYAPEETH WOMEN’S
UNIVERSITY.”
Place: Jaipur Prof. Dr. M.P. Sharma
Date: Dean/ Director

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DECLARATION
I certify that, the work contained in the thesis is original and has been done by myself
under the supervision of my supervisor.
Whenever I have used materials (data, theoretical analysis, and text) from other
sources, I have given due credit to them by citing them in the text of the thesis and
giving their details in the references.
Whenever I have quoted written materials from other sources and due credit is given
to the sources by citing them.
Date: Name of the Intern:
Place: Jaipur Shruti Singh
JV-U/14/7262

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ACKNOWLEDGEMENTS
My deepest thanks goes to principal of “JAYOTI VIDYAPEETH WOMEN
‘S UNIVERSITY” for extending their support. It is my greatest pleasure
to my profound gratitude towards my guide, Dr.MEENAKSHI SONI
for providing me various resources as and when required. He proved to
be very helpful in resolving various hurdles and difficulties faced during
completion of this assignment.
A word of praise is due to my PARENTS and friends and hospital
staff for being my pillars of strength & constantly encouraging
me for completion of this assignment.
THANKING YOU

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ABSTRACT
Iron deficiency anemia is the most common type of anemia. WHO estimates that
42% of children less than 5 years of age and 40% of pregnant womenworldwide are
anemic.
It can result from inadequate iron intake, decreased iron absorption, increased iron
demand, or increased iron loss by any means, either result from heavy
menstruation, by injury, by surgical event, or due to lack of nutrition. Iron deficiency
anemia is treated with iron supplementation and homeopathic medicine. The
homoeopathic medicines like Ferrum phosphoricum, china officinalis, sepia,
kalium carbonicum., Calcarea phosphoricum, Natrum muriaticum, pulsatilla etc.
can cure the cases of anemia permanently and restore the sick to health.

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LIST OF FIGURES
S.NO TOPIC PAGE
NO.
1. INTRODUCTION 8
2. EPIDEMIOLOGY 10
3. ETIOLOGY 11
4. PATHOPHYSIOLOGY 14
5. CLINICAL FEATURES 16
6. DIAGNOSIS AND INVESTIGATION 19
7. DIFFERENTIAL DIAGNOSIS 20
8. MANAGEMENT OF MODERN MEDICINE 21
9. HOMOEOPATHIC MANAGEMENT 23
10. BIBLIOGRAPHY 28
11. MASTER CHART 30

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INTRODUCTION
As the name suggests ‘iron deficiency anemia’ is a type of anemia caused by lack of
iron, it is the decrease in the number of red blood cells or the amount of hemoglobin in
the blood.
It is the most common nutritional disorder in the world. It is commonly seen in
children, adolescent girls, and the women of child bearing age. The total body iron in a
70 kg man is about 4gm. This iron balance is maintained largely by regulating the iron
absorption of dietary iron and body losses. Usually female have smallest stores of iron
when compared to male due to blood loss during menstruation. The daily iron
requirement is 7-10mg in men and 7-20mg in woman.
Hemoglobin is needed to carry oxygen and if you have too few or abnormal red blood
cells, or not enough hemoglobin, there will be a decreased capacity of the blood to
carry oxygen to the body’s tissues. This results in symptoms such as fatigue, dizziness,
weakness, and shortness of breath, among others. The optimal hemoglobin
concentration needed to meet physiologic needs varies by age, sex, smoking habits,
elevation of residence and pregnancy status. The most common causes of anemia
include particularly iron deficiency, nutritional deficiencies, though deficiencies in

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folate, vitamins b12 and are also important causes; haemoglobinopathies; and
infectious diseases, such as tuberculosis, malaria, HIV and parasitic infections.
The condition of having a lower-than-normal number of red blood cells or quantity of
hemoglobin. Anemia diminishes the capacity of the blood to carry oxygen. Patients
with iron deficiency anemia may feel tired, fatigue easily, appear pale, develop
palpitations, and become short of breath. Children with chronic iron deficiency
anemia are prone to infections and learning problems. The main causes of iron
deficiency anemia are bleeding, hemolysis (excessive destruction of red blood cells),
underproduction of red blood cells (as in bone marrow diseases), and underproduction
of normal hemoglobin (as in sickle cell anemia and in iron deficiency anemia).
Women are more likely than men to have iron deficiency anemia because of
menstrual blood loss. In children, iron deficiency anemia is most commonly due to
insufficient iron in the diet. Iron deficiency anemia is also often due to
gastrointestinal bleeding caused by medications, including such common drugs as
aspirin and ibuprofen.

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EPIDEMIOLOGY
Anaemia affects 1.62 billion people (95% CI: 1.50–1.74 billion), which
corresponds to 24.8% of the population (95% CI: 22.9–26.7%). The highest
prevalence is in preschool-age children (47.4%, 95% CI: 45.7–49.1), and
the lowest prevalence is in men (12.7%, 95% CI: 8.6–16.9%). However, the
population group with the greatest number of individuals affected is non-
pregnant women (468.4 million, 95% CI: 446.2–490.6).
Global overview
• WHO Global Database on Anaemia for 1993–2005, estimated the
prevalence of anaemia worldwide at 25%.
 Estimated prevalence
• High development countries – 9%
• Low development countries – 43%.
• Africa and Asia account for more than 85% of the absolute anaemia
burden in high-risk groups

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ETIOLOGY
 Dietary lack of iron: In such cases infants are at high risk because milk diets
contain very small amount of iron.
 Impaired absorption: Occurs in cases of sprue, intestine steatorrhea, chronic
diarrhea and gastrectomy.
 Increased requirement: This is an important cause of iron deficiency anemia
as it commonly seen in infants, children, adolescents, premenopausal and
pregnant women.
 Chronic blood loss: As can be seen in conditions like peptic ulcer, uterine
fibroids, HIV/AIDS, malaria, worm infestations (pinworm/hookworm disease).
Red blood cells bring oxygen to the body's tissues. Healthy red blood cells are
made in bone marrow. Red blood cells circulates through body for 3 to 4 months.
Parts of the body, such as spleen, remove old blood cells.
Iron is a key part of red blood cells. Without iron, the blood cannot carry oxygen
effectively. Body normally gets iron through diet. It also reuses iron from oldred
blood cells in the ferric form of iron.

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Iron deficiency anemia develops when the body's iron stores run low. This can
occur because:
Losing more blood cells and iron than the body can replace
The body does not do a good job of absorbing iron.
Body is able to absorb iron, but person is not eating enough foods that contain
iron.
Body needs more iron than normal (such as if you are pregnant or breast feeding)
 Bleeding can cause iron loss. Common causes of bleeding are:
 Heavy, long, or frequent menstrual periods
 Cancer in the esophagus, stomach, small bowel, or colon
 Esophageal varices, often from cirrhosis
 The use of aspirin, ibuprofen, or arthritis medicines for a long time, which
can cause gastrointestinal bleeding
 Peptic ulcer disease
 The body may not absorb enough iron in diet due to:
 Coeliac disease
 Crohn’s disease

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 Gastric bypass surgery
 Taking too many antacids or too much of the antibiotic tetracycline
 A person may not get enough iron in diet if:
 A person is a strict vegetarian
 Person do not eat enough foods that contain iron

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Fe2+ ion enters into cell with the help of DMT-1
(divalent metal transporter-1) protein
Fe2+ ion
Fe3+ react with C-reductase enzyme
and convert in
Fe2+ ion.
fe3+(plant source)
fe2+(animal source,hemoglobin,myoglobin)
inside the cell ions storedas
ferritin
when our body needs iron, Fe2+
gets out through ferroportin.
outside the cell, enzyme
hephastin convert Fe2+ ion in
Fe3+ ion.
Fe3+ ion released in circulation
Apo transferrin present in blood
stream binds with Fe3+ ion. (it
binds with at least 2 ion at a time)
PATHOPHYSIOLOGY

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Upto 75% of iron used
for process of
erythropoiesis(in form
of fe2+ ion)
10-20% iron
Go to liver & transferin attachs to transferin receptor present
on liver cell
It goes inside the liver cell & stored as fe2+ ion
A master protein hepcidin
Regulate the level of iron in blood stream
It get feedback from inflammatory cytokine
Increased plasma fe3+ & lipopolysacheride
It manage the feroportin to stop or allow transfer of
fe2+ from tissue & from spleen
It also inhibit the absorption of iron in duodenum cell
mutation in HFE gen result in ''hereditory hemochromotosis" i.e.
iron overload in tissue

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CLINICAL FEATURES
Patient may have no symptoms if the iron deficiency anemia is mild.
Most of the time, symptoms are mild at first and develop slowly. Symptoms may
include:
 Feeling weak or tired more often than usual, or with exercise
 Headaches
 Dizziness
 Palpitations
 Problems concentrating or thinking
As the iron deficiency anemia gets worse, symptoms may include:
 Brittle nails
 Blue color to the whites of the eye
 Desire to eat ice or other non-food things (pica)
 Feeling lightheaded while standing up
 Shortness of breath
 Sore or inflamed tongue
 Mouth ulcers
 Uncontrolled movement of legs (during sleep)
 Hair loss

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Symptoms of the conditions (associated with bleeding) that cause iron
deficiency anemia include:
 Dark, tar-colored stools or blood in the stool
 Heavy menstrual bleeding (in women)
 Pain in the upper belly (from ulcers)
 Weight loss (in people with cancer)
 Lack of Oxygen
 The symptoms of anemia may range from mild and minimal to severe and
incapacitating, potentially even life-threatening. It may be difficult to carryout
normal, everyday activities. With hypoxia, the heart has to work harder to
support the body.
Iron deficiency anemia can affect many systems in the body and produce a
variety of symptoms and signs that affect health including
 Cold hands and feet, pallor
 Numbness, and
 Low body temperature.
 Pain, including in bones, chest, belly, and joints

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 Problems with growth, for children and teens
 Fatigue and diminished capability to perform hard labour.
 Leg cramps on climbing stairs.
 PICA especially for ice to suck or to chew.
 Poor scholastic performance.
 Decreased immunity.
 Impaired growth in infants.
 Irritability, headache, palpitations, dizziness, breathlessness.
Signs:
 Splenomegaly
 Pallor of the mucous membrane.
 Koilonychia i.e. spoon shaped nails.
 Glossy tongue with atrophy of lingual papillae, angular stomatitis.

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DIAGNOSIS AND INVESTIGATION
To diagnose iron deficiency anemia, following test will be done
 Complete blood count
 Reticulocyte count
 Iron binding capacity (TIBC) in the blood
 Serum ferritin
 Serum iron level
 Serum hepcidin level (protein and regulator of iron in the body)
 Bone marrow biopsy (if the diagnosis is not clear)
To check for causes (blood loss) of iron deficiency,
 Colonoscopy
 Fecal occult blood test
 Upper endoscopy
 Tests to detect sources of blood loss in the urinary tract or uterus

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DIFFERENTIAL DIAGNOSIS
Hemolysis during phlebotomy and significant hemodilution due to large volume fluid
resuscitation may lead to a falsely low red cell count.
In acute blood loss from trauma, iron deficiency anemia may not immediately be
present on laboratory testing, as the fluid shifts have not had time to occur to
normalize the circulating volume, thus diluting the number of red blood cells
remaining
Iron deficiency anemia of chronic disease: consider renal failure, underlying malignancies,
and autoimmune conditions
Bone marrow infiltration: consider in a patient with weight loss, fatigue.
Macrocytic anemia with B12/foliate deficiency: consider in a patient with
paresthesias, vegans/vegetarians or in patients withrecent gastric bypass surgeries
Hemolytic anemia: consider in all patients with jaundice, dark urine. Always question
the recent use of medications.
Acute upper or lower GI bleeds: trauma, carcinoma, peptic ulcer disease, use of
NSAIDs.

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MANAGEMENT IN MODERN MEDICINE
Management depends primarily on treating the underlying cause of iron deficiency anemia.
1) Iron deficiency anemia due to acute blood loss- Treat with IV fluids, cross
matched packed red blood cells, oxygen. Always remember to obtain at least two
large-bore IV lines for the administration of fluid and blood products. Maintain
hemoglobin of > 7 g/dL ina majority of patients. Those with cardiovascular disease
require a higher hemoglobin goal of > 8 g/dL.
2) Iron deficiency anemia due to nutritional deficiencies: Oral/IV iron, B12, and foliate.
 Oral supplementation of iron is by far the most common method of iron
repletion. The dose of iron administered depends on the patient's age, calculated
iron deficit, the rate of correction required, and the ability to tolerate side
effects. The most common side effects include metallic taste and gastrointestinal
side effects such as constipation and black tarry stools, nausea and diarrhoea.
For such individuals, they are advised to take oral iron every other day, in order
to aid in improved GI absorption. And they are also adviced to take this oral
supplement with orange juice (because of its high acidic content it helps in
absorption).The hemoglobin will usually normalize in 6-8 weeks, with an
increase in reticulocyte count in just 7-10 days.

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 IV iron may be beneficial in patients requiring a rapid increase in levels.
Patients with acute and ongoing blood loss or patients with intolerable side
effects are candidates for IV iron.
3) Iron deficiency anemia due to defects in the bone marrow and stem cells:
Conditions suchas aplastic anemia require bone marrow transplantation.
4) Iron deficiency anemia due to chronic disease: Iron deficiency anemia in the
setting of renal failure, responds to erythropoietin. Autoimmune and hematological
conditions causing iron deficiency anemia require treatment of the underlying
disease.
5) Iron deficiency anemia due to increased red blood cell destruction:
 Hemolytic anemia caused by faulty mechanical valves will need replacement.
 Hemolytic anemia due to medications requires the removal of theoffending
drug.
 Persistent hemolytic anemia requires splenectomy.
 Haemoglobinopathies such as sickle cell anemia require bloodtransfusions,
exchange transfusions, and even hydroxyurea to decrease the incidence of
sickling.
 DIC, which is characterized by uncontrolled coagulation and thrombosis,
requires the removal of the offending stimulus. Patients with life-threatening
bleeding require the use of antifibrinolytic agents.

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HOMOEOPATHIC MANAGEMENT
Homoeopathic medicine selected on the basis the totality of the
symptoms, constitution, temperament, diathesis and miasm.
There are some common medicines for iron deficiency anemia:-
1. CALCAREA PHOSPHORICA: - Medicine for children who has
nutritional disturbances. Patient has frequent attacks of tonsillitis.
Person are dark complexioned, dark hair, instead of fat. Children are
weak and emaciated, who are unable to stand. Acne in school going
anemic girls.
2. CHINA OFFICINALIS: - The patient if of dark complexion and
dull face. It especially works when anemia presents due to loss of
vital fluid, sexual excess and debility from exhausting discharges.
Heaviness of head and disturbed sight, with loss of interest in doing
work or exercise. Patient is sensitive to touch. Due to weakness

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patient feel numbness and trembling of limbs, and violent palpitation
of heart. The anemia may be present due to any traumatic injury or
excessive bleeding by any means. Skin is cold and clammy. China
acts both as a hemorrhage and controller and also increases the
amount of blood in body.
3. FERRUM PHOSPHORICUM: - Patient of Ferrum phosphoricum
is usually young, sickly looking and week internally.
Pseudoplethoric. Person got tired after doing any work, even after
walking and talking. Body looks sickly pale, white and bloodless. It
works in first stage of inflammation. Most frequently used
homoeopathic medicine to increase our hemoglobin level in body.
Suitable to all age groups and even during pregnancy. Skin appears
pale, pulse rate is quickened, also experience palpitation of heart and
weakness. Vertigo and headache may also be appearing as
symptoms. In females, there is excessive bleeding during periods.
And it is long lasting.
It is the medicine for controlling sweat especially at night.

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4. LECITHIN: - This remedy has action on blood and is usually given
for anemic individual to increase the number of RBC’s and amount of
Hb. There will be mental exhaustion. The individual will be weak
with shortness of breath, loss of breath, loss of flesh; will be forgetful,
dull and confused. The headache in the occipital will be pulsating
type and will crave for wine and coffee
5. NATRUM MURIATICUM: - It is medicine for anemia with weight
loss. It acts efficiently to control weight loss and excessive weakness.
Patient appears very lean, thin weak and emaciated with loss of flesh.
Anemia from loss of vital fluid. Headache from sunrise to sunset,
especially school going girls. Tongue is mapped with red insular
patches like ringworm on sides. Patient is very anxious and drop
things from nervous weakness. Patient has great liability to take cold.
Craving for salty food. Anemia due to long-lasting grief. Intermitted
fever paroxysm at 10 or 11 a.m.
Skin is dry and cracked around nails. Remedy for treating anemia
especially after malaria.
6. PHOSPHORUS: - This remedy is especially for anemia due to renal
disease. This remedy is adapted to tall, slender person, narrow chest,

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thin with transparent skin, weakened by loss of animal fluids. There
will be great debility with emaciation. There will be haemorrhagic
tendency. Chronic congestion of head, thirst for cold water. Violent
palpitation with anxiety while lying on left side and weakness and
trembling from every exertion.
7. PULSATILLA: - This is well known medicine for iron deficiency
anemia. Patient is mild, thirtless, aggravated by heat. Pulsatilla is the
great antidote to iron, and hence is indicated in the anemic condition
produced by large dose. The system is relaxed and worn out. The
patient is chilly and suffers from gastric and menstrual derangements.
Thus the symptoms resemble closely those calling for Ferrum. The
cause of the anemia must be sought for, and if the case comes from
allopathic hand. The pulsatilla patient feels better in the open air
.dizziness on rising, absence of thirsts, and the peculiar disposition
will lead to the remedy.
8. SEPIA OFFICINALIS: - Here women will have weak yellow
complexion. They feel cold even in a warm room. They are irritable.
There will be aesthetic inflammation of eye with uterine trouble.

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There is craving for vinegar, acids and pickles. Dyspnoea aggravates
after sleep and is better by rapid motion. Violent intermittent
palpitation.
Some rare homoeopathic medicine for iron deficiency anemia:
1. ALETRIS FARINOSA Q: - Homeopathic medicine for women suffering
from iron deficiency anemia with extreme weakness and fatigue. There is a
marked weariness and tiredness all day. The energy level seems to be
markedly reduced and the body feels powerless. A frequent episode of
faintness and vertigo and even the face appears very pale. Iron deficiency
anemia in women due to abundant bleeding during periods and repeated
abortions.
2. ALSTONIA SCHOLARIS 30- Alstonia Scholaris is considered a
complete tonic for patients who have anemia and other complaints
following malarial fever. The complaints apart from anemia are weak
digestion. The patients needing Alstonia Scholaris have a history of
diarrhea during malarial fever.
3. STROPHANTHUS HIS. Q- Strophanthus is prescribed when anemia

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with palpitations and breathlessness is present. Strophanthus tones up the
heart and is safer for the aged. Dyspnoea is present especially when
ascending. Lungs congested.
4. CEANOTHUS Q- Ceanothus is prescribed when anemia is due to
dysfunction of liver and spleen. There is violent dyspnoea is present.
Bronchitis with profound secretion occurs.
5. IRIDIUM MET 30—Iridium met is effective in anemia after exhausting
diseases or due to old age or in children growing too fast. It increases red
blood corpuscles.
6. TEUCRIUM 10M—Teucrium is very effective in children for anemia due
to pin worms. It will also eradicate worms.

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BIBLIOGRAPHY
Essential of medical physiology, 8th
edition, by K sembulingam and Prem
sembulingam.
Textbook of pathology, 7th
edition, by Harsh Mohan.
Pathology practical book, 3rd
edition, by Harsh Mohan.
Homoeopathic therapeutics, Samuel Lilienthal, MD.
Allen’s keynotes, 10th
edition, by H.C.Allen.
Boericke’s new manual of homoeopathic materia Medica with repertory, 3rd
edition & augmented edition based on 9th
edition, by William Boericke’s.
https://www.mayoclinic.org/diseases-conditions/anemia/symptoms-causes/syc-
20351360#:~:text=Anemia%20is%20a%20condition%20in,range%20from%20
mild%20to%20severe.
https://www.researchgate.net/publication/322994935_Iron_Deficiency_Anaemi
a
https://ijmedph.org/sites/default/files/IntJMedPublicHealth_2013_3_4_235_123
426.pdf
https://www.hindawi.com/journals/anemia/2019/1097547/

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https://www.who.int/vmnis/anaemia/prevalence/summary/anaemia_data_status_
t2/en/#:~:text=Globally%2C%20anaemia%20affects%201.62%20billion,CI%3
A%208.6%E2%80%9316.9%25).

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MASTER CHART
S.No OPD No. Name Age/sex Diagnosis Outcome
1. 43467 Ekta 26yr/F Anemia with
weakness
Improvement
2. 40014 Shivani
sharma
22yr/F Anemia with
weakness
Improvement
3. 38198 Anu
Kumawat
28yr/F Anemia with
weakness
Improvement
4. 38248 Ananya 28/F Anemia with
weakness
Improvement
5. 41456 Jaisingh 23yr/F Anemia with
weakness
Improvement