Last verified: April 2026

Anaemia — Pandu

पाण्डु — Pandu — pale; pallor — that which makes the complexion pale and yellow

Pandu is the classical Ayurvedic documentation of anaemia — the pallor and weakness condition arising from deficiency of Rakta Dhatu (blood/red blood cell component). Charaka Samhita, Chikitsasthana 16 documents five types of Pandu by Dosha, the distinctive clinical features of each, and a specific hierarchy of treatment that prioritises Agni correction before mineral supplementation — a clinically important sequence still relevant today.

Important noticeThis page documents what classical Ayurvedic texts record. This is not medical advice. Diagnosis and treatment require assessment by a qualified practitioner (BAMS or MD Ayurveda). Full disclaimer →

Charaka Samhita, Chikitsasthana 16.4

Pandu roge agni durbalam — In Pandu, the Agni is always weakened. No supplementation of iron or other blood-building substances will be absorbed or effective while Agni is impaired. Correction of Agni is always the first step in Pandu treatment.

Five classical types of Pandu

Vataja Pandu: Pallor with dark-coloured skin tinge; associated with dryness, cracking nails, pain, trembling, constipation. Pittaja Pandu: Yellow-toned pallor; associated with fever, burning sensation, yellow eyes and urine (documented resemblance to jaundice in some cases), excessive thirst. Kaphaja Pandu: White pallor; associated with heaviness, oedema, cold, clammy skin, nausea, and excessive sleep. Sannipataja Pandu: All three Doshas involved; the most complex form. Mridbhakshana Pandu: Pandu from eating earth (documented specifically for clay-eating as a cause — pica-associated anaemia from intestinal parasite load, which is the modern understanding of this classical observation).

Classical treatment hierarchy

Charaka Samhita's documented treatment sequence for Pandu: (1) Correct Agni first — Deepana-Pachana herbs (Trikatu, Chitraka) before any mineral supplementation; (2) Virechana where appropriate — specifically documented for Pittaja Pandu to clear the accumulated Pitta from the Rakta channels; (3) Lauha Bhasma (iron ash) — the primary iron preparation; (4) Supporting herbs for Rakta building — Draksha (grape), Amalaki, pomegranate, beetroot (Shalgam).

Classical iron preparations

Lauha Bhasma (iron ash — see Bhasma documentation) is the primary classical iron preparation. Modern research has documented Lauha Bhasma's nanoparticle structure (50–60nm iron oxide particles) and compared its bioavailability to pharmaceutical iron salts. Mandoor Bhasma (iron oxide — rust of iron) is documented as milder and specifically indicated for Pandu associated with liver conditions (Yakritvikar). Navayasa Churna — classical compound with Lauha Bhasma as primary ingredient.

The Agni-first principle in anaemia

The classical insistence on correcting Agni before administering iron is clinically significant. Modern gastroenterology documents that iron absorption is highly dependent on gastric acid production and mucosal integrity — both of which are equivalent to the classical Agni in the digestive channels. Administering iron to a patient with impaired gastric function produces poor absorption and GI side effects — exactly what the classical system predicted and addressed by requiring Agni correction first.

Dietary documentation for Pandu

Classical Pathya (beneficial foods) for Pandu: pomegranate, dark grapes (Draksha), beetroot, green leafy vegetables, sesame, and old ghee. Apathya (contraindicated): excess dairy (documented as blocking Rakta channel formation), incompatible food combinations, alcohol, and cold, heavy foods that impair the already-weakened Agni.