www.ijcmr.com International Journal of Contemporary Medical Research ISSN (Online): 2393-915X; (Print): 2454-7379 | ICV (2015): 77.83 | Volume 4 | Issue 7 | July 2017 1475 Yoga Enhances Bioavailability and Assimilation of Oral Iron in Young Female Patients of Iron Defciency Anemia Vikash K Tiwari 1 , Ragini Mishra 2 , Shuchi Chaudhary 1 , Hari Shankar Pandey 3 ORIGINAL RESEARCH ABSTRACT Introduction: Anaemia is one of most common ailment in women of developing countries. Most of dietary iron is not absorbed in gut so they get wasted. This study aims to search out the effect of selected yoga practices on bioavailabity and assimilation of oral iron. Material and Methods: 30 Young female patients divided in two groups with equal participants based on their interest in yoga practice. Case group received yoga practices along with standard treatment and control group received only standard treatment. Haemoglobin of both groups was recorded at time of diagnosis and during course of study (1 st , 8 th , 20 th week of treatment). Result: There was no signifcant difference in hemoglobin level between case and control group at start of study, 1 st , 8 th week of treatment. But there was signifcant difference in two groups at 20 th week of study (P Value = 0.01). Case group had signifcantly higher level of hemoglobin as compared to control group at 20 th week of study. Conclusion: Yoga enhances baseline concentration of iron transporters in gut and increases the secretion of erythropoietin. Selected yoga practices can be used as preventive measure in vulnerable population as it enhances both absorption and assimilation of oral iron. Keywords: Iron defciency anaemia, Yoga, DMT1, Ferroportin INTRODUCTION Anemia is one of the most common ailments in developing countries, especially in women and preschool children. 1-3 Although cut off value slightly differs in different literatures but anemia is usually defned as hemoglobin level less than 13 g/ dl for men and 12 g/dl for women. 4-6 The most common type of anemia encountered in general practice is iron defciency anemia (IDA) and it affect up to 10 % of world population. 7 Nutritional defciency of iron (pregnancy, lactation, poverty), intestinal malabsorption (excessive phytate or tannate in diet, atrophic gastritis), and blood loss (menorrhagia or GI bleeding, worm infestation) are common causes of iron defciency anemia (IDA). 5-8 Iron defciency anemia commonly presents with weakness, pallor, palpitation, and irritability. 6,7 Chronic IDA may present with koilonychias, angular cheilosis, and rarely with plummer-vinson syndrome. Peripheral blood smear shows microcytic hypochromic RBCs with decreased MCV, MCH, MCHC, and serum ferritin level while total iron binding capacity increases. 5 Diagnosis of IDA can be made either by laboratory investigations or therapeutic response to iron therapy. 6 IDA is treated by oral or parenteral iron supplementation. Oral route is preferred over the parenteral route. 7 Oral iron therapy includes ferrous sulfate, while parenteral therapy with sodium ferric gluconate. Parenteral preparations are advised only if oral therapy is not tolerated or there is iron malabsorption. 5-7 There is quick response to iron therapy with regression of symptoms within a few days and reticulosytosis within 5 days. Hemoglobin rises within a week and gets its normal level within 6-8 weeks of treatment. Iron therapy should be continued for 3 months after normalization of hemoglobin level to replenish iron stores in the body. 6,7 Dietary iron is available in two forms; heme iron and nonheme iron and is mainly absorbed from duodenum. 6,9 Only 1 – 5 % of nonheme iron and 10 to 20 % of heme iron is absorbed by duodenum and it is a small fraction of dietary iron available in diet. 6,10 Heme iron is present in meat and nonheme iron is mainly found in vegetarian diet. Absorption mechanism slightly differs for these two types of dietary iron. 10,11 Nonheme iron may be either in ferrous or ferric form. Ferrous form is easily absorbed but ferric form is diffcult to absorb. Ferric form gets converted to ferrous form by ferric reductase Dcytb, expressed on apical side of duodenal enterocytes. DMT1 present on apical side of duodenal enterocyte cotransports iron and hydrogen ion inside the cell. After entering the enterocyte ferrous form of iron binds with mobilferrin and gets transported to basolateral side. Ferroportin transports iron across basolateral membrane. Inside interstitial space ferrous form get oxidized into ferric form by ferroxidase and combines with transferrin for transport in blood. Heme iron is transported across apical membrane by some brush border protein or endocytosis. Internalized heme iron breaks down into ferric form of iron, CO, and biliverdin. Then ferric iron is reduced in ferrous iron and rest of mechanism follows same as that of non heme iron. 10 Primary goal of this study was to fnd out that does selected yogic practices has any impact over iron metabolism. A positive result in the study may give us a lead towards fnding a preventive measure of IDA in high risk population. MATERIAL AND METHODS This study was conducted at UPRIMS&R (Medical College) between January and July 2014. Patients of iron defciency anemia visiting Medicine OPD were recruited in the study as per following inclusion and exclusion criterion. Inclusion criterion 01. Female patients between 20 to 30 years of age 1 Junior Resident, Department of Physiology, BRD Medical College, Gorakhpur, 2 Tutor, Department of Pharmacology, BSA Medical College, New Delhi, 3 Tutor, Department of Forensic Medicine, Government Medical College, Azamgarh, India Corresponding author: Dr Vikash K Tiwari, Junior Resident, Department of Physiology, BRD Medical College, Gorakhpur, India How to cite this article: Vikash K Tiwari, Ragini Mishra, Shuchi Chaudhary, Hari Shankar Pandey. Yoga enhances bioavailability and assimilation of oral iron in young female patients of iron defciency anemia. International Journal of Contemporary Medical Research 2017;4(7):1475-1477.