Punarnavayolepa Choornam in Iron Deficiency Anemia Management: Pharmaceutical Insights and Biological Activity

Indigenous medical systems employ unique pharmaceutical techniques to meet the therapeutic needs. In the Indian System of Medicine, Ayurveda, a unique method called "Ayolepam" is described that facilitates efficient iron absorption from its source to the formulation. Punarnavayolepa Choornam (PC), prepared from Boerhavia diffusa L. (Punarnava in Ayurveda), is one such novel Ayolepam formulation developed by a traditional Ayurveda school of South India, widely used in the clinical management of iron deficiency anemia (IDA). This study aimed to scientifically evaluate the Ayolepam technique by assessing the iron-binding and bioavailability properties of PC, prepared from the leaves, root, and whole plant of B. diffusa, using in vitro model systems.

The iron content in both raw and processed samples of PC was quantified using inductively coupled plasma mass spectrometry (ICP-MS). A simulated in vitro digestion model was employed to assess the release of bioavailable iron from the formulation. Subsequently, iron bioavailability was evaluated using the human colorectal adenocarcinoma cell line (Caco-2) cell model of human intestinal epithelium following the ferrozine method.

PC preparation from leaves, whole plant, and roots of B. diffusa showed a significant increase in the iron content compared to the raw material. In vitro digestion studies confirmed the efficient release of bioavailable iron from these formulations, and subsequent Caco-2 cell assays confirmed their iron bioavailability properties.

To conclude, the observations from our preliminary study provide a scientific rationale for this unique pharmaceutical preparation (PC) from a traditional school of Ayurveda, supporting its clinical application in IDA management.