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=== ''Vidhi Vimarsha'' ===
 
=== ''Vidhi Vimarsha'' ===
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What is rakta’s relationship with blood?  Rakta is a dhatu, or a flowing tissue that is responsible for the sustenance of life. Unlike what has been written in various commentaries or texts on rakta, blood is not the same as raktadhatu. Blood contains formed elements (RBC, WBC, platelets) which are products of sarakta meda, the integral component of majjadhatu. It has plasma containing minerals, vitamins, procoagulant and anticoagulant factors, enzymes, hormones, neurotransmitters, nutrients, etc., which are mostly assigned to rasadhatu. Blood also contains fats, cholesterol, free fatty acids etc., which are products of medadhatu. It contains blood proteins such as actin, myosin, myoglobin, etc. which are integral components of mamsadhatu. It also contains metabolic wastes such as urea and lactic acid etc., which are mala. Therefore, raktadhatu is a component of blood, using it as part of its material structure for its functions.
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What is ''rakta''’s relationship with blood?  ''Rakta'' is a ''dhatu'', or a flowing tissue that is responsible for the sustenance of life. Unlike what has been written in various commentaries or texts on ''rakta'', blood is not the same as ''raktadhatu''. Blood contains formed elements (RBC, WBC, platelets) which are products of ''sarakta meda'', the integral component of ''majjadhatu''. It has ''plasma'' containing minerals, vitamins, procoagulant and anticoagulant factors, enzymes, hormones, neurotransmitters, nutrients, etc., which are mostly assigned to ''rasadhatu''. Blood also contains fats, cholesterol, free fatty acids etc., which are products of ''medadhatu''. It contains blood proteins such as actin, myosin, myoglobin, etc. which are integral components of ''mamsadhatu''. It also contains metabolic wastes such as urea and lactic acid etc., which are ''mala''. Therefore, ''raktadhatu'' is a component of blood, using it as part of its material structure for its functions.  
Blood is a balanced fluid that will not cause disease on its own, since its job is to give life. Rakta is a dhatu with the functions of jeevana, carriage, transformation, and the role of traveling through the arterial system, providing building blocks for creation and sustenance of the organs in the koshtha.  Indeed, it was rakta that helped create them in the embryonic state.  Prolonged consumption of pitta provoking diet and lifestyle vitiate rakta/blood. When the rakta/blood is vitiated, then it becomes an incompatible substance to the body. The body tries to clear it by expelling it in the form of ‘bleeding’.  
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The rakta, containing this contaminated pitta dosha provoking it, becomes increased in volume, and continues to circulate through the body, disturbing and dominating over all the functions of the rakta tissue. This rakta-pitta then blocks, coats, and vitiates the blood and the organs that rakta produces and nourishes. In Raktapitta, the disease requires recognition early in its course to provide a person a cure, as manifestation of actual symptoms indicates end-stage.   
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Blood is a balanced fluid that will not cause disease on its own, since its job is to give life. ''Rakta'' is a ''dhatu'' with the functions of ''jeevana'', carriage, transformation, and the role of traveling through the arterial system, providing building blocks for creation and sustenance of the organs in the ''koshtha''. Indeed, it was ''rakta'' that helped create them in the embryonic state. Prolonged consumption of ''pitta'' provoking diet and lifestyle vitiate ''rakta''/blood. When the ''rakta''/blood is vitiated, then it becomes an incompatible substance to the body. The body tries to clear it by expelling it in the form of bleeding.
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The ''rakta'', containing this contaminated ''pitta dosha'' provoking it, becomes increased in volume, and continues to circulate through the body, disturbing and dominating over all the functions of the ''rakta'' tissue. This ''rakta-pitta'' then blocks, coats, and vitiates the blood and the organs that ''rakta'' produces and nourishes. In ''raktapitta'', the disease requires recognition early in its course to provide a person a cure, as manifestation of actual symptoms indicates end-stage.   
    
Nutritional research claims on substances linked to hypo-coagulation and/or bleeding disorders
 
Nutritional research claims on substances linked to hypo-coagulation and/or bleeding disorders
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Vitamin K:
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==== Vitamin K ====
Much of the research on dietary interactions with bleeding disorders comes from the interaction of foods with warfarin. Since 1951, warfarin has been used as an anticoagulant, effectively preventing the formation of blood clots in the blood vessels and their migration elsewhere in the body respectively. warfarin reduces the availability of the reduced form of Vitamin K1, a critical molecule in the coagulation cascade, affecting blood coagulation proteins prothrombin and factor VII. Warfarin inhibits the enzyme vitamin K epoxide reductase, which recycles Vitamin K1 from its oxidized form to a ready reduced form. The net effect is that coagulation is lessened. Foods with high vitamin K1 directly supply the vitamin to the body, bypassing the inhibition of warfarin; thus they reinitiate the coagulation pathway.  
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Much of the research on dietary interactions with bleeding disorders comes from the interaction of foods with warfarin. Since 1951, warfarin has been used as an anticoagulant, effectively preventing the formation of blood clots in the blood vessels and their migration elsewhere in the body respectively. warfarin reduces the availability of the reduced form of Vitamin K1, a critical molecule in the coagulation cascade, affecting blood coagulation proteins prothrombin and factor VII. Warfarin inhibits the enzyme vitamin K epoxide reductase, which recycles Vitamin K1 from its oxidized form to a ready reduced form. The net effect is that coagulation is lessened. Foods with high vitamin K1 directly supply the vitamin to the body, bypassing the inhibition of warfarin; thus they reinitiate the coagulation pathway.  
    
These foods include leafy vegetables such as spinach, cabbage and broccoli, darker varieties of lettuces, some radishes, and the herbs parsley, cilantro and dill.
 
These foods include leafy vegetables such as spinach, cabbage and broccoli, darker varieties of lettuces, some radishes, and the herbs parsley, cilantro and dill.
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Spices and herbs with high salicylate content block vitamin K and act as natural blood thinners. The food substances mentioned in the etiology are rich in salicylates.  
 
Spices and herbs with high salicylate content block vitamin K and act as natural blood thinners. The food substances mentioned in the etiology are rich in salicylates.  
Garlic (Rasona) is clearly-mentioned among the etiological factors of Raktapitta (C.Ni. 2/4). Garlic contains nine different naturally-occurring anti-platelet compounds. It also acts as natural antibiotic that can kill intestinal bacteria, which manufacture vitamin K.
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Omega-3 Fatty Acids:
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Garlic (''Rasona'') is clearly-mentioned among the etiological factors of ''raktapitta'' (C.Ni. 2/4). Garlic contains nine different naturally-occurring anti-platelet compounds. It also acts as natural antibiotic that can kill intestinal bacteria, which manufacture vitamin K.
Fish oil is a rich source of omega–3 fatty acids. Omega-3-fatty acids help to thin the blood. Fish may therefore be a great food for people who are at risk of blood clots but too much consumption of omega-3 can be at risk of bleeding disorders. This fact was long back observed and reported in Ayurveda in Charaka samhita (Ni.2.4).   
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==== Omega-3 Fatty Acids ====
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Fish oil is a rich source of omega–3 fatty acids. Omega-3-fatty acids help to thin the blood. Fish may therefore be a great food for people who are at risk of blood clots but too much consumption of omega-3 can be at risk of bleeding disorders. This fact was long back observed and reported in Ayurveda in [[Charaka Samhita]] (Ni.2.4).   
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==== Alcohols ====
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Charaka describes a group of preparations containing alcohol under ''nidana'' (Ni.2.4) (etiological factors): ''sura, sauvira,'' ''shukta, badaramala''. Ayurvedic classics warn against excessive use of alcohols in ''pitta''-vitiated patients, due to their heating and drying. In addition, biomedical research in 1986, suggests that subclinical vitamin K deficiency occurs in alcoholics, contributing to hypo-coagulability.
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Alcohols:
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In summary, it appears that all the foods listed, either due to inherent ''veerya'' (heat ''dosha'' transfer potential) or combinations that create difficulty to digest using the body’s own heat, will raise a level of heat in the body that aggravates ''pitta dosha'' and initiates the cascade of ''pittakopa'' that leads eventually, if un-intervened, to ''raktapitta''.
Caraka describes a group of preparations containing alcohol under nidana (Ni.2.4) (etiological factors): sura, sauvira, shukta, badaramala. ayurvedic classics warn against excessive use of alcohols in pitta-vitiated patients, due to their heating and drying. In addition, biomedical research in 1986, suggests that subclinical vitamin K deficiency occurs in alcoholics, contributing to hypo-coagulability.  
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In summary, it appears that all the foods listed, either due to inherent virya (heat doṣha  transfer potential) or combinations that create difficulty to digest using the body’s own heat, will raise a level of heat in the body that aggravates pitta doṣha  and initiates the cascade of pittakopa that leads eventually, if un-intervened, to raktapitta.
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==== Excess heat ====
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Excess heat:
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Among the lifestyle factors that lead down to aggravated ''pitta'' (''viharaja nidanas'') and raktapitta are excessive exercise/vyayama, and exposure to sunlight. Scientific evidence has now established that vigorous exercise appears to lower vitamin K levels and thus thin the blood. Sunlight increases the conversion of Vit D to Vit D3 in the skin; a recent clinical trial of a biologically active metabolite of Vit. D3 demonstrated an unanticipated reduction of thrombosis in cancer patients. Therefore, it appears that Vit D3 reduces blood clotting.
Among the lifestyle factors that lead down to aggravated pitta (viharaja nidanas) and raktapitta are excessive exercise/vyayama, and exposure to sunlight. Scientific evidence has now established that vigorous exercise appears to lower vitamin K levels and thus thin the blood. Sunlight increases the conversion of Vit D to Vit D3 in the skin; a recent clinical trial of a biologically active metabolite of Vit. D3 demonstrated an unanticipated reduction of thrombosis in cancer patients. Therefore, it appears that Vit D3 reduces blood clotting.
      
Hereditary issues
 
Hereditary issues