Ayurveda biology concept <i>Shodhan–Maran</i> of metals can give a new treatment approach in managing intravenous iron sucrose toxicity: A case report

Intravenous iron sucrose is a routinely practiced medicine for iron deficiency anemia. Though many clinical trials have established its safety, it can give rise to adverse drug reactions like nausea, vomiting, cramps, swelling, and redness at the injection site. Doctors of modern medicine routinely manage them with the help of steroids, anti-allergic medications, and intravenous desferrioxamine. After intravenous administration, skin discoloration for longer is unusual and challenging to treat. Here, we have managed a case of severe blackish discoloration of the skin due to intravenous iron sucrose administration, which was unresponsive to allopathic management. Ayurveda concepts of Shodhana (bio purification) and Marana (∼bio calcination) of various (∼heavy metals) can offer unique ways of treating such complications. A 15-year-old female presented in the Out Door Patient Department (OPD) of Kayachikitsa with severe blackish discoloration over the left forearm and hypothyroidism after intravenous administration of iron sucrose. A skin specialist and physician treated her with a local application of clobetasone and thrombophob for one month. However, discoloration remained unaltered, and thyroid-stimulating hormone levels were also high. We treated her considering Lauha Vishaktata because of Amarit Lauha. Hence, the herbs mentioned in Lauha Marak Gana were used internally and locally. Virechan therapy (purgation for detoxification) and leech therapy, Siravedh, were done. Ayurveda’s approach regarding Shodhana and Marana of various Dhatu may give innovative treatment modules for managing complications with these modern medicines. Further studies in this direction may offer better, easier, and cheaper treatment options. Regression in blackish discoloration was observed within 30 days. TSH was also reduced from 10.4[Formula: see text]mIU/ml to 2.04[Formula: see text]mIU/ml, which was maintained for the next four months.