PAPAYA LEAF BENEFITS  

Papaya leaf is best known for its anti-thrombocytopenia actions and anti-dengue property.

Papaya leaf contains unique plant compounds that have demonstrated broad pharmacological potential in test-tube and animal studies. Papaya is one of the most widely cultivated crops in the world. Its fruit, seeds, and leaves are frequently utilized in a variety of culinary and folk medicine practices.

Papaya leaf contains unique plant compounds that have demonstrated broad pharmacological potential in test-tube and animal studies.

Papaya Leaf May :

• treat dengue fever induced thrombocytopenia or low plate count
• treat chikungunya and act as prophylactic for malaria
• treat Drug or Chemotherapy Induced Thrombocytopenia (CIT)
• treat Drug Induced Thrombocytopenia (DIT)
• treat Immune Thrombocytopenic Purpura (ITP)
• promote balanced blood sugar
• support digestive function
• have anti-inflammatory effects
• treat fever

WHAT IS THROMBOCYTOPENIA ?

Thrombocytopenia (pronounced “THROM-bo-sigh-toe-PEE-ne-ah”) occurs when your bone marrow doesn’t make enough platelets. Platelets are blood cells that form blood clots to help stop bleeding. If you have thrombocytopenia, you may bleed a lot, and the bleeding may be hard to stop.

Thrombocytopenia often affects people with certain medical conditions, like autoimmune disease or who take certain medications. Healthcare providers typically treat thrombocytopenia by treating the underlying condition and/or changing the medication that caused the issue.

What are normal platelet levels ?

A normal platelet count or level in adults ranges from 150,000 to 450,000 platelets per microliter of blood. Thrombocytopenia levels are:

• Mild thrombocytopenia: Platelet levels between 101,000 and 140,000 per microliter of blood.
• Moderate thrombocytopenia: Platelet levels between 51,000 and 100,000 per microliter of blood.
• Severe thrombocytopenia: Platelet levels between 51,000 and 21,000 microliters of blood.

What are thrombocytopenia symptoms ?

Some people with mild cases of thrombocytopenia don’t have symptoms. When they do, one of the first symptoms is a cut or nosebleed that won’t stop bleeding. Other symptoms include:

• Bleeding gums: You may notice blood on your toothbrush and your gums may appear swollen.
• Blood in poop (stool): Your poop may appear very dark.
• Blood in urine (pee): If toilet water is pale pink after you pee, you may have blood in your urine.
• Blood in vomit: Hematemesis, or blood in vomit, is a sign of bleeding in your upper gastrointestinal tract.
• Heavy menstrual periods: If your periods last longer than seven days or you’re bleeding more than usual, you may have menorrhagia.
• Petechiae: This symptom appears as tiny red or purple dots on your lower legs that resemble a rash.
• Purpura: You may have red, purple or brown spots on your skin. This happens when small blood vessels under your skin leak blood.
• Bruises: Bruises happen when blood pools under your skin. You may notice you’re developing bruises more easily than usual.
• Rectal bleeding: You may notice blood in the toilet water or after you wipe.

DENGUE FEVER

Dengue (break-bone fever) is a viral infection that spreads from mosquitoes to people. It is more common in tropical and subtropical climates.

Most people who get dengue won’t have symptoms. But for those that do, the most common symptoms are high fever, headache, body aches, nausea and rash. Most will also get better in 1–2 weeks. Some people develop severe dengue and need care in a hospital.

IN SEVERE CASES, DENGUE CAN BE FATAL. 

You can lower your risk of dengue by avoiding mosquito bites especially during the day.

Most people with dengue have mild or no symptoms and will get better in 1–2 weeks. Rarely, dengue can be severe and lead to death.

If symptoms occur, they usually begin 4–10 days after infection and last for 2–7 days. Symptoms may include:

• high fever (40°C/104°F)
• severe headache
• pain behind the eyes
• muscle and joint pains
• nausea
• vomiting
• swollen glands
• rash

Individuals who are infected for the second time are at greater risk of severe dengue.

Severe dengue symptoms often come after the fever has gone away:

• severe abdominal pain
• persistent vomiting
• rapid breathing
• bleeding gums or nose
• fatigue
• restlessness
• blood in vomit or stool
• being very thirsty
• pale and cold skin
• feeling weak.

People with these severe symptoms should get care right away.

After recovery, people who have had dengue may feel tired for several weeks.

“A Multi-centric, Double-blind, Placebo-controlled, Randomized, Prospective Study to Evaluate the Efficacy and Safety of Carica papaya Leaf Extract, as Empirical Therapy for Thrombocytopenia associated with Dengue Fever

Abstract

Dengue is a rapidly expanding global health problem. Approximately 2.5 billion people live in dengue-risk regions with about 100 million new cases each year worldwide. The cumulative dengue diseases burden

has attained an unprecedented proportion in recent times with sharp increase in the size of human population at risk. The management of dengue virus infection is essentially supportive and symptomatic and no specific treatment is available for increasing the fallen platelets, which have a significant role in causing the mortality of dengue patient. This study was conducted to evaluate the platelet increasing efficacy of Carica papaya leaf extract (CPLE) in patients with dengue fever (DF).

Aim: The administration of Carica papaya leaf extract should significantly increase the platelet count in cases of thrombocytopenia associated with dengue, preventing the patient to go in DHF or DSS conditions.

Material and Method: A Multi-centric, Double blind, Placebo controlled, Randomized, prospective study was conducted in 300 patients across 5 centres’, to evaluate the Efficacy and Safety of Carica Papaya Leaf Extract, as empirical therapy for thrombocytopenia associated with dengue fever. The subjects were randomized into two groups, as control and intervention group. Both the groups were managed by the standard management guidelines for dengue except steroid administration. In addition to this, the intervention group received CPLE tablet three times daily for five days. All of them were followed daily with platelet monitoring.

Results: The results indicate that CPLE had significant increase (p<0.01) in the platelet count over the therapy duration, in dengue fever patients, confirming CPLE accelerates the increase in platelet count compared to the control group. There were few adverse events related to GI disturbance like nausea and vomiting which were similar in both groups.”

Prabhu Nagnathappa Kasture, KH Nagabhushan, Arun Kumar, Manipal Hospital, Bangalore, Karnataka, Journal of The Association of Physicians of India ■ Vol. 64 ■ June 2016

CHEMOTHERAPY INDUCED THROMBOCYTOPENIA (CIT)

Chemotherapy-induced thrombocytopenia (CIT) is a common side effect of chemotherapy treatment. It occurs when chemotherapy drugs affect platelet production.

Platelets are a type of blood cells that allow the blood to clot. When platelet numbers drop too low, people may experience bruising, pinpoint-sized red or purple spots on the skin, and bleeding gums or nosebleeds.

The risk of developing CIT varies depending on the type of chemotherapy a person receives, the dose and duration of treatment, the type of cancer they have, and individual factors, such as age and underlying medical conditions.

How does chemotherapy cause CIT ?

Chemotherapy works by targeting rapidly dividing cells. This means chemotherapy can kill cancer cells, but it also means the drug affects other types of cells that divide quickly, such as the cells in hair follicles and bone marrow.

Bone marrow is responsible for producing blood cells, including platelets. When chemotherapy drugs damage the bone marrow, it cannot make enough platelets.

Some chemotherapy drugs also hinder the production of thrombopoietin, which is a hormone that stimulates platelet production. Other drugs can affect the function of platelets, making them less effective at clotting blood.

Some chemotherapy agents are more likely to cause CIT than others. It most commonly occurs in regimens that include gemcitabine, platinum, or temozolomide.

Common symptoms of CIT include :

• bruising
• blood spots under the skin
• nosebleeds
• bleeding gums
• bloody stools
• heavy menstrual periods
• joint and muscle pain
• coughing up blood
• feeling dizzy or weak

REFERENCE

“Efficacy of Carica Papaya Leaf Extract in Reducing Treatment-Delay Secondary to Chemotherapy induced Thrombocytopenia

ABSTRACT

Introduction: Chemotherapy Induced Thrombocytopenia (CIT) is a common problem in clinical oncology. It leads to delay in administration of chemotherapy resulting in inferior outcomes. Timely administration of chemotherapy is necessary to ensure maximal benefits to the patient.

Aim: This study was carried out to assess the efficacy of Carica Papaya Leaf Extract (CPLE) in reducing the delay in administration of chemotherapy.

Materials and Methods: This was a retrospective single centre study conducted at Amrita Institute of Medical Sciences, Kochi, Kerala from July to December 2018. Fifty events of chemotherapy induced thrombocytopenia in forty five patients with proven malignancy were assessed for therapeutic response to standard doses of CPLE. Wilcoxon signed rank test and Karl Pearson’s correlation coefficient was applied to test the statistical significance in mean values from baseline to follow-up period and to obtain correlation between continuous variables respectively.

Results: There was a significant improvement in the platelet count in 54% (n=27) patients within 5 days and another 16% (n=8) by 7 days of CPLE administration. The 18% (n=9) patients took longer than one week to recover their platelet counts. The 12% (n=6) patients had deteriorating platelet counts even after CPLE intervention, one among them mandating platelets transfusion.

Conclusion: The results suggest that use of CPLE may help mitigate the treatment delay in majority of patients with chemotherapy induced thrombocytopenia and should be considered as an option to prevent anti-neoplastic treatment delay.”

Priyanka Sreelatha, Wesley Mannirathil Jose, Journal of Clinical and Diagnostic Research. 2020 Mar, Vol-14(3): XC09-XC12

DRUG INDUCED THROMBOCYTOPENIA (DIT)

Thrombocytopenia is any disorder in which there are not enough platelets. Platelets are cells in the blood that help the blood clot. A low platelet count makes bleeding more likely.

When medicines or drugs are the causes of a low platelet count, it is called drug-induced thrombocytopenia.

Causes of DIT

Drug-induced thrombocytopenia occurs when certain medicines destroy platelets or interfere with the body's ability to make enough of them.

There are two types of drug-induced thrombocytopenia: immune and nonimmune.

If a medicine causes your body to produce antibodies, which seek and destroy your platelets, the condition is called drug-induced immune thrombocytopenia.

Heparin, a blood thinner, is the most common cause of drug-induced immune thrombocytopenia.

If a medicine prevents your bone marrow from making enough platelets, the condition is called drug-induced nonimmune thrombocytopenia. Chemotherapy drugs and a seizure medicine called valproic acid may lead to this problem.

Other medicines that cause drug-induced thrombocytopenia include:

• Furosemide
• Gold, used to treat arthritis
• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Penicillin
• Quinidine
• Quinine
• Ranitidine
• Sulfonamides
• Linezolid

IMMUNE THROMBOCYTOPENIC PURPURA (ITP)

Immune thrombocytopenic purpura (ITP) is a bleeding disorder in which the immune system destroys platelets, which are necessary for normal blood clotting. People with the disease have too few platelets in the blood.

There are two forms of ITP:

• Acute thrombocytopenic purpura. This usually affects young children, ages 2 to 6 years old. The symptoms may follow a viral illness, such as chickenpox. Acute ITP usually starts suddenly and the symptoms usually disappear in less than 6 months, often within a few weeks. Treatment is often not needed. The disorder usually does not recur. Acute ITP is the most common form of the disorder.
• Chronic thrombocytopenic purpura. The onset of the disorder can happen at any age, and the symptoms can last a minimum of 6 months, several years, or a lifetime. Adults have this form more often than children do, but it does affect adolescents. Females have it more often than males. Chronic ITP can recur often and requires continual follow-up care with a blood specialist (hematologist).

Causes of ITP

ITP occurs when certain immune system cells produce antibodies against platelets. Platelets help your blood clot by clumping together to plug small holes in damaged blood vessels.

The antibodies attach to the platelets. The body destroys the platelets that carry the antibodies.

In children, the disease sometimes follows a viral infection. In adults, it is more often a long-term (chronic) disease and can occur after a viral infection, with use of certain drugs, during pregnancy, or as part of an immune disorder.

ITP affects women more often than men. It is more common in children than adults. In children, the disease affects boys and girls equally.

The symptoms of idiopathic thrombocytopenic purpura

Normal platelet count is in the range of 150,000 to 450,000. With ITP, the platelet count is less than 100,000. By the time significant bleeding occurs, you may have a platelet count of less than 10,000. The lower the platelet count, the greater the risk of bleeding.

Because platelets help stop bleeding, the symptoms of ITP are related to increased bleeding. However, each person may experience symptoms differently. Symptoms may include:

The purple color of the skin after blood has "leaked" under it. A bruise is blood under the skin. Persons with ITP may have large bruises from no known injury. Bruises can appear at the joints of elbows and knees just from movement.

Tiny red dots under the skin that are a result of very small bleeds.

Nosebleeds

Bleeding in the mouth and/or in and around the gums

Heavy menstrual periods

Blood in the vomit, urine, or stool

Bleeding in the head. This is the most dangerous symptom of ITP. Any head injury that occurs when there are not enough platelets to stop the bleeding can be life threatening.

Reference

“Effect Of Carica Papaya Leaf Extract On Platelet Count In Chronic Immune Thrombocytopenic Purpura: A Case Series

Abstract

The leaves of Carica papaya have been used to treat thrombocytopenia in Dengue fever in areas where the virus is endemic. This case series describes the use of C. papaya leaf liquid extract (CPLE) as an adjunctive therapy for four patients receiving standard-of-care treatment for chronic immune thrombocytopenic purpura (ITP). The cases presented here indicate that CPLE may prove beneficial in the management of chronic ITP for patients interested in alternative therapy before progressing to second-line treatments. A larger clinical trial is warranted to evaluate CPLE as an adjunctive therapy in chronic ITP.

Methods

This case series describes the use of CPLE in the adjunctive care of four patients with chronic immune thrombocytopenic purpura. Patients in this case series were given either 1000 mg TID of 10:1 liquid glycerin extract of C. papaya leaf or 1200 mg TID of dried 10:1 glycerin extract of C. papaya leaf capsules as adjunctive therapy in addition to conventional standard of care. A toxicity study in rats revealed that CPLE extract was safe at a dose of 2 g/kg, 14 times the dose consumed in traditional medicine and 30 times the maximum dose consumed in this case series (0.06 g/kg). Hematologic parameters including platelet count and adverse events were recorded for each patient over time.

Conclusion

1. papaya leaf aqueous extract may prove beneficial in the management of chronic ITP for patients interested in alternative therapy before progressing to second-line treatments such as Rituximab or splenectomy. Based on the positive association observed in these cases, a larger clinical study is warranted to evaluate C. papaya as an adjunctive therapy in refractory ITP. This case series indicates that a dose of C. papaya leaf 10:1 glycerin extract at 3000 mg/day for two weeks may be sufficient for a preliminary trial in patients with chronic ITP.”

Katherine Hampilos, ND, Joshua Corn, ND, Wendy Hodsdon, ND, Peter Wagner, MD, Ryan Roop, MD, Anderes Elise, MD, and Lynn Troy, ND, Integr Med (Encinitas). 2019 Oct; 18(5): 30–35.