Study of Impact of Yoga on Hematological Parameters 

Iti Sasane*, Durgadas Sawant

The Somaiya School, Vidyanagar, Vidya Vihar East, Ghatkopar, Mumbai, Maharashtra 400077, India
** Yoga Vidya Niketan Plot # 14, Juhu Nagar, Sector 9A, Vashi, Navi Mumbai, Maharashtra 400703, India

Abstract– Regular practise of Yoga is said to have beneficial impact on overall well being. The purpose of this study was to observe how regular Yoga practise affects various hematological parameters.

Fifty nine healthy adults aged between 18 and 60 years volunteered to take part in the study. Prior written consent was taken from each participant. All participants were attending the one year Yoga teachers training course of Yoga Vidya Niketan, Navi Mumbai under the supervision of professional Yoga teachers. Hematological parameters like haemoglobin, C-Reactive Proteins, cortisol, white blood cell (WBC) count, platelet count, were measured before and after the training.

Results showed highly significant increase in haemoglobin levels, significant increase in platelet count, significant reduction of C-reactive proteins, but WBC and cortisol levels did not show significant improvement. The results are consistent with previous studies about the beneficial impact of Yoga on hematological parameters.

Index Terms- Hematological parameters, Impact of Yoga, Haemoglobin, C-Reactive Protein

Introduction

Yoga has been practised for spirituality and also for healthy living since ancient times in India and signifies unity and oneness of mind and body1. Now the International Day of Yoga is celebrated across the world annually on June 21 since 2015, following its inception in the United Nations General Assembly in 2014. Now Yoga is considered as one of the most important methods of complementary medicine in the United States2,3 .
There are many different styles of Yoga. The different Yoga styles contain different combinations and durations of components (e.g., postures, breathing, meditation, relaxation, and chanting)4. All different styles of Yoga are based on five basic principles: proper relaxation, appropriate use of most of the muscles in the body and massage to all the organs, proper breathing, appropriate diet, positive thinking and meditation. Although Yoga is not primarily a therapy, scientific studies have proved a significant role of Yoga in treating wide range of diseases such including coronary heart disease5, and mental health issues6. For this reason, some researchers describe Yoga to be a “lifestyle polypill7 ”.
There have been various research reports which suggest that regular Yoga practise has many health benefits. Some of the benefits reported are stress control, reduced anxiety, and muscle strength improvement8. However, there is not enough research about beneficial effects of Yoga on hematological parameters9. There is one study by Banerjee et al10, which has studied the effect of Yoga on physical and hematological parameters. This study can be considered as an extension of that study to examine how Yoga practise affects hematological parameters.

Methods

Fifty nine healthy volunteers participated in the study. Fourteen participants were male, and forty five were female. The age range was 19-69 years. The study was designed as an uncontrolled longitudinal study. Written consent was taken from all the participants after explaining the study and sharing information of the blood tests planned for the study.
All volunteers were going to start regular Yoga practise under Yoga Teachers Training Course from 21st July 2023. The participants were assessed just at the start of training on 6 August 2023, and again on 29 Feb 2024, after a gap of six months during which the participants had regular Yoga practise. The same subjects were chosen as both study and control groups. Exclusion criteria included those who did not practise regular Yoga for the six month period.
Table 1 shows the hematological parameters measured.
Table 1: Hematological parameters measured

Parameter measured Method
Haemoglobin (Colorimetric) Hb-SLS; RBC-Hemodynamic focus DC
Total and differential WBC count Flowcytometry
5 Part Cell Counter
Platelet and indices Hemodynamic Focus DC
C- Reactive Protein Immunoturbidimetric
Cortisol 8 AM CMIA

After the first blood sample was collected on 6th August 2023, all participants attended the Yoga training course over six months at Yoga Vidya Niketan, Navi Mumbai under the guidance and supervision of professional Yoga teachers. All participants also practised Yoga from 30 minutes to 90 minutes every week, daily or at least thrice a week.
The blood parameters from before and after the six month training period were compared as mean±standard deviation (SD). Student’s paired t test (two-tailed) before and after six months was calculated .
The paired t-test is a statistical procedure in which each entity is measured twice (“before” and “after”), resulting in pairs of observations. It is used to determine whether the mean difference (μd) between two sets of observations is zero. The paired t-test has two competing hypotheses, the null hypothesis (H0) and the alternative hypothesis (H1). The null hypothesis assumes that the true mean difference between the paired observations is zero, which means that the “before” and “after” values do not differ significantly. Under this hypothesis, all observable differences are explained by just random variation. Conversely, the alternative hypothesis assumes that the true mean difference between the paired observations is not equal to zero, which means that there is a statistically significant difference between the “before” and “after” values. The procedure for a paired observations t-test can be summed up in four steps. The symbols to be used are defined below:
D = Differences between two paired observations
di = The ith observation in D
n = The sample size
= The sample mean of the differences
σ= The sample standard deviation of the differences
t = The t-statistic (t-test statistic) for a paired observations t-test
p = The p-value (probability value) for the t-statistic.
The four steps are listed below:

1. Calculate the sample mean.

Calculate the sample standard deviation.

1. Calculate the test statistic.

Calculate the probability (p-value) of observing the test statistic under the null hypothesis. This can be done by looking up the value in a statistical textbooks, or with statistical software for more accurate results.
Statistical significance is determined by looking at the p-value. The p-value gives the probability of observing the test results under the null hypothesis. The lower the p-value, the lower the probability of obtaining a result like the one that was observed if the null hypothesis was true. Thus, a low p-value indicates decreased support for the null hypothesis. However, the possibility that the null hypothesis is true and that we simply obtained a very rare result can never be ruled out completely. The cutoff value for determining statistical significance is ultimately decided on by the researcher, but usually a value of .05 or less is chosen. This corresponds to a 5% (or less) chance of obtaining a result like the one that was observed if the null hypothesis was true.

Results

Out of 59 participants, 14 (24%) were male and 45 (76%) were female. Chart 1 shows the gender demographic of the participants.
Chart 1: Gender demographics of participants

Chart 1: Gender d

The age range of participants varied from 19 to 69. The age distribution is shown in Chart 2.

Chart 2: Age distribution of participants

Table 2 shows summary of hematological parameters before and after Yoga practise.

Table 2: Parameters before and after Yoga training
Parameter measured Before Yoga training After Yoga training P Value
Haemoglobin 12.75±1.40 13.08±1.39 0.000076
(Very highly significant)
Platelet count 297±78 318±80 0.018
(Significant)
C reactive Protein 3.16±3.32 2.20±1.98 0.020
(Significant)
WBC count 6574±1490 6758±1656 0.476
(Not significant)
Cortisol 11.84±3.07 11.88±4.28 0.993
(Not significant)

P’ value < 0.05 taken as significant, < 0.01 highly significant and < 0.001 as very highly significant;
Discussion
Based on the hypothesis that Yoga training has beneficial effect on health, various hematological parameters were compared before and after Yoga training. After six months of Yoga training, broadly all participants reported improvement in general well being.
Very highly significant (P<0.001) improvement was seen in haemoglobin levels in this study. As seen in chart 3a, most of the participants showed increase in haemoglobin levels.
Chart 3 a: Difference in haemoglobin levels before and after Yoga training

Around 66% of all participants showed increase in haemoglobin levels as seen in Chart 3b. In case of female participants, the proportion of females who showed increase in haemoglobin levels is even higher (71%) as seen in Chart 3c.
Chart 3b: Comparison of haemoglobin levels in all participants Chart 3c: Comparison of haemoglobin levels in female participants

Increased level of haemoglobin is consistent with earlier studies. In a study of 150 participants, Sayyad et al studied, among other factors, the effect of Sudarshan Kriya Yoga for 8 days. In the study, it was found that haemoglobin levels increased, along with better lipid profile and pulmonary functions11.
In another study of treating anemic patients with folic acid, iron and Yoga practise for three months, Ramanath et al observed various beneficial results like improvement in haemoglobin, pulse rate and blood pressure12.
The reason for increased haemoglobin can be explained by two different mechanisms:
release of erythropoietin due to hypoxia during Yoga practises; increased release of iron stores from reticulo-endothelial cells and
enhanced release of reserved RBCs by splenic contraction12,13.
A significant (P <0.05) increase was seen in the platelets in this study. As seen in chart 4, most of the participants showed increase in platelet levels.
Chart 4a: Difference in platelet count before and after Yoga training

Around 59% of all participants showed increase in platelet count levels as seen in chart 4b.

Chart 4b: Comparison of platelet count before and after Yoga training

This increase in platelet count is consistent with earlier studies. A similar study by Chohan et al was conducted involving 4 months of Yoga training for 7 adults. They also found a rise in platelet count14.
Purohit et al found a rise in platelets in 87.5% subjects. In their study, clotting time was increased while bleeding time was decreased significantly15. Bleeding time can be defined as the time interval between the moment when bleeding starts and the moment when the bleeding stops due to the formation of temporary platelet plug. Bleeding time usually lasts for 3–4 min. Clotting time is the time interval from onset of bleeding to formation of first fibrin thread and normal clotting time usually lasts for 5–8 min.
The reason for increased platelet count can be explained by two different mechanisms:
hypoxia induced during Yoga practises;
enhanced contraction of spleen which can release the reserved platelets.
Another significant observation of this study is the improvement in C-Reactive Proteins. A significant (P = 0.02) reduction can be seen in C-Reactive Proteins after the Yoga training. As seen in Chart 5a, most of the participants showed reduction in C-Reactive Protein levels.
Chart 5a: Difference in C-Reactive Protein level before and after Yoga training

Around 59% of all participants showed reduction in C-Reactive Protein levels as seen in Chart 5b.
Chart 5b: Comparison of C-Reactive Protein level before and after Yoga training

One study by Mehrabani et al. demonstrated that there was a significant C-Reactive Protein decline in both obese and non-obese groups after 19 weeks of aerobic exercises16. Since regular exercise decreases body fat percentage and fat is a source of IL-6 production, fat reduction decreases serum levels of cytokines and reduction in serum levels of IL-6 weakens the signaling pathway of C-Reactive Protein production. Improved physical readiness due to exercise physiology is the main reason for decline in levels of C-Reactive Proteins 17,18,19,20. This is consistent with results of our study.
Previous studies have shown that exposure to short-term stress (e.g., physical exercise) can lead to changes in WBC21,22. Some studies have reported alterations in leukocyte and subset counts in response to high intensity exercise23. In our study, however there is a minor decrease in WBC count, although this finding is not significant (P = 0.476).
In other literature, it has been suggested that reduction in stress may be expected to lower the cortisol levels. Considering that Yoga helps in reducing stress, reduction in cortisol levels may be expected, which can be attributed to the reduction of stress-related consequences24. However, our study shows a slight increase in the mean value of cortisol levels, although this finding is not statistically significant (P = 0.993). One explanation for this contradictory, although insignificant finding in our could be that the participants had a Shuddhi Kriya practical exam on the same day as the blood collection for the second sample (blood sample after 6 months Yoga training). The anxiety and stress of appearing for the test could have contributed to elevated cortisol levels.
Limitations
This study did not use control groups, and had relatively small sample size. Stricter inclusion and exclusion criteria could also refine the findings further. The study was also restricted by the available testing methods for hematological parameters. In future, a longitudinal research could be conducted over a longer duration – like 12 months to confirm the conclusions of this study.

CONCLUSION

This study shows that Yoga has positive effect on health. In particular, the findings of improved haemoglobin, platelet and C-Reactive Protein are statistically significant. Most of the findings in this study are consistent with previous studies. Further studies may further support or extend the findings of this study.
Acknowledgment
The authors would like to thank the participants of the Yoga Teachers Training Course 2023-24 at the Yoga Vidya Niketan, Navi Mumbai for volunteering to give blood samples for this study.
We are also thankful to Neuberg Diagnostics, Mumbai for their help in blood sample collection and testing various parameters required for this study.
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