Abstract

Anaemia remains a major global health burden with multifactorial aetiologies including nutritional deficiency, 
chronic disease, genetic disorders, and toxic exposures. Oxidative stress-an imbalance between pro-oxidant species 
and antioxidant defenses-plays a central and underappreciated role in the pathogenesis of many anaemia types. 
Reactive oxygen and nitrogen species damage erythrocyte membranes and haem proteins, precipitating hemolysis; 
they impair bone marrow erythropoiesis via oxidative injury to progenitors; and they dysregulate iron metabolism 
through ferritin/ferroportin modulation and hepcidin-driven sequestration. Exogenous toxicants (heavy metals, 
organic solvents, certain pharmaceuticals) amplify oxidative insults and may precipitate or worsen anaemia. 
Conversely, a growing body of experimental and clinical research suggests that selected herbal therapeutics-rich in 
polyphenols, flavonoids, alkaloids, and micronutrients-can mitigate oxidative damage, modulate iron homeostasis, 
and support erythropoiesis. This review synthesizes mechanistic links between oxidative stress and anaemia, surveys 
relevant toxicological drivers, evaluates evidence for herbal interventions, and highlights safety concerns and 
research priorities. We argue that phytomedicines, when standardized and deployed with attention to interactions 
and patient vulnerability (for example G6PD deficiency or iron-overload disorders), may serve as valuable adjuncts 
to conventional therapy, especially in resource-limited settings. Robust clinical trials with mechanistic endpoints, 
quality-assured formulations, and integrated safety monitoring are necessary to translate promise into practice.