<![CDATA[Anemia remains a major global health problem characterized by reduced erythrocyte count, hemoglobin concentration, and hematocrit levels, often resulting from iron deficiency and oxidative stress. Plant-based alternatives with proven hematological efficacy offer promising therapeutic potential. This study aimed to evaluate the anti-anemic effect of combined red beetroot (Beta vulgaris L.) and roselle (Hibiscus sabdariffa L.) extracts in sodium nitrite (NaNO₂)-induced anemic rats and to determine the most effective combination ratio. The extracts were prepared by maceration using 70% ethanol. Twenty-four female Sprague Dawley rats (±200 g body weight (BW) were randomly divided into six groups: negative control (Na-CMC), positive control (blood supplement tablet), roselle flower extract (40 mg/200 g BW), and three combination groups consisting of beetroot–roselle extracts at ratios of 1:2 (90 mg + 80 mg/200 g BW), 2:1 (180 mg + 40 mg/200 g BW), and 1:1 (90 mg + 40 mg/200 g BW). Anemia was induced using NaNO₂ for 14 days, followed by oral treatment for another 14 days. Hematological parameters, including erythrocyte count, hemoglobin concentration, and hematocrit value, were measured on days 0, 7, and 14 of treatment. Data were analyzed using one-way ANOVA followed by Duncan’s post hoc test (p < 0.05). NaNO₂ induction significantly reduced erythrocyte count, hemoglobin, and hematocrit levels, confirming successful anemia induction. All treatment groups showed significant hematological improvement compared to the negative control (P<0.05). Roselle extract alone produced the highest hemoglobin increase (84.1%), whereas combination treatments resulted in greater erythrocyte recovery. The beetroot–roselle combination at a 2:1 ratio demonstrated the most balanced improvement across erythrocyte count, hemoglobin, and hematocrit parameters. In conclusion, the combination of beetroot and roselle extracts exhibited synergistic anti-anemia activity, likely associated with enhanced iron utilization and antioxidant effects, with the 2:1 ratio showing the most favorable overall hematological response.]]>
