HYPOTHYROIDISM AND ITS AYURVEDIC MANAGEMENT

Hypothyroidism is a common condition where the thyroid gland does not release enough thyroid hormone.

Hypothyroidism affects up to 5% of the general population and further estimated as 5% being undiagnosed.99% of affected patients suffer from primary hypothyroidism. Incidence increases with age and nearly 1in 4 adults over age 45 exhibit some level of thyroid dysfunction most often in middle-aged and older women but anyone can develop the condition including infants.

Aetiology and pathology

The most common cause of hypothyroidism is the inability of the thyroid gland to produce enough thyroid hormone however less commonly pituitary and hypothalamus may also result in thyroid dysfunction. The main cause is an autoimmune disease (like Hashimoto thyroiditis, too much iodine or low iodine, damage to the pituitary gland, congenital hypothyroidism, and radiation.

Clinical features

Hair fall, dandruff, thinning of hair, periorbital puffiness, facial edema, impaired hearing, heaviness of head, headache, throat irritation, hoarseness of voice, neck swelling, breathlessness, exertional dyspnoea, aversion to food, tastelessness, lack of appetite, constipation, dry skin, coarse skin, cold skin, cold intolerance, diminished sweating, sleepiness, drowsiness, difficulty in awakening, slow movements, low libido, myofascitis, tightness of cloths, weight gain, joint pain, joint stiffness, numbness, paraesthesia, irregular menstrual cycle, dysmenorrhea, mood swings, feverish feeling

Investigation

1. TFT
2. Thyroid antibodies (TPO, Thyroglobulin, anti-thyroglobulin antibodies)
3. USG, MRI, fluorescent scanning
4. Radionuclide imaging
5. Thyroid Biopsy
6. BMR
7. Body Reflexes
8. Lipid Profile

How to diagnose Hypothyroidism

Physical Examination -Examination of Thyroid gland and look for changes such as dry skin, swelling, slow reflexes, slower reflexes, and slower heart rate.

TSH is an important and sensitive test for hypothyroidism. It measures how much of thyroid hormone(T4), the thyroid gland is being asked to make. Abnormally high TSH means hypothyroidism. The thyroid gland is being asked to make more T4 because there is not enough T4 in the blood.

Scoring of Symptoms

Management in Ayurveda

Management based on galaganda and gandamala treatment. In this condition, there is a major role in sapthadhadhu, srotas, tridosha. So, treatment should be based on agni, Aama and Srotorodha in conditions of Hypothyroidism. Shodana and Shamana chikitsa needed for Hypothyroidism.

Treatment principles

• Medo dhathvagnivardhanam
• pachanam deepanam
• Athisthoulya chikitsa.
• Adyavatha chikitsa
• Kapha Vata pandu graha, shophahara way of treatment

Galaganda chikitsa treatment can be adopted.

It includes Vataja galaganda – On Thyroid palpation, there is

1. a) Diffuse chance for autoimmune disease, graves’ disease, Hashimoto thyroiditis.
2. b) Multinodular goiter, single solitary goiter.

Treatment –

1. Swedam-Nadi Swedam
2. Rakthamoksham – Jaloukam.
3. Upanaha
4. Vranopacharam

Medaja galaganda –

1. Swedanam
2. Upanaham
3. Vamanam
4. Nasyam
5. Dhumam
6. Siravyadham
7. Vimlapanam

Kaphaja galagandam

(Firm mass, Nodules, chance for CA)

1. Upanaham
2. Swedanam
3. Vimlapanam
4. Vamanam
5. Nasyam
6. Dhoomam
7. Kharatailam

In case of Thyroid Nodule – varanadi Kashaya and kancharaguggulu

Common Drugs used are

1. Patolamooladi kashaya
2. Hamsapathyadhi kashaya
3. Varanadi kashaya
4. Guggulutikthakam kashaya
5. Mahatikthakam kashaya
6. Tikthakam kashaya
7. Kanchanara Guggulu
8. Shaddharanam

For autoimmune diseases related to the Thyroid gland, haridrakhantam, ashwagandha churna are used.