Common Thyroid Related Disorders
Thyroid is a butterfly shaped endocrine gland situated in front of neck with two lobes lies on either sides of trachea. In Ayurveda, the thyroid is located near Vishuddhi Chakra (in the throat area) with a predominance of Pitta and Kapha Dosha. Thyroid is the center of Agni, and its functions are to stimulate psychic and somatic growth, secrete hormones, and balance metabolism. T3, T4, and other hormones of thyroid are functionally representing dhathvagni in our body.
Common Thyroid Disorders
Any sort of dysfunction in the normal functioning of thyroid results in thyroid disorders. To create awareness on thyroid issues, January is observed as thyroid awareness month. Common types of thyroid disorders include Goiter, Hypothyroidism, Hyperthyroidism and Thyroiditis.
GOITER
Goiter is defined as thyroid enlargement caused by compensatory hyperplasia and hypertrophy of the follicular epithelium in response to thyroid hormone deficiency. It may be associated with an irregular amount of thyroid hormone in your body (hyperthyroidism or hypothyroidism) or with normal levels of thyroid hormone (euthyroid).
There are two morphological forms- diffuse goiter and nodular goiter. A goiter can be smooth and uniformly enlarged, called diffuse goiter, or it can be caused by one or more nodules within the gland, called nodular goiter. Nodules may be solid, filled with fluid, or partly fluid and partly solid.
Gala ganda and Ganda mala
As per Ayurveda Shastra, diffuse goiter can be correlated as gala ganda, characterized by vitiation of vata, sleshma, and meda which leads to mushkavat structure in kanda pradesha (neck region). Whereas multi nodular goiter can be correlated as ganda mala.
HYPOTHYROIDISM
It is a state due to the reduced production of thyroid hormones or may be due to the resistance of peripheral tissues to the effect of thyroid hormone. Hypothyroidism can affect people of all ages and genders. Women are more likely to develop hypothyroidism after menopause than earlier in life. It is divided into three types- Primary (originating from the thyroid gland), Secondary (originating from the pituitary gland) and Tertiary (originating from the hypothalamus
Causes and Symptoms of Hypothyroidism
Common causes of hypothyroidism are congenital developmental defects, primary idiopathic, iodine deficiency, hashimo-to thyroiditis, pregnancy, post- ablative, post radiation, goitrous, lymphoma, stress, and thyroid surgery.
The symptoms of hypothyroidism include unusual weight gain, edema, tiredness, loss of appetite constipation, anemia, irregular menstruation, infertility, dry skin, depression etc. There are two types of clinical presentations cretinism and myxedema
Cretinism
It is a condition of severely stunted physical and mental growth due to untreated congenital deficiency of thyroid hormones. There will be symptoms showing vitiation of manda guna in dhatu vaha and manovaha srotas
Myxedema
It is a skin and tissue disorder usually due to severe prolonged hypothyroidism, characterized by relatively hard edema of subcutaneous tissue with increased content of proteoglycan in the fluid. Characteristic symptoms will be gaining weight and signs will be pretibial edema and macroglossia. In Ayurveda, pathogenesis of myxedema is like features of mala, jala, and kapha sanchaya with sopha samprapti.
Diagnosis and Management of Hypothyroidism
Diagnostic investigation of hypothyroidism includes measuring the level of thyroid stimulating hormone (TSH). High levels of TSH indicate that the thyroid is not producing sufficient levels of (T4) and smaller amounts of (T3). Suggested minimum Blood testing are TSH, fT3, fT4, total T3 and total T4. Additionally, measurements such as anti-thyroid antibodies, Serum cholesterol and Prolactin may be required.
Hypothyroidism is considered as vata kapha pradhana vyadhi along with vitiation of Agni and srotharodha. Hence treatment focuses on Agni dipanam, sroto shodhan, and kapha vata samsamana.
HYPERTHYROIDISM
Hyperthyroidism is another thyroid disorder characterized by thyrotoxicosis, which is a hyper metabolic clinical and biochemical state caused by the excessive production of thyroid hormones. It is seen more in females and increase in T3 is greater than T4.
Symptoms of Hyperthyroidism
Major clinical features are weight loss often accompanied by a ravenous appetite, weakness, hyperactivity irritability polyuria and sweating palpitation and arrhythmias (notably atrial fibrillation dyspnea loss of libido, irregular menstruation, brittle hair, thinning of skin and intolerance of heat.
Graves’ Disease
Most common cause of hyperthyroidism is Graves’ disease, characterized by an overproduction of thyroid hormone which causes enlargement of thyroid and other symptoms such as exophthalmos, heat intolerance, and anxiety.
Diagnosis and Management of Hyperthyroidism
Diagnostic investigation of hyperthyroidism shows elevated serum free T3 and T4, serum TSH level is not detectable and thyroid uptake of radioiodine (1311) is increased
As per Ayurveda, pathogenesis of hyperthyroidism shows atyagni (excess digestive fire) at datwagni level with vata pitta samsarga. So, the treatment concentrates on normalizing atyagni and maintenance of pitta and vata equilibrium.
THYROIDITIS
Thyroiditis is the swelling of the thyroid gland. It causes either unusually high or low levels of thyroid hormones in the blood. Different types of thyroiditis include hashimoto thyroiditis, de quervain’s thyroiditis, drug induced, radiation induced and acute thyroiditis.
Hashimoto’s Thyroiditis
Hashimoto’s thyroiditis, also known as chronic lymphocytic thyroiditis, is a common cause of hypothyroidism. It is an autoimmune disorder involving chronic inflammation of the thyroid. Over time, it leads to a gradual decline in function and eventually an underactive thyroid. It occurs most commonly in middle aged women.
Conclusion
Ayurveda insists on understanding the constitutional status of a disease and adopting an appropriate treatment principle. Early detection of thyroid disorders mitigates the risk as it can be easily treated by consuming a healthy diet and proper nutrients to the body. Yoga pranayama and exercises have a very positive impact in its treatment. So, it can be concluded that by understanding thyroid disorder from Ayurveda perspective, can give safe and effective management
If the thyroid is kept normal there is no over-fire in the body and mind.