Hypothyroidism is defined as the “under-activity of the thyroid gland that leads to inadequate production of thyroid hormones and a slowing of vital body functions.”
Once a diagnosis is made, most people will take Thyroid hormones for the remainder of their lives. It affects 10% of women and 6% of men over the age of 65
The global incidence of hypothyroidism is increasing alarmingly as people are exposed to more stress and strain. The synthesis and transport of thyroid hormones play a vital role in the normal physiology and functioning of thyroid hormones.
The two main pathogenesis involved in the manifestation of hypothyroidism.
Hashimoto’s Thyroiditis
Autoimmune Thyroiditis
While analysing the signs and symptoms of hypothyroidism from Ayurvedic point of view, we note the involvement of all Srotasas (Srotas are the channels or inner transport system of the body which is the site for the activities of other bodily elements like Dosha, Dhatu, Mala, Agni, etc.).
The Kapha Dosha and Vata Dosha increase is elicited and Pitta Dosha decrease is seen. Though some physicians consider it as a Sthanika vyadhi (localised) under Galaganda Roga (Goitre), its Dushti lakshanas (symptoms) are seen in whole body.
Introduction
Hypothyroidism refers to any state that results in a deficiency of thyroid hormone, including hypothalamic or pituitary disease and generalised tissue resistance to thyroid hormone and disorders that affect the thyroid gland directly
According to World Health Organisation, 2 billion people are iodine deficient world-wide. The relative iodine deficiency causes Goitre and severe deficiency causes, Hypothyroidism & Cretinism. On the other hand oversupply of iodine results in autoimmune thyroid disease.
Thyroid Gland Anatomy
Thyroid gland is an endocrine gland situated in the lower part of the front & sides of the neck. It lies anterior to trachea between the cricoid cartilage & Suprasternal notch. It consists of two lobes connected by isthmus.
Along with thyroid gland there are 4 parathyroid glands which are located at the four posterior poles of thyroid gland.
Thyroid gland is larger in females and increases in size during pregnancy & menstruation.
Transport of Thyroid hormones in blood
The 80 % of thyroid hormones are transported by Thyroxine binding globulin and 10% by Albumin and Transthyretin ( Thyroxine binding pre-albumin) respectively.
Any defect in the stages of synthesis or transport of thyroid hormones will eventually result in Hypothyroidism.
Hypothyroidism is far more ubiquitous than hyperthyroidism. It is often the result of low intake of iodide or a lack of response to that nutrient by the body.
Functions of Thyroid Hormones
Growth & development- For normal axonal & dendritic development myelination & linear growth with maturation of growing epiphyseal end plates.
Energy Metabolism- Stimulates BMR, oxygen consumption & heat production.
Nervous system- It regulates nervous system activity by exerting effect on adrenergic receptors.
Heart- T3 maintains normal myocardial contractility.
Muscle- Normal skeletal muscle function is regulated.
Respiratory system- Lung volume and breathing capacity is maintained
Skin- Normal cutaneous circulation & secretion of glands.
Colon- Helps in controlling normal bowel movements.
Vitamins- Increases utilisation & clearance of vitamins.
Carbohydrate metabolism - Stimulates absorption of glucose from intestine.
Protein metabolism- Increases the synthesis of proteins in the cells.
Fat metabolism- Decreases fat storage by mobilising it and converting in to free fatty acid.
Action on sleep – Hypo-secretion of hormone causes excess sleep and hyper secretion causes sleeplessness.
Action on sexual function – Helps in normal sexual development & reproductive function.
Hashimoto’s Thyroiditis :
The Lymphocytic infiltration in thyroid follicles causes the germinal centre formation. The atrophy of follicles results in oxyphilic metaplasia. The absence of colloid matter and fibrosis happens which eventually leads to Atrophic thyroiditis.
Autoimmune hypothyroidism :
The pathogenesis of autoimmune hypothyroidism is uncertain. Various hypothesis for etiological factors are combination of genetic and environmental factors, HLADR polymorphism, T cell regulatory gene, sex steroid effects, Immunological effects, Direct thyroid toxicity, congenital rubella infection, Thyroid lymphocyte infiltrate, Antibodies to Thyroglobulin and Thyroid peroxidase enzyme.
Signs:
Dry & coarse skin
Cool extremities
Myxoedema
Diffuse alopecia
Bradycardia
Peripheral oedema
Delayed tendon reflexes
Carpel Tunnel syndrome
Serous cavity effusions
Symptoms:
Tiredness
Weakness
Dry skin
Feeling cold
Hair loss
Difficulty in concentrating
Poor memory
Impaired hearing
Constipation
Weight gain with poor appetite
Dyspnoea
Hoarse voice
Menorrhagia
Paraesthesia
Analysis of hypothyroidism in a Ayurvedic view:
Avatu means "Thyroid gland" in Sanskrit. A prolonged Vata and Pitta imbalance deranges Thyroid function and depletes Ojas (Vitality).
Ojas is our innate vitality and immunity- like our energy reserves.
Involvement of Agni in Hypothyroidism
It is Agni alone represented by Pitta in the body which brings about good or bad effects according to its normal or abnormal state, e.g.: digestion or indigestion, vision or loss of vision, excess or balanced heat, natural or unnatural complexion, valour and fear, anger and joy, bewilderment and happiness and such other pairs of opposite qualities.
Dehagni or Jataragni is the maintain life, colour, strength, health, enthusiasm, plumpness, complexion, Ojas, Tejas, other varieties of Agni and Prana. Extinction of this Jataragni leads to death; its proper maintenance helps a person to live a long life, and its impairment gives rise to diseases.
Importance of Ojas
Guarding ojas and then rebuilding it is essential to the treatment of this disease. Ojas is described as our reserve energy and our immunity to disease.
It is often compared to a bank account—if it gets depleted more than it gets refilled, the person’s health will be poor. A lack of sleep, excess work, worry, and busy lifestyle (an extremely common occurrence in the western world) indicates that more of this reserve energy is being used than saved.
Saving energy comes in the form of rest and rejuvenation.
Samprapti (Patholog)
Kapha is predominant once hypothyroidism has set in. Because of prior vata and pitta vitiation, ojas is depleted/low. With Vata’s influence, Kapha “accumulates in the Annavaha srota (are those channels in the body which transport the food and liquids we take) and overflows into the Rasa (Blood Plasma) and Rakta Dhatus (Blood ) and relocates into the Thyroid gland.
Thyroid gland is a part of the Rasavaha srota as it is mainly a hyper vascular epithelial tissue.” The subdosha affected is Avalambaka Kapha. This Kapha may also relocate to other Srotas/Channels of transportation and Tissues and can lead to blockage of Prana Vata.
Rupa (Symptoms)
The western symptoms of hypothyroidism align with this modern Ayurvedic
perspective.
In case of Kapha vitiation | In case of Vata vitiation |
· Slow speech | · Fatigue |
· Slow pulse | · Constipation |
· Low appetite | · Muscle cramps |
· Lethargy | · Amenorrhea |
· Thick skin | · Weakness |
· Menorrhagia | · Dry/coarse/scaly skin |
. Large tongue (macroglossia | · Sparse/coarse/dry hair |
· Goitre | · Hoarseness of the voice |
· Puffiness in the face and eyes | |
Weight gain, joint stiffness, and an inability to tolerate the cold can be Vata, Kapha, or a combination of the two.
When weight loss and/or weakness occur, especially in older people, this is usually indicative of a Vata imbalance but may also be from Pitta vitiation.
Inherited disorders of enzyme abnormality would seem to correlate with an issue with the Agni or perhaps Pitta in the thyroid gland.
Involvement and Impact on Body Tissues (Dhatu)
Dhatu | Symptoms |
. Rasa (Blood Plasma, or non cellular portion of the blood ; the lymph, and interstitial fluids) | Weight gain, Loss of appetite, Heaviness of body, Lethargy, Generalised aches, Somnolence, premature aging symptoms like hair loss, Cold intolerance, Puffiness, Anaemia, Menstrual disturbances, Infertility |
. Rakta (Blood) | Slow pulse rate, Dry skin, Slowing of mental activity, Lethargy |
. Mamsa (Muscle Tissues) | Heaviness in the body, Muscle ache, granthi, Galaganda |
. Meda (Fat Tissue) | Tiredness, Sleepiness, sluggishness, Hyperlipidemia, Dyspnea on exertion |
. Asthi (Bone Tissue) | Osteoporosis, Osteoarthritis |
. Majja (Bone Marrow) | Osteoporosis |
. Shukra (Reproductive tissues) | Loss of libido, infertility |
Nidana (Aetiology)
Main Etiological factor: Vata increase & Kapha increase
Main Cause for their increase: Imbalanced Agni
A stressful, mobile lifestyle in which a person travels a lot, for example, will bring about this condition. Also including diet that has excess of the Gunas like hot, light, and dry.
Holistic Management
Ojas Building Diet
Ayurveda suggests that a proper diet and lifestyle ensures proper digestion, the end result of which is ojas. Ojas is what is left over when digestion of food is done and the body has done a great job.
Some foods actually block the body’s ability to uptake iodine and are called goitrogens.
This includes a number of vegetables from the brassica family, including broccoli, cabbage, and Brussel sprouts, as well as soy, peanuts, and canola oil. Cooking seems to lessen this goitrogens effect.
Sweet foods build ojas, but not unless they are digested properly
Ojas is preserved when sweets foods are eaten with spicy foods
Proper digestion of any food can be made sure by including digestive spices like cinnamon, fennel, ginger, turmeric, and cardamom.
A mono diet of khichdi (classic mung bean and rice porridge) with pachana (Detoxifying spices/herbs like cumin and ginger) and Lekhana (thermogenic herbs like Ginger and Black pepper) help with weight loss.
Decreasing the intake of raw cruciferous vegetables, particularly radishes, and other goitrogenic foods is also advised.
Adding onions, garlic, and ginger, as well as teas of sage, thyme and strawberry leaf may also be useful.
Following Pathya Apathya (Do's and Dont's) is of the utmost importance
Pathya (to be followed) | Apathya (to be avoided) |
· Purana Ghrita Pana (Old Ghee) | · Kshira Vikruti (any product made from milk) |
· Jeerna Lohita shali ( old Red rice) | · Ikshu Vikruti (any products made of Sugarcane juice) |
· Yava (Barley) | · All types of mamsa/Meat |
· Muda (Green gram) | · Pishtaannam (stale food or rehated food) |
· Patola (Snake gourd) | · Madhura Amla Rasa (Sweet sour tasting food) |
· Rakta shigru (Red drumsticks) | · Guru Abhishyandakari Dravya (heavy sluggish foods like yogurt) |
· Kathillaka (spreading hogweed) | |
· Salinca saka | |
· Vetagra (well ripened fruit of kushmanda) | |
· Ruksha Katu Dravya (bitter and dry vegetables) | |
· Deepana dravya (appetising and digestive herbs) | |
· Guggulu (Comiphora Mukkul) | |
· Shilajatu | |
Common Ayurvedic Herbs
Most of the time we see that weight gain is the primary symptom which people want to focus on, but before going for any random weight loss procedures and supplements we must understand that these treatments are mostly Pitta stimulating and increased heat in the boy which in turn depletes the Ojas further resulting in Symptoms like Hair fall, Dry skin, etc.
It is always advisable to consult an Ayurvedic professional for the prescription of right plan and right herbs which as adjusted along with the volume and quality of food intake that prevents this loss of reserve energy.
Lower dosages or cooler Rasayanas (ojas building herbs) like Guduchi and Liquorice and may be used if Pitta is vitiated
Secondary symptoms may require other categories of herbs: laxatives can be used for constipation, for example.
Anti-inflammatory herbs for thyroiditis, immune-enhancing, anti-inflammatory herbs recommended include and Guduchi.
Other notable herbs are :
Gotu Kola leaf (Centella asiatica) for general thyroid support
Willow Bark (Salix alba)
Ashwagandha (Withania somniferum) for the glandular system and thyroid
Guggul gum (Commiphora mukul) for adjusting thyroid and cholesterol levels,
Vitamins A, B, and the amino acid Tyrosine
Kanchnar (is another herb used in both enlargement of the thyroid as well as hypothyroidism.
Cleanse Advised:
Snehapana- Medicated Ghee intake
Vamana- induced emesis
Mriudu Virechana- Colon Cleanse
Nasya- Nasal drop inhalation
Yogasanas:
The breathing exercises
Sheetali
| Seethkara
| Sadanda | Bastrika | Anuloma viloma pranayam | Ujjayi swasa |
|---|
CONCLUSION
Hypothyroidism can be considered as condition which results due to Agni Dushti.
Kapha Vata Dosha increase and Pitta decrease results due to Agnimandya (reduced Agni at cellular level). Dhatwagnimandya especially Rasa and Medho Dhatwagni Mandhya (Depletion of fat tissue metabolism) contributes to this condition.
Use of Rasayana herbs along with an Ayurvedic Diet, Lifestyle modification and a cleanse under the guidance of Ayurvedic Physician will give long term results.
NOTE : Do consult your Ayurvedic physician as the assessment of Dosha/ Body-type is a prerequisite for any Ayurvedic treatments & recommendations.
Consult Dr.Dharna (Ayurvedic Physician & Yoga trainer : contact@arujayur.com) who has 15 years of experience in managing PMS, PCOD/PCOS and various menstrual disorder.
Consultation includes tailored diet chart, lifestyle guidelines and one month WhatsApp support.
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