To know about hypothyroidism, it is important to understand the word “thyroid” first. The thyroid is basically a butterfly shaped gland located around windpipe right under the Larynx. This gland produces a T4 hormone which is made from Iodine and Tyrosine mainly referred to as T4. T4 is converted into T3 by organs such as the liver, kidney and spleen. These hormones tell cells in body to produce protein or increase oxygen usage. They also maintain metabolism as well as affect the growth and rate of function of other systems and organs. Thyroid also produces Calcitonin which stores excess calcium present in our bloodstream into bones and tells our body when we are no longer hungry.

Thyroid gland thus helps in controlling body temperature, energy consumption and reproductive organs. Thus thyroid is one of the most important glands of our body and when due to some reasons, thyroid gland is not able to produce enough thyroid hormone, it is known as hypothyroidism. There is no direct mention of the thyroid gland in Ayurveda. But a disease by the name "Galaganda" is mentioned in various Ayurvedic classics. The earliest description of neck swelling is found in the Atharvaveda by the name Apachi (a non-suppurative swelling in the neck, axilla, or groin).

What is Hypothyroidism

Hypothyroidism is made up of two words, "Hypo" means under & the word “thyroid" stands for the thyroid gland. So in short, Hypothyroidism is a common endocrine disorder in which the thyroid gland does not produce enough thyroid hormone. It can cause a number of symptoms such as tiredness, poor ability to tolerate cold & weight gain. In children, hypothyroidism leads to delay in growth & intellectual development, which is called cretinism in severe cases.

How it develops

Iodine deficiency is the most common cause of primary hypothyroidism and endemic goiter worldwide. In areas of the world with sufficient dietary iodine, hypothyroidism is most commonly caused by the autoimmune disease called Hashimoto's thyroiditis. It is an autoimmune disease in which the thyroid gland is attacked by a variety of cell- and antibody-mediated immune processes.

What Causes hypothyroidism

Thyroid hormone is required for the normal functioning of numerous tissues in the body. The thyroid gland is the only source of thyroid hormone in the body. This process requires iodine and the amino acid tyrosine. Iodine in the bloodstream is taken up by the gland and incorporated into thyroglobulin molecules. The process is controlled by the thyroid-stimulating hormone (TSH, thyrotropin), which is secreted by the pituitary. Not enough iodine or not enough TSH, can result in decreased production of thyroid hormones.

Features of Hypothyroidism in Pregnancy: Pregnancy leads to marked changes in thyroid hormone physiology. The gland is increased in size by 10%, thyroxine production is increased by 50%, and iodine requirements are increased. Many women have normal thyroid function but have immunological evidence of thyroid autoimmunity or are iodine deficient, and develop evidence of hypothyroidism before or after giving birth.

Hypothyroidism in early pregnancy, even with limited or no symptoms, may increase the risk of

• Offspring with lower intelligence and

• Risk of infant death around the time of birth.

How to diagnosis hypothyroid: The diagnosis of hypothyroidism, when suspected, can be confirmed with blood tests measuring thyroid stimulating hormone (TSH) and thyroxin levels.

Prevention: The World Health Organization recommends a daily intake of 250 iodine for pregnant and breast feeding women. As many women will not achieve this from dietary sources alone, the American Thyroid Association recommends a 150 µg daily supplement by mouth.

Management

Hormone replacement: Most people with hypothyroidism symptoms and confirmed

Features of Hypothyroidism new born children

• Drowsiness

• Hoarse-sounding cry

• Feeding difficulties,

• Constipation

• An enlarged tongue

• Umbilical Hernia

• Dry skin

• Decreased body temperature

• Jaundice.

• A goiter may also develop in children growing up in areas with iodine deficiency.

Features of Hypothyroidism in older children and adolescents

• Fatigue

• Cold intolerance

• Sleepiness

• Muscle weakness

• Constipation,

• Delay in growth

• Overweight

• Pallor

• Coarse and Thick skin

• Increased body hair,

• Irregular menstrual cycles in girls and delayed puberty.

Do’s for Hypothyroidism

• Seaweed

• Almonds

• Shellfish

• Banana

• Oatmeal

• Peas

• Blueberries

• Cherries

• Tomatoes

• Sesame Seeds and Oats.

• Fresh vegetables and whole grains.

Don’ts for Hypothyroidism

• Broccoli

• Cabbage

• Sprouts

• Cauliflower

• Spinach

• Turnips

• Soybeans

• Peanuts

• Alcohol

• Tobacco

• Millet and mustard greens

thyroxin deficiency are treated with a synthetic long-acting form of thyroxin, known as levothyroxine (L-thyroxin). In young and otherwise healthy people with overt hypothyroidism, a full replacement dose (adjusted by weight) can be started immediately in the elderly and people with heart disease a lower starting dose is recommended to prevent over supplementation and risk of complications.

Yoga for Hypothyroidism :

• Shoulder Stand (Sarvangasana) is the most recommended posture in this condition. It stimulates the thyroid gland to function properly because of the pressure effect and also helps stimulate other glands in the head region, such as pituitary and pineal glands, which also have an indirect control on the functioning of the thyroid gland.

• Inverted Pose (Viparitakarani)- Viparita Karani is a supine asana with vertical legs. This asana creates pressure effect as a result of which, thyroid gland gets stimulated to some extent which in turn have an indirect control on thyroid gland functioning.

• One-legged Forward Bend (Janu Shirasasana) Janu sirsasana is a forward bend posture that is also known as Head to knee pose. In Sanskrit janu means knee and sirsa means head thus the name janu sirsasana means head to knee posture. This asana is very beneficial in thyroid disorders.

• Fish Pose (Matsyasana) The asana is a backbend, where the practitioner lies on his or her back and lifts the heart (anahata) chakra by rising up on the elbows and drawing the shoulders back. The neck is lengthened, and the crown of the head Sahasrara chakra is "pointed" toward the 'wall' behind the practitioner. As the arch of the back deepens with practice, and the heart and throat open further, the top of the head may brush the ground, but no weight should rest upon it.

• Plow Pose (Halasana)- This asana can put significant strain on the cervical spine, which does not normally undergo this type of stress, and can cause injury if not performed properly

• Cat Stretch (Marjariasana) - Do this asana with slow and deep breathing and feel the stretch it gives to your back, neck and shoulders. Feel the stiffness disappear and the sense of greater flexibility in your back muscles and spine.

Pranayamas (breathing techniques) effective in hypothyroidism:

1. Kapal Bhati (skull shining breathing technique)

2. Nadi Shodhan (alternate nostril breathing),

3. Bhastrika and Ujjayi

Panchkarma for hypothyroidism:

1. Consumption of medicated ghee, considering the Dosha, type of Galgandha and the person for 5-7 days.

2. Detoxification by inducing vomiting(vamana), purgation (virechana) and enema (Vasti).

3. Application of Griva Basti. Griva Basti is the procedure of applying heat to the cervical region by retaining warm medicated oil with a specially formed frame on this area.

4. Application of medicated pack on the head and then pouring of medicated liquid medicine on the head in slow unbroken stream for specified time a procedure known as Shirodhara.

 

Home Remedies

1. Mix two spoons of coconut oil in milk and drink it daily or switch to coconut oil for cooking.

2. Taking a spoonful of Primrose oil daily is also recommended.

3. Omega-3 fatty acids, such as fish oil, 1 - 2 capsules or 1 - 2 tbs. of oil daily, helps to decrease inflammation and help with immunity.

Four lifestyle tips for hypothyroidism:

1. Daily 5-minute session of deep breathing.

2. Meditation or weekly massage.

3. Proper sleep schedule of about 7 - 9 hours daily.

4. Regular exercise like walking, light weight lifting etc.

Ayurvedic Management

1. Shaman (Internal medicines)-It includes intake of both single drugs as well as compound drug.

2. Shodhan (Detoxification): In shodhan, vaman, virechan, vasti, Griva vasti and shirodhara are used for the purpose of detoxification.

Ayurvedic herbs:

Single herbs : Kanchanara leaves, Guggulu oleoresin, Ashwagandha root, Brahmi leaves, Punarnava leaves.

Ayurvedic formulations: Kanchanar Guggulu, Punarnava mandoor, Ashwagandharishta, Amritadhaya taila and Mahayogaraj guggulu

Deputy Medical Superintendent,

Dayanand Ayurvedic College, Jalandhar.

nishu.raina2010@gmail.com