AYUSHDHARA ISSN: 2393-9583 (P)/ 2393-9591 (O)

An International Journal of Research in AYUSH and Allied Systems

Review Article

HYPOTHYROIDISM IN AYURVEDA - A CONCEPTUAL STUDY

Kadlaskar B.B.1*, Lakshmi Ravindranath2
*1Professor & HOD, 2PG Scholar Dept. of Kayachikitsa, Bharati Vidyapeeth College of Ayurved, Pune, India.

Article info ABSTRACT

Article History: Hypothyroidism is a clinical syndrome resulting from insufficient
Received: 28-08-2015 production of thyroid hormones, which is a common endocrinal disorder
Accepted: 18-09-2015 seen all over the world. It affects the metabolism of the body even at
cellular level and can affect any organ virtually. The incidence of
KEYWORDS: Hypothyroidism, hypothyroidism is rising rapidly. It is estimated to have affected 2-5% of
Dhatwagni Mandya, Vata-Kapha, global population. It is more prevalent among females. The symptoms of
Rasavaha, Raktavaha hypothyroidism are notorious for their non specific nature and for the
way in which they mimic symptoms of other systemic diseases. It leads to
a long life of pathological events and makes the affected person to remain
dependent on hormonal replacement throughout his life.
*Address for correspondence Thus, there is an increasing demand to understand the disease in view of
Dr. Kadlaskar B. B Ayurveda and to establish the management through Ayurvedic system of
Prof. & Head of Department medicine. On reviewing the clinical presentation from all classical texts it
Dept. of Kayachikitsa is found that in hypothyroidism there is abnormality of Jatharagni and
B.V.D.U. College of Ayurved Dhatwagni along with abnormality of Kapha and Vata Dosha as well as
Pune-411043, India. Rasavaha, Raktavaha, Medovaha, Sukravaha and Manovaha Srotases.
Email: drkadlaskar@gmail.com Dosha-dushyasamoorchhana in various Dhatus results in the systemic
Ph. 09422330084 manifestation of the disease. Thus, the line of treatment involves Deepana,
Pachana, Srotoshodhana and Kapha vata shamana.

INTRODUCTION
The concept that lifestyle is responsible for the Auto immunity plays a significant role in the etiology of
genesis of a disease is very old and well known in hypothyroidism. The disease hypothyroidism causes
Ayurveda. Now a days, there has been a drastic change complications like dyslipidemia which is a major risk
in the dietary habits and lifestyle of individuals due to factor for many serious illnesses and thyroidism itself
modernization and influence of western culture. in its peak can result in threatening condition[3]. Thus,
Unhealthy eating habits, along with sedentary lifestyle, it leads to a long life of pathological events and makes
cause various diseases including metabolic disorders. the affected person to remain dependent on hormonal
The Thyroid gland is considered to be one of replacement throughout his life. Hence, there is an
the most important organs of the endocrine system as increasing demand to understand the disease in view of
it regulates nearly all the bodily functions including Ayurveda and to establish the management through
metabolic, respiratory, cardiovascular, digestive, Ayurvedic system of medicine.
nervous and reproductive system either directly or This review is carried out with an aim to
indirectly. Lack of thyroid hormone or resistance of the understand the disease Hypothyroidism in Ayurvedic
body tissue to the thyroid hormone with respect to principles and to formulate the Ayurvedic management
metabolic demand results in disorder called protocol. The presentation of Hypothyroidism is
hypothyroidism. Hypothyroidism is posing a major reviewed critically by studying the pathogenesis and
health challenge in both developing as well as symptoms from various research databases and
developed world. There is 2 - 5 % prevalence of classical texts. The symptoms are studied in terms of
hypothyroidism in developed world[1]. The prevalence imbalance of Dosha, Srotas, Agni, etc and an effort is
of subclinical hypothyroidism in the developed world is made to obtain a standard possible Samprapti of
approximately 4-15%. The prevalence of hypothyroidism and line of treatment as per Ayurvedic
hypothyroidism in urban India is 10.95%. Major principles.
portion of hypothyroidism (approximately 3.47 %)
remains undetected. Incidence of hypothyroidism is
more in females and elderly patients[2].
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 AYUSHDHARA, 2015;2(4):246-250
MATERIALS AND METHODS Thyroiditis), radiation therapy, drugs or thyroid
This study was carried out by literature search surgery[6]. So far as, Ayurvedic Nidana is concerned, the
and critical review of the obtained facts. The etiological factors related to Kapha- Vata Prakopaka,
pathogenesis of hypothyroidism was studied from Agnimandya Janaka and Rasapradoshaka Nidan may be
modern pathology textbooks of various authors and by responsible for the genesis of hypothyroidism.
searching various online medical research databases PATHOGENESIS / SAMPRAPTI
like pubmed, Google scholar, and other national Primary Hypothryoidism results from two
research databases. mechanisms:
The study of various Ayurvedic texts were 1. Deficiency of Thyroid Hormones – caused by
made critically and an effort is made to understand the destruction of thyroid follicles, as in Hashimoto’s
complete pathogenesis of hypothyroidism in terms of thyroiditis (Autoimmune disorder)
Dosha, Dushya, Agni, and Srotas.
2. Resistance of peripheral tissues to thyroid
OBSERVATION AND DISCUSSION hormones
There are two major thyroid hormones -T3 In Ayurveda, we can consider these two pathologies in
and T4 which effects all body systems either directly or the following way:
indirectly at all stages of life. Thyroid hormones also
promote growth as they enhance amino acid uptake by 1. Dhatukshaya janya (Beejadosha janita)
tissues and enzymatic systems involved in protein Due to Apathya nidan sevana and also
synthesis thus promoting bone growth. Carbohydrate Bijadosha, there is Tridosha dushti leading to jatharagni
metabolism is also regulated by the thyroid hormone as mandya, which causes Dhatwagnimandya, leading to
it stimulates glucose uptake, glycogenolysis, Uttarrottara dhatu vikriti, ultimately causing Oja vikriti.
gluconeogenesis. These actions may be compared to This Vikrita ojas (in this case it is often caused by the
functions of Rasavaha Srotas as it supplies nutrition presence of Pitta dosha) affects the Vyadhi kshamatva
and energy to all body tissues. They help in fat of the body, attacking the thyroid gland and the
metabolism by mobilizing lipids from adipose stores autoimmune condition develops. Thus, it is a Kapha-
and accelerate oxidation of lipids to produce energy. pitta samsarga condition.
Lipid metabolism can compared to functions of
Medovaha Srotas. Thyroid hormones also increase 2. Avarana janya
basal metabolic rate (BMR) in all tissues except brain, Thyroid hormone functions are similar to the
spleen and gonads. This results in increased heat functions of Agni (Jatharagni, Dhatwagni and
production, increased oxygen consumption. This Bhootagni) in our body causing transformations /tissue
increased metabolic rate also results in increased metabolism at various levels and thus maintaining the
utilization of energy substrates causing weight loss. BMR. Agni mandya at any level due to Kaphakara
These actions can be compared to the functions of Agni nidana results in increased Dhatugata mala sanchaya,
in the body[4]. The adrenergic receptors in the blood resulting in Srotorodha causing compromised Dhatu
vessels are also increased by the action of thyroid saras leading to both physical and mental features in
hormone leading to regulation of blood pressure. hypothyroidism. Vata acts as a Yogavahi in aggravating
Thyroid hormone play a vital role in tissue growth the Kapha dushti. Thus, it is a Vata-kapha samsarga
particularly in skeletal, nervous system and condition.
reproductive system Cardiovascular action of thyroid
Samprapti Ghatakas
hormones are to increase cardiac output, heart rate and
contractility. They affect the respiratory system Dosha – Vata-Kapha
indirectly through increased BMR causing increased Dushya – Rasa, Rakta, Mamsa, Meda, Asthi, Shukra
demand for oxygen and increased excretion of carbon
dioxide[5]. These physiological actions if looked from an Agni – Jatharagnimandya, Dhatwagnimandya
Ayurvedic perspective are the action of Pitta and Vata Srotodushti – Sanga, Vimargagamana
Dosha in their normalcy. The Srotases affected by
Rogamarga – Bahya, Abhyantara, Madhyama[7]
thyroid hormone are mainly Rasavaha Srotas,
Mamsavaha Srotas, Medovaha Srotas, Asthivaha srotas, CLINICAL PRESENTATION/ ROOPA
Sukravaha Srotas. As discussed above, Hypothyroidism results in
ETIOLOGY/ NIDANA slowing down of the metabolic process. It usually
results in a number of clinical signs and symptoms. The
Hypothyroidism is caused by inadequate
severity of the signs and symptoms depends on the
function of the thyroid gland itself called Primary
degree of thyroid dysfunction and the time course of
hypothyroidism or by not getting enough stimulation
development of the disease. The symptoms of
by thyroid stimulating hormones called Secondary
hypothyroid are very nonspecific.
hypothyroidism.
Primary hypothyroidism is caused by iodine
deficiency, autoimmune disease (Hashimoto
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 Kadlaskar B.B., Lakshmi Ravindranath. Hypothyroidism In Ayurveda – A Conceptual Study
However common presentations of are tabulated below.
hypothyroidism along with its Ayurvedic perspective
Table 1 : Clinical presentations of Hypothyroidism w.r.s. to Dosha and Srotas involvement
Clinical presentation [8,9,10,11] Dosha involved Srotas [13,14]
[12]

Fatigue, loss of energy Vata, Kapha Rasavaha

Lethargy, sleepiness Kapha Rasavaha
Weight gain Kapha Rasavaha, Medovaha
Decreased appetite Kapha Rasavaha
Cold intolerance Vata, Kapha Rasavaha
Dry skin Vata Rasavaha
Hair loss, coarse, brittle, straw like hair Vata Asthivaha
Muscle pain, joint pain Vata Asthivaha
Dull facial expression, depression, mental Vata Manovaha
impairment, forgetfulness, inability to concentrate
Slowed movements Kapha Rasavaha, Raktavaha,
Mamsavaha
Decreased vision, decreased hearing Vata Rasavaha
Menstrual disturbances, infertility Vata Artavavaha, Shukravaha
Constipation Vata Purishavaha
Paraesthesia Vata Rasavaha, Medovaha, Majjavaha
Hoarseness of voice Kapha, Vata Pranavaha
Periorbital puffiness Kapha Rasavaha
Goiter ( simple or nodular) Kapha Rasavaha, Mamsavaha, Medovaha
Bradycardia Kapha Rasavaha, Raktavaha
Non-pitting oedema, pericardial effusion, Kapha Rasavaha
abdominal distension, ascites (uncommon)
From the above signs and symptoms, it is clear 1. Dhatwagni Deepana
that in hypothyroidism there is abnormality of 2. Dhatugata mala pachana
Jatharagni and Dhatwagni along with abnormality of
Kapha and Vata Dosha as well as Rasavaha, Raktavaha, 3. Srotoshodhana
Medovaha, Shukravaha and Manovaha Srotas. 4. Vata-kapha shaman
Cardiac function and cardiovascular 5. Manoharshana
hemodynamics is readily regulated by the thyroid
hormone T3. Hypothyroidism causes decreased cardiac 6. Rasayana
contractility and cardiac output as well as increased Classical Yogas which may be used
peripheral resistance[15]. These findings may indicate
 Dhatwagni Deepana
morbidity of Rasavaha Srotas in hypothyroidism.
Hypothyroidism patients show elevated total o Shaddharanam choornam (Bhaishajya-
cholesterol and Low density lipoprotein (LDL) ratnavali Vatavyadhiadhikara 26: 9-10,
cholesterol, and reduced levels of HDL cholesterol, Bhaishajyaratnavali Urustambachikitsa 28,
thereby causing higher chances of atherosclerosis and Sushruta samhita Vatavydhichikitsa)
other Cardiovascular Disease (CVD) risk factors, which o Panchakola choorna (Sharangdhara Samhita
improve on hormone replacement therapy[16,17]. These Madhyama Khanda 6: 13-14)
facts support the abnormality of Medovaha Srotas in
the pathogenesis of hypothyroidism. Hypothyroidism is o Vaishwanara choorna (Chakradtta Amavata
also known to induce various neurological and mental chikitsa)
dysfunctions which supports Manovaha Srotas o Indukanta ghrita (Sahasra yoga –
abnormality in this disorder. Ghritaprakarana 5)
PRINCIPLE OF MANAGEMENT / CHIKITSA  Dhatugatha Mala Pachana
The line of treatment with specific target to o Pachanamrutam kwatha (Sahasrayoga
Agni, Rasavaha, Mamsavaha, Medovaha, Manovaha Kashayaprakarana 39)
Srotas as well as Vata and Kapha Dosha should be
administered in Hypothyroidism. o Guggulutiktaka kwatha (Ashtangahrudayam
Chiktisasthana 21/57-60)
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 AYUSHDHARA, 2015;2(4):246-250
o Guduchyadi kwatha (Sharangdhara Samhita 2. Unnikrishnan AG, Kalra S, Sahay RK, Bantwal G,
Madhyamakhanda 2/8) John M, Tewari N. Prevalence of hypothyroidism
o Gorakhmundi swarasa (Sharangdhara Samhita in adults: An epidemiological study in eight cities
Madhyamakhanda, swarasa/16) of India. Indian J Endocrinol Metab.
2013;17(4):647–52.
o Chitrakadi kashaya (Sushrutha chikitsa -
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3743364/
o Shiva gulika (Ashtanga Hrudaya Uttarasthana
49 / 293) 3. Luboshitzky R, Herer P. Cardiovascular risk
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 Srotoshodhana hypothyroidism. Neuro Endocrinol Lett.
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o Ashtavarga kvatha (Sahasrayoga – Choukhambha Surbharati Prakashan, Varanasi
Vatarogachikitsa.) Edition Reprint 2005. Page-80
o Navaka guggulu (Bhaishajya Ratnavali 5. Bowen, R. "Physiologic Effects of Thyroid
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o Punarnavadi kwatha (Bhaishajya Ratnavali
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o Asanadi kwatha (Astangahradayam
6. Díez JJ. Hypothyroidism in Patients Older Than 55
Sutrastana 15/20)
Years An Analysis of the Etiology and Assessment
o Guggulu tiktaka ghrita (Ashtangahrudayam
of the Effectiveness of Therapy. J Gerontol A Biol
Chiktisasthana 21/57-60)
Sci Med Sci. 2002 May 1;57(5):M315–20.
 Manoharshana 7. Gopakumar, S. Vaishvanara (Clinical Presentations
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Ksheerapaka, Shilajatu(7) Ayurvedic Research Centre, 30-35.
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LM. Hypothyroidism Clinical Presentation
Although the disease hypothyroidism as such
[Internet]. Medscape, Drugs & Disease. Available
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from:
come to an understanding that Hypothyroidism is
http://emedicine.medscape.com/article/122393-
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Cite this article as:

Kadlaskar B.B., Lakshmi Ravindranath. Hypothyroidism In Ayurveda - A Conceptual Study.
AYUSHDHARA, 2015;2(4):246-250.
Source of support: Nil, Conflict of interest: None Declared

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