Hypothyroidism Causes, Symptoms, Ayurvedic Treatment, Remedies

By Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S

Hypothyroidism is caused due to low thyroid hormones in the bloodstream. This happens because the thyroid glands do not produce sufficient thyroid hormones. Insufficient thyroid hormones lead to slowing of metabolism, obesity, heart problems, mental disorders etc.
Read – How Endocrine System And Hormones Are Governed By Tridosha?

Home Remedies, lifestyle changes

Home remedies play only a partial role in the treatment of Hypothyroidism. The below mentioned home remedies, lifestyle adaptations and natural treatments may help in improving and balancing thyroid functions.

Planning diet

Diet which is low in fat with a good balance of fruits, vegetables, dairy, whole grains and lean protein are good.
You can also reduce the amount of carbohydrate in your diet but completely avoiding carbohydrate is not recommended.
Reducing the amount of salt intake is also helpful, ideally less than 2.3 grams per day. Rock salt (Saindhava Lavana) is a better replacement to table salt, as rock salt is rich in minerals.

Supportive Nutrients

1. Prefer balanced and wholesome diet, inclusions   

Food should not be preserved, processed or canned. Try to eat freshly made meals with natural ingredients, served hot.
Avoid hydrogenated oils, vegetable oils, artificial colors and flavors or white flour. Try to use sesame oil for cooking. As per Ayurveda, Sesame oil helps to burn fat quickly while nourishing the muscle tissues. If you live in a very hot place, then coconut oil can be used for cooking, , as it is a natural coolant.
Vegetables, fruits and whole grains reduce the effects of hypothyroidism and also boost up immunity.
Avoid soy products and soybeans. They contain goitrogenic compounds that interfere with levels of thyroid hormone in the body and also worsen the symptoms in hypothyroidism.

Essential oils and fatty acids – These are important for health of thyroid gland. Fish oils are good sources of omega 3 fatty acids. They promote production of thyroid hormones. They are immunity enhancers and also anti-inflammatory in nature.

Natural fats – available in the below mentioned help in maintaining hormonal balance

• Flaxseeds, Walnuts, Avocado
• Nuts, Fish

Caffeine and sugars / carbohydrates – Intake of coffee and high caloric starchy foods should be avoided. Starchy foods reduce metabolism and increase adverse effects of hypothyroidism. On the other hand, consumption of fiber rich foods and nuts help in reducing the symptoms and also to improve health.

Increase protein intake – Diet rich in proteins improves the reduced production of thyroid hormones by regulating the thyroid functions. Nuts, green vegetables, legumes, eggs and meat are rich in protein and help in combating hypothyroidism symptoms.

Include natural iodine – Reduced activity of thyroid might be due to low iodine in the diet or greater than required iodine. Have more of seafood, seaweeds, milk, egg, shrimp, cheese Avoid artificial iodine supplementation.

Probiotics – They are gut friendly bacteria that help in improving metabolism and better digestion. Improper digestion and low levels of good bacteria in the stomach may reduce thyroid hormone production. Have more of buttermilk, yogurt, fermented vegetable pickles, kefir, saurekraut, miso.
Studies showed that altered gastrointestinal motility commonly seen with hypothyroidism can cause small intestinal bacterial overgrowth. This ultimately leads to chronic GI symptoms like diarrhea. Probiotics have live helpful bacteria. These help to keep your stomach and intestines healthy.
Apple cider vinegar – It is useful to reduce body weight, improve fat and carbohydrate metabolism and to balance alkaline-acid balance in the body. It also helps in balancing cholesterol, blood sugar and blood pressure. 1 teaspoonful of apple cider vinegar and honey mixed in warm water will help in improving thyroid activity and control symptoms of hypothyroidism when consumed.

Regular exercise – Through a 30-minute exercise few thyroid-related symptoms like fatigue, loss of appetite and osteoporosis can be combated.

Balanced estrogen levels in women – Raised estrogen levels can cause hypothyroidism in women. Birth control pills, dairy products and consumption of large amount of meat may imbalance estrogen levels and deplete thyroid hormone production. These foods shall be avoided to maintain balance of thyroid hormones in the body.

Selenium – plays an important role in thyroid hormone metabolism. Examples of selenium containing foods are –

• Eggs, Legumes, Tuna, Turkey

Selenium supply in the body is reduced in Hashimoto’s thyroiditis. Selenium supplements have shown to balance thyroxine (T4) levels.

Sugar free diet – Sugar and processed foods can increase inflammation in the body which eventually slows down the conversion of T4 into T3. This can make your symptoms and thyroid disease worsen. It is wise to have a sugar free diet.

Vitamin B – The body’s vitamin B-12 levels may be affected by low thyroid hormones. Supplementing the same may help in repairing the damage caused by hypothyroidism to an extent. Vitamin B12 is helpful in warding off the tiredness related to thyroid disease. Vitamin B1 may also be affected by hypothyroidism. The below mentioned foods add vitamins to your diet when regularly consumed –

• Peas, Beans
• Sesame seeds
• Cheese, Milk
• Eggs, Asparagus

Gluten free diet – According to National Foundation for Celiac Awareness, many people with thyroid disease also have celiac disease. In celiac disease gluten triggers an immune response in the small intestines. Currently research doesn’t support a gluten free diet for treatment of thyroid disease. Once wheat and other gluten rich foods are removed from the diet, people with hypothyroidism and Hashimoto’s thyroiditis start feeling better. (A)

Foods alone won’t cure hypothyroidism. A combination of right nutrients and medication can help to restore thyroid function and minimize your symptoms.

3. Useful nutrients

Iodine – It is needed to make thyroid hormones. Hpothyroidism is less common in people who consume iodized salt and iodine rich seafood. One should add iodized table salt to meals or eat more iodine rich foods like dairy, fish, eggs and seaweed when they have iodine deficiency. According to some studies, getting too much of iodine may damage the thyroid gland.

Selenium – It helps to activate thyroid hormones. It also has antioxidant benefits. It may protect the thyroid gland from damage caused by free radicals. Selenium rich foods shall be added to the diet. Selenium supplements shall be avoided unless advised by the doctor since it provides large doses. A large dose of selenium is toxic.

Zinc – This too activates thyroid hormones. It is also shown to regulate TSH as per some studies. Hypothyroidism patients should consume zinc rich foods

Foods to Eat

Fruits – All other fruits apart from those avoidable shall be used. These include berries, bananas, tomatoes, oranges etc.

Vegetables – When cooked all vegetables (cruciferous vegetables) are good enough to eat in moderate quantities

Eggs – Much of iodine and selenium are found in egg yolk and proteins in whites. Therefore, using whole eggs are best.

Dairy products – milk, cheese, yoghurt, buttermilk

Gluten free grains and seeds – rice, flax seeds, chia seeds, buckwheat etc

Fish – all types of seafood including salmon, tuna, halibut etc

Meat – all meats including lamb, chicken etc shall be used

Beverages – water, non-caffeinated beverages, fresh fruit juices

Note – Diet predominantly consisting of vegetables, fruits and lean meats are low in calories. They are also filling. Owing to these qualities they may help to prevent weight gain.

Foods to avoid

Goitrogens – These are compounds which may interfere with normal function of thyroid gland. Common foods which contain goitrogens are –

• Vegetables – cabbage, broccoli, cauliflower, kale, spinach etc
• Fruits and starchy plants – sweet potatoes, cassava, strawberries, peaches etc
• Nuts and seeds – millet, pine nuts, peanuts etc
• Soy foods – tofu, tempeh etc

People with hypothyroidism should avoid goitrogens. Cooking foods with goitrogens may inactivate these compounds.

Foods that contain goitrogens should be eaten in moderation and ideally cooked. One should also avoid eating highly processed foods. They contain plenty of calories. If you have hypothyroidism it can be a problem since you may easily gain weight.

a. Below mentioned foods may be avoided –

• Millets
• Highly processed foods – cookies, cakes, hot dogs etc
• Supplements – too much of selenium and iodine in the form of supplements

b. Foods which can be eaten in moderation – These foods should be cautiously eaten because they contain goitrogens. They are known irritants and may be harmful when consumed in large quantities. They are –

• Certain fruits – peaches, pears, strawberries
• Certain (cruciferous vegetables) – cabbage, spinach, kale, broccoli etc
• Soy foods – soy milk, tofu etc
• Beverages – coffee, green tea, alcohol

7. Foods to avoid or to be limited

Below mentioned foods should either be limited or avoided.

Iodine – Iodine which is needed by the thyroid gland to make its hormones is available in many foods including iodized salt, cheese, fish and ice cream. Planned consumption of these foods will take care of iodine balance in the body. On the contrary, taking too many foods having iodine or iodine supplements causes hyperthyroidism.

Soy – Soy foods are high in protein, low in fat and rich in nutrients. They also contain estrogen. Estrogen could help in absorption of synthetic thyroid hormone. The amount of soy consumed should be reduced. (Read more)

Fiber – consuming too much fiber can interfere with absorption of thyroid medicine. 25 grams and 38 grams respectively are the recommended doses of fiber for women and men respectively. Fiber consumption should not be stopped entirely. Fiber is found in healthy foods like fruits, vegetables, beans and whole grain breads and cereals.

Cruciferous vegetables – These vegetables include cabbage, broccoli, Brussels sprouts. They are high in vitamins and fiber. These vegetables should not be consumed in excess.

Alcohol – Liver breaks down the drugs like thyroid hormone to remove them from the body. Excessive alcohol damages your liver. This damaged liver could lead to too much levothyroxine in your system. (read)

Gluten – This is the protein found in grains like wheat, barley and rye. It doesn’t affect the thyroid functions directly. Some people with autoimmune hypothyroidism also have celiac disease. In celiac disease the immune system mistakenly attacks the small intestine in people who have consumed gluten. Eliminating gluten from the diet may relieve the symptoms.

Iron and calcium – These minerals interfere with absorption of thyroid hormone medicine. Foods containing iron and calcium are safe to eat. Using them in supplement form shall be avoided.

Depression, Obesity and Hypothyroidism

How to treat hypothyroidism associated with depression?

Dr JV Hebbar

In any patient with depression and obesity, it is recommendable to think about hypothyroidism (decrease in thyroid hormones secretion) 
Decrease in Vitamin B 12 and Vitamin D is found in cases of autoimmune hypothyroidism.
Lack of Vitamin D is directly linked with depression. This is notably observed in people living in cold climates. Due to lack of sun exposure, long winters can make us feel gloomy.
So, if a person is diagnosed with hypothyroidism and if he has vitamin B12 and D deficiency, fixing this problem will also improve mood and relieve depression.

Hypothyroidism is associated with decreased metabolic rate, and has also been shown to correlate with a higher body mass index (BMI) and a higher prevalence of obesity.
Studies have shown that obese people are about 25 percent more likely to have depression. Hence, along with treating hypothyroidism, concentrating on obesity management with Ayurvedic medicines such as Triphala Churna, Navaka guggulu, Varanadi kashayam, Medohar Guggulu etc can be useful to address obesity and also help the patient with depression indirectly.

Hypothyroidism people will have decreased sleeping hours, which can cause or worsen stress, anxiety and depression. Hence, sleep improving herbs such as Ashwagandha, Sarpagandha, Brahmi, Tagara etc. can be advised based on need.  Kindly note that these are some of the ways to approach the complications or associated disorders of hypothyroidism. 

Maintaining a healthy weight

As we know that the metabolism is slow in hypothyroidism. This leads to weight gain in these patients. It is very important to keep a track on the weight of the patient and keep the weight in balance. Below mentioned measures may be helpful to maintain a healthy weight when followed regularly –

Well planned and mindful way of eating – One should pay attention to what they are eating, why they are consuming that food and how quickly they are eating. Studies have shown that these strategies can help in losing weight. Mindfulness, eating behaviors and obesity.

Low or moderate carb foods – One should avoid taking ketogenic diet. Eating too few carbs may lower your thyroid hormones.

Plenty of Rest – Sleep for at least 7-8 hours every night. When you sleep less you are likely to gain fat, mainly around the belly – Studies.

Practice Yoga or Meditation – Research works show that Yoga and meditation are helpful in maintaining healthy weight. Therefore, they need to be practiced regularly – Related Studies.

Important Yoga postures for Hypothyroidism

Below mentioned are some of the most beneficial yoga postures for those suffering from hypothyroidism –

• Sarvangasana – Shoulder stand
• Viparita Karani Asana – Inverted Pose
• Janu Sirsasana – Seated Head to Knee pose
• Matsyasana – Fish pose
• Halasana – plough pose
• Marjariasana – cat-cow stretch
• Surya Namaskara – Sun salutation
• Pranayama – Kapalabhati, Ujjayi Pranayama, Bhastrika, Nadi Shodhana Pranayama

Ayurveda Understanding

No disease explained in Ayurveda can be directly correlated with hypothyroidism. When the pathogenesis and symptoms of hypothyroidism are translated into Ayurveda language it can be understood on the lines of one or more of the below mentioned conditions –

• Udanavrita Samana
• Kaphavrita Udana
• Pathological increase of kapha
• Medoroga
• Agnimandya

Hypothyroidism should be understood on the basis of vitiation of doshas, tissues and channels involved in pathogenesis of the disease and also its predominant symptoms as understood from Ayurveda perspective.
Read – Dhatu – 7 Body Tissues As Explained In Ayurveda

Udanavrita Samana

Senior Professor, Dr S.N.Ojha has compared hypothyroidism with a condition called Udanavrita Samana.

It is a condition in which the subtype of vata located in the chest i.e. udana vata when aggravated will envelope the Samana Vata, another subtype of vata located in the stomach and intestine and cause deterioration of its functions. Due to weakening strength of samana vata, the digestive pitta in the stomach will become weak and there is pathological buildup of kapha. All these events will cause weakening of metabolism.

Hypothyroidism starts from

1. the thyroid gland located in the neck region producing low thyroid hormones and
2. the low thyroid hormones causing slowing of metabolism

Udanavrita Vata starts from

1. aggravation of udana vata in the chest and neck, the region of thyroid gland followed by
2. invasion and enveloping of samana vata in the gut by udana vata with consequential weakening of functions of samana vata leading to slowing of metabolism
   Read – Over A Period Of Time, My Metabolism Has Slowed Down

Therefore, this comparison of hypothyroidism with Udanavrita Samana seems logical.

Kaphavrita Udana

Kaphavrita Udana is a condition wherein the aggravated kapha envelopes udana vata and interferes with its functions. Thyroid gland is located in one of the regions of udana vata i.e. throat. When kapha surrounds udana vata, the udana vata is blocked and subdued. Due to this thyroid gland produces fewer hormones. This will cause deterioration of metabolism and these events mark the onset of hypothyroidism.

The seat of udana is also the primary seat of kapha. When kapha gets aggravated it dominates udana vata. Increased kapha associated with decreased vata marks the events leading to suppressed metabolism as happens in hypothyroidism.
Read – Mechanism Of Avarana, Types, Importance of Vata

Kapha Vriddhi

Hypothyroidism may be understood on the basis of ‘pathological increase in kapha’ in the body. This is due to proportional imbalance of kapha with pitta and vata. In hypothyroidism it is a consequence as already discussed in Udanavrita Samana. Since kapha increase can further deteriorate the digestive fire and tissue fire, addressing abnormal kapha increase in the treatment of hypothyroidism comes handy. In the later part of hypothyroidism most symptoms of the disease resemble those of kapha increase.
Read – Lifestyle, Food And Factors That Cause Increase Of Kapha Dosha

Medo vriddhi – Medo Roga

Medo vriddhi means increase of fat tissue. Medo roga means diseases caused due to errors of fat metabolism including obesity. Weight gain is one of the main symptoms of hypothyroidism and also an initial manifestation. When the thyroid functions and hormones are low at the beginning of the disease, key symptoms of low thyroid functions such as weight gain, fatigue etc may be noted. There is gradual deterioration of metabolism. Consequentially the other symptoms gradually develop. Weight gain, fatigue etc are also the symptoms of medo vriddhi. Also, most symptoms of hypothyroidism fit into the signs and symptoms of medoroga.

Hypothyroidism may be treated on the lines of treating medo vriddhi and medo roga. In newly diagnosed cases of hypothyroidism when the person had started to put on weight with imbalance of thyroid hormones relatively with TSH, it can be treated on the lines of medo roga. If this is done, the weight is kept in check, the metabolism is corrected and the consequences of lower metabolism shall be prevented beforehand. Since the metabolic corrections are made in the beginning itself, we would have halted the progression of the disease.
Read – Medo Dhatu Vruddhi, Kshaya: Pathological Manifestations Of Fat Tissue

Agnimandya

As Master Vagbhata has said – ‘Almost all the diseases are caused due to mandagni – low digestive fire, especially the abdominal diseases. Mandagni also denotes weaker metabolism. Hypothyroidism is also related to low metabolism, in fact a cause of it. c is a resultant of Hypothyroidism. Treating weak digestive fire in hypothyroidism and kindling the same might catch the disease by its horns. This will also disable the continuation of pathogenesis and worsening the symptoms of the disease. Balanced digestive capacity also means proper digestion, conversion, distribution and utilization of food and nutrients. This also reflects proper conversion of food into energy, the channels of nutrition getting open and clear as an impact of digestive and tissue fires and eventual nourishment of the tissues.
Read – Understanding Agni: Concept, Definition, Functions, Types

Can agnimandya cause hypothyroidism?

Low digestion fire and capacity in the gut can create an ideal condition wherein the samana vata gets weak by its own factors or owing to increase in kapha. The imbalance of these two components may hit hard on pachaka pitta and the digestion process will be upset. This can also happen due to kapha getting aggravated in the body or gut due to its own etiological factors. This environment provides a backdrop for the events of hypothyroidism. As a consequence of this the tissue metabolism too will be hampered leaving a gross slow down effect in the body, as happens typically in high kapha or low pitta pathological conditions. These events can lead to cause any metabolic disease of kapha or pitta origin. But given this condition if the weak Samana Vata is invaded by a stronger Udana Vayu the same pathogenesis which has set in worsens further. This leads to symptoms of hypothyroidism. So, hypothyroidism can manifest on the backdrop of agnimandhya providing an alternative pathway for the pathogenesis of this disease from an Ayurveda perspective.

Is Galaganda an explanation of hypothyroidism?

Galaganda is explained in the form of swelling of the neck and related symptoms. This seems to be an explanation of goiter rather than of hypothyroidism itself. If hypothyroidism is associated with presence of goiter it shall be treated on the lines of galaganda treatment.
Read – Home Remedy For Goiter Using Kanchanar

Dosha predominance

Complications of hypothyroidism – Ayurveda perspective

Goiter – The thyroid gland becomes larger due to its constant stimulation to release more hormones. It can be thought of being caused by vata and kapha along with involvement of fat tissue.

Heart problems are caused due to buildup of kapha and morbid fat in the body. These events are set in due to low digestive fire and deteriorating metabolism.

Depression and slowdown of mental functioning is due to increased kapha in the body.

Peripheral neuropathy happens due to severe aggravation of Vata and involvement of Vyana Vata in the later stages of the disease.

Myxedema too looks like a condition caused by morbid kapha wherein there is a grave impact on multiple channels of the body as caused by severely aggravated kapha. This will block the movements of vata and cause this condition.

Infertility may be caused by kaphavrita apana i.e. kapha blocking the functions of apana vata. In this condition there will be amenorrhea. Sometimes in hypothyroidism there may be anovulatory cycles causing dysfunctional uterine bleeding. This may be a case of hyperactivity of vata in hypothyroidism or pittavrita apana i.e. apana vata being blocked by pitta.

Srotas and Dhatus involved

Hypothyroidism is a metabolic disease. As a consequence of the disease multiple systems are involved. Symptoms and diseases pertaining to many tissues, channels and organs are seen in this disease.
Read – Srotas: Body Channels and Duct systems – Easy Explanation

Rasa dhatu and Rasavaha Srotas

Heart is the root of channels carrying rasa tissue. Insufficient thyroid hormone slows down the heart rate and reduces the elasticity of the arteries. As a consequence, the blood pressure rises to compensate the circulation. When hypothyroidism is associated with these events the involvement of rasa carrying channels should be considered.

In hypothyroidism we get to see amenorrhea and less production of breast milk. It also interferes with ovulation. Breast milk and menstrual blood are the sub-tissues of rasa tissue.

Rakta dhatu and Raktavaha Srotas

We know that slowed down metabolism causes excessive accumulation of fats in the body in hypothyroidism. These events are also linked with non-alcoholic fatty liver disease. Liver is one of the roots of the channels of blood. This disease is also related with excessive bleeding and thrombosis.

Mamsa dhatu and Mamsavaha Srotas

Galaganda which is often compared to goiter has been mentioned in the list of symptoms caused due to contamination of channels carrying muscle tissue. Muscular pains are also present in this disease.

Meda dhatu and Medovaha Srotas

Obesity is mentioned as one of the symptoms of contamination of channels carrying fat. In a disease called Medo roga it has been said that when excessive fat blocks all the pathways in the body no other tissue except fat is nourished. Excessive accumulation of fat makes a person incapable of performing any activity due to deprived nutrition. In hypothyroidism we can see that there is weight gain and fatigue at the beginning of the pathogenesis. Hypothyroidism is also associated with increased levels of serum triglycerides and cholesterol and non-alcoholic fatty liver disease. There is pain; stiffness and swelling in the joints in hypothyroidism and the ligaments and joints are the sub-tissues of fat.

Asthi dhatu and Asthivaha Srotas

Fat is one of the roots of the bone carrying channels. When fat metabolism is disturbed as explained above, there will be deficit formation of bone in terms of quality and quantity. In hypothyroidism there is reduced bone mineral density (BMD) and increased risk of fractures. Bone pain and bone related deformities are also explained in symptoms of contamination of bone carrying channels.

Majja dhatu and Majjavaha Srotas

Majja means bone marrow. The other meaning of majja is brain. Bones and joints are the roots of bone marrow carrying channels in the body. Joint pains and some neurological conditions like giddiness, fainting, blurring of vision etc are mentioned among the symptoms of contamination of these channels. Numbness, tingling, pain, burning sensation, psychosis, mood disorder, depression, confusion, dementia, seizures etc are some of the neurological symptoms recorded in hypothyroidism.

Shukra dhatu and Shukravaha Srotas

Hypothyroidism is associated with reduced sperm morphology, poor sperm quality, low sperm count, reduced testicular function and erectile dysfunction. Impotence, delayed ejaculation, lack of erection and infertility has been explained among the symptoms of contamination of channels carrying semen. Loss of interest in sex is also mentioned among the symptoms of medoroga – fat related disorders and there is gain of fat in hypothyroidism.

Pureeshavaha Srotas

Flatulence, hard feces, constipation etc are mentioned among the symptoms of contamination of channels carrying feces. Sluggish intestinal motility, mild constipation, paralytic ileus and colonic pseudo-obstruction are seen in hypothyroidism.

Swedavaha Srotas

Lack of sweating is seen in hypothyroidism. The same is explained among the symptoms of contamination of channels carrying sweat.

Annavaha Srotas

Large goiter can impart pressure on the thyroid gland making swallowing difficult. Aversion to food and vomiting which may be the effects of pressure on food pipe are explained among the symptoms of contamination of channels carrying food.

Pranavaha Srotas

This includes two systems i.e. respiratory and cardiovascular system and the pathways of nutrition. Heart is one of the roots of these channels, just like in the channels carrying rasa tissue i.e. the nutritive fluid. Various kinds of breathing disorders, screaming, perplexing and bending of body and giddiness – caused due to lack of nutrition and oxygenation have been mentioned among the symptoms caused by contamination of prana carrying channels. The respiratory symptoms associated in hypothyroidism are reduction in respiratory drive, sleep apnea or pleural effusion all of which can cause breathing troubles.

Treatment of Hypothyroidism

Treating Udanavrita Samana

In Avaranas the ggravated vata subtype which is enveloping the other vata subtype should be addressed first. The vata causing obstruction is said to be associated with ama. In Udanavrita Samana, udana vata is causing obstruction of samana vata. Therefore, udana is associated with ama. Therefore, the ama should be dealt with first and then vata is addressed.

Treatment strategies to destroy ama should include fasting, sudation, medicines, gruels and ‘light to digest’ foods prepared with ama digesting herbs.

Following this, interventions should be planned to strengthen the weak samana vata. This includes administration of medicines to kindle the digestive fire, emesis, light diet and use of Rasayanas – tissue rejuvenating formulations.

Treating Kaphavrita Udana

Initially the aggravated kapha should be addressed.

If kapha is associated with ama – the ama dissolving medicines and foods should be given.

If kapha is not associated with ama or if ama has been digested by medicines – kapha alleviating herbs, diet, emesis and purgation therapies to expel excessive kapha should be administered.

Once kapha has been dealt and taken into control, the udana vata should be addressed. Vata alleviating measures along with unctuous purgation and enema are the best choices for treating vata. Other treatments are similar to treating vata in udanavrita samana.

Other strategies of treatment

Treatment as per symptoms of the disease – Hypothyroidism should be treated according to the predominant and most bothering symptom or disease presenting along with symptoms of the disease and biological values of decreased thyroid hormones and elevated TSH.

Treatment in accordance to related tissues and channels – For this the related disturbance of tissue and channels related with the transportation and distribution of those tissues should be treated promptly. The complications too should be dealt according to the Ayurveda principles by decoding the complications into Ayurveda language as explained above.

Treating on lines of Galaganda – When goiter is present it should be treated on the lines of galaganda treatment.

Treating on lines of medoroga – Overweight, obesity, elevated cholesterol and triglycerides and fatty liver should be treated on the lines of treating medoroga / treating the diseases caused by contamination of channels carrying fat.
Read – Effective Obesity Treatment, Remedies, Ayurveda Tips

Vasti Chikitsa – Vasti – enema with oil or milk / decoction prepared with vata alleviating herbs should be administered in chronic and stubborn cases or in presence of symptoms of multiple system involvement. This is because enema is the best treatment for morbid vata.

Udwarthana – herbal powder massage will enable to remove obstruction in the channels, to kindle digestive and tissue fire, to remove excessive fat which has accumulated in the body and destroy morbid kapha.

Formulations to treat Udanavrita Samana

• Varanadi Kashayam
• Varadi / Triphaladi Kashayam
• Guggulutiktakam Kashayam
• Gandharvahastadi Kashayam
• Indukantam Kashayam
• Kanchanara Guggulu
• Navaka Guggulu
• Pippali Rasayanam
• Pippali Vardhamana Rasayanam
• Medoharavidangadi Lauha

Herbs, Research studies

1. Kanchanara – Animal experiments (in rats) have shown that Bauhinia variegate Linn i.e. Kanchanara when administered has enhanced the thyroid functions. Bark extract of its variant i.e. Bauhinia purpurea Linn increased serum T3 and T4 in rats.

Related Reading – Review of Ayurvedic drugs acting on Hypothyroidism

2. Ashwagandha – Withania somnifera – has shown to lower cortisol and balance thyroid hormones. The adaptogens in Withania somnifera works well with hormones of endocrine system which bring balance of the levels of thyroid hormones. It also increases thyroid hormones. It is also used in autoimmune thyroid conditions because it is a potent immunomodulator herb. It has a stimulatory effect on thyroid gland.

3. Shigru – Moringa oleifera – Its extracts have shown maximum percentage increase in hormone concentration of T3 and T4.

4. Varuna – Crataeva nurvula – It has anti-tumor property and can be readily administered in thyroid swellings and goiter.

5. Guggulu – Commiphora mukul – shown to raise the levels of T3 and T4.

6. Brahmi – Bacopa monnieri – stimulates thyroid activity by increasing the amount of T4. Its extract increases T3 and T4.

7. Apamarga – Achyranthes aspera – its leaf extract increases T3 and T4 levels.

8. Nirgundi – Vitex negundo – its roots ground with water is used as nasal drops in the treatment of thyroid swelling.

9. Aragvadha – Cassia fistula – Its root bark is ground with rice water and used for nasal drops and also for application on swollen lymph glands around the neck and also thyroid swelling. Its extract has shown to increase T3, T4 and to decrease TSH and cholesterol levels in the body.

10. Jalakumbhi – Pistia startiotes Linn – Its ash is used with urine of cow in goiter.

Hypothyroidism – Modern Aspects

Thyroid is a small butterfly shaped gland. It is situated at front of your neck, below Adam’s apple. It produces hormones T3 (Triiodothyronine) and T4 (thyroxine). These thyroid hormones have enormous impact on one’s health and affect all aspects of metabolism. They also influence the control of vital functions like body temperature and heart rate. When thyroid doesn’t produce enough hormones, it upsets the balance of chemical reactions in body.

An underactive thyroid is called as hypothyroidism. It is a condition wherein the thyroid gland does not produce enough hormones as it should. In the earlier stages it might not show any symptoms. But if it is left untreated, hypothyroidism can cause many health problems which include obesity, heart disease, infertility, joint disorders and many more.

Physiology and types of hypothyroidism

The thyroid gland releases thyroid hormones into the bloodstream when it receives TSH i.e. thyroid stimulating hormone. This signal in the form of TSH is sent from the pituitary gland when thyroid hormone levels are low.

Primary Hypothyroidism – Sometimes the thyroid gland doesn’t release hormones in spite of presence of plenty of TSH. This condition is called as primary hypothyroidism. It is the most common type of hypothyroidism. Hashimoto’s thyroiditis causes about 90% of hypothyroidism. Hashimoto’s thyroiditis is an autoimmune disease in which your immune system attacks your thyroid gland. Iodine deficiency, genetic disorder, taking certain medications and surgery wherein a part of thyroid is removed, all these can cause primary hypothyroidism.

Secondary hypothyroidism – Sometimes the thyroid gland does not receive enough TSH. This happens when the pituitary gland is not working properly. This condition is called as secondary hypothyroidism.

Thyroid hormones control growth, cell repair and metabolism. People with hypothyroidism make less thyroid hormone. This means to tell that these people have slower metabolism and burn fewer calories at rest. When the metabolism is slow, there are many health risks. It causes tiredness; increased blood cholesterol levels and harder to lose weight. Patients with hypothyroidism are benefitted with moderate to high intensity aerobic exercise which boosts the thyroid hormones and speeds up metabolism (research) and also from increased protein intake.

Symptoms of Hypothyroidism

Depending on the severity of deficiency of thyroid hormones, the signs and symptoms of the disease vary. The health problems related to this condition develop slowly over many years of time.

At the beginning key symptoms of low thyroid functions such as weight gain, fatigue etc may be noted. Gradually the metabolism deteriorates. As the metabolism slows down the other symptoms may develop in due course of time. (Read more)

Below mentioned are the important signs and symptoms of hypothyroidism –

• Fatigue
• Weight gain
• Increased sensitivity to cold
• Dry skin
• Puffy face
• Weakness in the muscles, muscle ache, tenderness and stiffness
• Pain, stiffness or swelling in the joints
• Constipation
• Hoarseness of voice
• Thinning of hairs
• Slow heart rate
• Elevated levels of blood cholesterol
• Enlarged thyroid glands (goiter)
• Irregular or heavy menstrual periods
• Depression
• Impaired memory

Hypothyroidism in Infants

This condition usually manifests in infants born without a thyroid gland or with a gland working low. The below mentioned signs and symptoms may manifest –

• Jaundice – yellowness of skin and whites of the eye
• Large, protruding tongue
• An umbilical hernia
• Difficulty in breathing
• Hoarse crying
• Trouble feeding
• Failure of normal growth and development
• Constipation
• Excessive sleepiness
• Poor tone of muscles

Untreated conditions lead to severe physical and mental retardation.

Hypothyroidism in children and teens

The symptoms other than those present in the adults include –

• Short statute (due to poor growth)
• Delayed development of permanent teeth
• Delayed puberty
• Poor mental development

Right time to seek doctor’s advice

One should immediately see the doctor and seek medical advice if –

• There is feeling of tiredness for no obvious reason
• In presence of signs and symptoms of hypothyroidism including pale and puffy face, dryness of skin, hoarseness of voice and constipation

Causes of Hypothyroidism

• Autoimmune diseases – Hashimoto’s thyroiditis is common among these
• Hyperthyroidism treatments – People suffering from hyperthyroidism are treated with radioactive iodine or anti-thyroid medications. Sometimes this may end up lowering the thyroid hormone production too much. This may result in permanent hypothyroidism.
• Radiation therapy – used to treat cancers of head and neck affect the thyroid gland and may lead to hypothyroidism
• Thyroid surgery – removing the whole or large portion of the thyroid gland can reduce or stop the production of thyroid hormones. One may need to take thyroid hormones for life in this case.
• Certain medications – example lithium used to treat psychiatric disorders

Hypothyroidism may also result from one of the below mentioned conditions –

Congenital diseases – Some babies are born without thyroid gland or have a defective gland. Some children may have an inherited form of the disorder.

Pituitary disorder – rarely due to a benign pituitary gland tumor.  

Pregnancy – some women develop hypothyroidism during or after pregnancy (postpartum hypothyroidism). This is often because these women produce antibodies to their own thyroid gland. If it is not promptly addressed it may increase the risk of miscarriage, premature delivery or preeclampsia. It can also seriously affect the developing fetus.

Iodine deficiency – too little iodine can cause hypothyroidism and too much iodine can worsen hypothyroidism in people who already have the condition. Addition of iodine to table salt has eliminated this problem to a large extent.

Risk Factors

• Woman
• Pregnant or delivered a baby in the past 6 months
• Older than 60 years of age
• Family history of thyroid disease
• Suffering from an autoimmune disease such as celiac disease or type 1 diabetes mellitus
• undergoing treatment with anti-thyroid medicines or radioactive iodine
• Received radiation to your neck or upper part of the chest
• Undergone thyroid surgery

Complications

Untreated, hypothyroidism leads–

Goiter – It is a condition in which the thyroid gland becomes larger due to the constant stimulation of gland to release more hormones. Larger gland can affect your appearance. It may also interfere with swallowing or breathing mechanism.

Heart Problems –This is because high levels of LDL (low density lipoproteins) can occur in people with underactive thyroid.

Mental disorders – Depression is commonly associated with hypothyroidism. It may occur early in the disease but it becomes severe with time. Hypothyroidism also causes slowed mental functioning.

Peripheral neuropathy – The peripheral nerves can get damaged. This may eventually cause pain, numbness and tingling in affected areas.

Myxedema – This life-threatening condition is the result of long-term undiagnosed hypothyroidism. Intense cold intolerance and drowsiness followed by profound lethargy and unconsciousness are its important signs and symptoms. If this is the case, one needs immediate emergency treatment.

Infertility – Low levels of thyroid hormone impairs fertility by interfering with ovulation. Some of the causes of hypothyroidism like autoimmune disorder can also impair fertility.

Birth defects – Higher risk of birth defects are found in babies born to women with untreated thyroid disease. These children are more prone to serious intellectual and developmental problems. Infants with hypothyroidism at birth, when untreated, are at high risk of serious problems related to physical and mental development.

Diagnosis

• Diagnosis based on the clinical symptoms
• Blood tests that measure the level of TSH
• Level of thyroid hormone thyroxine (sometimes)

Low level of thyroxine and high level of TSH is indicative of hypothyroidism.

TSH is also used to diagnose a condition called subclinical hypothyroidism. In this condition there are no outward signs and symptoms. In this condition the blood levels of triiodothyronine and thyroxine are normal, but higher than normal levels of TSH.

Treatment of Hypothyroidism

Standard treatment for hypothyroidism involves daily usage of synthetic thyroid hormone levothyroxine. It restores adequate hormone levels. It also reverses the signs and symptoms of hypothyroidism. It will gradually lower cholesterol levels and also may reverse weight gain caused by hypothyroidism. This medicine might be advised to be taken for life. The doctor may like to check TSH levels of patient every year.

A general practitioner may diagnose your hypothyroidism after thorough clinical evaluation and needed tests. You may be referred to an endocrinologist for accurate diagnosis. A pediatric endocrinologist is an expert who diagnoses and is equipped to treat hypothyroidism in infants and children.

Important Points

• Hypothyroidism affects 1-2% of people worldwide.
• Eating right nutrients and taking timely medications may help in reducing the symptoms and also to improve thyroid function.
• The right nutrients for the thyroid are iodine, selenium and zinc.
• The symptoms of hypothyroidism can be minimized and a healthy weight can be maintained by following a thyroid friendly diet. (Read)

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