Concept & Ayurvedic Treatment for Thyroid Problems

Thyroid diseases in Ayurveda can be identified as either a local swelling at thyroid gland called as galaganda or as the systemic presentation of the thyroid disease however without a recognition of association of these symptoms to thyroid. The examples of the later condition are shotha kind of conditions which might occur due to hypothyroidism and unmada kind of conditions which may occur due to hyperthyroidism.

Ayurvedic Treatment for Thyroid Problems

Galaganda in Ayurveda is considered as a variable swelling at neck which resembles to that of goitre. Typical features of Galaganda are 1. Nibaddhata (Attached) 2. Mahan (Large)  or Hriswa ( small) in size and 3. Mushkavata lambate (hanging like a pouch) . Two different patterns and causes are identified for thyroid swelling. Of these varieties Vata Galaganda is apparently similar to toxic goitre where as kapha galaganda is similar to that of simple goitre. This is interesting to note that no pitta variant of galaganda is described in classical Ayurvedic texts. A medoj variety of galaganda is also proposed however this is found not to be a real thyroid swelling but a fatty accumulation at the local area giving it a resemblance to that of goitre.

Vata Galaganda Has Following Clinical Features

1. Krishna siravnaddha ( Visible blue-black veins)
2. Shayava/Arun( Blue –black discolouration)
3. Parush ( Hard and dry)
4. Chira Vriddha ( Sustained swelling)
5. Talu Gala Prasshosha ( Dryness in mouth)

Kapha Galaganda Has Following Features

1. Sawarna (No discolouration)
2. Sthira (Stable)
3. Ugra Kandu (Itching)
4. Shita (Cold)
5. Chirabhivriddha (Slow progress)
6. Guru (Heavy)

Medoj Galaganda Has Following Features

1. It is not a thyroid swelling which is apparent through following features
2. Dehanurup Kshaya Vriddhi ( Increases or decreases as per the status of body)
3. Pralambate alabu vata ( hanging like a bottle guard)
4. Alpa Mulo ( small stalk)
5. Medoj galaganda looks like a fat collection or a lipoma at neck

Prognosis of Galaganda

Following are the bad prognostic features of Galaganda

1. Samvatsaratita (Chronicity): If the disease is for    more than one year
2. Pressure symptoms: Kriccha swasa ( respirartory difficulty), Bhina swara ( changed voice)
3. Metabolic Symptoms: Aartra ( sad mood), Kshina ( prostrated), Mridu sarva gatrama ( flaccid body), Arochaka ( Loss of appetite)
4. Metabolic feature present a mix of hypo and hyper thyroid state

Systemic Presentation Of Thyroid Disease In Ayurveda

Kapha shotha resembles to hypothyroidism for following reasons:

The shoth is guru, sthira and non pitting. Additionally the patient also has loss of appetite and increased sleep. These features are similar to myxedema of hypothyroidism.

Unmada

Bad prognostic features of Unmada 

• Sthulaksa ( exopthalmos)
• Druta ( Agitated)
• Patati ( Frequent falls)
• Kamp ( tremors)
• Jagruk ( reduced sleep)
• Kshina Bala Mansa ( Emaciated).

These features of Unmada are similar to that of Thyrotoxicosis.

Management of Thyroid Diseases in Ayurveda

Following classical drugs are recommended in Ayurveda for the Treatment for Thyroid Problems:

1. Oral preparations- Kanchanara gugiulu, Jalakumbhi bhasma
2. Massage- Amritadi Taila, Shakhotaka Taila
3. Nasya- Bimbadi Taila, Tumbi Taila, Nirgundi Taila

Pathya- Yava, Mung, Patol, Karela, Rakta Shigru, Ruksha-Katu rasa, Gugulu, Shilajatu, Trikatu and madhu with gomutra

Vaman, Virechana and Rakta Mokshana

Apathya- Khsira –ikshu vilkriti, Anupa mamsa, Pishthanna , Amla, madhura, guru, abhishyandi

Recent Developments In Herbal Therapy Of Thyroid Disease

Hypothyroidism

Ghallop M 1991 tried kanchanara gugulu upon 899 simple goiter patients for 10-20 months. 35 % patints under trial reported more than 50 % regression in goiter size.

Thyroid function was found stimulated after 14 days consumption of root extract of Sasurrea lapa ( Kushtha) in rats.

Tripathi YB 1995 reported a thyroid function stimulation following Inula recemosa root extract consumption for 20 days in rats

Coleus forskohlii is found to mimic the effects of TSH in regard to iodine uptake, organification of  iodine, thyroglobulin production and promotion of secretion of T3 and T4 .

Bacopa menniera ( Brahmi ) exhibits thyroid stimulating abilities through an increase of T4 serum concentration in animal studies. The increase  of T4 by 41% withpout any notable increase in T3 or hepatic activity suggests that the action of Brahmi has more to do with direct throid stimulating activity than it does with hepatic conversion of T4 into T3.

Ashwagandha root extract significantly increase the T4 level in blood.

Hyperthyroidism

Azadiracta Indica (Nimba)- reduces T3 level in rats possibly through interfering T4- T3 conversion

Embelica officinalis (Amala ) – decreses the T3 and T4 in mice and also intereferes with T3 T4 conversion

Momordica charantia ( Karela) – decreases T3 and T4 in mice

Convolvulus pleuricaulis – Root extract reduces T3 levels

Oscimum sanctum ( Tulsi) – Leaf extract inhibits T4 concentration

Piper betel ( Paan)- reduces T3 and T4 concerntration in male mice

Triphala extract is found to have signidficant affinity for CCK receptors expressing tumors. Thyroid medullary carcinoma is one example of this tumor.

In summary following drugs from Ayurveda can be used in hypo and hyper thyroid conditions respectively

Hypothyroidism

Herb	Part used	Mode of action	Use
Kanchanara	Bark		Simple goiter, Hypothyroiduism
Kushtha		Increased thyroid function	Hypothyroidism
Pushkara	Root	Increased thyroid function	Hypothyroidism
Ashwagandha	Extract	Increased T4	Hypothyroidism
Coleus, Brahmi	Extract	Mimics TSH	Hypothyroidism

Hyperthyroidism

Herb	Part used	Action	Use
Shankha  pushpi	Flower	Reduces iodine intake	Thyrotoxicosis
Nimba	Patra	Reduced T3,	Hyperthyroidism
Amala	Fruit	Reduced T3, T4	Hyperthyroidism
Karela	Fruit	Reduced T3, T4	Hyperthyroidism
Tulasi	Leaf	Reduced  T4
Piper Betel	Leaf	Reduced T3, T4
Haritaki	Fruit	CCK receptor affinity	Thyroid carcinoma
Haridra	Rhizome	Reduced TSH binding to receptor	Thyrotoxicosis
Triphala	Fruit extract	CCK receptor affinity	Throid carcinoma