Introduction

The thyroid is among the first endocrine glands to develop.^[1] The disease known as hypothyroidism is characterized by decreased thyroid gland function and decreased T3 and T4 production. The illness affects women roughly 6–8 times more frequently between the ages of 40 and 50.^[2]

Since every tissue in the body depends on thyroid hormones for proper operation, a shortage can cause multisystem involvement. The most practical physiological indicator of thyroid gland function, TSH is also a key regulator of the thyroid axis system. The main cause of the rise in endocrinological illnesses, particularly thyroid disorders, may be attributed to sedentary lifestyles and poor eating habits.

Thyroid diseases are also a result of rising stress and anxiety levels because the gland is extremely sensitive to stimuli. Primary and secondary forms of hypothyroidism are distinguished based on whether the disorder results from a thyroid gland anomaly or from pituitary or hypothalamic dysfunction.

The clinical manifestations of hypothyroidism include many of the Kaphaja Nanatmaja Vikaras, such as Gurugatrata (heaviness), Alasya (lethargy), Tandra (drowsiness), Atisthoulya (obesity/weight increase), Atinidra (excessive sleep), etc. Medodhatwagni provides nourishment and upkeep for Medodhatu. The symptoms of hypothyroidism will be exacerbated if there is an excess of Medo Dhatu ~Saama Meda Dhatu due to Medodhatwagnimandya.^[3]

Case Report

Patient Information

In September 2024, an 18-year-old female Hindu, unmarried, student by profession, came to OPD in the Ayurvedic institute. Primary concerns and symptoms of patient: Patient presented with complaints of the dryness in skin (Twakparushya) over palmar surface in both hands along with associated symptoms of increased tiredness lethargy, hair fall, excess sweating and constipation in the last 3 months. Medical history: The patient was unable to provide any documentation of prior treatments, but her response to those treatments was insufficient.

Pathya and Apathya (~wholesome and unwholesome)

Along with taking the drugs, the patient was instructed to strictly adhere to Pathya (wholesome) and refrain from Apathya (unwholesome), for instance Laghu Anna-Pana (eating foods that are easily digested), Amla (goose berry), Tikta Rasa Pradhan Ahara (bitter food items) Karela (bitter gourd), Parwal (pointed gourd), Mudga (green grams), Yava (barley), Vegavrodhvarjan (avoid holding natural urges), Yoga (exercise and meditation) was advised.

The patient was advised to avoid Dahi (curd), Virudhasana (mutually contraindicated food items) such as milk with fish etc.

Lavan (salty food), Amla Raspradhanahara (sour food), Mash (black gram), Adhyashana, Divasvapan (day sleeping), Avyayam (lack of exercise and physical activity) and excess Krodh, Soka, stress (exposing to negative emotions).

Table 1: Therapeutic Intervention

Follow-Up and Outcome

The treatment was given for almost 3 months, and monthly follow-up was done. There were 3 follow-ups during the course of treatment and 01 follow-up after one month of stopping the treatment wherein the TSH level was assessed after 3 months. Significant improvement was observed during follow-ups.

At the end of 1 month, constipation was relieved along with the dryness in palms. By the third follow-up, heaviness, excess sweating and lethargy were completely resolved. There was also improvement in the complaint of hair fall. TSH level was reduced to normal limits.

Discussion

The clinical condition known as hypothyroidism is brought on by insufficient thyroid hormone synthesis. Even at the cellular level, it interferes with the body's metabolism and can impact nearly every organ.

The condition hypothyroidism can be mainly categorized under Agni's activity, even though it is not specifically mentioned in traditional Ayurvedic texts. The Jathragni is the most important of the thirteen varieties of Agni that have been described in Ayurvedic texts. Ahara and Vihar are necessary for their equilibrium.^[4] When Guru, Madhur, Sheet, and Drava foods are regularly consumed along with inactivity, lack of exercise, Shodhan, etc., Kapha is vitiated, which causes Agnimandya, Ama accumulation, and Dhatwagnimandyata, as was the case in this instance. Hence, after thoroughly understanding the pathophysiology of the case, a treatment protocol was developed for bringing the vitiated Agni and Doshas back to their natural state. To attain this, formulations having Agnideepaka, Strotoshodhak, Vatakaphashamaka and Shothhara were prescribed.

The ingredients of Vaishvanara Churna are Saindhava Lavana, Ajwain, Ajamoda, Shunthi and Haritaki. All the constituents of drug are having Ushna Veerya, Madhura, Katu Vipaka and Vata Kapha Shamaka properties. Haritaki and Saindhava are having Tridoshashamaka property. All the ingredients of Vaishvanara Churna are having Deepana, Pachana, Anulomana properties which improve the status of Agni, subsequently prevent Ama formation and vitiation of Dosha.^[5]

Dashmool Kwath - It contains herbs with properties of entering in minute channels thus helping in alleviating Kapha Dosha with anti-inflammatory properties and analgesic effect. All of the drugs in dashmool have Ushna Virya thus helping in pacifying Avarana caused by Kapha Dosha over Jatharagni.^[6]

Shadang Paneeya - including Musta, Parpatak, Usheera, Chandana, Uddichya, and Nagar, a herbal infusion that was selected for its distinct therapeutic qualities. The purpose of this herb combination is to treat a number of Pitta-related symptoms, such as dehydration, excessive thirst, burning feelings, and appetite loss.