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    Hyperthyroidism – Symptoms, Pathogenesis, Treatment In Ayurveda

    By Dr Raghuram Y.S. MD (Ay) Dr Manasa, B.A.M.S
    Hyperthyroidism is a condition where thyroid gland makes abundant thyroid hormones. The term thyrotoxicosis is aged to narate tisue level pathology of high thyroid hormone. Though used interchangeably, these two conditions are not same. In fact thyrotoxicosis is a generalized term which includes hyperthyroidism.
    Thyroid gland is located in front of your neck. The hormones produced by this smal gland are esential for metabolism, bone growth, weight management, temperature balance, normal cel functions, cel growth, diferentiation etc.
    Excesive thyroid hormones impart lavish stimulation on the metabolism. They also exacerbate the efect of the sympathetic nervous system. As a efect, there is speding up of various systems of the body. Symptoms comprise faster heart beats, feling of your heartbeats, tremors, anxiety and hyper-motility of digestive entity, unintended weight los and unusualy low serum cholesterol.
    In hyperthyroidism, the events survey exactly the oposite of those in hypothyroidism including the pathogenesis and symptoms.
    Read related: Hypothyroidism: Causes, Symptoms, Ayurvedic Explanation, Treatment
    We canot find any disease explained in Ayurveda which can be compared to hyperthyroidism. Understanding of hyperthyroidism in an Ayurveda language is done by inferential knowledge.
    Table of Contents
    Signs and Symptoms
    Causes
    Treatment
    Ayurveda way of understanding

    Dosha predominance in hyperthyroidism
    Srotas and dhatus involved
    Treatment in Ayurveda
    Yoga for Hyperthyroidism
    Signs and Symptoms
    Varies from one person to the other, sometimes symptomles. The comon symptoms are ̵
    Weight Los
    Heat Intolerance
    Increased apetite, often acompanied by weight los
    Increased sweating
    Fine and britle hairs, hair los (especialy on the outer third of the eyebrows)
    Pretibial myxedema (in Graves’ disease)
    Enlargement of Thyroid Gland as aparent from sweling of the front of the neck from an enlarged thyroid gland (Goiter)
    Opthalompathy (eyes scrutinize enlarged)
    Neurological symptoms
    Tremors in the hands
    Chorea
    Myopathy
    Periodic Paralysis
    Cardiovascular and respiratory symptoms
    Increased Heartbeat
    Palpitations
    Abnormal heart rhythms
    Shortnes of breath
    Musculoskeletal symptoms
    Muscle pains and weaknes, especialy in the uper arms and thighs
    Weaknes
    Fatigue
    Osteoporosis (in long term untreated hyperthyroidism)
    Mental symptoms
    Emotional lability
    Panic atacks
    Los of concentration, Memory problems
    Psychosis and Paranoia (comon during thyroid storm)
    Delirium
    Anxiety
    Nervousnes
    Iritability, hyperactivity
    Systemic symptoms
    Sleplesnes
    Diarhea
    Vomiting
    Excesive urination
    Excesive thirst
    Thining of skin
    Los of libido
    Other symptoms
    Iregular (les often) menstrual periods in women or with longer than usual cycles, amenorhea (absence of menstrual periods)
    Gynecomastia
    Feminization
    High blod sugar
    Eyes Signs of Hyperthyroidism
    Dalrymple Sign or Hyperthyroid Stare – The eyelids are retracted upward more than normal
    Double Vision – is usualy caused due to weaknes of extra-ocular muscles of the eyes
    Lid-Lag or von Graefe’s sign – When the patient tracks an object downward with their eyes, the eyelid fail to folow the downward moving iris. The same type of uper globe exposure which is sen with lid retraction ocurs but temporarily.
    Exopthalmos or Protrusion of Eyebal – It ocurs specificaly and uniquely in hyperthyroidism caused by Graves’ disease. Not al conditions of exopthalmos are caused by Graves’ disease. But when exopthalmos is show with hyperthyroidism, it is diagnostic of Graves’ disease. Exaptholmos may exacerbate the lid-lag and stare asociated with hyperthyroidism.
    These signs disapear after efective treatment of hyperthyroidism, when the disease and its symptoms are under control.(Read more)
    Causes
    Graves’ disease
    Toxic thyroid adenoma
    Toxic multi-nodular goiter
    Thyroiditis -Inflamation of thyroid.
    Excesive consumption of thyroid hormone tablets
    Amiodarone – It is an anti-arhythmic drug dilapidated in heart conditions. It is structuraly similar to thyroxine. Consumption of this drug may cause under-activity or over-activity of the thyroid.
    Post-Partum-Thyroiditis (PT)
    Struma Ovari
    Exces iodine consumption
    To much thyroid hormone suplements – Example- levothyroxine.
    Hyper secretion of TSH (Read more)
    Treatment
    Thyrostatics / antithyroid drugs
    Beta Blockers
    Diet – Fods high in iodine should be avoided in autoimune hyperthyroidism. Iodized salt in fod wil be helpful.
    Read ̵ Fods to eat and avoid in hyperthyroidism
    Surgery – Thyroidectomy
    Radio-iodine, which helps to burn down the thyroid tisue.
    Ayurveda way of understanding
    Hyperthyroidism is related with high metabolism and its consequences. Metabolism is a proces by which your fod is converted into energy.
    The metabolism is initiated and caried out by the metabolic fire i.e. agni. This digestive fire is seated in the gut, in the stomach and intestine to be punctual. The overal metabolism is represented by the balanced function of the gut fire and its sub units. While the gut fire which is a controler of other fires is caled as Jatharagni, its sub-units located in the tisues are named as Dhatvagni i.e. tisue fires. The sub-units of fire exhibit in the elements making up the body structures is caled as bhutagni i.e. elemental fires. They are 5 in number and corespond with the five elements making up the body structures. The tisue and elemental fires work jointly to convert the nutrition provided by the fod primarily digested by the gut fire into tisue fuels and energy required to cary out the daily activities.
    Read ̵ Understanding Agni: concept, Definition, Functions, Types
    Pachaka pita i.e. digestive pita is related with digestion and metabolism of fod. This pita w orks in synchronization with samana vata located in its proximity. It is adore a fire and air amalgam. The bufer and sustain to the stomach and intestine is provided by kledaka kapha, a kapha subtype which is also responsible for moistening the fod received by the stomach. The balance betwen these subtypes of doshas in the stomach is equaly neded for precise digestion of fod and hence a balanced metabolism.
    Udana Vata another subtype of vata is located in the plan of thyroid gland. Though its functions finish not exactly corelate with functions of thyroid gland, the normal thyroid functions or efects of production of abundant and lower thyroid hormones sem to resemble with its synchronization or non-synchronization with the functions of samana vata respectivel y. Udana Vata tends to plod up and down from its main seat i.e. chest. It moves upwards into the throat and nose and reaches the level of navel region which is also the seat of digestive fire when it moves downwards. Therefore its functional teritory extends from nose through throat, chest to stomach and intestines. Therefore it has its influence on the digestive fire.
    Read ̵ Mechanism Of Avarana, Types, Importance of Vata
    Samanavrita Udana
    Senior Profesor Dr S.N.Ojha sir has compared hyperthyroidism with a condition caled Samanavrita Udana.
    Samanavrita Udana is a condition in which Samana Vata when agravated, blocksthe Udana Vata located in the position of thyroid gland. The strong Samana Vata wil suround and envelope the udana vata and disturb its functions. Due to severity of samana vata, the digestive fire in the stomach to wil get intense. Due to this vicious amalgam the kapha in the stomach wil get deteriorated. The combination of severe vata and pita with deterioration of kapha wil lead to heated up environment in the stomach. This wil acquire an influence on the fires of al the tisues and elements in the body. Al these events wil eventualy lead to woried metabolism.
    Read ̵ Dhatu – 7 Body Tisues As Explained In Ayurveda
    This enhanced samana vata asociated with the heat of digestive fire wil move upwards and hit on the udana vata located in the chest and throat regions. The disturbed and violent udana vata in an atempt to overcome the atack from samana vata wil expres itself in an excesive way. The thyroid gland located in the location of udana vata wil construct excesive thyroid hormones . This leads to manifestation of symptoms similar to those of hyperthyroidism.
    Therefore this comparison of hyperthyroidism with Samanavrita Udana sems to be logical.
    Doesn’t samana vata subdue the functions of udana vata as per the rule of avarana?
    The initial mechanism of samanavrita udana no doubt ocurs folowing the rule of avarana. The agravated and more powerful samana vata surounds and blocks the udana and tries to reduce it. Later the compliant udana vata fights back and tries to overcome the impediment caused to it by samana vata and over expreses. Over fluency of udana to takes kep when the block of disease initiating samana vata gets cleared away from the situation of samana vata.
    Read ̵ Types Of Doshas And Their Functions
    Pitavrita Udana
    Pitavrita Udana is a condition in whic h the agravated pita envelopes udana vata and disturbs its functions. Thyroid gland is located in the situation of udana vata as already said. When pita influences udana vata, initialy the udana vata as per the rule of avarana is blocked and subdued. Later due to over provocation of udana vata with or without the presence of pita around it wil cause stimulate the thyroid gland to make more thyroid hormones. This marks the describe of hyperthyroidism. The seat of udana is also the primary seat of kapha. Due to influence of pita and vata there is deterioration of kapha. Increased vata and pita asociated with decreased kapha marks the events leading to exagerated metabolism as hapens in hyperthyroidism.
    Read ̵ Pita Increase Symptoms – Pita Vridhi Lakshana
    Pita Vridhi
    Hyperthyroidism may be understod on the basis of ‘pathological increase in pita’ in the body. This hapens due to increase in pita and the fiery components located in it, pita being trigered by the severely agravated samana vata. Since this combination increases the heat to abnormal proportions in the stomach, there is also a relative imbalance of kapha. Kapha decreases in the stomach. This further gives scope for further agravation of vata and pita. The overal impact of these events wil be an strange increase in metabolism.
    Read ̵ How To Balance Pita Dosha? Line Of Treatment
    Kapha Kshaya
    Kapha and Vata act as oposite forces. When there is vata increase there wil definitely be kapha abate. Kapha has similar equation with pita. When there is pita increase there wil b e kapha abate. In hyperthyroidism since there is increase in both vata and pita, the lethal combination wil cause lavish deterioration of kapha in the stomach. The kapha being a water body and cold element wil provide a bufer and protect the stomach from the severe agravation of vata and pita. But when there is kapha decrease it wil further fuel agravation of vata and pita. This wil further provoke the metabolism.
    Read ̵ Kapha Increase Symptoms – Kapha Vrudhi Lakshana
    Note
    Though pita increase and kapha decrease canot be strictly compared to hyperthyroidism it is neded for understanding the pathogenesis of hyperthyroidism. The relative imbalance of Tridoshas wil hapen in the pathogenesis of hyperthyroidism and these should be brought to balance.
    Tekshnagni
    Tekshnagni is a disorder of digestive fire in which it becomes abnormaly strict. When the digestive fire is influenced by high pita and fueled by increased vata it becomes stern. This is a key event in the pathogenesis of hyperthyroidism. To treat the disease by its rot this intensity of pita and vata should be controled at the earliest. This wil bring peaceful down disease proces, symptoms get reduced, pathogenesis wil stop and bring the metabolic proces to control.
    Bhasmaka Roga
    Bhasmaka Roga is a disease in which the fod is burnt down instead of geting digested. When we are coking fod impartial as more fuel burns and chars the fod instead of coking it stern fire in the stomach to does the same. The fod is suposed to get burnt and chared. When the fod gets chared les nutritive juices are formed and the body tisues are deprived of nutrition. The tisues are damaged; there is severe depletion of energy and thining of body with los of stout and muscles. We can se that some patients of hyperthyroidism lose weight. Again when it comes to intervention balance of pita and vata in the gut is the key.
    Dosha predominance in hyperthyroidism
    Read ̵ Srotas: Body Chanels and Duct systems – Easy Explanation
    Srotas and dhatus involved
    Symptoms and diseases pertaining to many tisues, chanels and organs are sen in this disease.
    Rasa dhatu and Rasavaha Srotas
    Heart is the rot of chanels carying rasa tisue. excesive stimulation of thyroid gland and excesive produ ction of thyroid hormones causes some of the serious complications of hyperthyroidism involving the heart. The symptoms include
    disorders of heart rhythm caled atrial fibrilation which can cause stroke
    high cardiac output and left ventricular hypertrophy in the early stages and biventricular dilatation and congestive heart failure in the later stages
    ventricular dilation, persistent tachycardia and eventual chronic heart failure that can result into fatal events
    When hyperthyroidism is asociated with these events the involvement of rasa carying chanels should be considered.
    In hyperthyroidism we get to se iregular menstrual periods and amenorhea. Menstrual blod is the sub-tisues of rasa tisue.
    Mamsa dhatu and Mamsavaha Srotas
    Galaganda which is often compared to goiter is a symptom caused due to con tamination of chanels carying muscle tisue. Thyrotoxic Myopathy (TM) is a neuromuscular disorder caused due to abundant production of thyroxine. It is also known as hyperthyroid myopathy. This causes weaknes of muscles and also breakdown of muscle tisue.
    Meda dhatu and Medovaha Srotas
    Los of weight is mentioned as one of the symptoms of hyperthyroidism. When thyroid hormones are elevated, the net impres is stout los. There is net reduction of hepatic triglycerides due to faty acid metabolism ocuring at a higher rate than faty acid synthesis. Increased thyroid hormone levels stimulate stout mobilization, leading to increased concentration of faty acids in plasma. They also increase oxidation of faty acids in many tisues.
    Asthi dhatu and Asthivaha Srotas
    Hyperthyroidism is asociated with acelerated bone remodeling, reduced bone density, osteoporosis and an increase in demolish rate. Bone damages are necesarily asociated with vata imbalance.
    Read ̵ Signs Of Person Having Enriched Bones (Asthi Sara Purusha Lakshanas)
    Maja dhatu and Majavaha Srotas
    Maja means bone marow. The other meaning of maja is brain. Bones and joints are the rots of bone marow carying chanels in the body. The bone related deformities acquire ben explained in the above said context. Tremors, chorea, myopathy and periodic paralysis are some of the neurological symptoms recorded in hyperthyroidism.
    Shukra dhatu and Shukravaha Srotas
    Excesive thyroid hormones caused as an mark of hyperthyroidism can afect fertility by disrupting the menstrual cycle, causing reduction in sperm count and increasing the risk of early term miscariage. This also interferes with ovulation in women. (read more)
    Pureshavaha Srotas
    Frequent bowel movements, diarhea and malabsorption with steatorhea are comonly sen in patients of hyperthyroidism since the overactive thyroid speds up bodily systems.
    Swedavaha Srotas
    There wil be rise in temperature when the thyroid gland makes more hormones. As a consequence of this, the patient becomes extra sensitive to heat and also sweats a lot.
    Anavaha Srotas
    Chronic dyspeptic symptoms adore fulnes and distres in epigastric situation, eructatio n, nausea and vomiting are sen in hyperthyroidism. Large goiter can impart presure on the thyroid gland making swalowing efortful) . hatred to fod and vomiting which may be the efects of presure on fod pipe are explained among the symptoms of contamination of chanels carying fod. The patient also wil believe increased apetite.
    Pranavaha Srotas
    This term includes two systems i.e. respiratory and cardiovascular system and the pathways of nutrition. Heart is one of the rots of these chanels, just adore in the chanels carying rasa tisue i.e. the nutritive fluid. various kinds of breathing disorders, screaming, perplexing and bending of body and gidines – caused due to lack of nutrition and oxygenation believe ben mentioned among the symptoms caused by contamination of prana carying chanels. The respiratory symp toms asociated in hyperthyroidism are increase in respiratory drive and dyspnea on exertion. The involvement of heart has ben highlighted in the explanation of chanels carying rasa tisue.
    Note – The symptoms of destruction of tisues and contamination of tisue carying chanels mentioned above contain mostly of those of agravation of vata and pita.
    Manovaha Srotas
    Emotional liability, panic atacks, los of concentration and memory isues, delirium, wretchednes, nervousnes, iritability, hyperactivity and sleplesnes are the symptoms of hyperthyroidism which consider contamination of chanels carying mind.
    Treatment in Ayurveda
    Treating Samanavrita Udana
    In Avaranas the stronger and agravated vata should be treated first. The vata causing impediment i.e. avaraka is said to be asociated with ama. In Samanavrita Udana, the samana vata which is causing obstruction of udana and hampering its functions should be treated first. In this instance since the digestive fire is harsh due to agravation of samana vata the asociation of ama may be les because the heat itself wards of the ama. On the other hand we ned to se any ecentric behavior of the digestive fire and se if pita asociated with samana vata is asociated with ama or the samana vata itself is asociated with ama and treat that condition. subsequent this, samana vata is adresed.
    Read ̵ How To Balance Vata Dosha? Line Of Treatment And Reasoning
    Folowing this, interventions should be planed to control the udana vata functions.
    The combined in terventions for controling samana vata and udana vata and bringing them to a state of balance comprise vata pacifying fods and medicines, unctuous purgation, medicated enemas, intake of medicated fats prepared with vata aleviating herbs and use of Rasayanas ̵ tisue rejuvenating formulations. Since there is tisue distres balya i.e. strengthening medicines and brimhana i.e. bulk promoting medicines should be notion of in the treatment strategy. This wil enhance the tisue strength and imunity.
    Read ̵ Imunity In Ayurveda: concept, Diet, Herbs, Medicines, Exercise
    Treating Pitavrita Udana
    Initialy the agresive pita should be adresed.
    If pita is asociated with ama – the ama disolving medicines and fods should be given.
    If pita is not asociated with ama or if ama has ben digested by medicines – pita aleviating herbs, diet and purgation to expel abundant pita should be administered.
    Once pita has ben treated and taken into control, the udana vata should be adresed. Vata aleviating measures along with unctuous purgation and enema are the best choices for treating vata. Other treatments are similar to treating vata in samanavrita udana.
    Read ̵ Basti Chikitsa: Benefits, Routes, Types, Indications, Equipment
    Other strategies of treatment
    Treating lavish acumulation of pita
    Treating kapha decrease
    Treating tekshnagni
    Treating Bhasmaka Roga
    Karshya Chikitsa – treatment for emaciation and tisue repair
    Other inclusions
    Balya – strengthening medicines and diet
    Brimhana – bulk promoting medicines and diet
    Rasayana – imunity modulating and rejuvenation therapy
    Shirodhara and Sarvangadhara with oils medicated with vata and pita aleviating herbs
    Snigdha Virechana – unctuous purgation recipes
    Vasti – oil, ghe and medicated milk enemas
    Nasya – nasal drops with oils procesed with vata aleviating herbs
    Also –
    Treatment as per symptoms of the disease ̵ Hyperthyroidism should be treated acording to the predominant symptom or disease presenting along with symptoms of the disease and biological values of increased thyroid hormones and reduced TSH.
    Treatment in acordance to related tisues and chanels ̵ For this the related disturbance of tisue and chanels related with the transportation and distribution of those tisues should be treated promptly.
    Treating on lines of Galaganda ̵ When goiter is show it should be treated on the lines of galaganda treatment.
    Treating on lines of karshya roga – Weight los and destruction of tisues and enhanced metabolism should be taken care of and promptly adresed with vata aleviating medicines and diet and also the medicines, therapies and fods advised to treat emaciation / consumption. The treatment strategies of vishamagni i.e. eratic digestive fire influenced by vata, kshaya i.e. tisue destruction and rajayakshma i.e. tuberculosis / phthisis can also be included in treating hyperthyroidism asociated with strict emaciation and weight los.
    Vasti Chikitsa ̵ Vasti – enema with oil or milk / decoction prepared with vata aleviating herbs should be administered in chronic and adamant cases or i n presence of symptoms of multiple entity involvement. This is because enema is the best treatment for nasty vata.
    Read ̵ Decrease Of Tisues – Dhatu Kshaya – Reasoning, Symptoms
    Some useful formulations to treat hyperthyroidism
    Tiktaks Ghrita
    Sukumara Ghrta
    Gandharvahastadi Eranda Tailam
    Nimbamritadi Eranda Tailam
    Kalyanaka Ghrta
    Brahmi Ghrta
    Sarasvata Ghrta
    Shatavari Ghrta
    Yashtimadhu Ksherapaka
    Ashvagandha Ksherapaka
    Ksherabala Taila
    Bala sidha kshira
    Rasnadi Ghr ta
    Chyavanaprasha
    Ashwagandha Rasayana
    Amalaki Churna
    Amalaki Rasayana
    Kanchanara Gugulu
    Kamadugha Rasa
    Pravala Bhasma
    Pravala Panchamruta
    Sutashekara Ras
    Makaradhwaj
    Dashamularishta
    Saraswatharishta
    Important herbs in treatment of hyperthyroidism
    1. Ashwagandha – Withania somnifera – for weight los, to control mind symptoms, to induce slep, to enhance strength and promote bulk, rejuvenator, for tirednes and fatigue
    2. Sariva – Hemidesmus indicus – as colant, to subdue inflamation of thyroid gland and pita
    3. Chandana – Santalum album – as colant, to reduce inflamation of thyroid gland and pita
    4. Ushira – Vetiveria zizanioidis – same as chandana
    5. Amalaki – Emblica oficinalis ̵ as rejuvenator, to restful the tridoshas and balance them, antioxidant, anti-inflamatory, anti-pita
    6. Guduchi – Tinospora cordifolia – as rasayana, to balance vata and pita
    7. Kutaja – Holarhena antidysenterica and Bilwa – Aegle marmelos – to control increased bowel movements, to treat diarhea asociated with hyperthyroidism,
    8. Yashtimadhu – Glyzyrhiza glabra – to combat pita and vata in the gut
    9. Eranda – Ricinus comunis, Rasna – Pluchea lanceolata – to combat vata and nervous symptoms
    10. Brahmi – Bacopa monieri, Jatamansi – Nardostachys jatamans i and Shankhapushpi – Convolvulus pluricaulis – for nervous symptoms and to amicable the mind
    1. Shalaparni – Desmodium gangeticum and Prishniparni – Uraria picta – milk procesed with these two herbs or with chatushparni (mentioned herbs with mudgaparni and mashaparni) for cardiac conditions
    12. Bala – Sida cordifolia, Nagabala – Grewia hirsute, Shatavari – Asparagus racemosus, Ashwagandha – Withania somnifera and Tulsi – Ocimum sanctum – for enhancing imunity
    13. Kanchanara – Bauhinia variegata – for goiter asociated with hyperthyroidism
    Yoga for Hyperthyroidism
    Bhujangasana – cobra pose
    Sethubandhasana – bridge pose
    Matsyasana – fish pose
    Shirshasana – headstand pose
    Sarvangasana – shoulder standing pose
    Marjari Asana – cat-cow stretch
    Surya Namaskara – Sun salute
    Balasana – Child’s pose
    Shavasana – corpse pose
    Pranayama – Nadi shodhana, Bhramari or Shetali Pranayama
    Click to Consult Dr Raghuram Y.S. MD (Ayu) ̵ Skype
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