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''Vikaranamakusalo na jihriyat kadachana Nahi sarva vikaranam namoto asti dhrivasthitih''.[20] - Cha Chi. 18/44

Ayurveda doesn't emphasize the exact nomenclature of the diseases; rather it insists on diagnosis of the constitutional status of the disease as mentioned in Charaka.[20]
Based on Ayurvedic principles, the following are the main causes for hypothyroidism.
1. Genetical and hereditary defects come under Adibala Pravritta Vyadhis,[21] so no treatment is suggested;
2. Congenital defects come under Janmabala Pravritta Vyadhis [21] (the disease present from birth itself, i.e. congenital defects). Thyroid gland Agenesis, Dysgenesis, Ectopic thyroid gland come under this category;
3. Iodine deficiency is the main common cause for hypothyroidism. So 'Sarvadha sarva bhavanam samanyam vriddhikaranam'[22] applies here;
4. Auto immunity is another common cause, so immuno modulatory drugs are recommended here;
5. Side-effects of surgery and radiation: Kasta Sadhya [23] (difficult to treat);
6. For transient hypothyroidism no specific treatment is required;
7. If there is functional loss of thyroid tissue, or functional defects, thyroid stimulatory drugs are beneficial;
8. Selection of drugs acting at various levels:[24]

- At Hypo-thalamo pituitary level: anti-stress drugs, Medhya Rasayana [25] drugs, Nasyakarma [25] may be beneficial;
- At thyroid gland level: thyroid stimulatory drugs are recommended here;
- At metabolism level: Deepana, Pacahana, Lekhana [25] drugs which pep-up body metabolism is recommended;
- Immuno modulatory drugs for autoimmune related hypothyroidism.

'Samprapti vighatana' [6] is one of the main principles of treatment. Whatever may be the aetiology of the disease, it results in under-active condition of the thyroid gland and, ultimately, the slowing down of the body's metabolism. So the treatment should aim to stimulate the thyroid gland. Thyroid stimulatory drugs like Guggul should be selected to treat the disease.

As symptoms of hypothyroidism are notorious, symptomatic treatment is based to suit individual cases, i.e. sthoulya (obesity), menstrual irregularities, etc.

Pathyapathya {Regimes to be followed during Treatments} Eating goitrogenic foods such as rapeseed, cabbage, Brussels sprouts, broccoli, cauliflower, sweet potatoes, maize, lima beans, soya and pearl millet should be limited. These foods contain natural goitrogens, which are chemicals that cause the enlargement of the thyroid gland by interfering with thyroid hormone synthesis. Cooking is known to make the goitrogens elements less effective, but it would be wise not eat these foods raw.[27]

Smoking depresses TH levels and produces chronic underlying hypothyroidism. Research shows that nicotine increases the synthesis of T3 from T4 in the brain, while alcohol and opiates block the breakdown of T3 in the brain.

Foods that contain iodine, such as kelp, beetroot, radish, parsley, potatoes, fish, oatmeal and bananas, should be kept in the diet.

Vihara Another important factor in the treatment of hypothyroidism is exercise. Exercise increases tissue sensitivity to the thyroid hormone, and stimulates thyroid gland secretion. An exercise regime of between 15-20 minutes per day benefits hypothyroidism. This exercise needs to be strenuous enough to raise the heartbeat, such as walking, swimming, running and cycling, except in the case of who also have generalized hypotonia, as they may be at risk of ligamental injury, particularly from excessive force across joints. Physical and emotional stress inhibits thyroid gland secretion due to reduction of thyrotrophin output. So reduction of stress is essential for proper functioning of the gland.

Yoga Sarvangasana {shoulder stand}is the most suitable and effective asana for the thyroid gland. Enormous pressure is placed on the gland by this powerful posture. As the thyroid gland has a large blood supply, pressure has a dramatic effect on its function, improving circulation and squeezing out stagnant secretions. Also beneficial afterSarvangasana is the practice of Matsyasana (fish pose) and Halasna (plough pose). Other effective asanas includeSurya Namaskara (Sun salutation), Pavanamuktasana (wind relieving pose) with emphasis on head and neck exercises, Supta Vajrasana (sleeping thunderbolt pose) and all backward bending asanas.

Pranayam The most effective pranayama is ujjayi. It acts on the throat, and its relaxing and stimulating effects are most probably due to stimulation of ancient reflex pathways within the throat area, which are controlled by the brain stem and hypothalamus. Surya, Chandra, Nadi Sodhana pranayama (right, left and alternate nostril breathing) is useful in re-balancing metabolism. Thyroid is now a days a common ailment in most of the indian ladies. Thyroid is due to impurity in blood which causes hormonal imbalance and hence causing a no. of symptoms like weight gain ,anorexia,weakness, reduced in activity,loss of cheerfullness ect. In hyperthyroidism, there is increased metabolic activity, high pulse rate and weight loss, palpitation, in the patient.

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