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A Comparative study on Pathya Aahara and Yoga in autoimmune hypothyroidismA Comparative Study on Pathya Aahara and Yoga in Autoimmune Hypothyroidism

Phase 2
Not yet recruiting
Conditions
Autoimmune thyroiditis. Ayurveda Condition: GALAGANDAH,
Registration Number
CTRI/2022/04/041758
Lead Sponsor
Shri Narayan Prasad Awasthi Govt Ayurveda College Raipur Chattisgarh
Brief Summary

**INTRODUCTION:**

Inthe ancient science of *Ayurveda*, *Agni* is the one of the most importantconcept. *Acharyas* explained *Mandagani* as the cause of all disease conditions[1]. Balanced *Agni* in bodyleads to long and healthy life and imbalanced *Agni* results to *(Rogavastha)*state of disease in human.[2].There are various causes at variouslevel of *Agni (Jatharagni, Bhutagni andDhtvagni*) leading to *Mandagani*.This reduced digestive fire *(Mandagani)*leads to *Ama* formation i.e.incompletely digested food, *Ama* leadsto state of *Sthrotodusthi* andultimately formation of disease in body [3].

Amais a pathological qualitative change in a substance during the process of *paka* may be at *Jatharagni, Bhutagni or Dhtvagni* level. So during the digestionprocess if a food substance attain certain pathological qualities withoutattaining finality, such substance is called as Ama [4].*Pratyatmakaguna* of *Ama* are – *Drava, Guru,Snigdha, Piscilata, Tantum, Avipakam, Asamyuktam, Durgandhyam Abhisyandi,Srotoavarodha, Katu – Amala rasa, Sukatata[5]*

Thefactors causing *Mandagni*i.e.Disturbanceof *Agni* can be classified into two types:

1.     **Direct Factors: causing**direct influence on *Agni*. E.g.*Ansana, Adhyasana, Ajirna ahara,Virudhahara, Apkwa, Vidgdha Ahara* etc.

2.     **Indirect factors:**Have no direct influence on *Agni*e.g. anydisorder leading to *Agni Mandya* atvarious stages, Stress, All causes which firstly triggers the *Dosha* and than *Agni*.

**Hashimoto’s Thyroid disease** isan autoimmune condition in which body’s immune cells mistakenly attacks thehealthy cells of thyroid gland and gradually failure of thyroid gland. At earlystages anti thyroid antibodies are present in body but symptoms may not appear,over the time patient starts experiencing symptoms such as fatigue, weightgain, constipation, hair loss etc along with increased level of ThyroidStimulating Hormone (TSH). If the level of TSH are 10uIU/ml or less than10uIU/ml(but above normal range i.e. 5uIU/ml) and peripheral T3 andT4 level within normal range, it is called subclinical hypothyroidmean patients thyroid gland is underperforming and producing less hormone, butbody is managing to keep T3 and T4 levels normal byincreasing TSH by pituitary gland.

Ifpatient remain untreated and undiagnosed at this stage, the condition resultsin **overt hypothyroidism** i.e.clinical hypothyroidism with elevated TSH levels and low T4. At thisstage thyroid gland is unable to secret enough T3 and T4even by increasing TSH levels by pituitary gland, ultimately leads to very highTSH levels and decreased T3 and T4 levels in body. In *Ayurveda* there is no direct descriptionof hypothyroid or autoimmune disease (Hashimoto’s Thyroiditis). But itssymptoms have very close resemblance with symptoms of *Ama*and *Strotodusti* suchas *Gaurav, Shathilya, Avipaka, Avasada,Tandrai.Rasavaha Stroto Dusti Lakshana* – loss of appetite, sluggishness,dry hair and skin, anemia and constipation. *MedovahaStrotoDusti Lakshana* – Abnormal weight gain, tiredness etc. *Acharya Charka* explained that one should notashamed if name can’t be given to a pathological condition; instead he shouldfocus on *Dosha* and *Lakshana* and treat accordingly.[6][7]

On the basis of*Dosha, Samuthan, Sansthana* etc disease can be countless.

In*Charak Samhita*[8]*Virudha dusta asuchi bhojana* is told tobe one of the cause of *Manovahastrotodusti*and *Unmda* indicating relation of foodand mental issue. Also in *Charaka VimanaSthana* ch.5/13 explains *‘ChintyanamAtichintanaat’*[9] as cause of *Rasavaha Strotodusti.*The one who follow the *Pathya Aahar Vihar* remains disease free so there is no need oftaking medicine and diseased one who doesn’t follow *Pathya* also does not need medicine as it will not be fruitful.

*Nadishodhana Pranayama*causes *Agnideepana* and *Krishta karaka* effect on body, it calmsthe mind and improve gut functioning.[10]*Markatasana and Bhujangasana* also elevate the *Agni* and improve digestion system thus all these *Asana* could improve outcome of thyroidmanagement. [11]

Some studiesin modern science also emphasis upon role of gut in autoimmunity, gut –immunity – brain axis.

Modified food patternsand compositions (e.g. sugary, fried fatty foods) results in

Inflammation of gutlining

+

Change in gut microbiome

Causes

 

| | | |

| --- | --- | --- |

|Cause malabsorption of nutrients which are essential for thyroid regulation.

e.g. **vitamin D** – Regulates immune system

**Zinc & Selenium** – Necessary for T4 to T3 conversion.

**Iodine**– For Thyroid Hormone synthesis

Increased permeability of gut lining

  Easily allows the antigen to enter circulation

  Trigger immunity

Modulate the activation of different sensory receptor in the gut and consequently stimulate and regulate process of hormone release.

[12]

 Bothluminal nutrients and micro biome metabolite stimulate enteroendocrine cellslocated throughout GI tract, which represent large endocrine organ in body.[13]

Gutmicro biota determine what the host is capable of extracting from diet andnutrients to bioactive signaling molecule that influence brain function andhost behavior. [14]

**NEED OF STUDY:**

Autoimmunityis the case of hypothyroidism in 90% adult hypothyroidism. [15] 3-8%percent population has subclinical hypothyroidism out of which 80% areautoimmune positive [16].

Presentlythere is no cure for autoimmune thyroid disease. In Ayurveda various researcheshas done on role of Yoga in stress management, hormonal balance and digestionimprovement .As stress and *Agnimandya*has a huge role in onset of Autoimmune thyroid condition, early Ayurvedicintervention by *Yoga* and *Pathya Aahara* could be helpful in Hashimoto’sthyroiditis patients.

1.     Progressionof disease can be stopped at early stage.

2.     Complicationssuch as complete thyroid failure, CA thyroid etc can be prevented.

3.     Futuredevelopment of another autoimmune disease can be prevented such as celiacdisease, vitiligo, multiple sclerosis and SLE etc.

Keeping all aboveaspects in mind I have selected the topic.

Detailed Description

Not available

Recruitment & Eligibility

Status
Not Yet Recruiting
Sex
All
Target Recruitment
40
Inclusion Criteria
  • Patient age between 18 to 60 years.
  • Selection of patients irrespective of race, religion, sex socio economic, statuary marital status etc.
  • Patient not taking levothyroxin or any other medication for thyroid.
  • TSH from 5 uIU/ml to 10 uIU/ml.
  • T3 and T4 should be within normal range.
  • Either of the two Antibody test should be Positive Anti TPO antibody (Thyroid peroxidase) Anti TG antibody ( Thyroglobulin) 7.
  • Patient who have given written consent.
Exclusion Criteria
  • TSH level > 10uIU/ml.
  • T3 and T4 level is lower than normal range.
  • If both antigen test are negative (Anti TPO & Anti TG antibody) 4.
  • Patient suffering from another chronic systemic disease or autoimmune disease.
  • Patient underwent any thyroid surgery or already diagnosed case of carcinoma.
  • Patient with long term steroid treatment.
  • Patient who has not given written consent.

Study & Design

Study Type
Interventional
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
symptoms such as Fatigue, Loss of appetite, weight gain, Constipation, Menstrual irregulerities, Brain fog etc will be reduced in Subclinical Hashimoto Thyroiditis.4 week
Secondary Outcome Measures
NameTimeMethod
TSH ,t3 ,t4 will be assessed and symptoms such as Fatigue ,Loss of appetite, Weight gain, Constipation, Menstrual irregularity, Sleep, Brain fog will also be assessed90 days

Trial Locations

Locations (1)

Shri Khudadad Dungaji Government Ayurved Hospital

🇮🇳

Raipur, CHHATTISGARH, India

Shri Khudadad Dungaji Government Ayurved Hospital
🇮🇳Raipur, CHHATTISGARH, India
Shweta Rai
Principal investigator
9530605602
shwetamalethia5@gmail.com

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