A RANDOMIZED COMPARATIVE CLINICAL TRIAL TO STUDY THE EFFECT OF SHATPUSHPA CHURNA, DHANYAK SHUNTHI PANIYA AND NIDANA PARIVARJAN IN MANDAGNI WITH SPECIAL REFERENCE TO SUBCLINICAL HYPOTHYROIDISM.

Subclinical hypothyroidism (SCH) is biochemically defined as an elevated level of thyroid stimulating hormone (TSH) with normal level of free thyroxine (FT4) in the blood with minimal or no signs and symptoms of thyroid dysfunction. The most common cause of subclinical hypothyroidism is chronic autoimmune thyroiditis associated with antithyroid peroxidase antibodies (Hashimoto’s thyroiditis) but it can also occur due to other causes. Subclinical hypothyroidism can be classified as Mild Grade 1 SCH (upper limit of TSH 9.9 mIU/L) and severe grade 2 SCH (TSH ≥10mIU/L). Individuals with subclinical hypothyroidism are often asymptomatic, but clinical manifestations similar to overt hypothyroidism are present in milder form. Several meta-analyses of observational studies have revealed an association between SCH and coronary artery diseases.

There is no direct description of hypothyroidism or subclinical hypothyroidism  in Ayurvedic texts. There are many diseases which are not mentioned directly in Ayurveda texts and are called as Anukta vikar. Subclinical hypothyroidism is one of such disease. According to Acharya Charak,  it is not possible to name every disease but it is important to understand the possible pathogenesis of the disease in terms of Dosha, Dhatu, Mala & Agni because the vitiated Doshas due to difference in Nidana give rise to different disease at different places. Therefore, if a physician understands the Prakriti, Adhishthan and Samuthan vishesha of the disease it can be managed successfully.

On reviewing literature on SCH**,** it has been found that Subclinical Hypothyroidism in Ayurveda has been correlated with terms like Agnimandhya, Dhatwaagnimandhya, Raspradoshajvikara and Avranjanya vikara, the root cause of all these disorders being abnormality of Agni. However, there is a lack of scientific studies establishing an association of status of Agni and SCH.  With all these points in mind the current study has been planned with an aim to estimate the prevalence of Agnivaishamya in patients with Subclinical hypothyroidism and to study the effect of Agnideepan chikitsa in patients of Subclinical hypothyroidism with Mandagni.

In this study patients of subclinical hypothyroidism will be interviewed and an assessment of Agni will be done using Agni assessment questionnaire and Patients of subclinical hypothyroidism with Mandagni will be enrolled to study the effect of Shatpushpa Churna, Dhanyak Shunthi Paniya and Nidana Parivarjana on TSH level and symptoms of Mandagani.