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Review Article International Ayurvedic Medical Journal ISSN:2320 5091

REVIEW OF AYURVEDIC DRUGS ACTING ON HYPOTHYROIDISM


Tarun Sharma1, Malvika2, Monu Gupta3, Sumit Nathani4
1,2
P.G. Scholar, Dept. of P.G. Studies in Dravya Guna, 3P.G. Scholar, Dept. of P.G. Studies in
Kaya Chikitsa, 4Lect. Dept. of P.G. Studies in Dravya Guna,
N.I.A., Jaipur, Rajasthan, India

ABSTRACT
Thyroid problems are among the most common endocrine disorders presently seen
worldwide. Hypothyroidism results when the thyroid gland fails to produce enough of the
thyroid hormone, due to structural or functional impairment that significantly impairs its out-
put of hormones, this leads to the hypo metabolic state of hypothyroidism. It is estimated to
affect between 3.8-4.6% of the general population. The prevalence of primary hypothyroid-
ism is 1:100, but increases to 5:100. The female-male ratio is approximately 6:1. There is no
direct reference of thyroid in Ayurvedic classics, but Galganda and Gandmala have been fre-
quently used in these classics. According to Charaka presentation of multiple Granthi around
the neck is called Gandmala and single swelling on the Parshava of the neck is Galganda. So
Galganda and Gandmala can be co-related with hypothyroidism. The incidence of hypothy-
roidism is increasing day by day, and there is increasing demand to treat the disease through
the Ayurvedic system of medicine, as it is completely natural and safe. The root cause of hy-
pothyroidism is disequilibrium of tridosha. In this article effort is made to review some Ayur-
vedic herbs for correction of imbalance in tridosha and flawed function of the thyroid gland.
Keywords: Hypothyroidism, Galganda, Gandamala, Ayurvedic herbs.

INTRODUCTION
Thyroid problems are among the dine-containing chemicals. Because they
most common endocrine disorders present- are the only iodine containing hormones in
ly seen worldwide. About 1 to 2% of the the body, an adequate iodine intake is nec-
adult population is known to suffer from essary for the optimum functioning of the
thyroid disorders.1 According to the World thyroid gland. Doctors recommend about
Health Assembly report, about 1.5 billion 150 mg/day of iodine for normal thyroid
persons in more than 110 countries are function; less than 50 mg/day for a long
threatened with thyroid disorders. World period may cause goiter.3
Health Organization (WHO) estimation Hypothyroidism generally de-
also indicates that about 200 million peo- scribes an under-active thyroid that does
ple have goiter, although most of the goi- not produce enough thyroid hormones
ters are small and subclinical. causing an overall decrease in physical and
Thyroid is one of the earliest endo- mental activity. The disease is more preva-
crine glands to build up2.It is an endocrine lent in females around 6-8 times, between
gland located in the neck below the thyroid 40-50 years.4 Hypothyroidism can result
cartilage (which forms the laryngeal prom- from a defect anywhere in the hypothalam-
inence, or "Adam's apple"). It acts by pro- ic-pituitary-thyroid axis, either insufficient
ducing thyroid hormones, the principal TSH from the pituitary or insufficient
ones being triiodothyronine (T3) TRH from the hypothalamus. In the vast
and thyroxine (T4). Both T4 and T3 are io- majority of cases, it is primary hypothy-
Tarun Sharma et al: Review Of Ayurvedic Drugs Acting On Hypothyroidism

roidism, which is decreased secretion of constitutional make-up. Weakness, ma-


thyroxine (T4) and triiodothyronine (T3) by laise, lethargy, and weight gain, peri-
the gland itself, which results in a compen- orbital puffiness are the early symptoms. It
satory increase in TSH secretion. Thus, the is followed by cold intolerance, loss of
combination of a low serum T4 and a high hair, skin changes consist of dry and scaly
serum TSH concentration both confirm the skin, nails become brittle, and hoarseness
diagnosis of hypothyroidism. of voice and slowness of speech, constipa-
Main causes of hypothyroidism: tion, irregular cycle, PCOD and infertility.7
The main causes of hypothyroid- Ayurvedic perspective on hypothyroid-
ism can be classified5 into: ism:
1. Primary hypothyroidism- The most There is no direct mention of the
common cause of primary hypothyroidism thyroid gland in Ayurveda, but a disease by
is Iodine deficiency, AITDs (Autoimmune the name Galaganda, characterized by
thyroid diseases), Iatrogenic causes, neck swelling, is well known. The first de-
Drugs, Congenital etc. scription of neck swelling was mentioned
2. Secondary hypothyroidism (due to pitui- in Atharva Veda by the name Apachi.
tary TSH deficit). Charaka mentioned the disease under 20
3. Tertiary hypothyroidism (due to hypo- sleshma vikaras8. Sushruta {renowned an-
thalamic deficiency of TRH). cient Indian surgeon} in Shareera
Pathogenesis: Sthana has mentioned that of the seven
Thyroid hormone is required for layers of the skin, the sixth layer Rohini is
the normal functioning of each and every the seat of Galaganda9 In Nidana
tissue of the body, hence deficiency mani- Sthana he described Galaganda as two
fest as multi system involvement. The dai- encapsulated small or big swellings in the
ly requirement of iodine recommended is anterior angle of the neck, which hang like
150ug/day, when there is iodine deficien- scrotum10, whereas Charaka mentioned
cy. The thyroid compensates by increasing Galaganda as a solitary swelling.11
the iodine trapping mechanism and synthe- The climatic conditions, water sup-
sis of hormone under the influence of ply, dietary conditions, etc., are mentioned
TSH. This results in diffuse enlargement as the main aetiological factors.
of the gland, which later on becomes mul- Sushruta stated that Himvatprabhava riv-
tinodular.6 The onset and progression of ers might give rise to the occurrence of
disease is very gradual, the basal metabolic Galaganda12. Bhela described that Sleepda
rate (B.M.R.) is decreased, deposition of and Galaganda are more common
haluronidase in dermis and all tissues and in prachya desa (eastern part) of the coun-
hence leading to non-pitting oedema i.e., try, and that persons consuming predomi-
myxoedema, which is the result of long nantly fish are liable to develop Galga-
lasting hypothyroidism. ganda. Harita Samhitakara described the
Symptoms: role of dushtambu (contaminated water)
Hypothyroidism is one of the most and krimi dosha (infection) in the precipi-
undiagnosed and misdiagnosed diseases, tation of Galaganda.13Kashyapa Samhita-
as its clinical features are notorious. The kara added that any part of the country that
symptoms of hypothyroidism are quite is cold, damp, with densely grown long
variable, depending on the severity of the trees, water stagnation and heavy rains
hormone deficiency and of course one’s

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Tarun Sharma et al: Review Of Ayurvedic Drugs Acting On Hypothyroidism

may be prone for the development of Here brief description is given of some
Galaganda.14 important plants which are frequently used
From the above descriptions it is in management of hypothyroidism in pre-
tempting to associate Galaganda with goi- sent era:-
ter (abnormal swelling of the thyroid (1) KANCHANARA:
gland) where thyroid functions may or Latin Name - Bauhinia variegata Linn
may not be compromised. But hypothy- Family- Caesalpiniaceae
roidism is not just a localized disease. It Rasa- Kashaya Guna- Ruksha, Laghu
has many symptoms related to many sys- Virya- Sheeta Vipaka- Katu Kar-
tems of the body. Thus it is probably inac- ma- kapha-Pittahara Useful part-
curate to draw a parallel between hypothy- Bark
roidism and Galaganda. Kanchnara is considered as a drug
Planning of treatment: of choice for Granthi vikara and
'Vikaranamakusalo na jihriyat Galaganda.18External application of kan-
kadachana Nahi sarva vikaranam namo- chanara bark is done in Gandmala. Fresh
toasti dhrivasthitih'15 - bark of kanchanara is grinded with tandu-
Ayurveda doesn't emphasize the exact lodaka and mix with shunthi and used in-
nomenclature of the diseases; rather it in- ternally.19It has a balancing activity on the
sists on diagnosis of the constitutional sta- thyroxin production, increasing any defi-
tus of the disease as mentioned in Chara- cient production and decreasing any ex-
ka. cess. It also clears swellings in the neck
Based on Ayurvedic principles, the follow- and goitre. It is a specific herb for swollen
ing are the main treatments for hypothy- lymph nodes, cervical adenitis, scrophular-
roidism. ia or swollen glands in general.
1. Genetical and hereditary defects come Water-soluble fraction of total alcoholic
under Adibala Pravritta Vyadhis16, so no extract of Bauhinia variegata Linn at a
treatment is suggested. dose of 2 g/kg was fed to Neomercazole
2. Iodine deficiency is the main common (150 mg/kg)-induced hypothyroidic rats (n
cause for hypothyroidism. So 'Sarvadha = 12 in each group) for 20 days. The ex-
sarva bhavanam samanyam vriddhikara- periment resulted in enhanced thyroid
nam'17 applies here. function as evidenced by increased thy-
3. Auto immunity is another common roidal weight (p < 0.001), I131 uptake and
cause, so immuno modulatory drugs are decreased serum cholesterol (p < 0.05 for
recommended here. both), and active thyroidal histology20
4. If there is functional loss of thyroid Bark extract of Bauhinia purpurea
tissue, or functional defects, thyroid stimu- Linn. at 2.5 mg/kg orally administered to
latory drugs are beneficial. female mice (n = 7 in each group) signifi-
'Samprapti vighatana' is one of the cantly increased serum T3 and T4 concen-
main principles of treatment. Whatever trations (p < 0.001 for both) after 20 days
may be the aetiology of the disease, it re- of treatment21
sults in under-active condition of the thy- (2) ASHWAGANDHA:
roid gland and ultimately the slowing Latin Name- Withania somnifera Linn
down of the body's metabolism. So the Dunal Family- Solonaceae
treatment should aim to stimulate the thy-
roid gland.

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Tarun Sharma et al: Review Of Ayurvedic Drugs Acting On Hypothyroidism

Rasa- Katu,Tikta, Madhura Guna- The aqueous leaf extract of


Snigdha, Laghu Virya- Usna Vipaka- Moringa oleifera Lam. was evaluated for
Madhura its ameliorative effect in the regulation of
Karma- Kapha-Vatahara Useful thyroidism in rat model. Male albino rats
part- Root of 120-150 g were treated orally with dos-
Ashwagandha is an adaptogenic es of 500mg/kg body weight (b.w.) and
popular herb that has shown incredible re- 250 mg/ kg b.w. of aqueous extract of
sults for lowering cortisol and balancing Moringa oleifera Lam. leaf. The group
thyroid hormones. It has adaptogens which which received maximum test dose
works well with the hormones of the endo- (500mg/kg bw, 14days) showed maximum
crine system which brings balance to the percentage increase in hormone concentra-
thyroid hormonal level. It increases the tion of T3 and T4 whereas a maximum
hormones which are secreted by thyroid percentage decrease in TSH levels was ob-
gland. Ashwagandha is a immunomodula- served when compared to the other dose
tor herb so it is useful in autoimmune thy- levels, which clearly proves that the re-
roid conditions. sponse was dose effective and the M. oleif-
Animal studies reveal Ashwagan- era leaf extracts can be used in hypothy-
dha has a thyroid hormone balancing ef- roidism condition to normalize hormone
fect. In a 20 day study mice were given levels25
Ashwagandha and their T3 and T4 levels (4)VARUNA:
were analyzed, along with lipid peroxida- Latin name- Crataeva nurvula Buch-Ham.
tion (anti-oxidant protection). Significant Family- Capparidaceae
increases in serum T4 were found, which Rasa- Tikta, Kashaya Guna-
indicates this herb has a stimulatory effect Ruksha, Laghu Virya- Usna
on a sluggish thyroid.22 Vipaka- Katu
In another study, all three extracts (B. pur- Karma- kapha-Vatahara Useful
purea, C. mukul, and W. somnifera) were part- Bark, Root
administered simultaneously to mice (n = Decoction of Varuna root is given with
8) for 30 days at the doses mentioned honey in treatment of Gandamala26. Varu-
above. The results showed an increase in na also possesses anti tumor property
both T3 and T4 levels (p < 0.01 and p < which makes it beneficial in extra growths
0.001, respectively), suggesting that a of thyroid as well as in hyper trophy of
combination of the three plant extracts prostate.
may prove to be an effective treatment for (5)GUGGULU:
hypothyroidism.23 Latin name- Commiphora mukul (Hook ex
(3)SHIGRU: Stocks) Engl. Family- Burseraceae
Latin name- Moringa oleifera Lam. Rasa- Tikta, Katu Guna- Ruksha,
Family- Moringaceae Laghu, Tikshna Virya- Usna
Rasa- Katu,Tikta Guna- Ruksha, Vipaka- Katu
Laghu, Tikshna Virya- Usna Karma- Vata-Kaphahara Useful
Vipaka- Katu part- Oleo resin/gum
Karma- kapha-Vatahara Useful Guggulu (the gum resin of Commiphora
part- Root bark, seeds mukul) is reported to raise the triiodothy-
Shigru seeds paste with nichula is applied ronine (T3)/thyroxine (T4) ratio in female
locally in treatment of Galaganda.24 mice27 and reverse the effects of propylthi-

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Tarun Sharma et al: Review Of Ayurvedic Drugs Acting On Hypothyroidism

ouracil in hypothyroid mice by stimulating Root bark of Aaragvadha is grinded with


thyroid function.28 rice water and used for Nasya and Lepa in
Triphladya Guggulu gutika is used in treatment of Gandamala.34
Gandamala which main content is Guggu- Aqueous and ethanolic extract of
lu29 Cassia fistula Linn leaves were investi-
(6)JALAKUMBHI: gated for its potential to protect hypo-
Latin name- Pistia startiotes Linn thyroidism against hypothyroidism in-
Family- Araceae duced by propylthiouracil (PTU) in
Rasa- Tikta, Madhura Guna- Ruksha, rats. Serum T 3 , serum T 4 , TSH, choles-
Laghu Virya- Sheeta Vipaka- terol level and changes in body weight
Madhura were used for evaluation of antihypo-
Karma- kapha-Vatahara Useful thyroidism activity. Treatment with
part- whole plant both extracts of Cassia fistula in dose
Jalakumbhi bhasma is given with gomutra of 300 mg/kg significantly increased
in Galaganda.30 serum T 3 , serum T 4 and decreased TSH
Jalakumbhi is a widespread weed in rivers and cholesterol level compared with
and lakes which is applied in paste form control group 35
topically to reduce the swelling of Thy- (9)APAMARGA:
roid.31 Latin name- Achyranthes aspera Linn
(7)BRAHMI: Family- Amaranthaceae
Latin name- Bacopa monnieri Linn. Rasa- Tikta, Katu Guna-Laghu,
Family- scrophulariaceae Ruksha, Tikshna Virya- Ushna Vipa-
Rasa- Tikta, Kashaya Guna- Laghu ka- Katu
Virya-Sheeta Vipaka-Madhura Karma- Kapha-Vatahara Useful
Karma- kapha-Pittahara Useful part- Whole plant
part- Whole plant Achyranthes aspera Linn. leaf extract ad-
Brahmi is very well known Medhya drug ministered in rats (n = 7) at a dose of 200
in Ayurveda classics. Brahmi Stimulates mg/kg for 7 days caused an increase of T3
thyroid activity by increasing the amount and T4 (p < 0.001 for both). An increase in
of T4, useful in treating hypothyroidism. It blood glucose in this group (p < 0.05) fur-
is one of the most important nervine herbs ther supported the extract’s thyroid-
used in Ayurvedic medicine and helps to stimulating nature.36
improve memory, concentration and de- (10)NIRGUNDI:
toxify the nervous system.32 Lati name- Vitex nigundo Linn
Bacopa monnieri Linn (Indian pennywort) Family- Verbenaceae
extract has been observed to increase both Rasa- Katu, Tikta Guna- Laghu,
T4 and T3 levels in male mice.33 Ruksha Virya- Ushna Vipaka-
(8)AARAGVADHA: Katu
Latin name- Cassia fistula Linn. Karma- Kapha-pittahara Useful
Family- Caesalpiniaceae part- Root, leaves, seeds
Rasa- Madhura Guna- Mridu, Guru, Root of Nirgundi is grinded with water and
Snigdha Virya- Sheeta Vipaka- used for Nasya in treatment of Ganda-
Madhura mala.37
Karma- Vata-pittahara Useful
part- Root bark, leaves, flowers, fruit pulp

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Tarun Sharma et al: Review Of Ayurvedic Drugs Acting On Hypothyroidism

Taila, which is prepared by Nirgundi sva- 1. Pocock, G. and Richards, C.D., The
rasa and paste of Langali root, is used for thyroid gland, in Human Physiology:
Nasya in treatment of Gandamala.38 The Basis of Medicine, Oxford Univer-
DISCUSSION sity Press, New York, 1999, p. 212.
Hypothyroidism is common disor- 2. Yash pal manjul, Surendra k. Sharma
der now a days. Many modern medicinal editors, API Text book of medicine,
therapies and medicines are available for published by the association of physi-
the treatment of this disease but these are cians of India, 7th edition, 2003,
not devoid of side effects and the re- pg.1051.
occurrence rate is also high. It is very im- 3. Ganong, W.F., The thyroid gland, in
portant to show an interest in indigenous Review of Medical physiology, 7th ed.,
system of medicine and traditional herbal Appleton and Lange, Norwalk, CT,
remedies which are regarded as quite safe 1995, p. 295.
with no side effects and are cost effective. 4. Yash pal manjul, Surendra k. Sharma
Hypothyroidism is often correlated editors, published by the association of
with galganda mentioned in Ayurvedic physicians of India, 7th edition, 2003,
literature. Treatment often includes herbs pg.1057.
like Kanchnara, Shigru, Varuna, Apa- 5. Davidson's principles and practice of
marga, Brahmi, Jalakumbhi, Ashwagan- medicine, Churchill Livingston, 17th
dha. These herbs have also been tested in edition, London. 1995.
various experimental models and proved 6. Yash pal manjul, Surendra k. Sharma
efficacious. But still the mainstay for the editors, published by the association of
Ayurvedic treatment of Hypothyroidism is physicians of India, 7th edition, 2003,
samprapti vighatan (breaking of patho- pg.1052-1053.
genesis) of the disease and Lakshana 7. Yash pal manjul, Surendra k. Sharma
pratyanik (symptomatic treatment). These editors, published by the association of
Ayurvedic herbs not only provide relief in physicians of India, 7th edition, 2003,
various symptoms but also directly alter pg.1058 –1059.
the secretions of the different hormones 8. Agnivesha, Charaka, Dridhabala,
involved in pathogenesis of the disease and Charaka Samhita, Sutra-sthana, Maha-
stimulate the normal functioning of thyroid roga Adhyaya, 20/17, edited by Dr.
gland. Brahmanand tripathi, Chaukhamba
CONCLUSION surbharati prakashana Varanasi, reprint
From this review we conclude that 2008, pg. 395.
hypothyroidism can be very well managed 9. Sushruta, Sushruta Samhita, Shareera-
with Ayurvedic medicines, depending upon sthana, Garbhavyakarana sharira
the symptoms, and careful selection of Adhyaya, 4/4, edited by kaviraaj Am-
drugs to be made. Herbal extracts possess bikadutta shastri, Chaukhamba San-
natural antioxidants, which not only help skrit sansthan Varanasi, reprint 2010,
in curing the diseases, but also improve the pg. 37.
body’s defense system. So Ayurveda based 10. Sushruta, Sushruta Samhita, Nidana-
herbal remedies should be preferred for the sthana, Granthi-apachi-arbuda-
management of Hypothyroidism. galaganda Adhyaya, 11/31, edited by
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khamba Sanskrit sansthan Varanasi, 21. Panda S. and Kar A., Withania somnif-
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CORRESPONDING AUTHOR
Dr. Tarun Sharma
Email: tarunsharma1286@gmail.com

Source of support: Nil


Conflict of interest: None Declared

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