Abstract

A SYSTEMATIC REVIEW OF HYPOTHYROIDISM AND ITS CORRELATION WITH THE AYURVEDIC PARADIGM: PATHOPHYSIOLOGY, DIAGNOSTIC CONCORDANCE, AND INTEGRATIVE MANAGEMENT STRATEGIES

Dr. Indumati Sharma*, Dr. Bhanu Priya Choudhary

Abstract

Background: Hypothyroidism, the most common endocrine disease in medical practice, which is caused by inadequate production of thyroid hormones, is an emerging global public health issue with diverse clinical presentations that have been reported.[1,2,45] However, the traditional Indian system of medicine, Ayurveda a unique ontological and physiological model for this relating to metabolic disorders, categorized under Mandagni (reduced digestive fire) and Jatharagni defect resulting in Dhatvagni Vishama (inadequate digestive fire that is imbalanced).[8,9,57] An organized investigation of the relationship between biomedical hypothyroidism and Ayurvedic concepts is necessary for furthering integrative prospects.[64,78] Objective: To systematically review the existing studies available on pathophysiological, diagnostic, and therapeutic correlations between hypothyroidism and Ayurvedic principles with emphasis on Agnimandya and Kapha-Siddhanta. Methods: We performed a comprehensive literature search according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta- Analyses) 2020 guideline.[11,53] An electronic search of databases (PubMed, Scopus, Web of Science, AYUSH Research Portal, DHARA, and IndMED) was carried out from inception until October 2023. The authors used search terms such as "hypothyroidism," "thyroid vitamins," "Ayurveda," and also Indian names for the conditions, namely "Agnimandya, Kapha vitiation", Bhasmaka, Sthaulay (Obesity), Galaganda. Theoretical correlations, including clinical and Ayurvedic interventions, along with biomarker studies were considered in the systematic review. Data were reviewed and synthesized thematically. Risk of bias in clinical trials was evaluated with Cochrane RoB 2 and NIH tools.[54,55] Results: From the 2,587 records identified, 187 studies were included. The synthesis there was a good second degree of concordance in terms of conceptuality between hypothyroidism and the Ayurvedic state Agnimandya (especially with respect to the impairment of Jatharagni and Dhatvagni as a result, Ama formation and Srotodusti).[12-15,56] Kapha and Vata dosha imbalance, in particular Avalambaka Kapha and Prana Vata disturbance, have been frequently highlighted.[18-21,51] Clinical manifestations of hypothyroidism resemble very much with those of Kapha Vata Pitta symptoms, fatigue (Daurbalya, Alasya), weight gain (Sthaulya) cold intolerance (Sheetaasahatva), dry skin (Rookshata), and depression (Avasad).[4,26-28,49] Analysis and Diagnosis Both of them have the same parallels in analysis and diagnosis, with Nadi Pariksha (pulse reading) indicating a Kapha-Vata dominant pulse.[29,30,70] Treatment modalities of Ayurveda are based on Dipana (boosting digestive fire), Pachana (digestion of Ama), Kapha-Vata balancing, and Rasayana (rejuvenation) utilizing herbs like Kanchanara (Bauhinia variegata), Guggulu (Commiphora wightii), Ashwagandha (Withania somnifera), and Shilajit.[32,33,34,35,36,37,62,66,67,76] Conclusion: The current review provides strong theoretical as well as clinical correlation of aetiopathogenesis between hypothyroidism and Ayurvedic syndromes, Agnimandya and Kapha-Vata Imbalance. Although biomedicine is accepted as the gold standard of diagnosis[5,46], Ayurved may be used for a holistic functional appraisal.[69,85] The most effective bridging therapies Integrated approaches are considered monotherapies in disguise[40,65], but prospective RCTs Integrative approaches look promising with regard to validation of its efficacy, optimization of the protocols and determination of the safety profile of the combined treatment regimens.[44,87,90] Work is needed (translational research) on determining the effects of Ayurvedic interventions on single molecular therapeutic biomarkers and QoL indices.[42,82-84,96]

Keywords: Hypothyroidism; Ayurveda; Agnimandya; Kapha Dosha; Ama; Integrative Medicine; Thyroid Hormones; Systematic Review.