Scientific Basis for
Ayurvedic Therapies
edited by
Brahmasree Lakshmi Chandra Mishra
Ayurvedic Therapies for Thyroid Dysfunction
Anand Kar and Sunanda Panda
8.1 Introduction
Thyroid problems are among the most common
endocrine disorders presently seen worldwide.
Patients with thyroid disorders suffer either
from hypofunctioning or from hyperfunctioning
of the gland. Whereas the former leads to a
decrease in the concentrations of
circulating thyroid hormones, the latter
increases the same. These two dysfunctions are
commonly referred as hypothyroidism and
hyperthyroidism, respectively.
About 1 to 2% of the adult population is
known to suffer from thyroid disorders.
1
According to the 1999 World Health Assembly
report, about 1.5 billion persons in more
than 110 countries are threatened with
thyroid disorders. A World Health Organization
(WHO) estimation also indicates that about
200 million people have goiter, although most
of the goiters are small and subclinical.
Although small in size, the thyroid is
considered to be one of the most important organs
of the endocrine system, as it regulates
nearly all body functions, including metabolic,
respiratory, cardiovascular, digestive,
nervous, and reproductive systems either directly
or indirectly. Many abnormalities in a
person’s body can be the result of thyroid dysfunction.
In fact, some typical problems directly
related to thyroid abnormalities were known
since the existence of Ayurveda, the ancient
system of medicine in India.
In Ayurveda, the common thyroid-related
problem that has been described from time
to time is enlarged thyroid gland (
galaganda
),
2
which is now known as the simple goiter,
a state of hypothyroidism. Some other
diseases that are commonly mentioned in endocrine
text,
3,4
such as myxedema, cretinism, Graves’ disease,
and nodular goiter, have not been
well described in Ayurveda symptom-based
herbal treatments.
Despite several investigations on the herbal
therapies, the use of Ayurvedic medicines in
the regulation of thyroid problems continues
to require more investigation. The primary
aim of this chapter is to review the
available literature including the experimental studies
conducted to date and then to highlight the
scientific basis of Ayurvedic therapies for thyroid
dysfunctions. However, before we deal with
the treatment of thyroid problems, it is necessary
to have a basic understanding of the thyroid
gland, its hormone, and functions.
8.2 Basic Understanding of Thyroid Gland: Its
Hormones and Functions
The thyroid is a two-lobed gland that lies
over the trachea (windpipe) just below the
larynx. It synthesizes and secrets two major
hormones, thyroxine (T
4
) and triiodothyronine
(T
3
). Both T
4
and T
3
are iodine-containing chemicals. Because they
are the only iodinecontaining
hormones in the body, an adequate iodine
intake is necessary for the optimum
functioning of the thyroid gland. Although
the entire amount of circulating T
4
is produced
in the gland itself, T
3
is mostly generated in liver and kidney by
peripheral monodeiodination
of T
4
with the help of an enzyme, 5-monodeiodinase
(5-D).
Although basically metabolic, thyroid
hormones regulate almost all physiological processes
directly or indirectly. The hormones are
vital to the well-being of a person, and an
imbalance in their physiological levels leads
to health problems.
8.3 Thyroid Abnormalities: Hypothyroidism and
Hyperthyroidism
Hypothyroidism occurs when the thyroid is
hypoactive and does not produce enough
thyroid hormones. The most common form of
hypothyroidic diseases described in
Ayurveda is the enlarged thyroid gland (
galaganda
), now known as goiter. In fact, goiter
is produced by the inadequate secretion of
thyroid hormones, resulting in a positive
feedback of a pituitary hormone, thyrotropin
(thyrotropin-stimulating hormone [TSH]),
on the thyroid gland that ultimately
enlarges. This disease process was recognized by
early Ayurvedic practitioners.
As thyroid hormones regulate growth and
development (both physical and mental) of
a person, hypothyroidic children suffer from
cretinism (mental retardation). In Ayurveda
this is known as a condition of low
intelligence
(manda buddhi)
.
Hyperthyroidism is the result of excess
production and delivery of the thyroid hormones
to the peripheral tissues often referred as
thyrotoxicosis. In Ayurveda this is believed to
be an air or energy disorder (
vata
). Conventional medical text relates it to
the production
of TSH receptor-stimulating antibodies,
leading to enhanced secretion of thyroid hormones,
which are responsible for increased
metabolism and energy wastage.
At present, diseases such as thyrotoxicosis,
exophthalmic goiter or Graves’ disease, and
thyroid carcinoma and adenoma all come under
the category of hyperthyroidism. These
diseases can be serious, as the patients may
end up with heart ailments and diabetes
(
madhumeha
), the two most common modern health
problems.
5
Several symptoms are associated with
hypothyroidism and hyperthyroidism. The comthe
lower legs (thyroid dermopathy), is also
observed in chronic hypothyroid individuals.
At the beginning of the thyroid dysfunction,
visible symptoms may not be observed.
8.4 Etiology
8.4.1 Hypothyroidism
According to Ayurvedic literature,
2
impairment of air
(vayu
), mucus or water (
kapha
), and
the fat (
meda
) leads to the enlargement of the thyroid gland
(galaganda). This is often
known as bronchocele. According to common
belief, the most common cause of hypothyroidism
is iodine deficiency, and this disease is
prevalent only in iodine-deficient areas
mon symptoms are listed in Table 8.1. A rare
symptom, the thickening of the skin over
such as hilly regions or areas with high lime
content. In urban areas, iodine deficiency
can also be considered a major factor of this
disease, as people in these areas are following
low sodium diet and using less iodized salt
(as a preventive measure for heart problems
and high blood pressure). Doctors recommend
about 150
m
g/day of iodine for normal
thyroid function; less than 50
m
g/day for a long period may cause goiter.
3
Because of the
inadequate iodine in the diet, the thyroid
cannot synthesize sufficient amount of T
4
and
T
3
, resulting in the abnormal increase in
circulating TSH, which causes abnormal increase
in the size of the thyroid gland (simple
goiter).
Other factors causing hypothyroidism are
stress, hereditary defects in thyroid iodide
transport, thyroglobulin and hormone
synthesis, reduction in TSH or thyrotropin-releasing
hormone (TRH) (secondary or tertiary
hypothyroidism, respectively) and conversion
of T
4
to T
3
, peripheral resistance to the action of
thyroid hormones, excess consumption
of adulterated and goitrogenic foods (e.g.,
cabbage, cauliflower, cassava, peanuts, sweet
potatoes, etc.),
4
selenium deficiency, and consumption of heavy
metals and pesticides.
6–8
Very often it may be a result of the
development of autoimmune antibodies, which destroy
the thyroidal tissues by an immunological
process.
3
8.4.2 Hyperthyroidism
According to classic Ayurvedic text,
hyperthyroidism is the result of imbalance in air (
vata
)
and fire (
pitta
), which govern the neurohormonal system. In
the conventional system of
medicine, physicians relate constant
psychological stress and excess secretion of cortisol
with thyrotoxicosis. Apart from genetic
susceptibility, an immunological increase in immunoglobin
G (IgG) antibodies (sometimes referred as
thyroid stimulating antibodies), which
act on TSH receptors on the gland to
stimulate hormone production, are considered as
major factors for hyperthyroidism.
9
Prevalent data indicate that more young women
(ages 20 to 40) suffer from thyroid
dysfunctions than do males. This difference
may exist because of high-circulating sex
steroids, estrogen and progesterone, in
females. Thyrotoxicosis may be aggravated during
pregnancy, as human chorionic gonadotropin
(hCG), a placental hormone, also possesses
TSH-like activity.
9
Formation of thyroid carcinoma also increases
T
4
and T
3
production.
TABLE 8.1
Common Signs and Symptoms of Hypo- and
Hyperthyroidism
Hypothyroidism Hyperthyroidism
Weight gain
Husky, hoarse voice
Tiredness/lethargy
Intolerance to cold
Cold hands and feet
Dry skin and hair, brittle nails
Puffiness of the body
Periorbital swelling
Memory loss
Constipation
Bradycardia
Muscle stiffness
Impotence
Anemia
Depression
Weight loss
Thinning of hair
Sweating
Nervousness
Vomiting
Tachycardia
Diarrhea
Tremor
Muscle weakness and fatigue
Insomnia
Angina
Increased appetite
Eyelid pain
Loss of libido
Exophthalmos
8.5 Pathogenesis (
Samprapti)
Although in Ayurveda the pathogenesis of
thyroid dysfunctions has not been well
described, most available literature relate
hypothyroidism with excess of mucus (
kapha
)
and fats (
meda
). When the above factors get excited and
become out of balance, they
produce hormonal (
ojas
) imbalance and then enlargement (a slow
process) of the gland,
known as
Galaganda
.
2
It may start with loss of appetite and
disgust for food or with loss
of immunity.
There is limited Ayurvedic literature on
hyperthyroidism. However, some physical and
behavioral changes do indicate that
vata
and
pitta
lead to insomnia, which may manifest
a condition of hyperthyroidism. Excessive
sweating, intolerance to heat, and warm soles
and palms also indicate the onset of
hyperthyroidism.
2
Conventional medicine describes autoimmunity
development as the major pathogenesis
process for thyroid dysfunctions. This could
be due to genetic predisposition or it could
be hormone or virus induced.
10
A characteristic finding in the pathogenesis
of hypothyroidism
is that there is an accumulation of
glycosaminoglycans (mostly hyaluronic acid)
in interstitial tissues that generally
accounts for the edema. In Graves’ disease, sensitized
T-lymphocytes stimulate B-lymphocytes to
synthesize antibodies that enhance thyroid cell
function. Some factors that may also
stimulate the immune response of hyperthyroidism
are postpartum period of pregnancy, excess
iodide or lithium therapy, and glucocorticoid
withdrawal.
10
8.6 Prognosis (
Sadhyata
)
Hypothyroidism always results in a gradual
decrease in metabolism with the slowing of
mental and physical activity. Patients may
experience one or more common symptoms,
including sensitivity to cold, dryness of the
skin and hair, constipation, anorexia, angina,
anemia, and disordered menstrual function.
With proper Ayurvedic therapy, these symptoms
can be overcome. Goiter in which there is a
considerable dyspnea along with emaciation
of body, and if there is more than 1 year of
standing, may be incurable.
2
According
to conventional medical text, untreated
myxedema may eventually lead to myxedema
coma and death. However, the prognosis has
been vastly improved with the use of
L
-
thyroxine with frequent monitoring of the
thyroidal status.
With respect to hyperthyroidism, Ayurvedic
therapies have been found to provide about
60 to 80% symptomatic relief.
14
With conventional medicine, when patients are
treated for
12 to 24 months with antithyroid drugs,
prolonged remissions of their illness are generally
observed and many patients develop
hypothyroidism. With radioactive iodide, 40 to 70%
of patients develop hypothyroidism as a side
effect within 10 years. Lifetime follow-up is
therefore required for all hyperthyroid
patients.
8.7 Diagnosis (
Nidan
)
Diagnosis of the thyroid dysfunctions is made
on the basis of inspection of the thyroid
gland both in Ayurveda and in Western
medicine. The size and consistency of the swelling
differ based on the disorder (
dosa
) of
vata, pitta,
or
kapha
involved in causing the dysfunction.
Confirmation of diagnosis is done by the
estimation of thyroid hormones and thyrotropin
by radioimmunoassay (RIA), examination of
gland activity by the use of
radioiodine, basal metabolic rate
(BMR)/oxygen consumption studies, and measurement
of autoimmune antibodies.
8.8 Ayurvedic Therapies (
Chikitsa
)
According to the Ayurvedic management of
thyroid diseases, the first line of treatment is
to clear the blocked channels (
srotas)
in order to balance
vata, pitta
, and
kapha
. Several
herbal preparations are also administered to
increase the digestive fire at a cellular level
and restore metabolism. For the treatment of
goiter, some ayurvedic preparations are used
to clean
kapha
internally.
Few herbal products are already available for
the treatment of thyroid dysfunctions; the
food supplements,
Vimbadi
oil (with sesame oil) can be applied four
times/day on the
goiter.
2
Yograj guggul
(0.5 to 2.25 g/day) and
Ashwagandha
powder (
churn
) (1 to 6 g/day)
are also used in the treatment of
hypothyroidism. A study on Liv-52, an Ayurvedic liver
tonic, has revealed that it stimulates
thyroid hormone secretion, particularly the T
3
.
11
In
fact, action of the most commonly recommended
Ayurvedic drug,
Kanchnar guggul
(prepared
from
Bauhinia variegata
)
,
has been found to be similar to that of the
allopathic drug
Eltroxin.
12
For the treatment of hyperthyroidism, Charaka
has mentioned
Shankapushpi
extract (
rosa
)
as a brain tonic (Medhya rasayana, Charaka,
Ch.1/30), although this is known to be a
very effective supplement. Gupta et al.
14
studied the comparative effects of an
allopathic
TABLE 8.2
Commonly Used Ayurvedic Herbal Formulations
and Food Supplements for the Treatment of
Hypothyroidism
Formulation and Food
Supplement Dose Major Herbs Used Manufacturer
Thyro-L#455 2 capsules three times/
day
Laminaria sarassum
Herbal Doctor Remedies,
Monterey Park, CA
B 37 K Para-Thy-Mix 1 tablet/day Natural
iodine from dulse
with raw glandular extract
Penn Herb Comp.,
Philadelphia, PA
Suddha guggulu 2.25 g twice/day Commiphora mukul Himalya Drug, New
Delhi, India
Kanchnar guggulu 500 mg–1.0 g Bauhinia variegata, C. mukul Dabur Pharmaceuticals,
New Delhi, Indiaa
Gayatrin 1 to 2 tablets, two to
three times/day
B. variegata, C. mukul Arya Aushadhi
Pharmaceutical Works,
Indore, India
Kelp 1 tablet three times/day
(660 mg kelp)
Fucus vesiculosus Herbal Doctor Remedies,
Monterey Park, CA
Note: These products are not intended to cure or prevent the disease.
aAlso from Ayurvedic Formulary of India,
Central Council for Research in Ayurveda and Siddha, Ministry of
Health and Family Welfare, Government of
India, New Delhi.
popular ones have been mentioned in Tables
8.2 and 8.3. Besides the mentioned drug and
antithyroidic drug, Neomercazole (15 mg three
times/day), and the Shankapushpi
extract
(125 mg twice/day) for 9 months. They
reported that the plant extract is more effective
(as evident by 60 to 80% symptomatic recovery
and significant changes in I131 uptake and
concentration of serum cholesterol (p < 0.05 and p < 0.01, respectively), with no side
effects
as compared with the allopathic medicine.
Another formulation, Sutshekhar
rasa sada of
Zandu Pharmaceuticals, is sometimes suggested
for the amelioration of hyperthyroidism,
and the recommended dose is 130 to 250 mg
twice/day for 3 to 4 months (as recommended
TABLE 8.3
Common Ayurvedic Herbal Formulations and Food
Supplements for the Treatment of
Hyperthyroidism
Formulation and Food
Supplement Dose Major Herbs Used Manufacturer
Herbal-supra Power
(product no. HZ1003)
1 capsule/day Valerian root, passion
flower, hops, skullcap, and
wood betony
Viable Herbal
Solutions Comp.,
Morrisville, PA
Biolite 1 capsule/day Ephedra, kola seed,
white
willow, kelp, ginger, Ginkgo
biloba, juniper berries,
buchu leaves, Cascara
sagrada
Bionomics
International Inc.,
Delray Beach, FL
Thyro-H #450 1 capsule three times/
day
Oyster shell, nourish yin,
scrophularia, Arnemarrhena
fritillaria
Herbal Doctor
Remedies, Monterey
Park, CA
Thyrovedic 1 tablet Garcina, ginger, cambogia
Herbal Doctor
Remedies, Monterey
Park, CA
Lemon balm 1.5–4.5 g several times/
day
Melissa officinalis Herbal Doctor
Remedies, Monterey
Park, CA
Astrgalagus extract 1 vegicapsule/day Raw astragalagus powder
(250 mg in each capsule)
Suzannes com, Joplin,
MO
Shankpuspi syrup 125 mg twice/day C. pluricaulis Dabur India Ltd.,
New Delhi, India
TABLE 8.4
Promising Plant Extracts Suggested for the
Treatment of Hypothyroidism
Plants Effective Dose Tested in
Days
Treated Ref.
Bauhinia variegata 2 g/kg Animal models 20 12
B. variegata, C. mukul, G.
glabra, and C. pluricaulis
100 mg from each plant
(Thyrocap)
Humans 15 19
Echhorina crassipes 2 g/kg Animal models 20 12
Bauhinia purpurea 2.5 mg/kg Animal models 20 20
Commiphora mukul 0.2 g/kg Animal models 15 21, 22
Withania somnifera 1.4 g/kg Animal models 20 23
W. somnifera, C. mukul,
B. purpurea
1.4 g, 0.2 g, 2.5 mg/kg Animal models 30 24
Achyranthes aspera 200 mg/kg Animal models 7 25
Saussurea lappa 400 mg/kg Animal models 14 26
Inula racemosa 400 mg/kg Animal models 21 27
by Zandu). According to some reports, Potentilla alba and Kalanchoe brasiliensis are also
effective for the treatment of
thyrotoxicosis.15,16
8.9 Conventional Medicine Treatment
Several preparations of L-Thyroxine,
including Eltroxin and Synthroid, and thyroid
extracts are used for hypothyroidism.
Neomarcazole, Methimazole (Tapazole), Carbimazole,
and Propyl thiouracil are commonly prescribed
for hyperthyroidism. Radioiodine
(not in pregnancy) and surgery are suggested
in acute cases, but these medicines are not
free from side effects17,18 and are also
expensive. A report revealed that 21 patients indicated
abnormal T4 suppression after receiving
Carbimazole for 10 to 12 months and the disease
relapsed after 1 year of stopping the
therapy.16 With Thyroxine therapy, side effects including
bone fracture and sudden increase in heart
rate have been observed.5 As suggested
by some other authors,14 Ayurvedic medicines
based on scientific studies appear to be the
best choice.
8.10 Scientific Basis
For many years people have been using
seaweed, including kelp, as a supplement of
iodine, a basic component of thyroid
hormones. Several plants have also been screened
from time to time and few appear highly
promising for the treatment of thyroid dysand
in Table 8.5 (for hyperthyroidism) along with
their respective references.12,19–40 All
these scientific studies are presented
separately as clinical trials and pharmacological
investigations.
TABLE 8.5
Promising Plant Extracts Suggested for the
Treatment of Hyperthyroidism
Plants Effective Dose Tested in
Days
Treated Ref.
Lycopus virginicus 1–2 g Humans 50 28
Azadirachta indica 100 mg/kg Animal models 20 29
Momordica charantia 500 mg/kg Animal models 15 30
Convolvulus plauricaulis 400 mg/kg Animal models 30 31
Emblica officinalis 30 mg/kg Animal models 20 32
Ocimum sanctum 0.5 g/kg Animal models 15 33
Piper betel 0.1 g/kg Animal models 15 34
Rauwolfia serpentina 2.5 mg/kg Animal models 30 35
Trigonella foenum-graecum 0.11 g/kg Animal models 15 36
Moringa oleifera 175 mg/kg Animal models 10 37
Lithospermum officinale 400 mg/kg Animal models 1 38
Melissa officinalis,
L. verginicus, L. officinale
2 mg, 3 mg, 2 mg Humans 1 39
Lithospermum ruderale 23 mg/kg Animal models 5 40
functions. Some important ones have been mentioned
in Table 8.4 (for hypothyroidism)
© 2004 by CRC Press LLC
Ayurvedic Therapies for Thyroid Dysfunction 141
8.10.1 Clinical Trials
8.10.1.1 Thyrocap
Thyrocap is a herbal preparation containing
solid extracts of Bauhinia
variegata, Commiphora
mukul, Glycyrrhiza glabra, and Convolvulus plauricaulis (100 mg of each extract/capsule).
This drug was prepared and tried in 50
patients of simple diffuse goiter at a dose of one
capsule three times a day for 3 months.19
After 3 months treatment, a marked improvement
was noticed in weakness, fatigability,
dyspnea, and reduction in neck swelling. A significant
increase in serum T4 and T3 concentrations (p < 0.001 and < 0.02, respectively) and
a decrease in serum cholesterol concentration
(p < 0.02) confirmed its thyroid-stimulating
property.
8.10.1.2 Kanchnara Guggul
Prepared from gum resin of Commiphora mukul and bark powder of Bauhinia variegata,
kanchnara guggul (237 mg three times/day) was given to 899
tribal people of India bearing
simple goiter. They were also asked to apply Kanchnara ointment simultaneously. Treatment
was continued for 10 to 20 months. A 90 to
100% improvement was observed in the
swelling of the gland in 163 patients, a 50
to 100% improvement was seen in 148 patients,
and up to a 50% improvement was observed in
149 patients.13 It was also observed that
patients over 50 years old exhibited only 40
to 50% improvement.
8.10.1.3 Sankhapushpi Syrup
One hundred sixty thyrotoxicosis patients
were divided into three groups. Group 1 (n =
100) received a standard allopathic drug,
Neomercazole (15 mg/day), along with Diazepam
(tranquilizer; 5 mg/day) B.D.; group 2 (n =
30) received 125 mg of Shakapushpi (C.
pluricaulis) syrup alone B.D.; and group 3 (n = 30) was treated with
equivalent doses of
Shankhapushpi syrup and Neomercazole. The treatment was continued for 9
months. Maximum
improvement (73 to 93%) in clinical features
such as tremors, weakness, palpitation,
increased appetite, and nervousness was
observed in the Shankhapushpi-treated group.
Thyroidal I131 uptake was also minimum in
this group. These observations and a significant
increase in serum cholesterol (p < 0.01) suggested that Shankhapuspi is a
better thyroid
inhibitor as compared with the modern
allopathic drug, Neomercazole.14
8.10.1.4 Miscellaneous Studies
Some minor investigations have also been made
on few plant extracts in relation to the
regulation of hyperthyroidism in human
beings.
It was discovered that a whole plant extract
of Lycopus verginicus (bugle weed) at a dose
of 1 to 2 g/day for 50 days could decrease
serum TSH and T4 levels in hyperthyroid
patients, suggesting that it can ameliorate
secondary hyperthyroidism caused by increased
TSH.28 In an in vitro study,
extracts of Melissa
officinalis (2 mg), L. verginicus (3 mg), and L.
officinalis (2 mg) were
found to decrease the TSH-binding activity in human thyroidal
membrane when incubated for 24 h. These
results indicate that these plant extracts are
effective in secondary hyperthyroidism.39
Some scientific investigations have been made
on animal models considering different
plant extracts to suggest their potential use
in further investigation toward the treatment
of thyroid dysfunctions. Whereas some have
been found to stimulate the production or
release of thyroid hormones, others have been
found to inhibit the same, indicating their
possible use in hypothyroidism and
hyperthyroidism, respectively.
8.10.2.1 Bauhinia variegata
This plant’s water-soluble fraction of total
alcoholic extract at a dose of 2 g/kg was fed
to Neomercazole (150 mg/kg)-induced
hypothyroidic rats (n = 12 in each group) for 20
days. The experiment resulted in enhanced
thyroid function as evidenced by increased
thyroidal weight (p < 0.001), I131uptake and decreased serum cholesterol (p < 0.05 for both),
and active thyroidal histology.12 It was
found that the action of this plant extract was
comparable with Eltroxine.
8.10.2.2 Echhornia crassipes
In the same investigation, water-soluble
fraction of E.
crassipes ash at 2 g/kg/day for 20
days was also found to stimulate the thyroid
function in the similar manner (p <
0.001 in
all) as B. variegata.12
8.10.2.3 Bauhinia purpurea
Bark extract of B. purpurea at 2.5 mg/kg orally administered to female mice (n = 7 in
each
group) significantly increased serum T3 and
T4 concentrations (p < 0.001 for both) after 20
days of treatment.20
8.10.2.4 Commiphora mukul
Commiphora mukul extract at a dose of 200 mg/kg administered
for 15 days in mice
(n = 10) significantly increased the T3
concentration (p < 0.001) and also the food
consumption (p <
0.001).21 A dose of 200 mg of its petroleum ether extract was also
earlier reported22 to enhance thyroidal
weight and I131 uptake (p < 0.001) in melatonininduced
(250 mg/kg) hypothyroid rats (n = 36).
8.10.2.5 Withania somnifera
Withania somnifera root extract at 1.4 g/kg, orally administered
in albino mice (n = 10 in
each group) for 20 days, stimulated both
thyroid hormones (p < 0.001) without any
hepatotoxic effect.23 In another study, all
three extracts (B.
purpurea, C. mukul, and W.
somnifera) were administered simultaneously to mice (n = 8) for 30 days at the doses
mentioned above. The results showed an
increase in both T3 and T4 levels (p < 0.01
and
p < 0.001, respectively), suggesting that a combination of the three plant
extracts may
prove to be an effective treatment for
hypothyroidism.24
8.10.2.6 Achyranthes aspera
Achyranthes aspera leaf extract administered in rats (n = 7) at
a dose of 200 mg/kg for 7
days caused an increase of T3 and T4 (p < 0.001 for both). An increase in blood glucose in
this group (p <
0.05) further supported the extract’s thyroid-stimulating nature.25
© 2004 by CRC Press LLC
8.10.2 Promising Plants for the Treatment of
Hypothyroidism (Table 8.4)
Ayurvedic Therapies for Thyroid Dysfunction 143
8.10.2.7 Saussura lapa
Thyroid function stimulation as evidenced by
thyroidal histology was reported in rats (n
= 7) treated either with 400 mg/kg of S. lapa root extract for 14 days26 or with the equivalent
dose of Inula racemosa root extract for 20 days.27
T3 is metabolically the most potent thyroid
hormone. Plants that have been found to
decrease at least the serum level of this
hormone have been suggested to act in the
treatment of hyperthyroidism.
8.10.3.1 Azadirachta indica
Two doses (40 and 100 mg/kg) of the leaf
extract of A. indica was administered in albino
mice (n = 7 in each group) for 15 days; the
higher dose could decrease the serum concentration
of T3 (p <
0.05). It was postulated that the inhibition of T3 production was mediated
through T4 to T3 conversion, the principal
source of T3 generation.29
8.10.3.2 Momordica charantia
Fruit extract of M. charantia (500 mg/kg) orally administered for 15 days decreased
serum
T3 and T4 concentrations (p < 0.001 for both) in mice (n = 8 in each group).30 However, this
dose was found to enhance hepatic lipid
peroxidation (LPO).
8.10.3.3 Convolvulus pluricaulis
The root extract of C. pluricaulis (0.4 mg/kg/day for 30 days) administered to
L-thyroxineinduced
hyperthyroid mice (n = 7 in each group)
decreased serum concentration of T3
and hepatic 5-D activity. These results
indicate that the plant extract-induced inhibition
in thyroid function is primarily mediated
through T4 to T3 conversion.31
8.10.3.4 Emblica officinalis
The fruit extract of E. officinalis at 30 mg/kg for 20 days decreased both serum T3 and T4
concentrations (p < 0.05 and < 0.001, respectively) in mice (n = 8 in each group). It
was
thought to decrease T3 production
particularly by inhibition of peripheral conversion of
T4 to T3 in extra thyroidal tissues.32
8.10.3.5 Ocimum sanctum
The leaf extract (0.5 g/kg) of O. sanctum administered to male mice for 15 days (n = 10 in
each group) significantly inhibited only T4
concentration (p < 0.001).33
8.10.3.6 Piper betel
Administration of the P. betel leaf extract (0.1 g/kg) to male mice (n = 7) for 15 days
significantly decreased both serum T3 and T4
concentrations (p < 0.01 for both).34
© 2004 by CRC Press LLC
8.10.3 Promising Plants for the Treatment of
Hyperthyroidism (Table 8.5)
144 Scientific Basis for Ayurvedic Therapies
8.10.3.7 Rauwolfia serpentina
The R. serpentina root extract (2.5 mg/kg) administered to T4-induced hyperthyroid mice
(n = 7 in each group) for 30 days
significantly decreased both the serum T3 and T4
concentrations (p < 0.001 for both).35
8.10.3.8 Trigonella foenum graecum
T. foenum graecum seed extract treatment (0.11 g/kg for 15
days) given to both mice and
rats (n = 7 for both) decreased serum T3 (p < 0.01 in mice and p < 0.001 in rats) and
increased
T4 concentration (p < 0.01 in both mice and rats). The seed extract induced reduction in
T3 level could be the result of inhibition in
peripheral conversion of T4 to T3 in extra
thyroidal tissues.36
8.10.3.9 Moringa oleifera
M. oleifera leaf extract treatment (175 mg/kg) of female rats for 10
days (n = 14 for each
group) decreased serum T3 concentration (p < 0.05) and increased in serum T4 concentration
(p <
0.05). This observation suggests the inhibitory activity of the plant extract
in the
peripheral conversion of T4 to T3.37
8.10.3.10 Lithospermum officinale
An extract from the powdered leaf of L. officinale, administered at a dose of 400 mg/kg
for 24 h to rats (n = 42), decreased serum T3
concentration (p < 0.01) in TSH-induced
hyperthyroidic animals.38
8.10.3.11 Lithospermum ruderale
The root extract of L. ruderale (23 mg/kg/day) administered to TSH-treated guinea pigs
(n = 5) for 5 days decreased thyroid weight (p < 0.01) and exhibited low active thyroidal
histology. The results suggested its
antithyroidal nature.40
8.10.3.12 Allium sativum
A. sativum bulb extract (500 mg/kg) administered to hyperthyroid
rats (n = 8) for 15 days
showed a decrease in serum T3 (p < 0.05) and cholesterol (p <
0.05) concentration.41
8.10.3.13 Nelumbo nucifera
Rhizome extract of N. nucifera (400 mg/kg) administered to rats (n = 8) for 15 days
decreased both serum T3 and T4 concentrations
(p < 0.01 and < 0.05, respectively).42
8.10.3.14 Aloe vera
Diluted parenchyma of Aloe vera leaf at 125 mg/kg/day administered for 15 days in mice
(n = 7 in each group) has been reported to
inhibit both T4 and T3 concentrations (p < 0.05
and < 0.01, respectively).43
8.10.3.15 Aegle marmelos
Dried leaf powder extract of A. marmelos at a dose of 1 g/kg/day for 15 days significantly
(p <
0.001) decreased only serum T3 concentration.43
All these findings indicate the
plant-specific role in the regulation of thyroid functions.
Although some were found to be thyroid
stimulatory as evidenced by the increase in
serum T3 and/or T4 concentrations, the others
were inhibitory to either one or both of the
thyroid hormones. Although these finding do
not claim to cure or treat the thyroid
dysfunctions, certainly the plants can be
further studied for their potential use in the
treatment of hypo- and hyperthyroidism.
8.11 Prevention Strategies
Because thyroid-related problems affect
nearly all systems of the body, it is advisable to
take some preventive measures, particularly when
one or more symptoms of thyroid
important to supply the thyroid gland with
adequate quantity of nutrients so that it can
manufacture the required amount of thyroid
hormones. If hypofunctioning of the gland
is suspected, one has to avoid the
goitrogenic food such as rapeseed, cabbage, cauliflower,
kale, and turnip. One should also ensure the
iodine intake of 150 mg/day through food
and water supplementation apart from using
filtered water with less chloride and fluoride.
Left untreated, hyperthyroidism has a serious
consequence and much precaution should
be taken for its prevention. Scientists
believe that hyperthyroidism has a genetic susceptibility.
People who have a family history of
thyrotoxicosis should avoid stress, trauma
(both physical and mental), and excessive
steroid therapy, which are very often considered
as causative factors. From a safer point of
view, serum T4, T3, and TSH should be estimated
every year to ascertain the thyroid status
and accordingly follow medical advice, if warranted.
8.12 Summary
Considering all the literature available on
Ayurvedic therapies in the regulation of thyroid
dysfunction, it can be said that the
management of the thyroid problems in Ayurveda is
nearly similar to the conventional allopathic
therapy, because both primarily aim to augment
thyroid function (for hypothyroidism) or to
reduce it (for hyperthyroidism). However,
herbal therapy appears to be safe when
compared with the modern allopathic
treatment.14 This is because Ayurvedic
preparations include mainly herbs that make the
body work more efficiently while supporting
many complex functions. Moreover, herbal
extracts possess natural antioxidants, which
not only help in curing the diseases, but also
improve the body’s defense system. On the
downside, allopathic drugs and chemicals
interfere in the body’s natural process,
resulting in unwanted side effects. Because they
offer fewer or no side effects, herbal
therapies should be preferred in the treatment of
thyroid dysfunctions.
Herbal therapies should be specific,
considering the specific type of thyroid diseases
and imbalance in the particular type of
thyroid or pituitary hormone. In fact, recent
researches have revealed a differential role
of herbal extracts in relation to the regulation
of thyroid function. Although some plant
extracts are potent in altering both thyroid
hormones, others have been found to be
effective in correcting either T4 or T3 levels.
abnormalities (see Table 8.1) are observed.
For the prevention of hypothyroidism, it is
8.13 Suggested Future Research
Although some Ayurvedic preparations are
already available for the regulation of thyroid
dysfunctions, further research is required.
Thyroid problems are indirectly related to many
other diseases, including diabetes and
gastrointestinal, neural, and heart problems. Further
investigations on the different aspects of
herbal regulation may provide a better understanding
on the Ayurvedic management of thyroid
dysfunctions. It is suggested that
research activities should be undertaken in
the following areas:
1. Screening of more plants to find out the
highly effective plant extracts for the
treatment of thyroid diseases
2. Concentration-dependent studies to
identify safe and effective doses
3. Long-term effectiveness studies of the
plant extracts to optimize the duration of
treatment
4. Comparative studies on the active
compounds and crude extracts
5. Target-specific studies on plants acting
either at glandular level or at the level of
peripheral tissues, including the liver and
kidney, which produce maximum
amount of T3 in both human and animal models
Acknowledgments
This chapter is dedicated to the late Shri
M.J. Kar (first author’s father). We are thankful
to Dr. M. Ghollap for his help in literature
collection, and Prof. S. Bharti, Prof. K.N.
Guruprasad, and Abhishek Kar for their
encouragement. Many of our results presented
in this chapter are from the investigation
made under UGC Research award scheme,
sanctioned to A. Kar.
References
1. Pocock, G. and Richards, C.D., The thyroid
gland, in Human Physiology: The Basis
of Medicine,
Oxford University Press, New York, 1999, p.
212.
2. Sengupta, N.N., The Ayurvedic System of Medicine, Logos Press, New Delhi, India, 1999, p.
268.
3. Ganong, W.F., The thyroid gland, in Review of Medical physiology, 7th ed., Appleton and Lange,
Norwalk, CT, 1995, p. 295.
4. Turner, C.D. and Bagnara, J.T., The
thyroid gland, in General
Endocrinology, 6th ed.,
W.B.
Saunders, Philadelphia, 1976, p. 178.
5. Williams, J.B., Adverse effects of thyroid
hormones, Drugs and Aging, 11, 460, 1997.
6. Aaseth, J. et al., Selenium concentrations
in the human thyroid gland, Biol. Trace Elem. Res.,
24, 147, 1990.
7. Chaurasia, S.S. et al., Free radical
mediated membrane perturbation and inhibition of type-I
iodothyronine 5’-monodeiodinase activity by
lead and cadmium in rat liver homogenate,
Biochem. Mol. Biol. Int., 39, 765, 1996.
8. Maiti, P.K. et al., Loss of membrane
integrity and inhibition of type-1 iodothyronine monodeiodinase
enzyme activity by Fenvalerate in female
mice, Biochem. Biophys. Res. Comm., 214,
905, 1995.
9. Hershman, J.M., Hyperthyroidism caused by
chronic gonadotropin, in Werner and Ingbar’s
The Thyroid: A Fundamental and Clinical Text, Braverman, L.E. and Utiger, R.D., Eds.,
Lippincott–
Williams & Wilkins, New York, 2000, chap.
32.
10. Greenspan, F.S., The thyroid gland, in Basic and Clinical Endocrinology, 4th ed., Greenspan, F.S.
and Baxter, J.D., Eds., Appleton and Lange,
Norwalk, CT, 1994, p. 160.
11. Dhawan, D. and Goel, A. Hepatoprotective
effects of Liv-52 and its indirect influence on the
regulation of thyroid hormones in rat liver
toxicity induced by carbon tetrachloride, Res. Exp.
Med., 194, 203, 1994.
12. Veena, K. et al., Effect of indigenous
drugs on experimentally produced goiter, J. Res. Ind.
Med., 10, 19, 1975.
13. Ghallop, M., Ghenga roga chikitsa me
Ayurveda ek bardan (in Hindi), Bulletin of Adimzati and
Vikash Pradhikaran, Indore, India, 19, 1991.
14. Gupta, R.C. et al., Probable mode of
action of shankpuspi in the management of thyrotoxicosis,
Ancient Sci. Life, 1, 46, 1981.
15. Prikhod’ko, E.I., Treatment of
thyrotoxicosis with the herb Potentilla alba, V. Del., 87, 1976.
16. Ferreira, A.C., Rosenthal, D., and
Carvalho, D.P., Thyroid peroxidase inhibition by Kalanchoe
brasiliensis aqueous extract, Food Chem. Toxicol., 38, 417, 2000.
17. Vitug, A.C. and Goldman, J.M.,
Hepatotoxicity from antithyroid, Drugs Horm. Res., 21, 229,
1985.
18. Goswami, R. et al., Remission with
Carbimazole therapy and associated T4 suppression acts
as an index of relapse on patients with
Grave’s disease in India, Indian J. Med. Res., 103,
272,
1996.
19. Pandit, R.K., Gupta, R.C., and Prasad,
G.C., Effect of an herbal compound: thyrocap in the
patients of simple diffuse goiter, J. Res. Edu. Ind. Med., 13, 16, 1992.
20. Panda, S. and Kar, A., Withania somnifera and Bauhinia purpurea in the regulation of circulating
thyroid hormone concentrations in female
mice, J. Ethnopharmacology, 67, 233, 1999.
21. Panda, S. and Kar, A., Guggulu (Commiphora mukul) induces triiodothyronine production:
possible involvement of lipid peroxidation, Life Sci., 65, 137, 1999.
22. Singh, A.K., Tripathi, S.N., and Prasad,
G.C., Response of Commiphora
mukul (guggulu) on
Melatonin induced hypothyroidism, Ancient Sci. Life, 3, 85, 1983.
23. Panda, S. and Kar, A., Changes in thyroid
hormone concentrations after administration of
Ashwagandha root extract in adult male mice, J. Pharm. Pharmacol., 50, 1065, 1998.
24. Panda, S. and Kar, A., Combined effects
of ashwagandha, guggulu and bauhinia extracts in
the regulation of thyroid function and on
lipid peroxidation in mice, J. Pharm. Pharmacol., 6,
141, 2000.
25. Tahiliani, P. and Kar, A., Achyranthes aspera elevates thyroid hormone levels and decreases
hepatic lipid peroxidation in male rats, J. Ethnopharmacol., 71, 527, 2000.
26. Chaturvedi, P. et al., Effect of Saussurea lappa alcoholic extract on different endocrine
glands
in relation to glucose metabolism in the rat,
Phytother. Res., 7, 205, 1993.
27. Tripathi, Y.B. and Chaturvedi, P.,
Assessment of endocrine response of Inula racemosa in relation
to glucose homeostasis in rats, Ind. J. Exp. Biol., 33, 686, 1995.
28. Blumenthal, M., The complete commission:
E monographs, in Therapeutic
Guide to Herbal
Medicines, Integrative Medicine Communications, Boston, 1998, p. 98.
29. Panda, S. and Kar, A., How safe is neem
extract with respect to thyroid function in male mice?,
Pharmacol. Res., 41, 419, 2000.
30. Panda, S. and Kar, A., Excess use of Momordica charantia extract may not be safe with respect
to thyroid function and lipid peroxidation, Curr. Sci., 79, 222, 2000.
31. Panda, S. and Kar, A., Inhibition of T3
production in levothyroxine-treated female mice by the
root extract of Convolvulus pluricaulis, Horm. Metab. Res., 33, 16, 2001.
32. Panda, S., Bharti, S., and Kar, A., Emblica officinalis and Bauhinia purpurea in the regulation of
thyroid function and lipid peroxidation in
male mice, J. Herbs Spices Med., 10, 1, 2002.
33. Panda, S. and Kar, A., Ocimum sanctum in the regulation of thyroid function in male mouse,
Pharmacol. Res., 38, 107, 1998.
34. Panda, S. and Kar, A., Betel leaf can be
both peroxidative and antiperoxidative in nature, Curr.
Sci., 74,
284, 1998.
35. Panda, S. and Kar, A., Regulation of
hyperthyroidism by Rauwolfia
serpentina root extract in
mice, Pharm. Pharmacol. Commun., 6, 517, 2000.
36. Panda, S., Tahiliani, P., and Kar, A.,
Inhibition of triiodothyronine production by fenugreek
seed extract in mice and rats, Pharmacol. Res., 40, 405, 1999.
37. Tahiliani, P. and Kar, A., Role of Moringa oleifera leaf extract in the regulation of thyroid
hormone status in adult male and female rats,
Pharmacol. Res., 41, 319, 2000.
38. Winterhoff, H., Sourgens, H., and Kemper,
F.H., Antihormonal effect of plant extracts —
pharmacodynamic effects of Lithospermum officinale on the thyroid gland of rats: comparison
with the effects of iodide, Horm. Metab. Res., 15, 503, 1983.
39. Auf’mkolk, M. et al., Inhibition by
certain plant extracts on binding and adenylate cyclase
stimulatory effect of bovine thyrotropin in
human thyroid membranes, J.
Endocrinol., 115, 527,
1984.
40. Noble, R.L., Plunkett, E.R., and Gragham,
R.C.B., Direct hormone inactivation by extracts of
Lithospermum ruderale, J. Endocrinol., 10, 212, 1954.
41. Tahiliani, P. and Kar, A., Mitigation of
thyroxine induced hyperglycaemia by two plant extracts,
Phytother. Res., 13, 11, 2003.
42. Tahiliani, P. and Kar, A., Relative roles
of some plant extracts in the regulation of serum thyroid
hormones and glucose concentrations in female
rats, J. Med. Aromatic Plant. Sci., 23, 64, 2001.
43. Kar, A., Panda, S., and Bharti, S.,
Relative efficacy of three medicinal plant extracts in the
alteration of thyroid hormone concentrations
in male mice, J.
Ethnopharmacol., 81,
281,
Om Tat Sat
(Continued...)
(My
humble salutations to H H Maharshi ji, Brahmasri
Sreeman Lakshmi Chandra Mishra ji and other eminent medical scholars and
doctors for the collection)
0 comments:
Post a Comment