E-ISSN:2456-3110

Review Article

Hypothyroidism

Journal of Ayurveda and Integrated Medical Sciences

2024 Volume 9 Number 4 April
Publisherwww.maharshicharaka.in

Effect of Vamana Karma and Panchkola Phanta in Hypothyroidism (Agnimandya)

Rawat M1*, Gupta A2, Vandana3
DOI:10.21760/jaims.9.4.21

1* Mohini Rawat, Post Graduate Scholar, Department of Panchkarma, Himalayiya Ayurvedic Pg Medical College, Dehradun, Uttarakhand, India.

2 Arvind Gupta, HOD Professor, Department of Panchkarma, Himalayiya Ayurvedic PG Medical College, Dehradun, Uttarakhand, India.

3 Vandana, Assistant Professor, Department of Panchkarma, Himalayiya Ayurvedic PG Medical College, Dehradun, Uttarakhand, India.

Modernization leads to improper balance and disintegration of health and environment, body, mind and soul leading to lifestyle disorders. Hypothyroidism is one among the lifestyle and endocrinal disorder which is commonly encountered now days continuing to pose a major health issue. As it also responds to stress and stimuli the global incidence of hypothyroidism is more. This is leading to many lifestyle disorders and hormonal imbalance in our body. Hypothyroidism also known as underactive thyroid is a condition where the thyroid gland does not create enough thyroid hormones, which decreases the basal metabolic rate. Hypothyroidism may not cause noticeable symptoms in the early stage. It occurs about 7-8 times more frequently in females than males. The only modern treatment available is lifelong use of hormonal therapy (Levothyroxine sodium) but it has side effects on long term use. Thus, in order to prevent life long medication and side effects of synthetic drugs, using traditional and natural substance for treatment of hypothyroidism. In Ayurveda there is no direct reference of thyroid in Ayurveda classics but all the metabolic processes of the body are under the control of Agni. Ayurveda mentioned Shodhana Chikitsa, in Agnimandya dominancy of Kapha Dosha and Vamana Karma is best line of treatment for Kapha Dosha. Panchkola Phanta serves the purpose of Deepan and Pachana, thus eliminating the root cause of the disease and correcting the Agni and does the digestion of Ama. In Agnimandya, Panchkola Phanta is useful for Amapachana and to increase the Agni.

Keywords: Thyroid gland, Hypothyroidism, Agni, Jatharagni, Agnimandya, Hormone, Endocrinal disorder

Corresponding Author How to Cite this Article To Browse
Mohini Rawat, Post Graduate Scholar, Department of Panchkarma, Himalayiya Ayurvedic Pg Medical College, Dehradun, Uttarakhand, India.
Email: 		Rawat M, Gupta A, Vandana, Effect of Vamana Karma and Panchkola Phanta in Hypothyroidism (Agnimandya). J Ayu Int Med Sci. 2024;9(4):137-141.
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https://jaims.in/jaims/article/view/3000

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2024-02-16 2024-02-26 2024-03-06 2024-03-16 2024-03-25
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
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© 2024by Rawat M, Gupta A, Vandanaand Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

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Mohini Rawat et al. Effect of Vamana Karma and Panchkola Phanta in Hypothyroidism

Introduction

Hypothyroidism is the most common endocrine disorder observed all over the world in present time.[1] Hypothyroidism also known as underactive thyroid is a condition where the thyroid does not create enough thyroid hormones, which decreases basal metabolic rate.[2] Thyroid is an endocrinal gland secrets T3 and T4 hormones regulated by TSH which is secreted by pituitary gland. These hormones have two major effects on the body

1. To increase the overall metabolic rate in the body.

2. To stimulate growth in children.[3]

Hypothyroidism may not cause noticeable symptoms in the early stage.[4] In infants, symptoms do not appear till six months because enough hormone is present in mother’s milk. Thyroid hormone regulates the way in which the body uses the energy metabolism, and without enough of this hormone many of the body’s functions slowdown.[5] The prevalence of hypothyroidism in India is 11%[6] which contributes to about 42 million people.[7] Ratio of disease occurrence among females and males is 6:1.[8] Common symptoms of hypothyroidism aretiredness, weakness, poor memory, feeling cold, hair loss, constipation, weight gain with poor appetite, hoarse voice, menorrhagia, impaired hearing.[9] Levothyroxine is the drug of choice for Hypothyroidism.[10] Levothyroxine starting dose is 25-50μg daily.[11] Common side effect of Levothyroxine are chest pain, discomfort, tightness , decreased urine output, menstrual changes, difficulty with swallowing, extreme fatique, irregular breathing, sweating, tremors.[12]

In Ayurveda treatment is effective as well as cost effective. Agni is the unique concept of Ayurveda related to Pachana or conversion, Dhatupaka or metabolism etc. i.e. various chemical reactions occurring in the body. It is responsible for control each and every process of conversion of thethirteentype of Agni (Jatharagni - 1, Bhootagni - 5, Dhatvagni - 7), Jatharagni is the one of prime importance controlling other Agni.[13] The normal as well as abnormal functions of thyroid gland can be correlated to healthy and altered status of Agni. So, Hypothyroidism can be considered as a stage of Agnimandya resulting in the formation of Ama. Jatharagni is responsible for initial

digestion of ingested food and its conversion into Rasa Dhatu. Agnimandya is the vitiated state where Agni is unable to digest even the meagre quantity of indigested food. Due to improper digestion Agnimandya results in formation of abnormal Rasa Dhatu i.e. Ama.[14] Thus the etiology of Agnimandya can be considered as etiology of Ama. Clinical symptoms of Ama are Srotorodha (Obstruction of body channels), Gaurava (Heaviness), Anil Mudhata (Abnormal movement of Vata Dosha), Aalasya (Laziness), Apakti (Indigestion), Malasanga (Obstruction of Mala), Aruchi (Loss of taste), Klama (Lethargy), Balabrinsha (Loss of body strength).[15]

Following comparison of signs and symptoms of Hypothyroidism with an Ayurvedic approach, the role of Dosha, Dhatu, and Dhatvagni becomes more obvious.

Weight gain

Due to Meda and Kapha Dosha involvement. Guru Guna of Kapha Dosha and Pruthvi and Jala Mahabhuta involved in Kapha Dosha the weight gain occur.

Cold intolerance: Coldness is caused by the Shita Guna of the Kapha and Vata Doshas.

Anorexia: It is caused by Mandagni, who is influenced by Kapha Dosha and Rasa Dhusti.

Bradycardia: The propagation of Kapha with its Mandaguna may result in bradycardia.

Coarse and dry skin: The inability of Augmented Rasa to nourish Rakta Dhatu results in dryness and harsh skin.[16]

Hoarseness of voice: Sharangdhara has highlighted hoarseness of voice as a Kaphaja Vikara.Hoarseness of voice appears as Manda Guna of Kapha increases.[17]

Menstrual disturbance: In Hypothyroidism Rasha Dushti occurs. It might be incapable of nourish Upadhat Artava and Uttardhatu Rakta. As a result menstrual disturbances occurs.

Excessive sleep: Tandra and Atinidra are caused by Kapha Vriddhi.[18]

All of the above symptoms point to the involvement of Kapha Dosha, Rasa Dhatu, and Rasa Dhatvagni in hypothyroidism. Kapha Dosha plays a major role in the disease Hypothyroidism.


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Mohini Rawat et al. Effect of Vamana Karma and Panchkola Phanta in Hypothyroidism

Samprapti

Agnimandyakara Nidana

↓

Vitiation of Tridosha (Vata, Pitta, Kapha)

↓

Vitiation of Jatharagni

↓

Ama Utpatti

↓

Rasavaha Shrotodusti

↓

Vitiated Rasadhatu

↓

Dosha – Dushya Sammurchana

↓

Vyadhi (Disease)

Discussion

Hypothyroidism is a Strotovarodh Pradhan Vyadhi, therefore Vamana will aid with Sroto Vishodhan as well as Pratilomagati of Vayu. Kapha Dosha is important in the etiology of hypothyroidism. Hypothyroidism is characterized by decreased Agni and slowness in physiological functioning.

Vamana: Shodhana Chikitsa was mentioned in Ayurveda for Pravriddha Bahu Dosha. In hypothyroidism, the Kapha Dosha is dominant, and Vamana Karma is the greatest line of treatment for the Kapha Dosha. Due to their Swavirya, the Vamana Yoga properties, such as Ushna, Tiksna, Suksma, Vyavayi, and Vikasi, are absorbed and reach the heart. Suksma and Vyavayi qualities enter Dhamani and travel to Shrotas (micro channels) throughout the body. Ushna Guna liquifies the morbid Dosha and evacuate it through the oral route, which is known as Vamana. It has an immediate effect on Agnisthan and so improves Agni. As a result, Vamana aids in Samprapti Vighatana of the disease.

According to Vagbhata, Vamana is to eradicate Kapha Dosha, which is associated with Pitta.

Because hypothyroidism is Kaphavritta Samanavayu and Pitta Vruddhi, it help in the elimination of Doshas and the release of Margavarodha. Mala of Rasa Dhatu is Kapha. Vamana facilitates the elimination of Kapha by guiding the Vriddhi of Malarupikapha under Rasadhatvagnimandya.[19]

Mechanism of Vamana

The Vamaka Dravya having the properties like Ushna, Tikshna, Sukshma, Vyavayi and Vikasi, get absorbed and reach to heart due to their Virya (Potency). Due to Sukshma and Vyavayi properties, they move through Dhamani to reach Sthula (Macro) and Sukshma (Micro) Srotas (Channels) throughout the whole body. They act on the sites where complex of the vitiated Dosha are built. At first, they liquify (Vishyandayanti) these complexes bye their Ushna property. Increased liquidity will further help to flow through circulation. Afterwards these complexes are fragmented into smaller molecules due to Tikshna property which will help them to extricate (Vicchindanti) from the micro channels. Then, these liquified and fragmented molecules are lead articulately to Amasaya, flowing through “Anu Srotas” (Anu Pravana Bhava) without adhering to them. Where from stimulated by Udana Vayu and due to the Agni Vayu Mahabhautika constitution and Prabhava, they march in upward direction to expel the vitiated Dosha, brought along with them.[20]

Properties : Ushna, Tikshna, Sukshma, Vyavayi, Vikasi.

Sites : Hridaya, Amasaya

Channels : Dhamani

Stimulant : Udana Vayu

Constitution : Agni + Vayu

Prabhava : Urdhva Bhagahara

Physiology of vomiting

Vomiting is accompanied by a complex series of movements which are controlled by the vomiting center in medulla oblongata. The vomiting center is the final common pathway for the act of vomiting. It receives afferent impulses from:

  • Chemoreceptor trigger zone (CTZ).
  • Higher centers in the brain

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Mohini Rawat et al. Effect of Vamana Karma and Panchkola Phanta in Hypothyroidism
  • Peripheral structures including the GI tract and nucleus tracts.

A major sensory relay stationed in the afferent vomiting pathway is the CTZ (Chemo receptor trigger zone) situated in the lateral border of the area postrema of the medulla oblongata. Direct electrical or chemical stimulation of the vomiting center can evoke vomiting irrespective of the CTZ (Chemo receptor trigger zone). Vomiting due to irritation or over excitation of the upper GI tract does not involve the CTZ (Chemo receptor trigger zone). But it directly mediated by the vomiting center.

Similarly, it is likely that vomiting of central origin due to emotions, nauseous odours and other similar factors does not involve the CTZ but is due to impulses directly reaching the vomiting center.

Vomiting is usually preceded by the sensation of nausea and increased secretion of saliva, bronchial fluid and sweat. The muscles involved in the act of coughing take part in the act of vomiting and the vagal, vomiting and cough centers have a close functional relationship.[21]

Properties of Panchkola Drugs

SNDrug nameLatin nameRasaGunaViryaVipakKarmaChemical composition
1.Pippali[21]Piper longum Linn.KatuLaghu
Snigdha
Tikshna		AnushnashitaMadhuraVata-Kapha Shamaka
Vatanulomaka		Piperine,piplartine, Sesamin, Piplasterol
2.Pippalimula[22]Root of the Piper longum Linn.KatuLaghu
Tikkshna		UshnaKatuKaphashamaka
Agnideepaka		Piperine,
B- sitosterol
3.Chavya[23]Piper chabaKatuLaghuUshnaKatuAgnideepana
Kaphavatashamaka		Pelitorin, piperine, piplartine, B- sitosterol
4.Chitraka[24]Plumbago zeylanicaKatuLaghu
Ruksha		UshnaKatuKapha vataharaPlumbagin
5.Sunthi[25]Zinziber officinaleKatuGuru
Ruksha		UshnaMadhurKanthroghanSitosterone

Panchkola

Panchkola having Ushna, Tikshna, Laghu, Ruksha Guna, Katu Rasa, Katu Vipaka and Ushnavirya. It has Kaphavata Shamaka, Dipana, Pachana, Rochana, Lekhana, Srotovishodhana and Shothahara

properties. Panchkola is regarded as one of the most effective medications for the treatment of Mandagni.[20]

Conclusion

Unhealthy eating habits and lifestyle choices are the root causes of disease manifestation. Analyzing the disease's symptomatology in light of Ayurvedic fundamentals reveals that Kapha Dusti linked with Vata Dosha vitiation is the major event, along with Agnimandya. According to Ayurveda, Agni is the entity that causes all types of alterations in the body. Agnimandya is a precursor factor in all disorders that cause Ama development. The symptoms of Ama and Hypothyroidism are almost same. Vamana Karma is the most effective therapy for morbid and elevated Kapha. Vamana performs Srotoshodhana at the Dhatu level.

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14. Ashtanga Hridaya, Edited by Dr. Anna Moreshwar Kunte, Chaukhamba Subharti Prakasan, Varanasi, Reprint Edition, 2002 Sutrasthana, Dosopakramniya Adhyaya, 13/25. Page no. 216

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