THYROID DISORDERS


Author: M.MARKSIM KARKI




 

M.MARKSIM KARKI
 

 

Thyroid gland is a small butterfly shaped organ situated on the anterior side of the neck, lying against and around the Larynx and Trachea. 

Its size is last pinch of the thumb and its weight is 2-3 gm for neonates, 18-50 gm for adults and increased more in pregnancy.

It receives blood flow 5 times more than its own weight and starts to function from the third month of pregnancy.

The hormones secreted in thyroid gland are Triiodothyronine (T3), Thyroxine (T4) and Calcitonin.

These hormones regulate the rate of metabolism and affect the growth and rate of function of many other systems in the body.

Thyroid disorders include hyperthyroidism (abnormally increased activity), hypothyroidism (abnormally decreased activity) and may be thyroid cancers. 

All these disorders may give rise to goiter, which is the enlargement of thyroid gland.

 

 PHYSIOLOGY

 

 Production of T3 & T4

       

           Hypothalamus

                       

  TRH (Thyrotropin Releasing Hormone)

                          Pituitary Gland

                    

TSH (Thyroid Stimulating Hormone)

                          Thyroid Gland

 

         

                                 T3, T4

 

Thyroid gland is regulated by thyroid stimulating hormone (TSH) produced by the anterior pituitary, which itself is regulated by thyrotropin releasing hormone (TRH) produced by the hypothalamus.

Also Iodine is an important component needed to produce T3 and T4 which the body cannot produce Iodine by itself. We have to take this Iodine only through food.

The hormones T3 and T4 are structurally different but functionally same. In T3 one Iodine atom is less when compared to T4.

Thyroid hormone secreted from the gland is about 80 – 90% T4 and about 10 – 20% T3

Up to 80% of the T4 is converted to T3 by peripheral organs such as liver, kidney and spleen. T3 is several times more powerful than T4.

 

Functions of T3 and T4

 

Increases BMR (Basic Metabolic Rate).

Increases O2 utilization.

Increases Blood sugar level (acts opposite to Insulin) by converting the glycogen in to glucose.

Increases Protein formation.

Increases the Lipid.

Responsible for growth (physical and mental). 

Increases the activity of the heart, brain and kidney (in general the Nervous system).

 

CAUSES 

 

Iodine deficiency becomes one of the main reasons for thyroid disorders. Daily need of Iodine ranges from 150 micrograms / day for adults to 200 micrograms / day during pregnancy. However the thyroid needs no more than 70 micrograms / day to synthesize the requisite daily amount of T3 and T4.

Once the intake of Iodine goes below the required amount it leads to thyroid problems, in particular during pregnancy if the mother has lack of iodine it leads to improper growth of her child.

Hyperthyroidism, the overproduction of the T3 and T4 is mostly caused by the development of Grave’s disease, an autoimmune disease in which antibodies are produced which stimulates the thyroid to secrete excessive quantities of thyroid hormones.

Hypothyroidism may occur as a result of congenital thyroid abnormalities, autoimmune disorders or the removal of the thyroid following surgery to treat severe hyperthyroidism and/or thyroid cancers.

Any imbalance or disturbance in the chain of the production of T3 and T4 can be lead to hyperthyroidism.

Hypothalamus is the seat of emotions. So extreme stress and tension affects the production of thyroid hormones as it disturbs the hypothalamus.

Many individuals may find the presence of thyroid nodules in the neck. It does not mean that one has thyroid disease. 

Majority of these nodules are non cancerous and do not cause any symptoms. If the nodule is suspicious then surgery is recommended.

Cancers do occur in the thyroid gland and are more common in females. In most cases, the thyroid cancers presents as a painless mass in the neck. It is very unusual for the thyroid cancers to present with symptoms.

 

SYMPTOMS

 

Hyperthyroidism

 

Increased BMR. 

Increased appetite but loss of weight.

Increased Heart rate (palpitations).

Excess sweating. Moist skin. 

Diarrhea (for unknown cause).

Frequent and short menstrual cycle. Also to some extent is lack of menstruation.

Restlessness (Physical & Mental) which leads to irritability and violence.

Intolerant to heat.

Protruding eyes and also may have double vision.

 

Hypothyroidism

 

All the symptoms seems in hyperthyroidism is reverse in hypothyroidism.

Decreased BMR and Heart rate (Bradycardia).

Abnormal weight gain.

The person suffers from constipation.

Irregular menstruation. The ovum production is stopped or sometimes menses without ovum.

Mentally depressed, lethargy, slowness in everything.

Urine output is reduced as the kidney function is affected.

The skin is dry with no perspiration (sweating).

The person is cold intolerance. 

The body reflexes are slows down as the functions of nervous system slows down. 

 

TREATMENT & ITS LIMITATIONS

 

Beta-blockers are used to decrease symptoms of hyperthyroidism such as heart palpitations, anxiety, tremors and anti-thyroid drugs are used to decrease the production of thyroid hormones.

These medications take several months to take full effect and have side effects such as skin rash or a drop in white blood cell (WBC) count, which decrease the ability of the body to fight off infections.

Due to the side-effects and inconvenience of such drug regimens, some patients choose to undergo radioactive iodine-131 treatment.

Hyperthyroidism as well as thyroid tumors may be treated with radioactive iodine-131, which is administered in order to destroy a proportion of, or the entire thyroid gland which causes hypothyroidism.

Hypothyroidism is the underproduction of T3 and T4, treated with hormone replacement therapy, such as levothyroxine, which is typically required for the rest of the patient’s life.

Thyroid cancer may require surgery include thyroidectomy, lobectomy and tracheostomy. Sometimes even the removal of the thyroid itself.

If the thyroid gland is removed, care must be taken to avoid damage to the adjacent structures, the parathyroid glands and the recurrent laryngeal nerve. 

Accidental laceration of either of the two or both recurrent laryngeal nerves may cause paralysis of the vocal cords and their associated muscles, changing the voice quality.

 

YOGA TREATMENT

 

BENEFITS

 

Yoga treatment has no side effects comparing with modern medicine if properly followed.

The practices for hypothyroidism and hyperthyroidism are same as because yogic treatment works on pranic body and always balances the imbalance in our body system.

Hence over production or under production of thyroid hormones are regulated. No worry about getting hypothyroidism by treating hyperthyroidism.

No steroids or no medications in any form.

The practices given to thyroid problems will be helpful to regulate all the other body systems as well.

Yoga acts directly on the charkas and energy system of the body, realigning the endocrine / chakra system so that the energy potential of the body is maximized.

Also yoga treats the root of the diseases (mind) and not only on the symptoms of the body. Hence the benefits of the practice is long lasting. 

 

DIFFERENT YOGA TECHNIQUES

 

Asanas :

 

Sarvangasana, Halasana, Hala Ugrasana, Matsyasana 

Kandha sanchalana (Neck movements),

Bhujangasana, Dhanurasana, Paschimottasana, Ushtrasana

Ardha Matsyendrasana, Shirshasana, Simhasana, Supta vajrasana

Trikonasana, Veerasana, Shavasana 

 

Sarvangasana is the best practice for thyroid disorders. As the thyroid has one of the largest blood supplies of any body organ this pressure has dramatic effects on its function, improving circulation and squeezing out stagnant secretions.

Halsana is another pose which has tremendous effect of this gland.

Matsyasana, Bhujangasana, Ushtrasana and other back bending poses are stretching the thyroid to its maximum, which gives opposite stretch to sarvangasana. This counter stretch also highly stimulates this gland.

Shirsasana stimulates the pituitary and hypothalamus, which helps to produce TRH & TSH. 

 

Pranayama :

 

            Ujjayi Pranayama with kumbhak for both types (10 min).

 

 For Hypothyroidism :

Suryabhedan pranayama with kumbhak (10 min).

Bhastrika Pranayama with kumnhak (10 min).

For Hyperthyroidism :

Sheetali pranayama with kumbhak (10 min).

Shitkari pranayama with kumbhak (10 min).

 

Ujjayi Pranayama is the best for thyroid problems as it stimulates the Vishuddhi chakra which corresponds to thyroid gland, which is concerned with purification and the harmonizing of all opposites.

Suryabhedana and Bhastrika stimulates the sympathetic nervous system to increase the thyroid hormones (for hypothyroidism) where as Sheetali and Sheetkari stimulates the parasympathetic nervous system to regulates the over production of thyroid hormones (for hyperthyroidism).

 

Mudras & Bandhas :

 

Viparita Karani mudra, Simha mudra, yoga mudra.

Jalandhara bandha, Uddiyana bandha.

 

Jalandhara bandha has almost same effect as like sarvangasana as it squeezes the thyroid gland and stimulates the function of Vishuddhi chakra.

Ujjayi pranayama along with jalandhara bandha increases the pranic flow towards throat region. Viparita karani mudra gives the reversible blood flow which is good for thyroid and pituitary as well.

 

Cleansing Techniques :

 

Vaman dhouthi (once a week).

Kapalabhati (120 strokes / round x 5 rounds).

Agnisar (100 strokes in 3 to 4 rounds).

Laghoo Shankhaprakshalana (once a week), Full Shankaprakshalana (once a year).

 

 

 

Omkar Chanting & Yoga Nidra :

 

Chanting of Omkar is one of the best effective treatments for thyroid problems. The vibration from the vocal cards affects the thyroid directly and regulates and stimulates its function.

Regular omkar chanting for 15 – 30 minutes gives a good progress. Also listening to Omkar chanting throughout night is very effective. This vibration throughout the head also stimulates pituitary and hypothalamus to function effectively.

Yoga nidra helps to relieve the stress and tension from the mind, which is the root cause of thyroid disorders. Once a day is recommended.

 

CONTRA INDICATIONS :

 

There are no specific contra indications for thyroid problems except the pranayama. 

For hypothyroidism stimulating pranayama (surya bhedana & Bhastrika) should be given and for hyperthyroidism cooling and soothing pranayama (Sheetali or Sheetkari with Bhramari) should be given.

 

A GENERAL PROGRAM FOR THE PATIENT :

 

 

 S.NO.

                   ASANA / YOGA TECHNIQUE

DURATION                           (MIN)

 1

Omkar Chanting

 5

 2

Basic Movements  (Arm, leg, knee)

 5

 3

Preparatory movements (shoulder, elbows, wrist, waist)

 5

 4

Kantha sanchalana type 1,2 (neck movements with slow speed)

 3

 5

Ashtang Dhant (2 rounds with slow speed)

 4

 6

Shavasana

 2

 7

Bhujangasana

 1

 8

Dhanurasana

 1

 9

Viparita Karani (As a preparation)

 2

 10

Shavasana

 2

 11

Sarvangasana (Shoulderstand)

 4

 12

Halasana (Plough)

 1

 13

Matsyasana (Fish)

 1

 14

Shavasana

 2

 15

Paschimottasana

 1

 16

Ushtrasana (Camel)

 1

 17

Ardhamatsyendrasana 

 3

 18

Trikonasana

2

 19

Veerasana

1

 20

Shavasana

4

 21

Agnisar (100 strokes in 3 – 4 rounds)

4

 22

Kapalabhati (120 strokes x 3-5 rounds)

5

 23

Ujjayi pranayama with kumbhak (jalandhara bandha)

10

 24

Sheetali (Inhale) + Bhramari (Exhale) OR Bhastrika pranayama with Kumbhak 

8

 25

Sheetkari (Inhale) + Bhramari (Exhale) OR Suryabhedana pranayama with kumbhak

8

 26

Prayer

5

 

 

 

 

Total 

90 min

 

DIET AND LIFESTYLE :

 

The intake of iodine is important but still under limit as over intake of iodine also affects the thyroid gland.

Normal food with less fats and carbohydrates but with high fibres.

Best food is fruits (except banana, mango & grapes) & vegetables.

Avoid Non-Veg food, milk & milk products (skimmed milk can be taken).

Avoid Oily & Spicy food, refined foods, Fast food and Preserved food.

Practice yoga regularly as a part of the daily routine.

Long term suppression and blockage of emotional expression is one of the prominent precipitating factors in states of thyroid imbalance.

Balancing the emotions, and giving a suitable outlet for their expression is an important part of yoga therapy for thyroid diseases.

Kirtan (singing of mantras collectively to the point of self forgetfulness and transcendence) is the best and ajapa japa meditaion in conjunction with ujjayi pranayama are effective technique.

 

CONCLUSION :

 

Health is the God’s gift to each and everyone. Using the intellect we have to maintain it properly till the end of our life.

One should understand the basic mechanism of body and mind in order to keep it effectively and peacefully. 

Also understanding the connection between body and mind, role of prana, interconnection of chakra and endocrine system helps to lead a successful happy life.

“Health is Wealth. Peace of mind is happiness, Yoga shows the way”.

 

 

The views expressed are solely those of the author. Yogapoint.com may or may not agree with all statements.