INTRODUCTION:

In the ancient science of Ayurveda, Agni is the one of the most important concept. Acharyas explained Mandagani as the cause of all disease conditions ^[1]. Balanced Agni in body leads to long and healthy life and imbalanced Agni results to (Rogavastha) state of disease in human^.[2].There are various causes at various level of Agni (Jatharagni, Bhutagni and Dhtvagni) leading to Mandagani. This reduced digestive fire (Mandagani) leads to Ama formation i.e. incompletely digested food, Ama leads to state of Sthrotodusthi and ultimately formation of disease in body ^[3].

Ama is a pathological qualitative change in a substance during the process of paka may be at Jatharagni, Bhutagni or Dhtvagni level. So during the digestion process if a food substance attain certain pathological qualities without attaining finality, such substance is called as Ama ^[4].Pratyatmakaguna of Ama are – Drava, Guru, Snigdha, Piscilata, Tantum, Avipakam, Asamyuktam, Durgandhyam Abhisyandi, Srotoavarodha, Katu – Amala rasa, Sukatata^[5]

The factors causing Mandagnii.e.Disturbance of Agni can be classified into two types:

1.     Direct Factors: causing direct influence on Agni. E.g.Ansana, Adhyasana, Ajirna ahara, Virudhahara, Apkwa, Vidgdha Ahara etc.

2.     Indirect factors: Have no direct influence on Agnie.g. any disorder leading to Agni Mandya at various stages, Stress, All causes which firstly triggers the Dosha and than Agni.

Hashimoto’s Thyroid disease is an autoimmune condition in which body’s immune cells mistakenly attacks the healthy cells of thyroid gland and gradually failure of thyroid gland. At early stages anti thyroid antibodies are present in body but symptoms may not appear, over the time patient starts experiencing symptoms such as fatigue, weight gain, constipation, hair loss etc along with increased level of Thyroid Stimulating Hormone (TSH). If the level of TSH are 10uIU/ml or less than 10uIU/ml(but above normal range i.e. 5uIU/ml) and peripheral T₃ and T₄ level within normal range, it is called subclinical hypothyroid mean patients thyroid gland is underperforming and producing less hormone, but body is managing to keep T₃ and T₄ levels normal by increasing TSH by pituitary gland.

If patient remain untreated and undiagnosed at this stage, the condition results in overt hypothyroidism i.e. clinical hypothyroidism with elevated TSH levels and low T₄. At this stage thyroid gland is unable to secret enough T₃ and T₄ even by increasing TSH levels by pituitary gland, ultimately leads to very high TSH levels and decreased T₃ and T₄ levels in body. In Ayurveda there is no direct description of hypothyroid or autoimmune disease (Hashimoto’s Thyroiditis). But its symptoms have very close resemblance with symptoms of Amaand Strotodusti such as Gaurav, Shathilya, Avipaka, Avasada, Tandrai.Rasavaha Stroto Dusti Lakshana – loss of appetite, sluggishness, dry hair and skin, anemia and constipation. MedovahaStroto Dusti Lakshana – Abnormal weight gain, tiredness etc. Acharya Charka explained that one should not ashamed if name can’t be given to a pathological condition; instead he should focus on Dosha and Lakshana and treat accordingly.^[6][7]

On the basis ofDosha, Samuthan, Sansthana etc disease can be countless.

In Charak Samhita^[8]Virudha dusta asuchi bhojana is told to be one of the cause of Manovahastrotodusti and Unmda indicating relation of food and mental issue. Also in Charaka Vimana Sthana ch.5/13 explains ‘Chintyanam Atichintanaat’^[9] as cause of Rasavaha Strotodusti.The one who follow the Pathya Aahar Vihar remains disease free so there is no need of taking medicine and diseased one who doesn’t follow Pathya also does not need medicine as it will not be fruitful.

Nadishodhana Pranayama causes Agnideepana and Krishta karaka effect on body, it calms the mind and improve gut functioning.^[10]Markatasana and Bhujangasana also elevate the Agni and improve digestion system thus all these Asana could improve outcome of thyroid management. ^[11]

Some studies in modern science also emphasis upon role of gut in autoimmunity, gut – immunity – brain axis.

Modified food patterns and compositions (e.g. sugary, fried fatty foods) results in

Inflammation of gut lining

+

Change in gut micro biome

                                                                          Causes

Both luminal nutrients and micro biome metabolite stimulate enteroendocrine cells located throughout GI tract, which represent large endocrine organ in body. ^[13]

Gut micro biota determine what the host is capable of extracting from diet and nutrients to bioactive signaling molecule that influence brain function and host behavior. ^[14]

NEED OF STUDY:

Autoimmunity is the case of hypothyroidism in 90% adult hypothyroidism. ^[15] 3-8% percent population has subclinical hypothyroidism out of which 80% are autoimmune positive ^[16].

Presently there is no cure for autoimmune thyroid disease. In Ayurveda various researches has done on role of Yoga in stress management, hormonal balance and digestion improvement .As stress and Agnimandya has a huge role in onset of Autoimmune thyroid condition, early Ayurvedic intervention by Yoga and Pathya Aahara could be helpful in Hashimoto’s thyroiditis patients.

1.     Progression of disease can be stopped at early stage.

2.     Complications such as complete thyroid failure, CA thyroid etc can be prevented.

3.     Future development of another autoimmune disease can be prevented such as celiac disease, vitiligo, multiple sclerosis and SLE etc.