Hypothyroidism in association with obesity, the most common endocrine disorder among females in urban areas. The objective is to find out the effect of yoga intervention on hypothyroidism linked with obesity among working women leading sedentary lifestyles in urban areas. Further to assess the recovery through yoga practice in addition to diet follow up treated as safe, very low cost, natural therapy. A total of 150 obese women had a history of hypothyroidism within the age group 30-50 years located in eastern parts of West Bengal were enrolled for this study from June,17 to January, 18. A qualitative study by a purposive sampling method was used applying BMI as the main parameter along with questionnaires & thyroid function tests, blood tests as secondary data. The study revealed initially that there was no such deficiency of nutrients like Iodine even though elevated TSH & normal or low T4 among the subjects. The study concluded that diet in conjunction with yoga intervention resulted in significant improvement to all subjects at no cost. Moreover, yoga intervention was the safest choice for all of them in this study and that not only for physical health but also mental wellbeing.

1. ACADEMIC WRITING :
UGC19_GE03
Application No : 6e21baf8ec6211e9a6ff4b01d7402434
Name: Swapan Banerjee
Affiliation: Seacom Skills University, Birbhum, West
Bengal, Pin code -731 236
Date : 30-10-2019 CC BY-SA-NC

2. Topic
Study on yoga intervention along with diet on
hypothyroidism associated with obesity among
sedentary working women in West Bengal
Date : 30-10-2019 CC BY-SA-NC

3. Introduction
Obesity & Thyroid Hormones Imbalance
 The improper functioning of thyroid gland causes the imbalance of thyroid hormones
T3 & T4 in response to Thyroid Stimulating Hormone (TSH).
 In the system, the hypothalamus in the brain releases Thyrotropin-releasing hormone
(TRH) which stimulates the pituitary gland to release TSH. This hormone is
responsible to stimulate the thyroid gland to produce T3 & T4.
 Further, Iodine deficiency is another major cause of primary hypothyroidism.
Date : 30-10-2019 CC BY-SA-NC

4. Overweight & Obesity – The major cause of HT !!
 The association between body weight change (role of leptin) and TSH concentration may be driven by other
disturbances in the hypothalamic-pituitary-thyroid axis (Kumar et al.2008).
 Obese people even with a normal thyroid gland are more prone to HT due to activation of HPT Axis which
catalyzes the release of higher serum TSH and less thyroid hormones in serum. (Peter et al.2012).
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Source :World Health Organisation

5. The worldwide prevalence of obesity nearly tripled between 1975 and 2016.
About 13% of the world’s adult population out of which 11% of men and 15% of women were
obese in 2016 . (Source :WHO).
In India, scenario is given below – As per National Family Health Survey ( NFHS) :
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6. Prevalence of thyroid disorders in eight urban cities of India
Indian J Endocrinol Metab. 2013
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7. Research Problem
Hypothyroidism
One of the most common & concerned endocrine disorder now a days almost at every family !
 As per recent study in Kolkata, 21% persons were diagnosed with Hypothyroidism and
among them majority were women. (IJEM -2013).
 In the city, due to imbalanced diet & sedentary lifestyles middle-aged working women
are very much prone to obesity which often linked with so many diseases including
hypothyroidism.
 In fact, so far there is scanty research & insufficient data, but the day has come to start
thinking about preventive measures through diet in addition to Yoga.
 Date : 30-10-2019 CC BY-SA-NC

8. Objective of the Study
• The objective is to find out the effect of yoga intervention on
hypothyroidism linked with obesity among working women
leading sedentary lifestyles in urban areas.
• Further to assess the recovery through yoga practice in addition to
diet follow up treated as safe, very low cost, natural therapy.
Date : 30-10-2019 CC BY-SA-NC

9. Materials & Methods
 Study Design :A qualitative study with purposive sampling method was conducted based
on all the participants visited 4 times at diet clinic/camps with the common complaint
obesity along with HT & one or two comorbidities
 Study Duration : From June 2017 to January 2018 – total eight months.
 Study Setting : Considered Kolkata and peripheral districts.
 Subjects :Total 150 obese, hypothyroid female who attended the Diet Clinic (paid) &
diet camps (free) and later at Yoga camp.
 Inclusion Criteria :
 All overweight/ Obese based on BMI (Asian values) & Hypothyroidism -SCH, Mild,
Moderate stages.
 All undergone TSH, T4 tests compulsorily by Electro Chemi Luminescence Immuno
Assay method.
 Exclusion Criteria :
X Not severe HT, Pregnant women, Transferable Jobs. CC BY-SA-NC

10. Tools & Techniques
Data Collection : Collected primary data from the participants through diet consultations by
filling out the questionnaires & secondary data from laboratories.
Data collection through the semi-structured questionnaires based on : (Primary Data)
 Socio-demographic data
 Food-frequency
 Cooking habits
 Diet follow up or Dietary habits
 Body Mass Index
 Yoga or other exercises or activities
[Height in cm. & weight in kg. was directly taken on the spot during 1st consultation to calculate BMI dividing
weight (kg) by height (m2)]. BMI ≥ 23.0 was considered overweight as well as obese ≥25 in Asian
population. CC BY-SA-NC

11. Tools & Techniques
Laboratories tests reports collection: ( secondary data )
 TSH, T4
 As per physician/ endocrinologist’s prescription, Levothyroxine 25mcg-100mcg tablet
were considered for common treatment protocol based on Thyroid peroxidase
antibody (TPO ab).
 TPO ab < 60 U/ML was considered normal ( Reference : American Thyroid Association) mostly following
by all leading testing/diagnostic centers in Kolkata.
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12. Statistical Methods
The statistical analysis performed by SPSS version -16 as a tool.
The following tests were used :
1) Paired- samples T-test
2) Bivariate Correlations ( Pearson correlation coefficients ).
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13. (1st - phase) – Levothyroxine + Dietary Intervention
 First four months with 25-100mcg levothyroxine, a commonly recommended
medicine by physician/endocrinologist.
 Apart from that, all subjects were recommended average 1400-1600 kcal/day diet
plan with 50%-55% carbohydrate , 20% or per kg. body weight protein & 20%
visible fat & rest 5% other micro nutrients through more vegetables & fruits.
 The same diet plan was continued till the end of the first phase based on two visits
at every 2-month interval.
 BMR (Calorie) as per Harris-Benedict formula.
All subjects were under observation in terms of diet & medication since the date of start
of the study. CC BY-SA-NC

14. (2nd - phase) – Yoga Practice + Dietary Intervention
 2nd four months phase was performed without
Levothyroxine………. AND……
 Started yoga practice for average 30-45 minutes per day preferably in
the early morning in continuation with same weight loss diet plan at
participant’s own home/nearby place.
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15. Yoga Practise
1.Mountain pose(Tadasana);2.Modified sun salutation (Surya namaskara)
3.Core exercises (Navasana);4.Half shoulder stand (Ardha Sarvangasana)
5.Bridge pose (Setu bandhasana) ; 6.Fish (Matsyasana).
7.(Half) seated forward bend (Pascimottanasana);8.Cobra (Bhujangasana)
9.(Half) locust (Salabhasana) ;10.Cat (Marjaryasana)
11.Downward dog (Adho mukha svanasana);12. Child pose (Garbhasana)
13.Spinal twist pose (Ardha matsyendrasana);14.Tree (Vrksasana)
15.Warrior II (VirabhadrasanaII);16.Standing forward bend (Pada
hastasana). [1,11]
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16. 1st - Phase Graphical Presentation
Fig.1 - Weight status Fig.-2 – Hypothyroid Types CC BY-SA-NC

17. 2nd - Phase Graphical Presentation
Fig.1 - Weight status Fig.-2 – Hypothyroid Types -CC BY-SA-NC

18. Weight Status Vs Hypothyroidism states Vs 3 types Practices

19. Post Yoga Intervention – Observation
Table : -1. Weight Status
Weight States
Frequency Percent Valid Percent
Cumulative
Percent
Over Weight 4 2.7 2.7 2.7
Pre-Obese 69 46.0 46.0
48.7
Obese-Class-1 77 51.3 51.3
100.0
Total 150 100.0 100.0
Table -2 : Hypothyroid Type
Hypothyroidism States
Frequency Percent Valid Percent
Cumulative
Percent
Subclinical Hypothyroidism 80 53.3 53.3 53.3
Mild Hypothyroidism 62 41.3 41.3 94.7
Moderate Hypothyroidism 8 5.3 5.3 100.0
Total 150 100.0 100.0

20. Practice - Diet Vs Yoga or Combined
Table-3. Various Practices Frequency
Percent Valid Percent
Cumulative
Percent
Only Diet 27 18.0 18.0 18.0
Diet + Yoga Practice 78 52.0 52.0 70.0
Only Yoga 45 30.0 30.0 100.0
Total 150 100.0 100.0
Table – 4: Correlations – Variables of the study
Weight Status Hypothyroid Type Practice BMI TSHWeight Status Pearson Correlation
1
.427** .093 .808** .394**
Sig. (2-tailed) .000 .258 .000 .000
Hypothyroid Type Pearson Correlation .427** 1 -.039 .406** .786**
Sig. (2-tailed) .000 .639 .000 .000
Practice Pearson Correlation .093 -.039 1 .045 .199*
Sig. (2-tailed) .258 .639 .585 .014
BMI Pearson Correlation .808** .406** .045 1 .376**
Sig. (2-tailed) .000 .000 .585 .000
TSH Pearson Correlation .394** .786** .199* .376** 1
Sig. (2-tailed) .000 .000 .014 .000

21. Key Findings
 The statistical analysis showed that there were significate
relations with all the variables like obesity with TSH & BMI.
There was a negative correlation with Practice to Hypothyroid
Types which meant that if ‘practice’ increased the chance of
‘hypothyroidism’ decreased at its state ( Moderate to subclinical
conversions happened).
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22. Conclusion & Recommendation
 In general, participants were depending upon only Levothyroxine (as
western medicine protocol) for hypothyroidism, but post yoga
intervention, all were motivated to start practicing yoga around 45
minutes everyday & continuing the same.
 Diet in conjunction with yoga intervention resulted in significant
improvement quickly to all participants at no cost for both obesity & HT.
Finally, yoga practice is always recommended as it is the safest & cheapest
choice for all of us not only for physical health but also mental wellbeing.
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23. Acknowledgment
I would like to acknowledge Academic Writing Team for this ‘Academic
Writing’ course with value-added study materials & all time supports.
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24. References
• Pajai, M. S., & Pajai, S. V. (2014). Journal of Pharmaceutical and Scientific Innovation Review Article, 3(2), 111–113.
• Sciences, Y. (2017). Effect of Yogic Practices on Liver Function Parameters, 6(November).
• Devi, S., & Shrivastava, V. (n.d.). Effect of Yogic and Ayurvedic intervention on Hypertensive patients, 2, 114–118.
• Manna I. (2018). Effects of Yoga Training on Body Composition and Oxidant-Antioxidant Status among Healthy Male.
International journal of yoga, 11(2), 105-110.
• Sanyal, D., & Raychaudhuri, M. (2016). Hypothyroidism and obesity: An intriguing link. Indian Journal of
Endocrinology and Metabolism, 20(4), 554.
• Biondi, B. (2010). Thyroid and obesity: An intriguing relationship. Journal of Clinical Endocrinology and Metabolism,
95(8), 3614–3617. https://doi.org/10.1210/jc.2010-1245
• Ankad RB, Herur A, Patil S, Shashikala G V, Chinagudi S.(2011). Effect of short-term pranayama and meditation on
cardiovascular functions in healthy individuals. Heart Views, 12:58-62
• Galgani, J., & Ravussin, E. (2009). Energy metabolism, fuel selection, and body weight regulation. International Journal
Of Obesity, 32, S109.
• Unnikrishnan, A. G., & Menon, U. V. (2011). Thyroid disorders in India: An epidemiological perspective. Indian Journal
of Endocrinology and Metabolism, 15(Suppl2), S78–S81.
• Prasad, G., & Bhardwaj, I. (2018). Effect of Comprehensive Yogic Practices on General Well Being of Urban
Population, 2018(June), 40–44.
• Anandhasayanam A, Arivudainambi T, Kannan S and Udaya Chander JSJ: Prevalence of Hypothyroidism and Its Co-
Morbidities In Relation To the Causes and Risk Factors in Patients Undergoing Levothyroxine Therapy. Int J Pharm Sci
Res 2016; 7(3): 1251-57. CC BY-SA-NC

25. Further Readings
• Sharma R, Bharti S, Kumar KH. Diet and thyroid - myths and facts. J Med Nutr Nutraceut 2014;3:60-5.
• The Autoimmune Solution: Prevent and Reverse the Full Spectrum of Inflammatory Symptoms and
Diseases Paperback – May 2, 2017, by Amy Myers M.D. (Author).
• https://www.mayoclinic.org/diseases-conditions/hypothyroidism/symptoms-causes/syc-20350284.
• https://www.elsevier.com/health/medicine/journals/nutrition-and-diabetes
• https://www.intechopen.com/books/thyroid-and-parathyroid-diseases-new-insights
• https://www.elsevier.com/books/comprehensive-handbook-of-iodine/preedy/978-0-12-374135-6
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26. Date : 30-10-20 CC BY-SA-NC