1.
DEPARTMENT
OF PRASUTI
TANTRA EVAM
STREE ROGA
welcomes
you
all

2.
ROLE OF THYROID GLAND
IN REPRODUCTIVE
PHYSIOLOGY
Guide By
Dr.Gayathri Bhat NV Dr.Pooja Lekshmy P
HOD ,Dept. Of PTSR 1st Year PG Scholar
Dept Of PTSR

3.
Contents
Introduction
Anatomy
Physiology
Systemic action
Thyroid disorders
Ayurvedic aspect
Preventition
Critical analysis
3
Conclusion

4.
INTRODUCTION
 Endocrine system - second key regulator of organ
systems
Thyroid gland – one of the largest endocrine gland
metabolism
 growth
development.
 Well functioning TG - pivotal for a healthy body & to
conceive a healthy child.
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5.
5
ANATOMY

6.
Thyroid means “oblong
sheild.”
Brownish-red, butterfly
shaped structure - front of
the neck .
justinferior to larynx
from C5 to T1
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7.
Weight 25 gm./1 ounce
Each lobe - 5 x 3 x 2cm
Isthmus – 1.25cm x 1.25 cm x 1.25 cm.
Slightly heavier in females enlarging during
menstruation and pregnancy.
 Highly vascular receiving 80-120ml of
bloodmin.
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8.
Microscopic anatomy
includes thyroid follicles -spherical.
0.02 to 0.9mm in diameter.
 with a central colloid core surrounded by a
simple epithelium and basal lamina.
Colloid -thyroglobulin.
Parafollicular cells /“C”cells.
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9.
THYROID HORMONES
Thyroid gland – large storage capacity , store
thyroid hormone for 2 to 3 months.
Thyroid hormone include
1. 93% Thyroxine (t4) - 10-25pmol/ltr (normal)
2. 7 % Triiodothyronine(t3) - 1.1-2.3nmol/ltr
3. Thyrocalcitonin – parafollicular cells
 Normal value - TSH - 0.45 -5.5mmol/ltr
T3 is about 4 times as potent as T4.
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10.
P P
H H
Y Y
S S
I I
O O
L L
O O
G G
10
Y Y

11.
11

12.
Control of Thyroid hormone
Secretion
 Pic …
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13.
SYSTEMIC ACTIONS
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14.
Action of thyroid
hormones
•Cells Metabolic activity
•CVS Cardiac output
•RS Respiratory rate
•GIT GI motility
•CNS Excitability of nerves
•CARBOHYDRATE METABOLISM
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•FAT METABOLISM

15.
EFFECT ON REPRODUCTIVE
SYSTEM
Females Males
T3 induced modulation TH receptors in Sertoli cells
Estrogen metabolism Male reproductive tract
Sexual maturation development
Menstrual function Maturation of testes (in
Ovulation & Fertility pre-natal and post-natal)
Develop full term infants Maturation of sperm
Stimulates production of
SHBG
(based on research work by National Institute of Environmental
15
Health Science by US Govt)

16.
T3
T4
TB
G
16

17.
17

18.
T
H
Y
1ST DEPENDS ON MOTHER
F
TRIMISTER
R
O
O
I 8-10 Pituitary thyroid system
D WEEKS dev E
P
12-14
T
H Iodine Con.,TSH Secr.
Y WEEKS U
S
I
O
20-28
TSH S
WEEKS
L
O
G
Till
Y
18
term
T4 T3 remains Low

19.
19

20.
THYROID DISORDERS
20

21.
THYROID DISORDERS
Thyroid abnormalities – autoimmune, 10 times
more common in women than men.
Antigens Antibody
 Thyroglobulin(Tg)  Antithyroglobulin(anti-tg)
 Thyroid  Antimicrosomal thyroid
peroxidase(TPO) peroxidase (anti-TPO)
 TSH receptor(TSHR)  Anti-tsh receptor(anti-tshr)
 Na /I symporter(NIS)  Anti-na/I symporter(anti –
21 NIS)

22.
Classification of thyroid disorders
Mainly into two divisions
Hyperthyroidism
Hypothyroidism
22

23.
HYPERTHYROIDISM
23

24.
Anti TSH-r H
Y
Present P
E
TSH R
T
T3&T4 H
Y
R
O
Triad of I
Symptoms D
I
S
M
HYPERTHYROIDIS
24 M

25.
CLASSICAL SYMPTOMS
Hoarseness or Persistent
Deepening of Voice Sore or Dry Throat
Nervousness
Swelling Irritability
(Goiter) Difficulty
Sleeping
Difficulty
Swallowing
Rapid or Irregular
Frequent Heartbeat
Bowel
Movements
(diarrhoea)
First-Trimester
Increased Miscarriage
Sweating
Unexplained Excessive Vomiting in
Warm, Moist Palms Weight Loss Pregnancy
Fine tremors
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26.
Effect of Hyperthyroidism in Reproductive system
FEMALES MALES
Increased mean Increased estrogen
plasma estrogen level.&LH
production.
level .
Increased level of SHBG. Defective
Increased incidence of spermatogenesis.
oligomenorrhea Low sperm count with
amenorrhea & anovulation. sperm motility defect.
.
26

27.
May cause early onset of menopause
Symptoms – lack of
menstruation, hot flushes,
insomnia, mood swings –
mistaken for menopausal
symptoms.
Treatment of hyperthyroidism –
alleviate symptoms of ,or the
actual onset of early
menopause.
27

28.
COMPLICATIONS IN PREGNANCY
 Mild maternal tachycardia
 heart murmur with irregular heart-beat.
 Unexplained weight loss or failure to have normal
pregnancy weight gain.
 Spontaneous abortion.
 Pregnancy-induced hypertension.
 Pre term delivery.
 Anaemia.
 Higher susceptibility to infections.
 Placental abruption.
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 Post partum thyroid dysfunction.

29.
Transient hyperthyroidism in pregnancy
Thyroid activity increase in
conditions of
Molar pregnancy.
When hyperemesis gravidorum is
associated with high level of hCG
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30.
EFFECT ON FOETUS
Intra uterine growth retardation.(IUGR)
Low birth weight.
Intrauterine foetal death.
Still birth.
Prematurity.
Skeletal developmental abnormalities.
Foetal-neonatal hyperthyroidism.(plancental transfer
of anti TSH- R).
Overtreatment with antithyroid drugs-foetal
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goiter.

31.
TREATMENT OF
HYPERTHYROIDISM
Antithyroid drugs:
Methimazole : 10 -20 mg daily, once it is
controlled -5 -10 mg daily.
Propanol : 20-40 mg every 12 hr orally.
Surgical removal .
.
31

32.
HYPOTHYROIDISM
32

33.
HYPOTHYROIDISM ELEVATED SERUM LEVEL
OF TSH, LOWT3- T4
VALUE
Swelling (Goiter)
Difficulty Swallowing
Irritability Forgetfulness/
Persistent Dry or
Sore Throat Slower Thinking
Hoarseness/ Depression
Deepening of Voice Inability to Concentrate
Constipation
Slower Heartbeat
Dry, Patchy Skin
Menstrual Irregularities/
Heavy Period
Cold Intolerance Infertility
Elevated Cholesterol Decreased libido
33 Muscle Weakness or Cramps
Thinning Hair or Hair Tiredness
Loss Weight Gain

34.
Myxedema –bagginess under
eye and swelling of face.
Atherosclerosis
Slow and husky voice.
34

35.
EFFECT ON REPRODUCTIVE
SYSTEM
Delay in onset of puberty with
anovulatory cycle.
Increased prolactin Level; GnRH
reduced
Diminished libido .
Recurrent miscarriage
Amenorrhea, oligomenorrhea,
galactorrhea – due to high prolactin
level
Incidence of infertility and PCOD
Testicular atrophy in men
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36.
Effects on pregnancy
 High risk of pre-eclampsia ,often lead to premature
delivery .
 Muscle cramps,constipation
 Still birth ,low birth weight.
 Placental abruption & PPH.
 Associated with hypertension,type 1
diabetes,anaemia.
 Increased risk of spontaneous abortion.
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37.
EFFECT ON FOETUS
 Congenital abnormalities.
Delay in sexual maturity.
 Lower IQ in infants of every mild hypothyroid
women.
 CHILDREN: CRETINISM:
Congenital Hypothyroidism
Dwarfism
Mentally Subnormal: MR
Enlarged, Protruding tongue
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Pot bellies.

38.
TREATMENT OF HYPOTHYROIDISM.
ELTROXINE
L- THYROXINE – to be given.
Brand name - Eltroxin
During pregnancy regular check up btw
every 4 week .
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39.
INVESTIGATIONS
THYROID FUNCTION TEST
Level of TSH, T3,T4 in blood sample.
Thyroid scan
FNAC
MISCELLANEOUS TEST
 include serum cholesterol ,serum creatine
etc
39

40.
INCIDENCE RATE.
42 million people in India – TD
Hypothyroidism –
congenital 1 out of 2640 children in India
1 out of 3800 children in World
Adult- 3.9%
Hyperthyroid
Adult -1.6%
40

41.
Ayurvedic Perceptive
The “Hidden” Health Problem

42.
Thyroid gland - AuÉOÒû
LMüÅuÉOÒû (cÉ.zÉ.7/11)
The goiter is termed as “galaganda”
xuÉÃmÉqÉç
ÌlÉoÉlkÉÈ µÉrÉjÉÑrÉïxrÉ
qÉÑwMüuÉiÉç sÉqoÉiÉå aÉsÉå ||
(xÉÑ.ÌlÉ11/29)
 ...
Prakupita kapha – situated at galabahya –
shotha (
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43.
Vataja - iÉÉåSÇ,M×üwhÉÍxÉUÉ AuÉlÉ®Ç
TYPES (xÉÑ.ÌlÉ11/23)
M×üwhÉÉÂhÉuÉhÉïÇ
AÌiÉÎxlÉakÉiÉUÇ(qÉåSÉåÎluÉiÉÇ),AÉxr
ÉuÉæUxrÉÇ .
Kaphaja -ÍcÉUÉiÉç mÉÉMÇü, qÉlS ÂeÉÇ,
EaÉëMühQÒû, qÉkÉÑUÉxrÉiuÉÇ.
Medojam -SåWûÉlÉÑÃmÉ
¤ÉrÉuÉ×ήrÉÑ£Çü lÉÏÂMçü,
AÌiÉMühQÒû
lÉ ÌmɨÉålÉ xuÉpÉÉuÉålÉ ÌmɨÉeÉxrÉ
43
aÉsÉaÉhQûxrÉ ApÉÉuÉÉiÉç ||

44.
CHIKITS
A
Vataja Galaganda : Kaphaja Galagand
 Nadi Swedam  Swedana
 Raktamokshanam  Upanaham
 Raktavisravanam
 Upanaham
 Magadhikadi siddha tailapanam
 Pradeha
 Vamanam
 Taila panam with  Nasya
Amritavalyadi yoga
 Vairechanika Dhumapanam,
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45.
Medoja galagandam
Swedanam
Siravyadhanam
Sastrakarmam- avapaatanam
Sivanam
Agnikarma
Triphalakshaya panam
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46.
PATHYAS (Su.Chi.18)
Trikatu + Honey + gomutram
Yavannam
Mudgarasam
Shrungaveram
Patola
Nimba
Purana ghritha panam
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47.
Yoga:
Sarvangasna
Bhujangasanam
Chakrasanam
Arthamatsendriyasanam
Pavanmuktasana
Suptavajrasana and all backward bending
asanas.
Pranayam

48.
PREVENTION - organ damage
unpleasant symptoms
negative consequences
Beeja Srotho Viprakrushta
dushti vaigunya Hetu
AVOID THE HETU
Early detection
and proper
48
treatment

49.
CRITICAL ANALYSIS
Vataja galaganda as per symptoms –Hyper
thyroidism
Kaphaja galaganda as per symptoms –
Hypothyroidism
In other sense hyperTh as Apatarpanotha
vyadhi/ and hypoth as santharpanotha vyadhi
Hence management can be adopted according
to the condition
49

50.
CASE REPORT
Name X Symptoms Since
Age 19years
Presenting C/O Weight gain(7kg), 3 months
menorrhagia
History of thyroid nodules Birth
presenting
illness y
 PCOD 3 years
Increased TSH 7 Years
Family History Mother - Hypothyroid
Treatment Tab Eltroxin 7 years
50
Investigation TSH level 12mmol/ltr

51.
Diagnosis – Hypothyroid(Kaphaja Galagandam)
Treatments given
Kanchanara guggulu 2 Bd for 5 days
Varanadi kwatham 15ml Bd for 5 days
Panchakarma Treatment
Snehapanam with Satavaryadi
Ghritam(30,60,90,110ml)
Vamanam
Satavaryadi avaleha 1tsp Bd
51
TSH after treatment 2.2mmol/ltr

52.
Conclusion
TD – Most
Undiagnosed,
overlooked,
overhidden disease.
Present medicinal
therapy – Inadequate
Further research – to
early diagnose and
52
treatment

53.
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54.
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