Hypothyroidism correlation between modern and unani concept.

1. HYPOTHYROIDISM
CORRELATION BETWEEN
MODERN AND UNANI CONCEPT
DR. SHAHNAZ BANO, PG
SCHOLAR
Department of Mahiyatul Amraz
TOPIC

2. HYPO - MEANS - REDUCED
THYREOS - MEANS - SHIELD
EIDOS - MEANS - FORM
THE WORD HYPOTHYROIDISM IS
DERIVED FROM GREEK

3. Hypothyroidism is a disorder of the endocrine system in which the
thyroid gland does not produce enough thyroid hormone for prolonged
periods, or rarely from resistance of the peripheral tissues to the
effects of thyroid hormone. Amongst all the endocrine disorder
Hypothyroidism is the most common and usually affects females.
Hypothyroidism may vary from mild illness to severe life threatening
complication like Myxoedema and coma.

4. The thyroid gland is located in the
anterior neck and pass over the C5 to
T1 vertebrae.
It consist of two lobes [Rt and Lt] which
are connected by central isthmus
anteriorly.
This produces a butterfly- shaped
appearance.

5. The lobes of thyroid gland are
wrapped around the cricoid cartilage
and superior rings of the trachea.
The glands are located with in
visceral compartment of the neck
along with the trachea, oesophagus,
and pharynx.

6. P
H
Y
S
I
O
L
O
G
Y
The tissue of the thyroid gland is
composed mostly by thyroid follicle.
The follicles are made up of a central
cavity filled with sticky fluid called
colloid surrounded by a wall of
epithelial follicle cell.
The follicles are the center of thyroid
hormone production.
The production of thyroid hormone is
dependent on the hormones essential
and unique component - IODINE

7. THYROID HORMONES
RELEASE
Thyroid hormone are released as part
of the hypothalamic pituitary thyroid
axis.
The hypothalamus detects a low
plasma concentration of thyroid
hormone and release TRH
{Thyrotropin Releasing Hormone} into
the hypophyseal portal system.

8. TRH binds to receptor found on thyrotrophic cells
of the anterior pituitary gland. causing them to
release TSH { thyroid stimulating hormone} into
the systemic circulation.
TSH bind to TSH receptors on the basolateral
membrane of thyroid follicular cells and induces
the synthesis and release of thyroid hormone.
Two types of hormone
release from thyroid
gland.
T3 –
TRIIDOTHYRONIN
T4 - THYROXIN

9. COMMON CAUSE OF HYPOTHYROIDISM
AUTO IMMUNE DISEASE –
- HASHIMOTO’S THYROIDITIS
- ATROPHIC THYROIDITIS
IATROGENIC –
- RADIO ACTIVE IODINE ABLATION
- THYROIDECTOMY
- DRUGS (CARBIMAZOLE,
METHIMAZOLE,
PROPILETHEOURACIL)
TRANSIENT THYROIDITIS –
- SUBACUTE THYROIDITIS
- POST-PARTUM THYROIDITIS
IODINE DEFICIENCY –
- EX - IN MOUNTANIOUS REGION
CONGENITAL –
- DYSHORMONOGENESIS
- THYROID APLASIA

10. SIGN AND
SYMPTOMS
The sign and symptoms of
hypothyroidism vary, depending on
the severity of the hormone
deficiency.
Problems tend to develop slowly.
FATIGUE
INCREASE SENSITIVITY
TO COLD
DRY HAIR AND SKIN
WEIGHT GAIN
ELEVATED BLOOD
CHOLESTEROL LEVEL
MUSCLES ACHE, JOINT
STIFFNESS, JOINT PAIN
PUFFY FACE
IRREGULAR
MENSTRUAL PERIOD OR
HEAVIER THAN NORMAL
DEPRESSION
IMPAIRED MEMORY
SLOWED HEART RATE
ENLARGED THYROID
GLAND
CONSTIPATION
CLINICAL FEATURES

11. The prevalence of hypothyroidism in India is 11%, compared with other
country, In the UK- Only 2%, In the USA – 4.6%
Compared with costal cities( ex. MUMBAI, GOA, and CHENNAI)
City located in Land (KOLKATA, DELHI, AHMEDABAD, BANGALORE, and
HYDERABAD) have higher prevalence (11.7% vs 9.5% ).
The highest prevalence of hypothyroidism (13·1%) is noted in people aged
46–54 years, with people aged 18–35 years being less affected (7·5%).
EPIDEMIOLOG
Y
E

12. OTHER CAUSE OF PREVALENCE OF HYPOTHYROIDISM
Environmental factors such as:
Use of Goitrogens and cyanogenic compounds
Use of unregulated pesticides
Unclean drinking water
Iodin supplementation can also induce or aggravate autoimmunity, resulting in
goiter and thyroid dysfunction.

13. DIAGNOSIS
Blood test
Measure T3, T4, and TSH level.
A normal level of Thyroxine and high level of TSH indicate an underactive
thyroid .

14. LABORATORY
ASSESSMET
REFERENCE VALUES OF THYROID FUNCTION
TEST
TEST RENGE
TSH
T3
T4
0.5 -4.7mIU/L
0.92- 2.78 ng/dL
58-140nmol/L
THYROID RELEASE 100-125nmol OF T4 DAILY
ONLY SMALL AMOUNT OF T3
HALF LIFE OF T4- 7- 10 DAYS
HALF LIFE OF T3 – ONLY 1 DAY
COMPENSATORY MECHANISMS MAINTAIN T3 LEVELS

15. Standard treatment for hypothyroidism in modern medicine is
Levothyroxine.
This oral medication restores adequate hormone levels, reversing the
signs and symptoms of hypothyroidism.
Determining proper dosage may take time.
To determine the right dosage of levothyroxine initially, generally checks
level of TSH after six to eight weeks.
After that, blood levels are generally checked six months later.
TREATMENT

16. Excessive amounts of the hormone can cause side effects, such as:
• Increased appetite
• Insomnia
• Heart palpitations
• Shakiness
SIDE EFFECTS OF LEVOTHYROXINE

17. The history of thyroid gland and its swelling are interwind and go back several
centuries. Some of the earliest recorded descriptions of the thyroid gland
originated from China, but most of the information was confined to Chinese
sub- continent.
The first description of goiter dates back to 2700 B.C., when people living in
the mountainous region of China were described to have both goiter and
baldness, and were treated with a combination of burnt sponge, algae and
seaweeds. The Chinese had developed the practice of treating children with
Cretinism with sheep and deer thyroid. They also recognised various forms of
benign and malignant goiters.
HISTORY OF THE HYPOTHYROIDISM IN CLASSICAL LITRETURE

18. Ayurveda, the ancient medical science of India, used the
term ‘galaganda’ to goiter as early 1400 B.C. The word
‘galaganda’ when translated, means the gland in the neck.
Ancient Ayurvedic texts have described remedies for the
treatment of goiter.
Aurellius Celsus and Gaius Plinius were the main
contributors to the understanding of thyroid disease in the
Greeco- Roman period which extended till around 500 A.D.

19. UNANI PHILOSOPHERS WHO TREATED SIMILAR DISEASES
LIKE
HYPOTHYRODISM
BUQRAT (460-377BC) named the GOITER as
“STRUMA”. around that period, GOITER was also
referred as “CHORION” and “GONGROMA”.
JALINUS (GALLEN 130-200 AD) was a great Greek
roman physician, who hypothesized that the secretion
from thyroid gland was important for lubrication of
larynx. he also documented that surgery in the area of
thyroid gland made many patients mute by damaging
the laryngeal nerve.

20. ALI IBN ABBAS MAJUSI (930-994 AD)
described surgery of GOITER early in 990’s in his
BOOK KAMIL-AL-SANA’T.
ABUL QASIM ZUHRAWI (936-1036 AD)
he was eminent surgeon of his era who is
considered “THE FATHER OF SURGERY”
has successfully operated a swelling of
throat which was in fact a goiter.
IBN-HUBUL-BAGDADI (1122-1213 AD)
has mentioned ‘hujuzul ain’ (exophthalmic goitre)
in his book ‘KITAB-UL-MUKHTARAT-FIL –TIB’.

21. The description of hypothyroidism as a disease is not directly found in
Unani Literature. But the clinical features of Hypothyroidism is quiet
similar to the SU E MIZAJ BARID MADDI/ SU E MIZAJ BALGHAMI
(Impaired substantial cold temperament/impaired phlegmatic
temperament) .
In Unani Medicine, Hypothyroidism is also known as Qillat-e- Afraj
Darqiyah.
The literal meaning of Qillat-e-Darqiyah is the decreased secretion of
Ghudda-Darqiyah.
In Qillat-e-Darqiyah, Mizaj of body is corresponds to SU E MIZAJ
INTERPRETATION OF HYPOTHYROIDISIM IN
UNANI
MEDICINE

22. In Unani medical system, the basic cause of disease are grouped
under three headings:-
Su’-e- Mizaj (Impaired temperament)
Su –e- Tarkib (Abnormal structure)
Tafarruq- e- Itisaal(discontinuity)
Su-e- Mizaj(impaired temperament) is divided into two types:-
1) Su-e- Mizaj Sada ( simple impaired temperament )
2) Su-e-Mizaj Maddi (impaired substantial temperament)

23. Su’-e Mizaj sada mufrad is divided into four types:-
1. Su’-e-Mizaj Harr ( impaired hot temperament)
2. Su’-e-Mizaj Barid (impaired cold temperament)
3. Su’-e-Mizaj Ratab (impaired moist temperament)
4. Su’-e-Mizaj Yabis (impaired dry temperament)
TYPES OF SU’E MIZAJ
SADA
1) Su’ e Mizaj sada mufrad
2) Su’ e Mizaj sada murakab

24. Any types of Su’-e-Mizaj produces particular clinical feature which are
determined to it, and help the Physician in Diagnosis and management of
the particular disease.
The signs and symptom of Su’e mizaj Barid Maddi/Su’e Mizaj balghami
are:-
Kusul - wa -mandgi (Lethargy),
Thakan (Fatigue),
Tahabbuj ( Puffiness),
du’f al- Ishtiha (loss of appetite),
Nind ki jeyadti (excessive sleep),
kund zehni (decreased intellectual function),
burd – atraaf (cold extremities) ,
Qabd (constipation)
Nabd Bati wa Mutafawit
.

26. Usul –e- ilaj (Line of treatment)
Eliminate the Asbab -e Maraz
Identify the age, diets, Occupation, Routine activities, Mizaj
etc. of individual for appropriate treatment.
Istifragh Madda by Munzij and Mushil(evacuation of matter
by concoctive and pergative)
To correct the Mizaj-e-A ‘da’ (temperament of organ)

27. TREATMENT OF HYPOTHYROIDISM IN UNANI
SYSTEM
Ilaj bil Ghiza – Dietotherapy
Ilaj bil Dawa – Parmacotherapy
Ilaj bil Tadbeer- Regimental therapy
Ilaj bil ghiza
Leafy greens, whole grains ,nuts, seeds and zinc-rich legumes like peas, lentils,
chickpeas, and beans – these foods contain amino acids like tyrosine, B- Complex
vitamins, minerals like selenium, and antioxidants – all of which supports thyroid
health.

28. FOOD THAT SHOULD TO BE AVOIDED IN
HYPOTHYROIDISM
SOY
Soy is a big source of plant oestrogens also knows phytoestrogens.
Research shows that plant oestrogens may inhibit the activity of enzymes
that helps in the production of thyroid hormones.
Soy food includes: Tofu, Soy Milk and Soy sauce.
GOITROGENS
Goitrogens, which can inhibit the function of the thyroid gland, including
cruciferous vegetables such as – Broccoli, Brussels, Sprout, Cauliflower
and fruits like – peaches, pears, plums, raspberries and strawberry.

29. Ilaj bil Dawa- Pharmacotherapy
Some compound medicine which is used in Management of
Hypothyroidism.
Itrifal Ghududi
Jawarishe Bisbasa
Jawarish Jalinoos
Dawaul kurkum Kabeer
Jawarishe mastagi banusqa kalan
Habbul Ghaar
Sufoof e kachnal

30. Ilaj bil Tadabeer
Increase the physical activities
Increase Mental activities
Fast running
Exercise
yoga