Small organ - great importance: The thyroid gland influences the metabolism and functional state of almost all organs and its health is therefore of paramount relevance from an Ayurvedic perspective.
Hardly any other organ reacts as sensitively to stress and, conversely, affects the psyche as quickly as the thyroid gland in the event of illness. This places a considerable burden on those affected and they feel that they are not adequately understood and supported by the sole administration of thyroid hormones or iodine tablets.
In my practice, I often see thyroid patients who are subjectively much worse off than their lab results and ultrasound images „objectively“ suggest. And this is precisely where the great strength of Ayurvedic medicine lies: it assesses symptoms in all their interrelationships, investigates causes and consequences, considers the body, senses and mind as a unit and treats not only the illness, but the person behind it.
Even though the thyroid gland as an organ was unknown in classical Ayurveda, clinical pictures and their treatment were described 2000 years ago that are comparable to today's thyroid diseases. The treatment successes in Ayurvedic practice speak for themselves.
The organ and its functions
The butterfly-shaped thyroid gland consists of 2 glandular lobes, which are located at the level of the larynx to the right and left of the trachea and are each the size of a large olive.
As an endocrine gland, it produces the iodine-containing thyroid hormones triiodothyronine (T3) and thyroxine (T4) as well as calcitonin and releases them into the blood. The thyroid hormones T3 and T4 stimulate the energy metabolism and increase the basal metabolic rate, i.e. the energy consumption at rest. From an Ayurvedic perspective, this is regulated by our body fire „Agni“. A strong Agni therefore stimulates thyroid function and a healthy thyroid maintains a healthy Agni.
Thyroid hormones influence cardiovascular and gastrointestinal functions as well as our body temperature. Bone growth and brain maturation are promoted, which is of great importance during pregnancy and childhood.
Thyroid Hormone Feedback
The regulation of the thyroid gland is subject to an extremely complex control loop:
The hypothalamus, located in the diencephalon, stimulates the pituitary gland via the messenger substance TRH, which in turn stimulates the thyroid gland to produce hormones via the hormone TSH.
The respective hormone status is measured in the blood via receptors and sent as feedback to the pituitary gland and the hypothalamus. Depending on the hormonal environment, the thyroid gland is further stimulated or inhibited by the two superordinate endocrine glands.
Image source: Author Armin Kübelbeck (CC)
In Ayurveda, we love such interrelationships - every change at one point in the cycle alters the entire cascade of hormone production. The principle of constant change is also recognisable here: your current blood values are only a snapshot and as soon as you read them, the conditions have already been readjusted. The thyroid gland cannot be understood and treated statically, but only in its entire dynamic.
The importance of iodine
Iodine is an essential trace element that our thyroid gland needs to produce hormones. If there is a lack of iodine, the thyroid gland initially enlarges diffusely (goitre) - if the deficiency persists, nodular remodelling, cysts or calcifications develop over the years. Around 35% of the German population have an enlarged and/or nodular change in the thyroid gland.
In Germany, salt is iodised to cover the daily iodine requirement of approx. 200 micrograms. Iodide is a synthetic iodine compound that is foreign to our thyroid gland and can never be one hundred per cent pure. Government subsidies are used to recycle iodine from hazardous waste (including printing ink, disinfectants and X-ray contrast media). The risk of overdosing is high - the regular consumption of pizza and sausages alone leads to an oversupply. Therefore, my urgent advice: stay away from synthetic iodised salt!
But it could be so simple: Everything that comes from the sea contains natural iodine, which is known to our body and is better metabolised. Eating sea salt and seaweed such as nori, sea lettuce or wakame can easily ensure your intake. And an additional benefit is guaranteed: Seaweed has the highest micronutrient density of any food on the planet.
The thyroid gland from an Ayurvedic perspective
Structurally, the thyroid gland with its embedding in the neuroendocrine regulatory circuit described above can be physiologically assigned to the sixth of seven body tissues, Majja Dhatu (medulla and nervous tissue).
If it becomes diseased, other body tissues can be affected:
- Rasa Dhatu (nutrient juice) - oedema or pronounced dryness occurs
- Rakta Dhatu (blood) - there is a stimulation or inhibition of haematopoiesis
- Mamsa Dhatu (flesh) - swellings, lumps or cysts occur
- Meda Dhatu (fat) - there is an increase or decrease in body fat
- Asthi Dhatu (bone) - bone loss (osteoporosis) occurs
- Shukra Dhatu (reproductive tissue) - infertility occurs
Functionally, the thyroid gland is closely related to Agni, Vata, Pitta and Kapha:
- The strength of Agni is proportional to thyroid function.
- Vata and Pitta correlate with a strong function of the organ.
- Kapha symptoms appear when the thyroid gland functions poorly.
Diseases of the thyroid gland
The thyroid gland can become structurally and functionally diseased. Both types influence each other.
The four most important disorders are
- Goitre - enlargement of the thyroid gland
- Hypothyroidism - hypofunction
- Hyperthyroidism - hyperfunction
- Thyroiditis - inflammation of the thyroid gland
In this article I will concentrate on the first three disorders, as the explanation of thyroiditis from an Ayurvedic point of view goes beyond the scope of this article and will therefore be dealt with in a separate article at a later date.
Enlargement of the thyroid gland - goitre
is usually caused by a lack of iodine or selenium. Other causes include medication, toxins or autoimmune diseases.
Those affected complain of a feeling of tightness in the throat, difficulty swallowing and breathing, fatigue and hoarseness.
Ayurvedically, goitre is associated with Kapha Dosha and a weak Agni of the third body tissue, through which this „Mamsa Dhatu“ increases in an immature form.
Therapeutically, we first avoid all factors that unnecessarily increase Kapha, for example:
- Foods such as cheese, meat, fresh cereals or confectionery;
- Sleeping late, daytime sleep, sleep directly after meals;
- Lack of exercise or sedentary behaviour.
We have already discussed the healthy intake of iodine, while Ayurvedic selenium is mainly found in Brazil nuts, unpolished rice, mung and urad dal.
In Ayurveda, growth processes are treated using a „scraping“ strategy (lekhana). Phytotherapeutically, products based on the tree resin guggulu (Indian myrrh) are used for this, the most important formulation being Kanchanara Guggulu.
Localised compresses (Galaganda Lepa) can be used for manual therapy after prior diagnostic clarification by an Ayurveda physician.
Underactive thyroid - hypothyroidism
can be caused by the thyroid gland itself or its higher-level control centres (pituitary gland, hypothalamus) and can be latent (T3/T4 are still within the normal range, TSH is already elevated) or manifest (T3/T4 are reduced). There are congenital and acquired hypothyroidisms, the latter usually occurring as a result of thyroiditis.
Those affected suffer from a systemic slowdown, they feel tired, listless and disinterested. The ability to concentrate diminishes, blood pressure and heart rate drop and sensitivity to cold increases. Appetite is poor, defecation is difficult and libido also weakens. At the same time, body weight increases despite low food intake and lipometabolic disorders develop.
Ayurvedically, this clinical picture is a prototype for high Kapha with low Agni (Mandagni). The characteristics (guna) cold, heavy and sluggish are in the foreground and cause 80% of all symptoms. Therapeutically, it is therefore important to stimulate the organ through heating, light and stimulating measures, thereby strengthening Agni and lowering Kapha.
Nutritional therapy similar recommendations are used as for goitre. The dietary system is primarily vegetarian - the only animal substances recommended are dark old honey, Ayurvedic buttermilk and small amounts of ghee. Fresh vegetables, light gluten-free cereals and mung dal are initially the main ingredients on the menu and are prepared with hot and bitter spices.
Movement therapy I work with the patient to develop a daily training plan that can be implemented, which includes strengthening their basic muscular characteristics of endurance, strength and flexibility.
Respiratory therapy Ujjayi Pranayama„ (victorious breathing) stimulates the thyroid gland. This involves whispering the sound “Haaa„ while breathing in and out with your mouth closed, thus narrowing the glottis. However, this exercise is not recommended if you have vocal cord problems or inflammation in the throat and pharynx area - you should therefore consult a qualified therapist.
Phytotherapeutic In addition to the guggulu products mentioned for goitre, pungent spice herbs such as trikatu (a mixture of dry ginger, long and black pepper) and bitter substances are used. I often recommend Vardhamana Pippali, a staircase cure with powdered long pepper for 15-30 days, under professional guidance with a specific cure diet.
Curative therapeutic I regularly recommend Panchakarma programmes to hypothyroidism patients to reduce excess body tissue, stimulate digestion and metabolism and improve their mental mood. If inpatient programmes lasting several weeks are not organisationally possible, individual detoxification procedures can also be accompanied on an outpatient basis.
Hypothyroid patients receive thyroid hormones from Western medicine, which in the vast majority of cases they must continue to take alongside Ayurvedic therapy. In my experience, however, the quantities of hormones required can often be reduced through combined therapy.
Overactive thyroid - hyperthyroidism
develops autoimmunologically, in the context of thyroid autonomy, accompanying a tumour disease or as a result of inflammation. A goitre is present in around 80% of all cases. A mild, latent form often occurs during pregnancy, which usually normalises itself over the course of the pregnancy.
In hyperthyroidism, too many hormones are produced and the metabolism accelerates. Those affected suffer from weight loss, palpitations, a feeling of heat and sweating, fine tremors, hair loss, diarrhoea and sleep disorders.
The pronounced restlessness and nervousness coupled with mood swings can put a considerable strain on social relationships in the partnership and at work.
In some cases, especially in the case of autoimmunological Graves' disease, eye symptoms are also present: these include sensitivity to light, a feeling of pressure, tearing, double vision and even bulging of the eyeballs (exophthalmos).
Hyperthyroid patients need urgent and rapid help as their disease progressively weakens. Tissues can no longer be sufficiently built up and maintained, resulting in a lack of vital energy (ojas). This weakens the immune system and puts a somatopsychic strain on the mind. Many of those affected therefore suffer from anxiety.
In hyperfunction, Vata and Pitta Dosha are aggravated, the primarily affected characteristics (Guna) are light, accelerated and hot. Agni burns too strongly (tikshnagni) and consumes body tissue. In therapy, slowing, cooling and stabilising measures are therefore carried out.
Nutritional therapy the blazing fire needs sufficient firewood. We therefore switch affected patients to a 3+2 meal system. Whole grains are just as much a part of the diet as dairy products, protein-rich pulses and, in many cases, white meat. The aim is to prevent the breakdown of tissue and physical strength. Caffeinated and alcoholic drinks as well as hot spices and cooking methods should be consistently avoided.
Order therapeutic I attach great importance to promoting a long, restful night's sleep. Sporting activities should be limited to strength programmes and yoga so as not to use up even more energy. Time pressure is poison for hyperthyroid patients, so it is important to plan work and rest phases realistically.
Respiratory therapy Measures and training in meditation are worth their weight in gold for those affected. Daily „breathing breaks“ to deepen and slow down breathing in all areas of the respiratory system act like an elixir, and morning and evening meditation practice helps the mind to centre itself despite all the restlessness.
Phytotherapeutic products from the Brmhana (nourishment), Medhya (nerve strengthening) and Rasayana (regeneration) groups are used. Many recipes contain plants such as Shatavari, Bala, Vidarikanda, Gokshura, Ashwagandha, Atmagupta, Brahmi and Mandukaparni. I strongly advise against self-medication.
Drainage procedures are absolutely contraindicated in patients with hyperthyroidism. However, therapeutic programmes of variable duration can work wonders.
Many sufferers require drug therapy with so-called thyrostatic drugs, which inhibit excessive hormone production in the thyroid gland. In some cases, surgical measures are necessary if self-regulation is no longer possible.
Psychosomatics and somatopsychology
In the hypothalamus, nerve stimuli can be converted into hormonal signals. It is the supreme regulatory centre for all vegetative and endocrine processes and controls our body temperature, food and fluid intake, circadian and sleep rhythms, blood pressure and sexual behaviour, among other things.
Our mental balance has a direct effect on the nervous and endocrine systems and can indirectly influence the healthy function of the thyroid gland. Long-standing unresolved social conflicts, chronic dissatisfaction at work, relationship problems, financial or health worries and fears of any kind also have a psychosomatic effect on the thyroid gland as stressors.
Conversely, our daily behaviour in the context of sleeping and eating habits, sensory stimuli, exercise and relaxation activities has a somatopsychic influence on the function of the thyroid gland.
A holistic therapy of this small but wonderful organ takes into account both paths, from the mind to the body and from the body to the mind. Our thyroid gland is much more than a hormone producer whose health can be measured purely by laboratory values. It teaches us to think in a networked way, to understand constant change and to experience ourselves as a unity of body, senses, mind and soul.
With best wishes for your health,
Ralph Steuernagel
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