Case Report: Ayurvedic Vamana and Virechana treatment in hypothyroidism and conception in a woman seeking infertility treatment at an ART clinic

Introduction

Infertility is defined as a failure to get pregnant after twelve months for women over the age of 30-40 or after one year of regular, unprotected sexual intercourse.¹ Over the past several decades, the thyroid-stimulating hormone (TSH) was diagnosed to have a role in reproductive issues such as ovulatory dysfunction, infertility, miscarriage, and harmful maternal problems (gestational hypertension, preeclampsia, anaemia).² Numerous studies have connected the physiology of reproduction, ovarian function, and thyroid function.³ The menstrual cycle, oestrogen and androgen metabolism, folliculogenesis, and endometrial receptivity may all be affected by TSH.⁴ The mainstream Indian medical practice referred to as Ayurveda continues to be among the oldest remaining common with an extensive intellectual and experimental foundation.⁵ The three fundamental ideas, known as doshas (vata, pitta, and kapha), are drawn from the five components of studies. Vata and its sub-doshas regulate input/output processes and motion. Pitta and its sub-doshas regulate throughtout, turnover, and thus energy, and Kapha and its sub-doshas regulate storage, structure, and lubrication. These fundamental physiological processes in living systems maintain their identity throughout their life history.⁶ Several instances of lifestyle disorders include diabetes insipidus, hypertension, and thyroid dysfunction. Thyroid disease is becoming more prevalent in society on a daily basis. In general population, hypothyroidism affects 3.8–6% of people.⁷ There are two types of thyroid dysfunction: overactivity (hyperthyroidism) and underactivity (hypothyroidism). The thyroid gland produces insufficient thyroid hormone in hyperthyroidism.⁸ An underactive thyroid is a common description of hypothyroidism. A common problem in women is hypothyroidism, who tend to demonstrate ovulatory disorders leading to infertility. Subclinical hypothyroidism (SH), a modestly raised level of TSH, is a milder form of hypothyroidism. The most frequent side effects of hypothyroidism include infertility, weight issues, depression, and chronic fatigue.⁸ The guru (heaviness) attribute of the kapha dosha is present in SH. It also possesses the manda, or dullness, attribute. Reducing manda guna of the Kapha dosha should be the primary goal of ayurvedic treatment for thyroid problems like hypothyroidism.

In this case report, a 29-year-old woman with hypothyroidism who had been married for the previous seven years is featured. The patient TSH level returned to within tentative normal range after receiving Vamana Virechhana treatment to diagnosed her doshas, which contributed to deal with patient’s infertility difficulties and thus, resulted in a positive clinical pregnancy.

Case presentation

Discussion

Excessive hypothyroidism often results in infertility and delayed implantation. The direct effects that thyroid hormones have on oocytes indicate that they directly interfere with the normal function of the ovaries. They have an impact on how LH and FSH, which are used for the treatment of granulosa cell function, are controlled. Trophoblast differentiation function assists to maintain the foetal placenta’s integrity and protects against conceptus loss before birth.⁸

Hypothyroidism can be recognised according to the Ayurvedic perspective as a broad spectrum of afflication encompassing Kapha dusti (Kapha, one of Ayurveda’s three doshas, is associated with the elements of earth and water. The body’s lubrication, structure, and stability are all under its control, and an imbalance in Kapha can make one feel heavy and exhausted). Rasa Dhatu dusti (imbalance of plasma tissue), Udanavruta Samana (the Sanskrit word “Udanavruta Samana” can be found in the medication system known as Ayurveda. It represents a specific type of pranayama, or breath control method, used to balance and integrate the body’s energies. The breath is directed upward and outward in Udanavruta Samana, releasing the “udana” energy and nurturing balance), Kaphavruta Samana, Agnimandya (slowness of digestion, loss of appetite), Kaphaja galaganda (Dysentry phlegm mumps), among others. The clinical presentation resembles the Kapha-associated Pitta dusti with vitiation of Vata spurred on by Margavarana and predominantly Rasavaha and Medovaha srotodusti lakshans, which are frequently categorised as Bahudoshavastha.¹⁰ If hypothyroidism gets treated early, it can have a significant impact on the speed at which women with thyroid antibodies become pregnant (on average, three to four years later), as well as the probability the pregnancy will be miscarried.¹¹ Considering its high prevalence in infertile women, hypothyroidism should be ruled out during general examination as often as possible. After a few attempts, we treated the patient with an Ayurvedic treatment named Kapha dosha. Guru, which means heaviness, is a characteristic of the Kapha dosha. Additionally, it had the manda, or dullness, attribute. Reducing manda guna of the Kapha dosha should be the main goal of ayurvedic treatment for thyroid disorders, including hypothyroidism. By getting TSH levels in the normal range, our patient’s SH was cured.⁶ It is important that TSH levels are in the normal range (0.5 to 5.0 mLU/L) for successful conception.

Conventionally and persistent Panchkarma procedures, which include Vamana and Virechana Karma, foster wellness.¹² Vamana and Virechana Karma symbolise the development of emesis and purgation, resulting in improvements in the body’s capacity to eradicate toxins, especially through the intestine. This Karma tends to be classified into three categories: Mridu (mild), Madhya (middle), and Tikshna (strong), depending on the level of severity of the process. These Karma are additionally taken out in three steps: Poorva Karma, Pradhan Karma, and Pashchat Karma, much like other Karma. Before conducting this Karma, Sneha Pana, fomentation, and oil massage are recommended to liquefy Dosha and toxins. Sroto shodhaka, Agnivardhaka, and dosha pratyanika chikitsa are the best therapies for hypothyroidism, assuming the prevalence of the Kapha and Pitta doshas.¹³

This formed the preliminary basis of our application of Vamana and Virechana medication in our patient. It was observed that patient thyroid profile was significantly improved upon the administration of ayurvedic medication, which resulted in a positive clinical pregnancy outcome.

Conclusions

This case report examined the impact of ayurvedic Vamana and Virechana medication for the treatment of hypothyroidism, which resulted in infertility in our patient. Our result indicated that there was considerable significant improvement in the levels of TSH, which is a prerequisite factor for the determination of thyroid profile. Performing IVF treatment in our patient resulted in positive clinical pregnancy outcome.

Consent

The couple registered in our infertility clinic gave their written informed consent for the publication of this case report.