adult hypothyroidism (galaganda)

the etiological factors in galaganda include climatic conditions, water supply, dietary conditions and other surroundings etc
*susrutha stated that rivers flowing towards east might give rise to the occurrence of galaganda. *bhela described that sleepada and galaganda are more common in prachya desa (eastern part) of the country,and the persons consuming predominantly fish are liable to develop galgaganda. *harita samhitakara described the role of dushtambu and krimi dosha in the precipitation of galaganda.
*kashyapa added that any part of the country which is cold, damp, with densely grown long trees, water stagnation and heavy rains may be prone for the development of galaganda.
* management:in this case may be iodine deficiency, as per sarvadha sarva bahvanam-iodine containing drugs like shigru, jalakumbhi should be given.shigru is a well-known plant in india. it is rich in iodine, which is an essential component of thyroid hormones, t3 and t4. it has deepana, pacahna, kapha vata hara properties. it is recommended in galaganda, kandu, sotha, apachi, vrana, medoroga, vidradhi, gulma etc.is selected as anupana along with kachnara guggulu. it appears to provide it with iodine, which the thyroid gland require.

selection of drugs acting at various levels:
*at hypothalamo pituitary level: anti stress drugs, medhya rasayana drugs, nasya karma may be beneficial.
*at thyroid gland level: thyroid stimulatory drugs are recommended here.
*at metabolism level: deepana, pacahana, ushna, teekshna, sukshma, lekhana drugs which pep-up body metabolism is recommended.
*immuno-modulatory drugs for autoimmune related hypothyroidism.

**yoga:sarvangasana is the most suitable and effective asana for the thyroid gland. an enormous pressure is placed on the gland by this powerful posture. as thyroid gland has one of the largest blood supplies of the any organ, the pressure has dramatic change on its function, improving circulation and squeezing out stagnant secretions. after sarvangasana practice of matsyasana and halasana is beneficial. other effective asanas include surya namaskara, pavanamuktasana with emphasis on head and neck exercises, yoga mudra, sputa vajrasana and all backward bending asanas.
**pranayama: the most effective pranayama is ujjayi. it acts on the throat and its relaxing and stimulating effects are most probably due to stimulation of ancient reflex pathways within the throat area, which are controlled by brain stem and hypothalamus. nadi sodhana pranayama is useful in re-balancing metabolism

**animal studies have revealed that guggul supports healthy thyroid function, mostly by increasing the conversion of less active thyroxin (t4) to more active triiodotyronine (t3) through increasing thyroid proteolytic activity and the uptake of iodine into thyroxin, and without increasing the production of thyroid stimulating hormone.
**selenium is required for a number of enzymes known as selenoproteins. the chemical reaction, which converts thyroid hormone t4 into t3, is catalyzed by specific selenoproteins. selenium deficiency can impair thyroid function. the drug pippali increases the absroption of selinium and this may be cause for the effectiveness of vardhamana pipppli in hypothyroid conditions