Ayurvedic Intervention in Severe Subclinical Hypothyroidism: A Case Report of Clinical and Biochemical Improvement

Abstract

Subclinical hypothyroidism is characterized by an elevated serum thyroid-stimulating hormone (TSH) concentration with free thyroxine (FT4) remaining within the reference range. When TSH is markedly elevated, the condition may be described as severe or marked subclinical hypothyroidism. This case report describes the clinical and biochemical response to a sequential Ayurvedic treatment protocol. A 22-year-old female presented with excessive hair fall and generalized weakness for five months. Serum TSH was markedly elevated at 85μIU/mL, while FT4 and FT3 remained within the laboratory reference range and thyroid ultrasonography showed normal morphology. She had not previously received thyroid hormone replacement. Treatment consisted of Deepana-Pachana with Triphala Churna and Shunti Siddha Jala for three days, followed by Koshtha Shodhana with Avipattim Churna 30 g as a single administration. This was followed by Kanchanara Guggulu (500mg), two tablets twice daily, with Hamsapada Kashaya 20 mL as Anupana for three months. Pratimarsha Nasya with Go-Ghrita, four drops in each nostril, was administered for 14 consecutive days each month for three months, along with dietary and lifestyle advice. Hair fall and generalized weakness progressively improved, appetite normalized, and overall well-being increased. Serum TSH decreased from 85μIU/mL at baseline to 10.087μIU/mL during follow-up and to 4.95μIU/mL with treatment of 3 months. FT3 and FT4 remained within the laboratory reference range. No adverse drug reactions were reported. This case was associated with clinical improvement and progressive reduction in TSH following a sequential Ayurvedic intervention. Because FT4 remained within the reference range, the case should be interpreted as severe subclinical hypothyroidism rather than overt hypothyroidism.