A Pilot Study to Assess the Efficacy of Kanchnaradi Kashaya in The Management of Hypothyroidism W.S.R. To Kaphavrutta Vata

: Hypothyroidism is a condition characterized by abnormally low thyroid hormone production. Subclinical hypothyroidism is one of the most common endocrine disorders in india affecting one in ten adults. Major portion of hypothyroidism remain undetected. Various treatment protocols are applied in this disease with portion success. In present clinical study, 20 patients of clinically proven hypothyroidism were treated with kanchnaradi kashayam to evaluate its efficacy. The ingredients of Kanchnaradi Kashaya are Kanchnar (Bauhinia variegata), Varun (Crateva religiosa) Shigru (Moringa oleifera),Shunthi (Zingiber officinale) Shaindhav and Madhu. Ayurveda parameters ( Nidan and Lakshan) and modern symptoms of hypothyroidism were used as subjective parameters, and investigations were used as objective parameters to assess the efficacy of the drug. Analysis was done and results were calculated statistically using P test. Results obtained are encouraging and indicates the efficacy of Kanchnaradi Kashaya ( Anubhoot yoga) in the management of hypothyroidism exploring many aspects of this clinical entity.

There are many diseases which doesn't mentioned directly in Ayurveda texts,and thatdiseases are called as Anuktavikar . Subclinical hypo-thyroid is one of such disease. Though there is lack of direct description of such disease, but its line of treatment described very well. In Charak Samhitas there is detailed description about Vata Vyadhi [4] , i.e. diseases caused due to vikrut vata dosha. In that reference, Aavrana are described. Under this topic signs and symptoms of Kaphavrutta Vata [5] are explained. These signs and symptoms can be correlated with that of Hypothyroidism. If we try to get a deeper insight into pathogenesis of hypothyroidism as per the theory of Ayurveda, we find that it is basically caused due to Kapha and Vata Dosha, dysfunction of Jathragni which in turn effect the Dhatavagni and eventually the disease sequence unfolds and the disease condition develop.
Aims and objective -1. To asses of clinical efficacy of Kanchnaradi Kashaya in the management of hypothyroidism 2. A meta analysis and systemic review of the published data looking at the the efficacy and safety of ayurveda interventions in the management of hypothyroidism.

Material and method -
Patients attending the OPD of Kayachikitsa department fulfilling the criteria for selection were incorporated into the study irrespective of caste religion etc. patient's detailed history regarding present illness, past illness, family history, and clinical finding pertaining to Dosha, Dushya, Agni, Strotus etc. A special preformed were prepared, total 20 patient were registered for this study.
All the patients were examined by thyroid profile to asses' hypothyroidism.

Study design -Open clinical randomized trial
Criteria for selection of cases -A) Inclusion criteria -• Newly diagnosed case of hypothyroidism.
• Already diagnosed hypothyroidism case (undertreated) • Patient's age should be above 16 years and below 60years.
• Elevated level of Serum TSH (more than 4.31 μIU/ml. normal value 0.38 to 4.31 μIU/ml) • Low serum T3 (less than 0.79 ng/ml, normal value 0.79 to 1.58 ng/ml) • Low serum T4 (less than 4.9 μg/dl, normal value 4.9 to 11 μg/dl) However, the cases of which T3 and T4 levels are within normal range and TSH level is high will also include. • Patients having undergone thyroid surgery C) Parameter of diagnosis and assessment of results-pt were selected on the bases of serum TSH.

D) Criteria for Diagnosis/ Subjective criteria for assessment -
The diagnosis of the disease will be mainly based on the signs and symptoms mentioned in texts of modern and thyroid profile. Following clinical signs and symptoms will be evaluated and considered. However, the main diagnostic tool adopted will be thyroid profile. Due to wide spectrum of the disease and high prevalence in the society, the current issue was adopted for study and its management by means of Ayurvedic principles significant improvement was observed on subjective and objective parameters.

RESULT AND DISCUSSION -
During the study the patients were first screened for their thyroid profile and the result recorded. After the treatment the thyroid profile of the patients was assessed again. It was observed that Kanchnaradi Kashaya was given as supplement with diet and Yoga. In the result of which their TSH level came down to within normal limits, along with associated symptoms of hypothyroidism like weight gain, constipation, swelling, indigestion, lethargy, was also relieved to a great extent the statistical analysis of the data to study the efficacy of treatment is below. The statistical analysis of the data in trial group with kanchnaradi kashayam showed t value at 3.35 with level of significance at 1% (P < 0.01) signifying that the efficacy of treatment in the trial group is highly significant.
Kanchnaradi Kashaya was found to be effective in normalized TSH value and in reducing symptoms associated with subclinical hypothyroidism. Clinical feature like swelling in extremities, Puffiness on face, tiredness, muscles ache, constipation etc were significantly reduced after the treatment. The drug shows significant result in obesity also the quality of life of all patients in this study was improved. This proves the effectiveness of the drug in this condition making it a miraculous drug.

CONCLUSION -
Hypothyroidism refers to the common pathologically condition of thyroid hormone deficiency. If uncontrolled, it can lead to serious adverse health effect and ultimately death. Volume 5, Issue 3, May-June 2023 5 After analyzing this study, it was concluded that Kanchnaradi Kashayam administered orally, have definite role in the treatment of hypothyroidism, to provide better and earlier relief to the patients of hypothyroidism. Present study revealed that various Ayurvedic Shaman treatment modalities are found to be significantly effective in hypothyroidism. These drugs are safe as no adverse effects were reported in any of these studies.
It is important to avoid aggravating factors like stress and include compatible diet and exercises in addition to the drug. At the end we can say that ayurvedic treatment regimen can provide promising results in the management of hypothyroidism. It followed as per the prescribed guidelines of Ayurveda.