Ayurvedic management of Sutika shotha (Post-Partum Thyroiditis): A case report

Abstract

Post-Partum Thyroiditis (PPT) is an autoimmune disorder characterized by lymphocytic infiltration of the thyroid gland, leading to transient thyrotoxicosis followed by hypothyroidism. This condition typically occurs within the 1st year after childbirth. In this case study, the management of a 37-year-old lactating female who exhibited symptoms of fatigue, weight gain, joint pain, indigestion, swelling on lower limbs, constipation, dry skin, depression, and poor exercise tolerance is presented. The subclinical diagnosis revealed PPT as the underlying issue. The patient was diagnosed as Sutika shotha as per the clinical signs and symptoms and treated with an Ayurvedic approach, involving the administration of Varunadi kashaya, Gokshuradi guggulu, and Erandabhrishta haritaki churna for a period of three months. As the symptoms were mildly improved, the patient was planned for Panchakarma (~five internal bio-cleansing therapies). With regard to environmental conditions and strength of the patient, classical Virechana (~therapeutic purgation) was planned. After Virechana, the Thyroid-Stimulating Hormone (TSH) levels decreased from an initial value of 143.94 µIU/mL to 16.52 µIU/mL. Body mass index was reduced to 26.8 kg/m2 from 28.8 kg/m2. Thereafter, the patient was prescribed the Shamana aushadha (~palliative medicines) for approximately six months duration leading to a further reduction in TSH levels to the normal range (2.84 µIU/mL) and an improvement in the clinical symptoms of the patient. This case study highlights the potential of classical Ayurvedic approaches in managing PPT and restoring thyroid function, providing valuable insights into management strategies for Sutika shotha (PPT).