1. DEPARTMENT
OF PRASUTI
TANTRA EVAM
STREE ROGA
welcomes
you
all

2. ROLE OF THYROID GLAND
IN REPRODUCTIVE
PHYSIOLOGY
Guide By
Dr.Gayathri Bhat NV Dr.Pooja Lekshmy P
HOD ,Dept. Of PTSR 1st Year PG Scholar
Dept Of PTSR

3. Contents
Introduction
Anatomy
Physiology
Systemic action
Thyroid disorders
Ayurvedic aspect
Preventition
Critical analysis
3
Conclusion

4. INTRODUCTION
 Endocrine system - second key regulator of organ
systems
Thyroid gland – one of the largest endocrine gland
metabolism
 growth
development.
 Well functioning TG - pivotal for a healthy body & to
conceive a healthy child.
4

5. 5
ANATOMY

6. Thyroid means “oblong
sheild.”
Brownish-red, butterfly
shaped structure - front of
the neck .
justinferior to larynx
from C5 to T1
6

7. Weight 25 gm./1 ounce
Each lobe - 5 x 3 x 2cm
Isthmus – 1.25cm x 1.25 cm x 1.25 cm.
Slightly heavier in females enlarging during
menstruation and pregnancy.
 Highly vascular receiving 80-120ml of
bloodmin.
7

8. Microscopic anatomy
includes thyroid follicles -spherical.
0.02 to 0.9mm in diameter.
 with a central colloid core surrounded by a
simple epithelium and basal lamina.
Colloid -thyroglobulin.
Parafollicular cells /“C”cells.
8

9. THYROID HORMONES
Thyroid gland – large storage capacity , store
thyroid hormone for 2 to 3 months.
Thyroid hormone include
1. 93% Thyroxine (t4) - 10-25pmol/ltr (normal)
2. 7 % Triiodothyronine(t3) - 1.1-2.3nmol/ltr
3. Thyrocalcitonin – parafollicular cells
 Normal value - TSH - 0.45 -5.5mmol/ltr
T3 is about 4 times as potent as T4.
9

10. P P
H H
Y Y
S S
I I
O O
L L
O O
G G
10
Y Y

11. 11

12. Control of Thyroid hormone
Secretion
 Pic …
12

13. SYSTEMIC ACTIONS
13

14. Action of thyroid
hormones
•Cells Metabolic activity
•CVS Cardiac output
•RS Respiratory rate
•GIT GI motility
•CNS Excitability of nerves
•CARBOHYDRATE METABOLISM
14
•FAT METABOLISM

15. EFFECT ON REPRODUCTIVE
SYSTEM
Females Males
T3 induced modulation TH receptors in Sertoli cells
Estrogen metabolism Male reproductive tract
Sexual maturation development
Menstrual function Maturation of testes (in
Ovulation & Fertility pre-natal and post-natal)
Develop full term infants Maturation of sperm
Stimulates production of
SHBG
(based on research work by National Institute of Environmental
15
Health Science by US Govt)

16. T3
T4
TB
G
16

17. 17

18. T
H
Y
1ST DEPENDS ON MOTHER
F
TRIMISTER
R
O
O
I 8-10 Pituitary thyroid system
D WEEKS dev E
P
12-14
T
H Iodine Con.,TSH Secr.
Y WEEKS U
S
I
O
20-28
TSH S
WEEKS
L
O
G
Till
Y
18
term
T4 T3 remains Low

19. 19

20. THYROID DISORDERS
20

21. THYROID DISORDERS
Thyroid abnormalities – autoimmune, 10 times
more common in women than men.
Antigens Antibody
 Thyroglobulin(Tg)  Antithyroglobulin(anti-tg)
 Thyroid  Antimicrosomal thyroid
peroxidase(TPO) peroxidase (anti-TPO)
 TSH receptor(TSHR)  Anti-tsh receptor(anti-tshr)
 Na /I symporter(NIS)  Anti-na/I symporter(anti –
21 NIS)

22. Classification of thyroid disorders
Mainly into two divisions
Hyperthyroidism
Hypothyroidism
22

23. HYPERTHYROIDISM
23

24. Anti TSH-r H
Y
Present P
E
TSH R
T
T3&T4 H
Y
R
O
Triad of I
Symptoms D
I
S
M
HYPERTHYROIDIS
24 M

25. CLASSICAL SYMPTOMS
Hoarseness or Persistent
Deepening of Voice Sore or Dry Throat
Nervousness
Swelling Irritability
(Goiter) Difficulty
Sleeping
Difficulty
Swallowing
Rapid or Irregular
Frequent Heartbeat
Bowel
Movements
(diarrhoea)
First-Trimester
Increased Miscarriage
Sweating
Unexplained Excessive Vomiting in
Warm, Moist Palms Weight Loss Pregnancy
Fine tremors
25

26. Effect of Hyperthyroidism in Reproductive system
FEMALES MALES
Increased mean Increased estrogen
plasma estrogen level.&LH
production.
level .
Increased level of SHBG. Defective
Increased incidence of spermatogenesis.
oligomenorrhea Low sperm count with
amenorrhea & anovulation. sperm motility defect.
.
26

27. May cause early onset of menopause
Symptoms – lack of
menstruation, hot flushes,
insomnia, mood swings –
mistaken for menopausal
symptoms.
Treatment of hyperthyroidism –
alleviate symptoms of ,or the
actual onset of early
menopause.
27

28. COMPLICATIONS IN PREGNANCY
 Mild maternal tachycardia
 heart murmur with irregular heart-beat.
 Unexplained weight loss or failure to have normal
pregnancy weight gain.
 Spontaneous abortion.
 Pregnancy-induced hypertension.
 Pre term delivery.
 Anaemia.
 Higher susceptibility to infections.
 Placental abruption.
28
 Post partum thyroid dysfunction.

29. Transient hyperthyroidism in pregnancy
Thyroid activity increase in
conditions of
Molar pregnancy.
When hyperemesis gravidorum is
associated with high level of hCG
29

30. EFFECT ON FOETUS
Intra uterine growth retardation.(IUGR)
Low birth weight.
Intrauterine foetal death.
Still birth.
Prematurity.
Skeletal developmental abnormalities.
Foetal-neonatal hyperthyroidism.(plancental transfer
of anti TSH- R).
Overtreatment with antithyroid drugs-foetal
30
goiter.

31. TREATMENT OF
HYPERTHYROIDISM
Antithyroid drugs:
Methimazole : 10 -20 mg daily, once it is
controlled -5 -10 mg daily.
Propanol : 20-40 mg every 12 hr orally.
Surgical removal .
.
31

32. HYPOTHYROIDISM
32

33. HYPOTHYROIDISM ELEVATED SERUM LEVEL
OF TSH, LOWT3- T4
VALUE
Swelling (Goiter)
Difficulty Swallowing
Irritability Forgetfulness/
Persistent Dry or
Sore Throat Slower Thinking
Hoarseness/ Depression
Deepening of Voice Inability to Concentrate
Constipation
Slower Heartbeat
Dry, Patchy Skin
Menstrual Irregularities/
Heavy Period
Cold Intolerance Infertility
Elevated Cholesterol Decreased libido
33 Muscle Weakness or Cramps
Thinning Hair or Hair Tiredness
Loss Weight Gain

34. Myxedema –bagginess under
eye and swelling of face.
Atherosclerosis
Slow and husky voice.
34

35. EFFECT ON REPRODUCTIVE
SYSTEM
Delay in onset of puberty with
anovulatory cycle.
Increased prolactin Level; GnRH
reduced
Diminished libido .
Recurrent miscarriage
Amenorrhea, oligomenorrhea,
galactorrhea – due to high prolactin
level
Incidence of infertility and PCOD
Testicular atrophy in men
35

36. Effects on pregnancy
 High risk of pre-eclampsia ,often lead to premature
delivery .
 Muscle cramps,constipation
 Still birth ,low birth weight.
 Placental abruption & PPH.
 Associated with hypertension,type 1
diabetes,anaemia.
 Increased risk of spontaneous abortion.
36

37. EFFECT ON FOETUS
 Congenital abnormalities.
Delay in sexual maturity.
 Lower IQ in infants of every mild hypothyroid
women.
 CHILDREN: CRETINISM:
Congenital Hypothyroidism
Dwarfism
Mentally Subnormal: MR
Enlarged, Protruding tongue
37
Pot bellies.

38. TREATMENT OF HYPOTHYROIDISM.
ELTROXINE
L- THYROXINE – to be given.
Brand name - Eltroxin
During pregnancy regular check up btw
every 4 week .
38

39. INVESTIGATIONS
THYROID FUNCTION TEST
Level of TSH, T3,T4 in blood sample.
Thyroid scan
FNAC
MISCELLANEOUS TEST
 include serum cholesterol ,serum creatine
etc
39

40. INCIDENCE RATE.
42 million people in India – TD
Hypothyroidism –
congenital 1 out of 2640 children in India
1 out of 3800 children in World
Adult- 3.9%
Hyperthyroid
Adult -1.6%
40

41. Ayurvedic Perceptive
The “Hidden” Health Problem

42. Thyroid gland - AuÉOÒû
LMüÅuÉOÒû (cÉ.zÉ.7/11)
The goiter is termed as “galaganda”
xuÉÃmÉqÉç
ÌlÉoÉlkÉÈ µÉrÉjÉÑrÉïxrÉ
qÉÑwMüuÉiÉç sÉqoÉiÉå aÉsÉå ||
(xÉÑ.ÌlÉ11/29)
 ...
Prakupita kapha – situated at galabahya –
shotha (
42

43. Vataja - iÉÉåSÇ,M×üwhÉÍxÉUÉ AuÉlÉ®Ç
TYPES (xÉÑ.ÌlÉ11/23)
M×üwhÉÉÂhÉuÉhÉïÇ
AÌiÉÎxlÉakÉiÉUÇ(qÉåSÉåÎluÉiÉÇ),AÉxr
ÉuÉæUxrÉÇ .
Kaphaja -ÍcÉUÉiÉç mÉÉMÇü, qÉlS ÂeÉÇ,
EaÉëMühQÒû, qÉkÉÑUÉxrÉiuÉÇ.
Medojam -SåWûÉlÉÑÃmÉ
¤ÉrÉuÉ×ήrÉÑ£Çü lÉÏÂMçü,
AÌiÉMühQÒû
lÉ ÌmɨÉålÉ xuÉpÉÉuÉålÉ ÌmɨÉeÉxrÉ
43
aÉsÉaÉhQûxrÉ ApÉÉuÉÉiÉç ||

44. CHIKITS
A
Vataja Galaganda : Kaphaja Galagand
 Nadi Swedam  Swedana
 Raktamokshanam  Upanaham
 Raktavisravanam
 Upanaham
 Magadhikadi siddha tailapanam
 Pradeha
 Vamanam
 Taila panam with  Nasya
Amritavalyadi yoga
 Vairechanika Dhumapanam,
44

45. Medoja galagandam
Swedanam
Siravyadhanam
Sastrakarmam- avapaatanam
Sivanam
Agnikarma
Triphalakshaya panam
45

46. PATHYAS (Su.Chi.18)
Trikatu + Honey + gomutram
Yavannam
Mudgarasam
Shrungaveram
Patola
Nimba
Purana ghritha panam
46

47. Yoga:
Sarvangasna
Bhujangasanam
Chakrasanam
Arthamatsendriyasanam
Pavanmuktasana
Suptavajrasana and all backward bending
asanas.
Pranayam

48. PREVENTION - organ damage
unpleasant symptoms
negative consequences
Beeja Srotho Viprakrushta
dushti vaigunya Hetu
AVOID THE HETU
Early detection
and proper
48
treatment

49. CRITICAL ANALYSIS
Vataja galaganda as per symptoms –Hyper
thyroidism
Kaphaja galaganda as per symptoms –
Hypothyroidism
In other sense hyperTh as Apatarpanotha
vyadhi/ and hypoth as santharpanotha vyadhi
Hence management can be adopted according
to the condition
49

50. CASE REPORT
Name X Symptoms Since
Age 19years
Presenting C/O Weight gain(7kg), 3 months
menorrhagia
History of thyroid nodules Birth
presenting
illness y
 PCOD 3 years
Increased TSH 7 Years
Family History Mother - Hypothyroid
Treatment Tab Eltroxin 7 years
50
Investigation TSH level 12mmol/ltr

51. Diagnosis – Hypothyroid(Kaphaja Galagandam)
Treatments given
Kanchanara guggulu 2 Bd for 5 days
Varanadi kwatham 15ml Bd for 5 days
Panchakarma Treatment
Snehapanam with Satavaryadi
Ghritam(30,60,90,110ml)
Vamanam
Satavaryadi avaleha 1tsp Bd
51
TSH after treatment 2.2mmol/ltr

52. Conclusion
TD – Most
Undiagnosed,
overlooked,
overhidden disease.
Present medicinal
therapy – Inadequate
Further research – to
early diagnose and
52
treatment

53. 53

54. 54