Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S
In Ayurveda we do not have any condition which can be closely compared to hypoparathyroidism. But considering all the perspectives of hypoparathyroidism and looking at them from Ayurveda lens we can draw some hypothesis so as to what conditions and symptoms explained in Ayurveda treatises fall under the umbrella of hypoparathyroidism or under the umbrella of which Ayurveda diseases and symptoms does hypoparathyroidism tentatively fall. This will help us understand hypoparathyroidism from Ayurveda perspective which will further help in treating it through Ayurveda interventions.
Brief introduction to Parathyroid Glands and Hypoparathyroidism
Parathyroid Glands
Parathyroid Glands are four small glands located behind the thyroid gland and at the bottom of our neck. These glands produce a hormone named ‘parathyroid hormone’. This hormone regulates the levels of calcium and phosphorus in the blood. It also controls the levels of vitamin D in the blood and bones which is mainly important for nerve and muscle functions and also for bone health.
Less production of parathyroid hormone (PTH) causes low amounts of calcium in the blood (hypocalcemia). Too much parathyroid hormone causes high amounts of calcium in the bloodstream (hypercalcemia).
Hypoparathyroidism
Hypoparathyroidism is a condition marked by low levels of parathyroid hormones in the blood. This condition causes low levels of calcium in the blood. It is caused by damage to the parathyroid glands and also by certain autoimmune and genetic diseases. It is a rare but treatable condition. On the other hand it is a chronic condition but can also be a temporary one.
Hypoparathyroidism also happens when the parathyroid glands are removed surgically or when the body is resistant to PTH (parathyroid hormone). Hypoparathyroidism can also be hereditary.
Hypoparathyroidism – Ayurveda Perspective
Hypoparathyroidism Symptoms: Dosha Link
Vata dominates the picture amongst the symptoms of hypoparathyroidism
Pain and different kinds of pain manifestations are due to aggravated vata. Muscle cramps, tingling sensation, muscle spasms are all caused due to vata aggravation. Likewise pain in the abdomen and painful menstrual periods which are common in hypoparathyroidism are also caused by vata.
Seizures and tremors are also caused due to vata. Kampa wherein there are tremors and akshepaka wherein there are seizures as predominant features are part and parcel of vatavyadhi – specific disorders caused by aggravated vata. All these are caused due to excessive increase of chala guna (mobility attribute or quality) of vata. Here we can see the disturbance of vyana and prana vata.
Likewise arrhythmias, confusion, anxiety, low blood pressure and heart failure are all caused by fluctuations in the chala (mobile quality) and or sukshma guna (minute quality) of vata. We can see that imbalance of Prana, Udana and Vyana Vatas are involved in these symptoms.
Dryness skin, dry hairs and scaly skin are caused due to increase in ruksha (dry) and khara (rough) qualities of vata and also affliction of rasa tissue and its channels and heart by aggravated vata. Hair loss is due to dry, light and minute qualities of vata.
Bone is an important seat of vata. Nails and hairs are said to be the waste products of bones. So they too have a vata connection. Therefore the bone diseases, weak tooth enamel (teeth are called as ruchakasthi – a type of bone in Ayurveda), dental problems, brittle nails and hair loss – all are caused by aggravated vata.
Likewise vata is also involved in the causation of cataracts.
Looking at a grosser picture it is clear that ‘aggravated vata’ is the main dosha involved in the causation of many symptoms of hypoparathyroidism. Hence mathematically hypoparathyroidism is also a condition caused by high vata activity in the body.
Hypoparathyroidism – Dhatu Link
Mainly it is seen that the mamsa dhatu – muscles and asthi dhatu – bone tissues are involved or affected in hypoparathyroidism as evident from its symptoms. Involvement of skin and heart and disorders occurring therein suggest involvement of rasa (lymph, plasma) tissue and the related channels. Seizures and tremors indicate the involvement of majja (mastulunga – brain and nerves) dhatu. Seeing the bigger picture it is once again the vata dosha which afflicts these tissues in the pathogenesis of hypoparathyroidism.
Vata connection in Hypocalcemia – Hypocalcemia is an important event occurring in hypoparathyroidism. When it happens the nerve functions, muscle contractions (body movements), proper heart functioning and clotting of blood are affected. We can once again see that vata is the chief culprit behind all these pathological manifestations. So we can infer that hypocalcemia symptoms are proximate to the symptoms of vata aggravation.
From the perspective of causative factors – We can see that hypoparathyroidism is caused by damage to the glands. Injury (surgery) and affliction of the body or body parts by external causes (radiation) will definitely cause vata aggravation. In Di syndrome which is the most common genetic cause for hypoparathyroidism, the parathyroid glands are absent in the child. Absence of any organ or tissues or destruction of the same in the intrauterine life of an individual are due to vata of the fetus afflicting, damaging or destroying those structures. By birth those structures may be absent. Vata is predominantly made up of Vayu (air) and Akasha (ether, space) elements and these elements are involved in spacing, structuring and shaping the structures of the body in the fetus.
From the perspective of complications of hypoparathyroidism – Just like the symptoms we can also see that most of the complications are ‘vata caused’. Poor growth, slow mental development and dental issues in children, kidney dysfunctions, seizures, spasms of larynx, cramps, muscle pains and twitches, tingling sensation, cardiac arrhythmias, fainting, heart failure, hardening of and change in shape of the bones, and problems related to body balance – all are caused by high vata.
From the Vyadhi perspective
Diseases (explained in Ayurveda) which can be considered under the umbrella of hypoparathyroidism
Aakshepaka – tetanic seizure
Akshepaka is one of the special vata disorders included in vata vyadhi. In this condition, the vitiated vata afflicts the nerves all over the body and causes severe convulsions. These convulsions occur repeatedly. This condition can be closely compared to the seizures occurring in hypoparathyroidism. This is called tetany or tetanic seizure. It is a medical sign consisting of the involuntary contractions of muscles. We can see vata vitiation causing akshepaka, a condition similar to tetanic seizures of hypoparathyroidism.
Other conditions (which fit into the explanation of symptoms and complications of hypoparathyroidism)
– Mamsagata Vata – aggravation of vata inside the muscles
– Asthigata Vata – aggravation of vata inside the bones
– Majjagata Vata – aggravation of vata inside the bone marrow / brain
– Rasagata Vata – aggravation of vata inside the lymph / plasma and channels of transportation of rasa tissue
Summing it up
In the bigger picture, the pathogenesis and symptoms of hypoparathyroidism clearly look like a ‘high vata condition’.
Ayurveda Treatment of Hypoparathyrodism
Treating Vata Aggravation
While treating hypothyroidism in an Ayurveda way the primary and most important approach would be treating vata aggravation and bringing it into a state of balance. So, all vata alleviating and balancing measures including foods, medicines, therapies and life activities should be brought into implementation.
Nidana Parivarjana – Avoidance of etiological factors that would lead to vata aggravation – including foods, life activities and seasons.
Among therapies, the important ones would be –
External
– Abhyanga – herbal oil massage
– Swedana – herbal sudation including showering and tub bath using herbal decoctions and milk, pinda sweda (fomentation with bolus consisting of paste of leaves of vata alleviating herbs or shashtika rice processed in medicated milk)
– Sarvanga dhara – pouring of herbal decoctions, oils or milk over the body
– Murdni Taila – oil therapies on the head, mainly shirovasti (oil pooling on the head) and shirodhara – pouring medicated oils or milk in streams over the head
Internal – Important Panchakarma therapies
– Vasti – oil and decoction enemas prepared with vata mitigating herbs
– Tikta Ghrta / Ksheera Basti – enema with ghee or milk prepared with bitter tasting herbs
– Virechana – therapeutic purgation
Other principles of treatment
Depending on the predominant symptoms and complications treatment principles of the below mentioned conditions can be administered –
– Mamsagata Vata Chikitsa – in presence of pain in the muscles and soft tissues
– Asthigata Vata Chikitsa – in presence of pain in bones, joints and teeth
– Majjagata Vata Chikitsa – in presence of seizures, tremors, pains and other neurological symptoms
– Rasagata Vata Chikitsa, Rasavaha Sroto Dushti and Hrdroga Chikitsa – in presence of heart conditions like arrhythmias
– Koshtagata Vata Chikitsa – in presence of abdominal pain
Useful herbs in Hypoparathyroidism
– Guggulu – Commiphora mukul
– Arjuna – Terminalia arjuna
– Ashwagandha – Withania somnifera
– Bala – Sida cordifolia
– Laksha – Lac
– Kapikachchu – Mucuna pruriens
– Brahmi – Bacopa monniera
– Sthira – Desmodium gangeticum
Useful formulations in Hypoparathyroidism
– Yogaraja Guggulu
– Lakshadi Guggulu
– Trayodashanga Guggulu
– Vatagajankusha Rasa
– Mahavatavidhwans Rasa
– Vata vidhwamsini Rasa
– Maharasnadi Kashayam
– Dhanwantaram Kashayam
– Ashwagandharishtam
– Dashamoolarishtam
– Saraswatharishta
– Arjunarishta
– Balarishtam
– Guggulutiktaka Ghritam
– Ashwagandhadi Ghritam
– Kalyanaka Ghritam
– Brahmi Ghrtam
– Saraswatha Ghrtam
– Gandha Tailam
– Ksheerabala tailam 101
– Dhanwantaram 101
Useful Yoga postures in Hypoparathyroidism
– Viparita Karani – Legs Up The Wall Pose
– Matsyasana – Fish Pose
– Navasana – Boat Pose
– Marjaryasana – Cat-Cow Pose
– Sarvangasana – Shoulder Pose
– Halasana – Plow / Plough Pose
– Shavasana – Corpse Pose
