WHAT ARE THYROID FUNCTION DISORDERS ?
Thyroid Function Disorder effectively is an Hormonal disorder related to secretion or synthesis or both of the T3 and T4 hormones. These hormones are secreted by the thyroid gland and are responsible for variety of functions in a human body
HOW ARE THYROID FUNCTION DISORDERS MAPPED ?
Effectively thyroid disorders are mapped in two categories functionally as
- Hyperthyroidism where there is excess production of Thyroid hormones
- Hypothyrodism where there is less than normal production of Thyroid hormones
Apart from this there are other categories of Thyroid function disorders which are nothing but causative factors for the above two disorders and are mapped individually for effective treatment . These disorders can arise due to
Nodular abnormalities – Goitre (Swelling of Thyroid gland)
- Endemic goitre
- Diffuse goitre
- Multinodular goitre
- Lingual thyroid
- Thyroglossal duct cyst
- Thyroid adenoma
Deficiences or Excess
- Resistance to Thyroid hormone
- Pituitary Malfunction
- Congenital Hypothyroidism
- Congenital absence of Thyroid Gland
CAN YOU EXPLAIN IN AN EASY LANGUAGE ?
To understand Thyroid function disorders one must know the basic pathology of thyroid gland. The major thyroid hormone secreted by the thyroid gland is thyroxine, also called T4 because it contains four iodine atoms. To exert its effects, T4 is converted to triiodothyronine (T3) by the removal of an iodine atom. This occurs mainly in the liver and in certain tissues where T3 acts, such as in the brain. The amount of T4 produced by the thyroid gland is controlled by another hormone,which is made in the pituitary gland located at the base of the brain, called thyroid stimulating hormone (TSH). The amount of TSH that the pituitary sends into the blood stream depends on the amount of T4 that the pituitary sees. If the pituitary sees very little T4, then it produces more TSH to tell the thyroid gland to produce more T4. Once the T4 in the blood stream goes above a certain level, the pituitary’s production of TSH is shut off.
HOW ARE THYROID FUNCTION DISORDERS DIAGNOSED ?
Thyroid function disorders are so closely related to certain symptoms , most prominent being weight; that in todays world, it would be improbable for an urban woman to have not been tested for thyroid functions. One can always search on the net for the list of symptoms that indicate a malfunctioning thyroid gland. I will put forth some definitive symptoms in women which indicate a Thyroid function compromise
- Sudden weight gain or loss.
- Similarly inability to bear temperature variations
- Mood swings
- Menstrual irregularities
- Food cravings
- Irregular bowel movements
- Muscle and tendon pain
- Shunted Growth
The listed symptoms with its manifestations on extreme sides would warrant a blood work and may determine whether one has an over or underperforming gland. There are certain secondary disorders in women which may arise due to Thyroid gland malfunction or conversely cause the malfunction.
- Polycystic Ovarian syndrome
WHAT ABOUT AUTOIMMUNE THYROIDITIS ?
In many parts of the world, Thyroid disorders are handled differently by medical practitioners. The most commonly missed point is the antibody involvement. The immune system of the body normally protects us from foreign invaders such as bacteria and viruses by destroying these invaders with substances called antibodies produced by blood cells known as lymphocytes. In many patients with hypothyroidism or hyperthyroidism, lymphocytes make antibodies against their thyroid that either stimulate or damage the gland. Though from modern medicine point of view presence of antibodies may not have significant alteration in the treatment modalities, it is very important to know the significance as it may help very much on holistic basis to tackle the problem. Having antibodies for Thyroid gland in brief indicates that your gland may be in danger even though it itself may not have any malfunction or be perfectly normal. Thyroid specific antibodies when secreted in the blood either destroy the thyroid gland cells or destroy the receptor cells on which the TSH hormone attaches contributing to malfunction. When this antibodies are at rest the gland functions perfectly normal. In such patients seasonal variations, infections or anything similar that provokes an immune response from the body activates these antibodies and attacks the gland. Such patients may many times find their blood work on extremes shunting from Hyper to Hypothyroid. Hence its very important to periodically check the Thyroid hormones to have proper dosages. There is view amongst certain endocrinologist to start Thyroid medication if high levels of antibodies are detected even if the Thyroid Function tests are normal to prevent long term damage.
WHAT BLOOD AND OTHER TESTS ARE DONE TO DIAGNOSE THYROID FUNCTION DISORDERS ?
A high TSH level indicates that the thyroid gland is failing because of a problem that is directly affecting the thyroid (primary hypothyroidism). The opposite situation, in which the TSH level is low, usually indicates that the person has an overactive thyroid that is producing too much thyroid hormone (hyperthyroidism). Occasionally, a low TSH may result from an abnormality in the pituitary gland, which prevents it from making enough TSH to stimulate the thyroid (secondary hypothyroidism). In most healthy individuals, a normal TSH value means that the thyroid is functioning normally.
T4 circulates in the blood in two forms:
- T4 bound to proteins that prevent the T4 from entering the various tissues that need thyroid hormone
- Free T4, which does enter the various target tissues to exert its effects.
The free T4 fraction is the most important to determine how the thyroid is functioning, and tests to measure this are called the Free T4 (FT4) and the Free T4 Index (FT4I or FTI). Individuals who have hyperthyroidism will have an elevated FT4 or FTI, whereas patients with hypothyroidism will have a low level of FT4 or FTI.
Combining the TSH test with the FT4 or FTI accurately determines how the thyroid gland is functioning. The finding of an elevated TSH and low FT4 or FTI indicates primary hypothyroidism due to disease in the thyroid gland. A low TSH and low FT4 or FTI indicates hypothyroidism due to a problem involving the pituitary gland. A low TSH with an elevated FT4 or FTI is found in individuals who have hyperthyroidism.
T3 tests are often useful to diagnosis hyperthyroidism or to determine the severity of the hyperthyroidism. Patients who are hyperthyroid will have an elevated T3 level. In some individuals with a low TSH, only the T3 is elevated and the FT4 or FTI is normal. T3 testing rarely is helpful in the hypothyroid patient,since it is the last test to become abnormal. Patients can be severely hypothyroid with a high TSH and low FT4 or FTI, but have a normal T3. T3 like T4 is also measured in its two forms
- Total T3
- Free T3
THYROID ANTIBODIES TEST
Anti- TPO [Antibody to Thyroid Peroxidase] & Anti-TG [Antibody to Thyroglobulin]
Positive Anti-TPO and/or Anti-TG in a patient with hypothyroidism make a diagnosis of Hashimoto’s thyroiditis. If the antibodies are positive in a hyperthyroid patient, the most likely diagnosis is autoimmune thyroid disease [Grave’s Disorder]
These antibodies are tested on basis of their activation and blocking mechanism and are confined to the nature of autoimmune thyroditis the patient acquires
- Activating TrAb antibodies bind to the TSH receptor causing overproduction of Thyroid hormones leading to hyperthyroidism. They are supposedly associated with a complication of Grave’s disease known as Grave’s opthalmopathy
- Blocking TrAb antibodies as name suggest block the activity of TSH causing Hypothyrodism. This antibodies many times cause fluctuation in long term treatment. These bodies can become predominant in patients who are being treated for Grave’s hyperthyroidism
The protein , thyroxine binding globulin (TBG) is caries the Thyroid hormones through circulation by binding to them. Though not a very reliable and popular test, the measurement of this protein can be sometimes ordered to evaluate synthesis of thyroid hormones especially in Hypothyroidism. It can also be used to understand the effectiveness of treatment.
Radioactive iodine uptake
Because T4 contains much iodine, the thyroid gland must pull a large amount of iodine out from the blood stream in order for the gland to make an appropriate amount of T4. The thyroid has developed a very active mechanism for doing this. Therefore, this activity can be measured by having an individual swallow a small amount of iodine, which is radioactive. The radioactivity allows the doctor to track where the iodine molecules go. By measuring the amount of radioactivity that is taken up by the thyroid gland (radioactive iodine uptake, RAIU), doctors may determine whether the gland is functioning normally.
A very high RAIU is seen in individuals whose thyroid gland is overactive (hyperthyroidism), while a low RAIU is seen when the thyroid gland is under active (hypothyroidism).
In addition to the radioactive iodine uptake, a thyroid scan may be obtained, which shows a picture of the thyroid gland abnormalities
HOW ARE THYROID FUNCTION DISORDERS TREATED IN MODERN MEDICINE ?
Thyroid disorders are treated as per the condition one acquires. Without going much into detail i will enlist the protocols for each
The aim here is to supplement the deficient hormone that the gland is unable to produce.
This treatment involves supplementation of levothyroxine alone, in a synthetic form. It is currently the standard treatment in mainstream medicine.
T4 and T3 in combination
This treatment protocol involves administering both synthetic L-T4 and L-T3 simultaneously in combination.
Desiccated thyroid extract
Desiccated thyroid extract is an animal-based thyroid extract, most commonly from a porcine source. It is also a combination therapy, containing natural forms of L-T4 and L-T3, as well as L-T1 and L-T2, which are not present in synthetic hormone medication.
The aim here is to suppress the production of Thyroid hormones. Thyroid hormone production can be suppressed or halted completely in these ways:
Radioactive iodide treatment : Administration of tablet or liquid containing radioactive iodide in amounts large enough to damage the cells of the thyroid gland and limit or destroy their ability to produce hormones. This is called “ablation” and the idea here is to induce Euthyroid or Hypothyroidism (which is then monitored by giving mostly synthetic T4 supplements)
Anti-thyroid medication (carbimazole , methimazole, propylthiouracil/PTU &potassium perchlorate.)
Surgery is sometimes recommended for people under age 45 when their hyperthyroidism is due to toxic nodules, because these nodules tend to be resistant to anti-thyroid medications.
CONGENITAL THYROID ABSENCE AND CRETINISM
Certain people are born without a Thyroid gland. In case of congenital absence of Thyroid gland, management on lines of Hypothyroid is done along with other supplements to account for the absent hormones. In many infants there is a congenital deficiency of Thyroid hormones which is left untreated and may lead to stunted growth and mental retardation. This condition is known as Cretinism and is treated on similar lines with additional supplements and medicines for growth enhancements. A separate article would cover these disorders.
These is just a general overview of the treatments available. The best approach is decided by the endocrinologist. Since this article deals with Ayurveda management, I would avoid explaining in detail on allopathy lines of management.
DO THYROID FUNCTION DISORDERS AFFECT MALES ?
Yes, they very much do, though the ratio compared to women is very less. In males these disorders are seen due to Auto Immunity. However since this blog deals with women disorders, I would be restricting the treatments and descriptions in view of women. The remedies mentioned here will also show good effect for males, but they are requested to consult an expert for long term management
HOW DOES AYURVEDA APPROACH THYROID MALFUNCTIONS ?
Ayurveda does not have direct references to these disorders as described by modern science. Ayurveda focusses on maintaining the health and equilibrium of the body, and the evaluation of Thyroid disorders can be done through various disorders and symptoms mentioned in the treatises. One must understand that Thyroid disorders, especially Hypothyroidism is a lifestyle disorder more prevalent in current ages of sedentary lifestyle. Hyperthyroidism as a disorder through its symptoms finds indirect references but clear mention in Ayurveda treatise though a disorder named “Bhasmak”.
The whole idea of explaining both the disorders under one article is to give a single approach towards the well being of human body. Metabolic disorders in brief can be understood in simple terms of failure of demand and supply. This pertains to each individual and hence Ayurveda gives individualized solution for betterment and a healthy life. For example a women working in the fields and a women who is a housewife are both detected with Hypothyrodism. The lab reports indicate same values. Most of the times the doctors may prescribe similar potency of hormone , but on individual terms if we understand the synthesis of hormones would be different as per the work and lifestyle each individual women has. It is important here is to understand the genesis and working of these hormones on minute levels with respect to each ones social and physical commitments.
To describe in brief,Thyroid disorders in women depict metabolic dysfunctions which affect the reproductive, mental and physical states of the body. These disorders arise due to abnormal secretion of hormones maybe due to structural or functional disorders. Only supplementing the hormones or blocking them may give pathological excellence but may not effect the synthesis. For a good healthy life these hormones must be effectively synthesized by the body which is the prime reason why symptoms occur. Ayurveda through its individual holistic approach has a corrective function on these micro metabolic apparatus and over a period of time creates a healthy environment for the effective production and synthesis of the hormones.
CAN YOU DESCRIBE SOME EFFECTIVE REMEDIES ?
The approach towards Thyroid disorders being simple the treatment modalities differ as per the presentation. I won’t go into detail of giving medicines for disorders and one must not even take them to be complete treatment. My aim here is to inform the patient about how one must go about in starting natural treatments and slowly incorporating them for long term gain.
My first and foremost advice would be to anyone who is trying to evaluate natural remedies for Hypothyrodism is NOT TO STOP the Thyroxine hormone one is taking. Remember there should not be any confusion as to what one is trying to achieve. It will be apparent from my above description that the main aim here is synthesis of the hormone and not supply. Since the hormone is not synthesized its dosage goes on increasing with time. It is quite common in many to have started with 25mcg and reached to almost 100mcg to 200mcg 2-3 times a day. One must not be obsessed with TSH values but rather focus on the symptoms and understand the pathology.
Thyroid medication must always be calculated as per month. So if you are taking 50mcg a day that effectively you are taking 1500mcg a month. When Ayurveda medicines start showing their effect , with constant monitoring the dose of Thyroxine must be reduced on basis of cumulative dosage per month. TSH values must be done every 45 days to monitor the progress. One must understand that the a value of TSH between 1-2.5 is optimum for women who are NOT ON thyroid medication. This is not a rule but one of observations I have seen in treating umpteen patients. If your diet and supplements are working than with thyroxine treatment the TSH must fall below 0.35 and if it does consistently than you can say your treatment is working and slow reduction of dosage is optimum. One must also understand that Thyroid functionality changes every season especially in women as it has to adjust to temperature variations keeping the environment of ovarian reserves constant. Prominently the gland variations can be seen in summer and winter season where TSH and T3 T4 values alter naturally. Hence once must always be aware of this fact when undertaking natural treatments and subsequent dose reductions
Another important point here is to know about Autoimmunity. If your antibodies are high many times after initial treatments the TSH may fall drastically and one may be in a false impression of getting cured and reduce the dose in high proportions which may trigger the body to increase TSH voraciously. When one has antibodies, one must try and know the SWEET spot on which the thyroxine dose could be maintained. Whether such patients can become hormone therapy free only time would tell, but in my practice even if the patients go into so called remission I always tell them to maintain the minimal dose of hormone for safety. The Antibodies must be checked 1-2 times a year and such patients must take care at change of each season.
In many countries like India, NDT [Natural Dessicated Thyroid] is not available. Also many doctors do not supplement T3 with T4 or only dose T4. This in long run has many chemical implications on the body. Hence one must always research on the exact dosing of hormones when it comes to AIT. Though this requires a complete separate chapter and is out of scope of this article, it never hurts to research if things are not working out.
Now understanding above points one must approach the disorder by modifying lifestyle.
- Food timings must be fixed.
- Salt restriction is another major aspect.
- Castor oil massage which I recommend to be done regularly. Warm castor by placing bottle in warm water. Massage in circular motion over the ovaries every night. Plus soak a swab in the oil and place it in navel before sleeping. This is very effective. In case of women who have big cyst on a particular ovary can apply castor oil packs. Castor oil packs are different from massage. One can search on the net how to prepare them, hre are plenty of self help videos.
- Avoid all forms of refined sugar, fruits, nuts. Even fruit juices which contain fructose. Reduce your insulin spikes. Do not eat after sunset. If you find cravings for sugar cut coconut rind [entire one with oil in it] and eat. It is highly beneficial
- Stay away from Aluminum, Steel. Use copper, brass [with tin work], earthen, iron cooking glass vessels for cooking
- Check your fasting Insulin levels and do Iron studies. Your ferritin levels must be ideally between 40-70 [normal range 15-150] and S.iron must be above 80. If not your mineral imbalance may cause problems. Through Ayurveda Bhasma this is effectively corrected in very short time but supervision is required. Do not self medicate.
The lifestyle modifications are identical to ones I describe in my other articles regarding Thyroid , Breast cancer and Endometriosis the reason being all these disorders have common metabolic anomalies and one must research in the diet to get good control of Estrogen. as these all disorders mostly happen due to Estrogen malfunctions.
A lecture on general dinacharya has been uploaded on the youtube channel. I am embedding it here.
Along with this following herbal preparations will help
- Vidang [Embelia ribes] 6gms, Kanchan bark [Bauhinia sp] 10gms, Arjun [Terminalia arjuna] 5gms, Manjishta [Rubia cordifolia ] 2gms. Soak these herbs in 300ml of water. Boiland reduce to 50ml. Filter and drink 2 times a day.
- Gorakhmundi [Sphaeranthus indicus] 100gms. Boil the herbs in 1ltre of water, reduce to 500ml and store in glass bottle. Drink 50ml of 75ml of the mixture 2 times a day. Make fresh when medicine gets over
The above medicines along with proper diet and lifestyle will help control thyroid malfunction. Do continue this for 3 months and see the results. If you do find positive result PLEASE CONSULT a good Ayurveda physician for long term benefit. Do not self medicate
A WORD ABOUT IODINE
Many patients seem to be bent on consuming iodized salt for Hypothyroidism. Do not be obsessed with iodine. Remember if one require iodine it is abundant in certain foods and one can use that source. Salt as such must be avoided as it disrupts metabolic systems and must be used with care.However if you are using Himalayan Crystal salt it contains all minerals including Manganeses so always prefer it rather than synthetic Iodized salts. Iodine deficinecy is found in certain parts of the world due to topographic reasons leading to Goitre, due to overstimulation of thyroid gland as a result of less production of the hormones. In such cases Iodine supplements as main lines of treatment may be valid, though role of iodine as the only reason to thyroid suppression is arguable. Iodine monitoring is required in cases of AIT and must be done in conjunction with the FREE fractions of Thyroid hormones as evaluated by testing.
The approach towards attaining an metabolic stability also forms the core of Ayurveda management towards Hyperthyroidism. Hyperthyroidism on lines of its manifestations finds similar mention in Ayurveda text described as Bhasmak. The disorder corresponds to corruption of digestive fire[Agni] at all levels of digestion correlating it to fire which devours anything that comes in it way and does not subside. In India especially in certain parts of Maharashtra Bhasmya is a term commonly associated with people who have huge appetite but do not put an weight.
Similarly in most people who suffer from Hyperthroidism the main signs are of insatiable appetite without appreciable increase of weight though this may not be the only symptom or may not be persistent across patients.
Hyperthyroidism must be treated under supervision as it is more of a crude disorder than Hypothyroidism whose most affluent causes are sedentary lifestyles apart from autoimmune reasons. Hyperthyrodism has relevant structural and functional anamolies not completely precipitated due to lifestyle afflictions. It is more of a physiological disorder which needs to be carefully treated on individual basis with care and expertise. The disorder quickly proceeds to Goitre where the gland enlarges and surgical intervention is warranted. I would enlist few remedies which patients can use to obtain relief but as indicated its always better to get an expert opinion as soon as possible
The vegetables I have mentioned to avoid during Hypothyroidism will be beneficial in Hyperthyroidism. In case of Auto immunity like Grave’s its better to use them with supervision.
- Jalkumbhi[Naturtium officinale, Watercress] is a very effective herb. If one can find fresh, juice in dosage of 30ml 2 times a day is very beneficial. One can create an infusion by soaking the herb in warm water overnight in a ceramic vessel. Next morning filter , crush and drink. Repeat in evening
- Use of bananas is very useful in not only alleviating symptoms of Hyperthyroidism but also supporting the hormonal imbalance. I always suggest to use banana as medicine. Mash natural green bananas with cow’ ghee and have for breakfast till stomach is full. This if taken continuously for 15-20 days helps in proper synthesis. However be area that this can cause phlegm disorders in certain people and hence use with supervision. One can sprinkle some cardamom powder to reduce the phlegm activity.
- Shankhpushpi [C.plauricalus] roots 50gms. boil in 300ml water, reduce to 50ml to obtain a tea. filter and drink empty stomach, morning and evening. This is very effective medicine especially in Goitre.
- Sitaphal leaves [Anona squamosa] juice 20 ml is very effective medicine. If juice cannot be procured, dried powder in 5gms 2 times a day is very good. This can be combined with herbal tea of Shankhpushpi
Feasting on cabbage, kohlrabi, broccoli proves very beneficial. Salt restriction helps immensely in Hyperthyroidism. In any thyroid disorders apart from food, the main insistence must be to follow strict sleeping and eating habits to normalize hormones. This if done regularly, I have seen good results in very short span.
Apart from above certain preparations like Ashwagandhaarishta, Dashmularishta, Suvarnamalini Vasant benefit a lot but they must be used under supervision.
MENSTRUAL SPOT TEST
As a part of my Ayurveda regime, I always recommend each women to do this self test at home to check the menstrual health. During menses on all three days take a small amount of menstrual blood on a clean white cloth and allow to dry. After few minutes wash it with warm water. The blood should wash away without leaving behind any stain in normal hormonal profile. If stains are left than it indicates disrupted or about to be disrupted cycle and hormonal imbalance. If the treatment is working, the stain should wash away.
NOTE ABOUT SECONDARY DISORDERS DUE TO THYROID MALFUNCTION
Thyroid disorders can lead to secondary disorders like PCOS and INFERTILITY. The disorders have been explained in detail in other articles. To avoid confusion I would like to state that Ayurveda does not approach these as separate entities but chalks out a sustainable plan where the entire balance of the body is restored. However the choice of herbs may differ as per situations and results. Herbs like Vidanga used in initial stages to get good control over Thyroid gland may later be substituted by others to fortify fertility. This all depends upon the discretion of your Ayurveda physician and hence when undertaking natural treatments for such complex scenarios its always better to consult a good Ayurveda physician. You can read articles about PCOS and INFERTILITY at the following links
NOTE ABOUT GESTATIONAL THYROID FUNCTION DISORDERS
Certain women develop Thyroid malfunction during pregnancy, most common of which is Hypothyroidism. I would recomend such women to continue with Thyroxine treatment till pregnancy is completed and than if the condition persist go for natural remedies. An uncontrolled Hypothyroid disorder during pregnancy can cause congenital hypothyroidism in the infant leading to Cretinism. If still one wishes to pursue natural remedies , i would advise it to do under expert supervision and not self-medicate.
A WORD ABOUT BENIGN THYROID NODULES AND CANCER
The causes of Thyroid cancer although can be traced and prevented from the points discussed , the approach towards cancerous nodules and their treatment is bit different and I intend to cover it i another article. One must understand that not all Nodules are cancerous. Thyroid nodules develop in an hyper functioning gland and are often benign. These can be confirmed by ultrasound magnetic scans and biopsy, though I myself do not recommend biopsy if the patient has decided to go for natural treatments. Its just my opinion and not restricted to other medical fraternity about biopsy which I feel can trigger metastasis and advancement of cancer and are unwarranted unless the patient has decided that they want to go for surgery. Modern scanning techniques and expertise of good radiologist can give a fair idea of whether the nodule is cancerous or not. I personally recommend to try natural methods before any invasive procedure is performed. It is much easier to control and reverse. But these observations are just mine as per my clinical experiences and must not be taken as general. One must take umpteen opinions, research and only then proceed ahead with any treatments one feels comfortable. Ultimately its our own body and we must take care of it with responsibility.
The medications mentioned under Hyperthyroidism and Hypothyroidism will also show good effects for Nodular goiter depending upon the stage and functioning of the thyroid gland and the state of Antibodies. However in advanced stages or for patients who are reading this article after an invasive or surgical procedure is performed , it is recommended to consult a good Ayurveda physician near you for further treatment. Do not self medicate.
I will be discussing Thyroid Cancer and treatments in another article
ROLE OF PANCHAKARMA ?
Panchakarma is a specialized section of Ayurveda relating to methods employed to purify the body and then produce an environment for sustenance. In complex disorders like Thyroid malfunctions its role must be assessed and supervised by an expert as to implementation of therapy and medicines. I would not recommend patients going of self purificatory methods without proper evaluation as it may cause , alter hormonal balances in long run
ROLE OF YOGA ?
Yoga most times is associated with health, but one must remember what alters the electrical conductivity and stimulates organs through various postures can also gave ill effects. This is documented through various treatises on yoga. Many patients do Yoga exercises without understanding its dynamics. Pranayama alters the sympathetic and para sympathetic nervous system altering hot and cold channels. This is in direct conjunction with the Thyroid gland. Similarly certain asanas and Bandhas can stimulate the thyroid causing disruptions especially if you are on hormonal treatment. I would recommend patients to undertake Yogic exercises under supervision of an Ayurveda consultant as Yoga is a part of ayurveda and it requires proper knowledge of body functions and Marma points. Do not undertake exercises advertised or from word of mouth as testimonials. What works for others may not work for you. More importantly understand what one is trying to achieve and combine it with proper lifestyle and medication under expert guidance so that the overall quality of life increases. As project of NLAM, elite Hatha Yog sequences of therapeutic nature are being taught under the Marma Yog cluster. Yog Teachers who wish to gain the knowledge can know more about it at [www.marmayog.in].
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The information mentioned here is for educational puposes only. Do not try and use all in conjunction. Follow proper diet , timings, pick a safe remedy and employ. Observe over 20-45 days & if found relief consult a good Ayurveda physician for long term gain. Do not self-medicate. Do not pass on remedies through social media irresponsibly. It causes more harm than good
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