Efficacy of yoga in controlling subclinical-hypothyroidism: a randomized controlled trial

Rukamani Nair; Ranjna Chawla; Vipin Rai Sood; B. K. Roy; Somnath Mukherjee

doi:10.18203/2349-3259.ijct20211464

Authors

Rukamani Nair Research and Development Division, Bapu Nature Cure Hospital and Yogashram, Delhi, India
Ranjna Chawla Department of Biochemistry, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, India
Vipin Rai Sood Department of General Medicine, Dr. Sood Clinic, Mayur Vihar Phase I, Delhi, India
B. K. Roy Department of Endocrinology, Hormone Clinic, Laxmi Nagar, Delhi, India
Somnath Mukherjee Research and Development Division, Bapu Nature Cure Hospital and Yogashram, Delhi, India

DOI:

https://doi.org/10.18203/2349-3259.ijct20211464

Keywords:

Yoga, Subclinical hypothyroidism, Thyroid stimulating hormone, Randomized controlled trial

Abstract

Background: A huge population in India is at high-risk of developing thyroid related disorders. Unhealthy lifestyle (lack of physical activity and consumption of junk food) is common among Indian population. Yoga is a form of physical activity and helps prevent many lifestyle disorders. The research question to be addressed by this randomised controlled trial (RCT) is whether yoga based intervention is effective in preventing overt hypothyroidism among sub clinical hypothyroid people in India as compared to untreated participants.

Methods: This is a single-blinded, two-arm, parallel-group RCT. Eligible participants should be aged 21-59 years, suffering from sub clinical hypothyroidism (serum thyroid stimulating hormone i.e. TSH level 4.2 mIU/l >TSH level <10 mIU/l; T3 and T4 within normal range). At least 100 participants will be randomised either to the intervention group or the control group. Intermediate follow up at 3 month and final follow-up will be at six month post intervention. This study is designed to study the effect of yoga intervention on biochemical tests {thyroid function tests (fT3, fT4 and TSH)}, physical parameters (waist circumference, waist hip ratio, fat percentage and BMI) and psychological parameters {quality of life (QOL) as assessed by World Health Organization (WHO)-QOL, sleep quality (assessed by PSQI) and depression (assessed by BDI-II)} in sub-clinical hypothyroid patients.

Conclusions: We are now conducting a RCT in Delhi, India to assess the efficacy of yoga in preventing progression of subclinical- hypothyroidism to overt hypothyroidism. If the yoga intervention used in this study is effective, it will be a low-cost feasible treatment for subclinical hypothyroidism in India.

Trial registration: Trial registration number is CTRI/2020/03/024023.

Metrics

Metrics Loading ...

References

Unnikrishnan AG, Menon UV. Thyroid disorders in India: An epidemiological perspective. Indian J Endocrinol Metab. 2011;15:78-81.

Unnikrishnan AG, Kalra S, Sahay RK, Bantwal G, John M, and Tewari N. Indian J Endocrinol Metab. 2013;17(4):647-52.

Taylor PN, Albrecht D, Scholz A, Gutierrez-Buey G, Lazarus JH, Dayan CM, Okosieme OE. Global epidemiology of hyperthyroidism and hypothyroidism. Nat Rev Endocrinol. 2018;14(5):301-16.

Møllehave LT, Linneberg A, Skaaby T, Knudsen N, Ehlers L, Jørgensen T, Thuesen BH. Trends in Costs of Thyroid Disease Treatment in Denmark during 1995-2015. Eur Thyroid J. 2018;7(2):75-83.

Gharib H, Tuttle RM, Baskin HJ, Fish LH, Singer PA, McDermott MT Subclinical thyroid dysfunction: a joint statement on management from the American Association of Clinical Endocrinologists, the American Thyroid Association, and The Endocrine Society. J Clin Endocrinol Metab. 2005;90:581-5.

Vanderpump MP, Tunbridge WM, French JM. The incidence of thyroid disorders in the community: a twenty-year follow-up of the Whickham Survey. Clin Endocrinol (Oxf). 1995;43(1):55-68.

Canaris G, Manowitz NR, Mayor G, Ridgway EC. The Colorado thyroid disease prevalence study. Arch Intern Med. 2000;160(4):526-34.

Danese MD, Ladenson PW, Meinert CL, Powe NR. Effect of thyroxine therapy on serum lipoproteins in patients with mild thyroid failure: a quantitative review of the literature. J Clin Endocrinol Metab. 2000;85(9):2993-3001.

Hueston WJ, King DE, Geesey ME. Serum biomarkers for cardiovascular inflammation in subclinical hypothyroidism. Clin Endocrinol. 2005;63(5):582-7.

Reuters VS, Teixeira Pde F, Vigário PS, Almeida CP, Buescu A, Ferreira MM, de Castro CL, Gold J, Vaisman M. Functional capacity and muscular abnormalities in subclinical hypothyroidism. Am J Med Sci. 2009;338(4):259-63.

Roberts LM, Pattison H, Roalfe A, Franklyn J, Wilson S, Hobbs FD, Parle JV. Is subclinical thyroid dysfunction in the elderly associated with depression or cognitive dysfunction? Ann Intern Med. 2006;145(8):573-81.

Anderson JG, Taylor AG. The metabolic syndrome and mind-body therapies: a systematic review. J Nutr Metab. 2011;276419.

Larson-Meyer DE. A Systematic Review of the Energy Cost and Metabolic Intensity of Yoga. Med Sci Sports Exerc. 2016;48(8):1558-69.

Wallace R K, Benson H, Wilson AF. A wakeful hypometabolic physiologic state. Am J Physiol. 1971;221(3):795-9.

Rawal SB, Singh MV, Tyagi AK, Selvamurthy W, Chaudhuri BN. Effect of yogic exercises on thyroid function in subjects resident at sea level upon exposure to high altitude. Int J Biometeorol. 1994;38(1):44-7.

Swami G, Singh S, Singh KP, Gupta M. Effect of yoga on pulmonary function tests of hypothyroid patients. Indian J Physiol Pharmacol. 2009;54(1):51-6.

Singh P, Singh B, Dave R, Udainiya R. The impact of yoga upon female patients suffering from hypothyroidism. Complement Therap Clin Pract. 2011;17(3), 2011:132-4.

Nilakanthan S, Metri K, Raghuram N, Hongasandra N. Effect of 6 months intense Yoga practice on lipid profile, thyroxine medication and serum TSH level in women suffering from hypothyroidism: A pilot study. J Complement Integr Med. 2016;13(2):189-93.

Banerjee S. Study on Yoga Intervention along with Diet on Hypothyroidism Associated with Obesity among Sedentary Working Women in West Bengal. Int J Yoga Allied Sci. 2019;8(1).

Ranjna C, Rukamani N, Somnath M, Ibotombi MY, Sood VR. Outcome of six months of yogic practices on psychological parameters in patients suffering from hypothyroidism. IJAAR. 2020;4(6):513-28.

Chawla R, Nair R, Mukherjee S, Chawla R. Therapeutic Effects of Yoga in Managing Anthropometric Measures, Signs and Symptoms in Hypothyroid Patients. Int J Ayu Alt Med. 2019;7(3):99-107.

Balayogi BA, Sanjay Z, Madanmohan. Effect of yoga on subclinical hypothyroidism: a case report. Yoga Mimamsa. 2011;18(2):102-7.

Gowda S, Mohanty S, Saoji A, Nagarathna R. Integrated Yoga and Naturopathy module in management of Metabolic Syndrome: A case report. J Ayurveda Integr Med. 2017;8(1):45-8.

Bhavanani AB, Sanjay Z, Mohan M. Effect of Yoga on subclinical hypothyroidism: A case report. Yoga Mimamsa. 2011;43(2):102-7.

Nilakanthan S, Metri K, Raghuram N, Hongasandra N. Effect of 6 months intense Yoga practice on lipid profile, thyroxine medication and serum TSH level in women suffering from hypothyroidism: A pilot study. J Complement Integr Med. 2016;13(2):189-93.

Saha M, Halder K, Tomar OS, Pathak A, Pal R. Yoga for Preventive, Curative, and Promotive Health and Performance. Translational Research in Environmental and Occupational Stress. Springer, New Delhi. 2014;169-80.

Saraswati, Satyananda S, Hiti JK. Asana pranayama mudra bandha. Bihar, India: Yoga Publications Trust. 1996.

Das S, Mitra K, Mandal M. Sample size calculation: Basic principles. Indian J Anaesth. 2016;60:652-6.

Shetty GB, Shetty B, Shetty P. Effect of short-term naturopathy and yoga intervention on anthropometric variables, lipid profile and thyroid profile in obese hypothyroid patients: a randomised controlled trial. Int J Basic Clin Pharmacol. 2020;9(2):247-53.

James F. Science Studies Yoga: A Review of Physiological Data. Honesdale,Penn: Himalayan International Institute of Yoga Science & Philosophy. 1977.

Singh RH, Shettiwar RM, Udupa KN. Physiological and therapeutic studies on yoga. Yoga Rev. 1982;2(4):185-209.

Khalsa SBS. Yoga as a therapeutic intervention: a bibliometric analysis of published research studies. Indian J Physiol Pharmacol. 2004;48(3):269-85.

Skevington SM, Lotfy M, O'Connell KA. The World Health Organization's WHOQOL-BREF quality of life assessment: Psychometric properties and results of the international field trial. A Report from the WHOQOL Group. Quality of Life Research: An Int J Quality Life Aspects Treatment, Care Rehabilitation. 2004;13(2):299-310.

Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatr. 1961;4:561-71.

Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatr Res. 1989;28(2):193-213.