Effect of integrated approach of yoga therapy practices on hypothyroidism: A randomized controlled study.

Abstract

ABSTRACT BACKGROUND The thyroid disorder is the most prevalent disorder especially seen especially in women in these years. The normal thyroid gland functioning is interrupted due to thyroid disorder and results in abnormal thyroid hormone production that leads to hypothyroidism. According to one of the survey, about 30% of individuals with hypothyroidism were unaware of their illness. Therefore, the majority of people have thyroid problems. As a result, they cannot cope with thyroid problems and do not seek the correct therapy. Traditional hypothyroidism treatment aims to minimize complications by controlling dyslipidemia, TSH levels, and thyroxine dose. According to the survey led by the Indian thyroid society, thyroid disease is the ninth ranked disease. Replacing the thyroid hormones is safe and effective treatment methods as it effectively manages the thyroid symptoms and prevents further complications. There are several prescription procedures used to treat this condition, but they all have adverse effects. Antithyroid therapy is available on the market today, although the prescription and side effects are severe. Antithyroid hormone replacement drugs can only be used as a last resort for general wellbeing, as they can cause side effects to the patient. Intake of thyroid medicines reduces the thyroid hormones, “thyroxine and triiodothyronine”. Intake of medications over extended periods, often years, or even a lifetime. These drugs damage the liver, expose the body to bacteria, increase allergic reactions such as skin rashes, and early death is the worst case scenario. As a result, there is a critical need to raise thyroid condition awareness and expand care options. The th yroid gland produces thyroxine (T4) (four iodine atoms), and triiodothyronine (T3) (three iodine atoms) hormones. Yoga is one of the great exercise forms where; äsana, präëayäma, meditation and chanting have been shown to reduce stress levels by stimulating hormone health, pituitary and pineal glands. Thyroid disorder is mainly caused by an irregular lifestyle and can be addressed using an Integrated Approach of Yoga Therapy (IAYT). Though tentative research indicates that yoga can help with personality formation, cognitive skills, and the treatment of psychosomatic ix disorders in thyroid patients, no randomized control trial with a broad enough sample size has been performed. AIM AND OBJECTIVES AIM AND OBJECTIVES OF DESIGN 1 Aim of the study: To develop an Integrated Yoga module for hypothyroidism. Objective of the study: Customization and validation of the IAYT module for the hypothyroid problem. AIM AND OBJECTIVES OF DESIGN 2 Aim of the study: • To study the effect of an Integrated Approach of Yoga Therapy on hypothyroidism. Objectives of the study: • To study the changes in thyroid function and related parameters before and after IAYT yoga intervention. • To study the effect of IAYT on Weight, BMI, and Quality of Life and their correlation with IAYT yoga intervention of subjects suffering from hypothyroidism. METHODS Participants A population mix of seventy four men and women clinically diagnosed with hypothyroidism was considered for this study. Design Two groups were formed with seventy four hypothyroidism subjects, namely IAYT yoga intervention and waitlist control groups. Five sessions for five days were offered per week for the IAYT yoga intervention group, where ninety minutes x yoga course was carried out for five sessions a week for over 90 days as a complementary therapy to thyroid dysfunction. No type of exercise or physical activity is suggested to waitlist control group subjects during the study period. Once the study period is completed, and post data is collected, IAYT intervention provides for control group subjects, and the subject’s lifestyle and diet routine will be maintained in a record. In addition, at the beginning and end of the program, the World Health Organisation – WHO BRIEF’s, the Quality of Life was evaluated. Assessments Parameters such as “T3, T4, TSH, Free T3, Free T4, TPO, Tg Antibody, SHBG, Cortisol, CRP, Weight, BMI, and Quality of Life” were assessed. In addition, data on thyroid parameters were obtained by laboratory test reports. With the Body Mass Index (BMI), height details and Weight details, of subjects was calculated. Data on Quality of Life is calculated using WHO BRIEF (World Health Organization) Questionnaire. Intervention The yoga IAYT intervention (independent variable) is a personalized IAYT based yoga sequencer (attachment 3.0 and 4.0) for this research project that tackled problems at the païca koça level and included prayers/chanting, relaxations, meditations, präëayäma, äsanäs, and awareness stage. Subjects in the waiting list control group take their thyroid medications and go about their daily routines as usual. Three months of IAYT yoga intervention, five days per week and one and half hour a day was provided to IAYT yoga participants. Opening prayer, breathing exercise, loosening practice, äsanäs (static physical postures), sürya namaskära (Sun salutation), präëayäma (scientific method of regulating breath), calming activities, reflection and awareness point, banda, mudra, and kriyäs are all included in each class. A progressive training intervention load was introduced, xi including exercise, complex grades, and repeated from the beginning to the last training cycle. There are a few yoga exercises that cannot be practiced daily, although some need time. Clear procedures were applied at the beginning of the preparation. On the other hand, the waitlist control group suggests no exercises or other physical activities; they are just advised to follow their daily routine. The lifestyle and diet details before and during the program determined by WHO BRIEF questionnaire were tracked in the general record logbook. The IAYT yoga training protocol was described in depth elsewhere. All of the activities in this module were designed to increase physical activity and metabolic rate, reduce muscle tone, facilitate toxin removal, aid in the proper secretion of digestive enzymes, and improve the digestive system, particularly the liver, assist in the improvement of bodily and mental rest, aids in the relief of mental stress and tension, which is the leading cause of thyroid disorders, aids in the advancement of physical and psychological health both of the rituals, as well as the om chanting vibration (frequency), produce chemical hormones that stabilize the body and have healing, mental, behavioral, and psychological consequences. Results The paired sample t-test for normal distribution for within the group showed significant reduction in TSH (p=0.000, 48.34%), Cortisol (p=0.000, 31.46%), CRP (p=0.000, 47.06%), Weight (p=000, 5.76%) and BMI (P=000, 5.71%), highly significant reduction in TPO Antibody (p=0.001, 52.93%) and significant reduction in Tg Antibody (p=0.013, 54.64%) and significant increase in T3 (p=0.000, 44.51%), T4 (p=0.000, 21.82%), Free T3 (p=0.000, 26.26%), Free T4 (p=0.000, 24.96%) and Quality of Life (p=0.000, 31.14%) and significant increase in SHBG (p=0.012, 39.33%). Independent measure t-test for normal distribution for between the groups shows decrease in TSH (p=0.000), Cortisol (p=0.000) and CRP (p=0.000) is found to be significant decrease and on variables TPO Antibody (p=0.032) and Tg Antibody (p=0.036) it is found to be significant decrease and increase in T3 (p=0.000), T4 (p=0.000), Free T3 (p=0.000), Free T4 (p=0.000) and xii Quality of Life (p=0.000) shows significant increase and variable SHBG (p=0.012) it is found to be significant increase. Weight (p=0.069) and BMI (p=0.101) shown positive improvement but not significant. RM ANOVA confirms the same results. Conclusion The Integrated Approach of Yoga Therapy has an exponentially meaningful impact on T3, T4, TSH, Free T3, Free T4, SHBG, and CRP. It is imperative on the vector TPO Antibody, and it is significant on the factors Tg Antibody and Cortisol. The IAYT has been shown to have a protective effect on thyroid issues, Weight and BMI show positive changes but are not significant. Quality of Life shows positive changes.