DOI: 10.4103/jras.jras_314_24 ISSN: 2456-5601

Management of primary hypothyroidism-associated hyperprolactinemia through Pradhamana Nasya Karma and Jalakumbhi Kshara: A case series

Amisha. P. Patel, Kalapi B. Patel

Abstract

BACKGROUND:

Thyroid hormones and prolactin are intricately linked through shared regulatory pathways. In primary hypothyroidism, elevated thyrotropin-releasing hormone levels can induce hyperplasia of thyrotroph and lactotroph cells, potentially leading to pituitary gland enlargement and concurrent hyperprolactinemia. The association between thyroid dysfunction and prolactin imbalance is well established across various clinical conditions.

MATERIALS AND METHODS:

This case series investigates four patients diagnosed with primary hypothyroidism and comorbid hyperprolactinemia. The therapeutic intervention consisted of two sessions of Pradhamana Nasya Karma and oral administration of Jalakumbhi Kshara (500 mg twice daily after meals) for 4 weeks. Serum levels of thyroid-stimulating hormone (TSH) and prolactin were quantified to assess the treatment efficacy.

RESULTS:

After 4 weeks of treatment, all four patients demonstrated improvement in thyroid function parameters. Serum TSH levels decreased from 8.67 to 16.87 µIU/mL at baseline to 3.50–7.25 µIU/mL post-treatment, while free T4 levels increased from 0.5–0.7 ng/dL to 1.0–1.2 ng/dL. Serum prolactin levels decreased in three patients and remained unchanged in one patient. Objective clinical assessment showed reductions in symptom scores for diminished sweating, dry skin, cold intolerance, constipation, hoarseness of voice, coarse skin, cold skin, puffiness, slowed movements, and pulse rate abnormalities across the cases. The four cases studied showed significant improvements in the parameters assessed using the Billewicz Diagnostic Index.

CONCLUSION:

The combined administration of Pradhamana Nasya Karma and Jalakumbhi Kshara was associated with favorable changes in thyroid function and prolactin levels in patients with primary hypothyroidism and comorbid hyperprolactinemia. Although the findings are encouraging, larger controlled studies are needed to confirm the therapeutic effects and explore the underlying mechanisms of action.

More from our Archive