Efficacy of Tumbhi Taila Nasya in the Management of Hypothyroidism (Galaganda): A Single-Arm Prospective Clinical Study with Emphasis on Thyroid Function Restoration

Background: Hypothyroidism, equated to Galaganda in Ayurveda, is a prevalent endocrine disorder marked by thyroid hormone deficiency, manifesting as fatigue, weight gain, dry skin, and metabolic sluggishness due to Kapha-Vata dosha vitiation and Mandagni. While levothyroxine remains the cornerstone of modern therapy, Ayurvedic Nasya Karma offers a non-invasive, dosha-specific intervention to enhance Agni, reduce Srotorodha, and support glandular function without dependency on synthetic hormones. Objective: To assess the efficacy and safety of Tumbhi Taila Nasya as an adjunctive therapy in hypothyroidism, with primary focus on thyroid profile normalization (TSH, T3, T4) and secondary emphasis on subjective symptom alleviation. Methods: This single-arm prospective clinical study was conducted at Shri D.G.M. Ayurvedic Medical College, Gadag following Institutional Ethics Committee approval (No. SDMC/PG/2017-18/IEC/02) and informed consent from participants. Thirty patients aged 25-55 years with diagnosed hypothyroidism (TSH >4.5 µIU/mL, symptoms per Charaka Samhita Nidana Sthana 1/29-30) on stable levothyroxine were enrolled. Exclusion criteria included secondary hypothyroidism, pregnancy, and severe comorbidities. Tumbhi Taila (Leucas aspera churna in Murchita Sharshapa Taila base, prepared per Chakradatta Taila Kalpa 2/15-18) was administered via Nasya (8 drops/nostril daily) for 8 consecutive days, preceded by Purvakarma (stanika abhyanga and Mrudu Sweda) and followed by Pashchatkarma (kavala and Dhumapana). Assessments occurred at baseline (BT) and day 24 post-treatment (AF): subjective parameters (Atinidrata, Ruksha Twak, Shrama, Agnimandya; graded 0-3) and objective parameters (serum T3: 80-180 ng/dL, T4: 4.6-12 µg/dL, TSH: 0.4-4.2 µIU/mL via chemiluminescence immunoassay). Data were analyzed using paired t-tests (p<0.05 significant) via SPSS v22.0; intention-to-treat analysis applied. Results: Baseline demographics showed mean age 38 ± 62 years, 70% females, and TSH 9.1 ± 1.3 µIU/mL. Post-intervention, significant TSH reduction occurred (5.3 ± 0.8 µIU/mL, mean decrease 3.8 µIU/mL; p<0.001), with T4 elevation (4.8 ± 0.7 to 7.5 ± 0.6 µg/dL; p<0.001) and T3 increase (p<0.001). Subjective scores improved by 72% overall (from 10.1 ± 1.6 to 2.8 ± 0.9; p<0.001), with 65% fatigue relief and 70% dry skin amelioration. No adverse events were reported beyond mild nasal warmth (resolved spontaneously). Response: 60% moderate (>50% relief), 30% marked (>75%), 10% mild. Conclusion: Tumbhi Taila Nasya effectively restores thyroid function and alleviates hypothyroid symptoms as a safe adjunct, leveraging its Deepana-Lekhana properties for Kapha pacification. Multicenter RCTs with longer follow-up are recommended to validate standalone efficacy.