Effect of Jalakumbhi Kshar (Eichhornia crassipes (Mart.) Solms) Included in an Ayurvedic Management of Hypothyroidism: A Case Study

Abstract

Hypothyroidism is a chronic endocrine disorder characterized by impaired thyroid hormone production, leading to disturbances in metabolic activities and multiple systemic manifestations. It is more prevalent among women and elderly individuals and commonly presents with fatigue, constipation, oedema, dry skin, hair fall, weight gain, and reduced physical activity. In Ayurveda, these features may be correlated with Kaphaja Galaganda involving Agnimandya(impaired digestion), Ama accumulation(metabolic toxins) , and vitiation of Kapha and Vata dosha. A 65-year-old female patient presented with generalized weakness, anorexia, body swelling, constipation, dry skin, and palpitations. She had been receiving Levothyroxine 75 µg/day for hypothyroidism for the previous eight years. Clinical examination revealed periorbital puffiness, coarse cold skin, and bilateral lower limb oedema. Baseline investigations showed an elevated serum thyroid stimulating hormone (TSH) level of 14.23 µIU/mL and a Zulewski’s clinical score of 8/12. The patient was treated with Jalakumbhi Kshar 350 mg, Gokshura Churna 2 g, Punarnavadi Mandoor 500 mg, and Makoya Ark 20 mL with water twice daily for three months. During the treatment period, the Levothyroxine dose was gradually reduced from 75 µg/day to 50 µg/day at the first follow-up and further to 25 µg/day at the second follow-up based on symptomatic improvement and thyroid function assessment. Progressive improvement was observed in both subjective and objective parameters. At the end of treatment, serum TSH decreased to 5.519 µIU/mL and Zulewski’s clinical score reduced to 2/12. Clinical symptoms improved markedly, and no adverse events were reported. This case highlights the potential utility of Jalakumbhi Kshar-based Ayurvedic management in hypothyroidism.