Brief Answer:
Treatment Protocol & Pranayam

Detailed Answer:
Dear
Thanks for contacting Ayurveda with your problem and after reviewing your history and treatment protocol, do let me know below mention queries:
1.Please let me know about your Thyroxine pill (whether you are taking it empty stomach (in morning) or at night.
2.Because the main cause of hypothyroidism is iodine deficiency thus iodine containing drugs like “Shigru” “jalkumbhi" "trikatu" are/should be advised/ instituted along with your current prescription.
3.Because hypothyroidism and PCOD Is due to low metabolism (digestive fire) thus drugs given to you works by increasing the Metabolism by acting as XXXXXXX pacahana,ushna,teekshna,sukshma,lekhana drugs and thus reducing the symptoms.
4.Since you are suffering from PCOS since teenage thus Acne is/are due to the main pathology (PCOS) and not due to under active thyroid, moreover Thyroid report as stated by you is 3.0 which probably implies TSH level (which is within the normal value)
5.Before commencing further, do consult with your Gynecologist regarding your PCOD profile,who might ask for Ultrasonography of Abdomen to check with any accompaniments of PCOD and might go for hormonal tests.
6.Apart from taking the said medicines you can practice certain “PRANAYAM” which helps in stimulation of thyroid gland like- ‘Brahmari pranayam’; ‘sheetali/ seetkari pranayam’
7.Avoid fatty food,curd,late night work,soyabean,milk,mustard oil,cabbage, and take moong dal,tambul,saindhav,tandulodak,coconut water, vegetable soups
8.You can consult with a Panchkarma Doctor regarding Lekhan Basti,Nasya Karma and Vaman procedure.

Do let me know if you need further clarifications
Dr. Munish Sood
Consultant & Physician
Naimittika Clinic.

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Brief Answer:
Pharmacodynamics

Detailed Answer:
Dear
Thanks for your feedback
1.Other iodine containing items which forgot to tell are: iodised salt/sea food, cauliflower.
2.Randomized trial report in Clinical endocrinology reported better improvement in clinical symptoms while taking thyronorm during bed time instead of morning (But please check with your Attending Doctor regarding the same and also with the Dosage) if deem necessary.
3.Make sure even after half an hour you don’t take any calcium or iron supplement which hampers absorption of thyroxine (Milk/milk product or calcium XXXXXXX fruits (guava),high fiber fruits are strictly to be avoided.
4.Arogyavardhini vati/Vridhivadhika Vati/Patrangassav: contains “Lauha bhasma” i.e Iron but in purified form, thus it won’t have any effect on the absorption of thyroxine (as they are from reputed pharma,chances of impurity are minimal)
5.Taking milk at night is OK, unless you are thinking to switch your Medicine during bed time.

Dr. Munish Sood
Naimittika

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Brief Answer:
Preventive Advise.

Detailed Answer:
Dear
Thanks for your clarifications
1.There is no alternative to HORMONE in any system of medicine, so you have to continue with Thyroxine.

2. Before explaining the procedure please keep following things in mind:
. Prior to taking thyronorm at night, discuss with your Endocrinologist regarding the same. I prefer giving it in the morning because the drug causes; it will keep you awake if you take it in night BUT again initially one has to be consistent so that the Brain adapts to this new regime,and if one still feel that it is not helping, he/she has to switch for morning dose.
. Reassess your TSH level and adjust the dose accordingly (by doctor preferably)

PROCEDURE: one has to take the dose 2 hours after dinner, since you will no longer have to worry when to eat breakfast also it is said that at night the movement (Bowel) of intestine is slow thus chances are that there will be more absorption of thyroxine.

3.If Acne are not improving despite treatment then immediately consult with Gynecologist regarding hormonal profile, [excess male hormone (androgen) and low female hormone(estrogen)]. Couple things are common in women with PCOS: high androgen level (male hormone) and Insulin resistance; both raises the androgen level thereby increasing Dihydro testosterone (DTH) a metabolite of testosterone which promotes oil production resulting in clogged pores and ACNE.

4. Because PCOS affect Ovulation so do check with your Doctor for Medications.
. AVOID: refined carbohydrates (packed cereals,white bread-rice-flour,pasta,cakes ,biscuits,sugar, honey, fruit juice concentrates,’starch’,watermelon, cantaloupe, pineapple,potato,carrots,dried fruits,ice cream,chocolates,jellies,pizza), and especially Milk which is cause both for reduced absorption of thyroxine and Acne production (As 90% of milk in market is produced from pregnant cows which contains hormone that can be broken down to DTH:Acne)
.TAKE: fresh green vegetables,whole grains,olives,soy products,whole legumes (peas,beans,lentils),brown rice,oat meal,barley.

Hope I have given enough time and due consideration to look into your Query, any suggestions are Welcome.

Dr. Munish Sood
Naimittika

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