Evaluation of Comparative Efficacy of Vamana Karma (Therapeutic Emesis) versus Virechana Karma (Therapeutic Purgation) in the management of Subclinical Hypothyroidism – A Study Protocol

Abstract

Background: Subclinical hypothyroidism (SCH) is characterized by elevated serum thyroid-stimulating hormone (TSH) with normal free thyroxine (FT4) concentrations and has a reported prevalence of 6–15% in India. SCH is associated with increased cardiovascular risk and progression to overt hypothyroidism. Biomarker-based monitoring of thyroid function is central to clinical decision-making. Traditional Ayurvedic detoxification procedures, Vamana and Virechana, are proposed to modulate metabolic homeostasis; however, objective biomarker-based evaluation of their effects in SCH remains limited.

Objectives: To evaluate and compare the effects of Vamana and Virechana Karma on biochemical thyroid function markers in individuals with SCH.

Materials and Methods: This randomized pilot clinical study will enroll 30 participants with SCH, allocated into two intervention groups. Following standardized preparatory procedures (Deepana-Pachana, Snehapana, Abhyanga, Swedana), Group A will undergo Vamana (Madanaphala- pippali churna - 5gm+ Saindhav lavana - 1 gm+ Honey 10 gm formulation) and Group B will receive Virechana (Trivritta Leha). Serum TSH and FT4 levels will be quantified using validated immunoassay techniques at baseline, post-intervention, and at 3-month follow-up. Secondary outcomes include body mass index (BMI) and symptom scoring. Statistical analysis will assess within- and between-group differences. The study has received ethical approval and is registered with CTRI (CTRI/2022/12/047833).

Results: The study anticipates measurable modulation of TSH levels and stabilization of FT4 concentrations in both groups.

Conclusion: This study aims to provide biomarker-based evidence regarding the effects of Vamana and Virechana in SCH. Findings may contribute to integrative approaches in thyroid disorder management.