Comparative Clinical Study to Evaluate the Efficacy of an Herbal Drug with Thyroxine in the Management of Primary Hypothyroidism

Background: Hypothyroidism was the first endocrine disorder to be treated with replacement of the deficient hormone. Initially animal glandular extracts were used. Synthetic LT4 is widely available today, as its Na salt in multiple strengths between 25 ug and 200 ug, and is the therapy of choice. The absorption is 80% in fasting state decreasing to 60% in the fed state. Desiccated thyroid, an animal preparation containing T3 and T4 in a ratio of 1:11 is still available but rarely used. A combination of T3 and T4, 12.5 ug of T3 and T4 is available and may be useful in minority of patients. Traditionally, the tablet is given in the morning. The half-life of serum T4 is 7 days which allows a single daily dosing.1-5The goal of treatment of hypothyroidism is the restoration of an euthyroid state in all tissues. This is usually achieved in patients with primary hypothyroidism by restoration of serum TSH concentrations to normal. The average full replacement dose is 1.6 ug/kg/d with inter-individual variation. Requirements for infants and children are higher.2,6 Though hormone replacement therapy has proved effective in the management of Hypothyroidism, but owing to adverse effects on long term use, the need to search for effective herbal drugs from the treasures of Unani system of Medicine(USM) for the management of Hypothyroidism was felt by the Researchers of the field and a herbal drug Commiphora mukul (Muqil)23-27 which has shown positive thyroid activities in experimental animals was selected to check its comparative efficacy with thyroxine. Hence a clinical study titled ‘comparative clinical study to evaluate the efficacy of an herbal drug with thyroxine in the management of primary hypothyroidism was designed.Keywords: Hypothyroidism, TSH, Thyroxine, Hormone, Herbal drug.