VIRECHANA KARMA AS A DETOXIFICATION APPROACH IN HYPERTHYROIDISM: INSIGHTS FROM A CLINICAL CASE

Hyperthyroidism, particularly when manifesting as Graves' disease, represents a complex autoimmune endocrinopathy characterized by the pathological overproduction of thyroid hormones and a consequent hypermetabolic state.[1] Within the Ayurvedic perspective, this severe metabolic acceleration closely mirrors Bhasmaka Roga[2] (condition of excessive digestive fire) or Atyagni (excessive digestive fire), which is fundamentally driven by an imbalance of Pitta (fire and water bio-element) and Vata Dosha (air and space bio-element), ultimately leading to Dhatu Kshaya (depletion of bodily tissues). This clinical report documents the physiological stabilization and therapeutic management of a 27-year-old male presenting with extreme weight loss of 15 kg, bilateral exophthalmos, and pronounced hand tremors. Laboratory investigations confirmed a severe thyrotoxic state featuring a highly elevated free T3 of 637 pg/dL, free T4 of 19.9 ng/dL, and a suppressed TSH of <0.005 µIU/mL. The primary therapeutic intervention centered on Shodhana (bio-purification), deploying in-patient Panchakarma treatment aimed at Virechana (Therapeutic purgation).[3] This procedure facilitated elimination of morbid Doshas (bio-humors), which may contribute to modulation of systemic inflammation and influence the hypothalamic–pituitary–thyroid axis.[4] Following this purification phase, the patient transitioned to Shamana (palliative) pharmacotherapy, which resulted in marked clinical stabilization and physiological recalibration.