The thyroid gland, one of the most vital endocrine organs, regulates metabolism, growth, and energy balance through the secretion of thyroxine (T4) and triiodothyronine (T3). Disturbance in thyroid function leads to significant metabolic derangements manifesting as hypothyroidism, hyperthyroidism, or autoimmune thyroiditis. Ayurveda, the ancient system of Indian medicine, describes a similar metabolic principle under the concept of Agni, the biological fire that governs digestion, transformation, and all biochemical processes essential for life. The proper functioning of Agni (Sama Agni) maintains Dosha equilibrium, tissue nourishment, and vitality (Ojas), while its derangement (Agnimandya, Tikshna Agni, or Vishama Agni) leads to disease. This review explores the role of Agni in thyroid physiology and interprets thyroid disorders as Agni vikriti conditions in light of Ayurvedic theory. It also examines the therapeutic potential of Panchakarma—Ayurveda’s comprehensive detoxification and rejuvenation therapy—in restoring Agni balance and metabolic homeostasis. The review was conducted through an extensive analysis of classical Ayurvedic literature (Charaka Samhita, Sushruta Samhita, Ashtanga Hridaya), contemporary Ayurvedic research, and modern endocrinological studies indexed in PubMed, Scopus, and AYUSH Research Portal. Conceptual analysis indicates that Manda Agni correlates with hypothyroid states characterized by sluggish metabolism, Ama accumulation, and Kapha-Vata predominance, whereas Tikshna Agni parallels hyperthyroid conditions marked by Pitta aggravation and excessive catabolism. Panchakarma therapies such as Vamana (therapeutic emesis), Virechana (purgation), Basti (medicated enema), and Nasya (nasal therapy) play crucial roles in re-establishing Agni, clearing Ama, and balancing Doshas. Adjunct Shamana and Rasayana therapies, including Kanchnar Guggulu, Ashwagandha, and Guduchi, further support glandular and systemic recovery. In conclusion, thyroid dysfunction can be viewed as a manifestation of Agni dushti, and management through Panchakarma offers a holistic, root-cause-oriented therapeutic approach that harmonizes metabolic, endocrine, and immune functions. Integrating these classical Ayurvedic insights with modern endocrinological understanding may offer a safe, sustainable, and individualized framework for managing thyroid disorders.
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