Improve the Psychological Health of Patients with Hypothyroidism with Tele-Yoga Practice

Stay Active and Healthy during COVID-19 - Aging Well Camarillo

By John M. de Castro, Ph.D.

 

In today’s Research News article “Enhancing Quality of Life in Patients With Hypothyroidism Using a Scientific Yoga Module: Randomized Controlled Trial” (See summary below or view the full text of the study at: https://pmc.ncbi.nlm.nih.gov/articles/PMC12246764/) Nilkantham and colleagues performed a clinical trial of the effectiveness of 6 months of yoga practice presented over the internet in comparison to a wait-list control condition on the physical and psychological well-being of patients with hypothyroidism. They found that telehealth yoga resulted in significant improvements in mental health, energy, vitality, and role limitations.

 

Tele-Yoga is an effective treatment for the psychological symptoms of hypothyroidism.

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on the Contemplative Studies Blog  http://contemplative-studies.org

 

Study Summary

 

Nilkantham S, Singh A, Majumdar V, K N H, Atmakur S. Enhancing Quality of Life in Patients With Hypothyroidism Using a Scientific Yoga Module: Randomized Controlled Trial. J Med Internet Res. 2025 Jun 26;27:e54078. doi: 10.2196/54078. PMID: 40570327; PMCID: PMC12246764.

 

Abstract

Background

The impact of hypothyroidism on quality of life is extensively documented, highlighting its substantial physical, psychological, and social burden. Yoga has demonstrated promising therapeutic benefits in improving hypothyroidism outcomes. Leveraging telehealth’s growth, this study used a rigorously designed scientific yoga module specifically tailored for digital delivery for patients with hypothyroidism undergoing levothyroxine treatment.

Objective

This study aimed to assess the impact of a 6-month tele-yoga intervention in patients with hypothyroidism by comparing outcomes between those receiving levothyroxine combined with tele-yoga and those receiving only levothyroxine treatment.

Methods

A single-blinded, 2-arm, parallel-group randomized controlled trial was conducted for 6 months (April 1, 2022-September 30, 2022) with 134 clinically diagnosed patients with hypothyroidism recruited from the Arogyadhama Holistic Health Home registry (2013-2021). Participants were randomized to either a yoga intervention group or a waitlist control group with 67 in each group and assessed at 3 time points (before, in the middle of, and after the intervention) for primary and secondary outcomes. The 36-Item Short Form Health Survey for health-related quality of life was used as a primary measure, whereas secondary measures included thyroid profile, BMI, blood pressure, the Fatigue Assessment Scale, the Perceived Stress Scale, and the Gita Inventory of Personality. Clinical data were collected via online questionnaires, and laboratory data (thyroid profile blood pressure and anthropometric measurements) were obtained in person using standardized instruments. A generalized linear model with repeated-measure ANOVA was used to evaluate both within- and between-group effects. In addition, in the yoga intervention group, performance was assessed using a yoga performance assessment scale, and satisfaction was measured through a structured feedback survey.

Results

The intervention showed highly significant effects across all domains of the primary outcome measure (P<.001), with the most notable effects on mental health (F2, 118=425.88; η2=0.88), energy and vitality (F2, 118=371.73; η2=0.86), and role limitations—emotional (F2, 118=335.45; η2=0.85). Secondary measures also showed significant improvements (P<.001), except for thyroxine (P<.014). Average yoga performance assessment scores increased significantly from 65.08 (SD 10.97) to 88.62 (SD 11.18; P<.001), indicating that most participants could easily perform the practices. Overall, 95% (64/67) of the participants in the yoga intervention group expressed high satisfaction with the tele-yoga intervention.

Conclusions

This clinical trial is the first to demonstrate the benefits of a digitally delivered scientific yoga module combined with levothyroxine treatment for hypothyroidism. It highlights the efficacy of instructor-led tele-yoga as a scalable eHealth intervention, enhancing accessibility, long-term engagement, and sustainable health outcomes. Patients receiving tele-yoga alongside levothyroxine showed significantly greater improvements than those on levothyroxine alone, highlighting the value of integrating eHealth into thyroid care for a more comprehensive, patient-centered approach.

Improve the Mental Health of Older Adults with Mindfulness

Meditation for Depression: How It Works and Types to Try

By John M. de Castro, Ph.D.

 

In today’s Research News article “Effectiveness of an age-modified mindfulness-based cognitive therapy (MBCT) in improving mental health in older people with depressive symptoms: a non-randomised controlled trial” (See summary below or view the full text of the study at: https://pmc.ncbi.nlm.nih.gov/articles/PMC11863447/) Wang and colleagues studied the effectiveness of mindfulness teacher and social worker led Mindfulness Based Cognitive Therapy (MBCT) for the relief of depression and stress in adults over 60 years of age. They found that the training significantly decreased depression and perceived stress and increased mindful non-reactivity in the older adults.

 

Mindfulness Based Cognitive Therapy (MBCT) improves mental health in older adults.

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on the Contemplative Studies Blog  http://contemplative-studies.org

 

Study Summary

 

Wang YH, Wang YL, Leung DKY, Ng ZLY, Chan OLH, Wong SMY, Chan RCL, Liu T, Wong GHY, Lum TYS. Effectiveness of an age-modified mindfulness-based cognitive therapy (MBCT) in improving mental health in older people with depressive symptoms: a non-randomised controlled trial. BMC Complement Med Ther. 2025 Feb 26;25(1):81. doi: 10.1186/s12906-025-04781-6. PMID: 40011881; PMCID: PMC11863447.

 

Abstract

Background

Emerging evidence has shown that mindfulness-based cognitive therapy (MBCT) is effective in improving depressive symptoms in the older population. However, the accessibility to MBCT is limited by the shortage of psychotherapists or mindfulness teachers. One potential solution is to involve social workers, who have the knowledge and skills to promote individual and community well-being in various settings, in delivering modified MBCT to enhance its accessibility and sustainability. This study examined the effectiveness of an eight-week age-modified MBCT led by different mental health professionals (mindfulness teacher only vs. mindfulness teacher and social worker) in improving mental health outcomes as compared with a control group.

Methods

Older adults (N = 112) were recruited through five community-based centres for older adults and mental wellness in Hong Kong. Participants were allocated to one of three groups: (1) mindfulness teacher-led modified MBCT, (2) social worker/teacher co-led modified MBCT (50% led by social workers and 50% led by mindfulness teacher), or (3) control (care as usual). The age-modified MBCT consisted of eight weekly sessions, with age-related modifications including more sitting meditation, shortened duration of each session, and the removal of the retreat. Outcome variables (i.e., depressive symptoms, anxiety symptoms, perceived stress, and mindfulness) were assessed at baseline (T0), after the intervention (T1), and four weeks after the intervention (T2), through self-reported questionnaires. Linear mixed models were performed while controlling for demographic variables to examine changes in outcome variables between the groups.

Results

Participants from the age-modified MBCT intervention groups (teacher-led and social worker/teacher co-led) showed significantly greater reductions in depressive symptoms and stress, as well as greater increase in mindful non-reactivity, compared to the control group post-intervention. No significant interaction effect of time and group was found for anxiety and both overall mindfulness and its other facets. The improvements in mental health and mindfulness outcomes post-intervention were not significantly different between the teacher-led and social worker/teacher co-led MCBT groups.

Discussion

Age-modified MBCT is beneficial in managing depressive and stress symptoms and in improving mindful non-reactivity among older adults at risk for depression. The findings support the feasibility and effectiveness of partial task-shifting in the delivery of MBCT to trained social workers. Future studies may explore the possibility for social workers in leading MBCTs independently to further improve its scalability and service accessibility for older adults in the community.

 

Improve Mental Health with Mindfulness-Based Cognitive Therapy

Figure 4

By John M. de Castro, Ph.D.

 

In today’s Research News article “Mindfulness-Based Cognitive Therapy in Clinical Practice: A Systematic Review of Neurocognitive Outcomes and Applications for Mental Health and Well-Being” (See summary below or view the full text of the study at: https://pmc.ncbi.nlm.nih.gov/articles/PMC11900371/) Gkintoni and colleagues Review and summarize the published research studies of the effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) for the treatment of psychological issues. They report that MBCT has been shown to be effective in the treatment of depression, anxiety, and stress and to improve cognitive function and the regulation of emotions.

 

Mindfulness-Based Cognitive Therapy is and effective therapy for a variety of psychological issues.

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on the Contemplative Studies Blog  http://contemplative-studies.org

 

Study Summary

 

Gkintoni E, Vassilopoulos SP, Nikolaou G. Mindfulness-Based Cognitive Therapy in Clinical Practice: A Systematic Review of Neurocognitive Outcomes and Applications for Mental Health and Well-Being. J Clin Med. 2025 Mar 3;14(5):1703. doi: 10.3390/jcm14051703. PMID: 40095733; PMCID: PMC11900371.

 

Abstract

Background/Objectives: This systematic review outlines the neurocognitive outcomes and mechanisms of mindfulness-based cognitive therapy (MBCT) that influence subjective well-being. MBCT is a clinical intervention that integrates cognitive therapy with mindfulness practices to prevent depression relapses and improve mental health. Methods: The review focuses on the effects of MBCT on brain structure changes, cognitive processes, and emotional regulation, which are related to improvements in subjective well-being. A total of 87 studies were included in the review to assess the effectiveness of MBCT. Results: Evidence from the studies highlights the effectiveness of MBCT in reducing symptoms of depression, anxiety, and stress. MBCT was also shown to enhance cognitive functions and emotional regulation across diverse populations. These findings point to the potential for MBCT to induce neuroplastic changes in the brain and widen the applicability of the treatment for a variety of disorders, calling for further research into long-term benefits and underlying neurobiological mechanisms. Conclusions: The review emphasizes the potential of MBCT to bring about neuroplastic changes, calling for further research into its long-term benefits and the underlying neurobiological mechanisms. This study underlines the need to incorporate multidisciplinary measures by integrating psychology and neuroscience to comprehend comprehensively the effects of MBCT.

Improve PTSD with Transcendental Meditation

PTSD Meditation: How It Works and How to Try It

By John M. de Castro, Ph.D.

 

In today’s Research News article “Systematic Review and Meta-Analysis of Transcendental Meditation for Post-Traumatic Stress Disorder” (See summary below or view the full text of the study at: https://pmc.ncbi.nlm.nih.gov/articles/PMC12028398/) Orme-Johnson and colleagues reviewed, summarized and performed a meta-analysis of the effectiveness of transcendental meditation for the treatment of post-traumatic stress disorder (PTSD) in both military and civilian populations. They report that the controlled trials demonstrated that transcendental meditation produced significant clinically meaningful improvements in PTSD symptoms in both populations and genders regardless of age.

 

Transcendental meditation improves post-traumatic stress disorder.

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on the Contemplative Studies Blog  http://contemplative-studies.org

 

Study Summary

 

Orme-Johnson DW, Barnes VA, Rees B, Tobin J. Systematic Review and Meta-Analysis of Transcendental Meditation for Post-Traumatic Stress Disorder. Medicina (Kaunas). 2025 Apr 3;61(4):659. doi: 10.3390/medicina61040659. PMID: 40282950; PMCID: PMC12028398.

 

Abstract

Background and Objectives. Our recent systematic review and meta-analysis of all studies on meditation as treatment for PTSD (61 studies) found a moderate effect size of Hedges’s g = −0.67 for post-minus-pre change in symptom scores. Separate tests of the four meditation categories found a large effect size of g = −1.13 for the Transcendental Meditation (TM) technique that is significantly greater than for each other category. The present follow-up used a different method, calculating effects relative to internal controls, to better characterize the effects of this meditation technique. Materials and Methods. Our study followed Prisma guidelines. Major databases, research anthologies, and bibliographies were searched for studies that used TM for treating PTSD, all military and civilian populations, and all age groups. Results. The searches located 15 controlled trials on TM that met the inclusion criteria (longitudinal and reporting sufficient statistics to calculate effect sizes), 1248 subjects total, mean age 40.5 years (range 20.6 to 54.4 years), and 46.9% males (range 0% to 100%). Using the random effects model, the pooled effect across all studies of TM compared to other treatments was g = −1.01, 95% CI = −1.29 to −0.74, p < 0.000000001. One-study removed analysis found that no study reduced the pooled effect to less than −1.0. Funnel plots indicated no risk of bias. TM was non-inferior to prolonged exposure therapy, p = 0.0001, and it worked significantly faster (p = 0.04 at week six). Conclusions. TM produced clinically meaningful reductions in PTSD for civilian and military personnel, young and older adults, and for both men and women. We recommend phase-III multisite studies comparing TM with known first-line treatments for PTSD.

 

Mindful Independence Day

 

By John M. de Castro, Ph.D.

 

“If today is a celebration of freedom, I think we as a nation, as a people, have squandered an opportunity. We have sought outer freedoms and ignored inner freedoms. We have pursued these freedoms with scandal, exploitation, and domination. Today, instead, I urge you to consider inner freedom.” – Arnie Kozak

 

Virtually every country in the world sets aside one day each year to celebrate its independence. In the U.S. that day is July 4th. On this day the country’s citizens celebrate their freedom and independence and the fight that achieved it. It’s a holiday filled with patriotism, flags, parades, picnics, and fireworks displays.

 

Although the founding of the great American democracy is something to celebrate, a mindful look at it produces a recognition that there are significant limitations on independence and freedom. We are nowhere near as free and independent as we think we are.

 

Independence from what? It’s certainly not from the imposition of government on the individual. July 4th only celebrates the changeover from government by the British monarchy to government by a more local political system. It’s certainly not independence from the imposition of laws and restrictions on the individual’s freedom. Perhaps there was a change of a few laws and regulations, but actually only a small number. It’s certainly not even the production of self-determination. In fact, the U.S. democracy was crafted and established by a few elite individuals and not by each individual in the country. In addition, democracy is rule by the majority, with the will of a significant number of people ignored. What we appear to be celebrating is the replacement of one system of control with another, perhaps better, system of control, but nevertheless a system of control: hardly independence.

 

Mindful reflection quickly produces an understanding that we’re never really independent. It’s certainly not even complete independence from another country. To this day the U.S. and the U.K. are very much dependent upon one another for trade of goods, ideas, culture, and mutual security. They’re locked together by treaties, cultural similarities, and close economic ties. The current political system that we’re celebrating is itself a recognition of how dependent upon one another we are. The system functions to set down the rules by which our relationships with one another are conducted. It’s there to ensure orderly cooperation supposedly for the benefit of all participants.

 

Mindful reflection reveals that we’re not only dependent upon each other but we’re also dependent upon our environment, animate and inanimate. We’re dependent upon the air we breathe that is in turn dependent upon all other living organisms. We’re dependent upon the water we drink that is in turn dependent on global weather systems and solar evaporative power. We’re dependent upon the food we eat that is in turn dependent upon air, water, soil, and sun, and the farmers who grow it. In fact, we are so dependent upon everything and everybody that it may be more appropriate to be celebrating Dependence Day.

 

Well maybe then on July 4th we’re celebrating freedom and liberty. But is any individual truly free. As the French philosopher Jean-Jacques Rousseau said “Man is born free: and everywhere else he is in chains. One thinks himself the master of others, and still remains a greater slave than they.” Regardless of political independence, each individual’s behavior is highly regulated by law and regulation. Our freedoms are actually very limited. They are bound not only by law but also the practicalities of earning a living, maintaining a residence, having a family, and limitations on resources. Our freedom is also highly constrained by the laws of physics, chemistry, and biology. After all, we can’t fly, become taller, change our eye color, stay underwater for protracted periods, stay awake continuously, or withstand cold or heat outside of a fairly small range, and we’re not faster than a speeding bullet. How much freedom do we actually have in any particular day?

 

Independence Day, though, does celebrate acquiring many soft freedoms. The freedoms to think and express our opinions and ideas, to worship as we please, to vote for whoever we like, to associate with whomever we choose, to live wherever we like, etc. Although there are bounds to many of these freedoms by the requirements of public safety, economics, cultural norms, and the practicalities of existence, these are very important and significant freedoms. Perhaps that is what we’re really celebrating, these soft freedoms that were provided by our Constitution as a result of the War for Independence.

 

Regardless, Independence Day should be celebrated mindfully. It is often spent with family and friends and the pleasure of these interactions can be amplified by doing it mindfully; by being truly present for them and deeply listening to them rather than thinking about our next response. By being mindful we can see them with compassion and understanding. Being in, and focusing on, the present moment we can enjoy these interactions, we can enjoy the picnics and parades, we can enjoy the fireworks, rather than thinking about where we would rather be or where we’re going next. We can find happiness precisely where we are.

 

But are we truly free. A bit of mindful reflection reveals that we find existence very unsatisfactory. In fact, unsatisfactoriness is everywhere. We’re not satisfied with things as they are and want them to be different. We’re not satisfied with where we live and want to have a nicer home.  We’re not satisfied with our appearance and want to lose weight. We’re not satisfied with what people think of us and want to be universally liked. We’re not satisfied with how we’re treated by our spouses and want them to be more understanding. We’re not satisfied with our children and want them to be obedient, respectful, straight “A” students and star athletes. We’re not satisfied with our health and want to have fewer aches and pains. We’re not satisfied with our jobs and want to make more money, have more time off and be appreciated by our bosses and coworkers. Even on the very short-term, things are not satisfactory. We want the car ahead of us to be moving faster, we want time to pass quickly so that we can be done with work for the day, we want to stop ruminating about past indiscretions, we want to finish a meal quickly so we can get back to the TV, etc. In other words, we’re not free from our desires. In fact, we’re slaves to them. We’re not happy with the way things are. In fact, we seem to want everything to be different. So, we can’t be truly free as long as we’re slaves to our desires.

 

True freedom can only be produced when we are liberated from our incessant needs and wants. That is not to say that we shouldn’t have desires, but rather that we will not be controlled by them. True freedom comes from equanimity. It comes when we’re able to desire something, seek it out, but be OK whether we get it or not. It comes when we not only accept the way things are but enjoy each second for what it is, a precious moment in a limited lifetime. It comes when what other people do and say is seen as a reflection of them and not of us and comes when we look at them with compassion and understanding. In other words, we can want ourselves, things, people, and circumstances to be different but we accept them as they are and appreciate and enjoy life and each experience as a gift.

 

This sounds wonderful, but is it achievable? It sure doesn’t seem like ourselves and the people we know haven’t achieved it. Is it possible to get to this state of complete freedom? It is, but it takes effort and discipline. There have been many instances throughout history and there are many exemplars present right now of people who have achieved complete equanimity. Jesus is a wonderful example. He worked hard and suffered to make his world a better place but, in the end, accepted what was. The Buddha, Christian mystics, Sufi masters, Zen masters, Gandhi, and a host of everyday people have all achieved true liberation. So, it is possible.

 

We do not, however, have to be aiming only at complete liberation. It is far better to work to simply improve our current state and thereby become more and more liberated. We can do this by engaging in mindfulness practices such as meditation, yoga, tai chi, contemplative prayer, etc. we can learn to focus more and more on the present moment. We can learn to appreciate what is. We can learn to enjoy every moment. Just by improving a little we can become happier and happier, more accepting, and more liberated from our desires. We can achieve greater equanimity and with it greater freedom. But we get there slowly and incrementally, building toward our complete liberation. Now wouldn’t that be a reason to celebrate Independence Day.

“Happy 4th of July.  Celebrate your freedom mindfully- express love and gratitude for all situations, people, places and things you encounter today. This practice of loving what is, is a mindful behavior. When we celebrate our freedom as a country, we bring love to the abundance we are free to encounter today. Take each situation you encounter as an opportunity to express your love, gratitude  – any kindness will do – that is freedom!” –  Regina Huelsenbeck

 

CMCS – Center for Mindfulness and Contemplative Studies