The effect of continued Wet-Cupping Therapy (Hijama) in Modulating Au-toimmune Activity of Hashimoto’s Thyroiditis: A Case Report Study

The potential for mitigating the autoimmune process in patients with Hashimoto’s Disease (HD) presents an opportunity to avert additional destruction of the thyroid gland, thereby improving its functionality. This raises an intriguing question regarding whether such an approach could also serve to inhibit the development of thyroid cancer. Currently, thyroid replacement therapy constitutes the primary treatment for HD. Should Hijama, or wet cupping therapy, be proven beneficial in enhancing thyroid physiological function and attenuating autoimmune destruction, it would be worthwhile to consider its integration into existing therapeutic protocols for managing HD [1-4].

The present study focused on the impact of extended Hijama therapy on two patients diagnosed with Hashimoto's thyroiditis. The case 1, who had been diagnosed and treated with L-thyroxine seven years prior to the initiation of Hijama therapy. At the commencement of the Hijama intervention, she was receiving 50 micrograms of L-thyroxine, and her thyroid ultrasound revealed normal size and vascularity. Following one year of treatment, her thyroid peroxidase antibody levels declined significantly, after which a moderate increase was observed one year post-Hijama, yet her levels remained within the normal range. Similarly, the anti-thyroglobulin levels decreased during the treatment year and continued to decline even after the conclusion of the Hijama sessions, as observed in the one-year follow-up. These improvements suggest that prolonged Hijama therapy, applied continuously for at least eight months in conjunction with conventional treatment, may yield superior results compared to short-term interventions noted in previous studies [8]. The management of Hashimoto’s Disease, an autoimmune thyroid disorder characterized by gradual destruction of thyroid gland tissues, typically remains reliant on thyroid hormone replacement therapy. Although this strategy alleviates symptoms associated with thyroid hormone deficiencies, it fails to address the fundamental autoimmune mechanisms that exacerbate glandular destruction. The potential to decelerate these autoimmune processes emerges as a compelling avenue for exploration, particularly in the context of prospective complementary treatments like Hijama [1,3].

Hijama has a rich historical background in various cultures and has recently garnered attention for its possible therapeutic advantages, notably in treating autoimmune conditions. The current study examined the effects of prolonged Hijama therapy on two patients with Hashimoto's thyroiditis. The findings suggest that Hijama could facilitate a reduction in TPO and TG antibody levels, indicating a possible modulatory effect on the autoimmune response. Case 1 exhibited a noteworthy improvement, showing a significant decrease in both TPO and TG antibody levels during Hijama therapy, accompanied by a clinically observed symptomatic improvement of approximately 50%. This finding implies that Hijama may enhance thyroid function while also mitigating the autoimmune assault, consistent with previous literature which advocates for alternative treatments that provide advantages in managing autoimmune conditions [8-10]. However, the absence of post-treatment ultrasound data limits the ability to conclusively evaluate any structural alterations within the thyroid gland following Hijama therapy. The case 2 presented a different pattern of antibody levels, with both TPO and TG levels initially decreasing but subsequently rebounding following the cessation of Hijama therapy.

This observation necessitates further investigation into the longevity of Hijama's effects, implying that while initial benefits may be observed, they may not persist without ongoing treatment. The existing literature underscores the importance of long-term follow-up in managing autoimmune diseases for effective intervention strategies [11]. Moreover, the relationship between autoimmune thyroiditis and the potential risk of thyroid cancer introduces an additional layer of complexity. Although current literature has not yet established a direct causative link, the inquiry into whether interventions that modulate autoimmune thyroiditis might concurrently reduce thyroid cancer risk remains an intriguing direction for future research [10]. Initiatives aimed at slowing autoimmune processes, such as extended Hijama therapy spanning nine months, could theoretically contribute to lowering the risk of thyroid malignancies, although empirical evidence is currently insufficient to substantiate these claims.