BACKGROUND: Hypothyroidism is the most prevalent endocrine disorder characterised by low thyroid hormone production, leading to a wide spectrum of cognitive and neuropsychiatric manifestations such as fatigue, depression, anxiety, cognitive impairment, peripheral neuropathy, Parkinsonism, tremor, ataxia, seizures and dementia. Although conventional treatment with levothyroxine replacement remains the standard of care, neuropsychiatric symptoms often persist, highlighting the need for safer and more effective alternative therapeutic strategies. PURPOSE: This narrative review aims to explore the effects of yoga-based interventions and Ayurveda-based herbal medicines in mitigating hypothyroidism and related neuropsychiatric symptoms. METHODS: A comprehensive literature search was conducted across PubMed, Scopus, Cochrane and Google Scholar. Studies examining the effects of yoga practices (asanas, pranayama, meditation) and Ayurveda-based herbal medicines such as Withania somnifera, Coriandrum sativum, Melissa officinalis, Commiphora wightii and other adaptogenic herbs on levels of thyroid hormones and neuropsychiatric outcomes of hypothyroidism were selected and included. RESULTS: Emerging evidence suggests that yogic interventions improve thyroid function and mental well-being by modulating the hypothalamic-pituitary-thyroid axis and neuroendocrine pathways. Ayurveda-based herbal medicines have been shown to exhibit antioxidant, anti-inflammatory and adaptogenic properties, contributing to enhanced thyroid function and neuroprotection. However, most studies are limited by small sample sizes, heterogeneity in intervention protocols, lack of standardisation and short follow-up periods, restricting the reproducibility and generalisability of study findings. CONCLUSION: Holistic interventions such as yoga and Ayurveda-based herbal medicines may offer potential benefits in managing hypothyroidism and addressing its neuropsychiatric manifestations. However, current evidence remains preliminary and heterogeneous. High-quality, randomised controlled trials with standardised protocols are necessary to substantiate these findings and assess their efficacy, safety, long-term outcomes and clinical relevance.