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Hyperthyroidism

Hyperthyroidism is the primary manifestation of a group of diseases characterized by an over-active thyroid gland and increased production of thyroid hormone. Major symptoms of hyperthyroidism include: rapid heartbeat resulting in palpitations; heat intolerance or sweating; emotional symptoms including but not limited to irritability, anxiety and insomnia; tremors; exhaustion; softer, finer hair; hair loss; easy bruising; lighter and more infrequent menstrual periods; muscle weakness; eye problems such as itching, watering, bulging and double vision; and weight loss.

Graves’ disease, an autoimmune disorder, accounts for more than 80% of all cases of hyperthyroidism. An over-active thyroid can also result from a toxic goiter condition seen most frequently in women over 60, or from taking too much synthetic thyroid hormone.

TSH receptor antibodies or thyroid stimulating immunoglobulins (TSI) are what cause Grave's disease, thyroid eye disease (Graves' ophthalmopathy), as well as the rare skin condition known as pretibial myxedema (waxy skin discoloration)

Western treatments include irradiation of the thyroid, surgical removal of the thyroid, and pharmaceutical preparations that block thyroxine.  Due to the danger of vision loss and heart damage, such as stroke, Graves’ Disease should always be managed and monitored by a licensed physician, who can keep up measurements of TSH, TSI antibodies, as well as Free T3 and Free T4. T3 and T4 monitoring are necessary because TSH can be a lagging indicator - not always accurate. 

It is imperative that whatever treatment is used, the patients heart rate and blood pressure be kept in normal ranges, and eye symptoms not be present. If this is not accomplished, usually because the patient cannot tolerate the presciption hormone blockers or the herbs, the patient should immedately use radioactive iodine to avoid consequences.

Some naural medicine proponents suggest using iodine in high levels for this condition, which I consider to be dangerous. Iodine should be kept in the low normal ranges, not exceeding 150 mcg per day from food. In practice this means folowoing a healthy diet with plenty of fresh fruits and vegetable, avoiding anything with excess salt, especially fast food.

The good news is that if the patient is kept safe and can maintain regular blood pressure and heart rate, the is a good chance the disease will go into remission, which is defined as the body reducing levels of TSI antibody to normal ranges. Remission happens spontaneously in a large number of patients. This is reason why keeping the patient safe until they go into remission is often the standard practice in Europe and China. This makes even more sense in light of the recent research that the use of radioactive iodine appears to increase the risk of stroke.

While the reason so many people go into remission is not known for sure, it appears that the "autoimmune aberration of Graves’ disease" is often basically quite mild and self-limiting. Natural medicine doctors think a bit differently, that these sorts of immune imbalances do not occur without reason, andbelieve that working on elimination of underlying issues will maximze the chances that remission will occur. In my experience, underlying dysbiosis and/or blood deficiency are often present.

Once remission is accomplished, then the patient can be gradually weaned off off the hormone blocking drugs (Methimazole or Propylthiouracil - PTU) or hormone blocking bugleweed preparations. Remission can occur relatively quickly, a few months, up to about 2 years.


Herbal Treatment of Hyperthyroidism

Herbalists use bugleweed and other Lycopus species plants in tincture form to treat hyperthyroid symptoms (Tincture form, 30 drops twice a day, adjusted based on heart rate). Animal research supports its effect on reducing blood levels of thyroid hormones (Winterhoff  et al., 1994). According to Dr. Duke (Jim Duke's medical botany course), many studies suggest that herbs rich in rosmarinic acid, such as bugleweed, lemon balm (Melissa officinalis), and verbena (V. species) may possess “amphithyroid” qualities.  This means they may be capable of acting on the thyroid in either direction, exciting hypoactive and depressing hyperactive thyroids.  Although not certain, it suggests that these herbs may be used to treat both conditions—a fascinating possibility.  Dr. Duke was one of the first herbalists to tell us that broccoli contains phyto-chemicals that are capable of reducing thyroid hormone production, called goitrogens (Duke, 1999). 

Goitrogens can be used to support hyperthyroid treatments. Other sources include vegetables in the genus Brassica, pine nuts, spinach, bamboo shoots, sweet potatoes, bok choy,  brussels sprouts, cabbage, cauliflower, Chinese cabbage, collard greens, horseradish, kale, kohlrabi, mustard greens, radishes and turnips.

Of course, natural medicine treatment is not just using herbs instead of prescription drugs. As with all medical conditions, any underlying causes must be treated simultanously. They body will not start attacking the thryoid without a reason. 

Chinese doctors believe that hyperthyroidism is a Yin deficiency syndrome with deficiency heat signs, and they primarily use self-heal (Prunella vulgaris or xie ku cao).  Use this in a high dose—it should comprise about 20% of your total formula.  Interestingly, this herb also contains rosmarinic acid. A typical TCM hyperthyroid formula might include self-heal , raw and cooked rehmannia, fritillaria bulb (chuan bei mu or F. cirrhosa), scrophularia root (xuan shen or S. ningpoensis), glehnia root (sha shen or Adenophora tetraphylla), scute root, coptis rhizome and phellodendron bark.

On a personal note, between 1999 and 2001 we treated three patients in our clinic with a combination of these herbs and nutrients. All three patients have experienced a gradual cessation of symptoms and improvement in blood test results, and they have been able to avoid radiaton or surgery. Two cases required a maintenance dosage of herbs.

It is difficult to express how grateful patients in danger of losing their thyroid glands are when they discover herbal treament (with the cooperation of a monitoring physician) can prevent this.

However, while the inflammation of the thyroid can often (not always) be calmed down, I want to emphaze again the secondary problem of eye inflammation (Grave's ophthalmopathy) is another matter.  It is caused by a reaction between TSI antibodies and proteins in eye muscle and the connective tissue and fat in the orbit around the eyeball, and can sometimes continue independently even after the thryoid itself calms down. For this reason, if the TSI abs are not controlled quickly and /oreye symptoms begin, I always tell the patient to seek radioactive iodine treatment. 


• Research note: A study of 89 cases of hyperthyroidism and 20 cases of hypothyroidism caused by Hashimoto's thyroiditis were analyzed via blood tests to check for correlation with TCM differentiations. In patients with Yin deficiency, the T3 and T4 hormone levels were higher than normal, and the TSH lower than normal. In patients with Yang deficiency, the T3 and T4 hormone levels were lower than normal, and the TSH higher than normal. This study showed that the TCM differentiations were almost exactly correlated with Western diagnosis (Chen et al., 1990).

Posted on Saturday, April 23, 2005 at 02:35PM by Registered Commenterposted by Dr. Tillotson in | Comments Off

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