Wednesday, February 23, 2011

Thyroid Disorders

Thyroid Disorders: Hypothyroidism and Hyperthyroidism

The thyroid gland is a small, butterfly shaped organ at the base of the neck just below the adam's apple. Its vital function is to secrete thyroid hormones, which control how much of our body functions. Thyroid hormones effect the metabolic rate by influencing how much oxygen our cells use and by stimulating tissues to produce proteins. Simply put, the rate and intensity of our bodily functions are controlled, in part, by the thyroid. It does this by releasing T4, which is converted to it's more active form T3 in the liver.

The thyroid is not an independent organ. It is controlled by the pituitary gland, which is in turn controlled by the hypothalamus. The hypothalamus secretes a hormone that causes the pituitary gland to produce Thyroid-Stimulating Hormone, or TSH. This hormone, as its name implies, stimulates the thyroid to produce T4. As T4 and T3 reach a higher level in the blood, the pituitary gland stops producing TSH. When T4 and T3 levels drop to low, this stimulates the thyroid to begin producing TSH again.

Of course for all of this to work, the hypothalamus, pituitary gland, thyroid gland, liver, circulatory system, and other aspects must be in good working order. Iodine must be obtained from the diet in sufficient quantities for the production of T4 to occur. If any of these functions are disrupted in any way, it can cause widespread changes in the body. Hypothyroidism (underactive thyroid) and hyperthryroidism (overactive thyroid) are two of the more common thyroid disorders.


Underactivity in the thyroid gland will cause a slowing down of the body's mental and physical processes. Common symptoms include weight gain despite diminished appetite, low energy and fatigue, slowed heart rate, constipation, dry rough skin, hoarse voice, depression, hair loss (especially eyebrows), low libido, infertility, poor memory, muscle weakness and cramps, delayed reflexes, heavy menstrual periods, and puffiness around the eyes. Some of these symptoms, such as slowed heart rate, can cause additional problems in the long term, like atherosclerosis.


Conventional Treatment of hypothyroidism

The deficient hormone is replaced by taking an oral preparation of an organic or synthetic version. Dried animal thyroids are occasionally used, but synthetic versions are generally preferred by doctors since the hormone levels are less variable and easier to control. Thyroid hormone replacement therapy has been used for almost 100 years and is considered safe and effective. Doses should be monitored carefully, with the lowest possible effective dose used.


Herbal Approaches to Treatment

Since conventional treatment is so effective, herbs are generally used to support the body in resolving symptoms. If a person's hypothyroidism is mild, they may elect to pursue a strictly botanical treatment. Treatment protocols include cardiovascular support, bitters, nervine tonics, adaptogens, circulatory stimulants, and emollients.


Specific Herbs

The following are examples of herbs that may be used safely in hypothyroidism to combat symptoms. They are not always appropriate for everyone, and do not represent the sum total of effective herbs. For the best and safest results, consult with a medical herbalist who can recommend the best herbs, diet, and lifestyle choices for your individual needs.


Fucus vesiculosus

Bladderwrack

This seaweed is only indicated when hypothyroidism is caused by an iodine deficiency. However, it has been known to worsen the condition or cause hyperthyroidism due to it's variable iodine content, and may interfere with conventional treatment. Prolonged use may also interfere with iron, sodium, and potassium absorption.


Withania somnifera

Ashwagandha

This adaptogen is a tonic and rejuvenative that has been used for centuries for it's dual ability to promote energy and calm at the same time. It is an immunomodulator, nervine, and muscle, heart, and lung tonic. It is beneficial in most stress related conditions. Ashwagandha is commonly used in hypothyroid conditions due to its ability to stimulate the thyroid to increase T4 production.


Commiphora mukul

Guggul

Guggul has been shown to act directly on the thyroid gland, increasing levels of T3 in the body. It also reduces levels of LDL cholesterol, is an anti-inflammatory, reduces blood clots, can help clear atherosclerosis, and enhances tissue healing throughout the body. It's ability to raise the white blood cell count can help with lowed immunity due to slowed metabolism.


Diet and Lifestyle

It is important to limit foods that block iodine utilization in the body. These include vegetables in the cabbage family (broccoli, cauliflower, turnip, mustard greens, rutabaga, kohlrabi, brussel sprouts, kale, radishes), peanuts, pine nuts, soybeans (and soybean products like tofu or tempeh), millet, strawberries, peaches, pears, spinach, and sweet potatoes. Supplementation with zinc and selenium, which help with the conversion of T4 to T3, may also be useful. Vitamins A, D, E, and C will also help the body to function more efficiently.

Dieting is not recommended as it causes the body to slow down the metabolic rate even further in order to conserve energy. Regular daily exercise will stimulate the metabolism and will counteract the metabolic slowdown in dieting overweight people.


Hyperthyroidism

In contrast to hypothyroidism, hyperthyroidism involves a speeding up of the body's metabolic processes due to overactivity of the thyroid. Causes include benign or malignant tumor, inflammation due to infection, or Graves' disease. The cause may also be unknown. Symptoms include heat intolerance, heart palpitations, night sweats, insomnia, excessive sweating, tremors, difficulty sitting still or quietly, increased appetite and weight loss, flushed skin, nervousness and irritability. In postmenopausal women symptoms are often confined to one organ system (ex. heart/cardiovascular system).


Conventional Treatment

There are three main treatments available, the first of which is an antithyroid drug therapy. One or more antithyroid drug is given until spontaneous remission occurs. According to Dr. Aviva Romm, “twenty to forty percent of patients have spontaneous remission within 6 months to 15 years,” and within that there is a “fifty to sixty percent relapse rate.” If drug therapy is ineffective or relapse occurs, thyroidectomy or treatment with radioactive iodine are the remaining options. In thyroidectomy part of the thyroid is surgically removed, with the end result being a lifetime of thyroid hormone supplementation. Radioactive iodine is given in one dose and shrinks the thyroid gland over a period of weeks. The major complication is hypothyroidism.


Herbal Approaches to Treatment

There are a number of herbs that have demonstrated antithyroid activity. Those, along with herbs to provide symptom relief, are very effective at controlling hyperthryroidism. It is important to note that this is a long-term treatment. Results are often not seen for 2-4 weeks, and treatment needs to continue for years or possibly indefinitely.


Specific Herbs


Lycopus europaea/virginicus

Gypsyweed/Bugleweed

Bugleweed acts directly by blocking TSH receptors and limiting the conversion of T4 to T3. It is also specifically indicated in heart palpitations, tremors, tightness of breath, insomnia, night sweats, and anxiety. Due to it's inhibition of the hormone prolactin, Bugleweed should not be used during pregnancy or lactation.


Leonurus cardiaca

Motherwort

The second half of the Latin binomial, cardiaca, suggests this plant's affinity for the heart. It is a specific for heart palpitations, especially with anxiety or tension. This cardiotonic also has thyroid inhibiting actions. For hyperthyroid conditions, Motherwort works best combined with Bugleweed.


Melissa officinalis

Lemonbalm

Lemonbalm is another herb that has been shown to inhibit TSH binding in the thyroid gland. It is a tonic for the heart, circulatory system, and nerves, and is especially useful if there are stress-related digestive upsets.


Diet and Lifestyle

Eat plenty of the foods listed above which are contraindicated for those with hypothyroidism. Be sure to avoid foods with high iodine contents, such as seaweeds. Eat foods high in flavanoids, which will have blue, purple, or red colors, such as berries, grapes, and cherries. Flavanoids decrease T4 levels and inhibit conversion of T4 to T3. Supplement with calcium, selenium, and zinc. Stress reduction will help ease symptoms as well. Yoga, tai chi, and meditation are all useful.


Sources

Bartram, Thomas. Bartram's encyclopedia of herbal medicine. 1998. Marlow & Company.

Berkow, Robert (Ed.). The Merck manual of medical information (home edition). 1997. Pocket Books.

Frawley, D. & Lad, V. The yoga of herbs. 2nd ed. 2001. Lotus Press.

Hoffmann, David. Medical herbalism. 2003. Healing Arts Press.

Holmes, Peter. The energetics of western herbs. Vol 2. 2006. Snow Lotus Press, Inc.

Pole, Sebastian. Ayurvedic medicine. 2006. Elsevier, Ltd.

Romm, Aviva. Botanical medicine for women's health. 2010. Elsevier, Ltd.



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