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Hyperthyroidism

Also listed as: Thyroid - overactive

• Signs and Symptoms
• What Causes It?
• What to Expect at Your Provider's Office
• Treatment Options
• Special Considerations
• Supporting Research

Hyperthyroidism is when your thyroid gland, located at the front of your neck, produces too much thyroid hormone, causing your metabolism to speed up. Hyperthyroidism has three forms that share several symptoms. The most common form is Graves' disease. Hyperthyroidism can also be caused by taking too much thyroid hormone when you are being treated for hypothyroidism. Hyperthyroidism is more common in women than men and usually occurs between the ages of 20 - 40. It often starts after times of extreme stress or during pregnancy.

Signs and Symptoms

• Rapid heart rate and palpitations
• Shortness of breath
• Goiter (swelling of the thyroid gland)
• Moist skin and increased perspiration
• Shakiness and tremor
• Anxiety
• Increased appetite accompanied by weight loss
• Insomnia
• Swollen, reddened, and bulging eyes (in Graves' disease)
• Occasionally, raised, thickened skin over the shins, back of feet, back, hands, or even face
• In crisis: fever, very rapid pulse, agitation, and possibly delirium
• Changes in menstrual periods

What Causes It?

Researchers suspect that Graves' disease (the most common form of hyperthyroidism) is caused by an antibody that mistakenly stimulates the thyroid to produce too much hormone. Toxic nodular goiter is caused by a noncancerous tumor in nodules that make up the thyroid gland. Secondary hyperthyroidism results when a gland called the pituitary overrides the thyroid's normal instructions, and orders it to make too much thyroid hormone.

What to Expect at Your Provider's Office

Your health care provider will ask you to extend your fingers to see if you have a telltale tremor. Your health care provider will also examine your thyroid gland while you swallow. A blood test can confirm that you have elevated levels of thyroid hormone. Your doctor may also order a radioactive iodine uptake test to determine why your thyroid is producing too much hormone.

Treatment Options

Drug Therapies

Your health care provider will most likely prescribe a single dose of liquid radioactive iodine, which calms down your thyroid gland. Often the thyroid then becomes underactive. If so, you may have to take replacement thyroid hormone. Alternatively, your health care provider may give you thyroid-depressive medication. You may also be prescribed beta-blockers to help slow a rapid heartbeat. If drug treatment fails, you may need surgery to remove part of your thyroid. If so, you will need to take replacement thyroid hormone.

Complementary and Alternative Therapies

Alternative therapies may be effective at minimizing symptoms of mild thyroid dysfunction.

Nutrition and Supplements

Foods that interfere with thyroid function include broccoli, cabbage, brussels sprouts, cauliflower, kale, spinach, turnips, soy, beans, and mustard greens. Avoid refined foods, dairy products, wheat, caffeine, and alcohol.

• Omega-3 fatty acids, over time, can help reduce inflammation and help your immune system function properly.
• Bromelain (250 - 500 mg three times per day between meals) reduces swelling.
• Vitamin C (1,000 mg per day) and B complex [(50 - 100 mg/day), augmented with vitamins B2 (riboflavin, 10 mg), B3 (niacin, 10 - 25 mg), and B6 (pyridoxine, 5 - 15mg)] can help achieve normal thyroid hormone production.
• Calcium (1,000 mg per day) and magnesium (200 - 600 mg per day) are cofactors for many metabolic processes. Hyperthyroidism may cause magnesium deficiency.
• L-carnitine (500 mg - 2 g per day) may help reduce thyroid activity.

Herbs

Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy, you should work with your provider to get your problem diagnosed before starting any treatment. You may use herbs as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, you should make teas with 1 tsp. herb per cup of hot water. Steep covered 5 - 10 minutes for leaf or flowers, and 10 - 20 minutes for roots. Drink 2 - 4 cups per day. You may use tinctures alone or in combination as noted. For best results, these herbs should be used under the guidance of an experienced practitioner.

Before taking any herbs to slow an overactive thyroid, talk to your health care provider to determine the proper dose. The following are general suggestions:

• Bugleweed (Lycopus virginica) and lemon balm (Melissa officinalis) help to normalize an overactive thyroid. Steep the following amount in one cup of boiling water. Strain and cool. For bugleweed, 1 - 2 g. For lemon balm, 2 tbs. These herbs may be combined.
• Motherwort (Leonurus cardiaca) can help regulate rapid heartbeat. Steep 2 g in a cup of boiling water. Strain and cool. Drink 3 times per day. Talk to your health care provider before taking motherwort if you already take medicine to slow your heartbeat.
• Turmeric (Curcuma longa) makes the effects of bromelain stronger and should be taken between meals, 500 mg three times per day.

Avoid the following herbs, as they may stimulate hyperthyroidism: ashwagandha ( Withania somnifera ) and bladderwrack ( Fucus vesiculosus ). Also avoid stimulating herbs such as goto kola ( Centella asiatica ), ephedra, caffeinated green tea products, and Chinese or Korean ginseng ( Panax ginseng ) -- although Siberian ginseng ( Eleutherococcus senticosus ) may be helpful in some cases.

Homeopathy

Few studies have examined the effectiveness of specific homeopathic remedies. Professional homeopaths, however, may recommend treatments for hyperthyroidism based on their knowledge and clinical experience. Before prescribing a remedy, homeopaths take into account a person's constitutional type -- your physical, emotional, and intellectual makeup. An experienced homeopath assesses all of these factors when determining the most appropriate remedy for a particular individual.

Physical Medicine

Castor oil packs to the throat will also reduce inflammation. Apply oil to a clean, soft cloth, place on the throat and cover in plastic wrap. Place a heat source over the pack and let it sit for 30 - 60 minutes. For best results, use for 3 consecutive days.

Acupuncture

Acupuncture may help correct hormonal imbalances.

Massage

Therapeutic massage may help relieve stress.

Special Considerations

Thyroid problems during pregnancy can cause serious complications.

Supporting Research

Auf'Mkolk M, Ingbar JC, Kubota K et al. Extracts and auto-oxidized constituents of certain plants inhibit the receptor-binding and the biological activity of Graves' immunoglobulins. Endocrinology 1985;116:1687–1693.

Bartram T. Encyclopedia of Herbal Medicine. Dorset, England: Grace Publishers; 1995:422.

Benvenga S, Ruggeri RM, Russo A, et al. Usefulness of L-carnitine, a naturally occurring peripheral antagonist of thyroid hormone action, in iatrogenic hyperthyroidism: a randomized, double-blind, placebo-controlled clinical trial. J Clin Endocrinol Metab . 2001;86:3579-94.

Berkow R. Merck Manual. 16th ed. Whitehorse Station, NJ: The Merck Publishing Group; 1992.

Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Boston, Mass: Integrative Medicine Communications; 1998:432.

Carr AC, Frei B. Toward a new recommended dietary allowance for vitamin C based on antioxidant and health effects in humans. Am J Clin Nutr. 1999;69(6):1086-1107.

Hoffman D. The New Holistic Herbal. New York, NY: Barnes & Noble Books; 1995:95.

Johnston CS. Recommendations for vitamin C intake. JAMA. 1999;282(22):2118-2119.

Levine M, Rumsey SC, Daruwala R, Park JB, Wang Y. Criteria and recommendations for vitamin C intake. JAMA. 1999;281(15):1415-1453.

Panda S, Kar A. Changes in thyroid hormone concentrations after administration of ashwagandha root extract to adult male mice. J Pharm Pharmacol . 1998;50:1065-1068.

• Review Date: 6/15/2006
• Reviewed By: Steven D. Ehrlich, N.M.D., private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.

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