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Hypothyroidism

Also listed as: Thyroid - underactive

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

Hypothyroidism occurs when your thyroid gland, at the front of your neck, doesn't produce enough thyroid hormone or when your body fails to use thyroid hormone efficiently. There are several types of hypothyroidism. The most common is Hashimoto's thyroiditis, an autoimmune disease in which the body attacks the thyroid gland. The disease affects both sexes and all ages, but is most common in women over age 50. Because the thyroid gland is involved in regulating metabolism, low thyroid levels cause your body to slow down and can affect everything from appetite to body temperature. Left untreated, hypothyroidism can cause serious health complications.

Signs and Symptoms

• Slow pulse
• Lethargy
• Hoarse voice, slowed speech
• Goiter (caused by swollen thyroid gland)
• Intolerance to cold
• Weight gain
• Constipation
• Dry, scaly, thick, coarse hair
• Numbness in fingers or hands
• Confusion, depression, dementia
• Headaches
• Menstrual cramps or other menstrual disorders
• In children, growth retardation, delayed teething, and mental deficiency

What Causes It?

The various forms of hypothyroidism have different causes. In Hashimoto's thyroiditis, antibodies in the blood mistakenly attack the thyroid gland and start to destroy it. Post-therapeutic hypothyroidism occurs when treatment for hyperthyroidism leaves the thyroid unable to produce enough thyroid hormone. And hypothyroidism with goiter results when your diet lacks iodine. The addition of iodine to salt in the developed world has made this rare, though it still happens in undeveloped countries.

What to Expect at Your Provider's Office

Your health care provider will draw blood to measure levels of thyroid-stimulating hormone (TSH), which is produced by the pituitary gland. When levels of thyroid hormones are low, the body produces more TSH in an effort to increase production of thyroid hormones. Your doctor may also test for levels of T4, one of the hormones produced by the thyroid.

Natural medicine practitioners often take a different view of laboratory analysis of thyroid hormone. Many naturally oriented physicians pay particular attention to levels of T3 hormone. T3 is the active form of thyroid hormone, which comes from the body's conversion of T4. If you are unable to convert T4 to T3, your laboratory tests for T4 may be normal, but you still may experience all the symptoms of hypothyroidism. Talk to your doctor about including T3 laboratory tests in the treatment of your hypothyroidism.

Treatment Options

Drug Therapies

Your health care provider will prescribe drugs that you will take daily. Providers have two alternatives for drug treatment: synthetic thyroid hormone and dried animal thyroid hormone. The provider will want to adjust your dose over a period of several weeks, after regular blood tests to check the amount of thyroid hormone in your blood.

Complementary and Alternative Therapies

Nutrition and herbs can be useful as supporting therapies, but they cannot replace conventional treatment.

Nutrition and Supplements

• Avoid foods that interfere with thyroid function, including broccoli, cabbage, brussels sprouts, cauliflower, kale, spinach, turnips, soybeans, peanuts, linseed, pine nuts, millet, cassava, and mustard greens.
• Avoid refined foods, dairy products, wheat, caffeine, and alcohol.
• Essential fatty acids (1,000 - 1,500 mg three times per day) are necessary for hormone production.
• Vitamin C (1,000 mg per day), vitamin A (10,000 - 25,000 IU per day), B complex [(50 - 100 mg/day), augmented with vitamins B2 (riboflavin, 10 mg), B3 (niacin, 10 - 25 mg), and B6 (pyridoxine, 5 - 15 mg)], selenium (200 mcg per day), vitamin E (400 IU per day), and zinc (30 mg per day) can help promote normal thyroid hormone production. However, unless you are deficient in one or more of these supplements, there is no evidence that taking them will help hypothyroidism.
• L-tyrosine (500 mg two or three times a day) is a precursor to thyroid hormone and may help boost levels in the body. If you are taking prescription thyroid hormone medication, it is important not to take L-tyrosine without direction from your doctor. Do not take L-tyrosine if you have high blood pressure.
• Calcium (1,000 mg per day) and magnesium (200 - 600 mg per day) help many metabolic processes function normally.
• Do not take an iodine supplement unless directed by your doctor. Iodine is only effective in cases of iodine deficiency, which is uncommon in the developed world. And excessive iodine can cause hypothyroidism.
• If you take thyroid hormone medication, talk to your doctor before consuming soy products. There is some evidence soy may interfere with absorption of thyroid hormone.
• Iron may also interfere with the absorption of thyroid hormone medication.

Herbs

Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy, you should work with your health care 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.

Bladderwrack (Fucus vesiculosus) is often suggested as an herb to improve thyroid function, but that is because it contains iodine. Most cases of hypothyroidism in the developed world are not caused by iodine deficiency, and too much iodine can actually cause hypothyroidism. Avoid bladderwrack unless directed by your doctor.

Coleus forskohlii (50 -100 mg two to three times a day) may stimulate thyroid function with an increase in thyroid hormone production. In addition, herbs such as guggul, or Commiphora mikul, (25 mg of guggulsterones three times a day) and hawthorn, or Crataegus monogyna, (500 mg twice a day) are taken to counteract high cholesterol, which often accompanies hypothyroidism.

Homeopathy

Homeopathy may be useful as a supportive therapy.

Physical Medicine

Contrast hydrotherapy (hot and cold applications) to the neck and throat may stimulate thyroid function. Alternate 3 minutes hot with 1 minute cold. Repeat three times for one set. Do two to three sets per day.

Acupuncture

Acupuncture may be helpful in correcting hormonal imbalances.

Massage

Therapeutic massage can relieve stress and improve circulation.

Following Up

After you start on thyroid hormone replacement therapy, your provider will want you to have frequent checkups to monitor its effectiveness.

Supporting Research

Bartram T. Encyclopedia of Herbal Medicine. Dorset, England: Grace Publishers; 1995:304.

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

Conrad SC, Chiu H, Silverman BL. Soy formula complicates management of congenital hypothyroidism. Arch Dis Child. 2004 Nov;89(11):1077.

Messina M, Redmond G. Effects of soy protein and soybean isoflavones on thyroid function in healthy adults and hypothyroid patients: a review of the relevant literature. Thyroid . 2006 Mar;16(3):249-58.

Murray MT, Pizzorno JE. Encyclopedia of Natural Medicine. 2nd ed. Rocklin, Calif: Prima Publishing; 1998:386-390.

Roger PP, Servais P, Dumont JE. Regulation of dog thyroid epithelial cell cycle by forskolin, an adenylate cyclase activator. Exp Cell Res. 1990;172:282-92.

Tajiri J, Higashi K, Morita M, et al. Studies of hypothyroidism in patients with high iodine intake. J Clin Endocrinol Metab. 1986;63:412-17.

• 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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