The thyroid gland produces hormones that have two primary functions: they enhance protein synthesis and oxygen utilization. These physiologic activities, in turn, influence the basal metabolic rate (BMR). The level of thyroid hormone production is determined by levels of thyroid stimulating hormone (TSH) leased from the pituitary gland, by availability of iodine a tyrosine (converted by the gland to the thyroid hormones), and by the condition of the thyroid tissues themselves. TSH levelsare further regulated by the hypothalamus, and no doubt by other regulatory mechanisms, producing a feedback loop so that TSH increases as thyroid hormones decrease and TSH decreases when thyroid hormones increase. Measures of the amount of the thyroid hormones T3 (triiodothyronine) and T4 (thyroxine) in the blood plasma are considered a substantive evaluation of thyroid function. Additional diagnostic factors can reveal the presence and nature of thyroid disease. The thyroid gland also produces calcitonin, which acts in conjunction with parathyroid hormone to regulate calcium levels; thyroid disease may affect this function.
Thyroid disease affects about 2.5% of the American population, but because the disease predominantly strikes middle-aged women, the incidence within this group is rather high. Women are about four times more likely than men to suffer hyperthyroid disorders, eight times more likely to suffer hypothyroidism, and about twice as likely as men to suffer thyroid tumors. Approximately half the cases of thyroid disease involve hyperthyroidism and the other half involve hypothyroidism. Despite the differing outcomes, the main cause of the disease as it occurs todayis an autoimmune process. Grave’s disease is the most common hyperthyroid condition; in severe cases it is treated by removal of thyroid tissue either through surgery in young individuals and in pregnant women, or via irradiation from an iodine isotope-this rapidly binds to the thyroid, and thus causes maximum destruction of tissues at this site. Thyroid-inhibiting drugs, such as methimazole, may be used in less severe cases. Hashimoto’s thyroiditis is the most common autoimmune disorder that causes hypothyroidism. In its normal course, it begins with an episode of hyperthyroidism which spontaneously converts to hypothyroidism. It is treated mainly by giving oral thyroid hormone (thyroxine) as a replacement therapy, the same therapy given after thyroidectomy or irradiation of the thyroid gland for hyperthyroid patients.
Hyperthyroidism follows a course similar to many inflammatory autoimmunedisorders, that is, with periods of flare-up and remission. Hypothyroidism, however, appears to follow a more steady course, and might thus be comparable to early-onset diabetes; the thyroid gland becomes enlarged or shrunken and has little or no function, just as the insulin-producing cells of the pancreas of the diabetic patients have little or no function.
It is important to note, however, that a different form of thyroid disease was the dominant one in earlier times: iodine-deficiency goiter. This disorder often produces a very large mass in the neck area. It has become less common in the United States as a result of the practice of adding iodine to the national salt supply and by the recommendations to consume more seafood. It is also relatively easy to diagnose and treat.
The current medical therapies for thyroid disorders other than iodine-deficiency goiter are often deemed inadequate because of difficulties in regulating the level of thyroid hormones through use of drugs or an exogenous source of thyroid hormone. As a result, patients often experience only partial relief of the symptoms and those who suffer from hyperthyroidism often have to deal with hypothyroid conditions following medical destruction of the thyroid gland.
Therefore, it is of interest to investigate the methods used by Chinese doctors. Thyroid disease is common in China, and it is frequently treated by herbal medicine or a combination of herbs and drugs. Positive response is a common outcome.
First, there is a strong reliance on materials from the sea, mainly oyster shell (included in 12 of 18 clinical trials using a basic formula), seaweeds (laminaria, and sargassum, used in nearly half the clinical trials), and somewhat less frequent use of clam shells, arca shells, or pumice. While these materials, especially the seaweeds, would obviously be helpful for iodine-deficiency goiter, they are now often used for Grave’s disease and thyroid adenoma. In the recent book Practical Traditional Chinese Medicine and Pharmacology Clinical Experiences, formulas are presented for treatment of hyperthyroidism according to differential diagnosis: all five of the listed formulas contained seaweeds or seashells or both. Thus, current thinking about hyperthyroidism emphasizes these materials. Oyster shell and other shells not only resolve masses, but also help to calm liver wind, thought to be responsible for some hyperthyroid symptoms, such as trembling, and they astringe excessive perspiration, another common symptom.
Hyperthyroidism is thought by some doctors to start with an excess fire syndrome which later becomes yin-deficiency fire. Therefore, fire-purging herbs are used, especially in the early stages of the disease process. Several hyperthyroid symptoms, such as heart palpitation, general hyperactivity (psychological and physical), excessive perspiration, heightened appetite, aversion to heat, and, in more severe cases, wasting of the muscles, are characteristic of a yin deficiency In sum, Chinese doctors obtain clinically useful results from the application of formulas that have the primary function of resolving masses, with additional herbs to clear heat and nourish yin.
Hypothyroidism is also frequently mentioned in Chinese literature and is a common subject of clinical studies. All characteristic of hypothyroidism are standard symptoms belonging to traditional categories such as qi and yang deficiency. These conditions usually do not present immediate need for Western
medical attention as might occur with the irregular heart rate of hyperthyroidism. The basic herbal treatment for hypothyroidism is to administer qi and yang. Individual cases mentioned in the reports describing various treatments for hyperthyroid or hypothyroid conditions suggested that one to five year follow-up demonstrated continued relief, but that a few individuals might experience a relapse which could be treated effectively by applying again the original treatment.
Thyroid diseases can be cured or controlled in most patients, according to Chinese reports published during the past twelve years. For those who are cured, relapse is relatively rare during a period of up to five years following treatment. Among those who are not cured but show symptomatic improvement, usually with accompanying changes in blood parameters, continued use of herbs, alone or with Western drugs, is necessary. In those cases, it appears that Chinese herbs provide better results than using drugs alone. Only a small number of individuals fail to respond to the Oriental therapies.
There is a clear pattern of herb selection for treatment of thyroid diseases. When thyroid nodules or swellings are present, phlegm-resolving herbs are used. Other herbs are selected for treatment of specific syndromes or symptoms. Hyperthyroid cases are treated with yin nourishing and/or fire purging herbs while hypothyroid cases are treated with qi and yang tonifying herbs. The number of different herbs commonly used by Chinese doctors for treatment of thyroid diseases are relatively small, thus making selection based on accumulated Chinese experience-but applied to new cases-relatively easy. Acupuncture and moxibustion point selection may include local treatment plus a focus on treating the stomach and spleen meridians, the governing and bladder vessels along the back, and the kidney and conception vessels along the front.
The dosage of herbs used in Chinese clinical trials showing effective treatment of thyroid diseases is higher than commonly used by Western practitioners but comparable to those used in treating other chronic ailments. Powdered herbs in pill form are consumed in the amount of 18-30 grams per day, while decoctions are consumed in the amount of about 90-210 grams per day. Duration of therapy typically ranges from six weeks to six months, though some patients require more than a year of treatment to obtain satisfactory resolution of symptoms. Western drugs used in conjunction with Chinese herbs help to resolve symptoms during the treatment period and appear to enhance the overall effects of the therapy towards attaining a cure or major resolution of the disease. The mechanism of action of the Chinese herb therapies for thyroid diseases, as expressed in Western pharmacology terms, remains unknown. Clearly, some of the herb ingredients used in the complex formulas regulate the hormone system and/or the antibody attack that causes changes in thyroid function. There is some controversy about using iodine-rich materials (mainly seaweeds) n making Chinese herb formulas, but it appears that in most cases there is no roblem in utilizing such materials.
The continued use of surgical thyroidectomy and iodine-irradiation of the thyroid gland to remove thyroid activity in hyperthyroid patients may be deemed a last resort rather than a standard method of therapy if Chinese medicine is incorporated into the health care system. This can reduce the health problems encountered by Grave’s disease patients and also reduce the cost of life-long health care.
Doctor Qiqing Li will help you to choose the right herbal pills for your specific thyroid problem.
About the author: ChineseHerbalAdviser
