Overview
Thyroid hormone is important for all metabolic activity since it speeds up cellular energy and heat production.
Low levels of thyroid hormone can cause a variety of common symptoms, such as feeling cold, fatigue, weight gain, hair loss, depression, brain fog, and sleepiness.
From a Chinese Medicine perspective, the thyroid gland itself is closely related to Lung function, but any organ system can be implicated in a Western diagnosis of hypothyroid.
Simply treating low thyroid by supplementing with thyroid hormone often misses the deeper issue. Without examining the unique individual this can cause more problems in the long-term.
Treatment for thyroid issues can include diet, acupuncture, herbs, homeopathy, lifestyle and stress management, all geared towards helping the body self-regulate and return to health.
Thyroid problems are becoming more and more common. A health survey from 1999 to 2002 reported that 3.7% of all people in the US had a diagnosis of hypothyroidism. Hypothyroid is more common in the elderly population, and more common in women than in men. Also, depending on who you ask, subclinical hypothyroid is much more common, ranging from 15% of the population up to 40%, according to Dr. Broda Barnes in his book Hypothyroidism: The Unsuspected Illness. Given the importance of the thyroid gland, and the widespread thyroid dysfunction that exists, it is important to understand the thyroid better both from a biomedical and a more integrative perspective.
Causes & Symptoms
The prime cause of Hypothyroidism is the deficiency of Iodine. In many cases, this disease is caused by pituitary or hypothalamic disease or certain medications. Additionally, there can be other causes diagnosed during a consultation, all of which are considered when providing precise, root-cause Hypothyroidism treatment.
The thyroid sits in the throat and produces thyroid hormone in response to thyroid-stimulating hormone (TSH) from the pituitary gland, a small gland that sits behind the eyes and controls much of the body’s endocrine system. The main thyroid hormone produced by the thyroid, thyroxine (T4), is then converted to the active form (triiodothyronine, or T3) in the cells themselves. The thyroid also releases small amounts of T3, but primarily produces T4. While in the blood less than 1% of the T3 and T4 is available to stimulate the cells, as most of the thyroid hormones are bound to thyroxine-binding globulins and other carrier proteins that keep them inactive.
Once in the cells T3 goes into the mitochondria and increases energy output. The mitochondria are the cell’s main energy producers, and thyroid hormone speeds them up, increasing the rate at which fuel is burned. It’s similar to the gas pedal in a car: more T3 means more metabolic activity, which means more energy and more heat. More oxygen gets used, and more calories are burned. Thyroid hormone is important for making proteins, development of the fetus, and maintenance of the nervous system in adults. Thyroid hormone also increases sensitivity to adrenaline in the cardiovascular system by increasing the number of receptors in the blood vessels. This makes the startle response and reaction to acute stress more sensitive.
Symptoms of hypothyroidism
When TSH is high but levels of T3 and T4 are normal this is known as subclinical hypothyroidism. There are typically no symptoms. When levels of T4 and T3 get too low people to develop symptoms. Generally speaking, everything slows down, both physically and mentally. Physically, this manifests as fatigue, feeling cold, weight gain, decreased appetite, dry skin, hair loss, weakness in the extremities, joint pain, constipation, blurred vision, decreased hearing, slowed heart rate, low blood pressure, and swelling. If the hypothyroid is due to Hashimoto thyroiditis (an autoimmune thyroid condition) or iodine-deficiency goiter people can also have a feeling of obstruction in the throat and hoarse voice, as the enlarged thyroid presses on the esophagus and vocal cords. Mentally, hypothyroid manifests as depression, sleepiness, forgetfulness, and difficulty concentrating. If the deficiency is severe there can be a coma.
Types of Hypothyroidism
Deficiency of the thyroid hormone (THYROXINE) is called Hypothyroidism or Hypothyroid. It can affect any age group though it is most prevalent in older women. It is almost 10 to 20 times more common in females as compared to males. It is one of those conditions which are often present for many years before they can be recognized and treated effectively. An estimated one in every 50 females and one in 1000 men tend to suffer from this condition.
Hypothyroidism can be of two types:
Primary hypothyroidism: Here the problem lies in the thyroid gland and hence it fails to produce sufficient hormones due to certain causes. Secondary hypothyroidism: In this type, the pituitary gland is at fault and it is unable to produce sufficient quantity of TSH. Lack of TSH, in turn, causes decreased production of T3 and T4 by the thyroid gland due to lack of stimulus from the pituitary.
Hormone
Normal levels
T3 (Triiodothyronine)
80-180 ng/dl
T4 (Thyroxine)
4.6-12 ug/dl
TSH (Thyroid Stimulating Hormone)
0.5-6 uU/ml
Underactive thyroid results from an inability of the Thyroid gland to produce adequate Thyroxine hormone. This could be largely due to the genetic tendency. It is important to understand that since there is an inability or sluggishness of the thyroid gland, the treatment should ideally be aiming at stimulating the thyroid gland to do its job, rather than simply supplying deficient Thyroxine hormone from outside.
Causes of Underactive Thyroid (Hypothyroidism)
Primary Hypothyroidism or Underactive Thyroid can be caused due to several reasons such as follows:
Iodine deficiency in food is one of the common causes especially in certain geographic areas of the world. Inflammation of the thyroid gland which causes damage or death of the cells of thyroid leading to insufficient production of the hormones is a major cause of Primary Hypothyroidism. The main cause of failure of the thyroid gland in this manner is by Auto-immune Thyroiditis also known as Hashimoto’s Thyroiditis. In this disorder, the patients own immune system causes an inflammation of the gland. Post-thyroidectomy: Surgical removal of the thyroid gland or a nodule for treating hyperthyroidism often makes the patient land up with Hypothyroidism after a few years. Post-radiotherapy: Radiotherapy given for hyperthyroidism in order to destroy the hyperactivity of the gland. If a larger number of cells are destroyed by the radioactive iodine, the patient may have insufficient hormone production by the remaining cells and this may cause hypothyroidism.
Secondary hypothyroidism is commonly caused by the following:
Failure of the pituitary gland to secrete Thyroid Stimulating Hormone (TSH). This may be caused due to:
• Tumor in the pituitary region
• Infiltration of the pituitary by inflammatory cells from the immune system
• Infiltration of the pituitary by foreign substances (such as iron in Hemochromatosis) Hypothalamic dysfunction
Risk factors for secondary hypothyroidism include being over 50 years old, being female, and having a history of pituitary or hypothalamic dysfunction.
Symptoms of Underactive Thyroid (Hypothyroidism)
The symptoms of hypothyroidism are frequently missed out and especially in elderly females, these are mistaken to be symptoms of menopause. The beginning of the symptoms is often not noted markedly and hence the condition remains under-diagnosed.
A patient may experience a few of the following symptoms:
Fatigue, exhaustion, weakness, sluggishness, unexplained weight gain or increased difficulty losing weight coarse, dry hair and/or thinning of hair, hair loss, pale and itchy skin, cold intolerance (can’t tolerate the cold like those around you) constipation, depression, mood swings, Irritability, Memory loss, Abnormal menstrual cycles, increased menstrual flow, Decreased libidoInfertility, miscarriages, difficulty in concentrating, Thinning and/or falling out of sides of eyebrows, puffy swollen face and dull facial expressions.
Hypothyroidism Treatment
Conventional treatment in cases that don’t involve iodine deficiency is simply to supplement with thyroid hormone, either T4 or a combination of T4 and T3. Often patients take thyroid medication for life. This approach is not optimal, however, due to how the rhythmic secretion of hormones in a healthy person cannot be replicated with oral medications. An optimal approach would also recognize the need for the body to self-regulate, and any treatment that relies on lifelong medication is missing the deeper issues. I don’t accept the premise that hypothyroid can only be managed, but not cured. A more integrative approach provides treatments that can more completely address low thyroid. Making sure to address any potential adrenal fatigue is extremely important. Optimizing digestion, fixing leaky gut, and working with blood sugar dysregulation is vital. Working with stress management, releasing contained emotions, and regulating the nervous system with meditation or breathing exercises will help rebalance the system. In some cases, a small amount of thyroid hormone supplementation – for a short time – is helpful to restore energy and function while the body is being healed.
Though acupuncture is quite effective I won’t go into specific treatments protocols or point selection here. Similarly, with homeopathic remedies, the number of different remedies is broad enough that speculation without a detailed history would be pointless. However, some basic aspects of diet and possible approaches for herbal treatment can be considered.
Find out how Acupuncture treatment for hypothyroidism takes a personalized and holistic view from a traditional chinese medicine view as well.
