University of Maryland Medical Center
Introduction to Hypothyroidism
Hypothyroidism happens when your thyroid gland, located at the front of your neck, doesn’t produce enough thyroid hormone (underactive thyroid). There are several types of hypothyroidism. The most common is Hashimoto’s thyroiditis, an autoimmune disease where the immune system mistakenly attacks the thyroid gland. The disease affects both sexes and all ages, but is most common in women over age 60. Because the thyroid gland helps regulate your metabolism, low thyroid levels cause your body to slow down, affecting everything from appetite to body temperature. Symptoms can appear over time and can be hard to diagnose. Left untreated, hypothyroidism can cause serious health complications.
People who have hypothyroidism may be at increased risk for other chronic conditions including heart disease, arthritis, age-related macular degeneration, and cognitive impairment.
Signs and Symptoms
Hoarse voice, slowed speech
Goiter (caused by swollen thyroid gland)
Sensitivity to cold
Dry, scaly, thick, coarse hair
Numbness in fingers or hands
Confusion, depression, dementia
In children, slowed growth, delayed teething, and slow mental development
What Causes It?
There are different kinds of hypothyroidism with 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 happens when you don’t get enough iodine in your diet. In the developed world iodine is added to salt so goiter is rare, although it still happens in undeveloped countries.
What to Expect at Your Doctor’s Office
Your thyroid gland produces two main thyroid hormones, T3 and T4. In addition, the pituitary gland produces thyroid-stimulating hormone (TSH), which helps control how much T3 and T4 the thyroid makes. Your health care provider will draw blood to measure TSH levels. When thyroid hormones are low, your body produces more TSH to increase production of thyroid hormones. Your doctor may also test your levels of Free T3 or Free T4.
Natural medicine practitioners may pay particular attention to levels of T3 hormone. T3 is the active form of thyroid hormone. Your thyroid gland makes some T3, but the body also converts T4 into T3. If you are unable to convert T4 to T3, your laboratory tests for T4 may be normal, but you still may have all the symptoms of hypothyroidism. Talk to your doctor about including T3 laboratory tests in your treatment.
Your health care provider will prescribe a synthetic thyroid hormone called levothyroxine (Levothroid, Synthroid, Unithroid) that you will take daily. A natural dessicated thyroid (NDT) hormone drug, made from the thyroid glands of pigs, is also available by prescription. Your doctor 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. (or a combination)
Complementary and Alternative Therapies
If you have hypothyroidism, you need conventional medical treatment. Nutrition and herbs can help support conventional treatment, but should not be used by themselves to treat hypothyroidism. Studies show, for example, that practicing yoga can help hypothyroid patients manage disease-related symptoms.
Nutrition and Supplements
Following these nutritional tips may help reduce symptoms:
- Eat foods high in B-vitamins and iron, such as whole grains (if no allergy), fresh vegetables, and sea vegetables.
- 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.
- If you take thyroid hormone medication, talk to your doctor before eating soy products. There is evidence soy may interfere with the absorption of thyroid hormone.
- Taking iron supplements may interfere with the absorption of thyroid hormone medication, so ask your doctor before taking iron.
- Eat foods high in antioxidants, including fruits (such as blueberries, cherries, and tomatoes) and vegetables (such as squash and bell pepper).
- Avoid alcohol and tobacco. Talk to your doctor before increasing your caffeine intake, as caffeine impacts several conditions and medications.
These supplements may also help:
- Omega-3 fatty acids, such as fish oil, to help reduce inflammation and enhance immunity. Omega-3 fatty acids may increase the risk of bleeding, especially if you already take blood-thinning medication. Ask your doctor before taking omega-3 fatty acids if you take blood thinners such as warfarin (Coumadin), or if you have a bleeding disorder.
- L-tyrosine, 500 mg, 2 – 3 times daily. The thyroid gland combines tyrosine and iodine to make thyroid hormone. If you are taking prescription thyroid hormone medication, you should only take L-tyrosine under the direction of your doctor. Do not take L-tyrosine if you have high blood pressure or have symptoms of mania. Tyrosine may interact with Levodopa.
- Do not take an iodine supplement unless directed to by your doctor. Iodine is only effective when hypothyroidism is caused by iodine deficiency, which is rare in the developed world. Too much iodine can actually cause hypothyroidism.
Herbs are a way to strengthen and tone the body’s systems. As with any therapy, you should work with your health care provider to diagnose your problem before starting treatment. You may use herbs may as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). People with a history of alcoholism should not take tinctures. Unless otherwise indicated, 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 singly or in combination as noted.
Few herbs have been studied for treating hypothyroidism. More research is needed. (consult with a doctor first)
- Coleus (Coleus forskohlii), for low thyroid function. Coleus may interfere with certain medications, including some blood pressure medicines, nitrogylcern, and blood-thinning medications, such as warfarin (Coumadin). Talk to your doctor.
- Guggul (Commiphora mukul), for low thyroid support. Guggul may interfere with estrogen, birth control pills, and other medications. Talk with your doctor. Guggul may have an estrogen-like effect on the body and may not be appropriate for people with certain hormone-related conditions.
- Bladderwrack (Fucus vesiculosus), for low thyroid support. Do not take bladderwrack unless directed by your doctor. Bladderwrack contains iodine. Although lack of iodine can cause hypothyroidism, most cases of hypothyroidism in the developed world are not caused by iodine deficiency. In fact, too much iodine can actually cause hypothyroidism. Bladderwrack may also contain toxic heavy metals, interfere with pregnancy and fertility, and interact with blood-thinning medications, such as warfarin (Coumadin) among others.
Homeopathy may be useful as a supportive therapy.
Contrast hydrotherapy (application of hot and cold) to the neck and throat may stimulate thyroid function. Alternate 3 minutes hot with 1 minute cold. Repeat 3 times for 1 set. Do 2 3 sets per day.
Acupuncture may be helpful in correcting hormonal imbalances, including thyroid disorders.
After you start on thyroid hormone replacement therapy, your provider will frequently monitor its effectiveness. It is especially important to have your thyroid levels tested during pregnancy, as your needs tent to increase by about 30% when you are expecting. Over replacement is common, and may increase the risk of other conditions, such as atrial fibrillation and osteoporosis.