Hyperthyroidism

Grave’s Diseases, Hashimoto’s Thyroiditis
Hyperthyroidism is a condition in which there is excessive Thyroid hormone. As the Thyroid gland has a primary role in body metabolism, high thyroid function manifests as an excessively high metabolism. This manifests with high energy, sleeplessness, tachycardia, anxiety, loss of weight, thinning of hair etc.

In Traditional medicine, Hyperthyroidism tends to manifest as Heat, specifically Liver heat or Bile Humor, while Hypothyroidism tends to manifest as Yang deficiency or Phlegm humor.

Hyperthyroidism is typically treated with Herbs to clear Liver heat, such as Self Heal, Bugle and Balm, and formulas which clears Liver Heat such as Long Dan Xie Gan Tang of TCM,

Hashimoto’s Thyroiditis (Hashimoto’s Disease) is an autoimmune disease where the immune system attacks the Thyroid gland. Initially it presents as Hyperthyroidism due to inflammation of the gland. Over time as the gland becomes more dysfunctional, a lack of Thyroid hormone is produced leading to Hypothyroidism.

Misleading Thyroid Conditions
Sometimes we have someone who has erratic TSH levels. They may have had a test suggesting Hyperthyroidism followed weeks or months later with an opposing reading. We may also have someone who would appear to be a classical Hypothyroid condition (overweight, low energy, sluggish) and yet has a reading indicating Hyperthyroid condition. These types of cases may indicate an autoimmune condition (Hashimoto’s Disease), where an initial inflammation of the gland has created a Hyperthyroid effect, but as the gland and hormones are attacked by antibodies, it eventually manifests with Hypothyroidism. In such cases, it is always best in Traditional Medicine to treat the presenting syndrome. Secondly, herbs which may be of use in both thyroid conditions and autoimmune conditions can be used. This includes herbs such as Self Heal, Rosemary, Bugle, Balm, Figwort etc.
Western Tradition

Simples
Self Heal
Balm
Gromwell
Aloe
Bugle
Rosemary
Motherwort
Turmeric

Formulas

Some fo the Formulas for Scrofula can be used for Hyperthyroid conditions. As per the Chinese differential diagnosis (opposite), formulas can be selected.



Chinese Classification

Simples
Self Heal Xia Ku Cao
Figwort (Xuan Shen)
Gentian Long Dan Cao
Scutellaria Huang Qin

Formulas

Liver heat
Dang Gui Liu Huang Tang
Long Dan Xie Gan Tang
Chai Hu Jia Long Gu Mu Li Tang


Heart Fire
Tian Wang Bu Xin Wan


Qi and Phlegm Stagnation
Ban Xia Hou Po Tang
Chen Xiang Shu Qi Wan
Hai Zao Yu Hu Tang


Phlegm Heat
Xiao Luo Wan


Yin Deficiency
Liu Wei Di Huang Wan


Yin Deficiency with Heat
Zhi Bai Di Huang Wan
Da Bu Yin Wan

Special Formula

1.  Self Heal                1 handful
    Balm                       ½ handful
Prepare a standard infusion.

2. Er Dong Tang with Xiao Luo Wan Jiawei:
    Asparagus (Tian Men Dong) 15 g
    Ophiopogon Mai Men Dong 15 g
    Adenophora Sha Shen 15 g
    Trichosanthes Tian Hua Fen 15 g
    Anemarrheana Zhi Mu 15 g
    Rehmannia Sheng Di Huang 15 g
    Figwort (Xuan Shen) 15 g
    Licorice (Gan Cao) 6 g
    Gentian (Long Dan Cao) 10 g
    Self Heal (Xia Ku Cao) 10 g
    Schisandra Wu Wei Zi 10 g
    American Ginseng (Xi Yang Shen) 10 g
    Fritillaria Zhe Bei Mu 5 g
Prepare as a decoction. This has been studied for effectiveness.

3. Yikang Wan
    Antelope horn (Ling Yang Jiao)
    Paeonia Bai Shao
    Rehmannia Sheng Di
    Cyperus Xiang Fu
    Asparagus (Tian Men Dong)
    Polygonatum Huang Jing
    Abalone shell (Shi Jue Ming)
    Figwort (Xuan Shen)
    Buplerum Chai Hu
    Ligustrum Nu Zhen Zi




Case History
A 30 year old woman came for treatment after recommendation from a friend. She had been diagnosed with severe Hyperthyroidism and the endocrinologist had recommended radioactive iodine to destroy the thyroid, requiring her to take thyroxin for life. She was hesitant and really didn’t want the procedure. I explained that the condition can be dangerous and I would only undertake treatment if she agreed to return to her doctor if symptoms increased or deteriorated, which she agreed to. She was thin, fidgeting, had wiry hair, a rapid and strong pulse, a red tongue with a yellow coating. I told her to avoid coffee and reduce her cigarettes (she was smoking a lot). This was early on in my Herbal career and my formulas were more limited at that time, but I diagnosed her with Liver Heat and gave her Long Dan Xie Gan Tang as a powder, to be taken twice daily. The next week she returned, and said that she had felt a little more relaxed and had been sleeping better. She came another twice, continued the herbs and seemed to be improving nicely. She cancelled her next appointment and didn’t return despite me trying to contact her. About 8 years later, she tracked me down (I was working in another location about an hour away). She said she had been doing well, had kept her Thyroid, but she was just starting to become Hyperthyroid again and wanted more powder. After about 2 months of the powder, it had controlled her serious condition for around 8 years. Liver Heat or Bile is often manifest in Hyperthyroid cases, and clearing Liver heat often works very effectively.

Research

1. Chinese herbal medicines for hyperthyroidism
2. Dr Ji Wenhuang’s experience in TCM treatment of thyropathy
3. Clinical study on hyperthyroidism of yang hyperactivity type due to yin deficiency treated by jiakang ning capsule].
4. Effect of yin and qi tonifying herbs on hyperthyroid model of yin-deficient rats.
5. Effects of yang-restoring and yin-nourishing herbs on serum TRH, T3 and T4 levels in experimental hyperthyroid and hypothyroid rats.
6. Effects of yin-tonics and yang-tonics on serum thyroid hormone levels and thyroid hormone receptors of hepatic cell nucleus in hyperthyroxinemic and hypothyroxinemic rats.
7. Preliminary study on Chinese herb induced apoptosis of thyrocytes in Graves’ disease.
8. Analysis on the traditional Chinese medicine syndromes of the patients with autoimmune thyroid diseases. Changes in the thyroid and immune functions in 109 cases.
9. Effect of large dosage of Prunella on Hashimoto’s thyroiditis: A protocol of systematic review and meta-analysis of randomized clinical trials