Thyroid Gland and Function
The thyroid gland is a butterfly-shaped organ located in the throat area. It is an essential gland in the complex endocrine system which control numerous function through the secretion of hormones. The role of the thyroid is to regulate the body’s metabolic processes through the production of two hormones: thyroxine (T4) and tri-iodothyronine (T3). These two hormones are converted from iodine absorbed from the diet. T3 is the more active thyroid hormone and is produced in a lesser quantity than T4. Although T4 is less active than T3, it can be converted to T3 as well. Together, T3 and T4 control the body’s energy needs to grow and maintain homeostasis [1].
The production of T3 and T4 is controlled by another hormone called thyroid-stimulating hormone (TSH). TSH is produced from the anterior pituitary, a pea-sized gland within the brain, under the control of the hypothalamus. Under normal conditions, there exists a negative feedback loop from the controlling of thyroid hormones. When T3 and T4 levels fall below normal, the anterior pituitary is stimulated to release more TSH, spurring the increased hormonal production of the thyroid gland. The elevating concentrations of T3 and T4 in circulation will, in turn, inhibit the anterior pituitary from making more TSH. In this way, the body maintains the level of thyroid hormones in balance [1].
Regulation of thyroid hormones can be disrupted by many factors, including nutrition, stress, infection, inflammation, trauma, tumour, or medications, causing the thyroid gland to be overactive or underactive. We will discuss hyperthyroidism in this article, leaving hypothyroidism for the next topic.
Hyperthyroidism
Hyperthyroidism occurs when there is too much T3 in the body. The excess can cause an increased basal metabolic rate, leading to rapid heart rate, nervousness and irritability, trouble sleeping, mood swings and unintentional weight loss. Persistent increases in thyroid activities can also cause the enlargement of the thyroid gland, developing goitre [2]. Hyperthyroidism is commonly due to autoimmune attacks of the body (Grave’s disease), inflammation (thyroiditis), thyroid nodule, excess iodine consumption, or overdose of thyroid medication [2]. Women are more common to experience hyperthyroidism, with the female-to-male ratio reported to be about 3~6:1 [3]. Hyperthyroidism is commonly treated with antithyroid medicine, which inhibits the activities of the thyroid gland, and the treatment regime may take one to two years [4].
Herbal Remedies
In terms of natural treatment for hyperthyroidism, herbal medicine can help to reduce symptoms and gradually restore the thyroid balance. Here are some recommended herbs:
- Bugleweed (Lycopus virginicus) is native to North America and is found east of the Mississippi River. It has thyroid suppressive properties and has been reported to inhibited iodine metabolism and thyroid T4 output in humans, which can be beneficial for hyperthyroidism [5,6]
- Motherwort (Leonurus cardiaca) is traditional Chinese medicine called Yimucao (益母草). It is a traditional heart tonic and uterine stimulant. The German Commission E approved motherwort for cardiac and nervous disorders and as an adjuvant for thyroid hyperfunction [6].
- Lemon balm (Melissa officinalis) is a carminative herb with anti-TSH properties [7]. It is commonly combined with bugleweed to treat hyperthyroidism [8]. It also helps to lower heart rate [9] and improve sleep [10].
Nutritional Support
In hyperthyroidism, the body will need more energy and nutrients to sustain the increased metabolism rate. It is, therefore, essential to increase food intake, especially a high protein and energy diet [11]. It will also be advisable to eat small frequent meals throughout the day. In general, one should eat 50-60% more in energy intake to prevent uncontrolled weight loss and fatigue. Supplementation with glucose drink (e.g., Glucolin) for energy may be needed. Also, there is a need to avoid iodine-rich foods such as seaweed or fish.
The following nutritional supplement is also recommended [12]:
- High-potency antioxidant formula consist of vitamin A, E, C, selenium, and zinc – to support the increased oxidative stress due to the higher cellular metabolism
- Vitamin B complex – to support energy production and weight stabilisation
- Magnesium – for maintaining a healthy nervous system, muscle contraction and relaxation, and cardiac function
- Coenzyme Q10 – to augment the increased heart function
Lifestyle Recommendations
For hyperthyroidism, stress reduction is the most important lifestyle recommendation. One should avoid all forms of stress and agitation. Learn to manage stress with mind-body practices such as meditation or yoga. The goal is to maintain a calm and relaxed state of mind, conserve energy and improve sleep. Also, important not to perform any strenuous exercise as this will put unnecessary stress on the heart. Low-intensity exercise for relaxation, however, is recommended.
Summary
Hyperthyroidism is the excess production of thyroid hormone with symptoms such as rapid heart rate, nervousness and irritability, trouble sleeping, mood swings and unintentional weight loss. Natural treatment for hyperthyroidism includes herbal remedies to suppress thyroid activities (bugleweed), protect the heart (motherwort) and calm the nerves (lemon balm). A high protein and energy diet is recommended, and one should eat 50-60% more in energy intake. Nutritional supplements required include antioxidants, vitamin B complex, magnesium, and coenzyme Q10. Lifestyle-wise, stress reduction through mind-body techniques can help relaxation and improve sleep.
References
[1] M. Armstrong, E. Asuka, A. Fingeret, Physiology, Thyroid Function, in: StatPearls [Internet], StatPearls Publishing, Treasure Island, FL, 2021. https://www.ncbi.nlm.nih.gov/books/NBK537039/.
[2] National Institute of Diabetes and Digestive and Kidney Diseases, Hyperthyroidism (Overactive Thyroid), (2016). https://www.niddk.nih.gov/health-information/endocrine-diseases/hyperthyroidism (accessed August 6, 2021).
[3] H. Li, J. Li, Thyroid disorders in women., Minerva Med. 106 (2015) 109–114.
[4] I. Kravets, Hyperthyroidism: diagnosis and treatment., Am. Fam. Physician. 93 (2016) 363–370.
[5] E. Yarnell, K. Abascal, Botanical medicine for thyroid regulation, Altern. Complement. Ther. 12 (2006) 107–112. doi:10.1089/act.2006.12.107.
[6] K. Welch, Herbs for potential adjunct treatment of thyroid disease a review of botanical preparations for hypo- and hyperthyroidism, thyroid nodules, and thyroid cancer, HerbalGram J. Am. Bot. Counc. (2008) 52–56. https://www.herbalgram.org/resources/herbalgram/issues/79/table-of-contents/article3314/ (accessed August 6, 2021).
[7] K. Bone, The Ultimate Herbal Compendium, Phytotherapy Press, Warwick, QLD, 2007.
[8] D. Kaplan, C. Dosiou, Two cases of graves’ hyperthyroidism treated with homeopathic remedies containing herbal extracts from Lycopus spp. and Melissa officinalis, J. Endocr. Soc. 5 (2021) A971–A971. doi:10.1210/jendso/bvab048.1984.
[9] S. Joukar, H. Asadipour, Evaluation of Melissa officinalis (Lemon Balm) Effects on Heart Electrical System, Res. Cardiovasc. Med. 4 (2015) e27013–e27013. doi:10.5812/cardiovascmed.4(2)2015.27013.
[10] J. Cases, A. Ibarra, N. Feuillère, M. Roller, S.G. Sukkar, Pilot trial of Melissa officinalis L. leaf extract in the treatment of volunteers suffering from mild-to-moderate anxiety disorders and sleep disturbances, Med. J. Nutrition Metab. 4 (2011) 211–218. doi:10.1007/s12349-010-0045-4.
[11] E. Cunningham, Are there foods that support thyroid health?, J. Acad. Nutr. Diet. 112 (2012) 588. doi:10.1016/j.jand.2012.02.011.
[12] L. Hechtman, Clinical Naturopathic Medicine, Churchill Livingstone, Sydney, NSW, 2014.
[13] H. Suzuki, T. Naitoh, S. Kuniyoshi, N. Banba, H. Kuroda, Y. Suzuki, M. Hiraiwa, N. Yamazaki, M. Ishikawa, Y. Hashigami, Cardiac performance and coenzyme Q10 in thyroid disorders., Endocrinol. Jpn. 31 (1984) 755–761. doi:10.1507/endocrj1954.31.755.