In my previous blog post, I have discussed how to manage an overactive thyroid naturally. (Please see “How to manage an overactive thyroid naturally?”). Here, I will follow up with a discussion on hypothyroidism – What if you have an underactive thyroid?

As introduced previously, the thyroid gland is a butterfly-shaped organ located in the throat area responsible for regulating the body’s metabolic rate through thyroid hormones T3 and T4. Having hypothyroidism means one has insufficient thyroid hormones. This condition can develop over time with no noticeable symptoms in the early stages. Initially, the thyroid can still produce T4 for the body’s use, albeit being inefficient, as shown with rising thyroid-stimulating hormone (TSH). The anterior pituitary needs to make extra TSH stimulate enough hormones production from the thyroid. Eventually, even the excess TSH can no longer sustain sufficient T3 output for the body’s need [1].

**Hypothyroidism**. *Attribution: http://www.scientificanimations.com, CC BY-SA 4.0 https://creativecommons.org/licenses/by-sa/4.0, via Wikimedia Commons*

Symptoms and causes

The patient may experience fatigue, weight gain, muscle weakness, decreased concentration, depression, abnormal menstrual cycle, and other metabolic, cardiovascular, neurological and psychiatric symptoms [2]. This condition affects more women than men, with a female-to-male ratio of about six to one. Age is another determining factor as the disease is more common after 60 years old [3].

**Fatigue is a common symptom of hypothyroidism**

The possible cause of primary hypothyroidism can be chronic autoimmune thyroiditis. That is, the body’s immune system mistakenly attacks the thyroid gland leading to inflammation. Iodine deficiency can be a nutritional cause. Environmental causes such as exposure to radiation earlier in life through medical radiation diagnostic or treatment can also trigger the condition [1]. The patient may also develop goitre, which is the enlargement of the thyroid gland visible at the neck.

Herbal treatment

Many herbs can be used to support hypothyroidism. Among them include Bladderwrack, Bacopa, Withania, and Coleus.

Bladderwrack (Fucus vesiculosus) is known as a thyroid stimulant. It is a type of seaweed found mainly in the Pacific Ocean. It is rich in iodine and antioxidants [4] and has been used to treat goitre in Ayurveda [5] and Western herbal medicine [1].
Bacopa (Bacopa monniera) is a nervine tonic that can help to enhance cognitive function. As shown in a mice model, it also possesses thyroid-stimulating properties to increase T4 concentration [6].
Withania (Withania somnifera) or Ashwagandha in Ayurveda is a traditional herb for boosting energy in patients weakened by disease [1]. It has been shown in a double-blind placebo-controlled trial in patients with subclinical hyperthyroidism to normalise thyroid indices after eight weeks of treatment [7].
Coleus (Coleus forskohlii) is another Indian medicinal plant that can assist in maintaining a healthy metabolism of the body. It has been shown to stimulate TSH production by activating a specific enzyme (adenylate cyclase) in the thyroid gland [8].

**Bladderwrack is a type of seaweed that has high iodine content.**

A herbal formulation that combined Bacopa, Withania, and Coleus has been shown to restore the sub-optimal thyroid function of mice in an experiment [9]. Hence, the use of traditional herbal medicine to improve hypothyroidism is also supported by scientific evidence.

Nutritional considerations

A diet rich in trace minerals for thyroid hormone production and activation is recommended. Iodine is essential, and the sources include seafood and sea vegetables, such as kelp, kombu, or nori. Zinc is also crucial, and it can be found in seafood, oatmeal, spinach, nuts and seeds. Copper is found in eggs, beans, nuts, and seeds. Also, make sure to eat Brazil nuts as it is especially rich in selenium. B vitamins are also needed for energy production, and they can be found in yeast and whole grains [1].

Also, please avoid raw food. Foods should be cooked for better digestion and to break down any goitrogens, that is, substances that can interfere with the normal function of the thyroid gland.

The following nutritional supplements can also be helpful in hypothyroidism [1]:

Activated B complex – for energy production
Iodine – only if iodine is deficient
L-carnitine – an amino acid that can help to reduce fatigue-related symptoms [10]
Coenzyme Q10 – as an antioxidant in the cardiovascular system
Omega-3 essential fatty acids – to improve cognitive function
Vitamin A, C, D, and E
Zinc and selenium

**Eat a diet rich in whole grains, nuts and seeds for hypothyroidism.** *Photo credit: Marco Verch under Creative Commons 2.0 license.*

Lifestyle recommendations

Exercise and maintaining a healthy weight is vital for the improvement of hypothyroidism. Aerobic exercise is a way to improve the quality of life of patients with subclinical hypothyroidism. It can improve emotional, mental and physical health [11]. Moreover, maintaining an exercise regime can lead to weight loss that can help reduce inflammation and lower serum TSH [12]. So, make sure to keep an active lifestyle.

Summary

Having hypothyroidism means one has not enough thyroid hormones to sustain the body’s metabolism. Common symptoms are fatigue, weight gain, muscle weakness, decreased concentration, and depression.

Herbal medicine, including Bladderwrack, Bacopa, Withania, and Coleus, can restore the sub-optimal thyroid function and improve hypothyroidism. A healthy diet rich in whole grains, sea vegetables, nuts and seeds can provide iodine, B vitamins, zinc, copper, and selenium to the thyroid function. Supplementation with L-carnitine, omega-3 essential fatty acids, coenzyme Q10, and multi-vitamins can be helpful to reduce oxidative stress, relieve fatigue and improve cognitive functions. Exercise and maintaining a healthy weight is also vital for the improvement of the condition.

**Keep up with exercise. It can help to improve the underactive thyroid.**

References

[1] L. Hechtman, Clinical Naturopathic Medicine, Churchill Livingstone, Sydney, NSW, 2014.

[2] L. Chaker, A.C. Bianco, J. Jonklaas, R.P. Peeters, Hypothyroidism, Lancet (London, England). 390 (2017) 1550–1562. doi:10.1016/S0140-6736(17)30703-1.

[3] B. Nygaard, Primary Hypothyroidism, Am. Fam. Physician. 91 (2015) 359–360. www.aafp.org/afp (accessed August 20, 2021).

[4] J. Stansbury, P. Saunders, D. Winston, Promoting healthy thyroid function with iodine, bladderwrack, guggul and iris, J. Restor. Med. 1 (2013) 83–90. doi:10.14200/jrm.2012.1.1008.

[5] A.K. Niazi, S. Kalra, A. Irfan, A. Islam, Thyroidology over the ages, Indian J. Endocrinol. Metab. 15 (2011) S121–S126. doi:10.4103/2230-8210.83347.

[6] A. Kar, S. Panda, S. Bharti, Relative efficacy of three medicinal plant extracts in the alteration of thyroid hormone concentrations in male mice., J. Ethnopharmacol. 81 (2002) 281–285. doi:10.1016/s0378-8741(02)00048-x.

[7] A.K. Sharma, I. Basu, S. Singh, Efficacy and Safety of Ashwagandha Root Extract in Subclinical Hypothyroid Patients: A Double-Blind, Randomized Placebo-Controlled Trial., J. Altern. Complement. Med. 24 (2018) 243–248. doi:10.1089/acm.2017.0183.

[8] B. Salehi, M. Staniak, K. Czopek, A. Stępień, K. Dua, R. Wadhwa, D. Kumar Chellappan, O. Sytar, M. Brestic, N. Ganesh Bhat, N. Venkatesh Anil Kumar, M. del Mar Contreras, F. Sharopov, W. C. Cho, J. Sharifi-Rad, The Therapeutic Potential of the Labdane Diterpenoid Forskolin, Appl. Sci. . 9 (2019). doi:10.3390/app9194089.

[9] S. Singh, V. Panda, S. S, P. Dande, Protective effect of a polyherbal bioactive fraction in propylthiouracil-induced thyroid toxicity in ratsby modulation of the hypothalamic-pituitary-thyroid and hypothalamic-pituitary-adrenal axes, Toxicol. Reports. 7 (2020) 730–742. doi:10.1016/j.toxrep.2020.06.002.

[10] J.H. An, Y.J. Kim, K.J. Kim, S.H. Kim, N.H. Kim, H.Y. Kim, N.H. Kim, K.M. Choi, S.H. Baik, D.S. Choi, S.G. Kim, L-carnitine supplementation for the management of fatigue in patients with hypothyroidism on levothyroxine treatment: a randomized, double-blind, placebo-controlled trial., Endocr. J. 63 (2016) 885–895. doi:10.1507/endocrj.EJ16-0109.

[11] F.Z. Werneck, E.F. Coelho, S.P. Almas, M.M. do N. Garcia, H.L.M. Bonfante, J.R.P. de Lima, P.D.S. Vigário, M.R.M. Mainenti, P. de F.D.S. Teixeira, M. Vaisman, Exercise training improves quality of life in women with subclinical hypothyroidism: a randomized clinical trial., Arch. Endocrinol. Metab. 62 (2018) 530–536. doi:10.20945/2359-3997000000073.

[12] D. Sanyal, M. Raychaudhuri, Hypothyroidism and obesity: An intriguing link, Indian J. Endocrinol. Metab. 20 (2016) 554–557. doi:10.4103/2230-8210.183454.

Nature care for hypothyroidism