Hypothyroidism and Hyperparathyroidism

Paul L. Reller L.Ac. / Last Updated: August 03, 2017

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An array of factors may be involved in the gradual imbalances in subclinical Hypothyroid and Hyperparathyroid syndromes, and these should be addressed in a comprehensive therapy

An holistic approach to overall treatment of Hypothyroidism and Hyperparathyroidism provides patients with a proactive way to insure a better quality of life and fewer problematic symptoms. Understanding the underlying causes and aggravating factors is a key component to this more comprehensive and proactive approach to health. Improving the immune health and hormonal balance with holistic medicine are essential in this approach, but attention to diet and lifestyle, and avoidance of environmental causes are also fundamental. Environmental factors may be playing a significant role in hypothyroid conditions, and thus avoiding further exposure to these potential environmental factors is essential in the holistic treatment protocol. Researchers in 2006 discovered that a chemical commonly used in sunscreens called 4MBC mimicked the estrogen molecule (a xenoestrogen) and significantly raised the level of thyroid stimulating hormone (TSH) in study animals, resulting in thyroid hypertrophy and deficient function. This chemical does not break down easily, and has been found by environmental researchers in the drinking water of many countries, and initial research has shown the potential for topically applied 4MBC to enter the bloodstream. Various estrogen-like chemicals used in common products, such as pthlalates in soft plastics, have also been linked to hormonal imbalances by researchers. While significant study on humans is not yet completed, the implications are alarming. These are just two common industrial environmental chemicals, 4MBC and pthlalates, among a host of threatening chemicals that may cause or contribute to hypothyroid pathology. Other common industrial chemicals that we are unwittingly exposed to, and that can be avoided, are perfluorooctanoic acids (PFOA) in non-stick cookware, such as teflon, and glyphosate organic herbicides (e.g. Roundup). The water that we drink may be contaminated with these chemicals, organic lead and mercury from dirty coal-fired power plants and air pollution, and small amounts of pharmaceuticals that could impact our thyroid health. While we measure the environment for high exposure and acute toxicity, the accumulation of such low level environmental toxins are largely ignored, and it is a combination of such environmental factors that we need to avoid. There may be many factors in the cause of hypothyroidism, and attention to potential environment causes should be considered in the overall holistic approach to restoring healthy function. These particular environmental links also show how estrogen imbalance is intricately tied to subclinical hypothryroidism, and how important healthy restoration of hormonal balance is to overall health in postmenopausal states or in women with menstrual problems.

A number of common industrial chemicals have been linked physiologically to thyroid dysfunction, including perchlorates, PCBs (polychlorinated biphenyls), PBDEs (polybrominated diphenylethers), BPA (bisphenol-A), organochlorine pesticides, and dioxins (see study citation link below). Perchlorates are used in the manufacture of military missiles, rocket fuel, airbags in autos, and flares, and these chemicals do not easily degrade in the environment. PCBs have been widely used in the manufacture of electrical transformers, capacitors, coolants in refrigerators, air conditioners, and many other devices, plasticizers in cement and paint, sealants, hydraulic fluids, flame retardants, adhesives, wood floor finishes, de-dusting agents, water-proofing, surgical implants, and carbonless copy paper, and PCBs do not decompose readily. PBDEs are widely used in flame retardants. BPA is used in the manufacture of soft plastics and epoxy resins. The EPA under the Obama administration is finally calling for a ban on many of these chemicals, but the accumulation in the environment will last for many decades, if not centuries. Mercury and lead organic compounds, which are common in the environment due to unregulated smokestack pollution from dirty coal electrical plants, smelters, and cement manufacturing, have also been definitively linked to thyroid dysfunction (see my article on these heavy metal toxins and the link to EPA reports on this website). While industry propaganda has consistently been generated and published to protect from liability, the scientific research from unbiased sources, such as University Schools of Public health and public research institutes, is now providing definitive proof of harm and can be easily accessed.

It is believed that the number of cases of subclinical hypothyroidism has grown substantially in recent years. Unfortunately, the standard treatment protocol for subclinical hypothyroidism, in most cases, is still the same as that for clinical hypothyroidism and involves synthetic thyroid hormone substitution such as Synthroid (Levothyroxine sodium). This type of treatment has become controversial, and a meta-analysis by the Cochrane Collaboration has shown no benefit and substantial risk in taking synthetic thyroid medication for subclinical hypothryoidism. The risks include the possibility of stimulating hyperthyroidism as well as increased cardiovascular risks from the medication. This type of standard treatment does not address the many factors that cause or contribute to the thyroid dysfunction, and is inappropriate treatment for the high percentage of cases that present as subclinical hypothyroidism. No matter whether one has to take synthetic T4 to maintain the euthyroid state, or can achieve a restoration of normal thyroid homeostasis with a more holistic approach, Complementary and Integrative Medicine and Traditional Chinese Medicine (CIM/TCM) can provide an array of therapeutic protocols to benefit overall health and prevent future disease for patients with Hypothyroidism. There is no danger in utilizing a sensible holistic approach that is restorative of the normal thyroid function, or a euthyroid state, and if achieved, the long-term health outcomes will be much better than that seen with most cases of chronic levothyroxine dependency.

The most widely prescribed brand drug in the United States in 2015 was Synthroid levothyroxine, and the medical industry of course invests heavily on continuance of this profitable drug even for conditions for which it may not be appropriate, such as a subclinical hypothroid state, and now, unlike in the past, insists that the synthetic T4 hormone must be taken forever. Fortunately, use of bio-identical hormone therapy and Complementary and Integrative Medicine (CIM/TCM) is finally being used in endocrine pathologies with great success, even among a small percentage of M.D.s, over the objection of the big pharmaceuticals. Studies have proven that use of T3 and dessicated thyroid in the treatment may control the deficiency of thyroid production with fewer risks and side effects than synthetic thyroid hormone (T4 Levothyroxine). One study showed substantial benefit from T3 use for both mood and cognitive ability, while a study of dessicated thyroid showed benefits across the board in symptom improvement compared to standard synthetic T4 use. This type of natural thyroid extract, called Armor Thyroid, was used successfully for decades in standard medicine without significant problems, but was all but eliminated from standard practice when patentable synthetic thyroid hormones, such as Synthroid, providing greater profits, were developed.

Today, many patients are again utilizing bio-identical dessicated thyroid extracts, but with a poor FDA regulation, and industry manipulation of these product sources, one must be aware of quality and integrity of the extracts. The company that has produced Armor Thyroid was bought by a large pharmaceutical company, and there has been suspicion for years that the quality of the medicine was altered. Compounding pharmacists may be utilized to insure higher quality and more individualized dosages and combinations of T3 and T4, but are more expensive. Integrating a variety of treatments of Complementary Medicine into the treatment regimen is now proven to benefit the patient in a number of ways as well. Use of iodine / iodide supplement (Iodoral), selenium, and other nutrient medicines have been proven useful in therapy in numerous studies. The use of chelating agents and detoxification with herbal medicine, supported with acupuncture therapy to stimulate improved physiological reaction, may also be useful for a high percentage of patients. The list of studied therapeutic options in CIM/TCM is now large, and daunting, but can be used as needed, individualized and used in a step-by-step restorative approach, not requiring the chronic therapy seen with us of levothyroxine. Each year the research uncovers more and more roles for Complementary and Integrative Medicine to address the variety of factors involved in these diseases, and a knowledgeable TCM practitioner may take advantage of this research and tailor a comprehensive treatment protocol for each individual.

Treatment protocols with hypothyroid conditions require accurate diagnosis and monitoring. Active hormone panels via saliva and blood spot tests have gained much renown in recent years for their accuracy and are relatively inexpensive. Since the patient gathers the samples, the tests can be performed outside of the hospital setting, which is ideal for the acupuncture TCM care. Patient levels of TSH, free T3, free T4, thyroid peroxidase antibody, cortisol, androgens, estradiol, progesterone, vitamin D3, DHEA-S and fasting insulin may be monitored this way. The thyroid profile of TSH, fT3, fT4 and TPO may cost as little as $240, and will usually be covered by your health plan. If the levels indicate clinical hypothyroid condition, the TCM physician may refer you to an endocrinologist to insure proper care in the complementary and integrative setting. If the case is subclinical, acupuncture and a variety of herbs and nutritional substances have been shown to be very effective when prescribed intelligently. A proactive and educated patient approach is essential in the long run. The patient should always be the main physician utilizing a team of integrated experts to achieve the best results with chronic diseases. Standard medicine still discourages an integrated approach in general, considering it a competitive issue, and the patient must address this fact and take charge of their care.

Treatment Protocol in Hypothyroid and Hyperparathyroid Syndromes with Complementary and Integrative Medicine

As stated, the CIM/TCM treatment protocols in these disorders are complex and individually tailored to the individual health problems that contribute to, or to health problems that are caused by, the syndromes, as well as the comorbid health problems that may be linked to the syndromes, or the adverse effects of the medications. There are choices that need to be made by each patient. The patient needs to take a proactive approach and find a knowledgeable physician to work with. Nevertheless, here are a few approaches commonly included in therapy, to be used as an example of the type of comprehensive therapeutic approach that may be needed. As stated, monitoring of thyroid hormones, along with steroid hormones and Vitamin D3 metabolites, is highly recommended in subclinical hypothyroid conditions, and there is much potential with bioidentical thyroid hormone therapy when necessary, although the manufacturers of dessicated thyroid medicines are few, and have been bought by larger pharmaceutical companies, with suspicion of quality an issue. An increasing number of M.D.s are adopting a more comprehensive and holistic approach and working within an Integrative medical model, so the patient may seek out a therapeutic team in Complementary and Integrative Medicine (CIM/TCM) that now utilizes both an M.D. specialist as well as a TCM physician, or Licensed Acupuncturist and herbalist. Unfortunately, this integration of specialties to treat thyroid disorders is progressing slowly, with much resistance in standard medicine. Each patient can benefit from care from any Licensed Acupuncturist and herbalist, though, and the degree of knowledge of these conditions may vary, but all CIM/TCM practitioners can provide an array of benefits. As with any chronic health condition, goal-oriented short courses of acupuncture and physiotherapy, with a more persistent step-by-step approach with herbal and nutrient medicines, is the proper course of care, and can be individually tailored to meet the time and money constraints.

The question of utilizing synthetic thyroid hormone in the treatment of subclinical hypothyroidism has long been a subject of hot debate. Most medical specialists have been discouraging of this treatment option for decades, for fear of negative effects on bone mineral density (osteoporosis), as well as the many side effects of therapy affecting a small percentage of study participants. Clinically, the complaints of patients on chronic synthetic thyroid medicines concerning adverse side effects have also discouraged the start of this treatment for subclinical hypothyroid cases. The risks did not outweigh the benefits in the minds of most specialists. In the last couple of decades, the health industry has seen less concern for risks and adverse health effects in general, as the guidelines and care have been taken over by corporations and larger and larger insurance companies, and larger pharmaceutical companies exerting greater influence. Recently, small studies have been generated to dispel this notion of risk and adverse health effects over time, and some reviews have found that synthetic thyroid hormone has no significant effect on bone mineral density. The authors caution that the size, nature, and quality of these studies indicate that this is still a preliminary conclusion, and there is need for further studies which review more parameters of bone health than bone mineral density, as there is an increased incidence of bone fractures with chronic use of synthetic thyroid hormones. As usual, the focus on a single risk factor, and a single adverse health effect, has diverted the question of risk versus benefit away from overall quality of life considerations and the array or negative effects studied in relation to chronic use of synthetic thyroid hormone. The bottom line for many patients and medical specialists is now the choice between restoring overall health to correct the problem, or choosing to take a single pill, and ignoring overall hormonal health. Improved thyroid function can also decrease the need for a high dosage of synthetic thyroid hormone, decreasing the long-term risks and adverse health effects as well. All of this manipulation and controversy in scientific study diverts the patients and physicians from the most logical conclusion, though, that whether or not the patient chooses to utilize synthetic thyroid medications, there is still a need to address overall hormonal health with Complementary and Integrative Medicine and holistic therapy, and there is no downside or risk to this integrated care. The patient centered approach educates the patient, allows them to make the choice, and then provides the integrative care needed to restore a healthy state no matter what the choice is.

Another concern raised by a number of medical organizations devoted to endocrine pathology and thyroid issues is the large percentage of cases of subclinical hyperthyroidism that result from chronic use of synthetic thyroid hormone, which are largely ignored. The demand for thyroid hormone in the patient with hypothyroidism may be variable, and requires consistent monitoring and adjustment of dosage. If the dosage becomes too high, the reaction of the body is to bring TSH levels to a very low level. This very low TSH secretion, controlled by the hypothalamus, is the determining diagnostic factor in subclinical hyperthyroidism, and has an impact on overall health. Symptoms such as tiredness, nervousness, agitation, tremors of the hands or face, heart palpitations, shortness of breath, unusual sweating or intolerance to heat, and weight loss are seen in mild hyperthyroid states. The most prevalent cause of subclinical hyperthyroidism in large studies is chronic use of synthetic thyroid hormone medication, with other drug causes and nodular goiter also associated with a large percentage of cases. While these symptoms may onset slowly and gradually, and not present alarming intensity, subclinical hyperthyroidism does negatively affect quality of life and is associated with a much higher incidence of tachycardia and atrial fibrillation, as well as osteoporosis. This has led many medical doctors to question the chronic use of synthetic thyroid medication, and explore utilization of Complementary Medicine to help restore the thyroid function without drugs when possible. If this restorative approach does not succeed, use of CIM/TCM therapy may at least decrease the necessary dosage of synthetic thyroid hormone and address the common risk factors for patients. Each patient deserves a thorough medical assessment and careful monitoring and advice that is individualized, and often this is no longer provided.

In combination hyperparathyroid and hypothyroid syndromes, a holistic approach to health is highly recommended as well, and individualized analysis and treatment should be utilized. Gastrointestinal dysfunction and intestinal immune hyper-reactivity, such as Celiac disease, is often seen, and should be addressed to aid the various mechanisms of calcium and phosphate regulation, and to take stress off of the body. Stomach dysfunction may have a direct effect on thyroid function as the gastric hormones have a direct effect on levels of the thyroid hormone calcitonin. Adrenal deficiency and overall hormonal balance and homeostasis needs to be addressed and corrected as well, as the adrenal axis is very important in the thyroid regulation. Dehydration often accompanies hypercalcemia in hyperparathyroidism, and sufficient hydration and improved kidney and adrenal function are needed to correct this problem. All of these issues may be addressed in CIM/TCM protocol. No matter whether the patient chooses to directly address the thyroid pathology, or chooses to address these associated health issues, the care from the Licensed Acupuncturist and herbalist is important and invaluable. There is no such thing as 'alternative' medicine in professional care, a notion long stressed by the standard medical industry, only options of integrative care that complements standard practice in a variety of ways that standard medicine fails to address.

D3 hormone metabolism needs to be normalized. As stated, we still stubbornly call this molecule Vitamin D despite the knowledge that it is a hormone. The best form of D3 is cholecalciferol, which is a prohormone. We cannot treat this supplement lightly, as if it is like Vitamin C. It is a prohormone, and monitoring as well as restoration of hormonal balance should be considered. Restoration of D3 involves healthy cholesterol, sun exposure to the skin, healthy liver function and healthy kidney function. Sometimes, supplementation with cholecalciferol, either normal dose or temporary high dose (5000 IU liquid), may be helpful. Hormone and D3 levels may be monitored with active metabolite testing if this is desired. Excess circulating D3, called Vitamin D intoxication, has been seen as a cause of hypercalcemia, although most cases involve lesions or tumors in the kidney or adrenals, and not excess supplementation with the prohormone. Occasional use of a Vitamin D3 prohormone supplement is safe and may be very valuable to overall endocrine health.

Calcium supplementation may be used in some cases as therapy, but the patient should note that calcium is the most highly regulated molecule in the body, and we should quit acting like this mineral can be taken like Vitamin C as well. High dose Calcium carbonate has been found to be successful in cases of hyperparathyroid dysfunction, but only in high dose, and using quality calcium supplement. This type of therapy needs to be monitored, as circulating calcium and phosphate excess may occur, resulting in calcium deposition in tissue that leads to arthritis, soft tissue pain and injury, urinary stones, and calcification of organ tissue. Long-term calcium supplementation with poor quality or the wrong type of calcium molecule may be detrimental to the patient. One useful form of calcium in hypothyroid conditions is calcium pantothenate, a form of Vitamin B5, sometimes called pantothenic acid. If osteoporosis or weak bones are a consideration, calcium hydoxyapatite in a formula designed to increase absorption capability by the bone is desirable. The supplement calcium AEP is valuable for improved function of the hypothalamus. A combination of calcium and magnesium glycinate chelate is helpful for muscle function. A knowledgeable professional should be consulted to determine the need for and type of calcium supplementation that is useful to the individual condition, and this array of calcium supplements can be utilized in short courses to achieve a variety of physiological goals. This variety of calcium supplements in short courses is highly recommended, while the use of just calcium citrate or calcium carbonate taken constantly may cause health problems as well as provide potential benefits. Once again, a thoughtful proactive approach by each patient is essential.

Inflammatory stress needs to be decreased in many cases of thyroid dysfunction. Restoring healthy muscle and joint tissues, taking herbs and antioxidants, as well as proteolytic enzymes, may be helpful. In some cases, immune stimulation and restoration of healthy immune function is needed. Hypothalamic function needs to be restored in most cases. Some supplements that help restore hypothalamic function are CaAEP (calcium AEP), P5P (active Vitamin B6), B12 sublingual, pantothenic acid, maca, and inositol hexacotinate B3. DIM and vitex are also helpful. Acupuncture has been proven to have significant effects on hypothalamic function, and scientific studies are cited below. Thyroid function needs to be restored. This may involve monitored use of natural iodine, as well as restoration of adrenal function, and could involve correcting inflammatory problems as well as metabolic problems at the thyroid receptors. Some supplements useful in the protocol are zinc methionine, selenium, L-tyrosine, and B2, and a variety of herbs and formulas can be utilized, including those with extract of dessicated adrenal cortex, and PKA. Tinctures with Ashwagandha and Red Clover may also be utilized. Many of these therapies need to be monitored by a professional. Immune functions should be restored to as healthy a state as possible. While this is a long list, not every patient will need all of this therapy, and a step-by-step approach is important. Gradual restoration and cure should be expected, not a sudden and dramatic change.

If there is a problem with conversion of thyroid hormone in peripheral tissues, the list of possible causes and contributors needs to be examined, and the patient should be treated with appropriate supplementation, decrease in medication where possible, changes in diet and lifestyle as appropriate, and holistic therapy. Hormonal imbalances such as adrenal stress and dysfunction with altered diurnal cortisol could be involved. A lot of this treatment protocol should be the responsibility of the patient, as the physician has only so much capacity to monitor these various aspects of the problem for each of their patients. The patient needs to take a proactive approach and insure that the various problems are addressed in and intelligent manner, step by step, but needs a knowledgeable physician to explain and monitor the progress with nutrient supplements and dietary and lifestyle changes as appropriate.

Iodine supplementation is often useful in thyroid dysfunction. Iodine is used by the thyroid gland to form circulating thyroid hormone, and the removal of the iodine allows the thyroid hormone to function at the peripheral tissue receptors. This process is controlled in part by thyroid peroxidase enzyme. In autoimmune thyroiditis, commonly called Hashimoto's, antibodies form to attack the thyroid peroxidase (TPO). Since iodine is essential to thyroid hormone function, supplementation with iodine may help restore thyroid function, especially if the patient is deficient in iodine. The use of iodine as a supplement was well studied in the nineteenth century, and the safest and most effective form, called Lugol's Solution was first made in 1829, and is a combination of elemental iodine with potassium iodide. Lugol's solution was the most popular medicinal supplement in the early twentieth century, and many people used Dr. Lugol's solution, with almost no evidence of side effect, or ill effect, most often purchasing it from an apothecary. Today, this same solution is used as a supplement in the form of Iodoral, available in a moderate dosage of 12.5 mg, or in a larger dosage of 50 mg, both of which contain less elemental iodine than Lugol's solution. Iodine levels may be tested with a urine collection test or now a simple urine blotter test. A small percentage of patients with autoimmune thyroiditis will have a genetic propensity to overstimulate the thyroid with a larger dosage of iodine, and so monitoring by a physician is necessary for safety. This is why we start the therapy with the 12.5 mg dosage of Lugol's solution, and advance to the 50 mg dosage. Studies have revealed, though, that if symptoms of hyperthyroidism are noted, that these are reversed quickly by reducing or stopping the iodine supplementation. There is no real danger in this iodine therapy if monitored professionally and taken correctly. Since iodine stores in the tissues, supplementation may be needed for a few months to replenish the iodine stores. The overall benefits from such iodine therapy are broad, since iodine is the chief antioxidant that prevents cancers of the breast, thyroid glands, and other endocrine tissues, and serves as a valuable chemical to detoxify effects of radiation.

It has been well documented for a century or more that iodine supplementation is effective in reducing excess thyroid growth or goiter, as well as stimulating the thyroid to achieve a return of euthyroid function (normal homeostasis). For instance, in 1993, a study at Karl Franzens University School of Medicine, in Austria (study link cited below in additional information) showed that iodine supplementation was nearly as effective as levothyroxine, or synthetic T4, in reducing thyroid size in endemic goiter. This randomized controlled human clinical trial included patients with a variety of presentations, some with and some without iodine deficiency, and various levels of TSH noted. In the randomized group of patients prescribed synthetic thyroid hormone, the TSH levels were suppressed, while in those prescribed iodine solution, they remained physiologically normal. The success of the iodine treatment was attributed to various aids to thyroid health supplied by iodine, including antiproliferative actions, and that the TSH levels and TPO (autoimmune antibodies) were not the only factors that could drive excess thyroid growth. Despite such studies, iodine therapy was not utilized in the standard treatment of thyroid goiter, and instead discouraged, as almost all patients were prescribed the synthetic thyroid hormone T4, or levothyroxine. The use of Lugol's Iodine solution is proven effective, safe, providing a array of benefits, including prevention of cancer, and is inexpensive, as well as utilized in short courses rather than chronic use. The denial of this treatment defies all ethical logic, but is indeed what happened. The only logic to this denial of iodine therapy is that much greater profits are available with the use of levothyroxine. After the publication of this study, much anecdotal evidence that use of iodine supplement in thyroid therapy could cause autoimmune reaction was published. In 1999, a study at Ernst-Moritz-Arndt University in Munich, Germany (cited below) showed that there was a small percentage of patients with autoimmune thyroid disease that experienced a mild increase in thyroid antibodies with high-dose iodine solution, but that this produced no clinical symptoms of hypothyroidism, and that a combination of moderate dose iodine solution with low-dose levothyroxine showed no effects on raising antibody levels and was considered optimal. Of course, this randomized controlled human clinical trial of over 200 patients was completely ignored by the standard medical community.

Besides being important to the formation of active thyroid hormone, iodine also serves as an important antioxidant in the body, and is protective against cancerous mutation. The highest concentrations of iodine are in the thyroid gland and the breast tissue, and so sufficient iodine is protective against breast cancer. Lugol's solution has also been widely used to block the effects of radiation in the form of radioactive iodine, and was widely distributed after the Chernobyl accident. Lugol's solution is still used with monitoring to treat even clinical hyperthyroid disease, thyrotoxicosis and Grave's disease, when antithyroid drugs are not tolerated. Lugol's solution has been used, with monitoring, to treat hyperthyroidism by inhibiting the organification of iodine in the thyroid gland. Moderate iodine supplementation has been shown to modulate the genetic expression of thyroid stimulating hormone receptors to prevent Hashimoto's thyroid dysfunction (see the study citation below), and is proven in a number of studies to normalize various aspects of the thyroid metabolism in hypothyroidism. Iodine deficiency, in many geographical areas of the United States, has been found in a large percentage of targeted population, especially in women over 40 years old. The resurgence of prescription and general use of Lugol's solution, which has always been available over the counter, has been a concern of the pharmaceutical industry, which makes much profit from the sales of synthetic thyroid hormone. Restriction of the purchase of Lugol's solution was initiated in 2007 in the United States, purportedly to prevent its use in the making of methamphetamines, although the evidence of this use is scant. The discouragement of the use of Lugol's iodine / iodide solution is not warranted by safety concerns when prescribed and monitored by a knowledgeable physician, as this practice has been widely performed without evidence of harm for over a century.

Since the restoration of the individual endocrine balance and function is complex, guidance from a professional is needed, and a Complementary Medicine physician, such as a knowledgeable Licensed Acupuncturist and herbalist, may be the best choice to individually assess and form a treatment protocol that works in a step-by-step process to achieve these goals. As stated, the Complementary Medicine physician, such as the knowledgeable Licensed Acupuncturist and herbalist, may treat a variety of conditions associated with hypothyroid states as well as the condition itself. Cardiovascular health, immune health, neurological health, metabolic health, and side effects of radiation and chemotherapy, are just some of the aspects to this overall condition that may be addressed with Compelemtary Medicine. There are so many reasons to incorporate Integrative Medicine into your care that they can't be properly addressed in this web article. The time, expense and effort you invest in this type of care will pay great dividends to your overal health and productivity.

Treatment Protocols in CIM/TCM Care that Address an Array of Health Issues in Hypothyroidism

While the standard advice in thyroid disease and hypothyroidism is that all we need to do is to take synthetic T4 thyroxine, a synthetic analogue to the prohormone in the thyroid cascade, and all of the problems with a deficient thyroid metabolism will be taken care of, scientific study for decades has shown that this is not true. There are many inadequacies in the complex regulation by the thyroid endocrine system that are not fully addressed by this simple therapeutic approach, as well as a number of health problems associated with chronic use of the drug, and with the inability to fully regulate the changing needs in the diurnal thyroid feedback metabolism. The thyroid hormonal metabolism is integral to our whole bodily system of regulation, and this complex endocrine system is constantly changing and reacting to changes in our needs for regulation and control. There is no single level of any of the key hormones in this system that is constant and optimum, TSH, T4, T3, or the array of neurohormones that exist in the endocrine axis to insure healthy homeostatic reactions and balanced effects. While synthetic levothyroxine does work well to control the most problematic dysfunctions seen in hypothyroidism for most patients, it does not solve all of the problems. In addition, studies show that for a significant percentage of patients taking T4 levothyroxine, that T3 and TSH levels are not maintained properly. A 2011 study at the University of Catania Medical School, in Italy, and Cardiff University, in the United Kingdom, showed definitively that for about a fifth of patients, T4 levothyroxine therapy did not maintain an optimal euthyroid balance. To see this study, click here:http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3148220/ . To continue to discourage a broader, more comprehensive, and holistic approach to care with CIM/TCM is not sensible. There are many ways that such complementary and integrative care can benefit the patient with hypothyroidism.

Common symptoms in both subclinical and clinical hypothyroidism can of course be addressed with a more comprehensive treatment protocol integrated into care. Anxiety and depression, fatigue, asthenia, weight gain, and muscle pathology (myopathy) occur in the majority of patients, and may be addressed with an array of treatments in CIM/TCM. One can go to the various other articles on this website to learn about these health problems, and scroll to the sections on treatment to discover more and more safe and effective complementary medical protocols to improve symptoms and quality of life. Some key treatment considerations involve prevention of common comorbid conditions, such as cardiovascular disease, Metabolic Syndrome and autoimmune syndromes. To address the symptoms that impact quality of life, such as fatigue and myopathy, many approaches may work, especially restoration of steroid hormone balance and adrenal function. CIM/TCM can help with hallmarks of these health problems, such as mitochondrial health, and muscle metabolism, as well as the immune inflammatory imbalances that drive many problems. There is no single treatment or herb to cure hypothyroidism, but there is a large array of safe, effective and healthy treatments that can be combined and individualized to achieve an array of goals. For instance, in 60 percent of patients with hypothyroidism, even when treated with synthroid, we see fluctuating elevations of creatine kinase (CK), a marker for myopathy. CK is an enzyme that regulates reversible transfer of phosphate in the ATP (adenosine triphosphate) metabolism that is integral to muscle energy and function, and to the mitochondrial energy metabolism. We see elevated CK in various chronic neuromuscular diseases, and studies reveal a relationship to increased permeability of muscle membranes due to calcium imbalance and hormone Vitamin D deficiency. Of course, these issues are integral to hypothyroidism. Elevated CK may be caused by chronic use of statin drugs, kidney and heart disease, chronic inflammation, and adrenal insufficiency. Cofactors for improved ATP function include forms of the Vitamins B2 and B3, and use of the supplement D-ribose before exercise could shift the muscle metabolism to an alternate pathway and decrease the ATP need. The supplements phosphatidylcholine and phsophatidylserine have been shown to improve membrane function, and adaptogenic herbs, such as Rhodiola, as well as Jiao gu lan, have been shown to enhance muscle function and recovery. Consulting a knowledgeable CIM/TCM physician opens the door to a variety of such simple and healthy treatments that could improve daily life .