Natural and Herbal Approaches for an Underactive Thyroid

Nothing galvalises me more than campaigning for better health care services, particularly when it comes to women. In the past week alone I have spoken to 3 female patients who report classic symptoms of an underactive thyroid gland, yet battle with their doctors and health care providers for further and thorough examinations to investigate their concerns. Part of this story should involve stating that that relevant and suitable blood tests reveal 'healthy' values within 'normal' ranges for the hormone(s) in question. As far as the doctors are concerned therefore further examinations into their concerns are not warranted.Be that as it may, to understand the condition of an underactive thyroid, one must explain what the gland does and the consequences of its underactivity. The thyroid gland is an endocrine (hormonal) gland that secretes 2 of the most important hormones responsible for regulating the body's metabolic rate and a range of physiological actions in maintaining body function. This includes all major organs, fertility, metabolism, body temperature, development and growth.

The gland itself secretes T4 (thyroxine) and T3 (tri-iodothyronine) which are detected as circulating hormones in the bloodstream. T4 is secreted much more in abundance than T3 by about a ratio of 20:1 but T3 is about 3-4 times more potent than its precursor T4. However, the action and regulation of the thyroid gland is under the influence of the Thyroid-Stimulating-Hormone (TSH) which is secreted from the pituitary gland (located in the brain). Therefore any abnormality in circulating levels of thyroid hormones, or indeed the gland itself, must explore underlying causes and perhaps an exhaustive primary analysis of symptoms, family history, autoimmunity, diet and previous history/medication for an overactive thyroid.

An underactive thyroid is more common than people think and it is one of the most routinely underdiagnosed conditions in the medical profession. So how will one know if the thyroid is underactive - well, one needs to start at the symptoms which can include any or many of the following:

1. feeling tired and sleeping a lot

2. feeling the cold easily
3. dry and/or pale skin

4. course, thinning hair & brittle nails

5. sore muscles, slow movements & weakness

6. a hoarse or croaky voice

7. a change in facial expression

8. depression

9. problems with memory & concentration

10. weight gain

11. constipation

12. fertility problems & increased risk of miscarriage

13. heavy, irregular periods which may last longer than normal

14. a slow heart rate

The thyroid gland may also be enlarged which appears as a swelling in the neck; this is called a goitre.

Detecting abnormalities of the thyroid invariably involves a blood test to determine circulating levels of hormones: TSH, T3 and T4. However, this is the debate since the range of normal values for TSH is very broad so determining what is normal for one individual requires information of TSH levels prior to symptoms. The same may also apply to T3 and T4 levels. Although some experts disagree, most doctors believe that if the TSH is on the higher side of the normal range, and if all other results are fine, then treatment is not required. This heavy reliance on blood test results is also an issue in itself - 'normal' ranges vary between laboratories, and whilst they are useful as an indicator, they do not suit everyone. Two women may feel very differently with the same set of thyroid blood test results.

What's really frustrating for those women affected by this diagnostic process and experience is that they are incorrectly deemed healthy for an underactive thyroid based solely on their blood test results despite the overwhelming set of symptoms exhibited. A suspected underactive thyroid may go unrecognised and undiagnosed for many years based on the 'normal' test result. Women approaching the menopause are told that it is their raging hormone fluctuations and in some cases, antidepressants are prescribed! For women who experience unexplained weight gain are told to go away, eat less and exercise more (fine if the diagnosis was correct). As a result of this lazy attitude to diagnosis, many women feel misunderstood, chronically disregarded and neglected by the medical profession. Worse still, they feel that they have wasted their doctor's time. Family and friends may also be unsympathetic especially when test results come back 'normal'.

Although the current system has a very important remit, its value and purpose in determining underactive thyroid function needs to be rigorously examined since its anomalies and discrepancies has condemned millions of women to a low quality of life. Conventional treatment (if one is lucky to have the problem recognised) usually involves taking a synthetic or animal-derived (from pig thyroid called Armour Thyroid) thyroid hormone medication on a daily basis. Levothyroxine is the most common drug prescribed and treatment is life-long. Whilst this drug has benefitted many women, there are other thyroid hormones, notably, the significantly more potent T3 and this is made from the conversion of T4. Some women are unable to effect this conversion efficiently, and so whilst their T4 levels are normal, they have hypothyroid symptoms. T3 is not always tested and relies very much on the doctor making a special request for it. Yet another battle for the patient! However T3 supplementation is controversial with a greater risk of side-effects requiring regular monitoring of levels and dosage adjustment as necessary.

Another strand of this problem is subclinical hypothyroid which is when there are no symptoms of an underactive thyroid yet blood tests reveal lower than normal ranges of TSH, T3 and T4. Cases are normally given Armour Thyroid which has many advantages not least of which is that extracts from pig thyroid contain other ingredients (as yet, undefined cofactors) thought to be a more natural substitute to human thyroid deficiency and not just T4 supplementation. Another option (for milder thyroid underactivity) is a glandular hormone-free extract called Nutri Thyroid. These products contain cofactors to support the thyroid and can be used alongside conventional medications. As with all conventional medicines, side effects (heart palpitations, shakiness, increased appetite, insomnia and overdosing giving rise to hyperthyroid activity) are a real issue and requires regular monoitoring by a physician or doctor.

Natural and Herbal Help

By far the most popular route for addressing symptoms of an underactive thyroid is through natural interventions especially when there is incompatibility with conventional medicines. Dietary approaches include the avoidance of foods that depress thyroid activity. These include:

1. broccoli

2. Brussel sprouts

3. cauliflower

4. kale

5. spinach

6. turnips

7. soy

8. beans

9. mustard greens

Given the nutritious element of these vegetables, it is essential that proper nutritional advice is sought to prevent vitamin & mineral deficiencies by replacing the diet with suitable alternatives.

Other measures would be to avoid overly processed foods, limit dairy, refined sugar, artificial sweeteners, caffeine and alcohol intake.

Herbal remedies can be taken to support optimum thyroid function:
1. bladderwrack (Fucus versiculosus) - a natural source of iodine, a key part of thyroid hormones

2. makandi (Coleus forskohlii) - extensively studied for its supportive role in thyroid activity(clinical trials have shown that the active ingredient in makandi (forskohlin)may help to support thyroid hormone secretion)

3. Shilajeet-Asphaltum puniabiunum - an Indian herb considered a 'wonder drug' by many due to its high mineral content which may contribute to its suportive role in an underactive thyroid

4. oats straw - high mineral content so highly nutritious and supportive to the thyroid

5. horsetail (Equisetum arvense) and centella (Centella asiatica) along with oats straw facilitate the function of oestrogen that disturbs the normal function of the thyroid

6. another popular choice is kelp - it is mineral rich food especially in iodine. However, advice should be sought before any self-medication with herbal supplements

Hypothyroidism due to iodine deficiency is rare in the Western world since many of the foods we eat are fortified with this mineral. However, given that iodine is an essentail part of thyroid hormones, eating natural sources of iodine from foods is the preferred choice. Good sources are marine fish, shellfish and seaweed. Other nutrients are essential fatty acids (animal or plant sources), calcium and magnesium. Taking regular exercise to manage stress is also advisable.

Synthetic Thyroid, Natural Thyroid, T4 and T3 should only be prescribed by a doctor. DO NOT purchase any of these via internet sources.

A good book to read is Tears behind closed doors: Failure to diagnose a thyroid condition 2nd edition by Diana Holmes (2002) Normandi Publishing.

Another good book is by Dr. Gordon Skinner entitled: Diagnosis and management of hypothyroidism. Published in 2003 by Louise Lorne Publications.

Further information and support from Thyroid UK: www.thyroiduk.org.uk/