Counseling Sheet

By Agatha M. Thrash, M.D.
Preventive Medicine

Problems Caused by Overactive and Underactive Thyroid‍

The thyroid gland affects every cell in the body because thyroid hormone affects the metabolism of all body tissues. An overactive thyroid, a condition known as hyperthyroidism, is manifested by an increase in body temperature and pulse, occasional bouts of diarrhea, fatigue, a large appetite in the presence of a loss of weight, and often a mental state resembling mania. Under-function of the gland, called hypothyroidism, affects about ten percent of women sometime in their lives, most commonly after the age of 50. Signs include any of the following: mental sluggishness, poor memory, weakness, coarse and dry skin and hair, brittle nails, thinning of the hair, intolerance of cold, puffiness of the face and extremities from fluid retention, and decreased sweating. Such persons may gain weight, talk and move more slowly, and have slow reflexes and a slow pulse. Constipation and muscle cramping are common. Hoarseness may occur, and they may suffer from depression. Young women with this condition may develop menstrual irregularities.

Less common causes of hyperthyroidism include a focus of overgrowth of the thyroid called adenoma, the hyperthyroid phase of acute thyroiditis, and hyperthyroidism due to hydatidiform moles (tumors of a retained placenta) or choriocarcinoma. Rare causes are excess TSH (thyroid stimulating hormone from the pituitary) and excessive intake of thyroid hormone supplements. Hyperthyroidism should not be regarded as irreversible, as many cases can be treated with non-surgical and non-pharmaceutical remedies.

Goiter is an enlargement of the thyroid and produces a swelling in the neck. It may cause too much or too little hormone to be produced. An inadequate intake of iodine may cause goiter. The swelling associated with goiter may reduce in summer, as iodine in the diet goes up when fresh vegetables are eaten.

The most common cause of excess production of thyroid hormones is Graves' disease. Graves' disease, due to a goiter producing too much thyroid hormone, may also cause an abnormal protrusion of the eyeballs known as exophthalmos. It is five times more common in women than in men. Graves' disease tends to be hereditary and occurs most frequently between the ages of 20 and 40 years. It often arises after an infection or emotional stress.

Graves' disease is felt by many to be an autoimmune disorder, since an increased production of immune globulins is found in more than 60 percent of cases. Certain lymphocytes that should normally be suppressed following an infection, survive because of breakdown in one aspect of immune watchfulness. The lymphocytes interact with an antigen on the thyroid cells producing a thyroid stimulating immune globulin, simulating the action of TSH. Denaturing the immune globulins in the intestinal tract can help control the hyperthyroidism. Therefore one must pay attention to any bowel toxicity and encourage good bowel function in hyperthyroidism. Bacterium Yersinia, a germ growing in the intestines, has been associated with hyperthyroidism as Yersinia suppresses the proper functioning of T-lymphocytes and the overall effect is to give a TSH-like stimulus to the thyroid.

Persons with an overactive thyroid should recognize that a strain is put on the body. Sometimes the heart rate goes above 100, or even above 120. The blood pressure may be elevated, and the mouth temperature may be above 100.‍

Treatment for Hyperthyroidism - Overactive Thyroid

Plant medicines - Bugleweed inhibits iodine metabolism. It also inhibits thyroxin and some of the other hormones in the body. Use one-half teaspoon of the tincture three times a day, building up to one teaspoon three times a day in about four days. If the tincture cannot be obtained, the tea may be used, taking one cupful four times a day.

A tincture of motherwort is helpful for palpitations and tachycardia. Start with one-half teaspoon of the tincture, three times a day, and build up to one teaspoon three times a day. Hawthorn berry tea may be used instead, if preferred, four to six cups daily.We suggest one to two tablespoons daily of echinacea and one tablespoon daily of golden seal powder for Yersinia. Boil them for 20 minutes in one quart of water. The entire amount should be taken daily for 30 days. Other herbs can be mixed in the same formula. Make up fresh daily.

Quercetin, 1,000 milligrams twice a day in capsules, can help to reduce inflammation in the thyroid, as well as in the gastrointestinal tract. Other anti-inflammatory agents are hawthorn berry, licorice root, flaxseed oil (one teaspoonful three times a day), and feverfew. Use the herbs in standard quantities, one teaspoonful per cup of water. All roots, barks, berries, etc., are boiled gently for 20 minutes; whereas all leaves and flowers are merely steeped in freshly boiled water for 30 minutes.

Use sedative herbs such as catnip, valerian, passion flower, and skullcap as needed. A good herbal formula is 1-1/2 quarts of water and 2 tablespoons powdered hawthorn berries boiled gently for 25 minutes. Remove from the stove, add 2 tablespoons of bugleweed, 2 tablespoons of skullcap, and 1 tablespoon each of valerian, passion flower, or catnip if you need extra sedation. Up to seven herbs can be mixed in one formula. Cover and steep for half an hour.A person with hyperthyroidism should put kelp in their food generously. It is high in iodine and can suppress the function of the thyroid. It is well for them to use iodized salt and eat seaweed as much as tolerated. Iodine in pharmacologic doses (as compared to nutritive or homeopathic doses) inhibits the release of T3 and T4. Iodine can be obtained from a pharmacy. Ask the pharmacist for the therapeutic dose of the preparation you find. (Gree, W.L., and Ingbar, S.H., The Thyroid, third edition, New York: Harper and Rowe, 1971, p.41)

Get as much outdoor exercise as you deem appropriate in order to use up excess thyroid hormone. Take the exercise in the cool of the day, being careful not to overdo.

Apply alternating hot and cold compresses to the thyroid area. This includes hot compresses molded to the neck and upper chest and maintained for six minutes, alternating with ice cold compresses for 45 seconds. Have three to five changes. Do this treatment twice daily for seven days, then once in the morning for 30 days. If there is inflammation in the gland causing it to be hyperactive, this treatment will be helpful.

While there are certain foods that have a tendency to lower thyroid function, tofu and other soy products can mildly stimulate thyroid function. If a person has an overactive gland, they should avoid the soy products, whereas those with underactive glands should concentrate on eating them. Avoid certain foods which contain pressor amines which may stimulate the thyroid. Sauerkraut (histamine), cheese (tyramine, tryptamine, and phenyl ethylamine), bananas (dopamine, norepinephrine, and serotonin), and wine (histamine).

Thiourea tends to reduce the function of the thyroid. It is known to be present in large quantities in turnips, kale, cabbage, and rape seed. (Endocrinology. 43:105, August, 1948) The use of cabbage juice may provide a convenient way to obtain the anti-thyroid component. Consume at least one serving daily of the foods listed below, as they contain substances which suppress the activity of the thyroid. Goitrin is slightly more active than propylthiouracil in man. About 25-50 milligrams of goitrin is found in one to four pounds of fresh Brassica foods, such as cabbage, rutabaga, cauliflower, broccoli, Brussels sprouts, collards, kohlrabi, and kale.‍

Thyroid Suppressing Foods:

• Almonds
• Beans
• Brussels Sprouts*
• Carrots
• Filberts
• Honeydew
• Corn
• Peanut skins
• Radishes*
• Spinach*
• Turnips*
• Apples
• Beets
• Cabbage*
• Celery
• Grapefruit
• Kale*
• Millet
• Peaches
• Raspberries
• Strawberries
• Walnuts
• Apricots
• Blackberries
• Cassava (Manioc)
• Cherries
• Grapes
• Kohlrabi*
• Onions
• Peas
• Rutabaga*
• String Beans
• Yams
• Bamboo Shoots
• Broccoli*
• Cauliflower*
• Collards*
• Green peppers
• Lettuce*
• Oranges
• Prunes
• Sorghum
• Sugar cane
• Pears

For hyperthyroidism, take six to eight ounces of cabbage juice daily, and eat as much cabbage and its relatives (those foods marked with the * in the above list) as one can eat every day.

Foods having red, yellow, and blue coloring in flowers and fruit can cause an inhibition of thyroid function. Millet consumption can depress the functioning of the thyroid by means of a compound it contains called thiocyanate. Cooking the millet and storing it for a week increases its antithyroid activity by six-fold.

Constipation and diarrhea may both be present in hyperthyroidism, as the GI tract tends to empty itself periodically and then be unresponsive. Take one tablespoon of charcoal powder in water mid-morning, mid-afternoon, and at bedtime for one month. The charcoal tends to regulate the bowel function and may also take up some excess thyroid hormone if it is not already attached to protein. It may also help remove Yersinia.

Wear a heating compress or a charcoal poultice over the thyroid area each night to reduce inflammation.

Give a neutral bath for 40-90 minutes, the water being neither hot nor cold.

Prolonged cold to the thyroid area, as by an ice bag, for 30 minutes should be used in the mid-day beginning from the first day of the treatment with hot and cold compresses. The prolonged cold may suppress the activity of the thyroid.

Drink 8 to 12 glasses of water daily, sufficient to keep the urine pale and the bowels moving well.

The gastrointestinal function should be carefully monitored because the excess thyroid hormone can be secreted into the gastrointestinal tract and denatured or excreted there. To assist in gastrointestinal health, try the following:

(a) Three days of a water fast, or a juice fast if the water fast cannot be tolerated, to cleanse the bowel and reduce the total antigenic load. Antigens can be a cause of hyperactivity in some people. Fasting is sedating.
(b) Use gastrointestinal stimulants as needed, such as flaxseed or psyllium seed (one to three tablespoons), or slippery elm tea. These may also tie up products from Yersinia.
(c)Take two tablespoons of charcoal stirred into a large glass of water four times daily beginning on the day before the fast begins, and continue after the fast ends with one tablespoon in a large glass of water four times daily.
(d) Use digestive enzymes, especially trypsin, to help break up the immune globulins in the gastrointestinal tract. Amylase and lipase have also been recommended by some.

‍Treatment for Hypothyroidism - Underactive Thyroid

Low functioning thyroid should not be regarded as an irreversible condition, as many patients regain normal thyroid function after having low function for some weeks or months, even years. Iodine deficiency OR iodine excess may suppress the thyroid, certain drugs, items in the diet that depress thyroid function, as well as inflammation of the thyroid gland, may all cause reversible hypothyroidism. There are environmental agents having an antithyroid action, one of which is lithium carbonate, a common drug. The production of antibodies can sometimes inhibit thyroid function instead of stimulating it.

Women diagnosed with low functioning thyroid are often treated with thyroxin (Synthroid is the commercial name), the expectation being that they will be on Synthroid for the rest of their lives. However, after menopause a smaller dose is needed, if it is needed at all. Long-term use of thyroxin can weaken the bones and increase the risk of breast cancer; although many women are not warned that osteoporosis or breast cancer can result from long-term use of thyroid hormone replacement.

To correct low functioning thyroid naturally, use the following simple remedies:

• ‍‍Get out in the sunshine at least 70 minutes a week. Lack of sunshine may result in a thyroid deficiency.
• Free fats (margarine, butter, mayonnaise, fried foods, cooking fats, salad oils, and peanut butter) can inhibit the thyroid. These should simply be omitted from the diet.
• An increase in exercise can increase the function of the thyroid by stimulating TSH production in the pituitary. T3 increases slowly in the blood during and after vigorous exercise. (Act Med. Scand. 1984;216:269-75)
• For hypothyroid babies, mother's milk is a good treatment. It gives immune protection, and also protects against hypothyroidism in babies, lasting until the baby is weaned. (Medical World News. 2-7-77, p.27) Every baby deserves the right of breast feeding.
• In cretins who were born hypothyroid, after three years of supplementation try taking them off the thyroid medication. It may be that the thyroid will start up on its own after a bit of maturity occurs.
• Avoid those foods which are known to inhibit the function of the thyroid.
• Use one serving each of oats, soybeans, and bananas daily, as they stimulate the thyroid.
• In general, vegetables tend to suppress the thyroid. Fruits can be more generally eaten, except the ones listed. Avoid corn and corn products.
• Take a cool shower mornings and nights to stimulate the thyroid, water temperature about 98 degrees.
• Use a cold spray from the shower to the adrenal areas, followed if possible by tapotement (tapping with fingertips) over the area immediately beneath the shoulder blades to stimulate the adrenals, which subsequently stimulate the thyroid.
• Use a healing treatment of alternating hot and cold to the thyroid area as described under hyperthyroidism morning and evening for seven days, then mornings only for 30 days. If this treatment cannot be done, a charcoal poultice to the thyroid area each night, worn for eight hours, can be substituted.
• Use no electric blanket. Require the thyroid to produce its own heat to warm the body.
• Get three to five hours of out-of-doors labor daily to stimulate the thyroid gland.
• Use a salt-free, oil-free, sugar-free diet until the thyroid is under control. Blood fats tend to be abnormally elevated. Fluid tends to accumulate.
• Use a cup of dulse tea daily, or sprinkle one teaspoon on foods for flavoring daily instead of salt, for a little iodine.
• Coleus forskohlii and Commiphora guggul are good herbs to stimulate the thyroid function.

Concomitant with the treatment for hypothyroid conditions should be support for the liver to increase the conversion of T4 to T3. Use licorice, dandelion, and milk thistle. This routine assists in adrenal function as well, and more readily makes the conversion of T4 to T3 through the support to the liver and adrenals.

‍Foods Allowed in Hypothyroidism‍

Grains: Amaranth, buckwheat, quinoa, wheat, rye, rice, barley, spelt

Thickener: Arrowroot

Vegetables: Alfalfa sprouts, artichoke, asparagus, cucumber, cilantro, eggplant, garlic, portabella, maitaki, or shiitake mushrooms, potatoes, okra, parsley, parsnips, pumpkin, squash (acorn, zucchini, butternut, Hubbard, summer), Swiss chard, tomatoes

Legumes: Soybeans (boiled, baked, ground and scrambled, soy grits, etc.), tofu

Fats: Avocado, seeds (sesame, sunflower, poppy, psyllium, flax), Brazil nuts, cashews, coconut, macadamia nuts, olives, peanuts without skins, pecans, pine nuts, pumpkin seeds

Fruits: Cantaloupe, cranberries, currants, dates, figs, kiwi, mangoes, watermelon, persimmon, pineapple, papaya, pomegranate, nectarines, bananas, raspberries

Miscellaneous: Yeast, small amount of seaweed (kelp, dulse)

‍Thyroid Supplementation‍

The need for thyroid hormone often gets less as one gets older. If you are taking a thyroid supplement such as Synthroid and would like to try getting off the supplement, begin reducing the number of doses of Synthroid you take by one dose per week. Let us say that currently you are taking seven doses per week, the next week take only six doses, the next only five doses, the next four etc. At any point you believe you are having symptoms from low thyroid function, hold at that number of doses per week for four weeks to see if the thyroid will adjust itself to the reduced level of supplement. When you have stabilized for about one month, then begin reducing the number of doses per week again, but staying one month at each reduced level.

At that time you can get another TSH level from the laboratory to see if your pituitary is picking up its activity. Watch yourself for symptoms of hypothyroidism, excessively dry skin, increased cholesterol level in the blood, sluggishness, slow talking, reduced reflex time, and sensitivity to chilling. You may notice in reduced reflex time that it takes you a longer time to catch something which is falling, or to turn your head to see something moving.

Supplementation may cause severe side effects. Doctors once said that while thyroid supplementation "may do you no good, it will do you no harm," we now know it can cause a number of severe physical problems, even death. Heart problems can be caused in rare cases by thyroid supplementation. In the person whose cardiac reserves are very low, the giving of thyroid supplementation may increase the metabolism more than the heart muscle is capable of supporting. Congestive heart failure, or even cardiac arrest may be the result.

‍Case History‍

When I was in medical school I had a job at a small Georgia institution for which I received a small stipend and room and board. I was frequently called out of bed at night to attend the father of one of our staff members at the institution. In addition to a marginally low thyroid function, the elderly man had cardiac asthma, and would require a shot of aminophylline to get him breathing properly again so that he could finish the night of sleep.

After two nights in one week of getting out of bed at 2:00 a.m. to attend him, I suggested to him and his son that they take him to the university to the medical clinic where I was receiving training and get some thyroid medication to correct his low thyroid and see if this would not help him. The old country doctor who had cared for the elderly man for 20 years had "neglected his thyroid" in my opinion. The son dutifully followed my suggestion, took him to the clinic, where the young resident immediately put him on a medium sized dose of thyroid.

About ten days later, I was called out of bed very urgently in the middle of the night to attend to the elderly man. The son sounded desperate when he called. I rushed to the clinic to find the man already dead. The thyroid supplementation had given him a cardiac arrest. I went to see the old country doctor in a few days and asked him his opinion about the course of the old man. He said that as long as his thyroid was working at half mast, his flagging heart energies were just barely capable of keeping up. Putting him on supplementation was the straw that pushed him over the cliff.

Adrenal insufficiency can occur for very much the same reason as cardiac arrest. The adrenals will be functioning slowly because of the deficient thyroid hormone, as every organ in the body is slowed in its metabolism because of thyroid insufficiency. To increase the need of tissues for metabolic support at a time when the adrenals have not yet recovered sufficiently from their having been low in thyroid, now makes the body recognize an adrenal insufficiency and react. Adjustment to thyroid supplementation may require a few weeks.

Diabetes can be made worse by thyroid supplementation, as thyroid supplementation also increases the need for insulin. Anticoagulants can be upset. The dosage must be readjusted when thyroid supplementation is begun. Thyroid supplementation increases the need for more Coumadin. In newborn children synostosis can be caused by maternal thyroid supplementation.

For the skull bones to close early can mean the brain does not develop as well as it should.

Estrogen increases the production of certain thyroid fractions, particularly thyroid binding globulin.

Thyroid supplementation will increase the need of many patients for antidepressants. It may turn a simple case of depression into a case of agitated depression.

Cardiac arrhythmias may occur either from thyroid deficiency or from thyroid supplementation.

Digitalis (digoxin) may become more toxic with thyroid supplementation. Angina and tachycardia may occur with thyroid supplementation, even without thyroid toxicity.

Hair loss occurs in some persons with thyroid supplementation. Upon withdrawing the thyroid supplementation, the hair usually grows back within a year.