Hyperthyroidism is a condition that affects the endocrine system that is distinguished by a thyroid gland that produces excess amounts of hormones. Situated in the neck, the thyroid gland has an enormous impact on the well-being and health of a person. This gland secretes the thyroid hormone, which is the hormone that serves to regulate human maturation, growth and the metabolic rate of the body. The manner in which the thyroid gland functions is determined by a number of factors including the proper conversion of T4 (thyroxine) to T3 (triiodothyronine), the amount of iodine supplied in the body, and the proper functioning of the pituitary gland and the hypothalamus. An imbalance in one or more of these factors, will cause the affected person to start experiencing either hypothyroidism (the result of a thyroid hormone that produces inadequate amounts of the thyroid hormone) or hyperthyroidism.
A quite common health problem, hyperthyroidism usually develops in young adults with ages ranging 20 – 40; women are 4 times more likely to develop this condition than men.
Western Medicine Perspective on Hyperthyroidism
Hyperthyroidism can be caused by several factors. Diffuse toxic goiter or Grave’s disease is the most common underlying reason for it because in Grave’s disease, the entire gland becomes inflamed and swollen. Grave’s disease is an autoimmune condition. Instead of attacking foreign infiltrators, the immune system of the person turns against his/her body. The antibodies produced by the immune system attach to parts of the thyroid gland that causes the gland to manufacture excess amounts of hormones leading to hyperthyroidism.
Thyroiditis, which is the inflammation of the thyroid gland, is another albeit less common cause of hyperthyroidism.
To evaluate the plasma of T3, T4, TSH (thyroid-stimulating hormone) laboratory blood tests need to be conducted to rule out or confirm hyperthyroidism. The amount of TSH should be generally low while the level of T3 and T4 needs to be high for a positive diagnosis of hyperthyroidism. One other test to distinguish the different reasons for hyperthyroidism includes an iodine thyroid scan.
Signs and Symptoms of Hyperthyroidism
One of the signs and symptoms of hyperthyroidism include the slow development of vague signs and symptoms of sympathetic system excess, such as perspiration, low grade fever (with temperature less than 100 degree Fahrenheit), elevated blood pressure, palpitations, and/or tachycardia. Other symptoms include frequent bowel movements, increased appetite but with loss of weight, sleeping difficulties, aversion to heat, fine tremors of the fingers, irritability, possible arrhythmia, nervousness, and fatigue. There may be patients who may also experience symptoms of impotence, weak menstruation, or amenorrhea from this condition.
The eyes can also be affected by hyperthyroidism. Some patients are known to suffer from eye hypersensitivity to light (photophobia), eye irritation, increased tearing, bulging eyes, and/or bilateral or unilateral swollen eyes.
Medications and surgery are the two most common forms of Western medical treatment for hyperthyroidism. Drug therapy is meant to slow down the manufacture and secretion of the thyroid hormone. Tapazole (methimazole), PTU (propylthiouracil) and other thionamide-type medications are usually prescribed to hold back the synthesis of thyroid hormone. But since they have no ability to impact the secretion or storage of thyroid hormone, there is a significant delay in the commencement of their action. In addition, the use of Tapazole and PTU is related to the rise of several side effects in the body. These include loss of taste, swelling of the lymph node, hepatitis, edema, arthralgia, rash, and agranulocytosis. These adverse reactions as well as the intolerance of the patient to the drugs are major reasons why the drugs are not usually prescribed.
Since the medications used to treat hyperthyroidism produce inadequate results and harmful effects, physicians and patients seek out even more invasive procedures like surgery or radioactive iodine therapy to treat their condition. These modalities use radical procedures that are designed to remove or physically destroy the thyroid gland, to stop it from producing excess amounts of thyroid hormone. These procedures do come with risks even though they may be initially extremely helpful. Radioactive iodine therapy destroys a massive amount of thyroid tissue. If not performed appropriately, surgery may result in damage or hemorrhage to the local tissues and the laryngeal nerve. Moreover, the administration of radioactive iodine treatment often leads to long-term complications like hypothyroidism or hypoparathyroidism. And even if surgical or radioactive iodine treatment are done accurately, the patient who exhibits normal thyroid levels will need to maintain that by taking thyroid supplements for the rest of his/her life.
TCM (Traditional Chinese Medicine)
Hyperthyroidism, according to TCM, is a condition caused by a combination of phlegm stagnation, Liver fire rebellion, qi and yin deficiencies. The last cause (qi and yin deficiencies) is the underlying cause, while the signs and symptoms are the phlegm stagnation and uprising of Liver fire. When comparing TCM etiology to Western medicine’s, we see that the stagnation of phlegm can explain the enlargement of the thyroid gland, yin and qi deficiencies can equate to the fatigue and weakness of the body caused by the prolonged over stimulation of the thyroid gland, and the constant excitation caused by too much thyroid hormone in the body can correlate to the uprising of Liver fire. Hyperthyroidism’s symptoms are excess while its underlying cause is deficiency. Therefore, treatment may entail simultaneously addressing both the symptoms and the cause.
To come up with an appropriate type of treatment, differentiating between deficiency and excess in patients with hyperthyroid is crucial. The Kidney, Heart, and Liver are the three organs usually affected by hyperthyroidism. Apart from removing heat, the TCM practitioner also needs to nourish the yin of the patient as the yin can be damaged by bitter herbs if they are used for an extended period of time. They may treat the symptoms but may not resolve the underlying cause of the condition. In TCM, hyperthyroidism has symptoms that are quite the same as that of the wasting and thirsting syndrome (Hsiao ke). Therefore, diagnosing the condition correctly is important in order to prescribe the appropriate herbal formula(s). The patterns of disharmony that underlie the cause of hyperthyroidism include:
– Underlying Deficiencies in Yin and Qi and Liver Fire with Phlegm
-Heart, Kidney, and Liver Yin Deficiencies
-Phlegm and Qi Stagnation
-Deficiencies in Yin and Qi
Underlying Deficiencies in Yin and Qi and Liver Fire with Phlegm
Signs and Symptoms
Elevated blood pressure, increased appetite and hunger, perspiration, aversion to heat, ill temper, irritability, fidgeting, loss of weight, fatigue, tachycardia or palpitations, bilateral or unilateral bulging or swollen eyes, swollen thyroid glands, tremors of the fingers and tongue, and low grade fever.
Empirical Remedies for Hyperthyroidism
-Root of Astralagus (Wang Qi)
-Licorice (Gan Cao)
-Siler root (Fang Feng)
-Polygala root (Yuan Zhi)
-Thunberg Fritillary Bulb (Zhe Bei Mu)
-Oyster shell (Mu Li)
-Cyathula root (Chuan Niu Hsi)
-Carapax Trionycis (Bie Jia)
-Prunella spike (Hsia Ku Cao)
-Gardenia fruit (Shi Hsi)
-Anemarrhena rhizome (Shi Mu)
-Scrophularia Root (Hsuan Shen)
Heart, Kidney, and Liver Yin Deficiencies
Signs and Symptoms
Rapid and thread pulse, red tongue with little or no coating, dry throat and mouth, emaciation, tremors, light sleep or insomnia, and irritability.
Shi Bai di Wang Wan ( Rehmannia, phellodendron, and anemarrhena pills) and Tian Wang Bu Hsin Dan (Emperor of Heaven’s Special Pill to Tonify the Heart)
-Prepared Rehmannia Root (Shi Bai di Wang Wan), 28g
-Phellodendron Bark (Huang Bai), 7g
-Radix Anemarrhenae (Zhi Mu), 7g
-Cornus fruit (Shan Zhu Yu), 14g
-Poria (Fu Ling), 10g
-Alisma Rhizome (Hse Hsie), 10g
-Tree peony bark (Mu Dan Pi), 10g
-Chinese yam (Shan Yao), 14g
Tian Wang Bu Hsin Dan (Emperor of Heaven’s Special Pill to Tonify the Heart)
-Ophiopogon Tuber (Mai Men Dong), 8g
-Chinese Angelica Root (Dang Gui), 8g
-Spiny Zizyphus Seeds (Suan Hsiao Ren), 8g
-Red Sage Root (Dan Shen), 4g
-Asparagus Tuber (Tian Men Dong), 8g
-Platycodon root (Jie Geng), 4g
-Platycladus Seed (Bai Hsi Ren), 8g
-Ningpo Figwort Root (Hsuan Shen), 4g
-Chinese Magnolia-vine Fruit (Wu Wei Hsi), 8g
-Polygala root (Yuan Zhi), 4g
-Poria (Fu Ling), 4g
-Ginseng root (Ren Shen), 4g
-Rehmannia Root (Sheng Di Wang), 31g
Phlegm and Qi Stagnation
Signs and Symptoms
Slippery-wiry or wiry pulse, red tongue with greasy thin coating, enlargement of the thyroid gland, plum-seed syndrome, oppressive sensation in the chest, and Irritability
Magnolia Bark and Pinellia Decoction (Ban Hsia Hou Po Tang) and Bupleurum Powder to Spread the Liver (Chai Hu Shu Gan Tang) – to soothe the liver, normalize the flow of qi, and clear phlegm.
Magnolia Bark and Pinellia Decoction (Ban Hsia Hou Po Tang)
-Purple Perilla Leaf (Hsi Su Ye), 10g
-Bark of Magnolia (Hou Po), 16g
-Poria (Fu Ling), 21g
-Fresh Ginger Rhizome (Sheng Jiang), 26g
-Pinellia Rhizome (Ban Xia), 28g
Bupleurum Powder to Spread the Liver (Chai Hu Shu Gan Tang)
Baked Licorice Root (Shi Gan Cao), 5g
White Peony Root (Shi Tsiao), 14g
Purple Nutsedge Root (Hsiang Fu), 14g
Chinese Lovage Root (Chuan Hsiong), 14g
Orange Peel (Chen Pi), 19g
Asian Buplever Root (Chai Hu), 19g
Yin and Qi Deficiencies
Signs and Symptoms
Thready, deep and rapid pulse, thin coat, red tongue, hand tremor, lessened fluid intake, dry mouth, disturbed sleep, excessive sweating, palpitation, dry eyes, shortness of breath, and fatigue.
Linking Decoction (Yi Guan Jian) – to clam the Heart, soften the Liver, and tonify yin and qi.
Toosendan Fruit (Chuan Lian Hsi), 8g
Lycium Fruit (Gou Qi Hsi), 15g
Body of Chinese Angelica Root (Dang Gui Shen), 15g
Ophiopogon Tuber (Mai Men Dong), 15g
Four Leaf Lady-Bell Root (Sha Shen), 15g
Rehmannia Root (Sheng Di Huan), 30g
Signs and Symptoms
Rapid and wiry pulse, red tongue with thin yellow coating, palpitations, increased appetite, irritability, and fidgeting.
Gardenia Decoction to Clear Liver (Shi Hsi Tsing Gan Tang) – to purge fire and clear the Liver
-Licorice Root (Gan Cao)
-Great Burdock Fruit (Niu Bang Hsi)
-Chinese Lovage Root (Chuan Hsiong)
-Poria (Fu Ling)
-White peony root (Bai Shao)
-Chinese Angelica Root (Dang Gui)
-Asian Buplever Root (Chai Hu)
-Moutan Root Bark (Mu Dan Pi)
-Gardenia fruit (Shi Hsi)
Significant improvements within a month of herbal therapy can be seen in hyperthyroid patients (other than thyrotoxicosis). Usually, it takes three to six months of treatment to see a complete resolution of the symptoms. Herbal therapy, though, may not work for ocular protrusion. Modifications to traditional formulas may be prescribed depending on the symptoms manifested by the patient
Herbal formulas used by TCM practitioners offer reliable and consistent benefits in the treatment of hyperthyroidism. The effects of herbal therapy, once the condition of the patient is stabilized and despite the slower effects of the herbs, compare to conventional treatments. The empirical formula for hyperthyroidism can be prescribed to deflate the thyroid swelling and lessen the symptoms of sympathetic excess. This means that herbal remedies can be considered ideal treatment alternatives for patients who do not want to be treated with Western medicine or who are not able to tolerate it.
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