Hyperthyroidism: Botanical Treatment

2011

Traditional Western botanical medicine practitioners have found several herbs effective in the treatment of hyperthyroidism, a number of which have demonstrated antithyroid activity, inhibiting the binding of thyroid-stimulating hormone to thyroid tissue (Table Botanical Treatment Strategies for Hyperthyroidism). Additionally, a number of herbs are effective in the treatment of heart palpitations, anxiety, and adrenergic symptoms associated with hyperthyroidism. Note the treatment of mild hyperthyroidism only with botanical medicines is recommended.

Botanical Treatment Strategies for Hyperthyroidism

THERAPEUTIC GOAL THERAPEUTIC ACTION BOTANICAL NAME COMMON NAME
Inhibit thyroid-stimulating hormone binding Antithyroid Lycopus spp. Bugleweed
Lithospermum officinale Club moss
Melissa officinalis Lemon balm
Relieve palpitations Anti-arrhytmics Leonurus cardiaca Motherwort
Relieve anxiety Anxiolytics Leonurus cardiaca Motherwort
Melissa officinalis Lemon balm
See Nervines in index

Herbs that increase thyroid activity, as discussed under hypothyroidism, should be avoided in the hypo-thyroid patient. Additionally, the use of ephedra is contraindicated in patients with hyperthyroidism, and herbs with high caffeine content should be avoided. Increased consumption of goitrogens (leafy greens, cabbage, broccoli, and Brussels sprouts, as well as soy) can be part of a treatment strategy to reduce thyroid hormone.

Thyroid hormone excess causes an increase in metabolism, and thus an increase in nutritional needs, excessive glucose metabolism, and increased oxidative stress and increased susceptibility to liver damage. Botanical medicines and nutritional supplements to reduce oxidative stress (adaptogens, antioxidants) and protect the liver (Silybum marianum) also should be included in the protocol (see Additional Therapies).

Bugleweed

Bugleweed has a long history of use by herbalists for the treatment of palpitations and anxiety. It is widely recommended in medical herbalism texts: Priest describe it for the treatment of palpations, tachycardia, and dysregulation of the autonomic nervous system.

Weiss refers to bugleweed as having thyrostatic effects and suggests its use for the treatment of hyperthyroidism, whereas the British Herbal Pharmacopoeia (BHP) calls it a thyroxine antagonist. Hoffmann reports it to be indicated for mild forms of hyperthyroidism, especially when symptoms include tightness of breathing, palpitations, and shaking. Priest and Priest recommend combining bugleweed with motherwort for hyperthyroid cardiac reactions, a common practice among herbalists.

In vivo and in vitro evidence has demonstrated that Lycopus spp. can be beneficial in the treatment of hyperthyroid symptoms. Rosmarinic acid, ellagic acid, chlorogenic acid, and luteolin-7-beta-glucoside appear to be the active constituents leading to blocking of thyroid-stimulating hormone receptors and inhibition of peripheral conversion of thyroxine to T3. Aqueous, freeze-dried extracts of Lycopus spp., Lithospermum officinale, and Melissa officinalis have been studied in vivo and in vitro; preliminary results support their use in Graves’ disease. This combination was shown to inhibit thyroid-stimulating hormone effects on thyroid-stimulating hormone receptor sites on thyroid cell membranes, block effects of antithyroid immunoglo-bulins on thyroid-stimulating hormone receptors, and inhibit peripheral deiodin-ation of thyroxine to T3. No human clinical trials have been conducted using bugleweed. The German Commission E recognizes the use of bugleweed for mild hyperthyroid conditions with neuroanatomic dysfunction based on pharmacologic studies only, and states that in rare cases high doses have resulted in thyroid enlargement, whereas sudden discontinuation of use has increased disease symptoms.

Formula for Hyperthyroidism

Motherwort (Leonurus cardiaca) 25 mL
Bugleweed (Lycopus spp.) 25 mL
Lemon balm (Melissa officinalis) 25 mL
Nettles (Urtica dioica) 25 mL

Total: 100 mL

Dose: This is a classic herbal formula for hyperthyroidism. The late Hein Zelstra, well-known herbal educator from Tunbridge Wells, UK, recommended an equal part mixture of 1:5 tincture these herbs given in 5 mL doses three times daily.

Club Moss, Gromwell

Like bugleweed, Lithospermum has a long history of use for the treatment of hyperthyroid conditions. It was used by the Eclectic physicians for this purpose, and although less widely used than Lycopus, has been equally well studied. Animal studies using Lithospermum officinale have demonstrated its ability to block thyroid-stimulating hormone activity at the receptor level, block the release of thyroid-stimulating hormone from the thyroid, and suppress the iodide pump. It also inhibits peripheral T4-deiodination and conversion to T3. An in vitro study using freeze-dried extract demonstrated the ability to decrease antibody binding to thyroid tissue on Graves’ disease. No human clinical trials have evaluated the use of Lithospermum for hyperthyroid diseases.

Lemon Balm

Lemon balm, historically referred to as the “gladdening herb,” is calming to the nervous system and has been used since ancient times for this purpose. In vitro studies have confirmed this herb’s ability to block thyroid-stimulating hormone receptors and inhibit both binding of bovine thyroid-stimulating hormone to human thyroid tissue, and binding of autoantibodies in Graves’ disease. The herb has a high safety profile and is appropriate for the treatment of mild hyperthyroidism, as well as associated anxiety and depression.

Motherwort

Motherwort is classically used for the treatment of anxiety, depression, heart palpitations, and tachycardia, making it highly appropriate for symptomatic relief in hyperthyroid disease. Chemical analytical and animal studies confirm the herbs sedative, anxioly-tic, anti-arrhythmic, and antispasmodic effects. The German Commission E supports the use of motherwort for the treatment of cardiac disorders associated with anxiety and for the symptomatic relief of hyperthyroidism.