Hypothyroidism: Botanical Treatment

Traditionally, hypothyroidism would have been recognized and treated by herbal practitioners on the basis of its presenting metabolic deficiency symptoms, rather than as a discrete disease entity. The botanical practitioner recognized the patient picture as one of overall depletion. Herbalists today also view hypothyroidism with the goal of improving overall metabolism and the general integrity of the endocrine system. Many consider primary thyroid dysfunction to be a treatable condition with herbs and specific nutritional supplements (Table Botanical Treatment Strategies for Hypothyroidism). Symptoms of hypothyroidism (e.g., constipation) may be treated with a symptom-specific protocol.

Botanical Treatment Strategies for Hypothyroidism

THERAPEUTIC GOAL THERAPEUTIC ACTION BOTANICAL NAME COMMON NAME
Stimulate thyroid hormone production/thyroid activity Thyroid stimi ilating Bauhinia purpurea

Coleus forskohlii

Commiphora mukul

Fucus vesiculosus

Withania somnifera

Bauhinia

Coleu

Guggul

Bladderwrack

Ashwagandha

Support metabolic function, reduce damage from oxidative stress, improve energy and vitality Adaptogens Adaptogen section below
Supplement iodine in iodine deficiency-related cases Iodine-rich Fucus vesiculosus Bladderwrack

An adequate understanding of the influence of botanical medicines on the thyroid gland, thyroid hormone production, and metabolism is lacking, as are human studies on the use of herbs for hypothyroidism. In fact, there is limited evidence for the botanical treatment of this condition. In contrast, there is a long history of the successful and relatively safe use of thyroid hormone replacement therapy. Thus, unless a patient is responding poorly, conventional replacement therapy remains an excellent treatment choice. However, patients with borderline hypothyroidism may prefer and request alternatives to conventional therapy, and symptomatic euthyroid patients, or those with subclinical hypothyroidism, may be good candidates for botanical therapies that might support normalization of thyroid function. Note that botanicals that increase thyroid hormone levels are contraindicated in patients with hyperthyroidism; similarly herbs presented in the discussion of hyperthyroidism for the reduction of thyroid hormone levels are contraindicated for patients with hypothyroidism. Botanical therapies that increase thyroid function should not be combined with thyroid replacement therapies. Patients using botanical therapies to manage thyroid conditions should be monitored regularly (every 6 months) with thyroid testing.

Adaptogens

Adaptogenic herbs play a key role in regulating various metabolic processes through improvement in HPA functioning. Both hypothyroidism and hyperthyroidism are associated with enhanced oxidative stress. Adaptogenic herbs counter catabolic processes associated with stress on the body and increase the oxygen consumptive capacity to decrease metabolic markers associated with anaerobic metabolism. Additionally, adaptogens such as Eleutherococcus senticosus and many others have been demonstrated to improve fatigue, weakness, and debility. Ashwagandha (Withania somnifera) is the only adaptogen for which a thyroid-related study was identified. In one study, the effects of daily administration of Ashwagandha root extract (1.4 g/kg body wt.) and Bauhinia purpurea bark extract (2.5 mg/kg body wt.) for 20 days on thyroid function in female mice were investigated. Tri-iodothyronine and thyroxine concentrations were increased significantly by Bauhinia, and serum thyroxine concentration was enhanced by Withania. Both the plant extracts showed an increase in hepatic glucose-6-phosphatase (G-6-Pase) activity and antiperoxidative effects as indicated either by a decrease in hepatic lipid peroxidation (LPO) and/or by an increase in the activity of antioxidant enzyme (s). It appears that these plant extracts are capable of stimulating thyroid function in female mice. The importance of Withania somnifera root extract in the regulation of thyroid function with special reference to type-I iodothyronine 5′-monodeiodinase activity in mouse liver was investigated. Although the extract (1.4 g/kg, p.o. for 20 days) increased serum tri-iodothyronine and thyroxine concentrations and hepatic glucose-6-phosphatase activity, hepatic iodothyronine 5′-monodeiodinase activity did not change significantly. Furthermore, the extract significantly reduced hepatic lipid peroxidation, whereas the activities of antioxidant enzymes such as superoxide dismutase and catalase were increased. It was concluded that the extract stimulates thyroid activity and also reduces lipid peroxidation of hepatic tissue.

Bladderwrack

Many herbalists and naturopathic physicians have relied on seaweed species in the treatment of hypothy-roidism predicated on their iodine content. Fucus vesiculosus, or bladderwrack, for example, contains variable amounts of iodine, up to 600 mg/g. Much of the iodine content is organically bound, a more potent thyroid stimulating form than mineral bound iodine. There are case reports of seaweed, especially bladderwrack, causing both hypothyroidism and hyperthyroidism, and evidence suggests thyroid activity. However, there are no studies of efficacy, dosing, or safety to support its use, and no standardization of iodine content. Using seaweeds with the rationale that its iodine content is what is affecting treatment may be erroneous, as most thyroid insufficiency in the United States is not attributable to iodine deficiency. Further, excess iodine, as discussed, can contribute to or worsen hypothyroidism. Bladderwrack may interfere with thyroid replacement therapies such as thyroxine. Bladderwrack also contains organically bound arsenic, which although rapidly excreted, should suggest caution when using large amounts.

Coleus

Coleus spp. has been used for centuries in Ayurvedic medicine. Forskolin stimulated thyroid function with increased thyroid hormone production in the isolated gland. However, in vitro, low forskolin concentrations inhibited thyroid function. No other research on the use of this herb for thyroid conditions was identified.

Cuggul

Guggul has shown thyroid stimulating activity, but not via the pituitary-TSH mechanism. It is thought to have a direct action on the thyroid gland. It acts on the peripheral conversion of thyroxine to tri-iodothyronine increasing tri-iodothyronine levels without changing thyroxine levels. By increasing thyroid metabolism and activity, guggul reduces LDL cholesterol in individuals with functional hypothyroidism, which may be related to the stimulation of tri-iodothyronine by guggulsterones. The effect of a petroleum ether extract of Commiphora mukul was tested on mice thyroid gland grown in organotype of culture using modified Dulbecco’s eagle medium. There was significant increase in the structure and function of thyroid cultivated explants using media containing the guggul extract with raised media tri-iodothyronine resin uptake, PBI, and free thyroxine index. It is inferred that extract of Commiphora mukul augment thyroid hormone synthesis and release.

Tincture for Hypothyroidism

Coleus (Coleus forskohlii) 20 mL
Ashwagandha (Withania somnifera) 20 mL
Bladderwrack (Fucus vesiculosus) 15 mL
Licorice (Glycyrrhiza glabra) 10 mL
Guggul (Commiphora mukul) 10 mL
Nettles (Urtica dioica) 10 mL
Reishi mushroom(Ganoderma japonica) 10 mL
Ginger (Zingiber officinalis) 5 mL

Total: 100 mL

Dose: 5 mL morning and noon