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November 4, 2018
Hyperthyroidism is a state of overactivity of the thyroid gland. The thyroid gland synthesizes and produces too much thyroid hormone.
There is not a lot of information available regarding hyperthyroidism, especially in comparison to hypothyroidism (inadequate production or output of thyroid hormone). Hyperthyroidism is estimated to affect 0.1-0.5% of the population, whereas hypothyroidism is estimated to affect up to 10% of the population. Based on these figures, hypothyroid conditions are at least 20x more common than hyper conditions. Both disorders affect women more commonly than men.
While there is not a lot of information regarding hyperthyroidism, there is even less information available regarding the natural or holistic take on hyperthyroidism. It is my goal for this article to be a resource for those dealing with hyperthyroidism and who wish to approach it from as much of a natural perspective as possible.
Symptoms of Hyperthyroidism.
Hyperthyroidism can be totally debilitating. Many of the symptoms can be attributed to the excessive adrenaline being output as a result of the hyperthyroid state. Symptoms may include some or all of the following:
-Anxiety or Panic Attacks
-Muscle weakness and wasting
-"Wired and Tired" feeling
-Tachycardia, Heart Racing or Pounding
-Frequent Bowel Movements
-Weight Loss is more common, but some may actually have weight gain
-Bulging Eyes, Eye Pressure or Pain (with Graves' Disease, below)
-Inability to concentrate
-Mood Issues, including Depression or Irritability
-Swelling or Irritation of the Thyroid area
-Feelings of hypoglycemia, or low blood sugar
-High histamine symptoms, including flushing, anxiety, tachycardia after eating
-High blood pressure
Causes of Hyperthyroidism.
Hyperthyroidism is most commonly caused by Graves' Disease, which is an autoimmune condition in which the body attacks the thyroid. Graves' Disease patients often have elevated antibodies, which can include TSI (Thyroid-Stimulating Immunoglobulin) and TRAb (Thyrotropin Receptor Antibodies, or TSH Receptor Ab's). They may also have high TPO (Thyroid Peroxidase Antibodies) or TgAb's (Thyroglobulin Antibodies). These antibodies basically stimulate the thyroid gland to create and excrete excessive amounts of thyroid hormone.
The second most common cause of Hyperthyroidism is a toxic nodule. Nodules can grow and may either irritate the thyroid, or may start acting autonomously (independently) from the rest of the thyroid gland, taking up iodine and spitting out thyroid hormone, with no regard to the body's feedback mechanisms that tell the thyroid gland to stop pumping out hormone. Nodules can be solid tissue or fluid filled cysts.
The least common cause of hyperthyroidism is thyroiditis. This simply means "inflammation of the thyroid gland." I.e. the thyroid is pissed off for some reason. The underlying cause could be varied and unknown.
Testing for hyperthyroidism and its' causes may include the following:
-Blood tests including a full thyroid panel:
TSH, Total T3, Free T3, Total T4, Free T4, Reverse T3 (more on what these mean here)
Plus thyroid antibodies: TSI, TrAb, TPO, TgAb
-Possibly a radioactive thyroid uptake scan
The blood tests will give your current thyroid hormone levels. The antibody tests will show if your body is creating antibodies against the thyroid, which could indicate Graves' Disease and/or an autoimmune component. Note that up to 20% of those with Graves' Disease may not have positive antibody tests.
The thyroid ultrasound will detect thyroid nodules and show if they are solid or fluid filled, as well as their size. This is a very safe and non-invasive procedure.
Doctors may also recommend a radioactive thyroid uptake scan. With this test, a small amount of radioactive iodine is either ingested or injected. This iodine is then taken up by the thyroid gland, and a scan is done to see which areas "light up" on the thyroid after absorbing the radioactive iodine. This may further help to diagnose either Graves' Disease, toxic nodules, or thyroiditis. This procedure does use radioactive material. However, it is about 1/10th the level used in a CT scan, and is approximately equal to a chest x-ray. While some have no bad reaction to this test, I have heard from others that it caused a flare and declining health, since the already-irritated thyroid then has to deal with and detox both a surge of iodine, as well as radioactive material which is concentrated in the thyroid. Risks and benefits of this procedure should be weighed by the patient and discussed with a Doctor.
Traditional Doctors and Endocrinologists typically recommend removal or "killing" of the thyroid gland when one is hyperthyroid. This is usually done via surgery to remove the thyroid gland (thyroidectomy), or a large amount of radioactive iodine is given (RAI), which is then taken up by the thyroid gland, and the radioactive material kills the gland over a period of time. Patients who choose either of these treatments will require prescription replacement thyroid hormone for life.
If a patient chooses not to remove the thyroid, or while they are doing further testing, Doctors may prescribe anti-thyroid hormone medication to help with symptoms. The most common prescription medications include methimazole and PTU (propylthiouracil). Note that these drugs do carry side effect risks which include liver damage and immune system dysregulation. Beta blockers, such as propranolol, may also be prescribed to help block the effects of the excess adrenaline circulating through the body.
Natural Treatment Options.
There are some natural treatment options that may either be tried on their own, or in combination with a lower dose of prescription medication. As always, work with your Doctor or Practitioner.
These natural options usually work best for those with milder cases of hyperthyroidism, or in conjunction with medication. The natural options may or may not be strong enough for those with more severe cases of hyperthyroidism. I typically do not advocate medication unless absolutely necessary, but in these cases, I consider the medication a necessity if the natural options are not producing the desired effects in a quick enough time period, due to the risks and severity of symptoms involved with hyperthyroidism.
Those with hyperthyroidism can have a "thyroid storm," in which the hormone levels become so elevated that they produce symptoms which are life-threatening. I would recommend having a reliable blood pressure cuff and pulse oximeter on hand to keep an eye on blood pressure and pulse while one is hyperthyroid. Discuss with your Doctor regarding at what levels one would need to visit an Emergency Room.
Natural Antithyroid Herbs and Supplements.
I am typically not a big fan of "allopathic treatment," meaning treating symptoms (I prefer to work on the causes and underlying imbalances and then watch the symptoms fall away on their own), however, hyperthyroidism is a major acute issue that has to be dealt with allopathic-ally while also working on balancing the body overall. With that said, here are my natural support recommendations:
-L Carnitine: This amino acid blocks the entry of T3 and T4 into the cell nuclei. The dose ranges based on individual and may be 1000mg to 4000mg a day, in divided doses. Amino acid supplements should be taken on an empty stomach, away from other protein.
-Low iodine diet: It may be necessary for a period to decrease or remove high iodine sources from your diet. I do not advocate this long-term, as your body, more than just your thyroid, needs iodine. But, limiting iodine sources may be needed for a time.
Higher sources of iodine include, of course, iodine supplements, egg yolks, kelp and other seaweeds, dairy, including butter, cheese, yogurt, kefir, and whey, coconut oil and byproducts (I also removed monolaurin, just in case), sea salt and Himalayan salt, any seafood or byproducts (I also removed Cod Liver Oil during this time). I even found turkey to contain too much iodine for me at one time. You also need to be very careful about eating out, as many restaurants use iodized salt (or other higher iodine foods) in their preparation.
I switched to non-iodized kosher salt for cooking, and used sodium chloride tabs in my water, replacing Himalayan salt (yes, in my water. See my adrenals post which includes info on salt and sole water here). Again, this is not ideal for a long-term solution, as these processed salts are devoid of other nutrients.
-Clean up your diet and add goitrogens: When I joined the hyperthyroid groups, I saw many people stating that they went into remission after going Gluten Free (that's awesome for them...I've been GF and eating "clean" for several years already). I would highly recommend dropping gluten and most grains for the time being, as well as dairy. You want to eliminate any possible reason for your body to be angry. I also dropped eggs temporarily (they are a top allergen and also higher in iodine). Sugar and caffeine should also be eliminated (YUP). Instead, focus on whole foods such as grassfed meats and organic veggies.
Goitrogens are foods which can block thyroid hormone production. They are most potent when raw. However, I really don't like them raw, so I lightly steam my veggies. Broccoli, brussel sprouts, and kale are a few goitrogens. Here is a larger list. Millet is also highly goitrogenic. I would eat some puffed millet cereal with hemp milk daily for a while. I could definitely feel a bit of a calming affect after eating the millet.
-Topical solutions for calming the thyroid:
You can apply castor oil over the thyroid by itself, or use a castor oil pack for more oomph - info here.
CBD (cannabidiol) salve applied topically is another great option - my recommendation here.
-Anti-inflammatories, antioxidants, and calming supplements: Working on putting out the fire is one of the most important steps when dealing with hyperthyroidism. Here are some supplements I found helpful for knocking down the inflammation (fire) associated with hyperthyroidism:
-"Liver Loving," if you are not already focusing on the liver - more info and ideas here.
-Turmeric or Curcumin: excellent natural anti-inflammatory - here
-Taurine: can increase GABA, and is also needed to create bile, for liver and detox - here
-SAM-e: this is usually beneficial for undermethylators. If you are on an SSRI or MAO inhibitor, SAM-e is contraindicated. I also do not recommend taking it if you aren't able yet to "listen to your body," and I usually don't recommend it daily long-term. In some countries, SAM-e is a prescription drug. While I was hyperthyroid, it was an immense help to me by "clearing out" my excess adrenaline. I took one every 3 days or so. - here
-Remove anything stimulating in your routine:
This includes intense workouts (opt for calming, slow walks), caffeine, stress or sources of anxiety, and any supplements you are taking that could be stimulating. I had to trial-and-error everything that I had been taking, as my body had changed when I went hyper. This included temporarily eliminating my B vitamins, all but a very small amount of vitamin C, and random supplements and herbs that I wouldn't have thought would be stimulating, but my body told me otherwise. So, get everything you take, make a list, test them one-by-one via trial-and-error, and figure out what works best for your body in its' current state.
-Work on Regulating the immune system:
With Graves' Disease, the body is attacking the thyroid. Therefore, working on regulating the overactive immune response can help in calming down the thyroid activity.
-Work on the Th17 response. Great article here by SelfHacked (one of my all-time favorite bloggers). Scroll down to "How to Inhibit Th17 and IL-17."
-Stress: Ya gotta decrease stress and work on breathing. No if's, and's, or but's.
Decrease stress wherever possible. This is a time for rest and regeneration. Say no. Put away the to-do list. Cut out toxic people. Focus on you. I deleted my facebook app (all the drama can be stressful), and spent a lot of time curled up with the puppers and Netflix (happy, non-stressful shows only).
If you are a "stress breather" like me, you must work on learning to calm down your nervous system and relax your breathing. When you stress breathe, you are sending a message to your body that it needs to be hyper-vigilant, always on alert. This has a trickle down effect that results in physical symptoms. Here is a YouTube video teaching Buteyko breathing, which is one good breathing technique to try: https://www.youtube.com/watch?v=tKaUEVnducI&t=2s
Part of decreasing your stress is not only decreasing stressful situations, but how you handle stress. I have had a problem with this my entire life. Historically, I have been easily overwhelmed, and can always see the potential risks in any situation. Because of past traumas, my brain has become wired to look for danger. This is not conducive to healing the body. So, I started a new program (DNRS or Dynamic Neural Retraining System) to re-wire my brain. It has been immensely helpful in my journey. It is a 6+ month commitment, but if you're serious about making changes and healing, I can't recommend it enough. There is the choice of a 5-day interactive seminar, or an at-home DVD series. One of my next posts will go into further detail on the benefits of this program. https://retrainingthebrain.com/?wpam_id=77
-Sleep: This is a tough one, especially when the thyroid is amped up. Here is an article from one of my friends and colleagues with a plethora of helpful suggestions - here.
Some additional ideas include: Hawthorn (natural beta blocker herb), Passion Flower (a sedating herb), and liposomal melatonin if needed. I don't think high dose melatonin is great long term, but good grief...you just have to find a way to sleep when the body is zoomed up.
Ok, so what causes autoimmune activity (Graves' Disease) and thyroid nodules?
We do not fully understand all of the causes or mechanisms of Graves' Disease or thyroid nodules, however, some associations have been studied and documented. I am not separating out the causes between Graves or nodules, as I believe all of these issues can cause either/or.
There are links showing that high estradiol (a form of estrogen) can be linked to hyperthyroidism. High estradiol can also be linked to activation of underlying viruses (which are also linked to hyperthyroidism...everything is connected).
If one has higher than desired estradiol, some options to decrease this and move the estrogen down the desired pathway include:
-Sulphur Veggies daily (up to 3 cups!): Brussel Sprouts, Broccoli, Cauliflower, Onions, Asparagus, Kale are a few of my favorite.
-DIM and/or Calcium D Glucarate may be needed as well. Here is one that has a combination of both. I again suggest working with a practitioner when using this. Link here. A study on DIM, estrogen metabolism, and thyroid diseases:
-Work on your liver (this is really a constant need in today's toxic world). More ideas here.
-Progesterone support or supplementation may be required. Work with your practitioner.
-I'll say it again: decrease stress. Chronic stress derails your hormones (and your entire body).
There are strong and documented links between viral infections and hyperthyroidism. You can search and find many studies to this affect. Here is another study/link, in addition to the one posted under Hormones, above.
"A possible link between the Epstein-Barr virus infection and autoimmune thyroid disorders"
Some of the more common viruses include Epstein-Barr Virus (EBV), Cytomegalovirus (CMV), Herpes Simplex Virus (HSV) and Human Papillomarvirus (HPV).
Testing for viruses is not clear-cut. Some practitioners may interpret the results as merely showing old infections / exposure, but I like to say in this context: "If it walks like a duck and talks like a duck... (it's probably a duck)." Meaning, if the symptoms fit, and there are high viral antibodies, there is a decent chance that the infection is active or re-activated.
For testing EBV, I recommend antibodies plus Early Antigen. You can order your own testing here (Choose LabCorp or Quest before putting the test into your cart. Note that this is out of pocket. You can also try to get your Doctor to order via your insurance).
You can order other virus antibodies through the same website linked above, however, EBV is the only one I am aware of that has the helpful Early Antigen, which makes the interpretation of EBV results more clear-cut than the rest. This link goes over some interpretation of EBV results.
If decide that viruses are an issue for you, there are many ways to start helping your body get the infection "in check." Here are some ideas (again, best to work with a practitioner... if you do try to DIY, my recommendation is to add one thing at a time, very slowly, and rotate):
The following are either natural anti-virals or decrease viral replication:
-Lysine - the dose is individual. I took 2g 3x a day - here
-Baicalin (a derivative of Chinese Skullcap herb) - here
-StephenBuhnerherbs - various herbs discussed here
-ALA (Alpha-Lipoic Acid - don't take if you have mercury or metal dental fillings) - here
Several other infections have been linked with thyroid issues. I can't go into the details of how to test and deal with each of these pathogens, as this article would turn into a novel. I will cover each one in further detail in future posts.
Additional infections linked with thyroid issues include:
I was also on a low iodine diet, and further decreased stress and activities. I worked hard on natural anti-virals, decreasing inflammation, and balancing my estrogen. I had a couple of great natural health practitioners and experienced friends help along the way. Lastly, I started the DNRS program (mentioned above). That has been huge, and something I will continue for a long time.
I was able to titrate down and then discontinue the medications after only a month. My current thyroid levels are slightly lower than I'd like, but that is a bit to be expected, as my thyroid has been working overtime for months. But, overall, I'm feeling pretty decent and good many days. I am confident that with my continued work, my thyroid levels will balance back out to optimal again.
It is my hope that my journey and complied information will be able to help direct others to achieve victory in their health.
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