Other Proposed Treatments
In hypothyroidism, the thyroid gland fails to produce adequate levels of thyroid hormone. Symptoms include the following:
- Sensitivity to cold
- Weight gain
- Dry skin
- Loss of hair
- Excessive menstruation
- Goiter (a visible enlargement of the neck caused by a swollen thyroid gland)
Hashimoto’s thyroiditis is the most common natural cause of low thyroid hormone levels. In this autoimmune condition, the body develops antibodies that attack and gradually destroy the thyroid. A viral infection of the thyroid can also decrease thyroid hormone production, but the effect is generally mild and temporary. Finally, iodine deficiency can cause hypothyroidism, but this seldom occurs in the developed world where iodine is routinely added to salt.
Besides these natural causes, there is a still more common cause of hypothyroidism—medical treatment for hyper thyroidism (excessive production of thyroid hormone production). People with certain forms of hyperthyroidism receive treatment with radioactive iodine to inactivate the thyroid gland. This treatment causes hypothyroidism, which requires lifelong treatment with thyroid replacement therapy.
Until the 1990s, doctors commonly diagnosed hypothyroidism by conducting lab tests to measure thyroid hormone levels in the blood (the T 4 level). Unfortunately, normal thyroid levels vary widely between people, so this method couldn’t always correctly identify the disease. A much better lab test, which became available in the 1990s, involves measurement of a hormone called TSH, or thyroid stimulating hormone.
TSH is released by the pituitary gland in order to control the thyroid gland. The pituitary gland constantly measures the level of thyroid hormone in the blood and adjusts TSH levels as necessary to get it right. When thyroid hormone levels are high, it turns TSH levels down. When thyroid hormone levels are too low, the pituitary raises TSH levels to stimulate the thyroid. If the thyroid gland does not respond by raising thyroid hormone levels, the pituitary turns up the TSH levels even higher. When TSH levels are higher than normal limits, this means that the thyroid gland is having trouble producing enough thyroid hormone for the body’s needs: in other words, the person has entered a hypothyroid state, or is about to enter such a state. This method of determining thyroid status has proved very reliable. In other words, the pituitary gland knows what it is talking about.
Medical treatment for low-thyroid conditions is safe and very effective. Treatment involves use of a hormone called levothyroxine, or T 4 . The body actually uses two forms of thyroid, T 4 and T 3 , but in most cases the body easily and automatically converts T 4 to T 3 in the right proportions. The dosage of drug is adjusted by monitoring TSH levels. When the pituitary gland is satisfied, the dose is most likely correct.
Other Proposed Treatments
So-called natural thyroid hormone is popular among people interested in alternative medicine. Sold by prescription under different brand names, this extract of pig (or mixed pork and beef) thyroid contains both T 4 and T 3 (see previous section for description). There is no doubt that extract is as effective as standard synthetic thyroid hormone, and it is a satisfactory choice for those who prefer to use natural treatments. However, there is no evidence that extract is any more effective than standard medications, and there are some concerns that variations in stomach absorption may produce slightly erratic results.
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Besides prescription extract, there are no natural therapies with documented efficacy for the treatment of hypothyroidism. Treatments that are sometimes recommended but lack any meaningful scientific support include Bacopa monniera (brahmi), traditional Chinese herbal medicine, vitamin B 3 , and zinc.
The Theory of Widespread Marginal Hypothyroidism
There is very little doubt that many cases of marginal hypothyroidism go unidentified, and that occasional tests for thyroid adequacy should be part of routine medical care. However, some proponents of alternative medicine go further and suggest that undiagnosed hypothyroidism is a serious epidemic, causing a high percentage of all the illnesses afflicting modern man. (One of the most famous books on this theory is titled Solved: The Riddle of Illness by Stephen E. Langer, MD, and James F. Scheer.) Supposedly, laboratory tests for thyroid hormone levels are not reliable, and many people have marginally low thyroid levels despite normal lab readings.
These thyroid enthusiasts recommend that people use measurements of basal body temperature and not blood tests to determine whether thyroid levels are adequate. Basal body temperature is measured by placing a thermometer under the armpit before arising in the morning. According to proponents of the marginal hypothyroidism theory, a measurement of lower than about 97.5°F indicates a problem. People with basal body temperature readings below this level and symptoms consistent with hypothyroidism are advised to use animal-source thyroid gland supplements, which can be obtained with a bit of work. The net result is supposed to be a great improvement in overall health and the resolution of many illnesses.
However, there are a number of problems with this theory. One is that the majority of women have basal body temperature readings below 97.5°F in the period prior to ovulation, a fact used in the sympto-thermal method of natural family planning. Many healthy men have normal basal body temperatures below 97.5°F as well. Since symptoms consistent with hypothyroidism (such as, fatigue, depression, weight gain) occur in a great many people, this approach is guaranteed to recommend that enormous numbers of people take thyroid supplements.
Furthermore, the basal body temperature method was developed in the days before TSH levels could be measured. Back then, doctors could only measure T 4 levels, and as noted above, there is too great a variation in the normal level of T 4 for such tests to be reliable. However, now that the TSH test has become available, the situation has changed. TSH measurements indicate the body’s own determination of its thyroid hormone level. It is difficult to justify ignoring the body’s own opinion in favor of an arbitrary reading on a thermometer. Indeed, when people with normal TSH levels are given thyroid medication, the body responds by lowering its own production of thyroid hormone, essentially fighting this supposedly natural therapy.
The results showed that participants with symptoms of low thyroid hormone improved significantly. However, those taking placebo improved just as much! In other words, thyroid hormone proved no more effective than placebo. (Interestingly, the healthy participants showed little response to either placebo or thyroid hormone.)
This study indicates that synthetic human thyroid hormone supplementation (T 4 ) is not helpful for people with normal TSH but with symptoms that are reminiscent of low thyroid hormone. Unfortunately, it did not evaluate the effectiveness of the animal-source thyroid recommended by proponents of the hypothyroid theory, and therefore, does not entirely settle the controversy.
Herbs and Supplements to Use Only With Caution
For this reason, people with low thyroid hormone levels should not consume excessive amounts of these iodine-rich foods.
The bottom line: In view of soy’s complex effects regarding the thyroid, people with impaired thyroid function should not take large amounts of soy products except under the supervision of a physician.
- Reviewer: EBSCO CAM Review Board
- Review Date: 08/2013 -
- Update Date: 02/12/2014 -