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Hveragerthi Views: 4,598
Published: 11 years ago
 

Hypothyroidism


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Hypothyroidism

 

Introduction
Thyroid hormones affect virtually every organ system in the body. In children, thyroid hormone is critical for normal growth and development. In the adult, the major role of thyroid hormone is to maintain metabolic stability.(1)

The thyroid gland uses iodine to make thyroid hormones. The two most important are thyroxine (T4), which has four iodine molecules in its chemical structure, and triiodothyronine (T3), which has three. More than 99 percent of all thyroid hormones are bound to proteins in the blood and do not interact with the body cells. Only a small fraction is free, but these free thyroid hormones are the important and active hormones that directly interact with body cells.

 

Normally, the rate of thyroid production is regulated by the pituitary gland. When there is insufficient thyroid in the body for normal functioning of cells, the pituitary releases another hormone, thyroid stimulating hormone (TSH). This triggers the thyroid to make more hormones. Generally, the more severe the hypothyroid condition, the higher the level of TSH will be.

Hypothyroidism is defined as the clinical and biochemical syndrome resulting from decreased thyroid hormone production. Overt hypothyroidism occurs in 1.5 to 2 percent of women, and 0.2 percent of men, and its incidence increases with age.(2),(3),(4) The vast majority of hypothyroid patients have primary hypothyroidism, or thyroid gland failure. Less common causes include pituitary failure (secondary hypothyroidism) or even more rarely, generalized resistance to thyroid hormone. Hypothyroidism may be associated with heart disease(5), systematic lupus erythematosus (SLE)(6),(7) and preeclampsia.(8) Hypothyroidism is an independent risk factor for all-cause mortality.(9)

Thyroid hormone is essential for normal growth and development during embryonic life. Thyroid hormone deficiency during fetal and neonatal development results in mental retardation. In the child, thyroid hormone deficiency may manifest as growth retardation. In the adult, manifestations are varied and nonspecific. There is slowing of mental activity, as well as cardiovascular, gastrointestinal, and neuromuscular function.(10)

Causes of hypothyroidism include: primary hypothyroidism, Hashimoto’s disease, iatrogenic hypothyroidism, iodine deficiency, enzyme defects, thyroid hypoplasia, goitrogens, secondary hypothyroidism, pituitary disease, and hypothalamic disease.

Statistics

World Health Organization, 2001.

  • Permanent sporadic congenital hypothyroidism, with extremely elevated neonatal TSH, occurs in approximately 1 of 4,000 births in iodine-sufficient countries.

American Association of Clinical Endocrinologists, 2005.

  • If untreated, hypothyroidism can lead to a terminal stage called myxedema coma, which has a mortality rate of 80%.
  • Nearly one out of 50 women in the United States is diagnosed with hypothyroidism during pregnancy.
  • Six out of every 100 miscarriages are associated with thyroid hormone deficiencies during pregnancy.

American Medical Women's Association, 1999.

  • Hypothyroidism affects approximately 11 million Americans.

The Thyroid Society, 1996.

  • Hypothyroidism is 10 times more common in women then men.
  • 1 out of 5 women over the age 75 has Hashimoto's thyroiditis, the most common cause of hypothyroidism.
  • 1 out of 4000 babies are born without a working thyroid gland.
Signs and Symptoms
The following list does not insure the presence of this health condition. Please see the text and your healthcare professional for more information.
Common symptoms of hypothyroidism include dry skin, cold intolerance, weight gain, constipation, and weakness. Less specific complaints include lethargy and fatigue, or loss of ambition and energy. Depression may result from untreated hypothyroidism. Coarse skin and hair, cold skin, periorbital puffiness, and bradycardia may also be experienced. the persons speech is often slow and may be hoarse. Muscle cramps, stiffness and myalgia are frequent complaints. A rise in a person's TSH level may be the first evidence of primary hypothyroidism.
  • Dry skin, cold intolerance, weight gain, constipation, and weakness
  • Less specific complaints include lethargy and fatigue, or loss of ambition and energy
  • Depression may result from untreated hypothyroidism
  • Coarse skin and hair, cold skin, periorbital puffiness, and bradycardia
  • Speech is often slow and may be hoarse
  • Muscle cramps, stiffness, and myalgia are frequent complaints
  • Rise in TSH level may be the first evidence of primary hypothyroidism 
Treatment Options
Conventional
The goals of therapy are to restore normal thyroid concentrations in tissue, provide symptomatic relief, prevent neurological deficits in newborns and children, and reverse the biochemical abnormalities of hypothyroidism. Any of the commercially available thyroid preparations accomplish this goal; however, levothyroxine is considered to be the drug of choice.(11)
Nutritional Supplementation
Iodine deficiency disease (IDD) is still a problem in many areas of the world, causing goiters and cretinism in newborn infants. In the United States and many other developed countries, this problem has been largely eliminated by the addition of iodine to table salt. Generally, hypothyroidism is treated by giving the patient supplemental thyroid hormone. However, occasionally iodine supplementation is used to increase the production of thyroid hormone.(12),(13)

 

Iodothyronine 5'-deiodinase, which is primarily responsible for the conversion of thyroxine (T4) to triiodothyronine (T3), has recently been demonstrated to be a selenium-containing enzyme. This raises the possibility that low dietary selenium intake could create a hypothyroid-like condition due to a lack of T4 to T3 conversion.(14)

Selenium deficiency may cause an inhibition of deiodinase enzyme activity, which could result in elevated levels of circulating T4, and a corresponding decrease in the concentration of T3 in peripheral tissues. Low levels of selenium may also accelerate the depletion of iodine from the thyroid gland and increase some of the problems associated with iodine deficiency. Selenium deficiency may also be involved in the occurrence and development of iodine deficiency disorders. In China, Keshan disease, which is primarily due to selenium deficiency, was also observed to alter thyroid hormone metabolism.(15)

It has also been noted that selenium deficiency may cause a lowering of glutathione peroxidase activity in the thyroid gland. This in turn could allow hydrogen peroxide produced during thyroid hormone synthesis to be more cytotoxic. In individuals who are deficient in both selenium and iodine, selenium supplementation may aggravate hypothyroidism by stimulating thyroxin metabolism via the selenoenzyme type I iodothyronine 5'-deiodinase. In cases of combined selenium and iodine deficiencies, selenium supplementation is not used without iodine and thyroid hormone supplementation.(16)

 

Herbal Supplementation
Fucus, or bladderwrack, consists of the entire thallus of the marine plant Fucus vesiculosus. The fronds are dried as soon as possible after collection in the preparation of the dietary supplement. Bladderwrack is a rich source of iodine, and is traditionally used in weight loss and for hypothyroidism.(17),(18) The low incidence of goiter in maritime people has been attributed to the iodine content in bladderwrack.(19) Bladderwrack also contains potassium, magnesium, calcium, iron, zinc, and other minerals.(20) Historically, bladderwrack has been used in the dairy and baking industries, due to the gelling properties of the constituent algin. Bladderwrack is thought to stimulate the thyroid gland, thus increasing basal metabolism.

Overdosages of iodine may lead to symptoms of hyperthyroidism, including weight loss, fatigue, and frequent soft stools. These symptoms were reported in a 72-year-old female following six months of ingesting a commercial kelp product.(21) Another report of a 24 year old woman developing thyroid goiter after taking a proprietary product, which included 0.4-0.5mg/day of iodine for three months.(22) It is recommended that products be used in which the iodine content is assayed to avoid potential iodine toxicity problems.

 

Homeopathic

Typical Dosage: 6X or 6C, 30X or 30C
Weakness; Nervous restlessness; Cold sensitive

Typical Dosage: 6X or 6C, 30X or 30C
Coldness of hands and feet; Lowered metabolism

Typical Dosage: 6X
Sarcode support

Acupuncture & Acupressure
Acupuncture was used to treat 10 cases of coma due to myxedema (coma due to hypothyroidism). The patient was laid down on a flat surface to keep the respiratory tract unobstructed, and acupuncture treatment was applied on the following acupoints: Ren Zhong (Du 26), Zhong Chong (P 9), He Gu (LI 4), Zu San Li (St 36), and relevant otopoints (Shen Men (H 7), those related to the heart, brain, etc.). At the same time, the patients were treated with hormones, vitamin C, potassium chloride, thyroxin, and other medicine. After coma had been alleviated, the patients were further treated with Huang Qi Jian Zhong Tang. The results: all patients responded well to the treatment and all significantly improved.(23)

Acupuncture was used to treat 14 cases of hypothyroidism in patients recovering from serious brain injuries. Scalp acupuncture was applied at both the front slant (from Qian Ting (Du 21) to Xuan Li (GB 6)) and the rear slant of the temple (from Bai Hui (Du 20) to Qu Bin (GB 7)) on the side where intracranial hemorrhage occurred. For postoperation patients, acupuncture was applied at both the front and rear slants of the temple (from Qian Ting (Du 21) to Bai Hui (Du 20) and from Feng Fu (Du 16) to Ya Man (Du 15)) on the unoperated side. The needles were retained for an hour after insertion. In addition, body acupuncture was applied on Jian Yu (LI 15), Qu Chi (LI 11), Nei Guan (P 6) and He Gu (LI 4) in the upper limbs, and on Huan Tiao (GB 30), Zu San Li (St 36), Cheng Shan (UB 57) and San Yin Jiao (Sp 6) in the lower limbs. The uniform reinforcing-reducing method was in maneuvering the needles, and the needles were retained for 30 minutes. One course of treatment consisted of 15 sessions. The results: the thyroid function improved in all patients; in particular, T4, FT 4 (P<0.01), and rT3 (P<0.05) all significantly improved, so much so they were not significantly different from those of healthy people (P<0.05).(24)

Moxibustion treatment
Herb power-mediated moxibustion was used to treat 7 cases of hypothyroidism. Warming and kidney yang-reinforcing herbs were ground into fine powder and applied on Shen Shu (B23), Pi Shu (B20), and Ming Men (Du 4) as moxibustion medium. Three to five moxas were applied per acupoint in each session. Three sessions were conducted each week, and one course of treatment lasted four months. The results: 3 cases had the condition under control, 2 cases improved, and the remaining 2 cases did not respond to the treatment.(
25)

Traditional Chinese Medicine
Extensive information regarding the treatment of this health condition using Traditional Chinese Medicine is available through the link above.
Clinical Lab Assessments
Some of the following laboratory testing can provide information necessary for diagnosis and treatment. In addition, the tests listed may also give insight to functional metabolism and functional nutrient status in the body.
Proper assessment of thyroid function involves substantially more laboratory testing than is generally performed and interpretation of laboratory values appears to be inadequate to diagnose and manage what may be a virtual epidemic of thyroid disease in the USA.(26)
Deficiencies or imbalances in amino acids can indicate fundamental reasons for numerous disorders. Tyrosine, particularly, is necessary in reactions that occur in the citric acid cycle (CAC) and in neurotransmitter synthesis as well as peripheral conversion of T4 to T3.(27) Amino acid malabsorption syndrome or imbalanced amino patterns reflect abnormal organ and glandular processes that have critical bearing on optimal function.
The evaluation of essential and/or toxic elements can be of use in the evaluation of many clinical conditions. Essential mineral imbalances can affect nearly any tissue and organ resulting in a myriad of disorders. Trace element deficiencies can disproportionately affect enzyme systems that are used in regulatory substrates, resulting in amplified disease conditions. Numerous elements, especially iodine, directly or indirectly affect thyroid function.(28),(29) , Toxic elements can be particularly damaging as a result of toxicity responses and inhibition of essential nutrient-dependent mechanisms.
Clinical Notes
Glandular Extracts

Extracts derived from bovine, procine, or sheep have been used for generations by healers from a wide variety of cultures. The ingestion of gland materials was said to strengthen the corresponding organs or glands within the human body.

Glandular extracts are used for health maintenance, rejuvenation, and conditional support to organ-specific conditions. Glandular extracts consist of peptides, proteins, fatty acids, and traces of hormones, as well as signal or messenger substances. These constituents are thought to contribute to the physiologic effects of the substances. Some active peptides have been identified within various glands; however, it will take years to identify all of the various peptides that have beneficial effects. Isolating single fractions contained in these agents may negate the purpose of providing organ-specific nutrition. They can be thought of as concentrated food sources, supplying certain nutrients to support organ-specific function.

Thyroid extracts support thyroid functions and help regulate metabolic activities. These products may provide a mild increase in energy and stamina.(30)

Most recently, reactivity to foods has been implicated in thyroid dysfunction. Various labs offer food intolerance screenings. In addition, if this proves true in an individual, assessment of the status of nutrient exchange in the gut should be considered. In addition, a great deal of research is now being oriented at stress and its effects on the neuroendocrine response. Elevated cortisol or long-term adrenal exhaustion can contribute to down regulation of thyroid activity.

Other clues to investigate include heavy metal or halogen toxicity (toxic inhibitor for thyroid receptors).

 

 

 

 
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