Managing Hyperthyroidism

At 30 years old, one would not expect a major medical condition, but this young woman came to the clinic because she had been to her local GP, who had diagnosed her condition as hyperthyroidism, having carried out a series of blood tests and a thyroid scan that proved positive.

She initially went to her doctor when she became concerned because her anxiety levels had suddenly increased, her heart was racing, she was having trouble sleeping and she felt like her whole system had speeded up. She was becoming increasingly irritable and restless, was very fatigued and was losing weight. Her menstrual cycles had also become more irregular over the last few months for no apparent reason.

She had been taking thiamazole for several months; initially it was only given to her to try and reduce the thyroid overactivity, but this hadn’t happened (it can take several weeks to notice an effect) and she was given the options of either this medication for life or major surgery to remove the thyroid (and thus thyroxine) for life.

Hyperthyroidism is difficult to treat from a naturopathic perspective, and there is also the added risk of cardiovascular complications. However, we agreed to do so because she had only been diagnosed in the last few months and had predisposing conditions such as diet, lifestyle and major stress factors. I insisted that she be monitored by her GP regularly and, with her GP’s permission, to monitor her progress while utilising alternatives, in case cardiovascular symptoms increased.

With further testing, we determined that she did not have the autoimmune Graves disease, but the treatment options would have been very similar.

Initially it was important to check vitamin D levels; at 60 nanograms per millilitre (ng/mL), while still within the in normal range, it is on the lower end of this range. There is a strong relationship between low vitamin D and thyroid disease. So we supplemented her diet with vitamin D3 and vitamin K2 spray — vitamin K also helps protect the heart. I also recommended urinary iodine as well as tests for liver function and homocysteine levels.

She was experiencing digestive symptoms such as nausea, diarrhoea and bloating and her diet needed improving. She was largely eating processed foods such as pizza, pasta and packaged meals, had a sweet tooth and loved coffee, drinking several cups per day, all of which were potentially contributing to her condition.

My initial advice was to change her diet and eat foods to lower her thyroid function, such as soy foods, which also reduce absorption of thyroid medication. Cruciferous vegetables such as broccoli and cabbage also reduce thyroid hormone production, although they do not have as much of an effect if well cooked.

Coffee is stimulating and should be avoided. It can lead to increased heart rate and irritability. Caffeine also blocks absorption of thyroid medications.

Diet

The diet I suggested consisted of plenty of fruits and vegetables, particularly leafy greens including brassicas, unsalted nuts and nut butters, oats, olive oil, cold-water fish, lentils, all non-GMO soy foods except soy milk, tofu, soy sauce etc as these often have iodine added. I recommended iron-rich food as there is a link with low iron and hyperthyroidism: red meat, poultry, red and purple vegetables, red cabbage, eggplant and blueberries. I also recommended thyroid-balancing herbs such as turmeric with black pepper and green chillies.

Selenium-rich foods are also important for the conversion of the T3 thyroid hormone to T4, so we added mushrooms (left in the sun for a few hours before eating to increase the vitamin D levels), sunflower seeds and Brazil nuts.

As a low iodine diet is important, she needed to avoid iodised salt, all processed foods, seaweeds and excess seafoods, along with dairy and gluten as this can cause thyroid inflammation.

Supplements

I recommended were selenium and zinc in animal foods, as nuts and seeds need to be sprouted before the zinc becomes bioavailable, and antioxidants are critical. I suggested probiotics such as coconut kefir mixed with slippery elm to reduce the diarrhoea and improve the gut microbiome.

In hyperthyroidism, the metabolism of the body is sped up so there is greater need for nutrients, so we included magnesium for calming and vitamin A.

I also prescribed her a herbal mix consisting of bugle weed, motherwort, hawthorn and lemon balm to reduce the overactivity of her thyroid and support her heart and cardiovascular function. We added ashwagandha (withania) to help manage adrenal function and her stress levels and to help her sleep.

Returning a couple of months later, she had stopped her medication and changed her diet; she had been quite dedicated in following the program and was feeling better. She was being checked regularly by her GP and, to the GP’s surprise, her thyroid levels had dropped considerably and her thyroid function was almost too low, so we changed the herb mix by reducing the thyroid herbs for another month. After this time, thyroid function had swung around again, indicating there was some trigger we had missed.

On further questioning, I found that she had had significant dental work in the couple of months prior to the initiation of her symptoms, so I suggested a hair analysis. Surprisingly, her mercury levels were high.

Six months later she returned, her fillings removed. She was still following the diet but was eating less of the anti-thyroid foods and had included more small deep-sea fish with lower mercury. To our delight her thyroid function had totally stabilised; she was on no medication or herbal medicines but was continuing the supplements, particularly the mercury detoxification supplements. In hindsight the mercury and her strong sensitivity to it had been a major factor in her thyroid instability — there is research on the relationship between thyroid dysfunction and heavy metal toxicity. She and her GP were very happy.

This article is featured in WellBeing 206