Thyroid
dysfunction is epidemic in North America. One in ten adult American
women have been diagnosed with thyroid disorders and some endocrinologists
suggest that as many as 25% of adult American women are presenting with
clinically detectable thyroid dysfunction. Health practitioners in Canada,
Saudi Arabia, and Ireland (pers. comm) report a similar apparent very
startling increase in female thyroid disorders. Most veterinarians in
small animal practice are seeing thyroid problems in cats and dogs balloon
up to 40% of their respective practices (cats tend to be hyperthyroid
and dogs tend to be hypothyroid; the proportional dosage for pets seems
to be much higher for thyroid hormone treatments.) What has happened?
ARE
PRACTITIONERS FINALLY BECOMING MORE AWARE OF THE MANY FACETS OF THYROID
DYSFUNCTION PRESENTATIONS? Or, has something happened in the environment
which is responsible for the apparent great increase in clinical and
subclinical thyroid dysfunction? In clinical practice I am somewhat
incredulous at the recent rapid increase in patients (90% female) presenting
with both diagnosed and probable thyroid dysfunction (1995-2001). Just
for a reality check, I went back to my old (1967) Robbins' Pathology
to see if he had anything to say about frequency of thyroid presentations.
He did: "Diseases of the thyroid, while not common in clinical
practice, are nonetheless of great importance because most are amenable
to medical or surgical management."
"NOT
COMMON IN CLINICAL PRACTICE"!!! Either people, practitioners,
or the environment have changed, singly or perhaps in concert. I do
not believe that Robbins was joking. His so hopeful prognosis for thyroid
case management might bring bitter responses from the millions of women
who have experienced surgical or radiation ablation removal of their
thyroids only to have many or most of their presenting symptoms and
others return with a vengeance. The patient help phone lines at the
Thyroid Foundation of America are flooded with thousands of calls from
women wondering "how come I feel awful again?" Too often their
endocrinologists dismiss their valid complaints as imagination or psychological
character flaws. These mostly female patients are being very poorly
managed from my viewpoint. Currently, TFA endocrinologists are actively
trying to improve this situation. (pers. comm from L. Wood to RD.)
Worldwide,
thyroid dysfunction is a probable risk factor for 1 to 1.5 BILLION people
(WHO figures) usually considered due to simple iodine deficiency and
presenting as goiter (at least 200 million), complex mental retardation
from fetal and neonate iodine deficiency (iodine deficiency causes more
mental retardation worldwide than all other causes combined), and physical
deformities (at least 20 million). The two main thyroid gland hormones
are T4 (65% iodine) and T3 (59% iodine); calcitonin does not contain
iodine.
The American
thyroid dysfunction picture does not seem so simple: rather than just
simple iodine deficiency, it is the thyroid gland itself which seems
to be failing. The claim has been made for almost 80 years that North
Americans are getting plenty of dietary iodine due to the ubiquitous
use of iodized salt. Braverman and others have even been suggesting
that Americans are getting too much iodine and that increases in the
incidence of autoimmune thyroid disease, namely Hashimoto's Hypothyroiditis
and Graves' disease (hyperthyroidism) parallel increased dietary iodine
intake. So that our high iodine intake, especially during the years
1940-1990, may be responsible for the thyroid dysfunction plague currently
presenting. Recent surveys of food and alleged diets now indicate that
the American diet may be borderline deficient in iodine intake, down
from 5-800ug in l980 to about 135ug in 1995. The truth is difficult
to ascertain about any of these numbers since no real people with real
diets were followed very carefully by measuring iodine intake using
precise analyses of iodine content in all food ingested per individual
in the study population with concomitant precise measurement of urinary
iodine for all urine secreted per 24 hours, for a few years; so, the
authors merely fiddled and fudged and extrapolated until they had fallen
prey to all of the traps of the SWAG syndrome. They just sort of guessed
and pretended to be precise and then whined a lot about it at the expense
of a lot of trees and tax dollars.
Until about
a year ago when I began to seriously read the materials and method sections
of the original research papers on dietary iodine consumption, I truly
believed all of the assumptions and conclusions. After reading the only
paper (a British effort) which actually analyzed iodine content of a
few foods and then extrapolated the rest, I learned that everyone else
was just guesstimating with assumed academic authority. Too bad, it
was such a great riff. For almost 60 years, the main dietary sources
of iodine were not from iodized salt, but from flour products and dairy
products. Iodates were/are used as dough conditioners; they improve
the cross-linking in gluten molecules; they also act as mild antiseptics
and mold retardants. The widely-varying amounts of iodine in dairy products
result from the use of copious amounts of iodine disinfectants used
as teat dips in all commercial machine-milking dairy factories (hardly
farms in either the traditional or realistic sense). The iodine solutions
drip into the milk instead of large quantities of topical microbes.
Furthermore, most dairy factories wash their stainless steel equipment
with strong iodine solutions for sterilization. Do you ever wonder why
you get a little hyperactive from eating cheese or drinking lots of
milk? Iodized salt was not purchased by some Americans because it was
a little more expensive, and plain salt was usually available nearby
often on the same shelf. People still continue to get obvious low-iodine
goiters even though the academics claim it is virtually impossible.
The situation is much improved from the 1915-1919 years when the number
one cause of recruit rejection for military service was overt goiter.
Low dietary iodine is associated with increased rates and risk for breast,
endometrial, and ovarian cancer; the cause is probably gonadotropin
stimulation with a resulting hyperestrogenic state characterized by
relatively high production of estrogen and estradiol.
Now, I
mention all of this because I personally believe that situational iodine
deficiency regularly occurs in modern Americans as a result of both
dietary peculiarities and the chronic use of fluoridated, chlorinated,
bromated water supplies, internally and externally. Fluorine, chlorine,
and bromine are all more chemically reactive than iodine; when in the
body, they all tend to disrupt stable iodine molecules, displacing the
iodine and causing its excretion. When experimental rats (many dietary
experiments are performed using volunteer incarcerates) are fed high-bromine
diets, the bromine enters their respective thyroid glands and replaces
the iodine already there; the proportion of bromine in the thyroid glands
of those rats is directly proportional to the amount of bromine in their
diet. We get bromine from pesticides, dough conditioners, and from disinfectants
for water in hot tubs and commercial spas. So, not only can we avoid
eating iodized salt, we also can lose iodine from aggressive halides;
our bodies have no known mechanisms for dealing with relatively large
amounts of fluorides, chlorine, bromine, since these substances are
normally too reactive to be available in the so-called natural environment;
our exposure is totally modern. Gaseous chlorine is regularly released
from shower and tub water freshly drawn from water supply taps. I recommend
showering with the window open; I recommend bathing in tubs filled with
the hottest water and allowed to out-gas while they cool to bearable
temperature. Reduce your exposure to iodine-robbing halides for optimal
thyroid health. Aspirin and other related salicylates as well as anticoagulants
like Warfarin (di-coumerol) increase iodine excretion and can induce
mild hypothyroidism; always inquire of mild hypothyroid patients about
aspirin and anticoagulant use.
Where does
iodine come from? It is mined in Oklahoma, Chile and Japan from subterranean
brine deposits. How can we best get it into our diets and our bodies?
No land plants are a good reliable source of iodine. Garlic grown near
the sea often has relatively high amounts of biological iodine. Another
peculiar phenomenon, biologically speaking, is the curious stuff called
"snack foods". These are extended shelf life products that
cater to the most basic food desires of the economically-deprived: greasy
salty fried carbohydrates with lots of spoilage retardants and mystery
ingredients euphemistically called "spices and other flavorings".
The world's largest snack food supplier, Frito-Lay, a division of PepsiCo,
does not use iodized salt; presumably neither do any of the other snack
food manufacturers, in part to reduce actual product production costs,
but, also, with a wise eye to sloppy industrial mixing of potassium
iodide in huge multi-ton batches of sodium chloride which has resulted
in occasional pockets of nearly pure potassium iodide. Since both potassium
and iodine are potentially deadly, this is a great potential source
of ghastly liability. The hazard from Potassium poisoning is probably
greater than from iodine; cardiac failure. Iodine would result in renal
collapse. Usually excess iodine is simply excreted in the urine. Relatively
huge amounts of iodine salts are used to serve as contrasting agents
for radiography in the intestinal tract, up to 10 grams at once. (And
these are the people that whine about eating a little kelp.) So, if
your dietary sources of salt are largely from commercial foods, you
might be iodine deficient. Iodized salt is approximately 0.01% potassium
iodide; one teaspoon of iodized salt provides about 150ug of iodine,
about the real daily adult requirement given 70-80ug intestinal uptake.
For my
patients, I prescribe daily dietary dosages of 3-5 grams of a good powdered
kelp which should provide enough iodine and most of the essential trace
elements (4 grams of powdered seaweed per day is 1 ounce per week, is
3 and 1/4 pounds of seaweed per year.) Any seaweed contains more available
dietary iodine than any landplant. The seaweeds with the most available
iodine are the giant kelps of the northern hemisphere, with the highest
concentrations of iodine occurring in the most northern kelps (8000
ppm in Icelandic kelp, 4000 ppm in Norwegian kelp, 1-2000 ppm in Maine
and California kelp; the seaweeds with the least amounts of iodine are
Nori, about 15ppm, and Sargassum, about 30-40 ppm). Besides garlic,
root crops, vegetables such as turnips, carrots, potatoes, parsnips,
sweet potatoes, and chocolate (actually, the iodine in chocolate probably
originates as teat dip and transfers into the milk of milk chocolate).
The amounts of iodine in land plants can be greatly increased by fertilizing
food plants with seaweeds applied directly to the soil as topical mulch
or tilled into the soil. I do not know if foliar sprays containing seaweed
extracts provide iodine which is taken into edible plant parts.
There is
one more terrible problem: the atomic age. Since 1945 every human has
been repeatedly dusted with radioactive fallout from both acknowledged
and unacknowledged nuclear explosions, nuclear power plant disasters,
and most insidious of all, the regular, continual, intentional release
of radioactive Iodine 131 from all nuclear weapons facilities and all
nuclear power plants just with so-called normal operations. In addition
to this, the government-sponsored nuclear industry regularly released
enormous quantities of radioactive Iodine, cesium, and strontium into
the atmosphere just to see what might happen. Eastman Kodak was forewarned
so they would not lose photoemulsion film to radioactive fogging. Families
downwind of Hanford reservation in Washington were not warned. For nearly
5 years a 100,000 page report prepared by the National Institutes of
Cancer, was suppressed until forced out of hiding by the efforts of
some senators and congressmen, most notably Senator Tom Harkin of Iowa.
The report shows total disregard for American citizens and military.
Hundreds of thousands of delayed thyroid pathologies are the long-term
heritage of this inexcusable outrage. I BELIEVE CONTINUAL AND REGULAR
EXPOSURE TO INCIDENTAL IODINE 131 IS THE ORIGIN OF MOST CURRENT THYROID
DISORDERS. The prescribed treatment would be cultural and political
maturation. Seaweeds alone are not enough.
It takes
about 18 minutes for all the blood in the body to pass through the thyroid
gland; it is the most thoroughly vascularized of all the endocrine glands.
Most of our respective bodies are iodine conservative: we can absorb
it through our skin in minutes when painted on; I have had participants
demonstrate transdermal movement of iodine absorbed from clothing thru
the skin. Iodine is easily absorbed from the intestines in efficiencies
up to 98% in very low-iodine diets. The radioactive Iodine we are all
breathing and eating is released in bursts as a product of nuclear fission
usually within legally allowable amounts; these allowed amounts are
calculated on a per day basis rather than as high-amount bursts or episodes.
This helps perpetuate the myth that the allowable releases are no health
hazard. Wrong. The episodic rather than regular release of iodine-131
means we get big hits and then none at all, especially in milk and milk
products. The reason that iodine-131 is so dangerous is that it has
a relatively short half-life of about 8 days; this means it has a radiogenic
life of about 60 days, and then the amount remaining is probably biologically
insignificant. Although this short half life is touted as a great thing
for patients, and incidental accumulators of iodine-131, the short half-life
means that most iodine-131 taken into the body will decay in the body
rather than being excreted. Rather than occurring over a relatively
long time, the short half-life means a lot of radioactive decay of iodine-131
within the thyroid gland, releasing unavoidably molecular-destructive
gamma radiation to nearby cell molecules. There is no safe dosage of
gamma radiation inside cells. Therapeutically, iodine-131 is fed to
patients to fry their thyroids with gamma radiation, released by radioactive
decay of iodine-131; the patient handout claims that this is a totally
safe procedure with no possible health hazards; on the other side of
the handout patients are severely warned to not nurse their babies for
5 weeks, not to hold children and other loved ones close, to not share
towels for a month or more. So much for totally safe! Our bodies tend
to be iodine aggressive in absorption and iodine conservative in excretion.
If we are at all iodine deficient, we will readily take in radioactive
iodine-131 and deposit it in our thyroid glands just as we do with non-radioactive
iodine-127. If we have a full, ongoing whole-body complement of iodine-127,
our bodies tend to not take up any iodine-131. This means that eating
seaweeds regularly in the diet, especially the big northern kelps, will
provide both dietary iodine and protection against the ongoing iodine-131
hazards and the next unplanned nuclear disaster. The major health problems
from the Chernobyl nuclear disaster on or about 26, April 1986 are all
related to the huge and deliberately underreported releases of radioactive
iodine-131 into the atmosphere and onto the soils, surface waters, plants,
animals, and cities within 1000 miles of the Chernobyl site. Within
five years, large increases in thyroid disorders of all sorts began
to occur, directly attributable to Chernobyl iodine-131 releases. The
worst is still developing since we know that the cancer rates from short
term radiation exposure tend to peak 20-30 years after a particular
release episode. The simplest protection against nuclear fallout is
to simply dismantle all nuclear facilities immediately. Without that,
we are all continually at risk for thyroid dysfunction. Our next best
protection against thyroid disruption is to body-load with iodine contained
in iodine-rich whole raw seaweeds as regular daily consumption. If our
bodies have an ongoing full complement of iodine-127, we can better
resist taking in incidental iodine-131.
There are
a few more little bits to the iodine part of the story: After the thyroid
gland, the distal portions of the human mammary glands are the heaviest
users/concentrators of iodine in tissue. Iodine is readily incorporated
into the tissues surrounding the mammary nipples and is essential for
the maintenance of healthy functioning breast tissue. I suspect that
this is ignored in the attempts to understand the developmental dynamics
of breast cancer; I believe that radioactive decay of iodine-131 in
breast tissue is a significant factor in the initiation and progression
of both breast cancer and some types of breast nodules. Iodine also
concentrates in the salivary glands and gonads. Salivary gland cancer,
and testicular cancer (especially in men over 25, a relatively recent
phenomenon) and ovarian cancer are all increasing in actual numbers.
I suspect that radioactive iodine-131 decay may be a significant contributing
factor.
The
largest of the endocrine glands, the one-half to one ounce thyroid gland
is almost twice as large in women on average, than in men. Its overt
function seems to be to manufacture, store, and release under strict
controls, thyroid hormones, mostly thyroxin, T4, and T3, tri-iodothyronine,
in about a 4:1 ration. In very low iodine intake situations, that T4:T3
ratio is reversed to 1:4. This rather comfortable view of the mechanistic
thyroid is incomplete: to quote Robbins (Pathology, 1967) further, "from
the physiologic standpoint, the thyroid gland is one of the most sensitive
organs in the body. It responds to many stimuli and IS IN A CONSTANT
STATE OF ADAPTATION.... During puberty, pregnancy, and PHYSIOLOGIC STRESS
FROM ANY SOURCE, THE THYROID GLAND INCREASES IN SIZE AND BECOMES MORE
ACTIVE FUNCTIONALLY. Changes in size and activity may be observed during
a normal menstrual cycle. This extreme functional changeability is manifest
as transient hyperplasia of thyroidal epithelium (follicular cells)
changing (to tall, columnar). When stress abates, involution obtains
and normal follicular cell shape (roughly spherical) and function resume".
Instead of just a passive hormone factory, the thyroid gland overtly
changes size, shape and function to reflect the changing reality of
its particular person. Patients and workshop participants regularly
provide real anecdotal evidence (I usually give more credence to a person's
evaluation of their own experience than I do to the numbers coming out
of dead machines; remembering that all information is technically anecdotal,
all machines are innately unreliable, data are usually massaged, and
scientists are no less biased and prone to lying than the general population)
about the apparent frequent overmedication with thyroid hormone replacement
medications: namely, that they stopped taking their thyroid medications
when they started to feel worse after several months or years, and they
not only felt better, but their symptoms never returned. The joyful
cynic can reasonably claim that the thyroid replacement hormone medication(s)
worked. Sometimes yes and sometimes no, is my evaluation of the situation.
I believe that brief thyroid hormone replacement therapy may be life-saving
and or life-modulating; but, I also think that the increasing reliance
on TSH tests and the aggressive attempts to normalize the thyroid gland
and its functions of a particular patient may mask the greater need
which is to understand what is the gain to the patient from a change
in thyroid function. The other point often just dismissed now, is the
full frontal location of the thyroid gland, with no bony protection
on the anterior side unless head drop occurs. When I see the same patients
over several years, modest changes in their respective thyroid size
and sometimes shape are often evident, and resolve with no overt intervention.
Unresolvable or otherwise overwhelming life situation stress often seems
to be if not an initiating factor, at least an accompanying reality
for benign thyroid enlargement. I am not yet clear from physiologic
studies if nonpathological increased thyroid size is always accompanied
by an increase in thyroid hormone production or release, or not. One
interesting point is that impact trauma can apparently squeeze a burst
of thyroid hormone out of the gland with a concomitant transient hyperthyroidism
episode; this means a physical hit, or a compression squeeze from poorly
placed shoulder belts in automobiles where the vehicle has been hit
or has hit something and a whiplash event occurs. So, mechanical stress
can also affect the thyroid gland. Many endocrine changes occur in anorexia
nervosa, including low levels of T4 and T3.
I further
believe that the situational low thyroid presentations (hypothyroidism)
which seem to be initiated by a known life trauma, particularly loss
of a loved one or similar grief-inducing events, are completely normal
thyroid responses and very desirable components of the grief response
and should not be treated unless acute (life-threatening), or persisting
for more than one year. I believe that it is a failing of the cultural
terrain that we do not honor and savor the natural grief response, with
the personal consequence that many of us suffer from chronic secondary
grief over the loss of therapeutic grieving and that this secondary
grief is a major factor in the current plague of hypothyroidism.
Other tissues
in the body, particularly the liver. can greatly influence the accessibility
of T4 to body cells; for T4 to be physiologically active, it must first
be converted to T3. This conversion is accomplished primarily by 5-deiodinase
in the liver. Of intriguing interest, this particular enzyme requires
selenium as its cationic enzymatic cofactor. This means that chronic
selenium deficiency can present as hypothyroidism due to reduced T4
to T3 conversion. The thyroid test for TSH and T4 will not reveal this
and unnecessary thyroid medication may be prescribed. In an associated
consideration, mercury in the body tends to quell or cripple selenium
in enzymes. This means that chronic or even possible acute mercury poisoning
can present as hypothyroidism. We all have steadily increasing body
burdens of mercury from both our foods and water. A test for selenium
and mercury is always indicated in cases of obvious hypothyroid signs
and symptoms with normal range TSH and T4.
Recently
I have read that isoflavones, such as genistein and equol, are inhibitors
of thyroid peroxidase, the thyroid follicle enzyme which makes T4 and
T3. This inhibition may generate goiters, hypothyroidism, and autoimmune
thyroiditis. Since isoflavones are being touted as cancer preventatives,
especially for breast and prostate cancers, their addition to non-soya
foods may be a potential thyroid disaster. Isoflavones already available
in soya foods may depress thyroid function through TPO inhibition.
Another
almost bizarre phenomenon is the RT3 situation. RT3 is also called reverse
T3. It is not reversed at all but instead is produced when the 5-iodine
on the interior benzene ring is removed by 5-deiodinase, instead of
the 5-iodine on the exterior site. RT3 is nearly inert and especially
so as a thyroid hormone. It has an extremely short half life in the
body of a few hours; it is rapidly excreted via the liver. In our bodies
normally, T4 converts to T3 at about 40% and to RT3 at about 45%. This
is most curious in an otherwise innately metabolically conservative
biological system. The RT3 mechanism is a way of regulating T3 and reducing
the likelihood of incipient hyperthyroidism, whilst maintaining the
capacity to boost T3 production as a situation may demand The body can
also decrease T3 production on demand: fasting, acute trauma, chronic
illness, and grief all tend to increase RT3 production and decrease
T3 production. A decrease in T3 tends to mean a slower metabolism, less
appetite, slower protein replacement and much less energy on demand
for spontaneous kinetics. A relatively high RT3 and low T3 is often
accompanied by a relatively low body temperature (less than 97.5 degrees
F) as measured in the axillaries before rising in the morning; this
low armpit temperature reading (one assumes carefully calibrated and
accurate mercury thermometers only being used) is often used as a simple
test for hypothyroidism, since body temperature is tightly controlled
by metabolic rate and that metabolic rate, the rate at which fuel is
converted to heat and kinetics is controlled by T3. A shortage of T3
means lower body temperature and possibly death if prolonged. The relatively
high production of RT3 compared to T3 is sometimes referred to as Wilson's
Syndrome, and is clinically treated with T3 until a normal body temperature
is "captured" and maintained. There is not yet a positive
consensus about either the efficacy or desirability of T3 therapy. I
tend to think it is indicated in life-threatening situations and maybe
in other cases. I believe that temporary low body resting temperature
and accompanying low T3 may indicate physiological grieving and/or the
need to slow down, get quiet, meditate, rest, regroup one's life resources,
and correct faulty attitudes or behaviours to more health-positive ones.
In the trauma response, low T3 and high RT3 function to keep the body
still and unavoidably calm to slow or prevent further trauma thru activity.
I think that up to a year of prolonged low T3 and or low T4 production
might be a genetically programmed requirement for health renewal in
a long-lived primate such as ourselves (remember that chimpanzees have
lived well past 65 years in captivity) so that we can remain healthy
for up to 120 years.
There is
a sad note to the increasing clinical thyroid plague: between 2 and
8 million North Americans (the exact numbers will never be known due
to poor record-keeping) were deliberately medically treated with X-rays
to the head and chest, foolishly and oftimes frivolously for a wide
range of presenting conditions. These conditions included: scalp ringworm,
asthma, chronic bronchitis, tonsillitis, acne, and neonate respiratory
problems. The thyroid glands of the respective patients received pathologically
significant amounts of powerful ionizing radiation. These treatments
(occurring between 1930 and 1980) have caused over 10,000 of cases of
thyroid cancers which develop 10-40 YEARS after the medical exposures
with a peak incidence between 20-30 years after the episodes. and as
much as a million cases of other thyroid structural deformities including
nodular goiters (at least 27% of all children and adolescents irradiated).
Who was punished for this gross instance of medical malpractice? By
the 1930's the connection between cancer and radium exposure was known.
The endocrinologists are relatively mum about responsibility for these
poor trusting victims, more than the total number of victims wounded
by the two atom bombs dropped on Japan in 1945.
If you
have a person born before 1980 (most will be over 30 years old since
the practice of sloppy upper body and head irradiation was largely discontinued
by 1970 but persisted in some remote clinics and offices for up to another
decade.), who presents with nodular goiter or thyroid cancer, be sure
and inquire about juvenile radiation exposure. Treatment prognosis is
mixed with thyroidectomy usually recommended with subsequent lifelong
obligatory thyroid replacement therapy.
SEAWEED
THYROID TREATMENTS
The complexity
of many presenting thyroid dysfunction cases precludes a simple set
of all-purpose formulas. Each one of my thyroid patients has a personally
unique thyroid presentation. I try to compose an individualized functional
treatment plan for each, using a few basic methods. Diet and behaviour
modification also are very important in thyroid case management. What
follows are some of my treatment approaches and some general guidelines
and notes:
1. Rather
uncomplicated seaweed therapy seems to help relieve many of the presenting
symptoms of thyroid dysfunction. Some of the results are very likely
from whole body remineralization (especially potassium, zinc, calcium,
magnesium, manganese, chromium, selenium, vanadium etc.) in addition
to thyroid gland aid from both sustained regular reliable dietary sources
of biomolecular iodine and from thyroxin-like molecules present in marine
algae, both the large edible seaweeds and their almost ubiquitous epiphytic
microalgae, predominantly the silica-walled diatoms. Seaweeds provide
ample supplies of most of the essential trace elements required for
adequate enzyme functioning throughout the body but especially in the
liver and endocrine glands.
2. Regular
biomolecular seaweed iodine consumption is more than just thyroid food:
it can also protect the thyroid gland from potential resident iodine-131-induced
molecular disruption and cell death when the thyroid gland is fully
iodized with iodine-127. The fear of eating seaweed which might be contaminated
with iodine-131 is easily mitigated by allowing the seaweed to be stored
for 50 days prior to dietary consumption; this will give enough time
for most (99%) of any Iodine-131 to radioactively decay. A simple folk
test for iodine deficiency or at least aggressive iodine uptake, is
to paint a 2 inch diameter round patch of USP Tincture of Iodine (strong
or mild) on a soft skin area such as the inner upper arm, the inside
of the elbow, the inner thigh, or the lateral abdomen between the lowest
rib and the top of the hip. If you are iodine deficient, the patch will
disappear in less than two hours, sometimes as quickly as 20 minutes;
if it fades in 2-4 hours, you may just be momentarily iodine needy.
If it persists for more than 4 hours, your are probably iodine sufficient.
Iodine deficiency seems to predispose to thyroid malignancy; this could
explain the apparent thyroid cancer distribution "fans" downwind
of nuclear facilities in previous goiter belt areas. This test is of
course easier to use with Caucasians and may not offer sufficient color
contrast in brown-skinned people.
3. Many
patients with underactive thyroid glands complain of a sense of "coldness"
or feeling cold all of the time; often they are over-dressed for warmth
by thyronormal people's standards. They may also present a low basal
body resting temperature, as measured by taking their armpit temperature
before rising in the morning (remember to shake down the thermometer
the night before). Other symptoms may include sluggishness, gradual
weight gain, and mild depression. For these patients, add 5-10 grams
of several different whole seaweeds to the daily diet; that is, 5-10
grams total weight per day, NOT 5-10 grams of each seaweed. I usually
suggest a mix of 2 parts brown algae (all kelps, Fucus, Sargassum, Hijiki)
to one part red seaweed (Dulse, Nori, Irish moss, Gracillaria). The
mixed seaweeds can be eaten in soups, salads; or, easily powdered and
sprinkled onto or into any food. I recommend doing this for at least
60 days, about two lunar cycles or at least two menstrual cycles; watch
for any changes in signs and symptoms and any change in average daily
basal temperature. (Please note that patients can have a normal 98.6
degree F temperature and still feel cold, and, also present many of
the signs and symptoms of functional hypothyroidism). Please do not
insist that all hypothyroid patients must have abnormally low basal
resting temperatures. If no symptoms improve or the temperature remains
low (less than 97.5 degrees F), continue seaweeds and request a TSH
and T4 test. If TSH and T4 tests indicate low circulating thyroxin levels,
continue seaweeds for another two months. It may take the thyroid that
long to positively respond to continual regular presentation of adequate
dietary iodine. Powdered whole seaweed may be much more effective than
flakes, pieces, or granules. The powdered seaweed is best added to food
immediately prior to eating; do not cook the seaweed for best results.
All corticosteroids
tend to depress thyroid function. Before trying to fix the thyroid,
be sure and aggressively inquire about both internal and topical steroid
use, including Prednisone and topical creams. These as well as salicylates
and anticoagulants can aggravate existing mild hypothyroidism.
4. Partial
thyroidectomy cases can be helped by regular continual dietary consumption
of 3-5 grams of whole seaweeds 3-4 times a week. By "whole seaweed"
I mean: untreated raw dried seaweed, in pieces or powder, not reconstructed
flakes or granules.
5. Patients
with thyroid glands on thyroid replacement hormone (animal or synthetic)
can respond favorably to carefully and slowly replacing part or all
of their entire extrinsic hormone requirement by adding dietary Fucus
in 3-5 gram daily doses. Fucus spp. has been the thyroid folk remedy
of choice for at least 5000 years. The best candidates are women who
seek a less hazardous treatment than synthetic hormone (after reading
variously that prolonged use of synthetic thyroid hormone increases
risk for heart disease, osteoporosis, and adverse interactions with
many prescribed drugs, particularly corticosteroids and antidepressants).
Fucus
spp. contain di-iodotyrosine (iodogogoric acid) or DIT. Two DIT molecules
are coupled in the follicular lumina of the thyroid gland by a condensing
esterification reaction organized by thyroid peroxidase (TPO). This
means that Fucus provides easy-to use-prefabricated thyroxine(T4) halves
for a boost to weary thyroid glands, almost as good as T4. European
thalassotherapists claim that hot Fucus seaweed baths in seawater provide
transdermal iodine; perhaps hot Fucus baths also provide transdermal
DIT?
The best
results with Fucus therapy are obtained with women who were diagnosed
with sluggish thyroid glands and who are or were on low or minimal maintenance
replacement hormone dosages and who may gleefully remark that they miss,
forget, or avoid taking their thyroid medication for several days with
no obvious negative short-term sequelae; others claim to have just stopped
taking their medication. I do not recommend stopping thyroid medication
totally at once: Thyroxin is essential for human life (and all animal
life); it has a long half-life in the body of a week or more so that
a false impression of non-dependency can obtain for up to two months
before severe or even acute hypothyroidism can manifest, potentially
fatal.
Even though
I personally do not recommend it, women regularly just stop taking their
thyroid replacement hormone, even after years of regularly and faithfully
taking their medication. In many cases their respective thyroid glands
resume thyroxine production after a 2-3month lag time with many of the
signs and symptoms of hypothyroidism presenting while their thyroid
glands move out of inactivity. IT IS IMPERATIVE TO UNDERSTAND THAT THIS
COMPLETE CESSATION OF TAKING THYROID REPLACEMENT CAN ONLY BE SUCCESSFUL
IN PATIENTS WHO HAVE A POTENTIALLY FUNCTIONING THYROID GLAND. Those
who have had surgical or radiation removal of their respective thyroid
glands must take thyroid hormone medication containing thyroxine to
stay alive.
Fucus can
be easily added to the diet as small pieces, powdered Fucus in capsules,
or freeze-dried powder in capsules. Sources of Fucus in capsules are
listed under Seaweed Sources at the end of this essay. The actual Fucus
is much more effective than extracts. A nice note is that Fucus spp
are the most abundant intertidal brown seaweeds in the northern hemisphere.
This is of especial interest to those patients who might be trading
one dependency for another, as seems to be the case for some. (A year's
supply can be gathered in an hour or less and easily dried in a food
dehydrator or in hot sun for 10-12 hours and then in a food dehydrator
until completely crunchy dry. Fucus dries down about 6 to one: six pounds
of wet Fucus dry down to about one pound. It has a modest storage life
of 8-12 months in completely airtight containers stored in the dark
at 50 degrees F. A year's supply at 4 grams/day is slightly more than
three pounds dry). Encapsulated Fucus is available from Naturespirit
Herbs, Oregon's Wild Harvest, and Eclectic Institute.
6. Aggressive
attempts to replace thyroid replacement hormone with Fucus involve halving
the dose of medication each week for four weeks while adding 3-5 grams
of dried Fucus to the diet daily from the beginning and continuing indefinitely.
If low thyroid symptoms appear, return to lowest thyroid hormone maintenance
level and try skipping medication every other day for a week, then for
every other two days, then three days, etc. The intent is to establish
the lowest possible maintenance dosage by patient self-evaluation and/or
to determine if replacement hormones can be eliminated when the patient
ingests a regular reliable supply of both biomolecular iodine and DIT.
Thoughtful, careful patient self-monitoring is essential for successful
treatment.
7. A more
conservative replacement schedule is similar to the aggressive approach
except that the time intervals are one month instead of one week, and
the Fucus addition is in one gram increments, beginning with one gram
of Fucus the first month of attempting to halve the replacement hormone
dosage, and increasing the amount of Fucus by a gram each succeeding
month to 5 grams per day. The conservative schedule is urged with anxious
patients and primary caregivers.
There is
some literature concern (a bit quite shrill and clumsily documented)
that excess (undefined) kelp (species either unknown or not mentioned)
consumption can/may induce hypothyroidism. It seems possible. The likely
explanation is an individual's extreme sensitivity to dietary Iodine;
Icelandic Kelp (a Laminaria sp.) can contain up to 8000ppm Iodine; Norwegian
kelp can contain up to 4000ppm Iodine. Most "kelps" contain
500-1500 ppm Iodine. Nori has about 15 ppm Iodine.
The only
definitive study I have seen reports from Hokkaido, Japan, where study
subjects at about an 8-10% rate of total study participants, presented
with iodine-induced goiter from the consumption of large amounts of
one or more Laminaria species (Kombu) of large kelps, known to be rich
(more than 1000ppm) in available iodine. Reduction of both total dietary
iodine and/or dietary Kombu led to complete remission of all goiters.
The apparent iodine-induced goiters did not affect normal thyroid functioning
in any participants. Two women in the study did not care if they had
goiters and refused to reduce their Kombu intake. Note that the Japanese
have the world's highest known dietary intakes of both sea vegetables
and iodine.
I think
the reduction or elimination of seaweeds from the diet is indicated
for at least a month in cases of both hyperthyroidism and hypothyroidism,
to ascertain if excess dietary iodine is a contributing factor to a
disease condition. Other dietary iodine sources, particularly dairy
and flour products should also be reduced and or eliminated during the
same time period. Some individuals do seem to be very dietarily iodine-extraction
efficient and iodine sensitive simultaneously.
BRIEF
CASE HISTORY OF A THYROID NODULE
A 35 year old female patient (two children) presented with a rapidly
growing thyroid nodule which seemed to arise with no overt cause. The
nodule was not firm but cystic. Once it had stabilized, a fine needle
aspirant sample was collected; the cyst was apparently totally benign
. Synthetic thyroid hormone was suggested to promote the nodule's shrinkage.
The patient refused. Almost four years after the nodule stabilized the
woman began taking 3-5 grams/day of powdered Fucus and Nereocystis kelp,
mixed. After six months, the nodule had completely disappeared. The
woman continues to take some maintenance dosages several times a week.
OTHER
HERBAL THYROID TREATMENTS
GRAVES'
DISEASE: HYPERTHYROIDISM
Unlike Hashimoto's hypothyroiditis, Graves' disease seems very amenable
to successful herbal intervention and control. The three main herbs
used are: Melissa officinalis (lemon balm), Lycopus virginiana (bugleweed)
and Leonuris cardiaca(motherwort) in descending order of strength and
apparent thyrosuppressive efficacy.
MELISSA
in particular, when delivered in measured doses as tincture, tea, or
less exactly, freshly extracted juice from a "wheatgrass juicer"
stops TSH from binding to its thyroid receptor sites, slows or even
quells the uptake of iodine by the active transport sites on thyroid
cell surfaces, suppresses the iodination of tyrosine residues in the
follicular lumina by TPO, and appears to also impede stored thyroid
hormone release from the thyroid gland. The results can be especially
rewarding (see following case history). My personal preference is to
have hyperthyroid patients grow and harvest their own Melissa, and also
to prepare their own medicine. Melissa grows abundantly in all except
xeric habitats with sufficient water and a little shade. It will overwinter
in pots. The freshly expressed juice can be frozen. I do not know if
freeze-dried Melissa products are effective.
A critical
point for herbal treatment of Graves' is the active and aware participation
of the patient in monitoring both symptoms and their respective body
responses to herbal treatment. Melissa has a fine reputation as a calming
herb and it may be that the calming action is not as a nervine, but
as a very effective thyrosuppressant. I do not have data on the proportions
of T4:T3, or T3 :RT3 in Melissa treatment of Graves'. The possibility
of potential overmedication with Melissa, a temporary hypothyroidism,
exists, but, I have no known cases to report.
LYCOPUS,
apparently both American species and the European one, are effective
in slowing down TSH adherence to its rightful cell surface receptors
and the uptake of iodine by thyroid cells. It does not seem as quick
as Melissa.
Ruth Dreier,
one of my former apprentices, reported in the 1994 Journal of the Northeast
Herbal Association about her long and arduous but eventually successful
efforts to slow and stop progressive Graves' using tea, tincture (found
only one from GAIA HERBS), and fresh plant material of Lycopus virginiana.
She found the tea and tincture to be more effective than the fresh plant
material, which suggests to me that some type of molecular cleavage
or rearrangement is necessary for effective use of Lycopus as a thyrosuppressive.
She also used severe dietary restrictions and careful self-monitoring
of her symptoms, using the tincture as a sort of quick fix medication.
I do not
have direct experience with LEONURIS as a thyrosuppressive. Some
of its purported almost narcotic effects as a somnambulant may be due
to thyrosuppressive activity.
I usually
recommend small (1-2 grams) daily dosages of Fucus in hyperthyroidism
since some dietary iodine is needed for basic body functions.
A cautionary
note: Persons with undiagnosed Graves' disease may become hyperthyroid
from absorption of increased dietary or topical iodine.
Contemporary
British Columbia coastal natives drink a strong tea (decoction ) of
DEVIL'S CLUB (Oplopanax horridum)
root and stem bark to allegedly cure hyperthyroidism (see: Turner ,
N, as ref. in Three Herbs). I do not know the dosages or the duration
of the treatment. I predict that a correlation exists between Devil's
Club's type II diabetes remediation and its successful thyrosuppression.
The post-consumption Devil's Club lethargy may be thyrosuppression at
the TRH hypothalamic level rather than direct action on the thyroid
gland.
A BRIEF
CASE HISTORY OF GRAVES' DISEASE
A 47 yr old female was diagnosed with Graves' disease based on blood
tests ordered by an endocrinologist she had been referred to by her
family doctor. She was first alerted to the likelihood of thyroid dysfunction
by her usual pedicurist who noted the recently greatly-thickened skin
on her feet. The patient also presented feeling hot all of the time,
increased sweating, heat intolerance, insomnia, huge appetite, hyperactivity,
fatigue, heart palpitations, manual tremor, and eye irritation, all
Graves' hyperthyroid symptoms. Her tests were TSH < 0.03 (normal
range is 0.5-3.5) and T4 224 (normal range 65-165). A family health
and emotional crisis generated acute worry and anxiety.
The endocrinologist
offered her three therapeutic choices: Surgical Thyroid gland removal,
Use of thyrosuppressive drugs, or Radioactive iodine burning of the
thyroid gland out of existence. None of these were acceptable so she
went to see a Naturopath-acupuncturist and began taking tinctures of
Bugleweed, Siberian Ginseng, Motherwort, Melissa, and a bit later, Hawthorn
in addition to acupuncture treatments. In 5 months her T4 had declined
a bit to 198, but her TSH remained essentially nothing at <0.03.
She started a homeopathic constitutional remedy (Pulsatilla 30 ). A
few weeks later I recommended she begin taking a green drink of freshly
blended Lemon Balm (Melissa officinalis) in daily doses of 2-3 liquid
ounces with food in addition to her tinctures and homeopathic remedy.
In three months her T4 was 50% lower at 113, but her TSH was still<0..03.
She continued the treatment plan for another 5 months until her THS
and T4 were in the normal range. She stopped all herbs and the homeopathic
remedy, and her endocrinologist declared her cured. WITHOUT THYROIDECTOMY
BY EITHER SURGERY, RADIOACTIVE ABLATION, OR STRONG ANTITHYROID DRUGS.
(There is a significant risk increase for women who use thyrosuppressive
drugs for hip fracture).
A few more
notes:
Maude Grieve in her extensive section on Nettles, discusses somewhat
cryptically, the use of powdered nettle seeds as a treatment for goiter
. No easy access to corroborating references or a case history. (which
was not her task). I know of only one anecdotal report where a young
woman claimed to have cured her goiter with nettle seeds. May bear investigating.
It was not at all clear as to what type(s) of goiter were treated.
Hypothyroidism
does not respond to any particular herbs that I know of, in either a
hopeful or remedial manner. Seaweed therapy with a strong fresh green
vegetable diet, particularly chickweed, dandelion, parsley, spinach,
and beet greens. seems to be the best. Brassicas are probably best kept
to a minimum because of their known goitrogenic activity.
Further
dietary comments: I usually recommend reduction to little or none, flour
products in an effort to reduce erratic iodine intake and to reduce
bromine intake as well as reduce the hyperglycemia that often accompanies
the eating of flour products and simple sugars (also recommended to
totally eliminate except in fresh fruit). All non-organic meat and meat
products are contraindicated since xenoestrogens can disrupt thyroid
function just as intrinsic estrogens generated by the patient's body.
I usually suggest elimination of all dairy products except unsalted
organic butter to further reduce exposure to growth hormones and iodine
and unwanted tetracycline residues. I usually recommend eating avocados,
organic eggs, and sardines to provide quality fats to keep that bile
flowing and wasted thyroid hormones moving out of the liver.
DIETARY
BLOOD AND BLOOD PRODUCTS
All blood will contain some thyroid binding globulin-bound thyroid hormone.
The consumption of red meat will always provide small but significant
sources of extrinsic thyroid hormone and at the least, some dietary
iodine. In areas of endemic goiter (continental Eurasia) blood products
such as blood sausage were regularly consumed. The blood from slaughtered
animals was carefully caught when the animals were bled. Blood pudding
and blood sausages are still regularly served in traditional Irish Breakfasts
and are regularly available in meat shops throughout Great Britain and
the European Union countries as well as in eastern Europe. Blood pudding
and blood sausage are folk treatments for fatigue and sluggishness.
I assume that T4 is the active constituent after iron.
In his
privately-published memoir, Of Desert Plants and Peoples, Sam
Hicks writes about the use of fresh deer blood by indigenous peoples
in the Sonoran Desert to treat what reads like hypothyroidism. The dosages
were about a pint or more of fresh deer blood biweekly or monthly. Just
about right for time-release T4. For meat-eating patients, I definitely
prescribe bloody organic meat and organic blood sausage; or, blood can
be caught from home-grown and slaughtered animals known to have no growth
hormones or pesticide exposure, for hypothyroid.
BIBLIOGRAPHY
AND SEA VEGETABLE SOURCES
Arem,
Ridha, The Thyroid Solution, 1999.
Barnes,B.& Galton, L., Hypothyroidism: The Unsuspected Illness,
1976.
Bergner,P., The Healing Power of Minerals, 1997.
Budd,M. Why Am I So Tired? 2000. Thorsons
Colburn T., Dumanoski, D., and Myers, J. , Our Stolen Future
1996
Ditkoff, B. and Lo Gerfo, P., The Thyroid Guide 2000
Grieve, Mrs. M. A Modern Herbal.v.2,1931 (1971 Dover Reprint)
p.578
Greenspan, F.S. & Strewler, F.J., Basic and Clinical Endocrinology,
1997.
Hamburger,J., The Thyroid Gland, Suite 303, 29877 Telegraph Rd.,
Southfield, MI 48034.
National Women's Health Report 22:#5.Oct. 2000. Thyroid Disorders
and Women's Health 1-877-986-9472
Oschman, J. L., ENERGY MEDICINE: The Scientific Basis, 2000
Pert, C., The Molecules of Emotion, 1997
Pert, C, Dreher, X.,& Ruff, M., "The Psychosomatic Network: Foundations
of Mind-Body Medicine", Alternative Therapies 4(4): 30-41, 1998.
Robbins, S. Pathology, 1967
Rosenthal, S., The Thyroid Sourcebook, 1996.
Schecter, S., Fighting Radiation and Chemical Pollutants, 1997.
Shannon, S., Diet for the Atomic Age, 1993.
Shomon, M. Living Well With Hypothyroidism. 2000. Avon
Surks, Martin. The Thyroid Book. 1999. Self-published.
thyroidnews@onelist.com Online thyroid resources
Wichtl,M. & Bissett, H.G., Herbal Drugs & Pharmaceuticals,
1994.pp 329-332.
Wilson, Dennis, A Doctor's Manual for Wilson's Syndrome, 1995.
1-800-621-7006
Wood, L. C., Cooper, D.S., & Ridgway, E.C., Your Thyroid,1995.
The best easy to read thyroid book. Doctor-biased and patronizing.
SEA
VEGATABLE SOURCES:
-
Ryan
Drum, Waldron Island, WA 98297
-
Maine
Coast Sea Vegetables. 3 Georges Pond Road. Franklin, ME 04634 207-565-2907
-
Maine
Seaweed Co. P.O. Box 57, Steuben, ME 0468
-
Mendocino
Sea Vegetable Co., PO Box 1265, Mendocino, CA 95460
-
Naturespirit
Herbs, PO Box 150, Williams, OR 97544 541-846-7995.
A good source of clean seaweeds and encapsulated powdered
Fucus and a blend of 5 powdered seaweeds: 3 browns and
2 reds
-
Oregon's
Wild Harvest 1-800-316-6869. Dried powdered Fucus in
capsules
THYROID
PATIENT SUPPORT ORGANIZATIONS:
-
American
Foundation of Thyroid Patients(281) 855-6608. 18534 N. Lyford, Katy,
TX 77449
-
American
Thyroid Assoc. (904) 353-7878. www.thyroid.org Email: admin@thyroid.org
-
National
Graves' Disease Foundation. (704) 877-5251. 2 Tsitsi Ct., Brevard,
NC 28712
-
Thyroid
Cancer Survivor's Assoc. (877) 588-7904; POB 1545, NY, NY 10159-1545
-
Thyroid
Foundation of America. (800) 832-8321. 410 Stuart St. Boston, MA
02116-2698
*The Proceedings
are available from: GAIA HERBAL Research Foundation. 1-800-831-7780
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