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Wednesday, 1 December 2010

Hashimoto’s disease and its TCM treatment

Tiejun Tang

Hashimoto’s disease is a thyroiditis caused by an autoimmune reaction. This disease was first described by a Japanese doctor called Hashimoto when he was practising in Germany in 1912. The average incidence of this disease is 1-1.5 in 1000. The incidence of women is 15-20 times more than in men. It occurs more frequently in the age group of 30 to 50, but may also be seen at other times.

In some cases, no symptoms may be seen at early stage, but in most cases, symptoms are similar to those of hypothyroidism. Common symptoms include: fatigue, unexpected weight gain, aversion to cold, muscle aches, cramps, tenderness or stiffness, joint pain or swelling, pale skin and puffy face, hoarse voice, constipation, depression, visibly enlarged thyroid.

It is not very clear what triggers this autoimmune disorder. Factors such as iodine, medications, infection, smoking and possibly stress may be involved. If you want to prevent Hashimoto’s disease or stop it developing, you should try to avoid these possible causes.

In Western medicine, this is usually being treated with levothyroxine. This hormone replacement therapy can only partially recover thyroid functions but not regulate the immune system in general. It cannot reduce the level of antithyroid antibody. Patients need to take medicine all their life. For some cases with a large goitre, they may even need surgical operation. After operation they still need to take thyroxine.

In Chinese medicine, it is believed that this disease is due to Qi stagnation, blood stasis and phlegm accumulation in the neck. It falls within the category of Ying Liu (瘿瘤) in the classic text of Chinese medicine. In China, we usually treat this disease with integrated traditional Chinese medicine and western medicine. I believe that the operation and iodine radioactive therapy will accelerate the process of hypothyroidism. Instead, we can use Chinese herbs to remove the liver qi stagnation and blood stasis. We can expel phlegm and soften the goitre by Chinese herbs. I usually use Chaihu (Bupleuri Radix), Chenpi (Pericarpium Citri Reticulatae), Xiangfu (Cyperus rotundus) for qi stagnation; Chishao (Radix Platycodi), Danshen (Savia miltiorrhiza) and Danggui (Angelica sinensis) for blood stasis; Banxia (pinellia tuberifera tenore), Houpo (Magnolia officinalis Rehd.), Zhebeimu (Fritillaria thunbergii Miq) and Dannanxing (Arisaema Cum Bile) for phlegm accumulation. In the past two decades, there were some different opinions about applying herbs which contain iodine such as Haizao (Sargassum), Kunbu (ThallusLaminariae) and Huangyaozi (Rhizoma Dioscoreae Bulbiferae). Some people believed that this kind of herbs will cause Wolff–Chaikoff effect which is harmful to the thyroid. Some people believed that herbs with iodine content are different from iodine preparation. I think it is still safe to use these herbs for some thyroid diseases with small doses administered for a short time, especially for cases with low iodine. I believe that Chinese herbs have many advantages in treating Hashimoto’s disease and it is good for improving symptoms and reducing side effects of western medicine.

This disease needs proper treatment once it is diagnosed. There are reports of patients with Hashimoto's thyroiditis being three times more likely to have thyroid cancer. (Larson SD. 2007).
To conclude, integrated traditional Chinese medicine and western medicine is always better than any single therapy.

Reference:
Larson SD, Jackson LN, Riall TS, et al (2007) Increased incidence of well-differentiated thyroid cancer associated with Hashimoto thyroiditis and the role of the PI3k/Akt pathway. J Am Coll Surg. 204 (5):764-73.

10 comments:

  1. natural remedies are always my choice.Just remember always that a healthy diet is important.

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  2. Hi Dr Tang,

    As a non-Chinese speaking student of TCM, I just wanted to express a very big thank you for freely sharing your clinical knowledge and expertise and writing about such interesting topics. Here, access to such knowledge tends to be fairly limited, unless you have a very big bank balance to afford to attend the seminars of visiting scholars!
    Thanks again and Cheers from Down Under :)

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  3. Nice review. Now, where's the beef?
    Have you treated this or seen it treated by Chinese medicine? What were the results?

    As a practitioner myself, I know it's easy enough to grind out boiler plate patterns of differential diagnosis. But I'm interested in what actually works. Case histories!

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  4. Actually it is the fact that TCM uses Iodine combined with the research of Drs. Abrahams, Brownstein, and Flechas that got me to believe conventional medicine in the U.S was wrong about Iodine. It seems to be a lack of Iodine combined with interference from other halogens such as Bromine, that cause many cases of Hashimoto's. You can refer to Dr. Brownstein's books or review other research as this site:

    http://www.optimox.com/pics/Iodine/opt_Research_I.shtml

    Doctors are always fast to point out people who have had a bad reaction to Iodine. However, I have yet to see they provide a sample of someone who had a bad reaction and first supported the antioxidant status of the Thyroid so it can properly manage H2O2 production in the oxidation and organification of iodide. If done properly then 50mg if Iodine and Iodide per day is fine for someone with Hashimoto's. Want an example? Here it is:

    Diagnosis of Hashimoto's in July 2010:

    TPO(Ab)= 253 uIU/mL TAb = 838 uIU/mL

    Synthroid started at 100 ucg/day

    March 2012 started antioxidant support:

    200 ucg to 300 ucg per day of selenium as a mix of L-Selenocysteine, L-Selenomethionine, Se-methylselenocystine.

    Vit C 500 mg three times a day minimum.

    Vitamin E 200 IU two to three times a week minimum.

    Vitamin B-Complex.

    Vitamin D

    Krill Oil

    Cal/Mag Citrate with extra Mag.

    Then after about 3 to 4 weeks on that started low dose of Iodine/Iodide Lugol's or Iodoral. Actually started with Kelp because it was hard to lower the dose enough at first with Lugol's. Over a period of about a month this was increased to 50mg of Iodine/Iodide. In this case the protocol was not done every day. Rather it was done from between 3 and 7 days per week on average.

    June 2012 Thyroid Labs:

    TPO(Ab) = 148 uIU/mL TAb = 442 uIU/mL Also T4 was high and Synthroid was lowered to 88 ucg per day.

    December 2012 added Thorne MERIVA-500 and Thorne M.F. Bromelain to the protocol. Two capsules of each per day 3 to 7 days per week on average.

    February 2013 Thyroid labs:

    TPO(Ab) = 59uIC/mL TAb = 225 uIU/mL and T4 is high again. Synthroid dose is due to be lowered again.

    If a drug company could patent Iodine and Iodide the medical system in the united states would be very different and the people a lot more healthy. Instead, most grade school janitors know as much about how Iodine and Iodide works in the body as most Medical Doctors in the United States. Way? Because drug companies largely control what medical doctors learn. I have tested it and seen it work on many things Dr. Abraham talks about. Blood sugar, blood pressure, acid reflux, female reproductive organs.

    Yet most MDs fear it due to the idiotic research of Wolff and Chaikoff. If the human race is lucky, one of these centuries, if not sooner, people will look back and see our attitude toward Iodine as being as dumb as the use of lead pipes was during the days of the Roman Empire.

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  5. Typo correction:

    TPO(Ab) = 59 uIU/mL TAb = 225 uIU/mL and T4 is high again. Synthroid dose is due to be lowered again.

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