Traditional Chinese Medicine for thyroid health

By Melissa Carr, BSc, DrTCM

Photo by Freepik

The thyroid might not have always commanded the attention and seriousness it deserves. As a small gland, only about two inches across, it appears both in shape and placement somewhat like a dapper bowtie.

Traditional Chinese Medicine (TCM) did not specifically mention this organ through its decades of literature. But they did document its patterns of imbalance and offer methods of treatment through acupuncture, herbs, food, and lifestyle recommendations.  We now comprehend the vital importance of a healthy thyroid.

Assessing Thyroid Dysfunctions with TCM

One of the foundational concepts for a TCM assessment is Yin and Yang. The opposing but complementary forces offer a way to perform part of a differential diagnosis. Yin incorporates signs of cold, slowing, and passiveness, while Yang includes symptoms of heat, racing, and activeness.

Thus, in the case of hyperthyroidism causing an accelerated metabolism, feelings of or sensitivity to heat, increased appetite, weight loss, trembling hands, palpitations, hyperactivity, irritability, and anxiety, are signs of a deficiency of the calming activity of Yin. Hypothyroidism, conversely, demonstrates a deficiency of the stimulating activity of Yang, resulting in a slowed metabolism, feelings of or sensitivity to cold, decreased appetite, weight gain, slowed heart rate, impaired circulation, depression, and impaired memory.

In addition, because the thyroid gland affects a variety of body functions, including heart rate, respiratory rate, weight regulation, growth, muscle strength, body temperature, fertility, digestion, and mental state, TCM focuses on identifying where the patterns of imbalance are most deeply rooted.

Diagnosing and Treating Hypothyroidism Using TCM

Hypothyroidism is predominantly a Yang deficiency disorder. Because of constitutional inherited traits, overexertion, ongoing stress, trauma, chronic illness, or poor diet, the body may not have enough Qi, loosely translated as energy, in one or more TCM organs, particularly the Spleen, Kidneys, and/or Heart. When these organs’ functions are impaired, the body can’t sufficiently drive Yang Qi, resulting in a compromised ability to warm the body, move Qi and fluids, and transform nutrients into usable resources.

Early on, when the disease is subclinical, Spleen Qi deficiency is a common diagnosis. Spleen Qi deficiency is most marked by fatigue (physical or mental), poor appetite, bloating, and impaired digestion. Because of insufficient Qi to this organ, Spleen Yang can also become depleted, resulting in the patient feeling cold and having water retention, weight gain, and poorer digestion. If the Kidneys’ Yang Qi becomes depleted, symptoms of sore lower back, edema, low libido, and infertility can occur, and this pattern may also be associated with adrenal burnout. Then, if not treated, the Heart’s Yang Qi can become depleted, causing cardiac dysfunction.

It’s clear then, that treating Spleen Qi deficiency—a very common pattern—is important, particularly when it is paired with mildly elevated TSH levels, weight gain, hair loss, brain fog, and a tendency to feeling cold. While most of my patients with Spleen Qi deficiency also have other patterns of imbalance, to address this portion of the diagnosis, I may choose a formula like Si Jun Zi Tang, Bu Zhong Yi Qi Tang, or Shen Ling Bai Zhu San, depending on their other symptoms and patterns.

If Kidney Yang deficiency is at play, a TCM herbal formula such as Jin Gui Shen Qi Wan or You Gui Wan might be useful.

It’s worth noting that because Yin and Yang are in continuous flux—an ebb and flow that occurs naturally between the two states—it’s not simply a matter of prescribing herbs or acupuncture points that are only Yang in nature in the event of an underactive thyroid, though that is likely part of the treatment plan. This probably comes as no surprise to those who’ve experienced the palpitations and anxiety that can arise when put on too high a dose of synthetic thyroid medications to treat hypothyroidism.

The TCM herbal formula, Jin Gui Shen Qi Wan, for example, though classified as a Kidney Yang tonic, contains, as the base, the formula Liu Wei Di Huang Wan, a classic mix of herbs used to strengthen the Yin of the Kidneys and Liver. In in this case, to strengthen Yang, the seed of Yin is nourished.

Nutritionally, foods that are easy to digest are recommended. Because there is a deficiency of Yang’s warming energy, cooked soups, stews, slow cooked meals, roasted or steamed vegetables, and warming foods and spices like cardamom, ginger, and cinnamon are emphasized.

Diagnosing and Treating Hyperthyroidism Using TCM

Hyperthyroidism is most often caused by a deficiency of Yin, but it results in excess symptoms, like Fire uprising and Qi and Phlegm accumulation. Like hypothyroidism, one of hyperthyroidism’s main symptoms is fatigue, though it may also be paired with a feeling of hyperactivity, jitters, and palpitations as well because it is caused by a lack of Yin’s calming nature. It’s thus important to treat both the deficiencies (cause) and excesses (symptoms).

Many of the same reasons as for hypothyroidism can instead lead to hyperthyroidism. Ongoing stress or trauma for example, can cause energy to become depleted, but it can also cause Liver Qi stagnation, especially if it is associated with feelings of anger or frustration. When stuck for a while, Liver Qi stagnation can lead to Liver Fire Uprising, resulting in feelings of heat, easily sweating, irritability, an increased appetite, and palpitations. Prolonged excess Fire further consumes Yin’s nourishing properties, resulting in insomnia, anxiety, and tremors. The combination of stagnation of Qi and consumption of fluids by Fire results in Phlegm stagnation, symptomatic as an enlarged thyroid, a feeling of oppression in the chest, and what TCM calls “plum pit Qi,” a feeling as if swallowing around a plum pit stuck in the throat.

Early on, catching signs of Liver Qi stagnation that causes feelings of irritability, menstrual cycle irregularities, premenstrual syndrome, frequent sighing, and abdominal pain or cramping, especially when paired with Yin deficiency Heat signs like dry mouth and night sweats, can help slow or stop the progression into greater imbalance. TCM formulas like Yi Guan Jian, Chai Hu Shu Gan San, or Zhi Zi Qing Gan Tang may be combined with other formulas to suit the individual. This last formula may be particularly helpful if there is already an enlarged thyroid.

Adding on adrenal issues and signs of Heat might suggest the inclusion of a Kidney Yin-deficiency Heat formula like Zhi Bai Di Huang Wan (a more cooling variation of the aforementioned formula Liu Wei Di Huang Wan). If insomnia, and anxiety are prominent, Tian Wang Bu Xin Dan is a good option to include.

Because hyperthyroidism is, at root, caused by a deficiency of Yin energy, Yin nourishing foods like barley, millet, root vegetables, fish, tofu, dark leafy greens, zucchini, cucumber, water chestnut, watermelon, berries, pears, eggs, coconut milk, sesame seeds, flax seeds, and walnuts. Cooling and calming herbs like mint, dill, chamomile, and basil can also help.

Balance is Key

TCM is about customization to an individual’s current pattern and constitutional tendencies toward imbalance. While hypothyroidism is partly caused by Yang deficiency and hyperthyroidism is in part Yin deficiency, both diseases can be provoked by overwork, overexertion, chronic stress, lack of sleep, and poor dietary choices. As such, moderation is key and emphasized in TCM lifestyle recommendations.

Editor’s note: Organ names are capitalized when they describe the Traditional Chinese Medicine definition of the organ system as a whole, not just the physical organ.

References

Malikov, D. 2017. Traditional Chinese Medicine Approach to Hypothyroidism. International Journal of Complementary & Alternative Medicine. https://medcraveonline.com/IJCAM/IJCAM-05-00142.php