CLINICAL APPLICATIONS

* Hypothyroidism: with fatigue, lack of energy, dull facial expression, hoarse voice, drooping eyelids, puffy and swollen eyes and face, weight gain, constipation, aversion to cold, dry hair and skin, low body temperature, decreased heart rate and blood pressure, muscle weakness or sluggishness, and other related symptoms

* Chronic thyroiditis or Hashimoto’s thyroiditis

 

WESTERN THERAPEUTIC ACTIONS

* Regulates and restores the endocrine system

* Stimulates the production of thyroid hormones

* Increases basal metabolism and enhances energy levels

* Improves physiological functions

 

CHINESE THERAPEUTIC ACTIONS

* Tonify Kidney, Heart, and Spleen yang

* Nourish Liver and Kidney yin

* Tonify qi

 

DOSAGE

Take 4 capsules three times daily on an empty stomach. However, the dosage may need to be adjusted based on age, body weight, severity of condition, and response to the treatment.

 

INGREDIENTS

Fu Ling (Poria)

Fu Zi (Radix Aconiti Lateralis Praeparata)

Gou Qi Zi (Fructus Lycii)

Gui Ban (Plastrum Testudinis)

Hai Zao (Sargassum)

Kun Bu (Thallus Eckloniae)

Lu Jiao (Cornu Cervi)

Mu Dan Pi (Cortex Moutan)

Ren Shen (Radix et Rhizoma Ginseng)

Rou Gui (Cortex Cinnamomi)

Shan Yao (Rhizoma Dioscoreae)

Shan Zhu Yu (Fructus Corni)

Shu Di Huang (Radix Rehmanniae Praeparata)

Ze Xie (Rhizoma Alismatis)

 

BACKGROUND

Hypothyroidism is thyroid hormone deficiency with clinical manifestations such as fatigue, lack of energy, dull facial expression, forgetfulness, hoarse voice, drooping eyelids, puffy and swollen eyes and face, weight gain, constipation, cold intolerance, dry hair and skin, low body temperature, decreased heart rate and blood pressure, and muscle weakness or sluggishness. Hypothyroidism may occur at any age but is most common among the elderly. Hypothyroidism may be caused by autoimmune disorder (Hashimoto’s thyroiditis), iodine deficiency, drugs (i.e., lithium, amiodarone, interferon-α), radiation, or hormone imbalance [i.e., insufficient production of thyrotropin-releasing hormone (TRH) or thyroid-stimulating hormone (TSH)]. Optimal management requires treatment of the cause and the symptoms.

 

FORMULA EXPLANATION

According to traditional Chinese medicine, hypothyroidism is a condition characterized by yang deficiency. While the fundamental etiology is Kidney yang deficiency, complications may involve yin deficiency of the Kidney and yang deficiencies of the Spleen and Heart. Treatment, therefore, must address both yang and yin deficiencies of the organs involved.

        Rou Gui (Cortex Cinnamomi) and Fu Zi (Radix Aconiti Lateralis Praeparata) are two of the strongest and most commonly used herbs to fortify the yang of Kidney, Heart, and Spleen, the three organs implicated in patients with hypothyroidism. In addition, Rou Gui (Cortex Cinnamomi) treats insufficient ming men (life gate) fire, a condition characterized by accelerated aging. Fu Zi (Radix Aconiti Lateralis Praeparata) tonifies and restores depleted yang, a condition characterized by lower basal metabolism and compromised physiological functions. The combination of these two herbs has an excellent synergistic function to tonify yang and treat the underlying cause of hypothyroidism. Lu Jiao (Cornu Cervi) and Gui Ban (Plastrum Testudinis) are excellent herbs to tonify Kidney yang, Kidney yin, and Kidney jing (essence), and they are safe and effective when used at a large dose or for a long period of time.

        Hai Zao (Sargassum) and Kun Bu (Thallus Eckloniae) dispel phlegm and soften nodules. In other words, they have great effect to reduce the hypertrophy and enlargement of the thyroid glands. In addition, these two herbs are rich in iodine and will stimulate the production of thyroid hormone, especially in cases of hypothyroidism due to lack of iodine in the diet.

        Shu Di Huang (Radix Rehmanniae Praeparata), Shan Zhu Yu (Fructus Corni), Shan Yao (Rhizoma Dioscoreae), Ze Xie (Rhizoma Alismatis), Mu Dan Pi (Cortex Moutan), and Fu Ling (Poria) compose the classic Kidney yin tonic formula Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia), one of the most famous herbal tonics. Shu Di Huang (Radix Rehmanniae Praeparata) tonifies the Kidney yin and the Kidney jing (essence); Shan Zhu Yu (Fructus Corni) nourishes the Liver and prevents the leakage of Kidney jing (essence); and Shan Yao (Rhizoma Dioscoreae) tonifies the Spleen and stabilizes the Kidney jing (essence). Ze Xie (Rhizoma Alismatis) clears deficiency fire from the Kidney; Mu Dan Pi (Cortex Moutan) sedates Liver fire; and Fu Ling (Poria) dissolves dampness from the Spleen. These six herbs are formulated with careful checks and balances to maximize the therapeutic effects and minimize unwanted side effects. Furthermore, Gou Qi Zi (Fructus Lycii) is used to tonify Liver and Kidney yin. In addition to treating the underlying cause of the illness, Ren Shen (Radix et Rhizoma Ginseng) tonifies qi and immediately raises the energy level of hypothyroid patients.

        In conclusion, Thyro-forte is an excellent formula that tonifies Kidney, Heart, and Spleen yang and treats hypothyroidism.

 

CAUTIONS & CONTRAINDICATIONS

* This formula is contraindicated during pregnancy and nursing.

* Patients who wear a pacemaker, or individuals who take antiarrhythmic drugs [i.e., Tambocor (flecainide) and Procanbid (procainamide)] or cardiac glycosides [i.e., Lanoxin (digoxin)], should not take this formula. Fu Zi (Radix Aconiti Lateralis Praeparata) may interact with these drugs by affecting the rhythm and potentiating the contractile strength of the heart.[1]

* The etiology of Hashimoto’s thyroiditis is excessive autoimmunity causing destruction of the thyroid gland and reducing production of thyroid hormone. Therefore, during the acute inflammatory phase of the disease when the immune system is activated by the presence of pathogens, qi tonics that boost the immune system, such as Ren Shen (Radix et Rhizoma Ginseng), should be used with caution as this herb may further stimulate the immune system. During this acute inflammatory phase, Nourish may be a more suitable formula as it contains herbs that nourish yin to support the thyroid gland, and herbs that clear deficiency heat to reduce inflammation.

 

CLINICAL NOTES

* Patients with hypothyroidism usually notice improvement within one month, starting with increased energy and elevated body temperature. Stabilization and maximum effect may not be observed until the individual has been ingesting the herbs for two months or longer.

* Patients with hypothyroidism can be treated with drugs, herbs, or both. However, if both drugs and herbs are used, it is important to monitor the patient's condition frequently to ensure proper control of the signs and symptoms. Over-dosage with drugs and/or herbs may cause hyperthyroid-like signs and symptoms, and under-dosage may contribute to hypothyroid-like signs and symptoms.

* Progress of hypothyroid treatment can be monitored by checking the body temperature, heart rate, and blood pressure. It is best to check these parameters first thing in the morning to avoid fluctuations.

* It is important to be aware that long-term use of thyroid supplements (such as levothyroxine) has been associated with loss of as much as 13% of bone mass. Therefore, patients who have been or are currently using thyroid supplements should take calcium supplements to replenish the loss of bone mass.

Pulse Diagnosis by Dr. Jimmy Wei-Yen Chang:

* Deep, stagnating, sluggish pulse with low amplitude, but forceful upon pressure.

SUPPLEMENTARY FORMULAS

* For an immediate energy boost, add Vibrant.

* For edema and water accumulation, add Herbal DRX.

* To tonify Kidney yang, add Kidney Tonic (Yang).

* To tonify Kidney yin, add Kidney Tonic (Yin).

* For long-term increase in energy, add Imperial Tonic.

* For constipation, add Gentle Lax (Deficient).

* For dry hair and skin, add Polygonum 14.

* For lack of libido in men or women, add Vitality.

* For adrenal insufficiency, use with Adrenal +.

* To strengthen constitutional weakness and deficiency, add Cordyceps 3.

* For poor appetite or loose stool, add GI Tonic.

 

ACUPUNCTURE TREATMENT

Traditional Points:

* Pishu (BL 20), Shenshu (BL 23), Zusanli (ST 36), Guanyuan (CV 4), Qihai (CV 6)

* Apply moxa to Shenshu (BL 23), Guanyuan (CV 4) and Zusanli (ST 36).

 

Classic Master Tung's Points:

* Sanzhong (T 77.07), Tongguan (T 88.01), Simashang (T 88.18), Simazhong (T 88.17), Simaxia (T 88.19), Tongshan (T 88.02)

 

Master Tung’s Points by Dr. Chuan-Min Wang:

* Hypothyroid: Tianhuang (T 77.17), Dihuang (T 77.19), Renhuang (T 77.21)

 

Balance Method by Dr. Richard Tan:

* Left side: Shaohai (HT 3), Shenmen (HT 7), Taixi (KI 3), Yingu (KI 10)

* Right side: Zhongzhu (TH 3), Tianjing (TH 10), Yanglingquan (GB 34), Zulinqi (GB 41)

* Left and right sides can be alternated from treatment to treatment.

 

Auricular Medicine by Dr. Li-Chun Huang:

* Hypothyroidism: Thyroid, Pituitary, Exciting Point, Thalamus, Endocrine, Gonadotropin, Sanjiao, Kidney, Liver, Sympathetic

* Simple goiter: Thyroid, Endocrine, Pituitary, Thalamus, San Jiao, Kidney, Liver

 

NUTRITION

* Avoid fluoride and chlorine (which are found in many toothpastes and in tap water). These elements may block the iodine receptors in the thyroid glands, leading to reduced hormone production and eventually hypothyroidism. Drink steam-distilled water only.

* Minimize intake of foods that suppress the production of thyroid hormone, such as brussel sprouts, peaches, pears, spinach, turnips, cabbage, broccoli, kale and mustard greens.

* Encourage the consumption of foods (or supplements) rich in vitamin B complex to promote the proper generation and utilization of energy.

* Increase the intake of foods rich in iodine, such as seaweed. Iodine is the building block of thyroid hormone, and is essential for normal thyroid health.

* According to traditional Chinese medicine, vegetables are generally cold in nature and meats are usually warm. Since individuals with hypothyroidism often have yang deficiency and cold presentations, increased consumption of meats (especially lamb) will help warm up the body and dispel cold. Other foods that are warm include lycii, longan fruit and spices such as pepper, garlic, onions, basil, rosemary, cumin, funnel, anise, leeks, chives, scallions, thyme, saffron, wormwood, mustard, chili pepper, and wasabi.

* Avoid the following cooling foods: tofu, tomato, celery, asparagus, bamboo, seaweed, kelp, bitter melon, cucumber, gourd, luffa, winter melon, oranges, grapefruit, pear, banana, papaya, watermelon, white radish, mustard leaf, potherb mustard, cactus, Chinese kale, napa, and bamboo sprout. Long-term use of cold fruits and vegetables like the ones listed above may be damaging to the Spleen. To make the property more neutral, one can add about 20 pieces of Gou Qi Zi (Fructus Lycii) when cooking.

 

The Tao of Nutrition by Dr. Maoshing Ni and Cathy McNease:

* Goiter

§ Make soup from dried (preferably green) orange peel, carrots, and seaweed.

§ Soak cherry pits in vinegar until they disintegrate, then apply locally.

 

LIFESTYLE INSTRUCTIONS

* Regular exercise helps to stimulate thyroid hormone secretion and increases the tissue sensitivity to the hormone. Exercise is also beneficial by raising the basal body metabolism.

* Induce perspiration by taking hot water baths, saunas, or steam baths.

 

CASE STUDIES

* L.L., a 55-year-old female, presented with a fluctuating emotional state, frontal headache, elbow pain, and cramping in the neck area. She was also experiencing eczema on the scalp, heat in the face and neck, and irritability. The Western diagnosis was leaky gut syndrome and Hashimoto’s thyroiditis; the TCM diagnosis was heat in the San Jiao. After taking Thyro-forte, the lab test counts were normalized and the symptoms were alleviated. She is no longer taking the auto-immune supplement she had been taking previously. Submitted by T.B., Tucson, Arizona.

* C.T., a 44-year-old female, presented with constipation and bloating. Symptoms of stress, depression, cold body feeling, and fatigue were also present. She was having difficulty losing weight as well despite regular exercise. Testing of TSH levels showed 0.45 mU/L before the herbal treatment and 1.5 mU/L after three months of taking the herbs. The practitioner diagnosed the condition as Kidney yin deficiency, Spleen and Kidney yang deficiencies, and Liver qi stagnation. Her Western diagnosis was hypothyroid depression. The patient was given Thyro-forte three capsules three times a day for three months. As shown on her TSH tests, with the Thyro-forte, the patient’s TSH levels remained in a normal range. She felt a greater sense of energy and was able to increase her exercise. Stress remains an ongoing issue, however, due to her high stress work life. Constipation is still in progress of resolving but the thyroid TSH still remains normal. Submitted by L.M., Lafayette, Colorado.

* L.H, a 75-year-old female, presented with dry eyes, sweaty feet, tinnitus, and frequent urination with thirst. Additional symptoms included lower legs and knees being cold, and difficulty falling asleep. The Western diagnosis was hypothyroidism; the TCM diagnosis was Kidney yang deficiency and Liver blood deficiency. This condition was treated with Thyro-forte. After three weeks of taking the herbs the symptoms alleviated. Submitted by T.B., Tucson, Arizona.

* G.A., a 35-year-old female, presented with multiple symptoms including fatigue, weight gain, anxiety, and cold sensation all the time. Recently the patient’s blood tests showed signs of hypothyroidism, for which she was then started on medication for treatment. However the patient was warned that she could become dependant on it so she had stopped taking them and was looking into taking herbs instead. Blood pressure was 113/76 mmHg and pulse rate was 64 beats per minute. The practitioner diagnosed this condition as Heart yin deficiency and Spleen qi deficiency. Upon diagnosis, the patient was directed to take Thyro-forte. The patient had informed her NP about stopping the medication and beginning to take the Thyro-forte, in which the doctor had supported. After three months of taking the herbs, the patient felt she was no longer experiencing hypothyroidism symptoms. Her thyroid panel afterwards also showed her TSH levels were now normal. Submitted by R.C., Anchorage, Alaska.

* M.S., a 60-year-old female, presented with night sweats, insomnia, pimples, TMJ disorder, high blood pressure, chest pain, cough with phlegm, heartburn, neck pain, indigestion, urinary dribbling, and goiter. The Western diagnosis was hypothyroidism with improper treatment; the TCM diagnosis was Heart yin deficiency, phlegm accumulation, and stomach yin deficiency. This condition was treated with Thyro-forte. After taking the herbs, the sweating, insomnia, indigestion, dribbling urine, and goiter were all either relieved or reduced. Submitted by T.B., Tucson, Arizona. 

* T.T., a 50-year-old female, presented with multiple symptoms including fatigue, lack of motivation, bloating, and cold sensation. Blood pressure was 90/60 mmHg and heart beat was 54 beats per minute. The practitioner diagnosed this condition as qi and blood deficiency of the Spleen, Kidney, and Heart; her Western diagnosis was Hashimoto’s disease. Upon diagnosis the patient was prescribed Thyro-forte, and given both dietary and exercise plans to follow. After three months of taking the herbs and following her lifestyle changes, the patient had reported her thyroid levels were within normal range. Submitted by L.H., Chicago, Illinois.

* C.F., a 27-year-old female, presented with hypothyroidism, which included symptoms of low energy, weight gain, and cold sensation. Lab results showed decrease in thyroid activity. The practitioner diagnosed this condition as yang deficiency. Thyro-forte was prescribed at 4 capsules three times a day. After two and half months, she felt increase in energy, and less cold sensation. However, there was no effect towards her weight gain. Submitted by S.L., Yuma, Arizona

* S.H., a 60-year-old patient, presented with a variety of symptoms, including urinary incontinence, frequent urination, loss of hair, abdominal bloating, hip soreness, lumbar pain, sciatica, and a red pastel eczema on the lower legs. The Western diagnosis was hypothyroidism and bladder sphincter paralysis; the TCM diagnosis was Kidney qi sinking, Spleen qi deficiency, and Liver qi constraint. This condition was treated with Thyro-forte. After taking the herbs, she experienced 70% improvement in urinary incontinence, and 100% relief in abdominal bloating, lumbar pain and frequent urination. The patient still takes the herbs once a week to maintain the results. Submitted by T.B., Tucson, Arizona.

* D.W., 34-year-old female, presented with fatigue and cold sensation. Her TSH level was 6.34 mU/L (normal: 0.4-4.2 mU/L). Blood pressure was 104/90 mmHg and her heart rate was 60 beats per minute. The practitioner diagnosed this condition as qi deficiency of the Spleen, Kidney, and Heart as well as Liver blood deficiency. For treatment, the patient was prescribed Thyro-forte. After taking the herbs, the patient subjectively described an increase in energy, focus, and less cold sensation. Submitted by L.H., Chicago, Illinois.

* A 47-year-old female presented with low energy and excess uterine bleeding. She had been diagnosed with hypothyroid and uterine fibroids. The patient stated she wanted to get off Synthroid (levothyroxine). Her RBC, TSH and T4 levels were low. Her pulse was thready and her tongue was pale. The practitioner diagnosed the case as Kidney deficiency with Liver blood deficiency due to excess bleeding. A raw herbal formula was used to shrink the fibroids and control the uterine bleeding for six months. Once the bleeding and fibroids were under control, the patient was instructed to take Thyro-forte. Immediately, the patient experienced an increase in energy and overall health. The combination of 4 capsules three times daily of Thyro-forte accompanied with Synthroid (levothyroxine) was too potent, so the dose was reduced to 3 capsules three times daily with positive results. Without the Thyro-forte treatment, the patient noticed a drop in energy level. Submitted by F.V., Orlando, Florida.

* A 30-year-old female diagnosed with hypothyroidism displayed signs and symptoms of low energy, diarrhea, depression, coldness, and a low body temperature of 96.9° F. She was given Thyro-forte. Shortly after administering Thyro-forte, she reported an enhanced energy level along with an increase of overall body warmth by over 50% (basal temperature was increased to 97.8° F). The patient’s bouts with diarrhea and depression appeared to have resolved. She felt stronger, happier, and more energetic. Submitted by S.T., San Jose, California.

* L.D., a 31-year-old female, presented with fatigue, dizziness, low body temperature, coldness, and muscle weakness. Her blood pressure was 100/60 mmHg and her heart rate was 65 beats per minute. Her Western diagnoses were hypotension and hypoglycemia. Laboratory results showed she had decreased thyroid activity and adrenal medullary insufficiency. The diagnosis was yang deficiency. She was prescribed Thyro-forte and Adrenal + at 2.5 and 1.5 grams per day, respectively. She did not receive any acupuncture. After two months, she felt much more energized and the dizziness was gone. She no longer felt cold. Submitted by W.F., Bloomfield, New Jersey.

* T.M., a 53-year-old female, presented with constant fatigue, muscle aches and pain, dry skin and trouble with communication, with sensations of tightness in her throat. The Western diagnoses were fibromyalgia and a low T4 level; the TCM diagnosis was Spleen qi and blood deficiencies. Thyro-forte was prescribed along with Si Ni San (Frigid Extremities Powder), Gui Pi Tang (Restore the Spleen Decoction) and An Mian Pian pills. After nine months of treatment with acupuncture and herbs, the patient was able to completely cease use of thyroid drugs. Submitted by M.C., Sarasota, Florida.

* E.B., a 75-year-old female, presented with hypothyroidism. It started a number of years ago and she took Thyroxin until recently when a new medical doctor switched her, against her will, to Levoxyl that contains no T3. Thyroxin contains T3. The client attributed this to the severe reduction in her energy and recent weight gain despite a program of aerobic exercise five days a week, weight lifting, and careful attention to her diet. After 12 noon everyday she lost any desire to do anything. The patient described herself as lethargic and discouraged. The patient weighed 151 pounds. Her blood pressure was 148/80 mmHg with a heart rate of 56 beats per minute. A year ago, before switching to the new thyroid drug, she weighed 133 pounds. No lab reports were available. She presented with excellent spirits but was clearly distressed about her loss of energy and her weight gain. Her tongue was pale with a purplish cast. The Spleen pulse was large and empty. The TCM diagnosis was Spleen qi and yang deficiency with dampness. Thyro-forte was prescribed at 2 capsules three times daily. The patient reported increased energy levels to 8 out of 10 from the 2 out of 10 she rated herself before the herbal treatment. Her weight, however, did not change. About a year and a half after the herbal treatment, the patient persuaded her M.D. to put her back on Thyroxin and she then tapered off the Thyro-forte thereafter. Submitted by H.H., San Francisco, California.

 

PHARMACOLOGICAL AND CLINICAL RESEARCH

Hypothyroidism is an endocrine disorder. The cause of hypothyroidism is often associated with insufficient production of thyrotropin-releasing hormone (TRH) from the hypothalamus or thyroid-stimulating hormone (TSH) from the pituitary. The effect of insufficient thyroid hormones is slowed metabolism throughout the body. Therefore, optimal treatment requires managing both the cause (i.e., balance the endocrine system) and the effect (increase the metabolism).

        Thyro-forte is a contemporary herbal formula based on a classic herbal formula - Jin Gui Shen Qi Wan (Kidney Qi Pill from the Golden Cabinet) from Jin Gui Yao Lue (Essentials from the Golden Cabinet) by Zhang Zhong-Jing (150-219 CE). The classic formula has six herbs to balance the endocrine system (nourish Liver and Kidney yin) and two herbs to elevate the metabolism (tonify Kidney yang). Clinical applications of this formula include various endocrine disorders, such as thyroid disorder,[2] reproductive disorder,[3] diabetes mellitus,[4],[5] and many others. The mechanism of action includes stimulating of the endocrine system to increase the production of hormones from the pituitary gland, hypothalamus, and other glands.[6]

        Synthesis of thyroid hormone requires adequate quantities of iodine.[7] Without iodine as the raw material, the thyroid gland continually attempts to produce thyroid hormone without success. This eventually leads to hypertrophy and enlargement of the thyroid glands. Rich in iodine, Hai Zao (Sargassum) and Kun Bu (Thallus Eckloniae) will stimulate the production of thyroid hormone, and effectively reduce the hypertrophy and enlargement of the thyroid gland (in cases of hypothyroidism due to lack of iodine in diet).[8]

        For optimal treatment of hypothyroidism, it is imperative to ensure that the basal metabolism is increased and the physiological functions are improved. Basal metabolism may be increased with yang tonic herbs. Studies have shown that Rou Gui (Cortex Cinnamomi) and Fu Zi (Radix Aconiti Lateralis Praeparata) have stimulating effects on the body, leading to excitation of the cardiovascular,[9] gastrointestinal,[10] and immune systems.[11] Furthermore, physiological insufficiencies can be replenished with yin tonic herbs. Numerous herbs in this formula have shown marked stimulating effects on the endocrine system to increase the production of various endogenous hormones, such as Shu Di Huang (Radix Rehmanniae Praeparata),[12] Shan Zhu Yu (Fructus Corni),[13] and Shan Yao (Rhizoma Dioscoreae).[14] Ze Xie (Rhizoma Alismatis), Mu Dan Pi (Cortex Moutan) and Fu Ling (Poria) are added to balance the tonic herbs and minimize any unwanted side effects.

        Lastly, Ren Shen (Radix et Rhizoma Ginseng) is added to Thyro-forte as it has numerous physiologic effects. In addition to increasing energy, Ren Shen (Radix et Rhizoma Ginseng) improves learning and memory,[15] stimulates the pituitary gland to increase the release of various endogenous hormones,[16]^,[17] balances the cardiovascular system by restoring homeostasis,[18] and enhances the immune system.[19]

        Thyro-forte is an herbal formula developed specifically for patients with hypothyroidism. Herbs in this formula have been shown to regulate the endocrine system, stimulate the production of thyroid hormone, increase basal metabolism, and improve the overall physiological functions.

 

COMPARATIVE ANALYSIS

Hypothyroidism is one of the most common disorders in developed countries. The disease is well understood, and treatment is simple and straightforward. In Western medicine, hypothyroidism is the lack of thyroid hormone, and therefore, treatment is to use synthetic thyroid hormone to supplement the insufficiency. Synthroid (levothyroxine) is generally considered to be the drug of choice, and when used carefully, it is generally safe and effective. Because Synthroid (levothyroxine) is very potent, it must be monitored carefully, as inappropriate dosing contributes to hyper- or hypothyroid signs and symptoms. It has also been noted that Synthroid (levothyroxine) may contribute to hypersensitivity problems, presumably because it is synthetic and may have compatibility issues. Lastly, it has been observed that long-term use of synthetic thyroid hormones is associated with increased loss of bone mass density and higher risks of osteoporosis. In short, synthetic thyroid hormone is the only drug treatment available for hypothyroidism patients. Furthermore, once synthetic thyroid hormone therapy begins, endogenous production slowly decreases and the body becomes more and more dependant on the exogenous source. Eventually, the patient will become dependent on thyroid drugs for life. In conclusion, though synthetic thyroid hormone is effective, it must be prescribed correctly, monitored carefully, and potential complications must be address with preventative measures (such as taking calcium supplements daily to avoid developing osteoporosis).

        Many herbs effectively treat hypothyroidism. Because this condition is diagnosed as Kidney yang deficiency, it is treated with warm herbs that tonify Kidney yang. These herbs have been shown to have a marked effect to increase body temperature, elevate body metabolism, and improve mood to alleviate many symptoms associated with hypothyroidism. Furthermore, these herbs also have marked effects to regulate endocrine system and stimulate thyroid glands to increase production of thyroid hormones. Because herbs are effective to treat both the symptoms and the cause, they often exert both immediate and long-lasting effects. However, there is one major limitation to herbal therapy. Because these herbs work primarily by stimulating the thyroid gland to produce thyroid hormone, those who cannot produce thyroid hormone (such as those who have had a complete thyroidectomy) will not benefit from herbs. They must be treated with synthetic thyroid hormone to ensure proper regulation of growth and metabolism.

        Both drugs and herbs treat hypothyroidism effectively. The main benefit of drug therapy is potency and consistency, and the main disadvantages are the potential adverse reactions and long-term dependence on the drugs. The main advantage of herbal therapy is its effectiveness to manage both symptoms and cause of hypothyroidism, and the main drawback is the absence of means to treat patients who can no longer produce thyroid hormone internally. Optimal treatment depends on complete understanding by an informed and educated practitioner and an equally informed patient who both know of the pros and cons of both modalities of medicines, deciding together on the most appropriate therapy.