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Schildklierproblemen / Hypo- en Hyperthyroïdie

Herbal Treatment of Thyroid Disorders—Western Herbal Tradition

There are few herbs in the Western herbal tradition specifically indicated for thyroid disease. Of these, there are little to no data on their effectiveness in humans. There are no herbs specifically indicated for the treatment of physical irregularities of the thyroid or thyroid cancer per se; rather, herbs in Western alternative and complementary medicine believed to affect the thyroid specifically address symptoms of either hypothyroidism or hyperthyroidism only.

Hypothyroidism

Kelp (Laminaria spp., Laminariaceae) is recommended by many herbalists for the treatment of hypothyroidism or thyroid nodules.7 Kelp is a rich source of iodine, which is necessary for the formation of thyroid hormone. Historically, iodine deficiency was the largest cause of thyroid swelling (commonly known as “goiter”); however, while iodine deficiency may precipitate hypothyroidism, goiter, or physical irregularities of the gland,6 this deficiency is rare in developed countries. Autoimmune disease, rather than iodine deficiency, is the primary cause of hypothyroidism in the United States.4

While iodine is one of the oldest known remedies for thyroid diseases,2 iodine supplements and seaweed products should be used with caution and under medical supervision in all patients with thyroid disorders, since the effects of iodine supplementation on thyroid function are unpredictable and vary over time. Excess iodine can trigger hyperthyroidism in some patients with seemingly normal thyroid function, yet the normal physiologic response to an acute increase in plasma iodine load is temporary hypothyroidism (an adaptive response to prevent dangerous fluctuations of thyroid levels, known as the “Wolff-Chaikoff effect”).8 In hyperthyroid patients, supplemental iodine may temporarily suppress, but then later increase, synthesis of thyroid hormone.9 A recent study of 3018 subjects in China demonstrated that excessive iodine intake may lead to hypothyroidism and autoimmune thyroiditis.10 Improper use of a kelp-containing supplement has been linked to at least one case of iodine-induced hyperthyroidism.11

Hyperthyroidism

Lycopus europeus
Four herbs are commonly suggested by Western herbalists, other practitioners of complementary and alternative medicine, and naturopathic medical textbooks for treating hyperthyroidism.11,12,13 Three herbs appear to have effects on thyroid hormone—lemon balm (Melissa officinalis, Lamiaceae), bugleweed (Lycopus virginicus, Lamiaceae), and gromwell (Lithospermum officinale, Boraginaceae); and one appears to reduce secondary symptoms of hyperthyroidism (heart palpitations and tachycardia), motherwort (Leonurus cardiaca, Lamiaceae).

Lemon balm is approved by the German Commission E for use internally for nervous sleeping disorders and gastrointestinal complaints.14 A systematic review of published articles conducted by the Natural Standard Research Collaboration in 2005 revealed that although no serious adverse effects have been reported with use of the herb, there is insufficient evidence for the use of lemon balm in treating Graves’ disease or cancer.15 However, freeze-dried extracts of lemon balm have been shown to have antithyroid activity in vitro by binding to TSH and preventing binding to its receptor, which prevents subsequent thyroid hormone manufacture and release. Likewise, lemon balm has been shown in vitro to interact with and prevent the binding of autoantibodies to the TSH receptor, suggesting the plant may have some use in Graves’ disease.16 The mechanism of action may be inhibition of TSH-stimulated cyclic adenosine monophosphate (cAMP, an enzyme activator) production.17 Another in vitro study revealed that aqueous extract of lemon balm inhibited the peripheral conversion of T4 to T3.18 No human trials have yet evaluated the efficacy of lemon balm for hyperthyroidism.

Bugleweed has also been shown in vitro to bind with TSH and TSH-like immunoglobulins, preventing binding to the receptor.16,19 Likewise, an aqueous extract of bugleweed appeared in vitro to inhibit the enzymatic reaction that converts peripheral T4 to T3.18,19 In rats, aqueous extracts of bugleweed appear to inhibit thyroid hormone production, possibly by inhibiting TSH.20,21 Although no human trials have demonstrated the efficacy of bugleweed for hyperthyroidism, the German Commission E approves internal use of the fresh or dried above-ground parts for mild thyroid hyperfunction, noting that in rare cases, with extended therapy and high doses, sudden enlargement of the thyroid can occur. The Commission E also warns against abrupt discontinuation of bugleweed.22

Freeze-dried and aqueous extracts of gromwell, like those of lemon balm and bugleweed, have demonstrated TSH-binding and hormone conversion-preventing effects in vitro, respectively.16,17,18 Another study revealed that injections of gromwell lowered TSH, T4 and T3 levels in animals.23 In rats, aqueous gromwell extract has been shown to inhibit TSH20,21 and decrease conversion of T4 to T3.24

Again, no human trials have examined gromwell’s efficacy for treating hyperthyroidism.

Motherwort is traditionally known as a heart tonic and uterine stimulant.25 In vitro the plant has demonstrated negative chronotropic effects.26,27 There are no complete studies in humans for motherwort. It is approved by the German Commission E for nervous cardiac disorders and as an adjuvant for thyroid hyperfunction.14

Some common plant foods contain substances that can prevent the utilization of iodine, and, subsequently, impact thyroid hormone function. They include, most prominently, members of the family Brassicaceae: cabbage (Brassica oleracea), turnips (B. rapa), and rutabagas (B. napobrassica); soybeans, peanuts, pine nuts, and millet have also been reported to interfere with thyroid iodine uptake.28 While these foods must be consumed raw and in large quantities to have an antithyroid effect, this may be of clinical significance in some rare cases.12

Herbal Treatment of Thyroid Disorders: Eastern Herbal Traditions

Ayurvedic Medicine

One herb in traditional Ayurvedic medicine has been studied in animals for its effects on the thyroid—the fruit of amla (Emblica officinalis, Phyllanthaceae, syn. Phyllanthus emblica). Administration of amla extract to hyperthyroid mice reduced T3 and T4 concentrations to a greater extent than the prescription antithyroid drug propylthiouracil (PTU).29 There are no studies of the fruit’s effect in humans.

Chinese Medicine

Thyroid disease is often treated by herbal medicine in China. As with Western herbal medicine, in traditional Chinese medicine (TCM) the greatest use for herbs lies in treatments for hyperthyroidism, the symptoms of which are characterized in this modality as a “yin deficiency” or syndrome of “excess fire.” Hypothyroidism, in contrast, is characterized as “yang deficiency.” TCM also employs herbs for treating thyroid masses and nodules, which are interpreted as “entangled qi,” “accumulated phlegm,” and “static blood.”30,31,32

Chinese herbal remedies are traditionally given as combinations rather than single herbs. Some traditional combinations are known for use in thyroid conditions and may be sold in supplements in this form: for example, Jia Kang Wan and Pingyin Fufang.30 Both of these formulas contain herbs meant to target the thyroid, such as kelp, brown seaweed (Sargassum spp., Sargassaceae), Chinese yam (Dioscorea oppositifolia, Dioscoreaceae), fritillary (Fritillaria spp., Liliaceae), Prunella (Prunella vulgaris, Lamiaceae), scrophularia (Scrophularia ningpoensis, Scrophulariaceae), and rehmannia (Rehmannia glutinosa, Scrophulariaceae), in addition to other herbs. Both of the formulas also contain oyster shell, a common ingredient in TCM thyroid formulas, as sea materials with a high mineral content are considered in this modality to soften and remove masses.32

The Cochrane Collaboration recently published a systematic review, “Chinese Herbal Medicines for Hyperthyroidism.”33 Cochrane reviews (published quarterly and available by subscription) regularly collect and review all available evidence for and against the effectiveness of various treatments (medications, surgery, etc) for specific conditions, taking care to include evidence that is unpublished, published in languages other than English, or unlikely to appear in major databases. In order to assess the effects of Chinese herbal medicines for treating hyperthyroidism, the authors of the review searched several databases (both in English and Chinese) for randomized controlled clinical trials of therapy for hyperthyroidism with Chinese herbs alone, or herbs in combination with antihyperthyroid drugs or radioactive iodine. Studies that met review inclusion criteria were obtained and the original authors contacted and interviewed to determine whether trial participants were correctly randomized. Only 13 trials met the Cochrane reviewers’ criteria at the time of completion of the review, while the authors of 52 additional trials could not be contacted; those are still waiting assessment.

Reviewers assessed the quality of evidence and detailed the specific outcomes in each of the 13 trials. Trials could not be directly compared, since the herbal preparations used in the studies were all different from each other. The reviewers found that none of the trials used double blinding. Exact causes of hyperthyroidism were detailed in only 4 of the studies. Primary outcomes in the trials varied and included relapse rates, adverse effects, clinical symptoms, physical symptoms, and thyroid function tests (serum T3, T4, and TSH). Each of the 13 studies evaluated a specific formula containing at least 5 or more combined Chinese herbs (2 of these studies did not mention the specific contents of formulas). Formula types tested by the studies included capsules of dried herbs, tablets of dried herbs, ampoules of decocted herbs, and injections of decocted herbs. A total of 65 different Chinese herbs were identified throughout the 13 formulas.

While the Cochrane review authors conclude in their systematic review that Chinese herbal medicines, combined with conventional antihyperthyroid drugs, may be of some benefit to patients in relieving hyperthyroid symptoms, they also conclude that the current available studies of Chinese herbal medicine used to treat hyperthyroidism were too poorly controlled and subject to potential conflicts of interest to provide a reliable indication for any type of Chinese herbal formula for treating hyperthyroidism. Therefore, according to the criteria employed by this systematic review, there is currently no strong clinical trial-based evidence for the use of any Chinese herb or herbal formula for the treatment of hyperthyroidism. Randomized, double-blind, placebo-controlled trials of Chinese herbs and herbal formulas are still needed to provide evidence for the efficacy of Chinese herbs in treating one or more specific causes or symptoms of hyperthyroidism.

Data from some of the clinical studies in humans for TCM formulas containing the following herbs are summarized in English in the Cochrane review, and also in other secondary sources.30,31,32 In vitro and animal data on these herbs published in English are also referenced below.

Kelp and Brown Seaweed: Kelp seaweed (Kun Bu in Mandarin) and brown seaweed (Hai Zao and Lou Shu in Mandarin and Hoi Chou in Cantonese) are common ingredients in TCM remedies for thyroid. Seaweeds are known traditionally as dissolvents that can soften chronic swellings, decongest lymphatic tissue, and reduce tumors.34

Modern research confirms seaweed as a rich source of trace minerals, including iodine; however, the iodine content varies with species and preparation of the plant.35 Bioavailability of iodine contained in seaweed is generally high (80-96%).36 As a result, clinicians must carefully dose and observe patients treated with seaweed-containing products due to these variabilities and also the unpredictable effects that iodine can have on thyroid tissue, as enumerated previously. Another issue regarding use of seaweed in treatments is the potential for contamination by pollutants. Research shows that Sargassum biosorbs cationic metals, especially lead, in both low- and high-salt containing wastewater.37

Clinical studies in English evaluating the effects of Laminaria spp. or Sargassum spp. on thyroid disorders in humans are lacking.

Chinese Yam: Traditional use of Chinese yam (Huang Yao Zi in Mandarin and Wong San Ji in Cantonese) root include to strengthen yin,38 resolve thyroid tumors, and hypo- and hyperthyroidism (decoction or tincture).34 Modern in vitro research reveals antibacterial39 and antitumor40 properties, but no studies or abstracts in English were found documenting the root’s effect on thyroid disease in humans. Dioscorea rhizome or shanyao was identified as a component of a TCM herbal formula in one of the 13 trials evaluated by the Cochrane review.33 This unblinded trial of 147 patients with Graves’ disease evaluated 20 mL 3 times daily of the decocted herbal formula Jiakangxin plus radioiodine, versus the antithyroid pharmaceutical drug methimazole alone, versus radioiodine alone.41 Outcomes evaluated included subjective symptoms, body weight, and thyroid hormone levels after 6 months of treatment. Statistical significance was found in improved hormone levels only in the radioiodine and radioiodine plus Jiakangxin groups, compared to the methimazole alone group, but the Cochrane review concluded the presence of potential conflicts of interest in the study.

Fritillary: The bulb of two species of fritillary (Fritillaria cirrhosa and F. thunbergii, Bei Mu in Chinese) is employed in TCM for “heat clearing” properties valuable in resolving cough, nodules, swellings, and thyroid cancer, among other things.34,38 Modern research reveals the genus to be rich in a wide range of steroidal alkaloids.42 Some may have acetylcholinesterase-inhibiting properties,43 which raises the potential for toxicity similar to organophosphate insecticides (with hypersecretion, excitation, diarrhea, bronchospasm, slowed or rapid pulse, and even seizures). No studies or abstracts in English were found documenting the bulb’s effect on thyroid disease in humans. Thunberg fritillary bulb or zhebeimu was identified as a component in formulas studied in two of the 13 trials evaluated by the Cochrane review.

The first, in 2003, was a parallel group, unblinded trial of 368 cases of hyperthyroidism defined by specific threshold levels of plasma thyroid function tests.44 One ampoule per day of the herbal formula Erdong Tang with Xiaoluwan Jiawei was decocted with water and orally taken in the morning and evening and compared to the control group taking either propylthiouracil (PTU) or methimazole. Outcomes included symptom relief, plasma thyroid hormone levels for 1 year after discontinuing the herbal formula or drugs, and relapse rates. While the study found symptom relief improvement, plasma hormone improvement, and relapse rates to be better in the herbal treatment versus the control group, the Cochrane reviewers note potential conflicts of interest in the study.

The second trial including fritillary, published in 2005, was also of parallel design and unblinded.45 It evaluated 62 cases of hyperthyroidism with symptoms of sweating, dysphoria, palpitations and emaciation. Interventions compared were the herbal formula Jiakangxiao (which included fritillary bulb) plus treatment with either methimazole or PTU, versus methimazole or PTU alone. Outcomes included symptom relief, measurement of plasma thyroid hormones after 50 days of treatment, and relapse rates after 1 year. The study found statistically significant improvement in the treatment versus control group in all outcomes, though the Cochrane reviewers note potential conflicts of interest in the study.

Prunella: The flower spike of selfheal (aka Prunella, Xia Ku Cao in Mandarin; Ha Gu Chou in Cantonese) are used in TCM as an antipyretic, diuretic, astringent, and lymphatic decongestant.34,38 Modern studies support selfheal’s ability to reduce inflammation and modulate the immune system in vitro46 and to suppress antibody production in mice.47 No studies or abstracts in English were found documenting the flower’s effect on thyroid disease in humans.

Xia Ku Cao was identified as a component in 4 of the 13 trials evaluated by the recent Cochrane review. Xia Ku Cao is included in the formula Erdong Tang with Xiaoluwan Jiawei, which was evaluated in the trial by Qiu et al (2003) enumerated above.44 In 1999, an unblinded parallel group trial evaluated 105 hyperthyroid patients taking methimazole plus 1 ampoule per day of an herbal formula including Xia Ku Cao, versus a control group taking methimazole alone.48 Outcomes included symptoms of palpitation, fatigue, emaciation and heat intolerance as well as plasma concentrations of thyroid hormones. The study found that while both groups improved with treatment, there was no statistically significant difference between the groups with regard to plasma hormone levels or symptom relief. The Cochrane review noted potential conflicts of interest in the study.

In 2001, another unblinded, parallel group trial evaluated 84 patients with hyperthyroidism identified through plasma thyroid hormone levels and clinical symptoms of palpitation, dizziness, tremor, fatigue, sweating, and emaciation.49 Methimazole plus an herbal formula containing Xia Ku Cao given in an unidentified dosage form and frequency were compared to methimazole alone for 2 months with 1 year of follow-up. The study found greater improvement in the treatment group compared to control with regard to the outcomes of symptom relief and plasma thyroid hormone levels at 2 months and relapse rates after 1 year. The Cochrane review notes potential conflicts of interest in the study.

Finally, Xia Ku Cao was part of a formula called Jiakang mianyi jiaonang evaluated in 2005 on 44 subjects with hyperthyroidism in a study of 86 hyperthyroid patients with diffuse toxic goiter (aka Graves’ disease) or subacute thyroiditis.50 PTU was taken by both the treatment and control groups; the treatment group additionally took 4 capsules of Jiakang mianyi jiaonang formula 3 times daily for 90 days, while the control group took the formula jiakangning pian (the herbs in this formula were not specified in the Cochrane review) at 6 tablets 3 times per day. The study was of parallel group design and single-blinded. Outcomes included symptom relief, body weight increase, and plasma thyroid hormone levels. The study found no statistically significant improvement in treatment versus control groups for any outcome. The Cochrane review notes the herbal preparation was prepared by the authors’ hospital and that this was a local government-supported project. In addition, the lack of distinction in this study between patients with Graves’ disease and those with subacute thyroiditis may have impacted outcomes since, as enumerated above, neither antithyroid drugs like PTU nor antithyroid botanicals can prevent the leaking of stored thyroid hormone from inflamed tissue that causes the transient hyperthyroidism characteristic of this condition. Furthermore, the lack of distinction between these two patient groups in this study would confound any potential immune-modulating benefit of the Xia Ku Cao-containing herbal formula.

Scrophularia: Scrophularia (Xuanshen in Mandarin or Hei Shen in Cantonese) root is administered in TCM fresh or dried to “drain fire and disinhibit the throat.”38 Scrofula is an archaic term describing tubercular swelling of the lymph nodes; its inclusion in the Latin binomial of this plant is indicative of its traditional use to treat nodules and goiter.32 Modern in vitro research reveals that plants in this genus contain antimicrobial,51 anti-inflammatory,52 and antitumor53 properties. No studies or abstracts in English were found documenting the root’s effect on thyroid disease in humans. Scrophularia root or Xuanshen is included in 2 formulas evaluated in the Cochrane review of included studies of Chinese herbal medicines for hyperthyroidism. Xuanshen is included in the Qiu et al (2003) study of the TCM herbal formula Erdong Tang with Xiaoluwan Jiawei described above in the sections on prunella and fritillary.44 Xuanshen was also one of 10 herbs in the formula Yikang wan, given as 1 pill 3 times per day plus methimazole, versus methimazole alone in an unblinded parallel group study of 62 hyperthyroid patients.54 Outcomes included clinical symptom relief and thyroid function tests at 2, 3, and 4 weeks after treatment. The study found improvement in all outcomes in more individuals in the treatment group vs. control, but statistical significance is unclear. The Cochrane review concluded there was potential conflict of interest in that the herbal formula was provided by the company sponsoring the magazine in which the study was published.

Rehmannia: Rehmannia (Shengdi in Mandarin) prepared or cured root or rhizome is considered in TCM to be nourishing to the liver and blood and also to have heat-clearing properties. Its use in thyroid formulas stems from the idea in TCM that thyroid disorders are ultimately rooted in liver and kidney disorder.34 Modern in vitro studies reveal that extracts of the plant may have antioxidant55 and anticancer56 activity. A study in mice suggested a hepatic protective effect.57 No studies or abstracts in English were found documenting the root preparation’s effect on thyroid disease in humans. Rehmannia rhizome or Shengdi is part of the herbal formula Erdong Tang with Xiaoluwan Jiawei evaluated by Qiu et al (2003) discussed previously.44 It is also part of the formula Yikang wan evaluated by Huang (2003) as summarized above for the herb scrophularia.54 A third study included Shengdi as one of 12 herbs, also including prunella flower.49 A fourth study included in the Cochrane systematic review examined Shengdi as one of 4 herbs of a formula used in a parallel single-blind study of 93 patients with Graves’ disease.58 The herbs were made into granules, and 1 ampoule per day was given for 8 weeks to the treatment group along with PTU, while PTU alone was used by the control group. Outcomes included plasma thyroid function tests. Free T3 and free T4 of both treatment and control groups were improved at 8 weeks; statistical significance is unclear. The Cochrane reviewers concluded there was potential conflict of interest in the study.

Conclusion

Herbal medicines may be used as adjunct treatments for autoimmune thyroid diseases such as hypothyroidism and hyperthyroidism, the physical abnormalities (often referred to nonspecifically as “goiter,” “nodules,” or “thyroiditis”) that can result from or precipitate the physical symptoms of these diseases, and for the malignant nodules that characterize thyroid cancers. However, large, randomized, double-blind, well-controlled studies in humans for their efficacy in any of these disorders are lacking. Most of the studies of botanical medicines for the treatment of thyroid disease have centered on hyperthyroid conditions. For herbs used to treat hyperthyroidism in TCM, a recent systematic review of 13 trials that met reviewers’ inclusion criteria suggests that some herbal formulas used in conjunction with pharmaceutical antihyperthyroid drugs may provide marginal improvement over antihyperthyroid drugs alone with regard to symptom relief, thyroid hormone function tests, and relapse rates.33 However, reviewers evaluated these studies as low quality due to small sample sizes, unblinding or single blinding, and potential for conflicts of interest. The authors of the systematic review have 52 more studies to evaluate, which may yield more information. Currently there is scant published information supporting use of TCM herbal formulas alone for treating hyperthyroid conditions.

Therefore, initiation of treatment with any herbs for any type of thyroid disorder should be considered only under the supervision of a healthcare provider well trained in the use of herbs or TCM for thyroid disease. Such treatment is best done using information obtained with some tools of conventional medicine—blood chemistry analysis, FNAB, ultrasound, and radionuclide imaging—which can give the practitioner and patient an idea about the possible source, characteristics, and progress of thyroid disease. Because disorders of the thyroid are complex, idiosyncratic, and impact other body systems, courses of treatment with either alternative or conventional regimens (or both) must be carefully tailored to the individual, with assiduous attention to the individual’s symptoms and plasma thyroid function analysis.

Katie Welch is an herbalist and pharmacist currently practicing at an independent compounding pharmacy in Portland, Oregon. Welch earned her PharmD at Oregon State University in 2007 and was the 2007 recipient of the Natural Medicines Comprehensive Database Award, which is presented to an outstanding pharmacy school graduate who has shown an interest in evidence-based approach to patient care with regard to natural medicines. In 2006, she spent part of her fourth-year pharmacy-school curriculum as an intern at the American Botanical Council, where she broadened her knowledge of, and consolidated her research skills in, botanical medicine. A survivor of papillary thyroid cancer, Welch is especially interested in alternative treatment of thyroid disorders.

References
  • Larsen PR, Davies TF, Schlumberger MJ, Hay ID. Thyroid physiology and diagnostic evaluation of patients with thyroid disorders. In: Williams Textbook of Endocrinology. Eds. PR Larsen, HM Kronenberg, S. Melmed, KS Polonsky. Tenth Edition, Philadelphia: WB Saunders, 2003.
  • Farwell AP, Braverman LE. Thyroid and Antithyroid Drugs. In: Goodman and Gilman’s The Pharmaceutical Basis of Therapeutics. Eds. LE Brunton, JS Lazo, KL Parker. Eleventh edition. New York: McGraw-Hill, 2005.
  • Schteingart DE. Thyroid gland disorders. In: Pathophysiology: Clinical Concepts of Disease Processes. Eds. SA Price and LM Wilson. Sixth Edition. St. Louis: Mosby, 2003.
  • Singer PA, Cooper DS, Levy EG, et al. Treatment guidelines for patients with hyperthyroidism and hypothyroidism. JAMA. 1995;273:808-812.
  • Cooper DS, Doherty GM, Haugen BR, et al. Management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2006;16:109-141.
  • Weiss RE, Lado-Abeal J. Thyroid nodules: diagnosis and therapy. Curr Opin Oncol. 2002;14:46-52.
  • Kligler B, Lee R. Integrative Medicine. New York: McGraw-Hill, 2004.
  • Dong, BJ. Thyroid disorders. In: Applied Therapeutics: The Clinical Use of Drugs. Eds. M Koda-Kimble, LY Young, WA Kradjan, BJ Guglielmo. Eighth Edition. Philadelphia: Lippincott Williams & Wilkins, 2005.
  • Phillipou G, Koutras DA, Piperingos G, et al. The effect of iodide on serum thyroid hormone levels in normal persons, in hyperthyroid patients, and in hypothyroid patients on thyroxine replacement. Clin Endocrinol. 1992;36:573-578.
  • Teng W, Shan Z, Teng X, et al. Effect of iodine intake on thyroid diseases in China. NEJM. 2006;354:2783-2793.
  • Mussig K, Thamer C, Bares R et al. Iodine-induced thyrotoxicosis after ingestion of kelp-containing tea. J Gen Intern Med. 2006;21(6):11-14.
  • Murray MT, Bongiorno PB. Hyperthyroidism. In: Textbook of Natural Medicine. Third Edition. London: Churchill-Livingstone, 2006.
  • Drum R. Botanicals for Thyroid Function and Dysfunction. Available at: http://www.planetherbs.com/showcase/. Accessed February 19, 2007.
  • Blumenthal M, Goldberg A, Brinckmann J, eds. Herbal Medicine: Expanded Commission E Monographs. Austin, TX: American Botanical Council; Newton, MA: Integrative Medicine Communications; 2000.
  • Brendler T, Gruenwald G, Kligler B, et al. Lemon balm (Melissa officinalis L.): an evidence-based systematic review by the Natural Standard Research Collaboration. J Herb Pharmacother. 2005;5(4):71-114.
  • Aufmkolk M, Ingbar JC, Kubota K, et al. Extracts and auto-oxidized constituents of certain plants inhibit the receptor binding and the biological activity of Graves’ immunoglobulins. Endocrinology. 1985;116(5):1687-1693.
  • Santini F, Vitti P, Ceccarini G, et al. In vitro assay of thyroid disruptors affecting TSH-stimulated adenylate cyclase activity. J Endocrinol Invest. 2003;26(10):950-955.
  • Aufmkolk M, Kohrle J, Gumbinger H, et al. Antihormonal effects of plant extracts: iodothyronine deiodinase of rat liver is inhibited by extracts and secondary metabolites of plants. Horm Metab Res. 1984;16(4):188-192.
  • Aufmkolk M, Ingbar JC, Amir SM, et al. Inhibition by certain plant extracts of the binding and adenylate cyclase stimulatory effect of bovine thyrotropin in human thyroid membranes. Endocrinology. 1984;115(2):527-534.
  • Sourgens H, Winterhoff H, Gumbinger HG, Kemper FH. Effects of Lithospermum officinale and related plants on hypophyseal and thyroid
  • hormones in the rat. Int J Crude Drug Res. 1986;24(2):53-63.
  • Sourgens H, Winterhoff H, Gumbinger HG, Kemper FH. Antihormonal effects of plant extracts, TSH-and prolactin-suppressing properties of Lithospermum officinale and other plants. Planta Med. 1982;45:78-86.
  • Blumenthal M, Busse WR, Goldberg A, Gruenwald J, Hall T, Riggins CW, Rister RS, eds. Klein S, Rister RS, trans. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Austin, TX: American Botanical Council; Boston: Integrative Medicine Communication; 1998.
  • Brinker F. Inhibition of endocrine function by botanical agents I. Boraginaceae and Labiatae. J Nat Med. 1990;1:10-18.
  • Winterhoff H, Sourgens H, Kemper FH. Antihormonal effects of plant extracts: pharmacodynamic effects of Lithospermum officinale on the thyroid gland of rats; comparison with the effects of lodide. Horm Metab Res. 1983;15:503-507.
  • Grieve M. A Modern Herbal. New York: Dover Publications, 1971.
  • Yanxing X. The inhibitory effect of motherwort extract on pulsating myocardial cells in vitro. J Tradit Chin Med. 1983;3(3):185-188.
  • Milkowska-Leyck K, Filipek B, Strzelecka H. Pharmacological effects of lavandulifolioside from Leonurus cardiaca. J Ethnopharmacol. 2002;80(1):85-90.
  • Greer MA, Astwood EB. The antithyroid effect of certain foods in man as determined with radioactive iodine. Endocrinology. 1948; 43:105-119.
  • Panda S, Kar A. Fruit extract of Emblica officinalis ameliorates hyperthyroidism and hepatic lipid peroxidation in mice. Pharmazie. 2003;58:753-755.
  • Dharmananda S. Treatments for thyroid diseases with Chinese herbal medicine. Institute for Traditional Medicine Web site. Available at: http://www.itmonline.org/arts/thyroid.htm. Accessed November 27, 2006.
  • Liu C, Tseng A. Chinese Herbal Medicine: Modern Applications of Traditional Formulas. Boca Raton: CRC Press, 2005.
  • Bensky D, Barolet R. Chinese Herbal Medicine Formulas and Strategies. Seattle: Eastland Press, 1990.
  • Zen XX, Yuan Y, Liu Y, Wu TX, Han S. Chinese herbal medicines for hyperthyroidism. Cochrane Database of Systematic Reviews 2007, Issue 2, Art. No.: CD005450. DOI:10.1002/14651858.CD005450.pub2.
  • Holmes P. Jade Remedies: a Chinese Herbal Reference for the West. Boulder: Snow Lotus Press, 1996.
  • Teas J, Pino S, Critchley A, et al. Variability of iodine content in common commercially available edible seaweeds. Thyroid. 2004;(10):836-841.
  • Aquaron R, Delange F, Marchal P, et al. Bioavailability of seaweed iodine in human beings. Cell Mol Bio. 2002;48(5):563-569.
  • Tsui MT, Cheung KC, Tam NF, et al. A comparative study on metal sorption by brown seaweed. Chemosphere. 2006;65(1):51-57.
  • Yen K. The Illustrated Chinese Materia Medica. Taipei: SMC Publishing, 1992.
  • Teponno RB, Tapondijou AL, Gatsing D, et al. Bafoudiosbulbins A and B, two anti-salmonellal clerodane diterpenoids from Dioscorea bulbifera L. var sativa. Phytochemistry. 2006;67(17):1957-1963.
  • Gao H, Kuroyanagi M, Wu L, et al. Antitumor-promoting constituents from Dioscorea bulbifera L. in JB6 mouse epidermal cells. Biol Pharm Bull. 2002;25(9):1241-1243.
  • Chen Y, Qiu L, Zhang CY, Zhang SS, Li WP. Combined treatment of Graves’ disease with radioiodine and a traditional Chinese medicine herb preparation Jiakangxin. Lin Chuang Hui Cui (Clinical Focus). 2004;19(18):1032-1034.
  • Jiang Y, Li P, Li HJ, et al. New steroidal alkaloids from the bulbs of Fritillaria pugiensis. Steroids. 2006;71(9):843-848.
  • Lin BQ, Ji H, Li P, et al. Inhibitors of acetylcholine esterase in vitro—screening of steroidal alkaloids from Fritillaria species. Planta medica. 2006;72(9):814
  • 818.
  • Qiu WY, Gu XW. An analysis on long-term curative effect of TCM combined with western medicine for hyperthyroidism. Xin Zhong Yi (New Chinese Medicine). 2003;35(5):43.
  • Zhu XN, Cao JH, Ou XM. Treatment on 62 cases of hyperthyroidism with Jiakangxiao. Shan Xi Zhng Yi (Shangxi Journal of Traditional Chinese Medicine) 2005; 26(9):926.
  • Harput US, Saracoglu I, Ogihara Y. Effects of two Prunella species on lymphocyte proliferation and nitric oxide production. Phytother Res. 2006;20(2):157
  • 159.
  • Sun HX, Qin F, Pan YJ. In vitro and in vivo immunosuppressive activity of spica prunellae ethanol extract on the immune responses in mice. J Ethnopharmacol. 2005;101(1-3):31-36.
  • Yan H, Zhang SL, Jiang YS, Zhang DH. Treatment of hyperthyroidism with tapazole plus TCM. Qian Wei Yao Za Zhi (Qianwei Journal of Medicine and Pharmacy) 1999;16(1):24.
  • Ding YY, Zhang CX. Observation on curative effect of treatment of TCM combined with western medicine for hyperthyroidism. Zhong Guo Zhong Yi Yao Xin Xi Za Xhi (Chinese Journal of Information on Traditional Chinese Medicine). 2001;8(4):66.
  • Ding P, Huang QY. Treatment of 44 cases of hyperthyroidism with Jiakang Mianyi Jiaonang. Zhong Yi Yan Jiu (Research of Traditional Chinese Medicine). 2005;18(10):31.
  • Stavri M, Mathew KT, Gibbons S. Antimicrobial constituents of Scrophularia deserti. Phytochemistry. 2006;67(14):1530-1533.
  • Diaz AM, Abad MJ, Fernandez L, et al. Phenylpropanoid glycosides from Scrophularia scorodonia: in vitro anti-inflammatory activity. Life Sci. 2004;74(20):2515-2526.
  • Wang S, Zheng Z, Weng Y, et al. Angiogenesis and anti-angiogenesis activity of Chinese medicinal herbal extracts. Life Sci. 2004;74(20):2467-2468.
  • Huang FQ. Clinical observation on treatment of hyperthyroidism with TCM combined with western medicine. Zhong Guo Di Fang Bing Fang Zhi Za Zhi (Chinese Journal of Control of Endemic Diseases). 2003;18(2):117.
  • Choi DG, Yoo NH, Yu CY, et al. The activities of antioxidant enzymes in response to oxidative stresses and hormones in paraquat-tolerant Rehmannia glutinosa plants. J Biochem Mol Biol. 2004;37(5):618-624.
  • Chao JC, Chiang SW, Wang CC, et al. Hot water-extracted Lyciom barbarum and Rehmannia glutinosa inhibit proliferation and induce apoptosis of hepatocellular carcinoma cells. World J Gastroenterol. 2006;12(28):4478-4484.
  • Xiao LC, Gen, XP, Peng LD. Modern Research and Application of Chinese Medicinal Plants. Hong Kong: Hong Kong Medical Publisher, 2000.
  • Yu JY, Liu F. Clinical research on treatment of Graves’ disease accompanied by hepatic impairment with TCM combined with western medicine. Jiang Su Zhong Yi Yao (Jiangsu Journal of Traditional Chinese Medicine). 2002;23(11):13.


Een aantal voedings- en leefstijlrichtlijnen voor een gezonde schildklierfunctie:
Groente, fruit, onbewerkt voedsel / best alternatief.nl

Misschien wel de belangrijkste tip om mee te beginnen: eet veel meer kalium (groente en fruit) en calcium (ook voornamelijk in groente en fruit). Vooral een goede balans tussen calcium en kalium is belangrijk, maar ook een goede natrium-kaliumbalans is uitermate belangrijk.

Rust en regelmaat

De schildklier wordt aangestuurd door de hypothalamus, ook de regulator van onze biologische klok. Deze is gebaat bij rust en regelmaat. Het klinkt wellicht saai maar ons leven zou zo veel mogelijk regelmaat moeten hebben: wat betreft eetmomenten, slaapmomenten, rust- en actiemomenten. Onze hele (hormonale) gezondheid is afhankelijk van een biologische klok die wordt aangestuurd in de hypothalamus.

Dagelijkse beweging

Beweeg bij voorkeur nuchter of vóór de maaltijd, omdat beweging de (vet)verbranding sterk stimuleert. Bovendien heeft dit een positieve uitwerking op het verlagen van ontstekingen die ook vaak aan de basis liggen van schildklierklachten. Zonder dagelijkse beweging wordt het lastig om de schildklier te prikkelen om zijn functies weer te gaan uitoefenen. Zoek een beweging die bij je past en die je leuk vindt. Kortdurende, krachtige beweging en krachttraining dragen bij aan herstel van de hormoonbalans.

Dagelijks omega 3 en vitamine A & D

Zonder voldoende vitamine A, D en DHA kan de aansturing van de schildklier (vanuit onze hypothalamus) niet goed verlopen. Bovendien is de omzetting van het schildklierhormoon T4 naar T3 afhankelijk van de ‘vloeibaarheid’ van onze celmembranen. En deze vloeibaarheid staat of valt bij de consumptie van omega 3-vetzuren. Omdat de schildklier zo bevattelijk is voor toxische stoffen lijkt vis (noch uit de zee, noch kweekvis) de ideale bron om schildklierklachten aan te pakken.

Vitamine D is ook belangrijk omdat er veel auto-immuunaandoeningen van de schildklier bestaan. Een gezonde vitamine D-status is o.a. belangrijk om dit te voorkomen, dan wel in goede banen te leiden. Laat eventueel een vitamine D-bepaling uitvoeren bij je (huis)arts.

Vitamine A kan door onze lever aangemaakt worden uit bètacaroteen. Daarom is voldoende groente en fruit een must, zeker de oranje en gele soorten. Toch is bij lang niet iedereen de lever in staat om zelf vitamine A uit bètacaroteen te maken.

Jodium

Dit betekent dat je, om aan je behoefte te voldoen, 2 tot 3 keer per week iets uit zout water zou moeten eten: zeewieren/algen of zoutwatervis. De laatste lijkt de minst logische keuze.

Thermogenese
Alle stofwisselingsreacties in ons lichaam zorgen voor energie en warmte. Het ene voedingsmiddel geeft een grotere warmteproductie (thermogenese) dan het andere. Hoe groter dit thermogene effect, des te meer calorieën omgezet worden in warmte (in plaats van energie) en niet kunnen worden opgeslagen als vet. Als je verbranding door schildklierproblemen verlaagd is, kies dan voor voedsel dat deze thermogenese activeert. In het kort komt het hierop neer:
  • Koolhydraten en verzadigde vetten als hoofdbestanddeel van je voeding verlagen de stofwisseling.
  • Eiwitten en gezonde vetten activeren de stofwisseling. Maar ook een dieet met te veel eiwitten zorgt weer voor verstoring van de schildklier. Het gaat gewoon om de balans: eet in elke maaltijd iets van langzame koolhydraten, gezonde vetten en eiwitten.
  • Een klein beetje alcohol BIJ de maaltijd activeert de stofwisseling (dit effect is er niet als je het buiten de maaltijden om gebruikt of als je veel alcohol gebruikt).
  • Gember, kurkuma, peper, chilipeper, cayennepeper, paprika, ui, knoflook, mierikswortel, groene thee.
  • Gezonde vetten: met mate omega 6 en ruimschoots omega 3- en omega 9-vetzuren. 
  • De stof CLA uit vlees en zuivel, van grasetende en loslopende dieren of oude koeienrassen.
  • Jodium plus vitamine A, D en omega 3-vetzuren in zeevoedsel (zeevis of zeewier/algen).
  • Kokosolie.
Voldoende vitamine B12
Voldoende vitamine B12 de voeding is nodig om jodium op te kunnen nemen en op de plaats van bestemming te krijgen. B12-tekorten kunnen dus schildklierklachten veroorzaken. Ook is B12 samen met selenium, zink, magnesium en ijzer nodig om het pre-hormoon T4 daadwerkelijk om te zetten in T3. En dat is wat in elke cel zo belangrijk is voor de energieaanmaak. 

Dagelijks zink-rijke voedingsmiddelen
Mensen die veel stress hebben, veel zweten, of meer dan 1,5 liter water per dag drinken, hebben een grotere zinkbehoefte. En mensen die roken en een trage schildklier hebben, kunnen niet voldoende zink uit de voeding halen.

L-tyrosine-rijke voedingsmiddelen
Uit het aminozuur L-tyrosine maakt ons lichaam heel veel stoffen aan, waaronder schildklier-, maar ook stresshormonen. L-tyrosine is als het ware de benzine voor onze schildklier. Bij veel stress maakt ons lichaam echter alleen nog stresshormonen aan uit L-tyrosine en komt onze schildklier zonder benzine te zitten.

Voldoende vitamine C
Dit is nodig om de omzetting uit eiwit naar tyrosine en van tyrosine naar dopamine mogelijk te maken. Mocht je te weinig groente en fruit eten, dan is het raadzaam dit drastisch te verhogen en daarnaast vitamine C als supplement in te nemen. Onder invloed van stress gaan we namelijk heel veel meer vitamine C verbruiken. En niet alleen vitamine C verbruiken we dan veel meer, maar ook van eiwitten, B-vitamines, magnesium, zink etc. worden we dan ‘grootverbruiker’. Allemaal stoffen waar onze schildklier van verstoken blijft in tijden van stress.

Voldoende selenium
Zonder selenium wordt ons schildklierhormoon T4 niet omgezet in zijn werkzame T3-vorm. Iemand van 70 kilo heeft minimaal 200 mcg selenium per dag nodig voor een optimale schildklierfunctie. Mensen met (chronische) ontstekingen moeten letten op een voldoende seleniuminname. Deze ontstekingen ‘vreten’ namelijk ook veel selenium, zodat de schildklier het onderspit delft.

Enzymen
Door de te lage lichaamstemperatuur die bij een schildklierverstoring hoort, kunnen enzymen hun werk niet goed meer doen. Sommige enzymen werken tot wel 1.500 keer minder bij een ochtendtemperatuur van rond de 36,2 graden Celsius. Dit betekent dat niet alleen de energieaanmaak in onze cellen, maar ook onze voedselvertering sterk vermindert. Ook bij het verteren van voedsel hebben we immers veel enzymen nodig. Alleen rauwe, onbewerkte voedingsmiddelen en kiemen bevatten veel enzymen. Probeer deze dus dagelijks op het menu te zetten. NB: dit is absoluut geen pleidooi om alles rauw te eten. Zowel rauwe als warme voedingsmiddelen hebben elk hun eigen gunstige eigenschappen voor onze gezondheid.

De lever
Zorg voor een goede conditie van de lever, ook door je darmen zo goed mogelijk in balans te houden. De lever moet goed functioneren om het schildklierhormoon T4 om te zetten in het uiteindelijk werkzame T3-hormoon.

Verkoelende voedingsstoffen
Volgens de ayurvedische voedingsleer kun je ‘verkoelende voedingsstoffen’ beter zo veel mogelijk mijden als je stofwisseling vertraagd is. Denk aan tarwe, rogge, melkproducten, suiker, soja, sinaasappel etc. Dit geldt ook voor (letterlijk) koude voeding en dranken uit de koelkast. Zorg in elk geval dat je voeding op kamertemperatuur gegeten en gedronken wordt. Zo hoeft je spijsvertering geen ‘dure energie’ aan te wenden om voedsel te verwarmen.

Verdere ondersteuning
Bij ernstige, langdurige verstoring van de schildklier zal alleen aanpassing van de voeding niet meer afdoende zijn. Dan is het belangrijk om ook verdere ondersteuning in te zetten om de schildklier weer in balans te krijgen. Het kan ook zijn dat eerst de bijnieren weer adequaat moeten functioneren of chronische ontstekingen moeten worden geremd, alvorens de schildklier weer naar behoren kan functioneren. Begeleiding door een natuurarts of therapeut die mogelijk ook de oorzaak kan achterhalen, lijkt aangewezen. 

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