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INTRODUCTION: The two key hormones produced by the thyroid gland are T4 and T3. The normal thyroid gland produces about 80% T4 and about 20% T3, however, T3 possesses about four times the hormone “strength” as T4. Also, three iodine molecules are added to make T3 (triiodothyronine), and four for T4 (thyroxine).

SUMMARY: Supporting the nervous system and the digestive system (including the liver) is critical in balancing thyroid function. In fact, the reason some hypothyroid patients cannot be effectively treated using thyroid hormone alone (be it synthetic or natural) is almost always due to poor digestive function and/or emotional imbalance. These systems do not have to be “diseased” in order to be “supported” naturally. The task of balancing these two systems, and thus the thyroid, is indeed rather easy using natural therapies.

Many patients with diagnosable hypothyroidism are easy to treat. They simply take either synthetic thyroid hormones (such as Synthroid=T4 and/or Cytomel=T3) or natural thyroid hormone (such as USP or Armour thyroid). Note that naturopathic doctors often do prescribe thyroid hormone(s) (synthetic and/or natural) to their hypothyroid patients unless the hypothyroidism is not very advanced.

There are also patients whose blood thyroid hormone tests (TSH, T3 and T4) are all normal, and yet have signs and symptoms of hypothyroidism, including fatigue, hair loss, constipation, dry skin, depression, etc. This condition is referred to as “subclinical hypothyroidism,” and is often easily treatable using nutrients and herbs that support thyroid function. Notice that such patients do not and should not take thyroid hormone, especially considering the fact that thyroid hormones (both synthetic and natural) have long-term complications, most notably osteoporosis.

There are, however, some cases of hypothyroidism (regardless of whether their blood tests are normal or abnormal) that are much more difficult to treat using pharmaceutical drugs only. With the exception of one patient that I am currently working with, I have always been able to treat even the most challenging hypothyroid cases using the protocol below. Note that this patient has also worked with many endocrinologists who are also unable to help balance her thyroid. IMPORTANT: Most of the key medicines/supplements listed below are not available over-the-counter. Even if they were, you should not treat yourself since each patient is unique, and requires a UNIQUE COMBINATION of the following therapies at doses unique to them.

1) Thyroid hormone (synthetic or natural): Note that some patients respond better to synthetic thyroid hormones and some respond better to natural thyroid hormones. I typically recommend thyroid hormone(s) if the patient’s TSH is abnormal (above 5) and the patient suffers from many of the signs and symptoms of hypothyroidism. Otherwise, I simply skip this step, and offer the rest of the protocol as outlined below.

2) Natural supplements that support thyroid function:

2a. Nutrients (Iodine, selenium, and L-tyrosine) that support thyroid function:

-Iodine and L-tyrosine are required by the thyroid gland to synthesize T4 and T3.
(The thyroid takes in iodine, obtained through food, iodized salt, or supplements, and combines it with the amino acid tyrosine. The thyroid then converts the iodine/tyrosine into the hormones T3 and T4. The “3” and the “4” refer to the number of iodine molecules in each thyroid hormone molecule.)

Note: The gammadyn or oligotherapy form of iodine (which comes in liquid ampulles) is highly bio-available (readily usable by the body) and can be much more effective than OTC (over-the-counter) iodine pills. Gammadyn iodine is typically not available over-the-counter, and is only sold at a few naturopathic offices around Puget Sound.

-Selenium helps conversion of T4 to T3, and can be the missing link for some hypothyroid patients.

2b. Herbs that support thyroid function: I typically recommend a supplement called Fucus complex. Fucus or kelp contains iodine.

2c. Homeopathic medicines that directly balance thyroid function. My favorite homeopathic remedies for this purpose are UNDA #16, #273 and #1000.

3) Supporting the digestive system, most importantly the liver:
Why is liver support important in treating hypothyroidism?
The liver converts T4 to T3. Remember that the normal thyroid gland produces about 80% T4 and about 20% T3, however, T3 possesses about four times the hormone “strength” as T4.
If our liver is overwhelmed by toxins, which is always the case nowadays, it may have a difficult time doing this conversion. This appears to be the case based on what I am finding with my own patients since a basic liver detoxification/cleansing appears to significantly help the more “complicated” hypothyroid cases.

The role that the liver plays in converting T4 to T3, and the functions it performs in order to assure proper digestion/absorption of nutrients (which are vital for proper thyroid function) is so significant that I have come to call the liver “the mother of the thyroid gland.” I believe that it is unhealthy function of the liver along with poor nerves that causes poor thyroid function to begin with.

4) Supporting the nervous system :
Supporting and relaxing the nervous system is often rather easy using natural medicines, most importantly, “constitutional” homeopathy. I find that when people’s nervous system is relaxed and they feel happier, their need for other therapies (including thyroid hormones or thyroid supportive supplements) is reduced over time.

5) Healthy lifestyle and diet:
Regular aerobic exercise, drinking sufficient amount of pure water and eating plenty of vegetables, avoiding processed foods and other toxic substances (such as nicotine, alcohol, coffee, etc.) are the highlights of healthy living and healthy eating. Healthy lifestyle and diet are, of course, the most important steps in healing (Refer to the “7 Steps to Healing” article on our website).

All the systems within the body influence one another heavily. The interactions amongst the nervous, endocrine and digestive systems are numerous and sometimes very complex. I have already stated some such interactions. However, I’d like to expand on the subject a little more:

The liver converts T4 to T3, and you need to be able to absorb the nutrients (iodine, L-tyrosine, selenium, etc.) necessary for proper thyroid function; thus the need for a healthy digestive system to assure proper thyroid function. Note that patients who take drugs to treat their acid reflux, patients with chronic constipation or any other digestive complaints do NOT have healthy digestion. In order to balance thyroid function in such patients, the health of their digestive system must improve. This is often not too difficult using natural medicines. In fact, treating digestive complaints and improving the health of the digestive system is one of the primary services that naturopathic doctors privide to their patients.

The role that the nervous system plays in balancing thyroid function is an obvious one. The nervous system and the endocrine (or hormonal) system are the two main systems that assure homeostatis (meaning, balance) in the body. It only makes sense that if one of these systems is not optimally functioning, the other system will directly be impacted. I find that balancing the nervous system (i.e. treating depression, anxiety, stress, etc.) is an integral part of optimizing thyroid function.

The fact is that “supporting” the nervous system and the digestive system is the missing link in most hypothyroid patients’ protocol if they are seen by conventional medical practitioners. Notice I am using the word “support,” not “treat.” Even if the person does not have diagnosable digestive or nervous system problems (and does not need to be treated with pharmaceutical medications for diagnosable digestive or nervous complaints), they could still use natural SUPPORTIVE therapies in order to optimize and support the function of these systems (i.e. digestive and nervous) which will, in turn, positively influence the endocrine (or hormonal) system.

Helping a difficult case of hypothyroidism may take a few months (typically no more than 3 months), but is hardly ever unachievable using the above protocol.

I would like to also mention that most of my hypothyroid patients end up requiring less and less thyroid hormone as they continue to be treated using their tailored version of the above protocol. As the thyroid gland becomes healthier, the dose of thyroid hormone required by the patient decreases by a small amount every few months; thus the need for close monitoring (i.e blood thyroid hormone tests).

Dr. Sharif