Positive Health Online

Hyperthyroidism

The thyroid gland, located at the base of the neck in front of the windpipe, is one of the body's crucial hormone-producing glands. It releases the hormones triiodothyronine (T3) and tetraiodothyronine (T4 – thyroxine), which regulate metabolism in all body systems. The overall effect of the thyroid hormone, for which there appears to be a receptor in every body cell, is to increase the amount of energy that the cell uses; it is essential for life, and it is the only part of the body known to require iodine. Blood levels of these hormones are kept in narrow limits by a feedback control system whereby, when levels fall, the hypothalamus (an area of the brain) is triggered to increase production of the hormone thyrotrophin-releasing hormone (TRH) which travels to the pituitary gland in the brain. The pituitary then increases production of thyroid-stimulating hormone (TSH), which in turn stimulates the thyroid gland to increase its production of T3 and T4. The thyroid hormones are so named because there are four atoms of iodine (their major constituent) in each molecule of thyroxine (T4) and three atoms of iodine in each molecule of triiodothyronine (T3). It is believed that T4 starts to be active only when it is converted, mainly in the liver, to T3 by the removal of one atom of iodine.

Anterior view of thyroid gland

When for any reason the thyroid becomes overactive, chemical actions in the body are speeded up, with many resultant physical and psychological symptoms. Food calories are quickly burned off, causing weight loss, excessive body heat and increased frequency of urination and bowel movements. Restlessness, sleeplessness and lack of concentration also result, together with breathlessness and heart palpitations as all of the body systems accelerate. Muscle tone diminishes (including that of the heart muscle) and muscle tremor and weakness are experienced – the changes in the muscles of the eyes cause their characteristic bulging appearance, together with blurred vision and heightened sensitivity. The reproductive system is also affected, and there is a noticeable deterioration of the skin, hair and nails. The person affected will probably be hyperactive and restless, but also prone to resultant periods of extreme exhaustion.

Enlargement of the thyroid gland (goitre) is present to some degree, with or without nodules in the gland which are often noticeable enough to be easily felt with the fingers. These nodules overproduce thyroid hormones in their own right and are not under the control of the negative feedback loop described above.

The causes of hyperthyroidism are not understood, but there is thought to be an autoimmune stimulus whereby for an unknown reason the body produces a thyroid- stimulating immunoglobin; also, thyroid-stimulating antibodies which attack THS receptors in the thyroid are found in the serum of hyperthyroid patients. Environmental pollutants have certainly been linked with thyroid disorders by some research, and there are also possibilities that parasitic or fungal infections of the thyroid could be involved. Stress, of course, affects the immune system, and often traumatic life events appear to have taken place a few months before hyperthyroidism is noticed.

Personal History

1999 was a stressful year for many people, with the lead-up to the millennium looming, and an extra stress for me was the gradually increasing awareness that 'something was wrong'. Hyperthyroidism is especially common in women, like me, around the time of the menopause, though I had no previous knowledge or experience of the condition. It's easy to confuse menopausal symptoms (like flushes, and emotional highs and lows) with those of an overactive thyroid – and in fact the two are related at this time, when the hormones are running riot. In my case, with my gung-ho approach to the menopause, I ignored the signs for many months, even to the extent of putting down to fatigue such symptoms as muscle tremor, breathlessness, insomnia and palpitations. That is, until the day in November 1999 when I realized that I'd lost nearly a stone in weight and so immediately made an appointment to see my GP.

The diagnosis came a few days later, with the blood test results. My GP made no bones about the seriousness of the condition and the treatment options, which will be familiar to others who have experienced the disorder: drug treatment (carbimazole), or radioactive iodine treatment, or surgery – and possibly all three, in the long term. Without treatment, my doctor said, my condition would inevitably worsen and I would end up in an incurably weakened state, at risk of blindness and psychosis. As with all cases of hyperthyroidism, he wrote a letter of referral to a consultant and started to write a prescription for carbimazole, and for beta-blockers to control the palpitations.

Straight away, this didn't feel right, since for many years I've preferred to let my body do its own healing rather than use remedies, especially pharmaceuticals. I asked the GP for a period of grace to think about it, and he reluctantly agreed to see me two weeks later.

With reference to the drugs, I am talking here about my own reactions and my personal choice; whether to take a drug treatment is of course a choice for each individual to make, based on the nature of the disorder, on our views on our own body's healing process, and on our views on the pharmaceutical industry. Each individual must make a personal decision, but the point is that there is a choice and we can be in control of the choice. In fact, my period of 'grace' turned out to be quite a depressing time, as I searched the literature, searched the web and asked as many people as I could for any information on alternative treatments for hyperthyroidism. Again and again I came up with the same thing – drug treatment, radioactive iodine, surgery – and no alternative at all.

My first breakthrough came when I was introduced to a range of nutritional supplements which I learned had helped someone with hyperthyroidism (albeit in addition to drug treatment) and the second was the discovery that medical herbalism could possibly be of help.

By the time my first appointment with the consultant came up in January 2000 I had been taking nutritional supplements and medicinal herbs for several weeks and my symptoms were improving slightly – though the medics did not 'count' this, saying that the thyroid was still basically out of control. I was still determined to avoid the drugs if possible, whilst being clear all along that if things got really bad then of course I would probably decide to take it. The consultant, however, strongly opposed my plan. He said that very many of his patients over the years had tried alternative treatments without success. He also said that before the advent of drug treatment, one-third of people with the condition used to die from it, and that I was at serious risk of heart failure (at that time my resting pulse was way up in the nineties and I experienced frequent palpitations). My herbalist had written the consultant a letter detailing my treatment, but the consultant merely took a quick glance at this and handed it back to me instead of putting it on my file. He did, however, agree to continue to monitor me, for which I was grateful.

Six months later, in July 2000 and on my third visit, the consultant's reaction to a quick check of my pulse rate was to say, "That's amazing!". Later, the results of the blood test taken on that visit showed that my thyroid hormone level (FT4) had come down from 37.3 on first diagnosis to a level of 12.5, which is within the normal range. FT3 was also normal at 6.5. Additionally, Thyroid Stimulating Hormone had reappeared and this had been absent in my previous readings. Considering what I had been told by both the GP and the consultant, I felt that this was a marvellous result! Later still, the consultant has written to me following the subsequent test in October that the result shows that my thyroid 'is under perfect control'.

I still need to be monitored; I feel that our hormones are a complex – magical! – and incredibly sensitive system that is constantly acting and reacting with other systems as part of our body's continual working on our behalf towards balance and health. I cannot declare myself 'cured' and then forget all about it. Like most aspects of life, this is a process, not a cure. Indeed, with this condition, there is often a pattern of recurrence. But I do feel that there has been a lot of healing going on, and I'd like to describe here the various things that I did which were all part of my healing. I hope it may be helpful to others with the condition, and also to others who need to work on restoring their health. Some of my strategies are very practical, whilst others involve the emotions and spirit. They are not listed in order of importance.

Information

On diagnosis, the first thing I did – as with many previous challenges in my life (the driving test, the first baby) – was to go out and get a book about it. I got several books, in fact. Information is part of the strengthening and empowering process.

Reassessment

I knew that the fundamental thing to do, when faced with illness, was simply to stop doing whatever it was that made me ill. This involved reassessing the whole of my life, including habits of work, play, eating, sleeping, thinking and breathing! Hyperthyroidism is one of the few conditions that even orthodox medicine recognizes to be stress related (whilst a more wholistic view is that all conditions are related to stress of some kind). The first thing to do, then, was to examine why it was that my life had become unmanageable, and to do something about it. We can't just abandon responsibilities, of course, and being self-employed I felt unable to stop working, but I did manage to take some things at a different pace and, most importantly, to resolve not to work in the evenings for a while. I made more time for myself wherever possible, without feeling guilty, and sometimes I just abandoned ship and went to bed. I said 'no' more often.

Most importantly, I schooled myself to change my attitude to uncomfortable situations that I can't change. I had an ongoing 'problem' at this time, which in fact got worse and not better during the period I am describing. Paradoxically, I think the spiritual discipline needed to address this problem was just what I needed in order to make improvements, which helped me with the other areas of life at that time as I slowly and deliberately became a different person from the one who had become ill. I was able to see my problem (in my better moments!) not as an extra burden but as a very appropriate opportunity for more emotional development.

Breathing and Relaxation

It's good to take time out, but in reality for many people that's a rare treat. I had already learned relaxation techniques and thought I was quite good at doing a swift 'body check' at any time to see if I was unnecessarily tensing any muscles. And realizing that opportunities for 'deep' relaxation were normally very limited, I began to practise a less profound but much more sustained type of relaxation which I now think has benefited me more than occasional periods of complete 'switch off'. I have made a habit of checking for tension almost all of the time; of slowing and deepening my breathing almost all of the time; of approaching tasks at ease, and at a slower pace.

Breathing is especially important, being the only part of the sympathetic nervous system over which we have some conscious control; calming the breathing has a marvellous effect on other parts of the sympathetic nervous system, which we can't, of course, consciously control. In normal breathing, the in-breath is a muscular effort, which takes less time than the effortless out-breath. In stressed breathing, the in- and out-breaths are quicker and of an almost equal duration. By becoming aware of our breathing, and sometimes counting with the breaths, we can deepen and regularize our breathing to one that has strong, refreshing in-breaths and long, luxurious out-breaths; this delivers the right amount of oxygen to our body cells and soothes and balances the nervous system with enormous benefit to our other body systems. This is a way of breathing which with practice can become normal – not just something reserved for special times. It is of particular benefit to the hyperthyroid condition where the body is under too much stress of its own making.

All of this, I think, may have been more beneficial than taking limited periods of time out for relaxation and deep breathing during an otherwise hectic life.

Likewise, with meditation and healing, the 'big picture' is the most important. Of course, there is no substitute for meditation (devotion, healing, or prayer, depending on your views), and I have taken every opportunity I could over the past year to give and receive healing.

However, I really think that what these practices are actually 'for' is to be carried over into every aspect of our lives. If we can practise loving and healing thoughts wherever we are, and in whatever circumstances, not just at special times, then we've really achieved our own healing (and needless to say, I'm not quite there yet!).

On a practical level, I found that listening to tapes of beautiful visualizations and strengthening affirmations helped with this. I would listen to my tapes each night before falling asleep and I'm sure that this really helped with bringing the peacefulness of the meditative state into the other parts of my day and night. When I remember that I am, in fact, a soul, then I regain a calm perspective and many things slip back into place. When things go wrong and I can feel myself getting 'wound up' and exhausted, it's usually because I have temporarily forgotten the simple fact. So I just remind myself of it once more.

Medical Herbalism

I've been interested in herbs for many years, and perhaps that's what gave me an affinity for this choice of treatment. Robyn James who practises in Sheffield is my herbalist and she is a Member of the National Institute of Medical Herbalists. From the outset, Robyn made it clear that she would not be happy to treat me were I not also being monitored by a hospital consultant; all responsible herbalists (as with other practitioners) will clarify what they can and can't treat, and will refer to a doctor or another practitioner when appropriate. Robyn conducted a much more thorough consultation than either the GP or the consultant, including blood pressure and cardiac examination, neither of which the GP or the consultant had done.

Robyn has treated me with different combinations of several herbs over this period, all in the form of tinctures, taken in a mixed dose twice a day. The herbs used have been: Leonurus cardica (motherwort), Lycopus virginicus (bugleweed, i.e. NOT Lycopus europaeus [gipsywort] and NOT bugle [Ajuga reptans]), Verbena officinalis (vervain), Valeriana (valerian), Withania (ashwagandha) and Crataegus spp (hawthorn). At Robyn's suggestion, I also drank a pot of tea made from fresh garden lemon balm (Melissa officinalis) on most days. Lemon balm is calming and has anti-thyroid properties; and it is not a coincidence that for the last two years the plant has been running all over my garden – reaching out to me, it seems. I consider that the treatment with herbs has been absolutely pivotal in the rebalancing of my thyroid hormone levels. Herbs work on the chemical level, of course, but I'm sure that they also work on subtle levels that are not yet fully rediscovered. It is important to note that I have not been self-treating with herbs, which might have been possible if I had consulted a herbal and just taken recommended doses of suitable plants. A practitioner is able to see us from a different perspective from our own, and to make a prescription based on our biochemical and personal individuality – not to mention knowing sources of organic herbal tinctures, which would not be easy for an individual to find and to buy in suitable quantities. I do use herbal remedies from the garden, fields and shops for minor ailments and general health, but I feel lucky that in this case of a serious health problem I was able to consult a professional herbalist.

Eye Care

Robyn also advised on eye care because of the changes in my eyes caused by the condition – which, again, the medics did not. Hyperthyroidism causes a bulging of the eyeballs – exopthalmus – because of a weakening of the muscles behind the eye. This condition is thought to be irreversible and in extreme cases leads to cataracts and blindness. I told Robyn that for some time past I had experienced streaming of the eyes during the night. She said it sounded as if I had been sleeping with my eyes open, and I immediately realized that this was the case. I'd also experienced dry and 'gritty' eyes during the daytime, which I had put down to tiredness, not having noticed the changes that had imperceptibly taken place in my eyes. Robyn suggested I use eye drops to lubricate the surface of the eye and prevent the damage that could eventually result in cataracts if the constant unnatural dryness of the eye were left untreated. I started using the only eye drops available over the counter, which do not contain antibiotics (they do, however, contain a harmless form of sugar as a preservative). The drops simply mimic tears. Robyn told me that pure castor oil can also be used as an eye protector, but I find the drops more convenient. I use them before working at the computer and before going to sleep, and they have made my eyes much more comfortable. I expect my GP would have prescribed them if I'd asked him, though he hadn't mentioned eye care even though the appearance of my eyes had caused him to suspect hyperthyroidism in the first place. Now that my condition has abated, I am sure that the shape of my eyes has improved, just as the general muscle tone in other parts of my body is ready to be restored. My eyes no longer constantly feel as if I need to close them and there is less 'white' visible around the iris. This proves to me that in the early stages, at any rate, thyroid-induced eye problems are by no means irreversible.

Nutrition

During this time I have been supporting my body with the highest quality nutritional supplements. One of my earliest rays of hope after diagnosis was talking to a friend who introduced me to this particular range of products, some of which I started taking about two weeks after diagnosis. The two that I feel have helped me, and which I still take, are a multi-mineral with vitamins, in solution, and a powerful antioxidant formula in tablet form. In particular I remember that in November last year my muscles had become so weak and my shoulder joints had become so stiff that I found myself crying out in pain with the effort of taking off a sweater. I feel sure that nutritional support has helped me to overcome these symptoms completely by helping to deliver nutrients to the muscles. Before my illness I had resisted taking supplements for many years, wanting to demonstrate the healthiness of my wholefood vegan diet. I've now come to a compromise between this puritanical attitude and the proven case that all food is in fact far less nutritious than it was 60 years ago, because of the depletion of the soil under intensive farming. So this is yet another reassessment!

Needless to say, I tried to make doubly sure during this time that I ate a varied and fresh wholefood diet, including a wide range of vegetables, fruits, pulses, nuts, seeds and grains. Some foods (mainly members of the cabbage family – turnip, broccoli, cabbage, Brussels sprouts etc.) contain substances called goitrogens which interfere with the workings of the thyroid gland and are not recommended for people experiencing thyroid imbalance, though they are sometimes recommended for hyperthyroidism. However, I believe that a huge amount of raw cabbage would be needed to have this effect, and so avoidance or overuse of this food group was not part of my strategy. I consider these green leaves to be vital foods (not eaten in isolation, of course, but together with the full palette of other coloured vegetables which together provide the antioxidant vitamins and phytonutrients) and they are normally part of my diet.

At the same time I have not altered my consumption of soya products, which have also been implicated with hormonal disturbances recently (though this is controversial and I personally tend to think that chemical pollutants such as indestructible pcbs and dioxins etc, which mimic oestrogen, and which are now disastrously widespread in the environment, are the real problem). As a vegan I have been using soya for many years – I use a small amount of soya milk (about 60ml per day) and I eat tofu perhaps once a week. I rarely use TVP, which as a factory-produced food I consider suspect anyway!

Stimulants

In a stress-related illness, the last thing to do is to provide the body with more stress in the form of stimulants – all of which cause some kind of chemical 'rush', followed by depletion and fatigue (and the need for more stimulant). The prospect of giving up coffee was very depressing for me, but nonetheless a challenge. I had always despised decaffeinated coffee, but on Robyn's instructions I immediately changed over to it (another reassessment!). Technically, though, I haven't actually given up caffeine, because the decaffeinated stuff I drink does contain smaller amounts of it, not to mention other drugs (theobromine, theophylline) and potentially harmful substances from the processing. Still, I feel I have taken a huge step, and could go further when the time comes. I have also drastically cut down on sweet snacking. Sugar as such (even in a 'wholefood' product) is really a stimulant, since it floods our system with glucose and brings the endocrine system into play. I'm now much more disciplined about sweet snacks and use them far less often than in the days when my symptoms were at their worst and when a coffee with flapjack was practically a life-support system – albeit one that was spiralling quickly downwards! Certainly, when I 'got serious' about reducing stimulants, I immediately saw an improvement in my symptoms.

Exercise

I have a feeling that in the last few years my attempts to maintain fitness with a sporadic exercise programme and jogging routine – without proper recovery periods in between – actually contributed to the onset of my condition. After my diagnosis, I simply dropped any exercise as such (sweet relief!) and admitted fatigue. My work and family amply provided as much exercise as I could cope with and when possible I just went for gentle outdoor strolls and got out of the city as much as I could. Gradually, when I felt better, I introduced some easy muscle building in order to rebuild lost muscle tone. When I am ready to regain even more fitness, I shall do it with caution and take notice of my pulse rate to ensure that I don't overdo it again.

Receiving Help from All Sides

When we are ill, we need all the help we can get. Not one thing, but many things and people, have helped me, and I am thankful to them all and to 'the universe'. I don't claim to have found a cure, but I do feel that I have made some good changes in my inner life and that a process of restoration is taking place. I hope it will be continual. Illness often changes us for the better. The following quote from M Scott Peck is really about mental illness, but it sums up beautifully:

'The symptoms and the illness are not the same thing. The illness exists long before the symptoms. Rather than being the illness, the symptoms are the beginning of its cure. The fact that they are unwanted makes them all the more a phenomenon of grace – a gift of God, a message from the unconscious, if you will, to initiate self-examination and repair.'