More and more people with hyperthyroidism are looking for a natural treatment option. This makes sense, as radioactive iodine is commonly recommended to those with hyperthyroidism…mainly Graves’ disease and toxic multinodular goiter. While conventional treatment methods are sometimes necessary, before considering radioactive iodine or thyroid surgery it makes sense to look into a natural treatment approach.
Of course I’m a tad biased, as in the fall of 2008 I was diagnosed with Graves’ disease, took a natural treatment approach, and I’ve been in remission since 2009. Since then I’ve published hundreds of articles on thyroid health, written a book entitled “Natural Treatment Solutions For Hyperthyroidism and Graves’ Disease [1]”, and have helped thousands of people with hyperthyroidism avoid radioactive iodine and thyroid surgery. I’ll admit that taking a natural treatment approach isn’t easy, and in fact it is much easier to receive radioactive iodine or thyroid surgery. But there are consequences to both of these conventional treatment procedures, and the truth is that while some people who receive radioactive iodine and thyroid surgery are happy with their decision, many people have regrets.
Conventional Hyperthyroid Treatment Options
Before diving into the different natural treatment remedies for hyperthyroidism, I think it’s important to briefly discuss the most common conventional treatment options recommended by most endocrinologists.
Conventional Treatment Option #1: Antithyroid medication and/or beta blockers. Methimazole is the most common antithyroid medication [2] prescribed in the United States, although sometimes Propylthiouracil (PTU) is recommended for those with hyperthyroidism. Antithyroid medication lowers thyroid hormone levels by inhibiting the enzyme thyroperoxidase, which plays an essential role in the production of thyroid hormone. Carbimazole is frequently recommended in other countries, which converts into methimazole.
Although I chose not to take antithyroid medication when I was diagnosed with Graves’ disease, many of my patients take this type of medication, and it usually is quite effective in lowering thyroid hormone levels. The downside is that side effects are common, including elevated liver enzymes [3], depressed white blood cells, skin rashes, hair loss, dizziness, and nausea. PTU puts more stress on the liver, which is why it’s not as frequently recommended, although pregnant women with hyperthyroidism will usually be prescribed PTU during the first trimester of pregnancy, and the reason for this is because there is clearer evidence of teratogenicity with methimazole.
Conventional Treatment Option #2: Radioactive Iodine. Many endocrinologists recommend radioactive iodine as the first line of treatment for hyperthyroidism. This treatment obliterates the cells of the thyroid gland. It involves swallowing an oral pill, and while the thyroid cells are the main cells in the body that absorb iodine, other areas of the body can also be affected by radioactive iodine, including the breasts. Most people need only a single dose of radioactive iodine, although occasionally multiple doses are needed, and in some cases it can take up to six months before someone becomes hypothyroid.
Hypothyroidism is the most common side effect of radioactive iodine treatment, and most people who receive this treatment will need to take thyroid hormone replacement on a permanent basis. While some people with hyperthyroidism do perfectly fine after receiving radioactive iodine, many people never feel the same again after receiving this treatment method. As I mentioned earlier, many people who receive radioactive iodine regret their decision.
Conventional Treatment Option #3: Thyroid Surgery. A complete thyroidectomy is another option recommended by endocrinologists to their hyperthyroid patients. Complete removal of the thyroid gland will lead to hypothyroidism 100% of the time, and thus the person will need to take thyroid hormone replacement on a permanent basis. Although most people who receive thyroid surgery do fine, there are risks with any type of surgery. Some general risks of surgery include an infection, uncontrolled bleeding, and problems with anesthesia. Risks specific to thyroid surgery include damage to the recurrent laryngeal nerve, superior laryngeal nerve, and/or parathyroid glands.
Two Other Treatment Options Worth Mentioning
1. Low dose naltrexone (LDN). LDN isn’t commonly recommended by medical doctors, but it is a type of medication that can help with many different types of autoimmune conditions, including Graves’ disease. The way LDN works is by modulating the immune system, apparently by increasing regulatory T cells [4], which suppress autoimmunity. LDN could be a good alternative for those who are unable to tolerate antithyroid medication and prefer not to receive radioactive iodine or thyroid surgery. However, LDN isn’t always effective, and it might be challenging to convince your medical doctor to write a prescription for it, although you can search for a local practitioner who would be willing to prescribe LDN by visiting www.ldnscience.com [5] or www.ldnresearchtrust.org [6], or you can visit www.ldndirect.com [7] and schedule a remote consultation with a practitioner who will prescribe LDN.
2. Cholestyramine. Cholestyramine [8] is a bile acid sequestrant that binds to certain components of bile, and is sometimes used for the treatment of chronic diarrhea. It also is commonly used as a treatment for toxic mold by binding to mycotoxins. It can also bind to and lower thyroid hormones, which is how it can be beneficial to those with hyperthyroidism. I do need to let you know that most of the research shows that cholestyramine is effective at decreasing thyroid hormone levels when combined with methimazole (1) [9] (2) [10], but there is a case study that showed it was effective when taken alone (3) [11], and a few of my patients with hyperthyroidism have had success with it when taking it with bugleweed. So this can be another alternative for those who are unable to take antithyroid medication.
Graves’ Disease and The Triad Of Autoimmunity
Although this article doesn’t just focus on Graves’ disease, the truth is that most people with hyperthyroidism have Graves’ disease. As a result, I want to briefly mention the triad of autoimmunity, which states that three components are necessary for autoimmunity to develop. This includes 1) a genetic predisposition, 2) an environmental trigger, and 3) an increase in intestinal permeability, which is also known as a leaky gut. While genetics is one of these components, one’s environment is a greater factor in the development of autoimmune conditions, which explains why autoimmunity has increased dramatically over the last few decades. After all, our genes haven’t changed that quickly, but our environment has without question worsened over the years, as we eat toxic food, drink toxic water, breathe toxic air, and deal with more stress than ever before.
Managing Your Symptoms While Addressing The Underlying Cause
As I mentioned earlier, when I was diagnosed with Graves’ disease I chose not to take antithyroid medication. While many of my patients take antithyroid medication, at the time I decided that I would try to manage my symptoms through the herb bugleweed. Bugleweed is an herb with antithyroid properties. It isn’t as potent as methimazole and other prescription antithyroid agents, but many people are able to use it as an alternative to antithyroid medication.
Fortunately taking bugleweed turned out to be a good decision in my situation, as this herb did a wonderful job of helping to lower my resting heart rate. While many of my patients have successfully used bugleweed to manage their symptoms naturally over the years, I do need to tell you that some people are unable to significantly lower their thyroid hormone levels through bugleweed alone. Sometimes increasing the dosage of the bugleweed and/or adding another natural agent with antithyroid properties can help (i.e. high doses of L-carnitine), but some people will need to take antithyroid medication. I’ll also add that while bugleweed helped to lower my resting heart rate, I still had some palpitations, and therefore added the herb motherwort.
Let’s take a closer look at some of the natural agents that can be beneficial for managing the symptoms of hyperthyroidism:
Bugleweed. This herb has the greatest antithyroid properties, and is what I most commonly recommend to my patients. Keep in mind that different herbs have different potencies. For example, when I was dealing with Graves’ disease I took Mediherb Bugleweed, which has a 1:2 extract ratio. I personally took 5 mL 2x/day, but not everyone needs to take the same potency or dosage. As another example, bugleweed from the company Herb Pharm has a lower potency (1:5 extract ratio), but for some people this is sufficient to lower their thyroid hormone levels.
Motherwort. Unlike bugleweed, motherwort doesn’t have antithyroid properties, but instead is similar to a natural beta blocker. In my case it helped with heart palpitations, but it can also help to decrease the heart rate (not by lowering thyroid hormone levels), and it also has antiarrhythmic activity.
Hawthorn. Although I recommend motherwort frequently to my patients with hyperthyroidism, probably because I took it when I dealt with hyperthyroidism, hawthorn is another herb to consider for managing the cardiac symptoms. Like motherwort, hawthorn doesn’t have antithyroid properties, but it can help with heart palpitations, cardiac arrhythmias, and high blood pressure.
Lemon balm. Lemon balm has mild antithyroid properties, and thus can be beneficial in some people with hyperthyroidism. I personally didn’t take this herb when I had hyperthyroidism, but many of my patients have found it to be helpful. I usually recommend it for those who have problems sleeping, as it also has some mild sedative properties (4) [12].
L-carnitine. L-carnitine has antithyroid properties when taken in higher doses (i.e. 2,000 to 4,000 mg/day). Given the choice I would prefer for my patients to take bugleweed since it has greater antithyroid properties, although some people with hyperthyroidism will take both bugleweed and L-carnitine.
Lithium. Lithium can also decrease thyroid hormone production directly, as well as by decreasing the conversion of T4 to T3 (5) [13]. Some healthcare practitioners will recommend lithium to all of their hyperthyroid patients, but rarely is it something I recommend. One reason is because there is some evidence that lithium can negatively affect kidney health, although this might be true only when taken for a prolonged period of time (6) [14] (7) [15].
Iodine. Iodine is quite controversial, as since it is involved in the production of thyroid hormone many endocrinologists will warn their patients with hyperthyroidism to avoid iodine supplementation, and to even avoid eating foods high in iodine, such as sea vegetables. But while an iodine deficiency can cause hypothyroidism, high doses of iodine can actually lower thyroid hormone levels. The problem is that not everyone does well with iodine, and in some cases it can exacerbate the autoimmune response in Graves’ disease patients if certain precautions aren’t taken. As a result, if you choose to supplement with iodine it is best to work with a competent healthcare practitioner.
Hyperthyroidism and Natural Treatment Solutions
Now that I’ve discussed conventional treatment options, along with some different ways to manage the hyperthyroid symptoms, I’d like to focus on addressing the underlying cause of your hyperthyroid condition. After all, the primary goal should be to try to address the cause of the problem. While most endocrinologists and other medical doctors will tell their patients with hyperthyroidism that the only treatment options are 1) antithyroid medication, 2) radioactive iodine, or 3) thyroid surgery, this simply isn’t true.
So here are some of the things you want to do in order to reverse your hyperthyroid condition:
1. Clean up your diet. Eating well is important when dealing with any health condition. This isn’t to suggest that eating well alone will reverse your hyperthyroid condition, but it’s probably safe to say that those with hyperthyroidism and Graves’ disease who eat poorly are less likely to receive good results when following a natural treatment protocol. It’s also important to mention that for those who have Graves’ disease, certain foods can potentially trigger the autoimmune response, including gluten, dairy [16], and corn. Regardless of whether food is a trigger or not, there is no question that certain foods are inflammatory (i.e. fast food, refined sugars), while other foods can interfere with healing of the gut (i.e. legumes [17]).
I probably should add that while I followed a strict diet when I was dealing with Graves’ disease, since getting into remission in 2009 my diet hasn’t been nearly as strict as when I was trying to restore my health. Overall I still eat healthy most of the time, but I do indulge every now and then. So hopefully you understand that I’m not suggesting that those with hyperthyroidism and Graves’ disease need to follow a strict diet on a permanent basis, but you probably will need to do so while looking to restore your health, and even once you’re in remission it is a good idea to continue to eat well thereafter.
2. Reduce stress and improve stress handling skills. The research shows that stress is a big factor in the development of Graves’ disease (8) [18] (9) [19]. For many people it can be challenging to reduce their stressors, and while you should still make an effort to do this, at the same time you want to work on improving your stress handling skills. Consider incorporating mind body medicine techniques such as meditation and yoga [20]. The key is consistency, as you want to block out time for stress management on a daily basis. This doesn’t mean that you need to spend an hour or two per day on stress management. Heck, you don’t even need to spend 30 minutes every day on this. Start out with five minutes per day, and then once you’re in the routine you can gradually increase until you’re blocking out 10 to 15 minutes per day. Sure, if you’re able to spend more time working on stress management that’s great, but you can still get some wonderful benefits by blocking out 10 to 15 minutes per day, which is what I personally do.
3. Reduce your toxic load. It is impossible to eliminate your exposure to environmental toxins, as there are tens of thousands of man-made chemicals in our environment, including xenoestrogens such as BPA [21], plasticizers such as phthalates, and herbicides/pesticides such as glyphosate [22]. And of course there are heavy metals such as lead, mercury [23], cadmium, arsenic, and aluminum. Although you won’t be able to completely eliminate your exposure to these and other chemicals, you can reduce your exposure by eating organic food, using natural cleaners and cosmetics, and by making other wise choices. For example, since most people spend a lot of time in their bedroom, it makes sense to do everything you can to reduce your exposure to any chemicals in this room. While investing in a natural mattress is an example of something you can do, another approach is to invest in a good quality air purification system (i.e. Blueair, IQAir).
You also want to do things to eliminate chemicals from your body. You should do as much as you can through diet, such as eating plenty of vegetables, as this will help support your detoxification pathways. Certain nutritional supplements can also help with the elimination of toxins from your body by increasing glutathione [24] production, such as N-acetylcysteine (NAC) and alpha lipoic acid [25]. Sweating out the toxins from your body through exercise or by using an infrared sauna is also something you can do.
4. Correct nutrient deficiencies and Mitochondrial Dysfunction. Being deficient in certain nutrients can make someone more susceptible to developing a hyperthyroid condition. For example, certain nutrient deficiencies can cause a decrease in regulatory T cells, which play an important role in preventing autoimmunity from developing. Vitamin A and vitamin D [26] are especially important, and so if someone is deficient in vitamin A and/or D this can lead to a decrease in regulatory T cells, making them more susceptible to developing Graves’ disease.
Another example involves selenium [27], which is important for the production of the master antioxidant in the body, glutathione. If someone is low in glutathione then they will have increased oxidative stress, which is a factor with Graves’ disease, as well as thyroid eye disease. For those with toxic multinodular goiter, estrogen dominance is a potential cause, and keep in mind that glutathione is important for phase 2 detoxification, which in turn is important for the detoxification of estrogens. Of course one can be deficient in other nutrients as well, including zinc, magnesium, iron, the B vitamins, essential fatty acids, CoQ10, etc. These deficiencies usually won’t directly cause hyperthyroidism and Graves’ disease, but as mentioned earlier, they can make someone more susceptible to developing hyperthyroidism.
In addition, many of these nutrients are important for optimal health of the mitochondria, which are the energy powerhouses of our cells. Mitochondria play an important role in the production of adenosine triphosphate (ATP), which has an impact on numerous biological processes. In addition to CoQ10, some of the other nutrients important for the health of the mitochondria include lipoic acid, acetyl-L-carnitine, magnesium, omega-3 fatty acids, biotin, vitamin B2, B3, B6, and resveratrol.
5. Optimize the health of your gut microbiome. Approximately 80% of the immune cells are located in the gastrointestinal tract. As a result, having a healthy gut microbiome is necessary for optimal immune system health. On the surface this might only seem applicable to Graves’ disease since this is an autoimmune condition. But this definitely isn’t the case. For example, I briefly mentioned earlier how problems with estrogen metabolism is one of the main causes of toxic multinodular goiter. And having a healthy gut is necessary for proper estrogen metabolism.
So how do you optimize the health of your gut microbiome? In the past I’ve spoken about the 5-R protocol, which involves the following:
Remove
Replace
Reinoculate
Repair
Rebalance
All five of these factors are important, as you want to remove any factors that are causing gut dysbiosis (imbalance of the gut flora) or an increase in intestinal permeability (leaky gut). If someone is deficient in digestive enzymes or dietary fiber then these need to be replaced. Reinoculation with prebiotics and probiotics is necessary in most cases. Repairing the gut is essential, but the problem is that many people try to repair the gut without removing the cause of the gut dysbiosis or leaky gut. And you want to rebalance the body.
Also, I mentioned how correcting nutrient deficiencies is important, but remember that a healthy gut is necessary for optimal digestion and absorption of the nutrients you consume. And so while sometimes it’s necessary to supplement with vitamins and minerals, it’s also vital to optimize the health of your gut so you will be able to properly digest and absorb the nutrients from the food you eat and any supplements that you take.
6. Address stealth infections. Stealth infections include bacterial or viral infections, and these are very challenging to treat, mainly because they live within our cells. Two examples of stealth infections include Epstein-Barr [28] and Borrelia Burgdorferi. The truth is that other types of infections can also be problematic (i.e. H. pylori), but stealth infections are especially difficult to deal with because they employ mechanisms to evade the immune response. 90% of people have Epstein-Barr, but this virus isn’t problematic in everyone, and the reason for this has to do with the health of the person’s immune system. In other words, if someone has a healthy immune system then Epstein-Barr is unlikely to cause problems, whereas if someone has a compromised immune system then this virus might cause a lot of health issues.
Borrelia Burgdorferi is the pathogen associated with Lyme disease, and I was personally diagnosed with chronic Lyme disease [29] in 2018, almost 10 years after being diagnosed with Graves’ disease in 2008. The good news is that if this pattern continues I won’t have to worry about another major health concern until 2028! Seriously though, although it was a bummer that I was diagnosed with Lyme disease, just as is the case with my past Graves’ disease diagnosis, dealing with Lyme disease turned out to be a blessing in disguise, as it allowed me to better relate to others with this chronic infection, and hopefully over the years this will allow me to help some people with Lyme disease get their health back. Fortunately I didn’t have severe symptoms that many Lyme disease sufferers experience, and I attribute this to my immune system being in a better state of health than most people, although apparently there were some “weak links” or else I probably wouldn’t have become symptomatic in the first place.
7. Improve estrogen metabolism. Problems with estrogen metabolism can lead to numerous health issues, including thyroid nodules. There are a few different ways in which people develop problems with estrogen metabolism, including eating a poor diet consisting of an abundance of nonorganic meat and dairy products, combined with not eating a sufficient amount of vegetables. Being exposed to xenoestrogens such as bisphenol A (BPA) can have a negative effect on estrogen metabolism. This is one big reason why you don’t want to drink water out of plastic bottles on a regular basis, although there are other ways you can be exposed to xenoestrogens, including through plastic food storage containers, plastic utensils, some canned foods, and thermal paper receipts. So in order to improve estrogen metabolism you want to eat plenty of vegetables, decrease your exposure to xenoestrogens, support detoxification and methylation, as well as exercise regularly.
What You Need To Know About Treating Thyroid Eye Disease Naturally
Some people with Graves’ disease have thyroid eye disease [30], also known as Graves’ ophthalmopathy. In this condition the immune system attacks the tissues of the eyes, which can lead to symptoms such as swelling, pain, bulging of the eyes, and in more severe cases double vision. In my practice I’ve seen a correlation between very high thyroid stimulating immunoglobulins and thyroid eye disease. In other words, the higher the TSI levels, the greater the likelihood that someone with Graves’ disease will have eye symptoms.
As for how to treat thyroid eye disease naturally, everything discussed in this article thus far applies. However, because there usually is a more vigorous immune system response I find that having the patient take higher doses of natural anti-inflammatory agents can help. Having healthy vitamin D levels and taking a selenium supplement can also be beneficial. I’ve had some patients claim that CBD oil has helped, while others haven’t noticed any difference while taking this. Either way, the primary goal should be to find and remove the autoimmune triggers.
Can thyroid eye disease be reversed? It depends on the stage and severity of the disease. If someone has moderate to severe thyroid eye disease and are in the inactive stage, then it is highly unlikely that their eyes will go back to normal upon following a natural treatment protocol. On the other hand, if someone has mild thyroid eye disease and they’re in the active stage, then there is a good chance of reversing the condition. While it would be great if everyone with thyroid eye disease were able to avoid anti-inflammatory drugs such as Prednisone and surgical intervention, the truth is that conventional treatment is sometimes necessary. However, high doses of natural anti-inflammatory agents can also be beneficial in many people with this condition.
So hopefully you have a better understanding as how to reverse your hyperthyroidism. Whether you have Graves’ disease, toxic multinodular goiter, or a different type of hyperthyroid condition, the goal is to find and remove the triggers and correct underlying imbalances. As discussed in this article, eating well is very important, as is improving your stress handling skills, reducing your toxic load, correcting nutrient deficiencies, and optimizing the health of your gut microbiome. Stealth infections might need to be addressed, and estrogen metabolism also can be a factor, especially with toxic multinodular goiter. While some people do need to take antithyroid medication while following a natural treatment protocol, others are able to manage their symptoms through herbs