Which Are The Best Herbs For Managing The Symptoms Of Hyperthyroidism & Graves’ Disease?

When someone with hyperthyroidism or Graves’ Disease is following a natural treatment protocol, the goal should be to address the underlying cause of the condition.  However, while this is being accomplished it is important to manage the hyperthyroid symptoms.  While many people choose to do this with antithyroid medication such as Methimazole or PTU, or beta blockers such as Propanolol, others choose to manage their symptoms naturally.  In this post I’ll discuss some of the most common herbs used to manage the hyperthyroid symptoms.

Bugleweed. This herb has antithyroid activity, as it reduces the thyroid hormone levels, which in turn causes a decrease in the cardiac symptoms associated with hyperthyroid conditions.  Lycopus virginicus and Lycopus europaeus are the two main species.  Most of the research studies involving bugleweed which I have come across have involved lycopus europaeus (1) (2) (3).  These studies show that bugleweed is effective in mild forms of hyperthyroidism, although in my clinical experience I’ve had patients with moderate to severe forms respond to a 1:2 extract ratio.  On the other hand, for some people this isn’t potent enough, and in these cases taking antithyroid medication may be necessary to lower the thyroid hormone levels while addressing the cause of the problem.

Dosage: According to master herbalist Kerry bone, 2 to 6 mL of a 1:2 liquid extract should be used, although I have used higher doses than this on some patients.  6 to 18 mL/day of a 1:5 tincture is recommended by Kerry Bone.

Pregnancy and Lactation: According to Kerry Bone, bugleweed is associated with a substantial risk of causing harmful effects on the fetus or neonate, and he suggests that it shouldn’t be taken during pregnancy.  He also says this herb is contraindicated during breastfeeding due to the possibility of both prolactin reduction in the mother and antithyroid constituents passing into the breast milk.

Motherwort. This herb can greatly help with the cardiac symptoms of hyperthyroid conditions.  It can help to reduce the heart palpitations, decrease the heart rate, and also has antiarrhythmic activity.  While bugleweed is specifically used for hyperthyroid conditions, motherwort can be beneficial for other conditions, such as digestive disorders, bronchial asthma, amenorrhea, and even externally in wounds and skin inflammation (4).  So in addition to its effects on the heart and circulatory system, pharmacological studies have confirmed its antibacterial, antioxidant, anti-inflammatory, and analgesic activity (4) (5).  The results of one study showed that motherwort can weaken the generation of free radicals in mitochondria (5), which is one of the ways that it offers cardioprotection.  Another small study looked at the effect of motherwort in patients with arterial hypertension accompanied by anxiety and sleep disorders, and concluded that this herb may help with arterial hypertension and concurrent psycho-neurological disorders, with minimal side effects (6).

Dosage: According to Kerry Bone, 2 to 4 mL of a 1:2 liquid extract should be used, although I have used higher doses of this in some patients.  If using a 1:5 tincture then 6 to 12 mL should be used by most people.

Pregnancy and Lactation. There has been no increase in frequency of malformation or other harmful effects on the fetus from limited use in women.  However according to Kerry Bone there is evidence of increased fetal damage in animal studies, and as a result I don’t recommend motherwort during pregnancy.  Kerry Bone does mention that it is compatible with breastfeeding, and I have had some breastfeeding women take motherwort.

Lemon Balm. In past articles and blog posts I have briefly mentioned the benefits of lemon balm for people with hyperthyroidism and Graves’ disease.  However, I’m admittedly biased towards bugleweed and motherwort since I took those two herbs when I was diagnosed with Graves’ Disease, although I didn’t take lemon balm.  However, lemon balm can benefit many people with hyperthyroid conditions.  It has antithyroid activity, as it may block the binding of TSH to its receptor by acting both on the hormone and receptor itself, and might also inhibit the TSH receptor antibodies binding to the TSH receptors (7).  Lemon balm also has been used as a mild sedative, spasmolytic, and antibacterial agent, and might even have antitumoral activities (8).  I also came across a few studies which showed that lemon balm has inhibitory activity on the herpes simplex virus (9) (10).  Another study showed that lemon balm can decrease elevated liver enzymes due to its strong antioxidant properties and phenolic compounds (11).  Another study conducted on mice showed that lemon balm has anti-diabetic effects, which is probably due to enhanced glucose uptake and metabolism in the liver and adipose tissue, and the inhibition of gluconeogenesis in the liver (12).

Dosage:  Kerry Bone hasn’t listed doses for lemon balm, and so if I recommend this herb I usually will start someone on the recommended dosage provided by the manufacturer.

Pregnancy and Lactation: Even though lemon balm has some antithyroid activity, some consider lemon balm to be safe during pregnancy, while others recommend to avoid it.  It does seem to be compatible with breastfeeding, although it might produce a mild sedative effect in the baby.

Hawthorn. Although I usually recommend motherwort to help manage the cardiac symptoms associated with hyperthyroidism (elevated pulse rate and palpitations), I also will recommend hawthorn at times.  This can also be helpful in those people with cardiac arrhythmias.  Hawthorn also has anti-inflammatory, gastroprotective, free radical-scavenging, and antimicrobial activity (13).  With regards to its antimicrobial activity, hawthorn seems to be most effective against gram-positive bacteria, with no effect on Candida albicans.

Dosage: According to Kerry Bone 3 to 7 mL of a 1:2 liquid extract should be used.  If someone is taking a 1:5 ratio then 9 to 20 mL should be used.

Pregnancy and Lactation: According to Kerry Bone, hawthorn has shown no increase in the frequency of malformation or other harmful effects on the fetus from limited use in women.  Just as is the case with motherwort, I typically don’t recommend hawthorn during pregnancy.  According to Kerry Bone, hawthorn is compatible with breastfeeding.

Reminder: The Quality Of The Herb Does Make A Difference

When someone is taking one or more of these herbs and they aren’t helping to manage the symptoms, one needs to consider a few factors.  First of all, the potency of the herb is important.  For example, some people will prepare herbal teas using one or more of these herbs, which can offer some benefit, but many times won’t be potent enough to manage the hyperthyroid symptoms.  If you purchase a liquid herb then the extract ratio is important.  For example, a 1:2 ratio is more potent than a 1:5 ratio.  There aren’t a lot of companies which sell bugleweed, but most that do offer it as a 1:5 ratio.  If you are taking bugleweed as a 1:5 ratio and it’s not helping then you might need to increase the dosage, or switch to a 1:2 extract.

Speaking of dosage, I always get emails from non patients asking what specific dosage of bugleweed or motherwort they should take.  Obviously this depends on the person, as if someone has thyroid hormone levels well outside of the reference range, along with a very high pulse rate, and they’re not taking antithyroid medication, then they most likely will require higher doses of these herbs.  On the other hand, if someone has slightly elevated thyroid hormone levels and a pulse rate which isn’t too high then they most likely will require a lower dosage.

Finally, the quality of the herb does make a difference.  So for example, if you go online and purchase some motherwort to help with the elevated heart rate and palpitations, and it doesn’t seem to be helping, while there’s a chance the dosage isn’t high enough, there’s also the chance that the quality of the herb is poor.  So before coming to the conclusion that motherwort isn’t effective you might want to try a different brand.  If you have been following me for awhile you know that I recommend working with a natural healthcare professional who has experience working with hyperthyroidism and Graves’ disease, as they will have experience dealing with the proper dosing, and they should be able to recommend some good quality brands.

Where Does L-Carnitine Fit In?

L-Carnitine isn’t an herb, but I figured I’d briefly mention it here since it can help to lower thyroid hormone levels when taken in higher doses.  This also isn’t something I personally took when I was diagnosed with Graves’ Disease, but over the years many of my patients have taken this.  For more information on L-carnitine I’d recommend reading my article entitled “How Does L-carnitine Help With Hyperthyroidism and Graves’ Disease?”

In summary, while the goal of a natural treatment protocol should be to restore the health of the person with hyperthyroidism and Graves’ Disease, managing the cardiac symptoms is important.  In many people this can be accomplished with herbs, and four herbs which can play a role in managing the hyperthyroid symptoms include bugleweed, motherwort, lemon balm, and hawthorn.  Both bugleweed and lemon balm have antithyroid activity, while motherwort and hawthorn help with the cardiac symptoms.  Motherwort, lemon balm, and hawthorn also have other benefits as well.  And L-carnitine taken in higher doses also can lower thyroid hormone levels.