Although it’s a wonderful feeling to help someone with hyperthyroidism avoid radioactive iodine and thyroid surgery, there are certain precautions you need to take when trying to restore your health. This is true whether you have Graves’ disease, or a different hyperthyroid condition (i.e. toxic multinodular goiter). In this blog post I’m going to specifically focus on five precautions you should take when trying to reverse your hyperthyroid condition through a natural treatment approach.
Precaution #1: Safely manage your symptoms. Although not everyone with hyperthyroidism experiences an elevated resting heart rate, many people do. Some people have a resting heart rate between 80 and 100 beats per minute, while others have a resting heart rate well over 100 BPM. I’ve worked with some patients whose resting heart rate was around 150 BPM when they weren’t taking anything.
Without question there is a risk of uncontrolled hyperthyroidism. When I was dealing with Graves’ disease back in 2008/2009 I was able to effectively manage my symptoms by taking bugleweed and motherwort. Some people choose to manage their symptoms by taking antithyroid medication and/or beta blockers. Others prefer to manage their symptoms naturally like I did. Others attempt to manage their symptoms with bugleweed, motherwort, and/or other herbs but are unable to do so, and need to resort to taking the medication.
In any case, while there might not be as big of a concern if your resting heart rate is slightly elevated, if it is moderately or severely elevated (i.e. greater than 90 BPM) then you want to do something to manage the symptoms. This might involve taking antithyroid medication (i.e. Methimazole) and/or beta blockers, or in some cases nutritional supplements and herbs such as bugleweed, motherwort, lemon balm, and/or L-carnitine.
Precaution #2: Monitor your liver enzymes. Many people with hyperthyroidism have elevated liver enzymes. This is especially true for those who take antithyroid medication such as Methimazole or Propylthiouracyl (PTU). However, some people with hyperthyroidism have elevated liver enzymes even when not taking antithyroid medication.
Ordering a liver function panel is a good idea for anyone with hyperthyroidism. This can be ordered separately, although it’s also part of a comprehensive metabolic panel. The two main liver markers it tests for are alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Alkaline phosphatase is also commonly elevated, although an elevation of this enzyme doesn’t always indicate a problem with the liver.
I wrote a separate article that focused on these liver markers, and in the article I also discuss what you can do to lower elevated liver enzymes. The name of the article is entitled “How To Decrease Liver Enzymes in Hyperthyroidism and Graves’ Disease“.
Precaution #3: Monitor your white blood cell count. Agranulocytosis is a serious condition involving a severe lowering of the white blood cell (WBC) count, which is also known as leukopenia. There are a few different drugs that can cause this condition, with one of them being antithyroid medications (1). An absolute neutrophil count of <500/μl while taking antithyroid drugs establishes the diagnosis (2).
The way agranulocytosis is diagnosed is through a complete blood count (CBC) with differential. This is also a good reason to obtain this test prior to being on antithyroid medication, and then again thereafter, as if someone has a normal WBC count prior to taking the meds but then it becomes depressed after being on the medication, then it’s highly likely that the medication is what caused the decrease. In this case the antithyroid medication needs to be stopped.
Precaution #4: Don’t overexert yourself. Although I’m in favor of people being active, those with hyperthyroidism shouldn’t overdo it. The problem is that many people don’t realize that they are overexerting themselves. This is especially true for those who exercise on a regular basis. For example, prior to being diagnosed with Graves’ disease I was overtraining, but at the time I didn’t realize this. And while I don’t think this was the sole reason why I developed Graves’ disease, overtraining causes dysregulation of the immune system and weakens the adrenals, and so without question it could have been a contributing factor.
Upon being diagnosed with hyperthyroidism I definitely took it easier, and the same is true with many of my patients. But some people still work out too hard AFTER being diagnosed with hyperthyroidism. While most people with hyperthyroidism are able to do some light walking and weightlifting while trying to restore their health, you should be cautious about engaging in activity that will significantly result in an increase in your heart rate. This is true even for those who are taking antithyroid medication, beta blockers, and/or herbs (i.e. bugleweed, motherwort) to help lower the resting heart rate.
Precaution #5: Be aware of thyroid storm signs and symptoms. Thyroid storm is a rare state of acute hyperthyroidism that can be life-threatening, and some of the potential triggers include trauma, myocardial infarction, surgery, an infection, and iodinated contrast medium (3). This is especially a concern in cases of uncontrolled hyperthyroidism, such as someone who refuses to take antithyroid medication to manage their symptoms. Some of the clinical manifestations of thyroid storm include fever, cardiac arrhythmias, vomiting, and impaired mental status (3).
If you are experiencing any of the symptoms I mentioned above it is critical to visit the nearest emergency room. Treatment of thyroid storm usually involves decreasing the thyroid hormone levels with antithyroid medication and lowering the resting heart rate by taking beta blockers. If someone is unable to tolerate antithyroid medication they might receive large amounts of potassium iodide to inhibit thyroid hormone production, or therapeutic plasma exchange (4).
Share These Precautions With Your Healthcare Practitioner
In addition to taking the precautions I mentioned in this blog post, I really do think it’s wise for those with hyperthyroidism to work with a competent natural healthcare professional. Some may think I’m “tooting my own horn”, and while I do work with people who have hyperthyroidism and Graves’ disease, I’m not mentioning this here as a way to promote my practice. The truth is that many functional medicine doctors are capable of helping people with Graves’ disease improve their immune system health. However, besides the fact that not everyone with hyperthyroidism has Graves’ disease, many healthcare professionals are afraid to work with people who have hyperthyroidism.
This is one of the reasons why it’s much more common to see functional medicine practitioners who see people with hypothyroidism/Hashimoto’s. Another reason is because more people have hypothyroidism than hyperthyroidism. But the primary reason is because most healthcare practitioners are uncomfortable working with hyperthyroid patients. This is also true with many endocrinologists, and is one of the reasons why they commonly recommend radioactive iodine and thyroid surgery to many of their hyperthyroid patients as the primary treatment option. They feel that it’s easier (and safer) to manage hypothyroidism when compared to hyperthyroidism.
If you happen to be working with a chiropractor, naturopath, or a different healthcare practitioner who doesn’t have a lot of experience working with hyperthyroid conditions, I urge you to share this blog post with him or her. Even if they tell you that they are comfortable with treating hyperthyroidism naturally, I’d still ask them to read this blog post so that they understand the importance of having their patients with hyperthyroidism take these precautions. Because while it’s important to address the underlying cause of your condition, you want to be safe while taking a natural treatment approach.
Hi
Re: Exercise
I’ve been on tiroidil (methimazole, 5mg) for a while now (February ) and responded well. I’m down to a tablet a day and bloods are within range; all except the antibodies which are on the way down, but still out of range.
I’ve also changed my diet since diagnosis eliminating as much as possible gluten, sugars, tomatoes and other things (I adhere to “extreme moderation”; i.e., these are eliminated when I can control it, but if I’m eating at the in-laws for example – once a month or so – and there is gluten, i’ll limit but still eat on not make a fuss). I don’t smoke (never have) and haven’t drunk for 3 years or so.
I feel pretty good almost all the time.
My question is regarding exercise. I’m a cyclist and before diagnosis 10-15 hours a week (200-300km a week) was not over training, but normal. I could tell when I overtrained and that was above 15 hours, give or take. I’ve returned to the bike, not to the big numbers, but to around 8 hours a week so far and felt no adverse effects. Arguably feel better, or more constantly less tired, than before. The cruz of the question, I guess, is that if I monitor how I feel (relative perceived as well as heart rate monitor related – using a algorithm to assess long term stress based on heart rate; current resting HR is about 55 bpm), I should be able to continue riding/training without adverse effects to the recovery process correct? And when I say monitor, I mean with a level head, not a hero head of “i can do anything” but being honest and assessing (and using the HR data).
Thoughts appreciated.
ian
Hi Ian,
It sounds like you have been doing some great things for your health, and so please keep up the good work. As for whether it’s fine to cycle around 8 hours per week, I’m honestly not sure. Since your body was used to cycling 10 to 15 hours per week then it might be fine to continue doing this 8 hours per week, and I agree that if you do this it would be a good idea to continue monitoring your condition. I can’t say for certain that it won’t have a negative effect your progress, but I realize that it would be hard for you to stop cycling, and I’m glad that you will be honest while monitoring your condition.
I have Graves’ disease. Unfortunately, I took the RAI which was a big mistake and caused TED. Eyes are always extremely dry no matter what I do. I was diagnosed with a severe nickel allergy. Didn’t realize all the foods that are high in nickel. The foods which are extremely good for me are high in nickel very discouraging.
Since you are a chiropractor, have you ever heard of NAET. Allergy eliminating testing. If you have, could you please tell me your thoughts
I have a rash on my eyelids and it won’t go away. I’ve changed my supplements, diets and watch what foods I eat. Of course, this affects my blinking and my eyes. I’ve had several operations for orbital decompression. Eyes haven’t moved back entirely but much improved. Positioning.
Thank you
Hi Martha,
I’m sorry that the RAI caused TED, and that’s a bummer about the nickel allergy. Although I have heard of NAET, I can’t say that I’m too familiar with it. I will say that since it involves muscle testing, it probably goes without saying that the skill of the practitioner is very important. As for the rash on your eyelids, while it’s great that you are eating a healthy diet and changed your supplements, other factors can be affecting the health of your gut and immune system, which in turn can be causing the rash. Rashes and other skin conditions are very common in Graves’ disease.
Good day,
My name is Marek, I am 25 y old. 171cm, 47-50 kg.
I would like to ask you, what can be a problem when I work whole day(all day long cleaning rooms in a hotel), I am no tired and also I can not sleep, Last night I slept just 3 hours and today no tiredness? I feel that something is very wrong, I am almost like hyperactive. And I also lost a weight(definitely 5%) and after each meal I feel like a little diarrhea is coming. On other side I am not sweating and I do not feel so much hot or cold that I should mention it. 2 weeks ago I got my hair analysis of minerals and it looks like malnutrition. I am taking minerals and vitamins(right forms/timing/combinations), I have also ashwaganda and gynostemma but for now I stop with taking, I am not sure whether is not worse with them.
Last two years I had very difficult a relationship(mentally and emotionally), Very often I felt my thyroid, also now I feel somethime during a day, like a little pain and also I did not eat so much.
Now I am without stress, everything great in my head, I changed myself, I feel peace, I eat healthy and right portions(I use cronometer) but my physical page is very bed. I feel again that I will not sleep tonight, I am not afraid but it is not pleasant, I was always healthy.
I am not sure what is the cause of my problem and how I remedy it.
Please can you help me ? Thank you.
Marek, some of the symptoms you’re experiencing (weight loss, diarrhea) are commonly found in those with hyperthyroidism, although it’s also possible that you have some type of infection. This is especially true if you don’t have other symptoms commonly associated with hyperthyroidism (i.e. elevated resting heart rate, palpitations). If you haven’t done so already I would recommend getting an updated thyroid panel, but if an infection is the culprit you might need to do some further testing, such as a comprehensive stool panel.
How much bugleweed, motherwort should a person start out on taking to reverse their hyperthyroid and graves disease?