Traditional Chinese Medicine, Acupuncture for Thyroid

The Yin and Yang of the Thyroid with Dr. Patrick Purdue

chinese medicine, thyroid, acupuncture
Chinese Medicine has a unique approach to thyroid disease. Getty Images/Mike Kemp

Interest in Chinese medicine

My youngest daughter began to have recurrent middle ear infections. At the time, I was a commercial photographer shooting images for brochures and catalogs. One of our neighbors was an MD, and so we took her to him and he put her on the standard 10-day course of Amoxicillin. The condition resolved, but she got another one not too long afterward. Another course of Amoxicillin resolved that one. But the episodes of ear infection  become frequent. Then her tonsils and adenoids became swollen and inflamed, and her nasal passages were chronically congested. She got to the point of being on antibiotics all the time and was on steroid inhalers for the congestion. The MD then suggested she have her tonsils and adenoids removed, and have tubes put in her ears. That's when we decided that there had to be another way

Luckily, we found a chiropractor who practiced nutritional medicine, and who quickly discovered that she had a dairy allergy. We removed dairy products from her diet and she shortly  became completely well and had no more ear infections. So I thought, they were going to do all this surgery on her, not to mention the fact that she'd been on all sorts of medications for the better part of a year, and it was a simple allergy which the doctor didn't even think to check out. 

I decided I wanted to figure out how to help out other people with natural medicine. Not long afterward, I learned of a TCM medical school. I checked into the program and it has been the most rewarding thing I've ever done. 

Since I began studying this medicine none of my three daughters have had an antibiotic or other prescribed drug. 

Understanding the Balance of Yin and Yang in Chinese Medicine

Most people have heard of yin and yang, and most have seen the yin/yang symbol. Interpreting yin and yang in TCM physiology is a bit different than the definition of those terms in other arenas such as the martial arts or Taoist philosophy. Yin, represented by the dark field in the yin/yang symbol, equates in medicine to body fluids such as blood, and to the actual structure of the body itself. It is cool in temperature. Yang, represented by the white field in the yin/yang symbol, equates to function and movement. It is warm in temperature. 

For example, the liver as an organ structure is yin, but its function is yang. If there's balance between structure and function, that organ or body is in balance and everything is working well. The yin/yang symbol has the opposite color "eye" in each field. This implies that nothing is 100% yin or 100% yang, but each contains elements of the other. Our goal in TCM is to help the body achieve balance between structure and function. 

The other important idea in TCM is the concept of "qi" (pronounced "chee"). It often gets interpreted as "energy," and, loosely, this is correct. There are many forms of qi in TCM. For instance, "clear qi" is their word for the air that we breathe. "Heart qi" is the beating of the heart.

There is a famous statement about pain in TCM which reads, "If there is pain there is no free flow. If there is free flow there is no pain." This implies that as long as the qi and blood are flowing smoothly one has no pain. Any pain, anywhere in the body, is due, in TCM terms, to a blockage or impairment in the flow of qi and blood.

Our job, through the use of dietary modification, medicinal formulas, or acupuncture, is to remove the obstacles so that qi and blood flow smoothly, or so that function is restored. This is the "return to balance."

Disease and imbalance

Diseases in TCM are thought to be the result of extremes, or overabundance, of the "six qi," and the "seven affects." The six qi are wind, cold, summer heat, dampness, dryness and fire. The seven affects are joy, anger, anxiety, thought, sorrow, fear, and fright. The six qi are considered, in excess, to be external disease sources, and the seven affects are, again in excess, considered internal disease mechanisms. Another ancient text also describes the "seven damages," which are food damage, anxiety damage, drink damage, sexual intemperance damage, hunger damage, taxation damage, and channel-network/construction-defense damage ("channel-network" refers to the acupuncture channels, and "construction-defense" refers to the mechanisms that build and repair the body and the immune system). 

So the idea here is that excessive amounts of any of the above can create a problem in one or more organ systems in the body and eventually lead to disease.

Using Patterns Are To Diagnose Imbalances

We are in the beginning of flu/cold season at the moment. What are our environmental conditions currently? We have more wind than usual, cooler temperatures, and dry conditions. "Wind-cold" is the TCM description of a group of symptoms that include aversion to cold with mild fever, headache, generalized body ache, and other symptoms. This is different than "wind-heat" which has the symptoms of cough with thick phlegm, and generalized fever among other symptoms.

In the West, we'd recognize all of the above symptoms as signs of the flu, and all would be treated with more or less the same medicines. In TCM, these are different disease "patterns" and require different treatment strategies.

Ways of diagnosing imbalance

Information used to determine a diagnosis is gathered through the "four examinations." These are inspection, smelling and listening, inquiry and palpation  Palpation includes touching the body to determine the type of pain in an area, and  zheng jia ji jiu (cysts, tumors, edema, and so on), plus a sophisticated method of pulse diagnosis. There are 28 different qualities of pulse. To feel these and know what they mean is a high art. A lot of information about the body can be derived from pulse diagnosis.

Since modern TCM is constantly evolving, modern techniques such as X-ray and blood labs could technically be included under "inspection." 

Once information from the four examinations is gathered, a pattern diagnosis is developed. This type of diagnosis is a statement about the unique combinations of symptoms that describe an individual patient. I may have ten female patients diagnosed by conventional MD gynecologists as having a uterine myoma or fibroid tumor. In TCM, they may have ten completely different patterns and receive ten very different treatments. 

Patterns of Thyroid Disorders in Traditional Chinese Medicine     

 During the development of TCM, which began over 25 centuries ago, they were not aware of the existence of what we call the endocrine system, which includes the thyroid gland. The existence of the endocrine system wasn't known in the West until a little over a hundred years ago. So it isn't that there isn't much importance placed upon the thyroid gland, they just didn't know of its existence until the last hundred years. 

Of course, in modern TCM, current state-of-the-art knowledge of anatomy and physiology are vigorously studied.  Again, you could have 10 people with the Western medical diagnosis of "hypothyroidism," but they may well have, according to TCM, 10 unique, separate patterns of symptoms. And that's what we address. 

For example, let's say a patient comes in with nodules on the neck that are firm and rubbery accompanied by a dry mouth and other difficulties. We contrast this patient with a second one who also has nodules or masses in the neck but of a more firm, rocklike hardness, are immobile and cause no skin discoloration. In conventional Western medicine, both patients may be diagnosed with goiter, would have blood tests done to determine thyroid hormone levels, and both be given the same medication, maybe in different dosages.

In TCM, these are two completely different patterns and would receive two different medicinal formulas. In the same way, not everyone with hypothyroidism has hair loss, or depression, or dry skin, or fatigue, and so on. In TCM, different treatments are required depending upon the entire constellation of one patient's symptoms. 

The famous physician Sun Si-Miao, who lived from 581 - 682 AD, was said to have used what we now know are the thyroid glands of animals to treat goiter. So, whether or not TCM described a thyroid gland as we know it, they obviously had some awareness of this gland and developed various treatments for it. 

Sun Si-Miao is quoted as saying something like, "The superior doctor has no patients [because he taught them proper diet and lifestyle habits to prevent illness], the inferior doctor treats disease [meaning that doctors who only spend their time treating disease are missing out on the most important aspect of medicine -- prevention]."

The basic TCM approach to preventing any disease is moderation. Eating a diet that is nutritious and healthy, without having extremes of sweets, hot and spicy and so on, keeping oneself balanced emotionally, with moderate exercise, and protecting oneself from environmental extremes is the way to health and long life.

Even when one attempts to "do the right thing" health-wise, we have a very stressful culture. So the best advice for all is to do the best one can.

How Does Chinese Medicine Look at Hypothyroidism?

Whenever any patient comes to me, regardless of the problem, I have them fill out a very thorough health history. I invite them to bring in any lab tests they have. I proceed through the "four examinations," and then add up all the signs and symptoms I find.

This leads me to a pattern diagnosis, which, as mentioned earlier, is a statement of that particular patient's uniqueness. A properly worded pattern diagnosis leads me to a treatment principle, which is a statement of how to proceed. This produces a basic medicinal formula which has to be altered to fit the patient's uniqueness. 

So, what symptoms might we have in hypothyroidism? Let's say the patient's complaints are hair loss, dry skin, mental depression, cold hands and feet, weight gain and disturbed sleep. All classic hypothyroid symptoms.

But let's say this patient also has dizziness on occasion, blurry vision at night, and other symptoms. To treat only thyroid symptoms would be missing the boat with this patient. Additionally, we couldn't help this patient with the same medicinal formula that we'd treat another patient who may have the same hypothyroid symptoms but a different range of other symptoms.

So I would treat this patient with a very complex, customized medicinal formula (we use concentrated powdered extracts of herbs that we load into gelatin capsules) probably consisting of 15 to 25 ingredients, plus specific dietary and exercise advice. I would also encourage the patient to meditate every day. 

I would also put her on various nutritional supplements. Though nutritional supplements may not sound "Chinese.” I'll never forget what an instructor once said in a lecture. He said that the major contribution of Chinese medicine is not herbs and acupuncture. These were incidental. The major contribution of TCM is its way of thinking about a case, the whole thinking process.

In that spirit, I have no trouble using TCM theory applied to Western nutritional supplements, and even homeopathy, if I think those will help the case. 

What About Hyperthyroidism?

Well, again, one can look at some of the classic hyperthyroid symptoms such as weight loss, rapid heartbeat rate, but also other, unique symptoms.  

This patient could not be treated with the same formula and treatment as someone with the same hyperthyroid basic symptoms but a different group of other symptoms. We would follow the same approach described for hypothyroid cases, including a customized formula, dietary advice, and other lifestyle suggestions. Our medicine is based upon pattern diagnosis rather than a Western-style disease "label."

Using Chinese herbs to treat autoimmune thyroid conditions

A lot of people are under the impression that because TCM is "old," and autoimmune conditions are "new," that TCM would not have a treatment approach.

Another famous Chinese physician from the past was a fellow named Li Dong-Yuan, who authored a classic text that proposed a very complicated set of diagnostic principles. It is clear he was observing, diagnosing, and treating what we would call autoimmune diseases. While Dr. Li figured out ways to treat these conditions, he still approached the condition in front of him in the same basic way, pattern diagnosis based upon the four examinations, treatment principle, medicinal formula. 

The TCM description of medicinals is completely different than the Western pharmacological understanding of herbal use.  In some, and certainly not all, conditions of autoimmune disorder there may be an appropriate use for the medicinals which are labeled in the West as"immune-boosting.”

Codonopsis and schisandra are thought to be "adaptogens" in the West, meaning that they tend to normalize function. Astragalus has been found to increase the activity of white blood cells, and there are several doctors who use it in the treatment of cancer patients as there is some evidence that astragalus can "switch on" natural killer cells, the specialized white blood cells that target malignancies. Isatis has shown to have anti-viral activity and has even been used in some AIDS research.

Whether these herbs “boost” the immune system is somewhat controversial. However, this has nothing to do with the TCM understanding of how these herbs function. With TCM, many ingredients are involved and the synergistic interaction of the ingredients changes the function of the herbs – as opposed to using herbs individually.

So the moral of this story is patients should not experiment with these medicinals on themselves, particularly in autoimmune conditions, and should seek the skills of a TCM practitioner who knows how to work these formulas.

This is not an easy medicine to practice. It is far from the simplistic Western herbal approach of "if you have a headache take feverfew, and if you have a bellyache take peppermint tea." It is serious medicine, and should not be experimented with lightly.

Further learning on Traditional Chinese Medicine 

A great book that explains this whole thing about pattern diagnosis and so on is The Web That Has No Weaver by Ted Kaptchuk. Blue Poppy Press (1-800-487-9296) is a publisher of really excellent TCM textbooks used in the schools, and also has very good publications for the lay public.

The following websites are also good sources:

Patrick Purdue, D.O.M.

Purdue Nielsen Wellness Center
10010 Seminole Blvd
Seminole, Fl 33772
Phone: 727-319-8819

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