Naturopathic and Integrative Care for Thyroid Conditions: What Is Known and Cautions

Do not stop or change thyroid medicine without your prescriber. The NHS says an underactive thyroid is usually treated with medicine to replace the hormone your body cannot make, usually levothyroxine, and you will usually need it for the rest of your life to prevent symptoms returning. [1] Regular blood tests check you are on the right dose. [1] This page is general information, not medical advice.

Why standard treatment matters

The NHS says that if an underactive thyroid is not treated, or you are on the wrong dose, you may have an increased risk of problems such as heart problems. [1] In the UK, the main cause is an autoimmune condition called Hashimoto's disease. [1] A wrong dose can also cause side effects. [1] Anyone with new or worsening symptoms, including after starting a supplement, should see a doctor. For the symptom picture, see thyroid and fatigue.

Who offers naturopathic care

NCCIH describes licensed naturopathic physicians as having completed graduate-level education at an accredited naturopathic medical school, and traditional naturopaths as trained in various non-accredited programs. [2] Licensing requirements vary across U.S. states and territories. [2] Other clinicians have their own training and regulation. See ND, MD, DO, NP and PA: what each credential means.

Whole-system naturopathic care for thyroid disease

Proper evidence not found. We searched PubMed for naturopathic care with thyroid or hypothyroid terms and found no trial of naturopathic care for thyroid disease. A scoping review of whole-system naturopathic research (33 studies) did not list thyroid disease in its abstract among the conditions where it found evidence of effect. [3] Evidence label: insufficient evidence.

Thyroid hormone preparations: levothyroxine and extracts

Some practitioners and websites promote desiccated thyroid extracts or compounded thyroid hormones. The American Thyroid Association task force reviewed thyroid extracts, synthetic combination therapy, triiodothyronine therapy and compounded thyroid hormones. [4] It concluded that levothyroxine should remain the standard of care, and found no consistently strong evidence that alternative preparations are better at improving health outcomes. [4] That guideline is from 2014 and is a task force statement. Evidence label for alternatives: no consistently strong evidence of benefit over levothyroxine.

Selenium for Hashimoto's thyroiditis

Selenium is the supplement most often studied for Hashimoto's.

Evidence label: mixed, and evolving. Even where antibody levels fall, that does not show people feel better or that medicine can be reduced. Supplement doses and the question of whether you are deficient are matters for your clinician, and are not covered here. See selenium.

Herbs and supplements marketed for the thyroid

NCCIH says ashwagandha is not recommended for people with autoimmune or thyroid disorders, and has been linked to rare cases of liver injury. [7] Tell your prescriber about any supplement, because some can interact with medicines. See natural remedy safety.

Tests and "root cause" claims

Broad panels, saliva hormone tests and adrenal "fatigue" testing sold alongside thyroid care are checked in tests sold in integrative practice. Your thyroid blood tests and doctor's review are the standard way to check treatment. [1]

Questions to ask

• What is my diagnosis, and who ordered the tests?
• Will any plan change my thyroid medicine, and who will monitor my blood tests?
• Do you sell supplements, and what evidence supports them? See questions to ask a naturopath or integrative practitioner.