Effective Treatment Protocols for Hypothyroid and Hyperthyroid Disease

By Dr. Mercola

Thyroid disease is one of the most common health problems we face today. From a practical standpoint, there are many ways to approach this issue. In this interview, Dr. Jonathan Wright, a pioneer in natural medicine, shares his protocols for addressing thyroid dysfunction.

Hypothyroidism, or underactive thyroid, is a very common problem, and there are many reasons for this, including drinking chlorinated and fluoridated water, and eating brominated flour.

Chlorine, fluoride, and bromine are all in the same family as iodine, and can displace iodine in your thyroid gland.

Secondly, many people simply aren't getting enough iodine in their diet to begin with. The amount you get from iodized salt is just barely enough to prevent you from getting a goiter.

A third principal cause of hypothyroidism is related to elevated reverse T3 levels. Interestingly, 95 percent of the time, those with elevated reverse T3 levels will see their levels revert back to normal after undergoing chelation with EDTA and DMPS, which draw out cadmium, lead, mercury, and other toxic metals. In essence, heavy metal toxicity can cause a functional form of hypothyroidism.

"It's very well-known that lead and cadmium interfere with testosterone production," Dr. Wright says. "What's not so well-known is that reverse T3 is stimulated by toxic metals, so up it goes.

In effect, we can have levels that are so high, they way outnumber the regular T3. You're functionally hypothyroid even if your TSHs and free T3s happen to be normal."

How Much Iodine Do You Need for Thyroid Health?

In Japan, the daily dose of iodine obtained from the diet averages around 2,000 to 3,000 micrograms (mcg) or 2-3 milligrams (mg), and there's reason to believe this may be a far more adequate amount than the US recommended daily allowance (RDA) of 150 mcg.

Some argue for even higher amounts than that, such as Dr. Brownstein, who recommends 12.5 milligrams (mg) on a regular basis. Another proponent of higher iodine amounts is Guy Abraham, an ob-gyn and endocrinologist at the University of Southern California.

"Oddly enough, he didn't publicize [his publications] much until he retired from the University of Southern California. But after that, he came out with a wonderful website, optimox.com, where you can read a lot of stuff for free," Dr. Wright says.

"There's a fairly careful study showing that the thyroid gland does not start to downregulate until we get to 14 or 14.5 milligrams of total iodine and iodide. This is probably why Dr. Abraham first, and then others, have designed both liquids and tablets that come out with 12 or 12.5 mg.

Oddly enough, in 1829, Dr. Lugol put together a combination of iodine and iodide. Two drops of that stuff equals exactly to 12.5 milligrams. How did Dr. Lugol know? We don't know. But it works so well for people ever since 1829 that it's still available (with a prescription) as Lugol's iodine...

Usually, in my practice, I'll say, 'One drop of Lugol's, which is six milligrams; six and a quarter.' Or for the guys, who don't have as much massive breast tissue, let's stay with three milligrams. [To] prevent cancer, I want more than three milligrams for the ladies."

Iodine Helps Protect Breast Health Too...

From Dr. Wright's experience, there are no adverse effects from taking upwards of 12.5 mg of iodine per day, and in some cases higher amounts may benefit more than your thyroid. There's compelling research suggesting that iodine is equally important for breast health, and that iodine – not iodide – combines with a lipid to form molecules that actually kill breast cancer cells.

"Breasts are big sponges for iodine," Dr. Wright notes. "Not iodide so much; that's the thyroid gland. But if you have enough iodine, why, those molecules are just sitting there ready waiting to kill new breast cancer cells!"

According to Dr. Wright, iodine is also crucial for other breast-related problems, such as fibrocystic breast disease, for which iodine works nearly every time. Interestingly, for severe cases, it's recommended to swab the entire cervix with iodine.

"For bad cases, you got to work with your doctor. Get the iodine swab done," Dr. Wright says. "The worse the fibrocystic breast disease is, the more treatment it takes. But that one, I can almost give a money-back guarantee... because I never would have to give you your money back."

That said, it would seem prudent for most to avoid taking such high doses unless they were using it therapeutically, for a short period of time. I personally feel that supplementation at a dose 10 times lower, or a few mg, might be best for most.

Good Sources of Iodine

Besides Lugol's, seaweed or kelp is a great source of iodine. One that is oftentimes recommended by herbalists for thyroid health is a seaweed called bladderwrack (Latin name: Fucus vesiculosus). You can find it in either powdered form or in capsules. If you want, you can use it to spice up your meals, as it has a mild salty flavor. The downside is that to reach three milligram dose, you'll need to take at least a couple of teaspoons per day.

Another concern is the potential radiation issue from the Fukushima reactor, which has contaminated much of the Japanese seaweed. So make sure you look at the source of your seaweed. Try to get it from the Norwegian Coast or as far away from Japan as you can get. While manufacturers have not started labeling their products as "radiation-free," you could simply check the bottle with a Geiger counter before taking it.

Dr. Wright's Thyroid Program

Dr. Wright always begins with a physical exam, where he looks for signs of thyroid dysfunction. This includes symptoms such as dry skin, thinning of the outer margins of your eyebrows, subtle accumulation of fluid in your ankles, constipation, lack of sweating, weight gain, and high cholesterol. An older yet helpful test is to take your temperature every morning and observing if your temperature registers close to 98.6.

This test stems from the work of Dr. Broda Barnes back in the '30s and '40s. Dr. Barnes found that if the temperature was low, it was a reliable indication of an underactive thyroid (hypothyroid). "These days, with all the other things going on, I find that sign useful in some people but not in others," Dr. Wright says. "But I do want it for everybody."

As for laboratory tests, the complete thyroid panel includes thyroid-stimulating hormone (TSH), total T4, free T4, total T3, free T3, and the reverse T3. He cautions against trusting the TSH test as a primary diagnostic tool, despite that being the conventional norm. He bases his recommendation on research by Dr. St. John O'Reilly, an expert on thyroid health at the University of Scotland, who has shown that the TSH test virtually never correlates with the clinical condition of the patient.

According to Dr. Wright, the TSH level doesn't really become a valuable indicator of hypothyroidism unless it's high, say around 5 or 10. Thyroid therapy has been around since the 1890s, and until the TSH test became the norm, the average dose of thyroid given was almost exactly twice what the average dose became when everybody started paying attention to the lab test rather than the clinical signs. Dr. St. John O'Reilly recommends basing the diagnosis on the physical exam and the Free T3 level instead, which is the protocol Dr. Wright follows in his clinic.

"The Free T3 is, of course, the free hormone, not the one bound up on the thyroid globulin, where it's temporarily inactive," Dr. Wright explains. "The Free T3 is the one that helps us to burn energy; it's the active hormone. The Free T4 is waiting to become active, but it's not active yet. It signals back to the TSH. But the Free T3 doesn't signal back to the TSH as much as the Free T4 does."

Meanwhile, the T4 is the type of thyroid replacement that is typically and traditionally given by almost every conventional physician. In my experience, it's one of the primary ways you can differentiate between a natural medicine physician and a traditional conventional physician: the type of thyroid replacement they prescribe.

Complicating Matters: Autoimmune Thyroid

Unfortunately, most people who end up on thyroid hormone replacement are placed on synthetic thyroid hormone, again, typically T4, commonly prescribed under the brand names Synthroid or Levothroid. Traditional doctors almost always prescribe this, and anyone who doesn't prescribe it is oftentimes severely criticized, and may even be called before their state medical board.

That actually happened to me, and I wasn't even prescribing it. I have stopped seeing patients, but have written about it in this newsletter. I was called before the medical board to defend my position on prescribing bioidentical whole thyroid hormone rather than Synthroid or Levothroid—even though my article was supported by a study reference from the New England Journal of Medicine, a very prestigious journal. Dr. Wright also prefers bioidentical thyroid replacement, and typically starts patients out on whole thyroid derived from animals (typically cow, sheep, or pig).

"In the whole thyroid are all the things that nature and creation put into whole thyroid. That's what we should be using unless you happen to have an autoimmune problem. Many people with... Hashimoto's disease... make antibodies to thyroid. If you're making antibodies to thyroid, I'm not sure that we should be putting in whole thyroid right away... because there is a small chance – it's not a large chance – that we're going to stimulate more antibody formation," he says.

In those with Hashimoto's disease, where your body is making antibodies against your thyroid hormones, Dr. Wright will typically start you out on T4 and T3, which are only two of the 12 iodinated substances your thyroid gland makes, and which are all found in whole thyroid.

The Role of Heavy Metal Toxicity

As mentioned at the beginning, one of the principal causes of hypothyroidism is related to elevated reverse T3 levels, which can become elevated in response to heavy metal toxicity. In such cases, Dr. Wright recommends detoxifying before beginning thyroid treatment. The detoxification protocol will vary depending on your level of lead, cadmium, mercury, and other heavy metals.

"Some people get these efficiently out of their bodies within 10 to 15 chelation treatments. There are other people, particularly those who lived in major metropolitan areas all their lives, where it takes 30 or 40 chelation treatments to pull out all the toxic metals," he notes. "When doing that, you have to make sure you're seeing a doctor who follows the procedure put out by the American Board of Chelation Therapy (ABCT).

Chelation pulls out toxic minerals. But no one has yet discovered a chelation material that pulls out toxic metals without pulling out normal metals, too – calcium, magnesium, zinc, and copper, the whole works. The doctors doing the chelation must be reinfusing normal minerals periodically according to his or her reading of the initial chelation test. The initial chelation test on page one shows all the toxic metals that are or not coming out. Page two, which should never be omitted, should always be done. It shows the normal minerals."

In the meantime, while you're trying to clear these toxic metal stores to bring the reverse T3 down, opinions are mixed on whether you should be treated with thyroid medication or not. Some believe it's beneficial to add in regular T3, but if the chelation rectifies your reverse T3 level, then by adding regular T3, you may simply end up with too much free T3. Others recommend waiting until the chelation is done to reevaluate, and if needed, put you on whole thyroid later on, provided you don't have a family history of autoimmune disease or have Hashimoto's.

"It simply takes the doctor's judgment and skill in deciding which way to go," Dr. Wright says.

Eliminating Heavy Metals Requires Special Care

Clearly, this is a process you're not going to be able to do by yourself. You really need to have a health coach, a trusted and respected healthcare clinician, who has the capacity to perform these relevant tests and procedures, who can also prescribe the appropriate supplements and thyroid hormone replacement, which you cannot obtain over the counter.

Elimination of carbon-based toxins, such as herbicides and pesticides, can be promoted through sauna-induced sweating. The Hubbard Protocol takes it a step further, and involves the use of niacin, high-intensity exercises, and sauna on a regular basis to help mobilize and eliminate toxins. Unfortunately, sweating doesn't readily eliminate toxic metals. For those, you need a more aggressive approach, such as chelation.

One option that can help minimize the loss of crucial microminerals is to use chelating suppositories. They will still pull out minerals from your system, but you don't have to worry about it nullifying the nutritional value of the food you just ate, which is a concern anytime you take an oral chelating agent. One drawback is that it takes a bit longer. "I've seen some people who have to do rectal suppository stuff for a couple of years to get all their toxic metals out," he says. "And yes, we check their normal minerals fairly routinely, every couple of months, just to make sure it's not being overdone that way."

Recommended Types of Thyroid Medications

Once your reverse T3 is normalized and any autoimmune issues have been addressed, Dr. Wright goes on to prescribe a thyroid hormone replacement, such as:

• Armour thyroid
• Nature-Throid
• Westhroid

The Armour Thyroid has one disadvantage: despite it being practically a generic now, it costs twice as much as the other two. But unless cost is a major factor, there are several types of tests to check for compatibility, to determine which one is likely to work the best for you.

"We've all heard of muscle testing. We don't have to employ that, but some doctors are very skilled at it," Dr. Wright says. "We use other sorts of compatibility testing to check for energy flow in the acupuncture meridians and how it's impaired or not impaired by certain types of thyroid. We'll go with the one that's compatible with that individual. But we do respect if people say, 'Look, I've heard that Westhroid and Nature-Throid are half the price of Armour Thyroid. Let's stick with those if we can.' We do respect that."

As for fine-tuning the dose, there are a wide variety of symptoms that can help you gauge whether you're getting enough of a dose—or help you determine whether you might have a thyroid problem to begin with. To learn more, Dr. Wright suggests picking up Dr. David Brownstein's book Overcoming Thyroid, Dr. Mark Starr's book Hypothyroidism Type 2: The Epidemic, or Dr. Ridha Arem's book The Thyroid Solution. All of these books contain checklists of symptoms to look out for.

If you're on thyroid hormone replacement, two key signals that you're taking too much are excessive sweating and rapid heartbeat or heart palpitations. If you get either of those symptoms, you're getting too much thyroid, and you need to cut back on the dose.

It's also worth noting that in some cases, if you're borderline hypothyroid, you may only need an iodine supplement rather than a thyroid hormone replacement. "Some people ask that very question. They're close enough to normal and they say, 'I could feel a little better. My test could be a little better. But can I just try some iodine?' They try and sometimes it succeeds. That's another option. Sometimes you could normalize with nothing more."

Treating Overactive Thyroid

At the other end of the spectrum of thyroid dysfunction, you have hyperthyroidism, where your thyroid is overactive. It’s far less common than hypothyroidism, but it’s no less of a problem when it happens. “It’s not common. No. But we should let everybody know that there is an effective treatment out there,” Dr. Wright says. This is particularly important in light of the conventional treatment options, which are really poor. Typically, you’re looking at using radioactive iodine, which is a disaster, or surgery.

In the video clip above Dr Wright reviews the treatment that originated at Walter Reed Army Medical Center (WRAMC), at their department of thyroid. They had enough people with hyperthyroidism there that they were able to divide them into four treatment groups. One treatment group received lithium. A second group received Lugol’s iodine. Group three took lithium first and then, three or four days later, started iodine. Group four took Lugol’s iodine first, and then three or four days later started taking lithium.

When the statistical dust settled, what they found was that the group that started with Lugol’s iodine and finished with lithium did significantly better than all of the other groups in getting the hyperthyroidism under rapid control. More than two decades ago, The Mayo Clinic also published an article on the treatment of hyperthyroidism using lithium. Here, they used lithium alone, and were also able to bring abnormally high T3 and T4 numbers down to normal within a week to 10 days. It didn’t work on everybody though.

According to Dr. Wright, Walter Reed’s system is profoundly effective. Of all the people treated for hyperthyroidism in Dr. Wright’s clinic, amounting to about 40, there have only been two cases where the protocol failed. Normal levels can often be achieved in less than two weeks. In summary, the treatment is as follows:

• Patient starts out on five drops of Lugol’s iodine, three times per day
• After four or five days, patient starts receiving 300 mg of lithium carbonate, one to three times per day

Take Control of Your Thyroid Health

Hypothyroidism is far more prevalent than once thought. Some experts believe that anywhere between 10 and 40 percent of Americans have suboptimal thyroid function. Thyroid hormones are used by every cell of your body to regulate metabolism and body weight by controlling the burning of fat for energy and heat. They're also required for optimal brain function and development in children. If you feel sluggish and tired, have difficulty losing weight, have dry skin, hair loss, constipation, cold sensitivity, and/or lack of sweating, these could be signs of hypothyroidism.

Iodine is the key to a healthy thyroid, and if you're not getting enough from your diet (in the form of seafood), you'd be well advised to consider taking a supplement, ideally a high-quality seaweed supplement (be sure to check its source to avoid potential radioactive contamination), or other iodine-containing whole food supplement.