Focus Area: Integrative Approaches to Care
Subclinical hypothyroid disease (SHypo) is defined as having serum thyroid-stimulating hormone (TSH) concentration above the normal reference range while serum free thyroxine (FT4) and free triiodothyronine (FT3) are within reference range. It is estimated that 4% to 10% of the general population has subclinical hypothyroidism, increasing to 20% in women over 60 years of age. The current treatment recommendation for SHypo with TSH levels between 3 MIU/L and 5 mIU/L is to monitor levels every 6 to 12 months. Studies have shown that levothyroxine is not effective for this TSH group. Based on Hans Selye's general adaption theory (GAS), it is known that acute and chronic stress can affect thyroid function via the hypothalamus-pituitary-adrenal (HPA) and the hypothalamus-pituitary-thyroid (HPT) axes. Acupuncture can reduce the body's stress response and therefore should improve thyroid function. This research was conducted to determine if acupuncture is a viable treatment option for SHypo.
Two cases were studied for replication. The female patients, aged 34 and 44 years, received 12 Japanese Meridian acupuncture constitutional treatments and moxibustion once per week. Serum TSH, FT4, FT3, salivary cortisol, Perceived Stress Scale–10 (PSS-10) were measured at pretreatment, mid-treatment, and posttreatment. Number of hypothyroid symptoms present (Zulewski index) were assessed prior to each treatment. All measurements were analyzed for changes over time and cross-case comparison.
Both patients had decreases in TSH and number of hypothyroid symptoms present and increases in total cortisol load and morning diurnal cortisol rhythm. Both patients reported improvements in bowel movements and menstruation.