24 Mar Thyroid Health from an Ayurveda + Western Science Perspective
The following are two in-depth audio lectures from part of a 2014 Mentorship Dr. Welch offered, on the relationship between stress, the liver, and thyroid function. They assume a fairly in-depth theoretical and clinical understanding of Ayurveda and should be considered within that context. We chose to put them on their own page because thyroid issues are so common and information on them from an Ayurveda + Western science perspective is not so common, and we are not currently offering the mentorship.
Lecture on Thyroid From March 06, 2014:
Summary: When our thyroids are hit they can go from a continuum from hyper to hpyo: Hyper/Graves (which looks mostly high laṅghana) to Hashimoto’s which has mixed laṅghana and bṛṃhaṇa symptoms to total burnout at Hypo, which can be a result of Hashimoto’s. We looked at what we would expect to see with adrenal burnout (the concept of the kidneys, adrenals, ovaries and testicles all being part of the “Kidney” system in TCM and the root of duality/bṛṃhaṇa and laṅghana in the body), what we would see with the insulin-producing portion of the pancreas being hit and what we would see w/ the various thyroid issues. We talked about the difference between single organs and double organs (like kidneys, brain, lungs) and the double ones relating to duality and the lungs “governing the entering and exiting of ojas”. We looked at the idea of when to treat an organ or problem directly and when to treat it locally and how we would apply this to the thyroid. Local treatment being things like herb mixes (sample mix: Ashwagandha 5, bala 3, kombu 3, hai zao 3, shatavari 3, guduchi 3, licorice 2) and “dissolving obstructions” track aimed at the throat, castor packs on the thyroid (without added heat, for 1⁄2 hr maybe 3x/week). We observed at the end that Graves and Hashimoto’s are considered autoimmune problems, where the body attacks itself and how maybe our bodies learn to do this from our behavior—from us attacking ourselves.
Important note on hai zao and licorice (gan cao) in this formula
A careful student pointed out that hai zao and licorice are classically listed together in Chinese herbology as one of the shí bā fǎn (“Eighteen Incompatibles”). That is correct. In the Chinese tradition, gān cǎo is classically said to be incompatible with hǎi zǎo (Chen et al., 2021).
At the same time, the tradition itself contains an important wrinkle. There are historical formulas used for goiter and thyroid-related swellings that include both herbs, most notably Haizao Yuhu Tang. Modern discussions of that formula explicitly note the tension: the pair is classically flagged as incompatible, yet it still appears in a longstanding formula used for thyroid-related conditions (Xiu et al., 2017; Chen et al., 2021).
So the point here is not that the incompatibility disappears because other herbs are present. We do not have a clear basis for saying that the rest of the formula “negates” the classical concern. The more accurate statement is that Chinese herbal tradition preserves both the caution and the exception. This is a real tension in the literature rather than a simple rule with no exceptions. Some modern research on Haizao Yuhu Tang suggests that outcomes may depend on context, including the exact species of licorice and Sargassum used, which adds further nuance (Xiu et al., 2017; Chen et al., 2021).
Because of that, a cautious practitioner may wish to omit the licorice from this formula. It would be especially prudent to omit licorice in anyone with hypertension. It is also wise to use caution where there is edema or concern about low potassium, since licorice is well known to be capable of contributing to hypertension, fluid retention, and hypokalemia through pseudo-hyperaldosteronism (Sontia et al., 2008; Sabbadin et al., 2024).
References
Chen, F., Zhang, J., Zhou, Y., et al. (2021). Comparative efficacy of Haizao Yuhu decoction composed of different varieties of Glycyrrhiza in goiter rats. Evidence-Based Complementary and Alternative Medicine, 2021, Article 6629713.
Xiu, L., Chen, F., Zhang, J., et al. (2017). Comparative efficacy and toxicity of different species of Sargassum in Haizao Yuhu decoction in PTU-induced goiter rats. Evidence-Based Complementary and Alternative Medicine, 2017, Article 9492135.
Sontia, B., Mooney, J., Gaudet, L., & Touyz, R. M. (2008). Pseudohyperaldosteronism, liquorice, and hypertension. Journal of Clinical Hypertension, 10(2), 153–157.
Sabbadin, C., Ceccato, F., Betterle, C., & Boscaro, M. (2024). Pseudohyperaldosteronism due to licorice: A practice-based learning from a case series. Endocrines, 5(3), 299–311.
Lecture on Thyroid From March 26, 2014:
On our final call of 2024 Mentorship, we explored the western view of the thyroid a bit more, looked at how we need to look holistically at the thyroid, instead of just at that one gland, when we are addressing treatment. The 10 vessels and heart (in western medicine the 5 senses and heart) provide feedback to the hypothalamus about the state of the organism. The hypothalamus sends messages to the anterior portion of the pituitary (through TRH-thyrotropin releasing hormone), which then uses TSH (thyroid stimulating hormone) to prod the thyroid to dial dhātu agni up or down. The thyroid dials up or down through T4 and T3. T4 is more plentiful than T3, which is more concentrated and powerful. T3 is made from T4 in not only the thyroid, but also the brain, gut, skeletal muscles, kidneys and, especially liver are all responsible, as well as the thyroid, for turning T4 into T3 and so we need to look at all of these organs and tissues, and not only the thyroid, to discover where the problem is coming from. We also looked specifically at the kidney and liver, to understand their roles more. We looked at Dr. X’s case study (unfortunately she couldn’t be here with us for this) and went through the case, looking at the thought process we might apply. We came back to the idea that most women’s health issues are due to either the bucket syndrome or stagnation and, in Dr. X’s case study, probably both. We looked finally at how intelligent prāṇa is, whether in directing blood cells, to maturing an ovum and how we could address recalibrating that intelligence through the basics: lifestyle, diet, nāḍi śodhana, abhyaṅga, and meditation.