In contrast to hypothyroidism, which is relatively easy to treat with Oriental medical modalities, hyperthyroidism is almost as equally difficult to address. The difference, of course, stems from the etiology of each condition, and the corresponding difference in correcting those causative factors.
As we recall from our understanding of zang-fu pathology (or see my previous articles on hypothyroidism1,2), hypothyroidism is caused by spleen or kidney qi and/or yang deficiency, liver qi stagnation and blood deficiency, with its corresponding symptoms of lethargy; intolerance to cold; modest weight gain; forgetfulness; and coarse, dry skin. Many times, however, its symptoms are subclinical. The appropriate treatment plan is to tonify the qi and yang of the kidney, move the liver qi stagnation, and tonify the blood.
Hyperthyroidism, with its symptoms of nervousness; increased sweating; hypersensitivity to heat; palpitations; fatigue; tachycardia; fidgeting; weight loss; insomnia; increased appetite; and various eye symptoms such as photophobia, irritation and dryness, is caused by a deficiency of the yin of the kidney and liver, and hyperactivity of liver yang. There may be heart yin deficiency symptoms as well. Energetically, on a continuum of qi, blood, yin and yang, yin is the deepest structural level and qi the most superficial; hence, we can see the reasons why hypothyroidism is more responsive to treatment than hyperthyroidism.
The doctors with whom I studied in China advocate the use of Western medications to treat hyperthyroidism, although they use some acupuncture as well. In my experience, because of the physical and psychological differences in both types of patients, i.e., quiet and sedate versus agitated and restless, hyperthyroid patients are more resistant to therapy. In terms of acupuncture treatment, the hypothyroid patients who are deficient in energy and yang, can be treated with needles and adjunct techniques such as moxibustion, the TDP lamp and herbs. Their symptoms of deficiency respond to energetic treatment better than symptoms of heat and fire, which are characteristic of hyperthyroidism.
For the hyperthyroid patient, reclining on the treatment table may be difficult because of the aforementioned symptoms. Since their energy is on the surface, superficial needling should be avoided. Long needle retention times should also be avoided, because hyperthyroid patients are deficient in a way more so than hypothyroid patients, because the yin is a deeper structural level. As such, hyperthyroidism takes longer to treat over time.
Two treatment plans are presented below. The plans are similar in construction, and can be used independently, depending on which modality you (as a practitioner) prefer, or which therapy the patient would best tolerate.
Treatment 1: Auricular Acupuncture
1. Shenmen: This point, analogous to HT 7 (shenmen) in the body, quiets the heart; grounds the patient; makes the heart serene; and puts the patient into a state of receptivity for treatment. It is useful for the heart yin deficiency symptoms of insomnia; restlessness; agitation; tachycardia; and palpitations. To accomplish this aim, treat this point first.
2. Kidney: Use to tonify kidney yin and liver yin, because the kidney is the mother of the liver. It will reduce fatigue.
3. Liver: Use to directly nourish the liver yin, reduce the liver yang and fire, and move liver qi stagnation. The liver point treats eye symptoms and decreases nervousness, fidgeting and heat hypersensitivity.
4. Brain: Use to influence all neurological functions, regulate the mind, and improve eye problems.
5/6. Spleen and Stomach: Choose these points to tonify the qi, which produced the yin and blood. The kidney yin will thereby be nourished through the control cycle. Because these points relate to the Earth element, they also ground and anchor the energy. This assists in treating insomnia, mental symptoms and appetite.
Figure 1: Auricular points to treat hyperthyroidism.Method: After cleaning the ear with an alcohol swab, allow the ear to dry naturally. Insert a half-inch #28-gauge needle perpendicularly into each point, with the exception of the brain point, which is needled obliquely and anteriorly due to its location on the posterior border of the antitragus. Obtain qi, ideally in the form of heat, and tonify with a slight clockwise turn. Retain the needles for 10 to 15 minutes. After removing the needles, to reinforce the treatment, affix gold magrain pellets to the same points, but in the opposite ear (which has also been cleaned). Instruct the patient to press gently on the pellets for 3 to 5 seconds, 3 to 5 times a day, for 3 to 5 days. Show the patient how to remove the pellets within the allotted time frame (or earlier, if the ear becomes irritated), or have the patient return to the office for you to remove the pellets. See Figure 1 for the location of these points.
Treatment 2: Body Acupuncture (standard Chinese point locations are used for all points)
1. HT 7 (shenmen): As the sedation point of the heart meridian, this point quiets and stabilizes heart energetics manifesting as palpitations; tachycardia; restlessness; and insomnia. Puncture the point bilaterally and perpendicularly 0.3-0.5 inches, and tonify with a small clockwise twist.
2. ST 36 (zusanli): As the he (sea) point of the stomach meridian, ST 36 tonifies stomach and kidney yin. It reduces stomach fire leading to increased appetite. It builds blood, and reduces fatigue and weight gain. Puncture the point bilaterally and perpendicularly 0.8-1.2 inches, and tonify.
3. SP 6 (sanyinjiao): As the group luo of the 3 leg yin, sanyinjiao nourishes the yin of the spleen, liver and kidney. It improves dry symptoms of the eyes, builds blood, and grounds the patient. Puncture SP 6 perpendicularly and bilaterally 0.5 inches. Try to direct the qi sensation to KD 1 (yongquan) by placing your thumb above SP 6 to block the qi, then tonify the point.
4. Liver 3 (taichong): According to the Chinese, this is the best point to tonify the liver yin. Concomitantly, it reduces liver yang rising, because source points have this function. It decreases nervousness and treats various eye disorders. Needle the points bilaterally, obliquely and proximally (that is, away from the toes) 0.3-0.5 inches in the direction of the meridian, and stimulate mildly.
5. Kidney 3 (taixi): The Chinese claim Kidney 3 is better than Spleen 6 to support the yin of the body, thereby reducing fatigue. Puncture Kidney 3 perpendicularly 0.3 inches.
6. GB 1 (tongziliao): For symptoms of eye involvement, pinch the skin to insert the needle, then direct laterally and horizontally 0.2-0.3 inches along the skin.
7. BL 2 (zanzhu): Bladder 2 also is effective for the various eye symptoms associated with hyperthyroidism. It soothes the liver, assists in nourishing the eyes, and reinforces the kidney. Pinch the skin in the eyebrow area and puncture the point horizontally 0.3 inches toward the lateral aspect of the face.
Exercise and herbs also are helpful support symptoms to the treatment of hyperthyroidism, and emotional factors should be explored with the patient. As always, it also is important to provide patient, caring treatment, and to offer behavioral recommendations about lifestyle factors that consumer essence and promote the development of fire in the body.
Abbate S. The early diagnosis and treatment of hypothyroidism. Acupuncture Today 2001;2(7).
Abbate S. Hypothyroidism revisited. Acupuncture Today 2002;3(7).
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