Alternative and Integrative Therapies for Hormonal Disorders

Strong Scientific Evidence:

Iodine: Iodine has been used to prevent goiters that are caused by iodine deficiency. Iodine is an element that the human body needs to make thyroid hormones. Iodine deficiency is one of the causes of goiter (hypertrophy of the thyroid gland because it tries to make more thyroid hormone in the absence of iodine). Other causes of goiter include autoimmune thyroiditis, excess iodine, other hormonal disorders, radiation exposure, infectious causes, or inborn errors of metabolism. Although goiter due to low iodine intake is rare in developed countries, it may occur in regions with endemic low iodine levels. To avoid iodine deficiency in the United States, table salt is enriched with iodine ("iodized" salt), iodine is added to cattle feed, and it used as a dough conditioner. Iodine supplementation is generally not recommended in developed countries where sufficient iodine intake is common, and excess iodine can actually cause medical complications (including goiters).

Iodine supplementation should be considered in cases of known iodine deficiency and should be administered under medical supervision, if possible. Notably, the treatment of goiters usually involves administration of thyroid hormone, most commonly levothyroxine sodium (Synthroid ®, Levoxyl ®, or Levothroid ®). Iodine generally does not play a role in the acute management of this condition.

Reactions can be severe and deaths have occurred with exposure to iodine. Avoid iodine-based products if allergic or hypersensitive to iodine. Do no use for more than 14 days. Avoid lugol solution and saturated solution of potassium iodide (SSKI, PIMA) with hyperkalemia (high amounts of potassium in the blood), pulmonary edema (fluid in the lungs), bronchitis, or tuberculosis. Use cautiously when applying to the skin because it may irritate or burn tissues. Use sodium iodide cautiously with kidney failure. Avoid sodium iodide with gastrointestinal obstruction. Iodine is safe in recommended doses for pregnant or breastfeeding women. Avoid povidone-iodine for perianal preparation during delivery or postpartum antisepsis.

Good Scientific Evidence:

Black cohosh: Black cohosh is a popular alternative for menopausal hormonal symptoms such as hot flashes, migraine headache, mood changes, sleep changes, sweating, fast heartbeat, and vaginal dryness. The exact action of black cohosh is unclear. Black cohosh is a popular alternative to prescription hormonal therapy for treatment of menopausal symptoms, such as migraine headaches, sleep disturbances, hot flashes, mood problems, perspiration, heart palpitations, and vaginal dryness. Initial human research suggests that black cohosh may improve some of these symptoms for up to six months. However, most studies are not well designed, and results are inconclusive. Well-designed studies are needed using black cohosh for longer than six months.

Use cautiously if allergic to members of the Ranunculaceae family such as buttercups or crowfoot. Avoid with hormone conditions (e.g. breast cancer, ovarian cancer, uterine cancer, or endometriosis). Avoid if allergic to aspirin, aspirin products, nonsteroidal anti-inflammatory drugs (NSAIDs), or blood-thinners (such as warfarin). Avoid with a history of blood clots, stroke, seizures, or liver disease. Stop use before and immediately after surgery/dental/diagnostic procedures with bleeding risk. Avoid if pregnant or breastfeeding.

DHEA: DHEA (dehydroepiandrosterone) is a hormone that is produced by the adrenal glands. Several studies suggest that DHEA may improve well-being, quality of life, exercise capacity, sex drive, and hormone levels in people with Addison's disease. Though promising, additional study is needed to make a strong recommendation. Adrenal insufficiency is a serious medical condition and should be treated under the supervision of a qualified health care professional, including a pharmacist.

Avoid if allergic to DHEA. Avoid with a history of seizures. Use cautiously with adrenal or thyroid disorders. Use cautiously if taking anticoagulants (blood thinners) or drugs, herbs, or supplements for diabetes, heart disease, seizures, or stroke. Stop use two weeks before and immediately after surgery/dental/diagnostic procedures with bleeding risk. Avoid if pregnant or breastfeeding.

Ginseng: For more than 2,000 years, the roots of this slow-growing plant have been valued in Chinese medicine. Several studies report a hypoglycemic effect of American ginseng in patients with type 2 diabetes. These results are promising, especially because ginseng does not seem to cause hypoglycemia. Future research needs to evaluate long-term efficacy of ginseng in managing blood sugar levels.

Avoid ginseng with a known allergy to plants in the Araliaceae family. There has been a report of a serious life-threatening skin reaction, possibly caused by contaminants in the ginseng formulation.

Iodine: Iodine supplements may help treat patients with Grave's disease. Grave's disease is an immune-mediated disorder that causes hyperthyroidism. Thyroid-stimulating immunoglobulins bind to the thyroid stimulating hormone (TSH) receptor and mimic the action of thyroid TSH, and stimulate thyroid growth and thyroid hormone overproduction. Iodide preparations can be used to suppress thyroid hormone release from the thyroid, such as strong iodine solution (Lugol solution), potassium iodide (SSKI), and iodinated radiographic contrast agents (sodium ipodate). Individuals undergoing thyroid surgery are commonly treated preoperatively with antithyroid drugs to achieve a euthyroid state, then SSKI.

Reactions can be severe, and deaths have occurred with exposure to iodine. Avoid iodine-based products if allergic or hypersensitive to iodine. Do no use for more than 14 days. Avoid lugol solution and saturated solution of potassium iodide (SSKI, PIMA) with hyperkalemia (high amounts of potassium in the blood), pulmonary edema (fluid in the lungs), bronchitis, or tuberculosis. Use cautiously when applying to the skin because it may irritate or burn tissues. Use sodium iodide cautiously with kidney failure. Avoid sodium iodide with gastrointestinal obstruction. Iodine is safe in recommended doses for pregnant or breastfeeding women. Avoid povidone-iodine for perianal preparation during delivery or postpartum antisepsis.

Stevia: Extracts of leaves from Stevia rebaudiana Bertoni (SrB) have been used for many years in traditional treatment of diabetes in South America. Studies report decreases in blood sugar levels when stevia was taken in healthy volunteers. However, there is currently no conclusive evidence of effectiveness when used for diabetes. Additional study is needed in this area to confirm these findings.

Avoid if allergic or hypersensitive to any members of the daisy family (Asteraceae/Compositae). Use cautiously with high blood pressure, calcium deficiency, or low blood sugar. Use cautiously if taking blood pressure lowering drugs, blood sugar-altering drugs, or insulin. Avoid with impaired kidney function or other kidney diseases. Avoid if pregnant or breastfeeding.

Unclear or Conflicting Scientific Evidence:

Barley: Barley is a cereal used as a staple food in many countries. It is commonly used as an ingredient in baked products and soup in Europe and the United States. Early research suggests that barley meal may improve glucose tolerance.

Avoid if allergic or hypersensitive to barley flour or beer. Barley appears to be well tolerated in non-allergic, healthy adults in recommended doses for short periods of time as a cereal or in the form of beer. Use cautiously with diabetes, asthma, or arrhythmia (irregular heartbeats). Contamination of barley with fungus has occurred. Traditionally, women have been advised against eating large amounts of barley sprouts during pregnancy. Infants fed with a formula containing barley water, whole milk, and corn syrup have developed malnutrition and anemia, possibly due to vitamin deficiencies.

Gamma oryzanol: Gamma oryzanol occurs in rice bran oil and it has also been extracted from corn and barley oils. Preliminary evidence has indicated that gamma oryzanol affects several parts of the endocrine system and may reduce thyroid-stimulating hormone (TSH) in patients with hypothyroidism. As a result, this may reduce the chance of a goiter developing. More studies are needed in this area and other areas of endocrinology to establish gamma oryzanol's effects.

Avoid if allergic/hypersensitive to gamma oryzanol, its components, or rice bran oil. Use cautiously if taking anticoagulants (blood thinners), central nervous system (CNS) suppressants, growth hormone, drugs that alter blood sugar levels, immunomodulators, luteinizing hormone, luteinizing hormone-releasing hormone, prolactin, cholesterol-lowering agents, thyroid drugs, or herbs or supplements with similar effects. Use cautiously with diabetes, hypothyroidism, hypoglycemia, or high cholesterol. Avoid if pregnant or breastfeeding.

Iodine: Although iodine supplements have been shown to prevent goiters caused by iron deficiency, it remains unknown if iodine is an effective treatment once a goiter has developed. Although goiter due to low iodine intake is rare in developed countries, it may occur in regions with endemic low iodine levels. Further research is warranted in this area.

Reactions can be severe, and deaths have occurred with exposure to iodine. Avoid iodine-based products if allergic or hypersensitive to iodine. Do no use for more than 14 days. Avoid lugol solution and saturated solution of potassium iodide (SSKI, PIMA) with hyperkalemia (high amounts of potassium in the blood), pulmonary edema (fluid in the lungs), bronchitis, or tuberculosis. Use cautiously when applying to the skin because it may irritate or burn tissues. Use sodium iodide cautiously with kidney failure. Avoid sodium iodide with gastrointestinal obstruction. Iodine is safe in recommended doses for pregnant or breastfeeding women. Avoid povidone-iodine for perianal preparation during delivery or postpartum antisepsis.

L-carnitine: L-carnitine is an amino acid that is produced in the muscles and liver. Although preliminary evidence suggests that L-carnitine may help treat hyperthyroidism, further research is needed before a firm conclusion can be made.

Avoid with a known allergy or hypersensitivity to carnitine. Use cautiously with peripheral vascular disease, high blood pressure, alcohol-induced liver cirrhosis, or diabetes. Use cautiously in low birth weight infants and individuals on hemodialysis. Use cautiously if taking anticoagulants (blood thinners), beta-blockers, or calcium channel blockers. Avoid if pregnant or breastfeeding.

Licorice: Licorice is harvested from the root and dried rhizomes of the low-growing shrub Glycyrrhiza glabra. In theory, there may be some benefits of licorice for high potassium levels caused by a condition called hypoaldosteronism. There is early evidence in humans in support of this use. However, research is preliminary and a qualified healthcare provider should supervise treatment.

Avoid licorice if allergic to licorice, any component of licorice, or any member of the Fabaceae (Leguminosae) plant family. Avoid with congestive heart failure, coronary heart disease, kidney disease, liver disease, fluid retention, high blood pressure, or hormonal abnormalities. Avoid if taking diuretics. Licorice can cause abnormally low testosterone levels in men or high prolactin or estrogen levels in women. This may make it difficult to become pregnant and may cause menstrual abnormalities.

Physical therapy: The goal of physical therapy is to improve mobility, restore function, reduce pain, and prevent further injury. Several methods, including exercises, stretches, traction, electrical stimulation, and massage, may be used. There is insufficient available information on physical therapy as a treatment for thyroiditis. Additional research is needed before a conclusion can be made.

Not all physical therapy programs are suited for everyone and patients should discuss their medical history with their qualified healthcare providers before beginning any treatments. Based on the available literature, physical therapy appears generally safe when practiced by a qualified physical therapist. However, complications are possible. Treatment options should be considered carefully. Physical therapy may aggravate pre-existing conditions. Persistent pain and fractures of unknown origin have been reported.

Physical therapy may increase the duration of pain or cause limitation of motion. Pain and anxiety may occur during the rehabilitation of patients with burns. Both morning stiffness and bone erosion have been reported in the physical therapy literature although causality is unclear. Erectile dysfunction has also been reported. Reports of major side effects are lacking in the available literature, but caution is advised nonetheless. All therapies during pregnancy and breastfeeding should be discussed with a licensed obstetrician/gynecologist before initiation.

Psyllium: Psyllium, also known as ispaghula, comes from the husks of the seeds of English plantain. Psyllium contains a high level of soluble dietary fiber. Several studies have evaluated the effects of psyllium on blood sugar levels when taken with meals or just before meals. Better evidence is necessary before a firm conclusion can be drawn.

Avoid if allergic or hypersensitive to psyllium, ispaghula, or English plantain (Plantago lanceolata). Prescription drugs should be taken one hour before or two hours after psyllium. Use cautiously if pregnant or breastfeeding because psyllium may lower blood sugar levels.

Seaweed, kelp, bladderwrack: Bladderwrack (Fucus vesiculosus) is a brown seaweed found along the northern coasts of the Atlantic and Pacific oceans and North and Baltic seas. Another seaweed that grows alongside bladderwrack is Ascophyllum nodosum, and is often combined with bladderwrack in kelp preparations. Bladderwrack contains variable levels of iodine. As a result, it has been used to treat thyroid disorders, including goiters, which are caused by low levels of iodine. While the evidence does suggest thyroid activity, there is not enough research to support this use of bladderwrack.

Avoid if allergic or hypersensitive to Fucus vesiculosus and iodine. Avoid with a history of thyroid disease, bleeding, acne, kidney disease, blood clots, nerve disorders, high blood pressure, stroke, or diabetes. Avoid if pregnant or breastfeeding.

Selenium: Selenium is a mineral found in soil, water, and some foods. An early toxic effect of selenium is disruption of endocrine function, including synthesis of thyroid hormones (T3). Selenium has been suggested to improve inflammatory activity in chronic autoimmune thyroiditis. Further research is needed before a clear conclusion can be drawn.

Avoid if allergic or sensitive to products containing selenium. Avoid with a history of non-melanoma skin cancer. Selenium is generally regarded as safe for pregnant or breastfeeding women. However, animal research reports that large doses of selenium may lead to birth defects.

Comments (0)