Hypothyroidism
Hypothyroidism (hereafter referred to as “hypothyroidism”) is a systemic hypometabolic syndrome caused by insufficient thyroid hormone synthesis, secretion, or biological activity due to various causes. In severe cases, it presents as myxedema. In TCM, primary hypothyroidism is generally classified under “edema,” “deficiency taxation,” and “overflowing fluid.” The prevalence of this condition in the general population is 0.8%–1.0%. By location, hypothyroidism caused by a disorder of the thyroid gland itself is called primary hypothyroidism; reduced TSH secretion caused by pituitary disease is called secondary hypothyroidism; reduced TRH secretion caused by hypothalamic disease is called tertiary hypothyroidism; and impaired thyroid hormone action in peripheral tissues is called thyroid hormone resistance syndrome. By age at onset, impaired thyroid function beginning in the fetal or neonatal period is called cretinism; onset before or during puberty in children is called juvenile hypothyroidism; and onset in adulthood is called adult hypothyroidism. By severity of reduced thyroid function, hypothyroidism is classified as overt or subclinical.
TCM Pattern Differentiation and Medication Reference
|Common Symptoms
Clinical description:
Fatigue and shortness of breath, sallow complexion, poor appetite, pale tongue, enlarged and tender tongue with teeth marks along the edges, thin white coating, and a fine, weak pulse
In plain language:
- You tire easily and feel short of breath when active or speaking.
- Your face looks sallow and dull, with little luster.
- You have a poor appetite and food seems unappetizing.
- Your tongue appears pale.
- Your tongue is somewhat enlarged and soft in texture.
- Clear teeth marks may be visible along the edges of the tongue.
- The tongue coating is thin and white.
- The pulse is fine and weak.
|Treatment approach
Clinical description:
Tonify the middle, boost qi, strengthen the spleen, and nourish the blood
In plain language:
- • May help replenish vital qi and support strength, easing discomforts such as fatigue, weakness, shortness of breath, reluctance to speak, or low energy.
- • May help support spleen and stomach function and digestion, easing symptoms such as poor appetite, abdominal bloating, loose stools, or indigestion.
- • May help nourish the blood, easing symptoms such as a dull complexion, dizziness, palpitations, or light menstrual flow.
|Related medication
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the packaging and package insert, and use under the guidance of a doctor or pharmacist.
|Common Symptoms
Clinical description:
Sensitivity to cold and cold limbs, soreness and weakness of the lower back and knees, poor appetite, abdominal bloating, constipation, facial and lower-limb edema, erectile dysfunction in men, menstrual irregularities in women, pale tongue, enlarged tongue, thin white or thin greasy coating, and a deep, slow, weak pulse
In plain language:
- You feel cold easily, and your limbs feel cold.
- Your lower back and knees feel sore and weak.
- You have a poor appetite.
- Your abdomen feels bloated.
- Your stools are hard and difficult to pass.
- Edema may occur in your face, lower legs, and feet.
- Men may experience difficulty achieving or maintaining an erection.
- Women may have irregular menstrual periods.
- Your tongue appears pale.
- Your tongue appears enlarged.
- The tongue coating is thin and white or thin and greasy.
- The pulse feels deep and slow, and is weak.
|Treatment approach
Clinical description:
Tonify the middle, boost qi, warm yang, and tonify the kidneys
In plain language:
- May help tonify qi in the middle burner, easing discomforts such as poor appetite, fatigue, shortness of breath, abdominal bloating, or loose stools.
- May help warm and support yang and nourish kidney qi, easing symptoms such as sensitivity to cold, cold limbs, soreness and weakness in the lower back and knees, or low stamina.
|Related medication
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the packaging and package insert, and use under the guidance of a doctor or pharmacist.
|Common Symptoms
Clinical description:
Sensitivity to cold and cold limbs, soreness and weakness of the lower back and knees, edema, sparse hair, decreased libido, pale and enlarged tongue, and a deep, moderate, weak pulse
In plain language:
- You feel notably cold, and your limbs are often cold; cold weather may make this worse.
- Your lower back and knees feel sore and weak, especially after standing or walking for a long time.
- You may develop swelling that leaves a pit when pressed, which takes longer to rebound.
- Your scalp and body hair may become thinner and sparser, and grow more slowly.
- Your libido and sexual desire may decrease noticeably.
- Your tongue appears pale and enlarged, with a moist appearance.
- Your pulse feels deep and slow when pressed, and lacks strength.
|Treatment approach
Clinical description:
Replenish essence and tonify the kidneys; warm and support kidney yang
In plain language:
- May help nourish essence and blood and tonify kidney qi, easing discomforts such as dizziness, tinnitus, soreness and weakness in the lower back and knees, or low stamina.
- May help warm and support kidney yang, easing symptoms such as sensitivity to cold, cold limbs, low energy, or difficulty urinating.
|Related medication
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the packaging and package insert, and use under the guidance of a doctor or pharmacist.
|Common Symptoms
Clinical description:
Sensitivity to cold and cold limbs, palpitations, chest tightness and pain, pale and dusky tongue, scant coating, deep, slow, faint, weak pulse, or an irregular pulse with skipped beats
In plain language:
- You feel notably cold, and your limbs are often cold.
- You feel anxious or unsettled, with an uncomfortable awareness of your heartbeat.
- Your chest feels tight and painful.
- Your tongue appears pale and dusky.
- There is very little coating on your tongue, or only a thin layer.
- Your pulse feels deep, slow, and weak, or has intermittent irregular pauses.
|Treatment approach
Clinical description:
Warm and tonify the heart and kidneys; support the heart and restore the pulse
In plain language:
- May help warm and tonify heart yang and kidney yang, easing discomforts such as palpitations, shortness of breath, sensitivity to cold, cold limbs, or soreness and weakness in the lower back and knees.
- May help nourish heart qi and support the pulse, easing symptoms such as palpitations, chest tightness, a weak pulse, or restlessness.
|Related medication
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the packaging and package insert, and use under the guidance of a doctor or pharmacist.
|Common Symptoms
Clinical description:
Drowsiness, clouded consciousness, limb edema, pale tongue, enlarged tongue, white greasy coating, and an extremely faint, almost imperceptible pulse
In plain language:
- You feel sleepy much of the time and have difficulty staying awake during the day.
- You may seem confused, respond slowly, or appear to have impaired awareness.
- Your limbs and body may become swollen, with a pit after pressing that takes a long time to rebound.
- Your tongue appears pale or whitish, as if lacking color.
- Your tongue appears enlarged and takes up more space in your mouth.
- Your tongue coating is white and greasy, with a thick, sticky appearance.
- Your pulse is extremely weak and difficult to feel, almost imperceptible.
|Treatment approach
Clinical description:
Restore yang and rescue from collapse; boost qi and secure collapse
In plain language:
- May help warm and support yang to address severe deficiency, easing serious symptoms such as sensitivity to cold, cold limbs, profound lethargy, or an extremely faint, almost imperceptible pulse.
- May help replenish vital qi and prevent collapse, easing symptoms such as profuse sweating, very weak breathing, or a pale complexion.
|Related medication
The products below are provided for informational reference only and do not constitute medical advice or a prescription. Follow the packaging and package insert, and use under the guidance of a doctor or pharmacist.
References
- Gao Tianshu. Practical Chinese and Western Medicine Thyroid Disease[M]. Shenyang: Liaoning Science and Technology Publishing House, 2013: 56–74.
- Ge Junbo, Xu Yongjian. Internal Medicine[M]. Beijing: People’s Medical Publishing House, 2013: 693–695.
- Liao Eryuan. Endocrinology and Metabolism[M]. Beijing: People’s Medical Publishing House, 2012: 477–493.
- Chinese Pharmacopoeia Commission. Pharmacopoeia of the People’s Republic of China: Clinical Medication Guide, Volume on Chinese Patent Medicines and Formulations[M]. Beijing: China Medical Science Press, 2011.
- Ma Changjun, Wang Zhongqiong. Clinical characteristics, treatment, and prognosis of 97 cases of hypothyroidism[J]. China Medical Herald, 2013, 10(22): 52–53, 56.
- Chinese Pharmacopoeia Commission. Pharmacopoeia of the People’s Republic of China, Volume 3[S]. Beijing: China Medical Science Press, 2010.
- National Essential Medicines List. National Essential Medicines List: Medicines for Use in Primary Medical and Health Institutions (2009 Edition)[M]. Beijing: China Legal Publishing House, 2009: 4–5.