Hashimoto's Disease (or Hashimoto's Thyroiditis) is an autoimmune disease. In Hashimoto's patients, the immune system attacks the thyroid gland causing an underproduction of thyroid hormones and hypothyroiditis.
Signs and Symptoms
Signs and symptoms look an awful lot like cold and damp retention if you think about it from a CM perspective. You can also see Spleen Qi deficiency and even Spleen Yang deficiency here as well. Fatigue, sluggishness, increased cold sensitivity, constipation, pale dry skin, puffy face, brittle nails, loss of hair, swollen tongue, weight gain despite no changes in eating or activity level, muscle aches, tenderness and stiffness, joint pain and stiffness, muscle weakness, depression, memory lapses, and excessive or prolonged menstrual bleeding are all possible symptoms.
There are also a number of health problems that can occur when Hashimoto's is not treated. Some of these are development of goiters, heart problems, myxedema, mental health issues, and birth defects.
Causes
While no one knows the causes of Hashimoto's Thyroiditis, there are some known risk factors. Women are more likely to get it. While it can occur at any age, it usually expresses during middle age. If someone in the family has had Hashimoto's or other autoimmune diseases, then the risk increases. Having another autoimmune disease also increases the likelihood of Hasimoto's - lupus, rheumatoid arthritis, and type 1 diabetes for instance. Radiation exposure also increases the likelihood of developing Hashimoto's.
Diagnosis and treatment
From a western medical perspective, Hashimoto's Disease is diagnosed through observed signs and symptoms, hormone testing (looking for low TSH), and antibody tests. Western medicine treats it with synthetic hormones.
Chinese medicine would look at a Zangfu diagnosis for herbal treatment and via channels involved to create a working differential acupuncture diagnosis. From a Zangfu perspective, if you look at the symptoms you can see Spleen deficiency, cold, and damp - fatigue and weakness, weight gain, sensitivity to cold, muscle aches and stiff joints, facial swelling, and constipation. The thermostat is basically set too low in the body. Lifestyle, diet, acupuncture and herbs are definitely in order here. Look back at the diet and lifestyle section of the autoimmune write up to get some suggestions here.
Acupuncture basic Rx
The sides given here are not a hard and fast rule. Liver usually expresses on the right side, hence the liver points there. You can move them around or even needle bilaterally.
Centerline:
Du 20 and/or Yintang
Right side:
Left side:
If there is constipation, add St 34 and St 37.
Point Discussion
This protocol addresses the Liver, Gallbladder, Spleen, and Kidney on the right side. The Kidney points sedate and tonify the Liver because water is the mother of wood. The Kidney points also stoke the internal Mingmen fire to "turn up the thermostat" in the body and increase the viability of both Qi and Yang.
The San Zhong points are go-to points for neck and shoulder pain, so the energy of these points guides Qi to the neck and throat.
Xia San Huang on the left balances the whole body and is on the Spleen channel, which helps with muscle weakness. This set also contains Shen Guan, a Kidney point on the Spleen channel, which is good for any internal disease. Xia San Huang nourishes both the Spleen and the Kidney.
Du 20 raises the energy, relaxes the mind and body, and helps move Qi. You could also add Yintang to this set to do this as well. If you've read much of what I've written you might know that I love auricular points for this too. Auricular Autonomic and Shenmen points are great to calm the mind and body.
You might notice this looks just like the Grave's Disease protocol. Why? Because acupuncture points are intelligent and know what to do when you point them in the right direction. That brings me to reason two: acupuncture is a targeting system. You are moving intelligent Qi to the neck and throat area so it can do its' job.
Herbal Medicine
Modify formulas to customize them for your patient whenever possible. This is always better medicine than giving formulas. Consider the following classic and modern formulas
Jin Gui Shen Qi Wan combined with Bu Zhong Yi Qi Tang to warm Kidney Yang and regulates the Middle Jiao. Add the single herbs hai zao and kun bu for thyroid regulation.
Evergreen's Thyroforte is a great formula to boost the thyroid.
You have to get the dosage strong enough for it to do any good. Many of us were taught to under-dose. Dose according to body weight and have your patient do a thyroid panel monthly to track the progress.