BY ROCHELLE FERNANDES, MSC., ND (CAND)
Thyroid disorders affect about 200 million people in the world and are four to seven times more common in women (Mircescu, 2010). These disorders are ubiquitous in the context that they are the root of many other diseases. Thyroid conditions include hyper/hypothyroidism, goiter, thyroid cancer, Graves’ disease and Hashimoto’s thyroiditis. The conventional treatment option for nodules and cancer is surgery. Medications are also used for many thyroid conditions. Pharmaceutical medications that are common for hypothyroid status include Synthroid and Cytomel. Hyperthyroidism is treated by radioactive iodine or anti-thyroid medications, such as Methimazole. There are several natural options available to treat thyroid conditions that can be used in conjunction with these medications or on their own, such as selenium, kelp and zinc. However, more recent attention has been drawn to other options, such as magnesium, vitamin D and carnitine. The following is a summary of the current evidence on these natural treatment options.
MAGNESIUM – 100-400MG DAILY
Magnesium is a vital part of cellular reactions; it is involved in metabolism, DNA replication, repair, transport mechanisms and cell proliferation. Food sources that are high in magnesium are whole and unrefined grains, seeds, cocoa, nuts, almonds, green leafy vegetables, avocados and fish (Blaszczyk, 2013). Magnesium has been used in a wide array of diseases, such as arrhythmia, hypertension, high cholesterol, premenstrual syndrome, asthma, diabetes and attention deficit hyperactivity disorder (ADHD), in doses of 100-400mg on average taken with meals (Micromedex, 2015). More recently, the relationship between magnesium abnormalities and the development of thyroid disorders has been considered.
❯EVIDENCE FOR MAGNESIUM
A growing body of evidence has shown the role and pattern of magnesium levels in thyroid disorders, including thyroid cancer and autoimmune thyroid disease. For example, after factoring out ethnicity, one meta-analysis showed a significant association between magnesium serum and thyroid cancer. This retrospective analysis found that individuals with thyroid cancer had lower serum levels of selenium and magnesium, but higher levels of copper than healthy controls (Shen, 2015). Further benefit from these findings in a future study would be to understand the results in the context of ethnicity. Another study on metabolic disorders indicated that mineral deficiencies, including magnesium, were found in patients with autoimmune thyroid disease, alongside protein and vitamin deficiencies (A, B’s and C). It suggests that an improved diet via maintenance of required daily intakes of vitamins and minerals could help decrease symptoms and prevent the recurrence of malnutrition-induced thyroid disease (Kawicka, 2015). Although this study was done on a malnourished population, it offers unique results that warrant further exploratory studies to see if the effect to correct the thyroid diagnosis is maintained in a non-malnourished population. One prospective cohort study showed no evidence of an association between thyroid cancer and micronutrient levels, including magnesium, however, this may have been partly attributed to the low statistical power of the study and lack of detail surrounding the population studied (O’Grady, 2014). Additionally, details were obtained via a food frequency questionnaire; it is possible that numerical, measurable outcomes could have different results if utilized in further study.
A well designed, cross-sectional study showed that overtly hypothyroid patients had reduced magnesium serum levels, among other abnormal serum levels of nutrients (Abdel Gayoum, 2014), thus suggesting the need for diet modification and supplementation with this micronutrient. It would also be beneficial to do an extension of this type of study to examine whether this effect changes and/or is maintained past six months. A study examined the effects of magnesium levels after treatment with thyroid medication; exam¬ining magnesium as a pathology marker. The study demonstrated that using Methimazole in the treatment of hyperthyroidism due to Graves’ disease led to normalizing magnesium levels (Klatka, 2013). These results are useful with further investigation on whether, in addition to magnesium as a pathology marker, it could be used therapeutically, and correction of magnesium deficiency could be beneficial towards correcting thyroid abnormalities.
VITAMIN D – 0.75-2.5MG DAILY
Vitamin D is a fat-soluble vitamin that is found in certain foods and can be produced internally when ultraviolet rays hit the skin. It is inactive and has to go through two transformations to be biologically active: primarily, the liver converts vitamin D to calcidiol (NIH, 2015). The function of vitamin D in the body is for bone and cell growth, neurological function, normal inflammatory response and thyroid optimization. Food sources of vitamin D include cod liver oil, swordfish, salmon, milk and liver.
❯EVIDENCE FOR VITAMIN D
The role that vitamin D plays in the development and treatment of thyroid conditions, such as Graves’ disease and thyroid cancer, remains to be uncovered. One study showed that the prevalence of vitamin D deficiency was significantly higher in Graves’ disease patients when compared to control subjects (Li, 2015). This suggests that vitamin D deficiency might be an independent risk factor for predicting the failure of RIT in Graves’ disease subjects. Another study found that low vitamin D was associated with three types of autoimmune thyroid disease (Ma, 2015).
Although the study of molecular mechanisms of vitamin D is beyond the scope of this article, the following should be noted as it illustrates the potential for future vitamin D therapy. The mortality due to anaplastic thyroid cancer (ATC) is high because of the fast progression of the disease and its high metastatic potential with no effective treatment exists. The active form of vitamin D3 has been shown to thwart metastases in pre-clinical studies but has not been used clinically because of its potential to create a state of hypercalcemia. A recent study unveiled that a category of less-calcemic vitamin D analogs is more potent than the active form of vitamin D3 in repressing cancer growth and metastasis in a variety of cancers. The study showed that both forms could effectively inhibit the migration and invasion of ATC cells, suggesting hopeful future clinical application (Chiang, 2015). Another emerging supplement for thyroid disorders is carnitine. VM
