Hypothyroidism in Traditional Iranian Medicine is a condition that is understood as an imbalance in the body’s natural temperament and metabolic regulation, affecting the proper function of the thyroid gland. The thyroid is a butterfly-shaped gland located in the front of the neck, below the larynx and above the collarbones. It plays a crucial role in regulating the body’s metabolism, including energy production and storage, through the secretion of thyroid hormones T3 (triiodothyronine) and T4 (thyroxine). At ACPFOOD, we aim to provide clear and reliable information based on traditional health perspectives. In this article, we will explain hypothyroidism in Traditional Iranian Medicine, including its causes, symptoms, and traditional approaches to treatment.
What Is the Thyroid and What Is Its Role in the Body?
The thyroid gland has a highly precise regulatory system responsible for producing thyroid hormones and releasing them into the bloodstream. Its activity is closely monitored and controlled by the pituitary gland, which continuously assesses hormone levels in circulation to maintain hormonal balance.
When levels of thyroid hormones T3 (triiodothyronine) and T4 (thyroxine) decrease, the pituitary gland responds by releasing thyroid-stimulating hormone (TSH). This hormone signals the thyroid gland to increase production of T3 and T4. Conversely, when thyroid hormone levels become elevated, the pituitary gland reduces TSH secretion to prevent overproduction and maintain equilibrium.
In some cases, this regulatory system becomes disrupted. The immune system may mistakenly attack thyroid cells, leading to dysfunction in thyroid activity. As a result, the gland may become either overactive or underactive.
When the thyroid produces excessive amounts of T3 and T4, the condition is known as hyperthyroidism, typically associated with low TSH levels. In contrast, when thyroid hormone production decreases significantly, metabolic activity slows down, leading to hypothyroidism, which is commonly associated with elevated TSH levels.
Thyroid disorders are often linked to autoimmune processes and may have a hereditary component, appearing in multiple members of the same family. These conditions are also more frequently observed in women compared to men, and in older individuals compared to younger populations.
In some cases, symptoms of hypothyroidism in Traditional Iranian Medicine may also be observed in individuals with type 1 diabetes, particularly when blood sugar control is not well managed.
Definition of Hypothyroidism in Traditional Iranian Medicine
In the most common form of hypothyroidism, which affects approximately 1% of the population and is especially seen in elderly women, the thyroid gland becomes reduced in size and structure, and its cells are gradually destroyed due to dysfunction in the immune system. In this condition, the body’s immune system mistakenly attacks the thyroid tissue, leading to impaired hormone production and reduced metabolic activity.
In some less common cases, immune system disorders may not only lead to hypothyroidism but can also cause enlargement of the thyroid gland, resulting in goiter. Both conditions are often associated with other autoimmune diseases, which may be discussed in later sections.
Although individuals with hypothyroidism in Traditional Iranian Medicine and modern medical understanding may have a higher tendency toward autoimmune conditions compared to the general population, the overall likelihood of developing additional autoimmune diseases remains relatively low.
One of the known causes of hypothyroidism is also the treatment of Graves’ disease, particularly when the thyroid is treated through surgical removal or radioactive iodine therapy, which can reduce or eliminate thyroid hormone production over time.
Hypothyroidism Causes
In Traditional Iranian Medicine, the term “hypothyroidism” is not directly used in classical texts. However, based on traditional interpretations and clinical observations, this condition is often associated with an increase in coldness in the body, particularly an excess of phlegm and sometimes black bile, which represent cold and moist or cold and dry temperaments. This imbalance is believed to slow down the body’s natural metabolic processes and reduce overall vitality.
From this perspective, hypothyroidism in Traditional Iranian Medicine may develop or worsen due to long-term lifestyle and dietary factors. These include excessive consumption of cold and moist or cold and dry foods, prolonged sleep, physical inactivity, overeating, and prolonged exposure to cold environments or cold winds. Such factors are traditionally thought to gradually weaken the body’s metabolic heat and disrupt thyroid function over time.
In Traditional Persian Medicine, it is emphasized that hypothyroidism does not usually develop suddenly, but rather progresses slowly over months or even years. In the early stages, symptoms may be mild and easily mistaken for normal aging, fatigue, or lifestyle-related tiredness. Today, modern laboratory testing makes it easier to detect thyroid dysfunction at an early stage through thyroid function tests.
In more advanced cases, hypothyroidism may be referred to as “myxedema.” However, not all patients experience the full range of symptoms described, especially in early stages of the condition.
Supportive traditional approaches may include lifestyle modification, dietary regulation, physical activity, gentle massage with oils, and cupping in the area under the throat, all of which are traditionally used to support balance in cases of hypothyroidism in Traditional Iranian Medicine.
Hypothyroidism Symptoms
The symptoms of hypothyroidism in Traditional Iranian Medicine are generally understood as manifestations of increased coldness and moisture in the body, particularly affecting metabolism and slowing down physiological functions. These symptoms may involve multiple body systems, including the skin, eyes, respiratory system, heart, digestive system, and nervous system. It is important to note that not all symptoms appear in every patient, and their intensity may vary.
Because hypothyroidism slows down the body’s metabolic and chemical reactions, it can lead to a wide range of signs and symptoms, including:
Weight Gain
Many patients may experience a weight gain of approximately 5 to 10 kilograms, often without an increase in appetite, and sometimes even with reduced appetite.
Sensitivity to Cold
Individuals with hypothyroidism are often highly sensitive to cold temperatures and may prefer wearing warm clothing or staying near heat sources. Muscle stiffness and cramping may also occur, especially in cold environments or during sudden movement.
Psychological and Cognitive Changes
Fatigue, mental sluggishness, excessive sleepiness, and slower reaction times are common. In older individuals, symptoms may sometimes be mistaken for dementia. Irritability, anger, and emotional instability may also occur.
Voice Changes
The voice may become hoarse, weak, or fatigued, and speech may become slower or less clear.
Cardiovascular Changes
The heart rate may slow down, sometimes reaching around 60 beats per minute or lower. Blood pressure may fluctuate, and in long-term severe cases, there may be an increased risk of heart complications. In some cases, chest pain (angina) may be an early sign.
Digestive Issues
Due to slowed metabolism, constipation is a common symptom.
Menstrual Irregularities
Women may experience heavier or more prolonged menstrual bleeding.
Skin and Hair Changes
The skin may become dry, rough, pale, or flaky, with swelling in the eyelids, hands, or feet. In some cases, skin may take on a slightly yellowish tone with visible changes in facial blood vessels. Hair becomes brittle and dry, and thinning of the outer eyebrows may occur.
Nervous System Symptoms
Some individuals may experience hearing difficulties, balance problems, and tingling or burning sensations in the fingers, especially at night.
General Symptoms
Other common features include fatigue, depression, facial swelling, infertility, forgetfulness, irritability, anemia, reduced metabolic rate, decreased sweating, and pale lips.
In Traditional Iranian Medicine, these symptoms are generally associated with cold and moist temperament imbalance and are used to guide dietary, lifestyle, and therapeutic approaches for hypothyroidism in Traditional Iranian Medicine.
Diseases That Occur Along with Hypothyroidism
Although the overall risk remains relatively low, individuals with hypothyroidism may have a higher tendency to develop certain autoimmune-related conditions compared to the general population. These conditions are often associated with immune system imbalance and may occur alongside thyroid dysfunction.
Diseases that may occur with hypothyroidism include:
- Severe anemia (pernicious anemia): This condition is linked to vitamin B12 deficiency and may require regular vitamin B12 supplementation or injections under medical supervision.
- Diabetes: Particularly autoimmune-related forms may appear more frequently in individuals with thyroid dysfunction.
- Addison’s disease: A disorder affecting adrenal gland function, often associated with autoimmune activity.
- Premature ovarian failure: This condition may lead to reduced fertility and early onset menopause in women.
- Hypofunction of the parathyroid glands: Since these glands are located near the thyroid, their dysfunction may also occur. This condition can lead to low calcium levels in the blood and is often managed with vitamin D supplementation.
- Vitiligo: A skin condition characterized by loss of pigment in certain areas of the skin, leading to white patches.
In the context of hypothyroidism in Traditional Iranian Medicine, these associated conditions are generally viewed as part of a broader systemic imbalance, particularly involving immune and metabolic regulation.
Treatment of Hypothyroidism in Traditional Iranian Medicine
The treatment of hypothyroidism in Traditional Iranian Medicine is based on continuous lifestyle regulation, dietary correction, and the gradual restoration of the body’s natural balance.
In this framework, hypothyroidism in Traditional Iranian Medicine is often associated with an increase in cold and moist temperament, particularly involving phlegmatic and melancholic imbalances. Therefore, treatment primarily focuses on reducing coldness and strengthening the body through warming and supportive measures.
1. Correcting Temperament and Avoiding Cold Foods
Since this condition is traditionally linked to cold and moist imbalance, reducing cold foods is considered essential:
- Avoid cold and moist foods such as yogurt, milk, fish, cucumber, and similar items
- Avoid cold fruits and drinking cold water, especially during meals, in the morning on an empty stomach, or at night
- Avoid consuming salads, pickles, and raw cold combinations such as tomato and cucumber with meals
- Avoid processed foods, supermarket oils, and foods with preservatives
- Prefer natural olive oil in cooking
- Use warming herbs such as thyme and dill with meals
- Avoid cheese at breakfast
- Prefer warm-temperament breakfasts, including honey-based jams and warming foods
- Use warming spices (ginger, cardamom, cloves, cinnamon) with chicken and fish in moderation
- Limit caffeine, refined carbohydrates, sugar, flour products, canned foods, sweets, and fast foods
- Avoid raw cold vegetables such as broccoli and spinach unless cooked
- Avoid cold foods especially at dinner
- Cook rice with warming spices such as dill, cumin, or saffron
2. Eating Habits
- Chew food thoroughly and reduce meal quantity moderately
- Avoid heavy foods such as pasta, noodles, lasagna, and cheese-heavy pizza
- Avoid frequent snacking and eating at short intervals
- Avoid overeating, especially starchy foods
- Take a short walk after meals
- Avoid sleeping immediately after eating
3. Physical Activity and Weight Control
Regular movement and prevention of weight gain are considered important for improving metabolism and supporting thyroid function.
4. Digestive Health and Constipation Management
Proper digestion and regular bowel movements are essential components of treatment, as digestive weakness is believed to worsen systemic imbalance.
5. Sleep Regulation
Maintaining a regular sleep schedule, typically from 11 pm to 7 am, is recommended to support hormonal balance and overall recovery.
6. Traditional Home Remedies and Supportive Measures
Additional supportive approaches may include:
- Gentle daily massage under the throat using chamomile oil for about 10 minutes over a period of four weeks (under medical supervision)
- Drinking warm water mixed with honey, and consuming small amounts of honey daily
- Gargling a mixture of water, salt, peppermint hydrosol, rose water, vinegar, sumac, and honey, then discarding it
- Drinking herbal infusions such as Persian Ziziphora (Ziziphora tenuior), saffron, peppermint, cinnamon, or ginger one to two times daily, preferably one hour after meals (not continuously or excessively)
- Consuming foods rich in vitamins B and E
- Using iodized salt in moderation
- Including leeks in meals as a traditional source of iodine
- Adding wheat germ to salads, yogurt, or cooked foods
- Warm cupping under the throat (only under medical supervision due to potential risks)
- Inhaling warm natural fragrances during sleep such as jasmine, tuberose, and narcissus
Traditional Iranian Medicine emphasizes that treatment should be gradual, consistent, and tailored to the individual’s temperament, with the aim of restoring long-term balance in cases of hypothyroidism in Traditional Iranian Medicine.
Precautions for Hypothyroidism in Traditional Iranian Medicine
In Traditional Iranian Medicine, managing hypothyroidism in Traditional Iranian Medicine involves not only dietary and herbal recommendations but also careful attention to daily habits and lifestyle patterns. Certain practices are believed to weaken digestion, increase coldness in the body, and further disturb metabolic balance, and therefore should be avoided.
General precautions include:
- Avoid drinking liquids during meals or immediately after eating
- Avoid consuming multiple different food types in a single meal
- Avoid eating fruit immediately before or after meals
- Avoid drinking water immediately after eating fruit
- Avoid eating fruit on an empty stomach in the morning
- Avoid consuming cold milk on an empty stomach in the morning
- Avoid eating fruits that are out of their natural season
- Avoid drinking very cold milk or water
- Avoid daytime sleeping, as it is traditionally believed to increase lethargy and imbalance
- Avoid sleeping in a prone (face-down) position
- Avoid bathing, exercising, or sexual activity immediately after eating a full meal
- Avoid consuming foods that have been cooked several days earlier and stored for long periods
- Limit excessive intake of soy products, broccoli, cauliflower, lettuce (in some cases), turnips, peanuts, and sweet potatoes
- Avoid excessive consumption of fruits such as peaches and pears
Traditional Persian Medicine emphasizes that these precautions are intended to support digestive strength, reduce coldness in the body, and help maintain metabolic balance as part of a holistic approach to hypothyroidism in Traditional Iranian Medicine.
Should We Stop Using Levothyroxine Tablets When We Are Doing the Above Treatments?
Levothyroxine is a standard medical treatment used to manage hypothyroidism by replacing or supplementing deficient thyroid hormones. In all cases, any adjustment to this medication must be done carefully and under strict medical supervision.
According to Traditional Iranian Medicine perspectives, supportive lifestyle, dietary changes, and temperament correction may be used alongside conventional treatment. However, even when following traditional approaches for hypothyroidism in Traditional Iranian Medicine, levothyroxine should never be stopped suddenly or without professional guidance.
If any reduction is considered appropriate, it should be done gradually and only under the supervision of a qualified healthcare provider or specialist familiar with both conventional and traditional approaches. This process should follow proper assessment of the patient’s condition, temperament balance, and clinical response.
Abrupt discontinuation of levothyroxine can lead to serious health consequences and worsening of symptoms. Therefore, patients are strongly advised not to change or stop their medication based on self-decision, internet advice, or recommendations from non-specialists.
Conclusion
Hypothyroidism in Traditional Iranian Medicine is understood as a long-term imbalance in the body’s temperament, often associated with increased coldness and reduced metabolic activity. From this perspective, lifestyle, diet, sleep patterns, and emotional balance all play an important role in both the development and management of the condition. While modern medicine focuses on hormone replacement therapy, traditional approaches emphasize gradual correction of temperament, strengthening digestion, and supporting overall vitality through appropriate foods and habits.
A balanced combination of medical supervision, proper nutrition, and consistent lifestyle changes can help improve overall well-being and support thyroid function. Ultimately, understanding hypothyroidism in Traditional Iranian Medicine alongside conventional treatment provides a more comprehensive approach to long-term health management and prevention of complications.
References:
-Daeratol Maarif Giah Darmanie Iran (Noskhehaye Shafabakhsh), by Haji Sharifi, Ahmad (Attare Esfahani)
-Traditional Iranian Medicine Doctor’s Prescriptions.