Botanical Medicine for Thyroid Regulation

Successful Maintenance Treatment of a Patient with Resistant Hyperthyroidism with Traditional Persian Medicine Recommendations: A Case Report and Literature Review

INTRODUCTION

Hyperthyroidism is a common endocrinology condition that could affect several aspects of the patient's life.

CASE PRESENTATION

We present a 27-year-old woman who was sent to the traditional Persian medicine (TPM) clinic with a diagnosis of uncontrolled chronic hyperthyroidism (lower levels of thyroid-stimulating hormone (TSH) and higher levels of T3 and T4) and its complications, such as developing exophthalmos, palpitations, anxiety, sleep problems, hair loss, and dry skin. The patient was under treatment with prednisolone and methimazole for up to 1 year, but no acceptable improvement was achieved. The patient received a package of TPM recommendations, which included lifestyle modification, Melissa officinalis herbal tea, and Persian barley water. The patient was followed for 1 year. After 2 months of follow-up of the patient, the level of TSH increased, and the level of T3 and T4 decreased. In addition, the patient's symptoms, including exophthalmos, palpitation, anxiety, sleep disturbance, and dryness of the skin, were improved considerably. After 3 months of consumption of the TPM-based regime and prescription, the serum levels of TSH, T3, and T4, of the patient were in normal ranges. In a 1-year follow-up of the patient, the patient's condition was stable and her thyroid function tests were normal. We hereby present the following case to be in line with the CAse REports (CARE) checklist.

CONCLUSION

It appears that TPM lifestyle recommendations, M. officinalis herbal tea, and Persian barley water were effective in treating the patient with uncontrolled hyperthyroidism. We recommend further studies and clinical trial designs in this regard.

New Perspectives for the Use of Potentilla alba Rhizomes to Treat Thyroid Gland Impairments

Potentilla alba is a valuable medicinal plant that has been highly praised even before its first appearance in herbal books; however, it has now been forgotten in Western Europe. Currently, this species is used in Eastern Europe as a remedy to treat dysentery and various thyroid gland dysfunctions. The present review summarizes the advances in the phytochemical, pharmacological, and toxicological research related to this plant species. Clinical trials that have been conducted to date support its traditional use for treating thyroid disorders, although its exact mechanism of action, bioavailability, and pharmacokinetics data are missing.

Ethnopharmacological study of herbal remedies used for the management of thyroid disorders in Algeria

Traditional medicine is gaining an increasing importance in diseases management. Besides, thyroid disease is one of the common endocrine disorders spreading at high frequency worldwide. The present work is an ethnopharmacological study aiming to identify, document and analyze aromatic and medicinal plants used in Algerian traditional medicines for thyroid disorders management. Semi-structured interviews with 120 herbalists and traditional practitioners and rural dwellers were realized in eleven locations in Algeria throughout field studies achieved from June 2017 to July 2019. Results reveal the use of 63 medicinal plants belonging to 59 genera and 34 families. The most represented botanical families were Lamiaceae, Fabaceae, Apiaceae, Amaranthaceae and Asteraceae. However, the most cited plant species were Atriplex halimus L., Bunium incrassatum (Boiss.) Amo, Nigella sativa L., Aquilaria malaccensis Lam. and Saussurea costus (Falc.) Lipsch. These species are taken alone or in mixtures of two or more ingredients from different origins such as honey, olive oil, and goat milk. Our findings revealed new therapeutic uses of 60 medicinal plants that have not been previously reported for the treatment of thyroid in Algeria. This is the first study documenting the traditional uses based on herbal medicine for thyroid management in Algeria. Our findings are relevant in the search for novel drug discovery. Obviously, it is the time to increase effective scientific studies on mechanisms of action of these medicinal plants in order to validate their popular usages.

Impact of Antioxidant Natural Compounds on the Thyroid Gland and Implication of the Keap1/Nrf2 Signaling Pathway

BACKGROUND

Natural compounds with potential antioxidant properties have been used in the form of food supplements or extracts with the intent to prevent or treat various diseases. Many of these compounds can activate the cytoprotective Nrf2 pathway. Besides, some of them are known to impact the thyroid gland, often with potential side-effects, but in other instances, with potential utility in the treatment of thyroid disorders.

OBJECTIVE

In view of recent data regarding the multiple roles of Nrf2 in the thyroid, this review summarizes the current bibliography on natural compounds that can have an effect on thyroid gland physiology and pathophysiology, and it discusses the potential implication of the Nrf2 system in the respective mechanisms.

METHODS & RESULTS

Literature searches for articles from 1950 to 2018 were performed in PubMed and Google Scholar using relevant keywords about phytochemicals, Nrf2 and thyroid. Natural substances were categorized into phenolic compounds, sulfur-containing compounds, quinones, terpenoids, or under the general category of plant extracts. For individual compounds in each category, respective data were summarized, as derived from in vitro (cell lines), preclinical (animal models) and clinical studies. The main emerging themes were as follows: phenolic compounds often showed potential to affect the production of thyroid hormones; sulfur-containing compounds impacted the pathogenesis of goiter and the proliferation of thyroid cancer cells; while quinones and terpenoids modified Nrf2 signaling in thyroid cell lines.

CONCLUSION

Natural compounds that modify the activity of the Nrf2 pathway should be evaluated carefully, not only for their potential to be used as therapeutic agents for thyroid disorders, but also for their thyroidal safety when used for the prevention and treatment of non-thyroidal diseases.

Pyrrolizidine Alkaloids-Free Extract from the Cell Culture of Lithospermum officinale with High Antioxidant Capacity

The benefits of Lithospermum officinale has encouraged people to continue using its extract (CAS 90063-58-4) in both medicinal and cosmetic industries despite the fact that chemical analysis confirms the presence of pyrrolizidine alkaloids (PAs) in the extract. While the cultivation of L. officinale takes, at least, 2 years to produce usable crops, its callus culture proliferated 8.3 times with 4.9-fold biomass in less than 30 days under the applied conditions in this study. Under the applied conditions, the cell extract contained no toxic PAs while phenylpropanoid pathway was active toward phenolic acids formation not toward naphthoquinone derivatives. Rosmarinic acid was produced as the main constituent. Total phenolic content and antioxidant capacity of the proliferated cell extracts were similar to those of the extracts of the natural plant tissues, in particular from the root. These results support the idea that the extract of L. officinale cells can be a reliable substitute for the extract of the natural plant tissues.

An evidence-based systematic review of rosemary (Rosmarinus officinalis) by the Natural Standard Research Collaboration

An evidence-based systematic review of rosemary (Rosmarinus officinalis), including written and statistical analysis of scientific literature, expert opinion, folkloric precedent, history, pharmacology, kinetics/dynamics, interactions, adverse effects, toxicology, and dosing.

Acaricidal activities of the active component of Lycopus lucidus oil and its derivatives against house dust and stored food mites (Arachnida: Acari)

BACKGROUND

Recent studies have focused on materials derived from plant extracts as mite control products against house dust and stored food mites because repeated use of synthetic acaricides had led to resistance and unwanted activities on non-target organisms. The aim of this study was to evaluate the acaricidal activity of materials derived from Lycopus lucidus against Dermatophagoides farinae, D. pteronyssinus and Tyrophagus putrescentiae.

RESULTS

The LD50 values of L. lucidus oil were 2.19, 2.25 and 8.45 µg cm(-2) against D. farinae, D. pteronyssinus and T. putrescentiae. The acaricidal constituent of L. lucidus was isolated by chromatographic techniques and identified as 1-octen-3-ol. In a fumigant method against D. farinae, the acaricidal activity of 1-octen-3-ol (0.25 µg cm(-2)) was more toxic than N,N-diethyl-m-toluamide (DEET) (36.84 µg cm(-2)), followed by 3,7-dimethyl-1-octen-3-ol (0.29 µg cm(-2)), 1-octen-3-yl butyrate (2.32 µg cm(-2)), 1-octen-3-yl acetate (2.42 µg cm(-2)), 3,7-dimethyl-1-octene (9.34 µg cm(-2)) and benzyl benzoate (10.02 µg cm(-2)). In a filter paper bioassay against D. farinae, 1-octen-3-ol (0.63 µg cm(-2)) was more effective than DEET (20.64 µg cm(-2)), followed by 3,7-dimethyl-1-octen-3-ol (1.09 µg cm(-2)).

CONCLUSION

1-Octen-3-ol and 3,7-dimethyl-1-octen-3-ol could be useful as natural agents for the management of three mite species.

Autism: transient in utero hypothyroxinemia related to maternal flavonoid ingestion during pregnancy and to other environmental antithyroid agents

The incidence and prevalence of autism have increased during the past two decades. Despite comprehensive genetic studies the cause of autism remains unknown. This review emphasizes the potential importance of environmental factors in its causation. Alterations of cortical neuronal migration and cerebellar Purkinje cells have been observed in autism. Neuronal migration, via reelin regulation, requires triiodothyronine (T3) produced by deiodination of thyroxine (T4) by fetal brain deiodinases. Experimental animal models have shown that transient intrauterine deficits of thyroid hormones (as brief as 3 days) result in permanent alterations of cerebral cortical architecture reminiscent of those observed in brains of patients with autism. I postulate that early maternal hypothyroxinemia resulting in low T3 in the fetal brain during the period of neuronal cell migration (weeks 8-12 of pregnancy) may produce morphological brain changes leading to autism. Insufficient dietary iodine intake and a number of environmental antithyroid and goitrogenic agents can affect maternal thyroid function during pregnancy. The most common causes could include inhibition of deiodinases D2 or D3 from maternal ingestion of dietary flavonoids or from antithyroid environmental contaminants. Some plant isoflavonoids have profound effects on thyroid hormones and on the hypothalamus-pituitary axis. Genistein and daidzein from soy (Glycine max) inhibit thyroperoxidase that catalyzes iodination and thyroid hormone biosynthesis. Other plants with hypothyroid effects include pearl millet (Pennisetum glaucum) and fonio millet (Digitaria exilis); thiocyanate is found in Brassicae plants including cabbage, cauliflower, kale, rutabaga, and kohlrabi, as well as in tropical plants such as cassava, lima beans, linseed, bamboo shoots, and sweet potatoes. Tobacco smoke is also a source of thiocyanate. Environmental contaminants interfere with thyroid function including 60% of all herbicides, in particular 2,4-dichlorophenoxyacetic acid (2,4-D), acetochlor, aminotriazole, amitrole, bromoxynil, pendamethalin, mancozeb, and thioureas. Other antithyroid agents include polychlorinated biphenyls (PCBs), perchlorates, mercury, and coal derivatives such as resorcinol, phthalates, and anthracenes. A leading ecological study in Texas has correlated higher rates of autism in school districts affected by large environmental releases of mercury from industrial sources. Mercury is a well known antithyroid substance causing inhibition of deiodinases and thyroid peroxidase. The current surge of autism could be related to transient maternal hypothyroxinemia resulting from dietary and/or environmental exposure to antithyroid agents. Additional multidisciplinary epidemiological studies will be required to confirm this environmental hypothesis of autism.