Laboratory Measurements and the Impact of Chinese Herbal Therapy

The following are standard laboratory measures of thyroid disease:

T3 and T4: Levels are elevated in hyperthyroid and reduced in hypothyroidism, and this measure is a defining feature of the diseases. One of the methods of determining duration of treatment with Chinese herbs is to monitor this parameter and stop treatment only when the values are normalized. Hyperthyroid treatment with Chinese herbs may have a duration as short as one month, or as long as 3 years.

Iodine Uptake: Radioactive iodine is utilized to allow monitoring of uptake, by measurement of radioactive emissions at the neck in the region of the thyroid gland. In general, iodine uptake is increased in hyperthyroid cases, due in part to the larger amount of thyroid tissue and the higher production of the iodine-based T3 and T4, and iodine uptake is reduced in hypothyroidism. Clinical values for iodine uptake usually keep pace with those for T3 and T4 production.

MCA (a.k.a. MSA) and TGA: Antibodies to the thyroid gland circulating in the plasma. The level of these antibodies is reduced by immune-suppressing therapies (e.g., tripterygium extract tablets) and has been shown to be reduced by moxibustion (in treatment of Hashimoto's thyroiditis), but these are not altered by administration of thyroxine or by other therapies that do not have an effect on the immune system. MCA and TGA are probably not altered in cases of thyroid tumor.

BMR: Basal metabolic rate is raised in hyperthyroid cases and lowered in hypothyroid cases. Since metabolic rate is influenced by T3 and T4 levels, the BMR measurement closely follows the T3 and T4 measures.

cAMP and cGMP: In hyperthyroid cases, cAMP is elevated and cGMP is reduced; the reverse situation exists with hypothyroid cases. Since cyclic nucleotides are directly involved in metabolism, changes in BMR and changes in cAMP/cGMP ratios should be parallel.

TSH: Thyroid-stimulating hormone is released from the pituitary in a feedback loop with T3 /T4 levels in normal individuals. TSH levels are usually reduced in hyperthyroidism and elevated in hypothyroidism.

    Several of the clinical reports provided detailed analysis of laboratory measures, while a few simply classified patient responses according to success or failure in restoring "normal values" for those items assayed. The following are offered as examples of changes in measured parameters, using average values for the clinical study group before and after the therapeutic program.

Treatment of hyperthyroidism with tripterygium tablets:1

Treatment of hyperthyroidism with Jiakangling herb tablets or decoction:5

Treatment of hyperthyroidism with rehmannia-based formula:14