How does Chinese Medicine view Hypothyroidism?

“I have thyroid” – I hear that all the time and yes everyone has a thyroid. But what they really mean is “I have hypothyroidism”. So what is a thyroid? Your thyroid is a butterfly-shaped gland in your neck, just above your collarbone. It is one of your endocrine glands, which make hormones. These thyroid hormones control the rate of many activities in your body such as how much calories you burn or how fast your heart pumps. We all want a happythyroidism but if it’s over-active, it means it’s hyper and if it’s under-active, it’s hypo and that’s what we are going to discuss today – Hypothyroidism.

Types of hypothyroidism

In Western medicine, there are 2 types:

Primary hypothyroidism:  This is more common. It is thought of as an autoimmune disease induced through chronic inflammation of the thyroid gland, also known as Hashimoto’s thyroiditis. Commonly seen in women.

Secondary hypothyroidism: Caused by failure of the hypothalamus in the brain to regulate the thyroid gland, or there is a lack of secretion of thyroid stimulating hormone (TSH) from the pituitary gland.

In TCM, it doesn’t really have a theory of hypothyroidism and they only have treatments for goitre (enlargement of the thyroid gland) which they call “Ying 瘿”. So, if there is no goitre, treatment will be based on the pattern differentiation; meaning physicians will access your symptoms and treat accordingly, with the aim of balancing your body and restoring proper function.


Symptoms of hypothyroidism

  • Fatigue, weakness
  • Feeling heavy and puffy
  • Stomach issues – bloating, constipation
  • Easily gaining weight or hard to lose weight
  • Delayed periods (longer than 35 days) or no period
  • Low mood, depression, impotence or low libido
  • Lower back pain, joint and muscle aches
  • Thin brittle nails /hair

🤔Don’t ask “What’s the normal TSH?”

When you experience these symptoms and go to the GP for a blood test, results come out fine. But you feel like crap, there must be something wrong! Here’s why. According to functional medicine doctor Will Cole, we shouldn’t be asking for “normal TSH”. Instead, you should be asking for “functional TSH”.

When you ask for normal, it’s asking whether or not it’s abnormal. And before something becomes abnormal, there’s this grey zone where something is amiss but cannot be detected. “Functional TSH” tells you whether or not your thyroid is working at its best.

A great analogy that I read:  It’s sort of like getting a “D”; where “A” is normal  and “F” is abnormal. “D” is still not abnormal nor a failing grade, but do you want it?

I’ve summarized the tests and its significance in the table below.

TestsMeaningNormal  rangeFunctional range

(this is your goal)



Thyroid-stimulating hormone is released from your pituitary gland  to communicate with your thyroid like a gas pedal. Higher the number, the more your brain is screaming out to your thyroid to work harder. 0.45-5.5 mlU/L 1.8-2.5 mlU/L
Total T4


Mostly metabolically inactive and has to be converted to T3 to be usable. 4.5-12 mcg/DL6.0-12.0 mcg/DL
Total T3


Total amount of the metabolically active thyroid hormone.80-200 ng/DL100-180 ng/DL
Free T4


Free means active form of T4. Hypothyroidism often has low T4 but can be normal in sub clinical, early stages of thyroid dysfunction.0.8-1.8 ng/DL1.0-1.5 ng/DL
Free T3


More active, usable form. Hypothyroidism often has low T3 and is linked to a higher risk of heart attack. 2.3-4.2 pg/mL3.0-4.0 pg/mL
Reverse T3Inactive form.This goes up during chronic stress and high cortisol.8-25 ng/DL9.2-24.1 ng/DL
Thyroid AntibodiesHigh levels of thyroid antibodies show an autoimmune attack against the thyroid such as Hashimoto’s disease.Thyroid Peroxidase (TPO) Ab: 0-15 IU/mLThyroglobulin Ab optimal : 0-0.9 IU/mL


☯️In TCM, hypothyroidism is “Exhaustion”

As mentioned earlier, there is no specific treatment protocol for hypothyroidism and is characterized under  “Exhaustion” or “Edema”. The common cause is Spleen and Kidney Yang deficiency but depending on the stage and constitution of a person, it can be due to the following 3 causes. Note that it can be a mixture of these types.

  1. Spleen and Kidney Yang deficiency
    Cold limbs, pale complexion, puffy face, under eye bags, shortness of breath, poor digestion.
  2. Qi and Blood deficiency
    Sallow complexion, palpitation, loose stools, dry skin, scanty or no period.
  3. Liver and Kidney Yin deficiency
    Feel heaty in the afternoon & evening, night sweats, tinnitus (ringing ears), hand tremor, blurred vision, dry throat.

Hypothyroidism emerge gradually as a result of “exhaustion”, slowing wearing itself out and running out of fuel, resulting in slow metabolism and depletion of body’s Qi. Qi and Yang are buddies, so when Qi depletes, Yang depletes together. As Yang Qi decreases, it starts to fail in its functions of warming, moving, motivation.

Without this life energy, the organs starts to weaken. At initial stage, the Spleen which magically transforms and transports nutrients from food starts to fail. No nutrients mean there is no building blocks for the creation of Qi and Blood.  This leads to less energy for the Liver and Kidney too.

Without the basic energy needs, Liver fails to deliver smooth flow of Qi around the body and nourish. Kidney also fails to maintain its energetic headquarters called the “Ming Men 命门’” (literally translates to “Life Gate”), and fails to support the back and water passageway hence you get symptoms such as puffy eyes and cold lower back pain.

See how everything is linked?


🍃TCM Herbs for hypothyroidism

  • Warming herbs: Fu Zi, Rou Gui, Gan Jiang
  • Qi boosters: Huang Qi, Dang Shen, Bai Zhu
  • For Spleen Yang: Si Jun Zi Tang
  • For Qi and Blood booster: Shi Quan Da Bu Tang
  • For Kidney Yang : You Gui Wan
  • For Kidney Qi : Ji Sheng Shen Qi Wan


📍Acupuncture for hypothyroidism

  • Local points: KI 27 (Shu Fu), Ren 22 (Tian Tu), ST 9 (Ren Ying)
  • Spleen: SP 6 (San Yin Jiao), ST 36 (Zu San Li), CV 6 (Qi Hai), CV 4 (Guan Yuan), BL 20 (Pi Shu)
  • Kidney: KI 3 (Tai Xi), KI 6 (Zhao Hai), BL 23 (Shen Shu), DU 4 (Ming Men). BL 23 and Ming men is located right smack in the middle of both kidneys.
  • Liver: LR 8 (Qu Quan)
  • Navel point CV 8 (Shen Que) – Means Spirit Gate,  where the Dan Tian or center of the energy of our body is centered.  This acupuncture point is forbidden but moxa or “Navel treatment” can be done. Insert 8 needles  towards the center of the belly button. 


🥢What to eat for hypothyroidism?

Here’s my simple food philosophy. Simply eat real food, mostly plants, eat meat like condiments, eat good fats in moderation and eat sugar like drugs- rarely and for fun. Digest well, chew well and savour every bite!

Goitrogenic food- You can eat them but make sure they are cooked fully. These food interfere with iodine uptake in the thyroid gland. Cruciferous vegetables such as bok choy, broccoli, brussels sprouts, cabbage, canola, cauliflower, Chinese cabbage, collard greens, horseradish, kai-lan, kale, and soy. Easy on the daily raw kale soy green smoothie!

Iodine (150–300 micrograms daily)They help to make the hormone thyroxine. Iodine rich foods include sea vegetables (kelp, nori, kombu, etc), sea salt, and salt water fish.

L-tyrosine (500 milligrams twice daily)Tyrosine is an amino acid that combines with iodine to make thyroxine. Tyrosine is found in meat, turkey, sesame seeds, lentils and legumes, pumpkin seeds.

Selenium (200 micrograms daily) Selenium is an essential mineral that fights free-radicals, aids in the proper functioning of the thyroid. Brazil nut has the best source of selenium. Eat about 2~3 pieces a few times a week, make sure you don’t overeat to avoid selenium toxicity.


 If you are up to some cooking, here’s 2 recipes for you. 

👨‍🍳Goji Lamb Stew

This is a great one-pot easy stew! Great for the fall but also suitable for people who are always cold in tropical countries too.  Lamb is one of the most warming meat. It is treated with less antibiotics and hormones so I would recommend using lamb. Embellish it with a handful Goji berries (at the very end!) for nourishing the Yin. 

Goji Lamb stew. Click for recipe 😋


👩‍🍳 Black sesame congee  

Black is the colour associated with Kidney. To boost kidney, add black food such as black rice, lentils, beans,garlic, berries. Sesame and seeds or nuts are packed with energy and great for boosting the Yang Qi. Congee or oats if you like is easy to digest for the Stomach and Spleen. Add in some bone broth or collagen powder for extra flavor and anti-inflammatory effects.

Black for Kidney. Click for recipe 😋


💃Movements for Hypothyroidism 

Exercise is optional but movement is essential. Here are 2 simple movements that you can try to help achieve a happythyroidism.

Neck Press

  1. Sit comfortably in a chair or on the floor.
  2. Clasp your hands and bring both palms to the back of your head. Sitting with a tall spine, ground your hips firmly into your seat.
  3. From here, begin to gently press your hands down toward your thighs, tucking your chin into your chest.
  4. Hold here for at least 30 seconds, then slowly lift your head up and release your hands.

Shoulder Stand (sarvangasana)

This increases circulation to the thyroid.  Try using visualization practices,the blood and nourishment flowing into the thyroid, waking it up gently. Don’t do this pose if you are pregnant or menstruating, have glaucoma, sinus problems or high blood pressure.

  1. Lie on your back with your arms along your sides.
  2. Raise your legs at a right angle to the floor.
  3. Then raise your hips so your chin rests on your chest, supporting yourself with your elbows and upper arms on the floor and your hands on your hips.
  4. Keep your neck and shoulders flat on the floor, and stretch your torso and legs as straight as possible.
  5. Hold as long as comfortable, slowly working up to 5 minutes a day.


Believe your body’s ability to heal. Accept the current situation and take time to trust and understand the situation. If you have the willingness to explore new ways of looking at yourself, you might find joy & peace in every step of this healing happythyrodism journey.




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