Hypothyroidism
Overview
Hypothyroidism is a systemic low-metabolic state from insufficient thyroid hormone production, commonly causing cold intolerance, fatigue, weight gain, constipation, dry skin, hair loss, somnolence, poor memory, menstrual irregularity, and edema. Chinese medicine groups it under deficiency-taxation, goiter disease, and edema, mainly spleen–kidney yang deficiency and qi–blood or qi–yin deficiency. Diagnosis relies on TSH/FT4 and most patients need standard thyroid-hormone replacement; TCM is adjunctive and replacement medication must not be stopped on one's own.
Pattern differentiation (clinical patterns)
Spleen–Kidney Yang Deficiency
Cold intolerance and cold limbs, fatigue and somnolence, weak cold low back/knees, poor appetite, bloating, constipation or fifth-watch diarrhea, edema, pale enlarged tooth-marked tongue with white slippery coating, deep slow pulse.
Warm and tonify spleen and kidney yang.
Qi–Blood Deficiency
Sallow or pale complexion, dizziness, fatigue, palpitations, poor memory, shortness of breath, sparse hair, scant menses, pale tongue thin coating, fine weak pulse.
Boost qi and nourish blood.
Connections
Daily care & prevention
Take levothyroxine regularly as prescribed—do not stop or change the dose yourself; take it on an empty stomach before breakfast, separated by several hours from calcium/iron supplements and soy products. Keep warm, sleep regularly, exercise moderately, and consume adequate but not excessive iodine (follow medical advice in Hashimoto's). Monitor TSH/FT4 and lipids. Gentle moxibustion or massage of Guanyuan (CV4), Qihai (CV6), Shenshu (BL23), Pishu (BL20), and Zusanli (ST36) may help. New marked coldness, fatigue, or edema warrants blood tests first.
When to seek medical care
Severe generalized/facial edema, difficult-to-arouse somnolence, slowed breathing, very low body temperature, or confusion (myxedema coma) requires immediate emergency care; pregnant or planning-to-conceive patients need prompt dose adjustment; marked chest pain or palpitations also require care.