Thyroid gland is located at the neck below the thyroid cartilage. It produces thyroid hormones including triiodothyronine (T3) and thyroxine (tetraiodothyronine, T4). These hormones regulate the metabolism rate of the body and affect growth and function of other part of the body. These hormones are important to maintain normal reproductive function. It has been extensively agreed that there are significant associations between thyroid disorders and abnormalities of the reproductive system; both hyperthyroidism and hypothyroidism in males and females affect reproductive function.
Changes of the thyroid function can lead to infertility both
in male and female. In male, hyperthyroidism is associated with low sperm count
and low sperm motility. Erectile function is also affected by thyroid function.
These factors may contribute to male infertility. Restore of thyroid function
after treatment results in sperm count increased and sperm motility improved.
Erectile function is also improved after treatment. Hypothyroidism may cause
testicular pathology, low testosterone levels and sperm abnormality.
Thyroid dysfunction and autoimmunity are common among women
in reproductive age. In women with hyperthyroidism blood hormone levels
including testosterone, adrostenedione, oestrogen (E2), luteinizing hormone
(LH) and follicle stimulating hormone (FSH) are increased. Abnormal period is
noted in women with hyperthyroidism. Absence of period is very common. Reduced
infertility is found in women with hyperthyroidism. Likewise hormonal changes
and period cycle disturbances are also present in women with hypothyroidism.
The prevalence of thyroid dysfunction during pregnancy is
about 2-3% and is mainly caused by chronic autoimmune thyroiditis. Thyroid
auto-antibodies are found in 5-15% of women in reproductive age with or without
thyroid dysfunction. Either thyroid dysfunction or thyroid autoimmunity is
associated with negative pregnancy outcomes during pregnancy. Emmyvan den
Boogaard et al conducted a systematic review on the clinical significance of
thyroid dysfunction and thyroid autoimmunity prior to conception and in early
pregnancy. They found that subclinical hypothyroidism (with high Thyroid
stimulating hormone-TSH and normal free T4) in early pregnancy was associated
with hypertension in pregnancy and perinatal mortality. Presence of thyroid
antibodies was associated with an increased risk of unexplained subfertility,
miscarriage, recurrent miscarriage, preterm birth and maternal post-partum
thyroiditis.
More recently acupuncture was reported in regulating thyroid
function and treating thyroid function disorders. There was a report of
effectiveness of acupuncture on hyperthyroidism. This was involved in 125
patients. After acupuncture treatment symptoms were controlled completely in 71
patients which were 56.8%. Other 41 patient’s symptoms were partly
controlled. Recent study by Lyzina KE et
al investigated the effect of acupuncture in 27 female patients with
subclinical hypothyroidism. The treatment period was 3-4 month. They found that
after the treatment, the initial clinical symptoms decreased significantly; TSH
level decreased to normal range; the quality of life was improved. They
concluded that acupuncture may be an alternative therapy for patients with
subclinical hypothyroidism.
Acupuncture is used to treat hyperthyroidism as an adjunct
therapy
Hyperthyroidism or overactive thyroid is a common hormonal
condition in which too much thyroid hormone is produced in the thyroid gland.
Excessive thyroid hormones can speed up metabolism causing a series symptoms.
These include that anxiety, irritability and nervousness, insomnia, fatigue,
muscle weakness, sensitive to heat, excessive sweating, weight loss, frequent
passing stolls and urination, light periods or infrequent periods or missing
periods, infertility. Physical signs include that enlarged thyroid gland, fast
heart beat, tremor, warm skin, redness on the palms of the hands, hives, hair
loss twitching in the face and limbs. Blood tests show that low level of
thyroid-stimulating hormone (TSH) and high level of thyroxine and
triiodothyronine (the thyroid hormones). The most common used medication is
thionamides, such as carbimazole and propylthiouracil. In China, acupuncture is
used as adjunct therapy together with these medications to increase the effect
of medications and reduce the side effect of medications. As early as 1934
acupuncture was reported to treat thyperthyroidism. In 1970s, there were more
researches on this subject. Now many
researches were done and provided the evidence that acupuncture improves
metabolism, improves symptoms, reduces side effect of the medications and
reduces recurrence rate. For example, there was a report with 125 cases of
hyperthyroidism. After acupuncture treatment, the symptoms were controlled in
71 cases, improved in 41 cases, no effect in 13 cases. More recently a research
studied the therapeutic effect and side effect of treatment on hyperthyroid
exophthalmos with the combination of acupuncture and medication.
Fifty-two cases were randomly divided into an acupuncture and
medication group (27 cases) and a medication group (25
cases). Acupuncture in combination of oral taking of Thiamazole and
Euthyrox were adopted for the acupuncture and medication group. And
acupoints such as Jingming (BL 1), Chengqi (ST 1) and Sizhukong (TE 23) etc.
were selected. Western medication for oral taking was applied as the only
treatment for the medication group. The results have shown that the improvement
of the objective marks of eye syndrome in the acupuncture and
medication group was better than that in the medication group. There were 4 cases with hypoleucocytosis, 3
cases with rash and 3 cases with aggravated symptom of exophthalmos in the
medication group during the treatment, while no case with side effects was
observed in the acupuncture and medication group.
References
Emmyvan den Boogaard et al Human Reproduction Update (2011)
17:605-619
Vopr Kurortol Fizioter Lech Fiz Kult (2011) 5:29-33
http://www.pharmnet.com.cn/tcm/zjdq/zjzl/100091.html
Xia Y et al Zhongguo Zhen Jiu (2010) 30:806-9
