The addition of Chinese herbal medicines to standard treatment has little benefit in patients with hyperthyroidism
(July 2007)
The background of the study. In China and other countries, patients with hyperthyroidism may be treated with herbal medicines in combination with an antithyroid drug or radioiodine (I-131), because these medicines may reduce the symptoms of hyperthyroidism or to have an antithyroid action. This review evaluated the efficacy of herbal medicines as treatment for patients with hyperthyroidism.
How the study was done. Multiple databases were searched for randomized trials in which the combination of herbal medicines and an antithyroid drug or I-131 were compared with an antithyroid drug or I-131 in patients with hyperthyroidism. The outcomes studied were the rate of recurrent hyperthyroidism one year after cessation of treatment, hypothyroidism after I-131 therapy, amelioration of symptoms of hyperthyroidism, and changes in thyroid function.
The results of the study. The search identified 635 trials, of which only 13 were considered to be randomized trials suitable for analysis. These trials included 1770 patients; 1333 were women and 437 were men (average age, 32 years). The duration of hyperthyroidism ranged from 1 month to >10 years. The herbal medicines were given as capsules, liquid, or teas or by injection. The daily dose was 5 to 30 g each of 2 to 13 ingredients. Overall, 55 herbs were used, and the highest total daily dose was 185 g. They were given with methimazole or propylthiouracil for up to 2 years or after I-131 with an antithyroid drug for 2 weeks to 3 months. The duration of treatment ranged from 10 days to 2 years and the duration of follow-up from 1 month to 4 years.
As compared with an antithyroid drug alone, the recurrence rate was lower in three trials in which the patients were treated with herbal medicines and an antithyroid drug, and in one trial hypothyroidism was less frequent in patients treated with either drug after I-131 therapy. During treatment, symptoms of hyperthyroidism improved in more patients receiving combined therapy in six trials. There were few differences in serum TSH and thyroid hormone concentrations in the two groups.
The conclusions of the study. Chinese herbal medicines, given in combination with methimazole or propylthiouracil or after I-131 have little benefit as additional therapy in patients with hyperthyroidism.
The original article. Zen XX, Yuan Y, Liu Y, Wu TX, Han S. Chinese herbal medicines for hyperthyroidism. Cochrane Database Syst Rev 2007(2):CD005450.
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