By: Girke, Matthias
Original title: Die Schilddrüse, Teil II. Der Merkurstab 1995;48(6):564-583.
DOI: https://doi.org/10.14271/DMS-16799-DE
English by A. R. Meuss, FIL, MTA.
This translation is published with the kind permission of the journal Der Merkurstab.

JAM Vol. 13(2), Summer 1996

Two diseases of the thyroid
Hypothyroidism and hyperthyroidism
The image of the thyroid given in Part 1 essentially arose from contrasting euthyroid with hypothyroid metabolism. The changes seen with hyperthyroidism will be considered below, largely leaving aside the underlying condition of the thyroid for the moment.

Again, the system of limbs shall be our starting point. With hyperthyroid metabolism, one often sees reduced muscle strength and easy fatiguability, which may also involve atrophy of skeletal muscle.(1) The term "thyrotoxic myopathy" applies. The condition is accompanied by creatinuria, with reduced muscle creatine and phosphocreatine levels. The negative nitrogen balance seen with hyperthyroidism is said to be largely due to loss of protein from muscle. Increased rather than physiological activity is reported to limit the skeletal muscle organization and hence the instrument by which the soul reveals itself in developing external will activity.

What changes occur in bone? Bone resorption is increased and greatly in excess of osteogenesis.(11) Hydroxyproline elimination is elevated, suggesting collagen degradation. A negative calcium balance develops, with increased fecal and renal elimination. The calcium concentration in sweat is said to increase more than twofold." The negative calcium balance gives quantitative expression to loss of calcium quality from the organism, especially if we include elimination in sweat, and we get the image of a subtle calcium sphere surrounding the organism. This combines with powers of soul that are freeing themselves from the life organization and restlessly seek to come to awareness. A metamorphic relationship to oyster shell secretion with its spirit-releasing quality can be perceived.(48)

Powers of soul turning to excessive awareness go hand in hand with extensive catabolic processes in the metabolic sphere. Protein catabolism, ultimately preponderant, with the level of protein synthesis lower than this, characterizes the changes in protein metabolism. Hepatic glycogen stores are reduced.(23) Lipid deposits also decrease, and fatty tissue may be generally reduced. The predominantly catabolic increase in metabolism is combined with increased generation of warmth. Soul development oriented towards the sphere of conscious awareness struggles to arise as fire processes with increased oxygen consumption(23) take hold of the organism. Reference has already been made to changes in the fluid organism, with special emphasis on the blood quality which is in contrast to hypothyroid cumulation of extracellular fluid that in many respects may be compared to lymphedema. The circulation grows hyperdynamic, with increased heart rate, contractility, and often also hypertrophy. The increased heart rate shows only minor reduction in the sleep phase.(34) With its dynamic and warmth organization clearly increased, the blood turns specifically to the sphere of the senses, above all the skin. Hyperthyroid individuals have a warm skin and, among other things, erythema due to increased dermal circulation. Episodic flushing may occur in face and thorax. These skin areas tend to show teleangiectasis.(7) Cerebral circulation is also increased, which will be discussed later. An excited blood quality enters into the sphere of the neurosensory organization, with the soul life at the same time restlessly turning to waking consciousness. The whole is a metabolic process excited by the NSS, in marked contrast to the anabolic metabolic process in the sleeping human being.

The soul turns to waking consciousness, which becomes impressively apparent in the symptoms of hyperthyroidism. Waking consciousness turning to the surrounding world is greatly increased, frequently combining with sleeplessness. Soul activity is generally accelerated and may become marked restlessness. This dynamic is not experienced as a power belonging to the individual; patients with hyperthyroidism feel as though they have been taken hold of by an unknown dynamic that rises from the organism and breaks it down in catabolic processes. Differentiation is apparent between excessive astral activity and a quality of I organization that does not adequately guide and structure this activity. This differentiation is vital with hyperthyroidism.(52)

Endocrine opthalmopathy
Rudolf Steiner gave the exophthalmos, seen with Basedow's or Graves' disease, as a characteristic example of this imbalance.(52)

A brief look at the embryological development of the eye organization shows two gestures. First, the optic cup develops and the stalk carrying the hyaloid artery. We see the eye organization turning to the outside. On the other hand, a centripetal process of invagination starts from the placode, opening inward like a gulf. The direction of these gestures may be said to be reflected in exophthalmos and enophthalmos. Exophthalmos is seen in conjunction with endocrine ophthalmopathy such as the hyperthyroidism of Graves' disease. This shows numerous relationships to the sympathetic nervous system, whereas enophthalmos, combined with ptosis and meiosis, is part of Homer's syndrome, where sympathetic quality is reduced, and the parasympathetic nervous system predominates (Fig. 4).

Citation: Girke, M. (1996). The Thyroid II (A. R. Meuss, Trans.). Journal of Anthroposophic Medicine, 13(2), 72–93.