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A systematic review, meta-analysis, and trial sequential analysis of the effect of acupuncture and moxibustion cake on thyroid function in patients with Hashimoto thyroiditis.

Medicine·May 2026·Ren Haitao, Li Gaokai, Liao Chunxia et al.
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Key Finding

Acupuncture significantly reduced thyroid antibodies (TPOAb and TGAb) and TSH levels in Hashimoto thyroiditis patients, though methodological limitations prevent reliable clinical recommendations pending higher-quality research.

What This Means For You

Hashimoto thyroiditis is an autoimmune condition where the immune system attacks the thyroid gland, affecting hormone production. While levothyroxine medication can improve thyroid hormone levels, it doesn't reduce the antibodies causing the problem. Researchers reviewed 15 studies to examine whether acupuncture and moxibustion cake (a warming therapy using herbal materials) could help manage Hashimoto thyroiditis.

The review found that acupuncture significantly reduced thyroid antibody levels (TPOAb and TGAb) and thyroid-stimulating hormone (TSH), suggesting potential benefits for thyroid function. Moxibustion also showed reductions in antibody levels, though the effects were smaller. Both treatments appeared to influence key thyroid markers that standard medication doesn't address.

However, it's important to understand the limitations. The researchers noted significant concerns about the quality of the included studies, differences between studies that made comparison difficult, and potential publication bias. These issues mean the results should be interpreted cautiously. The evidence isn't strong enough yet to make firm recommendations about using acupuncture or moxibustion for Hashimoto thyroiditis.

What this means for patients: While these traditional therapies show promise, especially for reducing thyroid antibodies, more high-quality research is needed before doctors can confidently recommend them. If you're considering acupuncture or moxibustion for Hashimoto thyroiditis, discuss it with your endocrinologist first, and continue any prescribed thyroid medications. These therapies might work alongside conventional treatment, not replace it. If you decide to try acupuncture or moxibustion, seek a licensed acupuncturist with experience treating thyroid conditions.

Clinical Notes for Practitioners

This systematic review and meta-analysis evaluated acupuncture and moxibustion effects on thyroid function in Hashimoto thyroiditis patients. Searching seven databases through March 2024, researchers identified 15 studies for inclusion. For acupuncture, pooled mean differences showed significant reductions in TPOAb (MD: -61.97, P<0.00001), TGAb (MD: -44.78, P=0.001), and TSH (MD: -2.64, P<0.00001), with increased free thyroxine (MD: 1.46, P=0.02). Moxibustion demonstrated smaller but significant reductions in TPOAb (MD: -11.44, P=0.0002) and TGAb (MD: -8.63, P=0.004), without significant TSH changes.

Clinical implications are limited by substantial methodological weaknesses, heterogeneity across studies, and publication bias. While results suggest acupuncture may influence thyroid antibodies and TSH levels—markers unaffected by levothyroxine monotherapy—the evidence quality precludes definitive clinical recommendations. Large-scale, rigorously designed RCTs are necessary to establish clinical efficacy and determine appropriate treatment protocols for integrating these modalities into Hashimoto thyroiditis management.

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