Hypothyroidism is a common endocrine disorder resulting from insufficient production of thyroid hormones, triiodothyronine (T3) and thyroxine (T4). While levothyroxine therapy remains the standard treatment, it may cause side effects and fail to provide complete symptom relief. Herbal medicine offers a complementary approach to regulating the hypothalamic-pituitary-thyroid (HPT) axis, promoting natural thyroid function. Several medicinal plants, including Withania somnifera (Ashwagandha), Commiphora mukul (Guggul), Bacopa monnieri (Brahmi), and Centella asiatica (Gotu Kola), have demonstrated thyroid-stimulating, antioxidant, and anti-inflammatory properties. These botanicals may enhance thyroid hormone synthesis, improve iodine uptake, and regulate thyroid-stimulating hormone (TSH) levels while reducing oxidative stress. This review examines the mechanisms underlying herbal modulation of the HPT axis and evaluates their efficacy in hypothyroidism management. Furthermore, the safety, potential drug interactions, and clinical evidence supporting these herbs are discussed. A thorough understanding of herbal therapies for hypothyroidism could lead to integrative treatment strategies, improving patient outcomes and offering an alternative or adjunctive approach to conventional therapies.
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