Thyrotoxicosis and its homoeopathy

Dr Greeshma Vikraman

ABSTRACT:
The purpose of this article is to discuss the formation and secretion of the thyroid hormones, their metabolic functions, and regulation of their secretion followed by a condition called thyrotoxicosis which is as a result of increased thyroid hormone and its homoeopathic management

KEYWORDS:

Thyroid, thyroxine, triiodothyronine, thyrotoxicosis, homoeopathy, remedy 

INTRODUCTION:
The thyroid gland is located immediately below the larynx on either side of and anterior to the trachea. It is one of the largest endocrine glands. It normally weighs 15 to 20 grams in adults. The thyroid secretes two major hormones- thyroxine and triiodothyronine, commonly called as T4 and T3. Both hormones increase the metabolic rate of the body. Complete lack of thyroid secretion usually causes the basal metabolic rate to fall 40 to 50 percent below normal, and extreme excesses of thyroid secretion can increase the basal metabolic rate to 60 to 100 percent above normal. Thyroid secretion is controlled primarily by thyroid-stimulating hormone (TSH) secreted by the anterior pituitary gland. The thyroid gland also secretes calcitonin, an important hormone for calcium metabolism.

THYROTOXICOSIS
Thyrotoxicosis has been known since its original descriptions by Parry in 1796, Graves in 1835, and Von Basedow in 1840. Students of thyrotoxicosis starting with Parry described the disease as having an emotional background. It is well known that during the time of stress like World War II in London. The incidence of thyrotoxicosis has risen sharply. Physicians in Europian countries hard-pressed by war, Yugoslavia noted the same phenomenon

Causes:
Approximately 76% of cases are due to Graves’ disease, 14% to multinodular goitre and 5% to toxic adenoma. Less common causes include transient thyroiditis (de Quervain’s, post­partum), iodide induced (drugs, supplementation), factitious and TSH­secreting pituitary tumour. 

The most common symptoms are: 

● Weight loss with a normal appetite. 

● Heat intolerance. 

● Palpitations. 

● Tremor. 

● Irritability. 

All causes of thyrotoxicosis can cause lid retraction and lid lag, but only Graves’ disease causes exophthalmos, ophthalmoplegia and papilloedema.

Investigations :
TFTs: T3 and T4 are elevated in most patients, but T4 is normal and T3 raised (T3 toxicosis) in 5%. In primary thyrotoxicosis, serum TSH is undetectable (< 0.05 mU/L).Antibodies: TSH receptor antibodies (TRAb) are elevated in 80–95% of patients with Graves’ disease. 

Imaging: 99m Technetium scintigraphy scans indicate trapping of isotope in the gland. In Graves disease, there is diffuse uptake. In multinodular goitre, there is low, patchy uptake within the nodules. A hot spot is seen in toxic adenoma, with no uptake in the dormant gland tissue. In low­uptake thyrotoxicosis, the cause is usually transient thyroiditis, although rarely patients may induce ‘factitious thyrotoxicosis’ by consuming thyroxine.

REPERTORIAL APPROACH

KENTS REPERTORY
GOITRE : Ail., aloe., am-c., ambr., apis., aur-i., aur., bad., bell., brom., calc-f., calc-i., calc-s., Calc., carb-an., carb-s., caust., cist., con., crot-c., ferr-i., fl-ac., form., hep., Iod., kali-c., kali-i., lach., lap-a., lyc., lycps., mag-c., merc-i-f., merc-i-r., nat-c., nat-m., nat-p., nat-s., phos., plat., podo., sep., sil., Spong., stram., tab., tarent., tub., urt-u.

right sided : Iod., lyc., merc-i-f., nat-c., phos., sep., sil., spong.

Left : Lach.

constriction : Calc-s., Crot-c., iod., lyc., spong

EXTERNAL THROAT p. 472

GOITRE, exophthalmic

exophthalmic : Aur-i., aur., bad., cact., calc., con., crot-h., ferr-i., ferr., Iod., lycps., nat-m., phos., sec., spong.

indurated : Iod., spong.

painful : Iod., plat., spong.

menses, during : Iod.

on swallowing : Spong.

sensitive : Kali-i.

vascular : Apis., calc.

LUMP in throat-pit : Lob.

PAIN : Bar-c., caps., fago., kreos., merc., nat-m., op., phos., puls., sul-ac.

Thyroid gland : Am-c., carb-v., cupr., spig.

moving head, on : Iod.

burning, sides : Alumn., berb., caust., coloc., form., grat., ign., merc-i-f., nat-s., stram., tab., vesp.

right : Alum., caust., merc-i-f., vesp.

left : Berb., coloc., form., nat-s.

SWELLING, thyroid gland

Thyroid gland : Ail., ars., aur-s., carb-an., caust., clem., kali-i., nat-c., nit-ac., ol-j., thuj.

right : Merc.

BOGER BOENNINGHAUSEN CHARACTERISTIC REPERTORY
Gland (goitre) :- Am-c., Am-m., Ambr., Apis (cyst), Ars. (r.), Ars-i., Aur. (pulsation of), Bad., Bar-c. (children), Bell., Brom., CALC., Calc-f., Calc-i., Caust., Con., Dig., Ferr-i., Fl-ac. (hard), Ham., Hep., IOD., Kali-c. (r.), Kali-i., Lap-a., LYC., Mag-c., Merc., Merc-i-f., Merc-i-r., Nat-c., Nat-m., Nit-ac. (r.) (children), Petr., Phos., Plat., Sep., Sil., SPONG., Staph., Sul-i., Sulph., Thyr.

BOERICKS REPERTORY
Thyroid (Goiter, bronchocele) — Adren., Am. c., Am. m., Apis, Aur. sul., Bad., Bar. iod., Bell., Brom., Calc. c., Calc. fl., Calc. iod., Caust., Chrom. s., Cistus, Crot. casc., Ferr. m., Fluor. ac., Fucus, Glon., Hep., Hydr., Hydroc. ac., Iod., Iodothyr., Iris, Kali c., Kali iod., Lapis alb., Mag. p., Merc. i. fl., Nat. m., Phos., Phyt., Pineal gl. ext., Puls., Sil., Spong., Sul., Thyr.
Thyroid-(EXOPHTHALMIC GOITRE – Basedow’s disease) — Amyl, Ars., Ars. iod., Aur., Bad., Bar. c., Bell., Brom., Cact., Calc. c., Can. ind., Chrom. s., Colch., Con., Echin., Ephedra, Ferr. iod., Ferr. m., Ferr. p., Fluor. ac., Fucus., Glon., Iod., Jabor., Lycop., Nat. m., Piloc.,Spart.Spong.,Stram., Thyr.
Paroxysm — Cact., Dig., Glon., Samb

REMEDIAL APPROACH

Major medicines used for the treatment of thyroid disorders are briefed below

1. Thyroidinum 

Thyroid produces anćmia, emaciation, muscular weakness, sweating, headache, nervous tremor of face and limbs, tingling sensations, paralysis. Heart rate increased, exophthalmus and dilation of pupils. In myxśdema and cretinism its effects are striking. Thyroid exercises a general regulating influence over the mechanism of the organs of nutrition, growth and development. Thyroid weakness causes decided craving for large amount of sweets.  Great weakness and hunger, yet loses flesh. tachycardia. Arrested development in children. Improves the memory. Goitre. Excessive obesity. Acts better with pale patients. Easy fatigue, weak pulse, tendency to fainting, palpitation Throat.–Dry, congested, raw, burning; worse left side.

2. Iodium 

Rapid metabolism: Loss of flesh great appetite. Hungry with much thirst. Better after eating. Great debility, the slightest effort induces perspiration. Iod individual is exceedingly thin, dark complexioned, with enlarged lymphatic glands, has voracious appetite but gets thin. Tubercular type. apid emaciation, notwithstanding good appetite, and glandular atrophy call for this remedy, in numerous wasting diseases and in scrofulous patients.

Throat: Thyroid enlarged. Goitre, with the sensation of constriction.

3. Spongia

thyroid glands are swollen. the sensation of constriction in throat. Rapid and violent palpitation, with dyspnśa; cannot lie down; also feels best resting in horizontal position. Awakened suddenly after midnight with pain and suffocation; is flushed, hot, and frightened to death. Swelling and induration of glands; also exophthalmic; Attacks of heat with anxiety; heat and redness of face and perspiration.

4. Ferrum iodatum

Scrofulous affections, glandular enlargements, and tumors call for this remedy. Body emaciated Anćmia Exophthalmic goitre following suppression of menses. Debility following drain upon vital forces. Food seems to push up into throat, as if it had not been swallowed.

5. Phosphorous

Indicated during ill effects of iodine and excessive usage of salt. Persons are Tall, slender , narrow chested, with thin, transparent skin, weakened by loss of animal fluids, with great nervous debility, emaciation, amative tendencies,

H A Roberts in his HOMŒOPATHIC THERAPEUTICS IN THE FIELD OF ENDOCRINOLOGY has clearly explained about the importance of our system in ductless gland disorders. He says that viewpoint of the modern physiologist reflects the theory that the vast majority of human ills are traceable to dysfunction of the glandular system; that most growth problems (over and under-development of the whole body or parts) and many maladjustments of the child to its environment, and even of the adult to his relationships and problems, are related in some degree to endocrine imbalance. Teachings of Hahnemann states that the human being is a unit, mind, body and spirit.

So it is that the function of some of the ductless glands is to secrets a minute quantity of specialized product into the system, a secretion that has a vital bearing on the health of the whole constitution. In many cases, this secretion of a normal gland is so minute that it approaches the homœopathic attenuation. With this concept of the importance of the endocrine glands in maintaining health, and with the almost infinitesimal amount of some of these glandular secretions, we can hardly fail to see the important relationship the homœopathic remedy may hold to the manifestations of endocrine dysfunction and to the balance of the ductless glands themselves.

REFERENCE

1. Roberts, H , A. (2009). The Principles and Art of Cure By Homoeopathy, New Delhi: B Jain Publishers Pvt. Ltd. 
2. Boger, C, M. (2015). Boger Boenninghausen’s Characteristic Repertory. 4^0th impression. New Delhi: B Jain Publishers Pvt. Ltd.
3. Boericke William. (2010). Boericke’s New Manual of Homoeopathic Materia Medica with Repertory. 26th impression. New Delhi: B Jain Publishers Pvt. Ltd.
4. Kent, J, T. (2015). Repertory of the Homoeopathic Materia Medica, ^9th impression. New Delhi: B Jain Publishers Pvt. Ltd.
5. Boericke W. Pocket Manual of Homoeopathic MateriaMedica,2010 Reprint Ed. New Delhi:B.Jain Publishers (P) Ltd; 2010. 
6. Edwards C, Bouchier I, Davidson L. Davidson’s principles and practice of medicine. [Edinburgh]: ELBS with Churchill Livingstone; 1993.

Dr Greeshma Vikraman
Calicut
Email : greeshmaviky@yahoo.com