A case of subclinical hypothyroidism treated with homoeopathy

Dr Ashna.E

ABSTRACT
Subclinical hypothyroidism is the term used to describe this condition, which has a high TSH level and normal free T4 and T3 level. Thyroid gland disorders are the most abundant disorders worldwide next only to diabetes mellitus. Due to the mild thyroid hormone deficiency, patients with subclinical hypothyroidism may be managed with total daily doses of levothyroxine as low as 25 to 50g.Case summary: A 27- year old female presented with menstrual irregularity and hair-fall. Individualized homoeopathic medicine was selected for the patient. Recovery was seen with restoration of thyroid- stimulating hormone levels within the normal range. Outcome assessment was done by measuring thyroid- stimulating hormone before and after treatment.

Following is a case of subclinical hypothyroidism treated by homoeopathic medicine

CASE: A 27 year old women from a middle socio economic status family reported to the outpatient department of government homoeopathic medical college, Bengaluru on 14^th January 2022.

PRESENTING COMPLAINTS

1. Complaint of early and profuse menses for 7 months.
2. Complaint of severe hair-fall for 4 months.

HISTORY OF PRESENTING COMPLAINTS

1. Patient attained menarche at the age of 13 and the menstrual cycle was regular. But now the patient is presenting with early and profuse menses since 7 months.

Cycle- irregular, once in 20 days, 6/20 day cycle

Nature of flow- Profuse, 6-7 pads/1^st day

Nature of blood- Dark red, no clots, not offensive

There are no other associated complaints.

LMP – 30/12/2021(PLMP- 12/12/2021)

2. Complaint of hair-fall since 4 months. There is no dandruff, no itching.

MENSTRUAL HISTORY

• LMP- 30/12/2021 (PLMP- 12/12/2021)
• Cycle- irregular, once in 20 days, 6/20 day cycle
• Nature of flow- Profuse, 6-7 pads/1^st day
• Nature of blood- Dark red, no clots, not offensive
• There is no dysmenorrhoea.

MENTAL GENERALS

• Sensitive to opinion of others, always think about what others will think.
• Fear of diseases

CLINICAL FINDINGS

Physical examination reveals normal blood pressure-110/70mmHg, normal pulse rate (74 bpm), dry skin on both the forearms, mild pallor, no peritibial edema, no swelling in the neck region, no lymphadenopathy and no tenderness in the neck region.

DIAGNOSIS: Subclinical hypothyroidism

INVESTIGATIONS: Done on 11/01/2022

• TSH: 6.22uIU/ml
• Total-T3: 154ng/dl
• Total-T4: 11ug/dl

RUBRIC AND REPERTORISATION

1. Mind- Fear-disease, of impending
2. Mind-Sensitive-opinion of others; to the
3. Female genitalia/Sex-Menses-copious
4. Generals-Food and drinks-milk-desire
5. Generals-Hypothyroidism

BASIS OF PRESCRIPTION: The above mentioned rubrics were taken for repertorisation. After repertorisation and in consultation with materia medica Natrum mur was selected (Calc carb scored the highest score, but depends on patient physical appearance i.e. tall, thin, anemic and hot thermals Natrum mur was prescribed)

FIRST PRESCRIPTION ON 14.01.2022
The patient was advised to take Natrum mur200 twice a day, for 3 days followed by placebo twice a day for 2 weeks.

CONCLUSION
Thus, this case shows the scope of homoeopathy in treatment of subclinical hypothyroidism. Individualised holistic treatment approach gives a good result to sub-clinical hypothyroid case.

DECLARATION OF PATIENT CONSENT
Patient consent was taken for images and clinical information to be reported for this article.

REFERENCES

1. Somashekar AR, Girish V, Rao C, Murthy NS. Correlation of Cognitive Performance and Thyroid Hormone Levels in Adolescents with Subclinical Hypothyroidism. OJPed Journal. 2014,4,169-175[Cited on 18-07-2021] Available from: https://www.scirp.org/journal/paperinformation.aspx?paperid=46480

2. Ambad R, Jain P, Kambale A, MahakalkarC.Thyroid Profile in Goiter Patients. European Journal of Molecular and Clinical Medicine.volume 08,Issue 01, 2021[Cited on 20-07-2021] Available from:https://ejmcm.com/article_6114_a28d75f2ba9805ac6a529278a9fc5f16.pdf

5. Pearce S, Brabant G, Duntas L, Monzani F, Peeters R, Razvi S et al.2013 ETA Guideline: Management of Subclinical Hypothyroidism. European Thyroid Journal.2013 Dec;2(4):215-228[Cited on 05-08-2021] Available from: https://pubmed.ncbi.nlm.nih.gov/24783053

6. Khan M A, Ahsan T, Lal U R, Jabeen R, Farouq S.Subclinical Hypothyroidism: Frequency, clinical presentations and treatment indications. Pak J MedSci 2017;33(4):818-822.[Cited on 17-07-2021]Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5648945/

Dr.Ashna.E
PG scholar, Department of Practice of medicine
PG Guide: Dr. Praveen kumar. P.D (HOD of Dept of practice of medicine)
GHMC Bengaluru

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