“Sluggish caterpillar to a vibrant butterfly” Hypothyroidism and homoeopathic management-A case report

Dr Aswathi K V

ABSTRACT:
Thyroid hormones act on nearly every cell in the body. The body systems can get out of balance when the butterfly shaped gland (thyroid gland) producing either too much or less hormones. Hypothyroidism is believed to be a common health issue in India, as it is worldwide. Here a 35 year old female presented with hypothyroidism and was treated by Homoeopathic medicines. Serial thyroid function test reports revealed progressive improvement in the hormonal levels.

INTRODUCTION:
 Reduced production of thyroid hormone is the central feature of the clinical state termed hypothyroidism. Primary hypothyroidism which is due to disease of thyroid itself, accounts for approximately 99% of cases, with <1% being due to TSH deficiency known as secondary hypothyroidism.

Plasma TSH is the best initial diagnostic test and a normal value rule out primary hypothyroidism. Low T₄ with isolated elevation of TSH leads to the diagnosis of subclinical hypothyroidism. Individuals with subclinical hypothyroidism who have elevated anti-TPO antibodies are more likely to progress to overt hypothyroidism than antibody negative individuals. Central hypothyroidism is characterised by a low T₄ and an inappropriately normal TSH.

Clinical features of hypothyroidism include fatigue, somnolence, weight gain, reduced appetite, constipation, cold intolerance, dry skin, easy bruisability, dry and brittle hair, hair fall, hoarseness of voice,  menorrhagia, diminished libido, reduced fertility, slowed physical and mental functions, joint pain, sleep apnoea, oedema, bradycardia, diastolic hypertension and decrease in exercise tolerance. 

Following is a case of hypothyroidism treated by homoeopathic medicines.    

CASE: A 35 year old married women from a middle socio economic status family reported to the outpatient department of government homoeopathic medical college, Bengaluru on 8^th February 2019 with the complaint of hair fall since 6 months. There were no other associated symptoms. 

INVESTIGATION REVEALED:  Thyroid function test as on 03/02/2019

                 T₃ – 1.24 ng/ml

                 T₄ – 5.99 µg/dl

             TSH – 12.65 µU/ml [figure 1]

       

PAST HISTORY: History of hypothyroidism 8 years back, taken allopathic medicine for 2 years and stopped the medication by herself as the thyroid hormones level came back to normal.

FAMILY HISTORY: Family history revealed PCOD and fistula in ano in younger sister. Others were apparently healthy. 

PHYSICAL GENERAL: 

• Appetite: good
• Thirst: 2-3 liters/day
• Desire: fish
• Bowel habits: once/day, no difficulties
• Bladder habits: 4 times/day, no difficulties
• Perspiration: generalized
• Sleep: good, refreshing
• Thermals: chilly

MENTAL GENERALS

• Disciplined
• Duty bound
• Fear of poverty

RUBRICS AND REPERTORISATION

1. Mind – Proper-too
2. Mind – Duty-too much sense of duty 
3. Mind – Fear-poverty of
4. Generals – Food and drinks-fish desire
5. Generals – Hypothyroidism

BASIS OF PRESCRIPTION: The above mentioned rubrics were taken for repertorisation. Kali carbonicum scored the highest score.[figure 2].

FIRST PRESCRIPTION ON 8/02/2019

Kali carbonicum 200 one dose and placebo for 15 days was given.

Follow up of the case is given in below table.

Follow up   date	Symptom	Medicine, potency and doses
25/02/19	Complaints of hair fall persist. No new complaints. All generals good.	Placebo/TID for 30days.
22/03/19	No change in hair fall. Generals good.	Thyroidinum200/1dose Placebo for 15 days.
08/04/19	Hair fall reduced. No new complaints. Generals good.	Placebo/TID for 30days.
08/05/19	Hair fall increased Generals good	Kali carb 1M/1dose Placebo/TID for 15 days.
27/05/19	Hair fall reduced. Generals good.	Placebo/TID for 30 days.
26/06/19	Complaints of hair fall better. Generals good	Placebo/TID for 2 months.
29/08/19	Patient feeling better. Generals good.	Kali carb 1M/1dose Placebo/TID for 1 month.
17/09/19	Patient feeling better. No new complaints. Generals good.	Placebo/TID for 3months.
16/12/19	Patient feeling better. No new complaints. Generals good	Placebo/TID for 3months.

           

                    

         

      

        

After treatment: As on 05/12/2019 

                           T₃ – 0.89 ng/ml

                           T₄ – 6.68 µg/dl

                       TSH – 4.58 µIU/ml [figure 5 & 6]

CONCLUSION:
This case shows the importance of holistic approach and positive role of homoeopathy in the treatment of hypothyroidism.

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

REFERENCES:
Nikhil Tandon, Gunjan Garg. Disorders of thyroid gland.In:Yash pal Munjal, editor, API Textbook of Medicine, 9^th edition vol.1.New delhi:Jaypee brothersmedical publishers(P)Ltd;2012.p. 425.

Radar software: Frederik Schroyens Synthesis Repertory, Version 9.1 

Dr.Aswathi.K.V
PG scholar, Department of Materia medica,
Government Homoepathic Medical College & Hospital, Bengaluru