ABSTRACT:

Hypothyroidism is the most common endocrine disorder in India whose incidence has been gradually increasing over years. Hypothyroidism is a hypo metabolic state characterized by general reduction of metabolic function, manifesting slow mental as well as physical functioning. This article deals with one such case of hypothyroidism which shows promising results with Staphysagria as a constitutional remedy.

KEYWORDS

Homoeopathy, Hypothyroidism, Thyroid Stimulating Hormone.

INTRODUCTION

Hypothyroidism (also known as underactive thyroid, low thyroid or hypothyreosis) is a clinical state resulting from insufficient synthesis and release of thyroid hormones. The prevalence of hypothyroidism in India is 11%.2 However, females are more affected than men with prevalence of 10% in adult women and 3% in adult men. Depending on the time of onset, the condition can be congenital or acquired later in life. Further, it can even be classified as Primary hypothyroidism, where the thyroid gland is primarily affected and Secondary hypothyroidism, where the thyroid gland is normal but the regulating system has some abnormality.

Following are the signs and symptoms of hypothyroidism: (Table 1)

DIAGNOSIS:

Diagnosis is made by thyroid function test (TFT) which measures the concentration of thyroid stimulating hormone (TSH), triiodothyronine (T3), and tetraiodothyronine (T4) in blood.

Homoeopathic system of medicine treats patient based on the ―law of similia‖. A careful review of homoeopathic literature describes the scope in management of hypothyroidism with homoeopathy. Most of the time constitutional defects leads to the development of endocrine disorders like hypothyroidism. Conventional treatment for hypothyroidism includes thyroxine given in a dose of 1.6 μg/kg in adults orally as single daily doses. Average daily dose for adults is 0.1-0.2 mg of L- thyroxine sodium.1 In aphorisms, it is mentioned that no real cure of a disease can take place without a strict individualization of each case of disease which is possible by studying the individual, characteristic symptoms produced by the patient. Homoeopathy plays a role in such conditions because the remedy selection depends on individual totality.4

CASE REPORT

This is a case report of a male patient aged 32 years, working for IT based company at Bangalore who presented to the outpatient department of Government Homoeopathic Medical College and Hospital on 04.11.2022 with the complaints of gradual weight gain and increasing hair fall since almost a year.

The patient was apparently healthy till last year after which he gradually started gaining weight (almost 8-9 kg in past 1 year) and eventually started noticing bunches of hair falling off from root. He also corroborates this incidence with development of his symptoms like increased mental sensitiveness and getting angered easily. The onset and progression of complaints has been gradual.

PAST HISTORY

Used to frequently get headaches during childhood

Known Case of- Hypothyroidism – diagnosed 1 week back- not under any medication

FAMILY HISTORY

Father- Apparently healthy

Mother- Hypothyroidism for 15 years

Brother- Apparently healthy

PERSONAL HISTORY

Diet- Mixed

Appetite- Reduced

Thirst- Thirsty

Desire- Nothing specific

Aversion- Nothing specific

Micturition- 4-5 times/ day; 1time/ night 

Bowel- Regular, Satisfactory. 

Sleep- Refreshing 

Dreams- Nothing significant 

Perspiration- Generalized, No odour, no staining 

Thermals- Chilly

LIFE SPACE INVESTIGATION

Patient belong to good socioeconomic status. His childhood was uneventful, has always been good at studies. He got married at the age of 28 years. Wife has always been dominating. He couldn‘t speak against her because he was scared of ruining their relationship. A year back there was an issue at home between his wife and his brother where he felt his opinion wasn‘t considered and his wife blamed him for not being supportive in spite of, he trying his best to be there for her. He was very hurt by this comment, but then tried moving on. Every small argument at home has started to make him very angry then on, but never really tried showing it as he felt he would again lose in argument. He still feels if he would have tried stopping his brother from getting into argument with his wife then, today he wouldn‘t have been blamed by his wife this way.

GENERAL PHYSICAL EXAMINATION

No signs of pallor, cyanosis, clubbing, icterus, oedema and lymphadenopathy.

Nails-pink.

Height-5 feet 7 inch.

Weight-72 kg.

Tongue-clean, moist.

Skin-No abnormalities.

Hair-Falling of hair from root. Thinning of hair was seen and hair was dry and rough in texture.

VITAL SIGNS

Temperature- afebrile at the time of examination.

Pulse- 72 beats /min.

Respiratory rate- 18 cycles/ min.

Blood pressure- 122/80 mm Hg.

SYSTEMIC EXAMINATION

Respiratory system- NVBS audible, no added sounds

Cardiovascular system-S1, S2 heard, no murmur

GIT-Bowel sounds heard, per abdomen soft and tender

LOCAL EXAMINATION

No swelling or lobe enlargement seen

No local tenderness

INVESTIGATION

28.10.2022 : TSH- 204.217; T3- 0.55; T4- 2.0

PROVISIONAL DIAGNOSIS

Hypothyroidism

EVALUATION OF THE CASE

With the help of ― "The Chronic disease by Dr Samuel Hahnemann‖" miasmatic evaluation for the presenting symptoms was done, which showed the predominance of Psoro-Sycotic miasm. Considering the above symptomatology.

REPERTORIAL TOTALITY:

1. MIND- ANGER- easily

2. MIND- EMOTIONS- suppressed

3. MIND- REPROACHING himself

4. MIND- SENSITIVE- opinion of others, to the

5. MIND- timidity

6. HEAD- HAIR- falling

7. GENERALS- HYPOTHYROIDISM

8. GENERALS- OBESITY

REPERTORIAL TOTALITY:

1. MIND- ANGER- easily

2. MIND- EMOTIONS- suppressed

3. MIND- REPROACHING himself

4. MIND- SENSITIVE- opinion of others, to the

5. MIND- timidity

6. HEAD- HAIR- falling

7. GENERALS- HYPOTHYROIDISM

8. GENERALS- OBESITY

PRESCRIPTION  (on 04.11.2022)

RX: Staphysagria 1M- 1 dose (early morning empty stomach)

Blank Globule (0-0-5) x 1 month given orally

AUXILIARY MANAGEMENT

• Regular exercise like walking, skipping.

• Taking iodine rich food.

• Avoid cabbage, broccoli and cauliflower

FOLLOW - UP

REPORTS -          Before Treatment                                              After Treatment

DISCUSSION

Homoeopathy is a holistic system of medicine and we treat based on individualization. In this diagnosed case of hypothyroidism, the patient was presenting with chronic complaints. After carefully examining the case, we formed a chronic totality and assessed the symptoms. Since there were distinct general symptoms, Kent's approach of repertorization was used and after differentiation from materia medica, Staphysagria was the chosen remedy. The patient showed some improvement during the initial follow up and significant improvement throughout the subsequent follow ups. The TSH reports also revealed falling levels of TSH. Apart from Staphysagria, Lycopodium, Natrum Mur, Calcarea, Sulphur received the highest values during repertorization. But Staphysagria was chosen over all these remedies because of the presence of marked presentation like suppressed emotions, reproaching oneself, sensitive to others opinion and thermals being chilly.

Also, in the following case the changes in the casual attribution were assessed using Modified Naranjo Criteria (Table 4). Total score as per the criteria in this case is (+8) which is relatively close to the total of +13 which signifies the positive casual attribution of individualized homoeopathic remedy to the clinical outcome.

CONCLUSION

The case study highlights the value of constitutional homoeopathic medicine treated on an individuality basis. It also demonstrates the critical significance that a carefully selected constitutional homoeopathic remedy plays in restoring the thyroid gland's functioning abnormality. It supports the fact that, in the treatment of hypothyroidism, a simple minimum dose is necessary, followed by infrequent repetitions. However, this is a single case report, additional research must be done that may make this study useful.

Consent of Patient 

Patients have agreed that their reports and other clinical information can be used for research work, and it can be reported in the journal. 

Acknowledgment 

The author acknowledges the consent given by a patient to use his case and report for research and publication. 

Conflict of interest: None 

Financial Support: Not Available

REFERENCE

1. V., K.D.K. (1992) A short textbook of medicine (2 vols). 6th edn. New Delhi: Jaypee Brothers Medical Publishers, Ltd.

2. Kharbuli, Dr.B., Papiah, Dr.S. and Rapthap, Dr.L. (2023) ‗Hypothyroidism treated with homoeopathic Medicine Natrium Muriaticum: A case report‘, International Journal of Homoeopathic Sciences, 7(2), pp. 217–221. doi:10.33545/26164485.2023.v7.i2d.830.

3. Kasper Fauci, Hauser Longo, Jameson Loscalzo. Harrison‘s Principles of Internal Medicine. 19th edition, volume 2. McGraw-Hill Professional ISBN: 978-0-07- 180214-7. p. 2289,2290.

4. Hahnemann S, Boericke W, Dudgeon R. Organon of medicine. 6th ed. New Delhi: B. Jain Publishers; 2011.